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Health Affairs This Week places listeners at the center of health policy’s proverbial water cooler. Join host Jeff Byers, editors from Health Affairs Publishing, and guests as they discuss health policy’s most pressing news and trends.
Hello and welcome to Health Affairs This Week. I'm your host, Jeff Byers. We are recording on 10/19/2026. Today on the pod, we're talking Gen Z and the healthcare workforce, and to do that, we have Adele Webb on the program. She is a healthcare workforce advisor for Workforce Edge, which recently released a report called the 2026 Healthcare Workforce Barometer.
Jeff Byers:It's the second year this report has been done, and some stuff in it caught my eye to discuss healthcare workforce expectations. Adele, welcome to the program.
Adele Webb:Thank you so much. I'm excited and honored to be here.
Jeff Byers:Yeah. So did you see Now You Can See Everything this weekend?
Adele Webb:Now I Can See Everything?
Jeff Byers:Did you see Now I Can See You Can See Everything this weekend, the Elizabeth Holmes documentary? No. Well, that's good because we don't wanna spoil it for the audience, but, you know, this is a healthcare podcast, so I had to make a reference. Thanks for indulging me. So Workforce Edge put out a report on the state of the healthcare workforce titled 2026 Healthcare Workforce Barometer, doubling up my efforts on that exposition.
Jeff Byers:It caught my eye as we hear about burnout in the industry often, as well as the healthcare space being a boon for the overall US economy, but also that certain jobs in the industry are shrinking. So the report, as pitched to me, highlighted generational divides between Gen Z employees and older employees, and that's kind of what I wanted to reflect on today. So one of the main findings from your survey is that 70% of Gen Z employees expect to explore a new role in the new year. So can you reflect on that for a moment? What are these youngins thinking?
Adele Webb:So absolutely, can. So, you know, if you look at the study, there are about 60% of health care workers overall looking to leave for a new role, but the Gen Z was 70%. That is just so much of our workforce. It's such an alarming statistic because we we already have, I think, forty percent of RNs are looking to retire by 2029. We're already short, 500,000 nurses.
Adele Webb:So we have to look at how are we gonna retain our nurses. So one of the things we looked at is what does Gen Z want? What is it that would keep them in the position that we have? And I think our findings were actually really surprising.
Jeff Byers:One of the things that arose for me while checking this study out was... So I'm in that weird group of individuals where we're not totally Gen X, but we're not totally millennials. So we're in the the Xennial. I don't... And, you know, I I didn't really want to try to say that because I knew I'd butcher it, but I remember similar red flags being thrown around about millennials.
Jeff Byers:So when I was coming up in like 2025, when I started to pay attention to reports like these, so I was curious if this behavior really just kinda speaks to the need of how to manage younger employees. So, like, is managing a Gen z employee in 2026 really that much different from, managing a millennial in 2014?
Adele Webb:Well, actually, I think it is, and I think it's because there's a fundamental difference in expectations. And I I have a personal experience with this because I have six grandchildren who are nurses. I'm actually very proud of that, and they're in patient care. And, my grandson just made a decision to leave a job he loves because the opportunities for him to advance his career aren't there. And so now more than ever, really, Gen Z is looking at what can I do next?
Adele Webb:What's leadership for me? What's education for me? How can I get certified? And I didn't see this in younger workers before.
Jeff Byers:No. Expand on that because to to me, I... You know, I... I'm drawing from personal anecdotes here. Like, I wanted to advance in my career when I was younger, and I I think that's a natural thing.
Jeff Byers:So... And I'm not trying to be argumentative, but, like, what's the difference between these two generations?
Adele Webb:Well, I think there's a couple things that happened, you know, just generally in society. We didn't actually look at that in the survey, so I can't speak directly to it. Yeah. But, you know, what I can say is the the younger, this Gen z group, and especially what I see with my experience within my own family, is they are interested in stability. They they wanna have the opportunity.
Adele Webb:They're loyal. They wanna stay with one employer, but they also wanna know that the employer cares about them. So it's kind of a mutually beneficial relationship that they have said, I'll stay and I'll support you, but I need to know you support me as well. They have to trust that that's gonna happen.
Jeff Byers:When you're looking at, like, general advancements for careers, like, are younger people looking for? What does advancement mean to them? What does career growth mean to them?
Adele Webb:Career growth, from what I see and what we see in the survey, is they wanna have the opportunity to grow within their position. So maybe learn a different skill. So maybe you're an ED nurse and you wanna go into surgery. How do I have the opportunity to do that at my employer? Maybe I wanna get certified.
Adele Webb:I'm an ER nurse and I wanna get ER certification. They're always looking at getting better at their job. And I think that's so important because, you know, the outcome of their job is patient care. Right? And we're all gonna be a patient one day, maybe many of us have.
Adele Webb:We want that nurse caring for us that is interested in improving their skills, improving their situation over time. So I think it's really exciting that this group is actually interested in that, and I'm just hoping that we can find ways to support them.
Jeff Byers:Yeah. So you mentioned, like, upscaling. When you say go into surgery, like, someone going to go... Does that displace their work over time in nursing, so essentially they, like, leave room for someone else? And when you're thinking about the patient, how we want to care for the patients, is that...
Jeff Byers:Like, how does that relate to the patients when it comes to the upskilling if they're leaving the workforce?
Adele Webb:Oh, I didn't mean leaving the workforce. I mean, changing where they work. So for instance, if you're a bedside nurse on a med surg floor and, you know, you're interested in advancing your career, one way to do that is to learn the skills of a different department so they could upskill and become an emergency room nurse. I have a granddaughter who just moved back from California. She's an RN there, and she was in a step down unit.
Adele Webb:She's training now to be an ER nurse because she's been there, she's done that, she wants to advance her career. So she's looking at, you know, what's the next logical step for me?
Jeff Byers:So the report mentioned that about 89% of Gen Z employees report that clear opportunities, for advancement are important to them. We kinda talked a little bit about that. This was in contrast to 77% of older generations. So to me, you know, 12% seems less about a generational divide to me, and more about, you know, employee management concerns. So how do generally health systems, provider network, etcetera, you know, how do they generally think about career advancements in the health care space?
Adele Webb:So I think the systems in it, it shows in the survey that they're aware that this is what these Gen Z nurses want. So, you know, they're looking at, can we provide tuition reimbursement, tuition assistance? What does that look like? How do we make sure we have that available for the nurses that we have so that we could retain them? And if you look at the cost of retention of nursing turnover, it's a good investment to keep the employees that you have by investing in tuition and tuition assistance.
Adele Webb:But one of the issues that came through is that a lot of employers offer this, and the employees don't know. So the employers have to find a way to educate their employees to help them with understanding what is career advancement, what opportunities are here from you. This is what we can provide because just knowing that it exists is a big step forward for the employees.
Jeff Byers:Yeah. Why do you think there might be that disconnect of, like, that resources are available? But... Because I think you see that in a lot of different organizations of, like... You know, I'm thinking back to some some old journalism jobs where, like, in theory, I could have bought books.
Jeff Byers:You know, the organization could have bought books for me to read to to upscale, but it was hardly ever talked about. So anyways, is there any... Like, what's the disconnect between, like, having those resources available but not the education? Like, why why might that be?
Adele Webb:Well, I think part of it is... So you're you're a new hire. Right? And you come in and they're going over the benefits with you and you're kind of excited about them and then you go through orientation, you get immersed in your job, maybe you don't remember what those were and then you start thinking of, you know, what can I do, what's next for me And and you don't know what's available? So I think, you know, constant communication, putting it in your newsletter or putting it in a poster, just reminding people that that option is available is so important because they're gonna start looking somewhere where they can get it if they can't get it through you.
Jeff Byers:Kinda moving... When you're thinking about that, like, employer employee management space, you know you know, so free association of AI and, employer employee relations. What might you tell me about that?
Adele Webb:Well, I... You know, in the survey, it showed that employers are less interested in AI as as how it's going to affect nursing than they were before. And I think there's a couple reasons for that. One is that AI is never gonna replace that human touch, right, that intuition, that experience that you have. The other thing is it's there to augment.
Adele Webb:So it's there to help us, not replace us. And so when you're working at the bedside, you're not actually getting involved really. I mean, you might have electronic medical records. Right?
Jeff Byers:One would hope.
Adele Webb:Yeah. One would hope, but not everyone does. But you're... Are really looking at, everything that you've done before. You're continuing to do.
Adele Webb:Maybe someone's gonna help you a little bit here or help you a little bit there, but it's not threatening our jobs. Employers aren't concentrating on it because they understand that it can really augment what we're doing. And so you're seeing less and less emphasis in nursing on AI.
Jeff Byers:What do what do you mean by that?
Adele Webb:Well, there are some positions, for instance, radiology. Right? And this is me talking, not our survey, that, you know, they're really using it because it can maybe read in a film better than someone else. But in nursing, there's so much that can't be replaced by a robot.
Jeff Byers:So we... I know it's a... You know, health care is a very high touch, industry, but, like, what kind of things can't be replaced?
Adele Webb:Well, when you think about... So I I actually have a good example. When you walk in a room... So there was a robot I saw that when you walk in a room, it would scan somebody's badge or armband, and a drawer would open with this medication in it. When I walk in a room, what do I do?
Adele Webb:First of all, I make sure they take the medicine. I look at what color they are. How are they laying in the bed? Can they answer me? Do they need turn?
Adele Webb:Do they need clean? Those things are not gonna be replaced by AI. And I think that's why employers are looking at, you you know, we don't need to concentrate on this as much because it's not really gonna be a factor.
Jeff Byers:Yeah. So as the picture becomes a little clear, you know, and it's still developing for sure, but as the picture becomes a little bit clear about employers' AI strategies in the health care workforce, let's say specifically in the nursing side of things, how are health systems... Know, we talked about there's potential turnover happening. We talked about how it's better to invest in employees instead of giving into that turnover or letting them slip away. How are health systems managing workforce pipelines and employee retention strategies, you know, in the face of, not in the face, but with this looming AI conversation that we're all required to be a part of?
Adele Webb:Not exactly sure I understand what you're asking me, but here's what I'll say. Really, what employers need to concentrate on is what the needs are of the nurses that they're trying to keep. So when you look at retention, when you look at turnover, and you look at the cost, and you look at loyalty... Organizational loyalty, quality of care, clinical skills, What is it that you can do to keep the staff that you have? And what we're know...
Adele Webb:What we know is what Gen Z wants is the opportunity to advance their career. They're not all asking to get a master's degree. Right? Or they're just saying, you know, what's the next step for me? And I think if you look across...
Adele Webb:And and you mentioned this. If you look across other jobs, everybody wants to have that opportunity to advance their career.
Jeff Byers:Yeah. So how can health care organizations better manage young workers? I think that's really one of the main questions I'm trying to get at.
Adele Webb:Okay. Well, I think it's communication. I think, first of all, you need to listen to what they're saying, and the survey does a good job of saying this is what we're saying. We need... We want...
Adele Webb:This will keep us here. Help us do this. And if it already exists, they need to communicate that. Let's let's have that open chain of communication, maybe doing some things with providing career passing. So I don't know what I wanna do, but I know I wanna do something different.
Adele Webb:Can I do it where I am, and can you help me do that? I think it's really a communication issue.
Jeff Byers:Yeah. How would you... So let's say I'm a young employee. I mean, I know I'm young, but let's say I'm a younger employee, and I'm coming to you, and I might feel at unease of, like, trying to express my, you know, career path desires or, like, have unease expressing how things could be changed in an organization? What might you say to a younger employee when it comes to that communication when you're trying to figure out, since communication is a two way street with that, but also there's a power imbalance.
Jeff Byers:So like, how might you advise the Gen Z employee to to take on that communication mantle?
Adele Webb:I would tell them to be brave. So I I see this in this generation, you know, they do a lot of their communication through texting, and they don't actually talk to anybody. So, you know, when they know this is what they want, they need to share that. They need to be brave about it and say... And you don't have to go straight to the chief nursing officer.
Adele Webb:Right? You could start with your charge nurse and say, what are the opportunities? And let that charge nurse find out. Maybe the charge nurse wants to move up. And so it's just a really situation of asking questions and sharing desires.
Jeff Byers:Yeah. And so what are... What employer policies may actually matter when it comes to, young workers today?
Adele Webb:Well, you know, the ones that we're talking about here are really the opportunity to advance. So, tuition assistance. So what that means is maybe they pay the tuition upfront for you to go. They're also interested in flexibility. So are there programs that are flexible that I can work full time and still be able to do this program?
Adele Webb:And then tuition reimbursement where you pay up front, and then they reimburse you as long as you maintain a certain grade. So really communicating that we're here for you. We trust you to stay with us if we help you improve your career and move along. So let's have mutual trust. We're gonna provide this for you and we'd like for you to stay.
Jeff Byers:So as we kinda wrap up this conversation, we talked a little bit about the, how Gen Z workforce wants, career advancements. They're looking to potentially move on to different opportunities that they might see as better. What other tidbits from the report, are you excited to share about today?
Adele Webb:Well, I was really excited to see that they were willing to stay. You know, when you look at how many are willing to leave, right, to pursue that opportunity, I was really excited to see the people who were willing to stay because I just think that's so important even looking at patient outcomes when they have that experience, they've been in the organization. So I think the one thing that excited me the most is that their willingness to stay.
Jeff Byers:Yeah. Yeah. It's kinda like that clash song, should I stay or should I go?
Adele Webb:Yeah. Exactly.
Jeff Byers:Any any other, tidbits from the, report that you want listeners to check out? We'll post a link in the show notes to the report, but happy to highlight any other, main findings that you might be interested in sharing.
Adele Webb:No. I think the most important thing, and especially if providers are listening to this, if nurses are listening to this, is that they need to ask for what they want. They need to be clear. And when they have the opportunity, they need to take advantage of it.
Jeff Byers:Okay. Adele Webb, any final thoughts?
Adele Webb:No. I appreciate this opportunity to share, and I'm excited about the generation that's coming up. I mean, let's face that they're our future. Right? And so if we can address their needs and we can keep them someday when I'm laying on a gurney looking up, I want a happy nurse to be taking care
Jeff Byers:of me. That is the dream. That's the dream. Yeah. Yeah.
Jeff Byers:Adele Webb, from Workforce Edge, thank you again for joining us today. The report is the 2026 health care workforce barometer from Workforce Edge. We'll put a link to the show notes. Thank you for joining me. And to you, the listener, if you enjoyed this episode, send it to the person...
Jeff Byers:I'm trying to make another you can see everything reference, but I'm not gonna land it. So just send it to a friend, and we will see you next week.