Nurses in need of a healthy balance

Unless work-life issues are addressed, nurses will continue to feel increasingly burnt out.

Gaps between policy and practice in ensuring a good work-life balance and the resulting "struggle to juggle" is resulting in nurses withdrawing and disengaging from the workforce, a new study reveals.

And unless work-life issues are addressed, nurses will continue to feel increasingly burnt out, leaving managers to face high staff turnover.

Examining the key factors that impact on retention and well-being, the study found that there was "substantial room for improvement" on current work practices surrounding work scheduling, workload, accessing leave and support for working parents.

Study co-author Natalie Skinner, a research fellow of the University of South Australia's Centre for Work + Life, said nurses and midwives were dedicated and committed professionals who worked very hard under difficult conditions.

However, she said, they were often frustrated by the growing pressures of work and that not enough was being done to look after their well-being.

"They know that there are a number of challenges, but they also know that things can be improved if they had the support of management," Skinner said.

"Participants in the study said work-life strains were often caused by inflexible management attitudes and policies. It's this inflexibility that leads to nurses leaving the workforce."

Many participants emphasised the link between inflexible and unsuitable shift schedules and staff turnover, stating that unnecessarily rigid shift arrangements "undermined their capacity to fit work with other activities", and were not in the best interests of staff or patients.

Whether a position offered flexibility in hours and work arrangements was a clear factor in job decisions, Skinner said.

According to one participant, a senior nurse, the link between loss of staff and inflexible work schedules was obvious: "Quite a few of the ladies...weren't getting what they wanted so they moved elsewhere and research is expanding so they've gone off to do research jobs," he said.

Implementing such things as self-rostering and reviewing traditional shift hours and patterns was suggested by participants to address the issue of flexibility.

Also having a negative impact on work-life balance was increased work demands, arising from staff shortages, the treatment of sicker patients and the continuous improvements in technology which had to be mastered quickly. Nurses reported working longer hours and not taking scheduled breaks.

One nurse manager told the study's authors: "We're burning out some of our staff way too quickly and some of them we know are doing too much overtime. We used to have unwritten rules that for example, we didn't roster them or let them do two consecutive double shifts. That's sort of gone out the window now."

Difficulties in accessing leave due to staffing shortages and workloads was another issue raised.

According to the study, some workers who wanted to get time off over school holidays had to apply for leave 12 to 24 months in advance or they would miss out.

A number of participants wanted more on-site childcare facilities, which were open
24 hours a day, 7 days a week to match shift patterns and included flexible places.

Addressing the issues raised in the study will only be achieved through organisational policies - as long as they are implemented, Skinner said. The implantation stage was where things fell down, according to the study's participants.

"You can have policies until the cows come home but they need to implement the policies, and that's where the failure is that I see," a community nurse commented.

The general inadequacy of policy implementation was also raised by a midwife, frustrated at the lack of follow-up following employee consultation: "After the meeting nothing was ever put into practice. It's frustrating. It's disappointing. Sometimes you feel like you're hitting your head against a brick wall."

Skinner acknowledges that the 24-7 nature of many nursing and midwifery roles presents obvious challenges to work-life interaction, but said a failure to address the issues for nurses and midwives had long-term consequences. The study, was published in the June edition of the Asia Pacific Journal of Human Resources.

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