Work Life Balance in Nurses

Work–life balance is defined as harmony between work and non-work aspects of life and is the prerequisite for workers to continue working healthily. Nursing is one of the most stressful professions and nurses need to have a work life balance to improve patient care and clientele satisfaction. This article assesses the job stress of nurses and identifies ways to improve the work life balance using demographic profile of the nurses and a structured questionnaire for nurses working in hospitals of Ferozepur, Punjab. About 50 % of the nurses revealed that they were more pressurized due to family responsibilities and felt that their career development has slowed down due to family responsibilities.  Most were of the view that their job leaves less time for their kids and husband.  70% of the nurses felt that it was difficult to manage their household and office work if and when they had small kids.  In case of conflict between household work and office work, 40% of nurses gave preference to household work.  Most nurses were in favor of flexible work arrangements to manage their household and office responsibilities and expected the organization to provide them with childcare facilities and flexible working hours. Recommendations in the form of provision of childcare facilities, flexible working hours and adequate childcare leave, establishment of work life balance cells to educate the nurses about stress at work, time management, interpersonal relationships and formulating human resource/ leave policies in such a way that nurses can have an optimum work life balance have been given to ensure wellbeing of nurses, increase productivity at work and reduce the attrition rate.

No one on his death bed has ever said, 'I wish I had spent more time in office'. Work life balance is the term used to describe how workers distribute their time between their professional and personal obligations. When someone has a good work life balance, he or she can allocate his or her time in such a way that he or she doesn't feel overworked but is able to focus on other equally important aspects of life like family, friends, hobbies and social interaction. It is a state of well-being that an individual wishes to attain, that allows him or her to efficiently manage multiple responsibilities at work, home and in the community while maintaining good physical, emotional and family health. Sirgy et al indicated that a better work–life balance nurtures job satisfaction, job performance, organizational commitment and family satisfaction and also reduces stress-related outcomes such as psychological distress, emotional exhaustion, anxiety, and depression [1].

Most people think that they have the most stressful job in the world, and no other job is more difficult than theirs. Every job has its share of stress, but some jobs are more stressful than others. Nursing profession is the third most stressful profession after that of military personnel and a police officer as per a survey carried out in Jun 2022 by Joanna Zambas, a career expert working with Career Addict. Nurses need a work-life balance for several reasons. Firstly, the physical, emotional, and mental demands of the profession need marking boundaries and accentuating self-care. Secondly, a tenable work-life balance may lead to improved efficiency, innovation and overall health. Thirdly, without a healthy work-life balance, nurses run the risk of burnout, depression, and poor patient outcomes. Fourthly, a balanced lifestyle is climacteric in staying motivated and get going, which can improve patient care and clientele satisfaction. It is often said that the wise rest at least as hard as they work. This article assesses the job stress of nurses working in selected hospitals of the state of Punjab, India and identifies ways to improve the work life balance.

Research Approach

Quantitative research approach was used to assess the work life balance of Nurses working in selected hospitals of Ferozepur district, Punjab.

Research Design

Nonexperimental descriptive research design was used to assess the work life balance of Nurses working in selected hospitals of Ferozepur district Punjab.

Settings of the Study

The study was conducted in rural and urban health centers of Ferozepur, Punjab.

Population

The population included in the study were nurses working in private and government hospitals of Ferozepur, Punjab.

Sample Size

In this study the sample size was 100 participants.

Sampling Technique

Purposive sampling technique was used.

Inclusion Criteria for Sampling

The study includes the Nurses who were

1. Working in Ferozepur district.
2. Willing to participate in the study.

Exclusion Criteria for Sampling

The study excludes the nurses who were

1. On maternity/ long leave.
2. Not available during the period of data collection.
3. Not willing to participate in the study.

Development of Tool

It consisted of two parts:

Part 1: Socio-demographic profile sheet.

Part 2: Structured questionnaire for Nurses working in Hospitals of Ferozepur, Punjab.

Content Validity

Content validity of tool was determined by expert’s opinion on the relevance of items.

Reliability of the Tool

The reliability of the tool was computed by appropriate statistical analysis.

Objectives of the Study

1. To study the demographic profile of the nurses.
2. To identify the problems of the respondents regarding work life balance.
3. To suggest appropriate measures to improve the work-life balance of employees based on the findings of the present study.

Analysis

Demographic data such as age, marital status, type of family, educational qualifications as shown in table 1.

Table 1: Demographic variable of the Nurses.

The above table showed that 45 per cent of the nurses belong to the 20-30 year of age group.  The marital status of 75 per cent of the respondents were married. About 25 per cent of the nurses had a nuclear family.  Most of the nurses fall in the 5-10 years working experience category.  Most of the nurses (60 per cent) were Undergraduates.

Table 2: Work Life Balance of Nurses.

50% of the nurses revealed that they were more pressurized due to family responsibilities. 55% of nurses felt that their career development has slowed down due to family responsibilities. Most of our respondents were of the view that their job leaves less time for their kids and husband. 70% of the nurses felt that it was difficult to manage their household and office work if and when they had small kids. In case of conflict between household work and office work, 40% of nurses gave preference to household work. Most nurses were in favor of flexible work arrangements to manage their household and office responsibilities. They also wanted the organization to provide them with childcare facilities and flexible working hours.

Education, health, leisure, friendships, romantic relationships, family, household management and community involvement are few factors which influence work life balance as brought out by Keeney et al, [1]. Most studies on the work–life balance have concentrated only on work and family roles, namely the work–family balance [2]. When the work-family balance is optimum, it has a positive effect in the form of family-to-work enrichment and if negative, it is called family-to-work conflict [3]. This study studies the impact of responsibilities, obligations and wellbeing promoted by one’s family on the professional work of nurses. The mammoth presence of women in the labor market has fostered the literature about work–family balance. Moreover, nursing profession is dominated by females since time immemorial. Women are likely to evaluate family as more central in their lives than men because of widespread cultural norms and gender-differentiated values [4]. This is another reason the hospital administration should be supportive to the nursing staff so that there is a fine balance between their work life and family life. 

A happy, contented, self-satisfied and healthy nurse will be a better health care provider and will be an asset to the health care facility where she is working for. Job satisfaction is defined as the extent to which workers like or dislike their job and is an indicator of psychological wellbeing of the employee [5]. Work-family conflict adversely affects job satisfaction and the Hospital Administrator has a key role in supporting the nursing staff by formulating human resource policies in such a way that nurses with additional responsibilities of looking after their children at home are able to play their dual role well. Nurses face job challenges in the form of work overload, staff shortages, low salary and burnout which may lead to poor patient outcomes [6]. Most nursing professional’s world over report low-to-moderate quality of work life [7]. Kaddourah et al. reported that more than half the nurses employed in healthcare institutions in Riyadh, were dissatisfied with their work life and about 94% of them wanted to resign from their current roles [8]. Our study also revealed discontentment and indication of inability to have an optimum work life balance of about 40 to 70%.

Literature review revealed that education and awareness activities, opportunities to enhance inter-personnel relationships, improving workplace environment and facilities, supportive supervisory staff and increases in salary contributed to improving the quality of work life among nurses in Canada and USA [9]. Our study also recommends   provision of breast-feeding room and childcare facilities in the form of creche, flexible working hours and adequate childcare leave, establishment of work life balance cells to help in spreading awareness about stress at work, time management, interpersonal relationships and the concept of work life balance. A study by Lee-Peng et al indicated that flexible work practices and team-based management reduces job demand and improves job engagement among nurses thereby promoting better work life balance [10]. Our study also recommends flexible working hours and lenient and considerate leave policies and duty rosters for nurses to retain nurses in this noble profession. Women contribute significantly to the nursing profession and a major reason for nurses leaving the workforce is the difficulty of balancing work and family life. Life events such as marriage or the birth of a child, shift duties, being continuously exposed to suffering, sorrow, grief while providing health care make balancing work and home life difficult thereby increasing their desire to leave their job.

Suggested Measures to Improve Work Life Balance

The balance between personal and professional life varies from person to person and varies with time.  The work life balance strategies differ for single, married women and women with children.  Based on the findings of the study the following suggestions are recommended. 

1. The hospitals may establish a work life balance cell to advise about the expectations and perception on the work life balance concept.  These cells may educate the nurses about time management and interpersonal relationships. These cells may play an important role in suggesting ways and means of increasing productivity and raising the morale of the employee thereby maintaining a fine work life balance. 
2. The hospital may adopt measures to provide a breast-feeding room and/or childcare facilities like a creche while the lady is at work. 
3. A buddy pair system can be established, and buddies be encouraged to discuss their personal matters so that they come out with their problems and are appropriately advised to solve their domestic issues timely. A psychological counselor, a yoga trainer or a Reiki healer may be hired to create awareness about stress at work and ways to cope with stress. 
4. Human resource policies and duty rosters be made keeping in mind that married women having small children have a poor work life balance and are more prone to stress at work and require more organizational support. 

A nurse will be a miraculous healer if she is assured that her child is secure and comfortable while she is at work. Small facilities in the form of provision of breast-feeding room and childcare facilities in the form of creche goes a long way in encouraging working women prove their competence and perform better.  Flexible working hours and adequate childcare leave would help the nurse play the dual role at work and at home with efficiency and enthusiasm. Work life balance cells can help in spreading awareness about stress at work, time management, interpersonal relationships and the concept of work life balance. Hospital Administrators and Principal Matrons while making duty rosters and formulating leave policies be considerate to married nurses having small children so that they can have an optimum work life balance. This study could also act as a guide for Human Resource practitioners in redesigning their policies in relation to work life balance, thereby ensuring the well-being of all nurses.