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RRR PROFESSIONAL DEVELOPMENT ARTICLE:  Work-life balance? We attach great cultural significance to the close of one year and start of another, whether dated by the Gregorian or Chinese calendar, Matariki or a more personal anniversary. Times of transition prompt review and reflection, prediction, and planning. Many of us will have taken stock of last year, wondered how we did it all, and resolved to better balance ‘work’ and ‘life’. In this learning activity, we’ll take a look at what work-life balance means – theoretically, critically and personally – by reviewing some of the themes most relevant to the experiences of nurses in New Zealand.   BY SHELLEY JONES

LEARNING OBJECTIVES

Reading and reflecting on this article will enable you to:

• Explain the importance of work-life balance

• Discuss key work-life balance concepts

• Draft a personally relevant definition of work-life balance

• Explore the fit between your roles and assess your work-life balance.

DEFINING WORK-LIFE BALANCE

In 1840, Samuel Parnell declared, ‘There are twenty-four hours per day given us; eight of these should be for work, eight for sleep, and the remaining eight for recreation and in which for [people] to do what little things they want for themselves'(1).

Work-life needs can be mapped within three different but connected areas, which should be in balance:

• Personal time and space – what we need to do for the care of self and maintenance of body, mind and soul.

• Care time and space – what we need to do to care properly for others.

• Work time and space – what we need to do to enable us to gain economic self-sufficiency(2).

The NZ Department of Labour (DoL) defines work-life balance as ‘…managing the juggling act between paid work and other activities that are important to us - including spending time with family, taking part in sport and recreation, volunteering or undertaking further study’(3).

Work-life balance is the issue

According to a quick enquiry via Google Scholar, there was a 2400% increase in published articles with the words ‘work life balance’ in the title between the 1990s and 2000s(4).

Factors cited for increasing academic and popular interest in work-life balance include:

• increased participation of women in the workforce

• changing family patterns, which include delayed family start, young adults staying longer in the family home, increased longevity of elders (who may be distantly located), and multi-generational families

• increased consumerism and cost-of-living, which, with incommensurate incomes, are likely drivers of the increase in dual-earner households

• globalisation resulting in hypercompetition in the private sector, and budget cuts in the state sector, both compounded by the global recession and both contributing to a long-hours culture

• increased time required for commuting to and from work

• the telecommunications revolution which enables some flexibility in where and when people work, but also means some workers feel always ‘on’

• that these issues are impacting on ‘baby boomers’ (the generation born between 1945 and 1965), who, at the same time, are encountering different values held by generations X and Y.

However, work-life balance is not a new phenomenon. That workers might possess ‘their own time’ and that work hours should be limited are ideas directly inherited from the social movements formed in reaction to the long hours worked in poor factory conditions by adults and children during the industrial revolution. Today, as then, risks associated with working long hours apply to workers, families, employers, and the community.

WORKING LONG HOURS: THE RISKS

The risks are theorized to stem from less time to recover from work, longer exposure to workplace hazards, and less time to attend to non-work responsibilities(5). Risks to workers include sleep deprivation, poor recovery from work, decrements in neuro-cognitive and physiological functioning, illnesses, adverse reproductive outcomes, and injuries. Risks to families include delayed marriages and child bearing, and obesity in children. Risks to employers include reduced productivity and increases in workers errors. Mistakes by fatigued workers have broad reaching impacts to the community: medical errors, automobile crashes with other drivers on the road, and industrial disasters that damage the environment.

Beyond managing risk, writers with perspectives as diverse as critical feminism and human resource management propose rethinking the distinctions and relationships between ‘work-life’ and ‘work-family’. They are looking at broader social values such as collective welfare and an ethic of care(6), or how work-life balance can add value to both organisations and individuals(7).

Approaches to work-life balance fall on a continuum7. At one end, in the trade-off approach, either business or personal life wins at the expense of the other. Mid-way, in an integrated approach, managers and employees work together to meet their respective needs, using ‘life friendly’ policies designed to attract and retain valuable staff. A leveraged approach, at the far end of the continuum, uses work-life balance practices to help people have more satisfying personal lives while adding business value by identifying better ways to get work done.

Key work-life balance concepts

Work-life balance is about ensuring that your personal responsibilities and commitments (e.g. nurse, friend, parent, child, learner, volunteer) are life-enhancing and satisfying in themselves, and that you can function well in each. This set of roles – and how you manage the way they fit together – is what creates your current life pattern.

Finding a good fit between roles involves combining their multiple dimensions (no small task), and is affected by life stage and personal or family resilience(8). Conflict or role strain results from negative spillover between roles or life spheres – for instance, a frustrating or distressing job may mean an individual cannot fully engage or ‘recharge their batteries’ during time spent with family and friends. Facilitation or role enhancement results from positive spillover – for instance, being involved in postgraduate study enhances the satisfaction of clinical work and can create solidarity with young adult children also studying. Spillover can be uni-directional or bi-directional. For instance, negotiation skills (learned at work or home) can be brought to relationships in work and personal life.

If roles are essentially separate, useful strategies for managing boundaries include detaching or mentally ‘switching off’. However, the boundary between work and home is especially permeable when workers have family responsibilities, and more so if childcare and domestic responsibilities fall unequally(9,10). Time bind – not being able to divide time as desired between work and family/personal roles ­– can make home more stressful than work(11). Variations to standard work hours, flexible working arrangements and ‘family-friendly’ policies (such as paid parental leave) are proposed to allow a better balance between work and family/personal life(12,13).

Hours worked is probably the most direct determinant of work-life balance; additional risk factors for work-family imbalance are dual-career partnerships and number of children(14). A representative sample study of the United States labour force reported that the most consistent work characteristic predicting imbalance between work and family/personal life is hours worked, and the most consistent family characteristic predicting imbalance is being a parent(13). What do we do know about these two factors for New Zealand nurses?

WORK-LIFE BALANCE FOR NURSES IN NEW ZEALAND

Many work extra time

Non-standard work hours (shifts) are long established in nursing, as are flexible arrangements (e.g. part-time work, job share, and casual work). It is difficult to establish the proportions of nurses working full-time and part-time hours – the difficulty lies in the cut-off point. Some District Health Board employers consider staff working 32 hours per week to be full-time, whereas the Nursing Council defines part-time work as fewer than 35 hours per week.

The New Zealand Nurses’ Organisation (NZNO) published the findings of a membership survey about employment matters in 2011(15). When respondents in this Employment Survey were asked about their employment contract, half indicated a full-time contract, and this group was more likely to provide half-to-all of the household income (see table). The Survey also reports that the motivation for the majority of the 16.5% who have other paid work (including nearly one in seven full-timers) is additional income.

Working extra hours

• The Employment Survey found that many nurses reported working extra hours by going without breaks or working for a few more hours at the end of shifts, and this was usually unpaid.

• Significant numbers are working what appear to be extra eight-hour shifts paid at the normal rate, but the reasons are not clear.

Working long hours

• The mean weekly totals for those working extra hours suggest that many nurses are working at or beyond the accepted definition of ‘long hours’ (i.e. 50 hours or more).

Nursing Council’s Workforce Profile shows that nurses under 30 represent 11% of the workforce(16), and according to NZNO’s survey of younger nurses(17), over 10% are considering leaving the nursing profession, possibly related to findings that:

• younger nurses were more likely to work longer hours (as full-time employees) and undertake rostered and rotating shifts more frequently than older nurses

• while flexible hours were a reason cited by respondents for choosing nursing (perhaps related to childcare responsibilities), some reported their perception that they receive the last and worst shift choices.

Working long hours poses obvious difficulties, simply by reducing the hours available to recover from work and undertake other responsibilities, and in turn, potentially heightening conflict between work and personal roles. Amongst the most concerning risks associated with long hours discussed in the literature are the impacts on mental health and wellbeing:

• a cohort study of mid-career Swedish women employed full-time in health, education, and service sectors found a positive correlation between long hours (more than 10 hours overtime per week) and elevated morning levels of the stress hormone cortisol(18)

• a five year prospective study of a cohort of mid-career British civil servants found employees working more than 11 hours a day were more than twice as likely to experience a major depressive episode than those working 7–8 hours a day(19).

Many have family responsibilities

Juggling paid work and unpaid family work is a significant challenge for those whose responsibilities include care of dependent children or older adults. The Workforce Profile reports that 34% of nurses identified parental responsibilities (including access to childcare) in response to the question ‘If you usually practise fewer than 35 hours per week … what is the one main reason contributing to this?’.

However, according to Employment Survey findings, nearly half the nursing workforce has caring responsibilities for children, elderly relatives, or other adults. Amongst them, there is little difference in the proportions of full-time, part-time, or casual workers or male and female. A small proportion (about 4.5%) find themselves ‘sandwiched’ between their children and older family members. It is not known what those without responsibility for dependent family members see as their main non-work commitments.

Making sense of what seems to work

The Employment Survey’s data suggests the nursing workforce, a sizeable portion with dependent children, is responding to the general employment uncertainty of 2009-2010 by working longer hours. Against these two crunch factors, it is surprising then to find that most respondents were “happy with their choice of shifts” (80.4% agreeing or strongly agreeing) and felt “able to balance work and home lives” (80.1% agreeing or strongly agreeing). However, younger nurses were less positive on these two items.

These findings reflect the possibility that positive work factors buffer or mitigate adverse aspects(19), and that perceived control over scheduling increases perceived balance(13). The Employment Survey reported relatively high job satisfaction and quite positive feelings (around 80% agreeing or strongly agreeing) about nursing as a career, quality of care, and job security – with younger nurses more positive than their older colleagues.

Another explanation for these levels of satisfaction in the face of threats to work-life balance is ‘fit’ – individuals have fitted the different spheres of their lives together in a way that makes sense and works for them. Setting things up so that they all come together at the right time, apparently effortlessly, for the patient/client is a key nursing skill and is doubtless brought to fitting work and other commitments together.

Balance is about what’s right for you at this time

Any image we bring to mind to visualise balance has a central point, a pivot. The first step in managing work-life balance is to understand that point or pivot is you. To ‘centre’ yourself is to be clear about what is important and meaningful to you –and why. Being clear about such things helps you assess the value of everything you do and enables the decision-making that keeps things ‘in balance’. If changes are needed, you will have to ‘have the conversation’ with your manager or significant others and family, but most importantly, you first need to ‘have the conversation’ with yourself.

If you looked back over the last year and wondered how you did it all, your self-talk could include just as much congratulation on your time management and organisational skills as advice on what lessons to take forward. If you find you need to make changes to your work life, have a conversation about that with a trusted colleague you respect for their understanding of the many ways to do a satisfying career in nursing.

Finding what works for you is pivotal to balancing your current roles, commitments, and interests.

About the author:

Shelley Jones RN BA MPhil has been working in nursing professional development for 30 years.

Acknowledgements:

Thank you to Faith Roberts, Annette Milligan, Jane Lawless and Heather Casey for their helpful comments as peer reviewers, and to the colleagues who gave the learning activity a test run.