Choice, Voice, and Control: NSW Nurses and Midwives’ Experiences and Aspirations in Hours, Rostering and Flexibility at Work examines the experience and needs of nurses and midwives in the New South Wales public health system, and the way in which work design can enable or inhibit high quality care, retention of a skilled workforce, and higher job satisfaction among workers.
The report is written by:
Nurses and midwives are the backbone of public health systems. They care for patients through birth, illness, recovery and end of life. They keep hospitals running 24 hours a day, seven days a week.
Like many frontline, highly feminised workforces, nurses and midwives experience a lack of flexibility, chronic understaffing and workload issues, and have limited control over their working time.
A failure to address this risks burnout and fatigue for nurses and midwives and exacerbates understaffing and chronic skills shortages for health systems.
If the public health system met these aspirations, research indicates they would retain staff and experience higher productivity.
Nurses and midwives would experience better wellbeing and job satisfaction, and lower rates of fatigue and burnout. They would no longer face a choice between their jobs and their wellbeing.
The public health system would embed skills, address understaffing and build institutional knowledge and capability through the attraction and retention of skilled nurses and midwives.
Choice, Voice, and Control identifies enablers and barriers to good flex hospitals.
Support for ‘good flex’ across managers and peers is critical. This can support a culture of flexible start and end times, work locations (for non-clinical roles), and rostering practices that account for the non-work needs of frontline staff, who are predominately female with caring responsibilities, as well as the operational needs of the health service. It can also extend to the initiation and support of formal flexibility agreements.
Resourcing and recognition of rostering as a specialised skill and important task can help create jobs that work for people as well as the organisation. This work and the skill it involves is often undervalued by senior leadership of organisations but can make a critical difference to work design, fatigue and job satisfaction.
Addressing understaffing through work design that appropriately values frontline workers in feminised occupations like nursing and midwifery, can attract skilled workers to fill vacant roles, preventing burnout and help create manageable workloads.
