Nurses and midwives urgently need better flexibility to improve working conditions and workforce sustainability, according to new research released today by the University of Sydney Business School and the NSW Nurses and Midwives’ Association (NSWNMA).

The report, ‘Choice, Voice and Control’, is based on a survey of over 2,000 public sector nurses and midwives, 15 focus groups and 13 one-on-one interviews designed to understand what these frontline professionals want in relation to hours, rosters and shifts – and why their aspirations are not currently met.

“Nurses and midwives are essential to the health and wellbeing of our communities and the functioning of our healthcare system. In this study, they told us they need flexibility and want better control over rosters and shifts, more manageable workloads, and work that lets them have a life,” said lead author Professor Rae Cooper, Director of the Australian Centre for Gender Equality and Inclusion @ Work.

“A sustainable workplace provides what we call ‘good flex’: predictability, support and genuine choice. This is different from ‘bad flex’, where workers are expected to absorb unpredictable hours or changes to their working time. Flexibility is only good when it works for both workers and employers, and this is a key retention factor in feminised, frontline workforces like nursing.”

Co-author Dr Elsie Foeken said the report had clear implications for the government in attracting and retaining the workforce needed to run NSW’s world-class healthcare system.

“Nurses and midwives derive great satisfaction from their jobs, especially the relationships with their patients and co-workers, and the difference they make in people’s lives. But many are desperately holding on and hoping for things to improve and are at risk of quitting or burning out due to the overwhelming demands they face on the job. Two-thirds regularly think about leaving the profession altogether,” Dr Foeken said.

“Small changes could make a big difference: more opportunities to swap shifts, changing start and finish times, access to paid leave for appointments and consistent managerial support.”

Co-author Associate Professor Josh Healy said good flex could unlock benefits for both workers and health organisations. 

“With better access to good flex, nurses and midwives would experience higher wellbeing and less risk of burnout. This flows through to benefits for employers, who are better able to attract and retain skilled staff, easing understaffing issues and helping to build more sustainable workforce capability,” Associate Professor Healy said.

“Without changes in work design that enable more sustainable workforce management, our public hospitals will continue to struggle to hold onto their nurses and midwives – including the most experienced of these staff, who are essential to high-quality care. Without reform we will continue to invest in training skilled nurses and midwives who do not stay in the profession, and we will continue to deter people who might otherwise like to become nurses and midwives.”

Michael Whaites, General Secretary of the NSWNMA, said the report highlights a need for urgent reform when it comes to work design allowing nurses and midwives to manage their caring and other responsibilities outside of work.

“Our highly-feminised nursing and midwifery workforce is crying out for help in a public healthcare system struggling to support them and their needs. We know that the lack of roster flexibility, unsustainable workloads and poor work-life balance is leading to burnout and the loss of highly experienced nurses and midwives from the industry,” Mr Whaites said.

“We are calling on the NSW Government and NSW Health to work collaboratively with us to improve flexibility and workloads which will lead to a healthier and happier workforce.”

Download the report here.