Self-scheduling may reduce worker stress
First: Obtain senior management buy-in
There is no magic template for initiating a self-scheduling practice, but there are some strategies hospital employee health departments could employ that will help reduce health care workers’ work-family conflict (WFC) stress.
The key is to develop a plan and obtain senior management buy-in, says Mira Grice Sheff, PhD, MS, assistant professor at Suny Downstate Medical Center in Brooklyn, NY.
Here are some steps to take:
• Assess your workforce: A first step to implementing self-scheduling is to assess the hospital’s workforce and let its needs dictate the kind of program to provide, Sheff suggests.
"It’s your workers’ needs that you’re trying to support, so let them tell you what they need," she adds. "Then you can tell them what you are doing to accommodate those needs."
• Obtain buy-in from hospital leaders: Employee health professionals can use the literature on the negative impact of work-family conflict to make the case for hospital leaders to address the issue.
"There are several different ways employers can help workers balance work and family, and one is to change when work is done, two is change where work is done, and three is to reduce the total work hours," Sheff notes.
None of those solutions would work in a health care setting, so an alternative option would be to give employees more control over their schedules, while still maintaining the overall levels of staffing necessary for the hospital unit.
Nurses love self-scheduling, Sheff says.
"For those who can manage it, their workers are very appreciative," Sheff says. "At least for the study I did, all the nurses who had access to self-scheduling were very happy with it, and they decided it was the main way they could take care of the things they needed to do outside of work, like taking an ailing mother to the doctor."
• Show managers different options for implementing self-scheduling: There is not one correct or optimal way to implement self-scheduling, so it’s best to leave the details up to each department.
"There are many ways to implement it and it will be based on the workforce, the hours that have to be covered, and whether or not it’s ambulatory care," Sheff explains. "It basically involves workers giving their supervisors the requested schedule, following certain conditions, such as having to work so many weekends a month, so many hours a week, so many holidays a year."
Managers will agree to do their best in giving each employee the schedule they need, while also balancing the individual worker’s needs with the department’s needs.
"Some research says that if you are trying to do self-scheduling then it’s best to pick one unit and test it out to see what the challenges are in your organization in trying to make it happen," Sheff says. "Then you can slowly expand it to other units; there’s a learning curve."
Piloting the plan gives a hospital an easier way to assess strategy’s successes and failures in order to target changes before a system-wide implementation.
"Let’s see if it’s really working or not," Sheff says.
• Use electronic solutions when available: Scheduling software exists and it can help, but it depends on the manager and how the manager prefers to set up the schedule, Sheff says.
"The manager might prefer to give schedule preference on a first-come, first-serve basis, or there might be other considerations," she adds.
Electronic scheduling could help reduce complaints of favoritism or unfairness, but it won’t take away all of the challenges of implementing self-scheduling.
• Promote having HCWs cover for each other: Self-scheduling can be its most effective when workers pull together as a team, pitching in to take shifts when one worker has a pressing personal need.
"There is greater success in units where coworkers will cover for each other and help out each other," Sheff says.
Management can set the tone for a collegial work environment, Sheff notes.
"You could try to have little events that recognize workers, like employee appreciation things, having lunch for them or a potluck," she adds.
• Provide or identify after-hours child care options: "At the institution where I did this research, the child care hours were 7:30 a.m. to 5:30 p.m., but nurses’ shifts are 8 to 8, so child care could be utilized by some health care workers, but not all of them," Sheff explains.
Having extended child care hours can accommodate nurses’ schedules.
"I know of a former nurse who opened up a private child care center that could accommodate nurses’ schedules with an early drop-off and late pick-up," Sheff recalls. "She even could have someone come in and watch a child overnight; she knew what the needs were for child care and created a day care center that could accommodate those needs."
• Start a nursing support group: "One thing that came up in my research was that nurses often said they wished there could be a support group of nurses," Sheff says. "Maybe they had concerns they didn’t want to talk about with coworkers, but needed to talk with someone about it, and they wished something like that existed for them."
A support group could help HCWs with overall stress, she adds.
