How Flexible Scheduling Can Help Improve Nurse Mental Health

As the Covid-19 pandemic continues into its third year, the general public has seemingly moved on with their lives, understandably ground down by the endless cycle of rising and falling case counts and deaths. If only it were that easy for our nation’s nurses, who have witnessed death and suffering on an unprecedented level for the last two and a half years. Unfortunately, even as the most acute phase of the pandemic subsides, nurse mental health has not rebounded to anywhere near its pre-Covid levels, according to new data from my colleagues at Trusted Health.

Our third annual survey on nurse mental health found that nurses continue to struggle with high levels of burnout, trauma and depression and experience suicidal thoughts at twice the rate of the average American adult. Perhaps the most disheartening finding was that, despite widespread attention given to the issue of clinician mental health over the last few years, nurses feel that the industry has made little in the way of substantive changes to make this a more sustainable career path. Two-thirds said that the healthcare industry’s stance on nurse mental health has not changed, and an overwhelming 95% said that their mental health was either not a priority or that it was a priority, but that there were inadequate measures in place to support it.

There is a silver lining to our findings. The things that nurses say would support their mental health are straightforward: access to fitness facilities and/or classes, wellness stipends and flexible scheduling. The call for new scheduling options has been growing for years, but it has reached a crescendo recently as nurses have faced chronic understaffing and watched other workers in highly skilled industries gain access to things like remote work, flexible hours and four-day work weeks.

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While “flexible scheduling” is a bit of a catch-all term, there are a variety of ways that hospitals could bring this to life. The first are alternatives to traditional twelve-hour shift direct patient care roles, the demands of which are often difficult for older nurses and those with physical limitations. These alternatives might include resource nurse, break nurse and nurse mentor roles; telehealth models; or seasonal weekend programs. All of these programs can be offered with different shift lengths and schedules to offer flexibility to retain experienced clinicians. Another option is by making it easier for nurses who only want to work part-time or are looking for extra shifts to pick those up more easily, a seemingly basic process that has nevertheless been stymied by the fact that most nurse staffing is done through archaic technology at best — and clipboards and phone trees at worst.

Float pools at both a facility and a system level can also play a critical role by providing flexible work opportunities and new clinical experiences to aid in professional growth and development. They can also provide unique scheduling and staffing options in alignment with seasonal trends by offering time off during summer months or low volume periods, promoting periods of rest and better overall work-life balance. Several health systems experimented with multisite float pools or internal agency models to cover surges during Covid-19 and prevent under-staffing by moving nurses from areas of low volume to areas with high patient demand through rapid up-skilling and cross-training. Maintaining and enhancing these flexible models are critical to cover future waves of the pandemic or surges from the flu or other seasonal diseases.

The bottom line is that there are a variety of ways that hospitals and health systems can start to offer nurses the kind of scheduling options that can make nursing into a profession that’s more compatible with mental health while at the same time solving many of their own staffing challenges. Given that fully 64% of nurses in our survey said they are less committed to the profession than they were pre-pandemic, the urgency for change on this issue couldn’t be greater.

Dr. Danielle Bowie

Dr. Danielle Bowie
Danielle Bowie is chief nursing officer at Trusted Health.

Dr. Danielle Bowie

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