By Jennifer Larson, contributor
Diane Gallardo works eight-hour shifts three or four days a week, runs errands, manages her family and shuttles her daughters to all their after-school activities. But this Memphis nurse and mother is able to make it all work, thanks to her employer’s willingness to let her work flexible shifts.
Studies have shown that scheduling accommodations such as flextime, non-traditional shifts and self-scheduling can help nurses with family obligations, continuing education and work-life balance.
“I give them my schedule and they adapt to it,” said Gallardo, LPN. “It’s awesome.”
Gallardo works for Baptist Memorial Hospital-Memphis, one of the hospitals of Baptist Memorial Health Care that offers shift flexibility for its nursing staff. The system is one of a growing number of health care institutions that have discovered that flexible scheduling can increase retention and even help with recruitment.
That phenomenon has been cited several times with regard to older nurses. A June 2006 paper from the Robert Wood Johnson Foundation titled “Wisdom at Work: The Importance of the Older and Experienced Nurse in the Workforce,” listed flexible work options as one potential solution to the challenge presented by older nurses leaving the workforce. The possibilities include alternatives for scheduling, part-time work and compressed work schedules.
Similarly, the 2006 Aging Nursing Workforce Survey noted that Magnet hospitals and hospitals applying for Magnet status from the American Nurses Credentialing Center tend to have more strategies in place to support the aging nurse workforce. Within those facilities, scheduling accommodations like self-scheduling and flex time are often cited as benefits that target older nurses.
But flexible scheduling opportunities can benefit nurses of all age groups. Many nurses like having the ability to choose a schedule that does allows them to easily continue their educations or spend more time with their families or tending to other pursuits.
Take Gallardo, for instance. Her flexible scheduling also allows her to take courses to become an RN while juggling her family and working around her husband’s job as a police officer. She is grateful for her job because she relishes the opportunity to be a very hands-on parent.
“It’s very important to me,” she said.
Gallardo is part of a group of nurses with Baptist who are classified as PRN, or the “as needed” category. That classification, which includes about 20 percent of Baptist’s nursing workforce, is one of several options for nurses who want more flexibility in their schedules.
“We have a whole menu of options,” said Dana Dye, RN, MPH, chief nursing officer at Baptist Memorial Hospital-Memphis. The hospital allows nurses to choose between eight-hour shifts or 12-hour shifts, and a weekend option program exists for nurses who are willing to work 24 hours on the weekend but still receive full-time pay.
Meanwhile, the PRN category does not provide any benefits, such as time off or insurance, to the nurses in this pool. There are also different levels within the category; some nurses work only a few shifts per month and very few holidays or weekends, while the nurses who are the most flexible and work the most shifts get paid more.
“But they can pick and choose when they work,” Dye said. “It’s very attractive to some people.”
It also helps the hospital because it allows for more nurses at times when more of them are needed. Baptist-Memphis tends to rely on this group the most in the winter months, when patient volumes go up. But having an array of flexible scheduling options has helped Baptist not only serve its patients but also its staff.
“It’s really helped us not only with recruitment, but with the retention of the staff that we have,” Dye said.
Other hospitals have found success with offering unusual nursing shifts or flexibility in scheduling for nurses, too.
Cedars-Sinai Medical Center in Los Angeles, California, began offering some untraditional shifts in its emergency department, which employs 94 nurses, several years ago.
ED unit manager Flora Haus, RN, MSN, ran some data on peak patient volumes, along with staffing patterns and then studied the results. She wanted to find a way to make sure there were more nurses on duty during peak volume hours. Her initial effort wasn’t successful, so she consulted with the night shift nurses to come up with a new plan.
The result? They staggered the starting times for a handful of nurses on the day, evening and night shifts. So instead of 14 day nurses starting their 12-hour shifts at 7 a.m., only 11 begin at that time. Another day nurse comes in at 8 a.m. and works 12 hours, and another at 9 a.m., and another at 10 a.m. The same type of staggered start times are also incorporated into the other two shifts.
“When we were finished, we had 24 nurses on duty at the peak time of day, when we had the most patients in the department,” said Haus. “Our peak time is basically from noon to midnight.”
No one was forced to give up a favorite shift. But the reorganized schedule gave some nurses the chance to work hours that better suited them. For example, one nurse discovered that she really liked coming into work at 4 p.m. so she could arrive home before dawn. She still got paid for the night shift, but she was able to get to bed before the sun rose.
“It works,” said Haus, referring to the new schedule’s effect on retaining staff. “In all sorts of ways it has made retention efforts easier.”
“You meet the needs of the individual’s home life, you don’t negatively affect their financials and you meet the needs of the patients,” she added. “You can’t do better than that.”
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