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Maintaining a healthy work–life balance

By Ian Peate - Professor of Nursing and Editor in Chief of British Journal of Nursing (BJN) First published: Last updated:

Introduction

It can be challenging to manage the demands of a highly stressful job while also fulfilling personal responsibilities. Maintaining wellness involves various factors including a healthy diet, regular exercise, adequate sleep, stress management and a work–life balance (National Academies of Sciences et al, 2021). When nurses prioritise their wellbeing, they are better equipped to address the physical and emotional demands of the job and offer the best quality of care to patients.

Nursing can be a demanding profession that requires long hours and shift work, and can cause high levels of stress. Nurses often work during weekends, holidays and night shifts, all of which can interfere with personal and family responsibilities. The nature of the job may also lead to physical and emotional exhaustion, making it difficult to maintain a healthy work–life balance.

This article discusses the importance of nurse wellness, the challenges that nurses face in maintaining a healthy work–life balance, strategies for achieving this balance and suggested best practices.

Work–life balance

A healthy work–life balance can mean different things for different people. Work–life balance does not necessarily mean that a person’s time should be split equally across work and leisure. Work–life balance means balancing one’s work and personal life, so as to achieve harmony in physical, emotional and mental health. There will be days when one area of your life takes priority, for example, when you are asked to work overtime, and that is acceptable, so long as the other areas of your life are not neglected for too long. Work–life balance can be about being satisfied with all aspects of your life, both in work and leisure, even when one aspect may take priority over the other.
The Mental Health Foundation (2021) suggest that a healthy balance could involve:

  • meeting deadlines at work, while still having time for family, friends and hobbies
  • having enough time to sleep well and eat a sufficient and healthy diet
  • not worrying about work when at home

Achieving this balance can be made more challenging if, for example, someone also has caring responsibilities, a demanding boss or is experiencing health difficulties.

For some nurses, the pressures of work are so great that this balance can often seem impossible to achieve. All staff are entitled to having a healthy work–life balance (Royal College of Nursing, 2023). The time away from work is as important as time spent at work for maintaining an effective level of performance. While a fast-moving work environment and constant demands may be stimulating in the short term, this is often unsustainable and can impede the nurse’s ability to work effectively and make good judgements. Donnelly et al (2020) reported that stressors can adversely affect competence and may result in behaviours that compromise safety and compassion fatigue.

The Royal College of Nursing Foundation (RCNF, 2020) noted that nurses are at substantial risk of work-related stress, burnout and mental health problems, including depression and anxiety. Wellbeing directly impacts the ability to demonstrate compassion (RCNF, 2020), which is a key trait of good nursing that, if lacking, can compromise patient safety (Francis, 2013).

The RCNF (2020) also found that the rate of suicide among female nurses is greater than that of the general working population, emphasising the risks posed by the nursing profession.

Achieving a healthy work–life balance

The first step in achieving a healthy work–life balance is to evaluate your priorities. After acknowledging the need for change, create a plan and continually assess the potential for modifications as situations change. Lifestyle changes are not easy, particularly when attempting to make these changes without assistance. One approach is to identify individuals and processes that can support you in this initiative. For example, coaching is a tool used for self-improvement, and there are many healthcare organisations that may offer this approach to help nurses achieve and sustain positive lifestyle changes.

Mullen (2015) suggested a work–life balance inventory may help to focus priorities where realistic success is achievable. Completing a work–life balance self-inventory can help to establish actions that need to be set in motion for lifestyle changes to occur.

The self-inventory involves:

  • Making a list of role models who have a healthy and sustainable balance between demands at home and at work
  • Thinking about what factors may be keeping you from achieving a healthy work–life balance
  • Reflecting on the events of today and how you were able to manage any stress
  • Naming one of the smallest things on your list that, if it were done, would feel like a weight had been lifted off your shoulders
  • Creating a support system. While your situation is unique, others may share similar experiences. Who could you turn to for support when making changes to your lifestyle?
  • Reflecting on how you experience stress in your mind, body and spirit (Mullen, 2015)

An unhealthy work–life balance

It can be easy to normalise working long hours or being under extreme stress, particularly if this is a regular occurrence or if you are working with others who are also in the same situation. Certain beliefs and routines concerning work can become the standard, so it is important to occasionally take a step back and reflect.

It may not always be easy or possible to make changes at work for a number of reasons, such as not feeling comfortable speaking up about working conditions. Lupu and Ruiz-Castro (2021) pointed out that work–life balance is a cycle, not an achievement, and suggested regularly checking your work–life balance using the following five steps:

  1. Pause. Ask yourself: what is currently causing me stress or unhappiness? How is it affecting my work and personal life? What am I prioritising? What am missing out on? Simply pausing, taking a breath and thinking about priorities can help uncover whether the way you are living and working is right for you.
  2. Pay attention to your feelings. Now that you are more in touch with your current situation, how does that make you feel? Do you feel fulfilled and happy, or angry and resentful? An awareness of these feelings can help you make decisions regarding which changes you want to make.
  3. Reprioritise. Think about what needs to change. Ask yourself, for example, if working long hours is worth missing out on time with family and friends, or if working on weekends is worth missing out on your social life?
  4. Consider alternatives. Is there anything at work that you can change to meet your new priorities?
  5. Make changes. This may be about asking for flexible work hours, ensuring that you use all your annual leave or not checking work emails at the weekend.

Workplace support

Finding a balance should also involve support from managers and the workplace. The workplace should promote a culture of openness, so that staff can speak up if they are feeling too much pressure. Healthcare organisations should consider implementing flexible roster options that allow nurses to choose shifts that better align with their personal lives (Royal College of Nursing, 2023). Nurses should be encouraged to take regular breaks during their shifts to reduce burnout and promote wellbeing.

The organisation should provide staff with access to counselling services and mental health resources, creating a supportive environment where nurses can feel comfortable seeking help when needed. Staff should be permitted to attend counselling and support services during working hours, as is the case for other medical appointments, and reasonable adjustments should be made when appropriate (Advisory, Conciliation and Arbitration Services, 2023).

Training should be compulsory for managers, to enable them to spot signs of stress and poor work–life balance among staff. Regular workload reviews should take place to ensure that work requirements are achievable and fair.

Conclusions

Improving one’s work–life balance involves the implementation of active, evidence-based strategies. The process involves self-reflection and taking action; nurses can learn various strategies to achieve a balance and enhance wellbeing. Understanding and implementing self-help strategies will support nurses as they become successful and effective at work, as well as maintain roles outside of work that bring happiness and joy. Recognising and acknowledging the need for change are the starting points for creating a healthy work–life balance.

References

Advisory, Conciliation and Arbitration Services. Supporting mental health at work: managing employees’ wellbeing. 2023. https://www.acas.org.uk/supporting-mental-health-workplace/managing-your-employees-mental-health-at-work (accessed 24 October 2023)

Donnelly EA, Bradford P, Davis M et al. What influences safety in paramedicine? Understanding the impact of stress and fatigue on safety outcomes. J Am Coll Emerg Physicians Open. 2020;1(4):460-473. https://doi.org/10.1002/emp2.12123 

Francis R. Report of the Mid Staffordshire NHS Foundation Trust public inquiry. 2013. https://www.gov.uk/government/publications/report-of-the-mid-staffordshire-nhs-foundation-trust-public-inquiry (accessed 24 October 2023)

Lupu I, Ruiz-Castro M. Work-life balance is a cycle, not an achievement. 2021. https://hbr.org/2021/01/work-life-balance-is-a-cycle-not-an-achievement (accessed 24 October 2023)

Mental Health Foundation. Work-life balance. 2021. https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/work-life-balance (accessed 24 October 2023)

Mullen K. Barriers to work-life balance for hospital nurses. Workplace Health Saf. 2015;63(3):96-99. https://doi.org/10.1177/2165079914565355 

National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on the Future of Nursing 2020–2030. The future of nursing 2020-2030: charting a path to achieve health equity. Washington DC: National Academies Press; 2021

Royal College of Nursing Foundation. The mental health and wellbeing of nurses and midwives in the United Kingdom. 2020. https://www.som.org.uk/sites/som.org.uk/files/The_Mental_Health_and_Wellbeing_of_Nurses_and_Midwives_in_the_United_Kingdom.pdf (accessed 24 October 2023)

Royal College of Nursing. Work-life balance. 2023. https://www.rcn.org.uk/Professional-Development/Your-career/Nurse/Career-Crossroads/Career-Ideas-and-Inspiration/work-life-balance (accessed 24 October 2023)

Ian Peate

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