Personal and career conflicts: effects on well-being.

New nurses are entering the workforce with college graduations in full swing across the United States. Are you looking forward to their contributions? At the same time, are you concerned about the nervous tensions and differences that novice nurses bring into your already hectic workplace? This article discusses the intersections of home and work life; looking at issues that may influence well-being along with career satisfaction. Are you experiencing a collision of opposing priorities, responsibilities, and expectations? Have you considered the effects of these and other conflicts on your health and wellbeing?

Psychologists tell us that quality ties to others are universally endorsed as central to optimal living. Social scientists have extensively studied the relational world, but in somewhat separate writings (e.g., attachment, close relationships, marital and family ties, social support). As nurses, you have many roles that vie with your professional career and work duties; as do those with whom you live and work. The conflict patterns are complex. So, put on your self-nursing assessment 'hat' and see what you discover!

Shift Work

Our lives have been undeniably altered by the growing 24/7 global economy. Employees from all walks of life are increasingly working shifts. Many of these workers are married and many also have children. Single parents have their own set of shift work issues. Studies indicate that working the evening shift is associated with striking differences in home life than working the day shift. Women's evening shift work results in re-gendering the divisions of household and childcare tasks. For example, fathers whose wives work evening shifts will spend more time with their children and do more 'feminine' household tasks than those whose wives work day shifts. At the same time, however, the shift mothers work is unrelated to the amount of time they spend with their children. Women who work evening shifts report significantly higher work-family conflict than do day shift workers (Barnett, Gareis & Brennan, 2008; Barnett & Gareis, 2007; Presser, 2003). Conflict at home related to work expectation--does this resonate with your work-family experience?

Hours Worked

A study reported in the American Journal of Nursing (Trinkoff, Geiger-Brown, Brady, Lipscomb, & Muntaner, 2006) states that extended work schedules--those that vary from the standard eight hours per day, 35 to 40 hours per week--are common in nursing and contribute to problems with nursing recruitment and retention in addition to compromising patient safety and the health and well-being of nurses. This study described the nature and prevalence of such schedules across nursing settings and concluded that the proportion of nurses who reported working schedules that exceed the recommendations of the Institute of Medicine should raise industry-wide concerns about fatigue and health risks to nurses as well as the safety of patients in their care. Is your health and well-being at risk due to the rising expectations and resulting conflicts from work expectations?

Flexible and Variable Hours

Nurses continue to advocate for more flexibility and variability in our work place and work schedules. Costa, Sartori, & Akerstedt (2006) investigated the influence of flexible and variable working hours. They analyzed how these two dimensions relate to health and well-being. The flexibility and variability of working hours appeared inversely related to health and psycho-social well-being: the most favorable effects were associated with higher flexibility and lower variability. Physical work, age, and flexibility were found to be the three most important factors affecting health and well-being. Flexibility was reported as the most important factor to influence work satisfaction; the second to affect family and social commitment and the ability to do the same job when 60 years old, as well as trauma, overall fatigue, irritability, and headache; and the third to influence heart disease, stomachache, anxiety, injury, and the feeling that health being at risk because of work. Variability was the third most important factor influencing family and social commitments. Furthermore, shift and night work significantly influenced sleep, digestive and cardiovascular troubles, as well as health and safety at work. Time pressure also showed a relevant influence, both on individual stress and social life. Workers who reported control of these variables had positive consequences related to coping strategies as evidenced by "feeling to be able to work until 60 years of age" (p.1125). The many issues surrounding the aging and shrinking nursing workforce apply here. Suitable arrangements of flexible working time, aimed at supporting workers' coping strategies, have been shown to have beneficial effects on worker health and well-being. How are you doing with so many "balls in the air?" Is your juggling of all of these conflicting roles and expectations taking a toll? Satisfaction results from having a sense of accomplishment, purpose, and control. As health care professionals, we must learn to take care to protect ourselves in order to protect our patients.

Next Steps

Share this information with your family and your co-workers. We must face the issues and talk about the conflicts. Review the information on vitality and resiliency presented in previous articles. As nurses, we must put into practice for ourselves all that we have learned about managing conflict in others. Seek out avenues for conflict mediation or other training aimed at acquiring skills in conflict management. Together we can creatively and collectively work to reduce the myriad of conflicts that plague our day-to-day lives.

References

Barnett, R., Gareis, K., & Brennan, R. (2008). Wives' shift work schedules and husbands' and wives' well-being in dual-earner couples with children. Journal of Family Issues, 29(3), 396-422.

Barnett, R., & Gareis, K. (2007). Shift work, parenting behaviors, and children's socioemotional well-being. Journal of Family Issues, 28, 727-748.

Costa, G., Sartori, S., & Akerstedt, T. (2006). Influence of flexibility and variability of working hours on health and well-being. Chronobiology International, 23(6), 1125-1137.

Presser, H. B. (2003). Working in a 24/7 Economy. New York: Russell Sage.

Trinkoff, A., Geiger-Brown, J., Brady, B., Lipscomb, J., & Muntaner, C. (2006). How long and how much are nurses now working? American Journal of Nursing, 106(4), 60-71.

Reprinted with permission from the Center for American Nurses *

* The Center for American Nurses is a national professional nursing organization that educates, equips, and empowers nurses to advocate for themselves, their profession, and their patients. The Center offers evidence-based solutions and powerful tools to navigate workplace challenges, optimize patient outcomes, and maximize career benefits. Established in 2003, the Center partners with its 42 organizational members, comprised of over 47,000 registered nurses nationwide, to develop resources, strategies, and tools to help nurses manage evolving workforce issues and succeed in their careers. Additional information about the Center can be found at www.centerforamericannurses.org.

by Susan Vorce Crocker, PhD, RN