These nurse managers were exhausted. Then their hospital gave them a 4 day work week

The four-day workweek has gained adherents in offices, government agencies and even industry. Today, the practice is making inroads into health care.

Since the pandemic, a handful of hospitals, including AtlantiCare Regional Medical Center in New Jersey, have begun offering a four-day work week to nurse managers, who are akin to CEOs in their level of responsibility overseeing large teams of nurses and ensuring appropriate care.

The move to a shorter work week has been driven by alarming turnover rates since the pandemic. Ten months later, AtlantiCare has seen no negative impact on patient care. No nurse managers resigned.

Instead, they report greater job satisfaction and a better work-life balance. After an extra day off, AtlantiCare’s charge nurses say they come back to work recharged and even more smiling.

Responsible 24/7

To understand why this works, it’s worth spending time with a nurse manager.

On a recent afternoon, Danielle DiLella is cheerful but very busy as she goes about her work, supervising 86 bedside nurses in her unit known as One Meadow.

His days are divided between administrative and clinical tasks. She is responsible for all recruiting, scheduling and payroll. of his great team. She is also responsible for the care they provide, working to minimize falls, pressure ulcers and infections, and handling patient complaints.

Throughout the day, she checks to make sure patients are discharged on time, so One Meadow can receive patients waiting in the emergency room.

The days are long and his to-do lists are even longer. And since hospitals never close, the responsibilities never end.

“You are responsible for your unit 24/7,” says DiLella. “It weighs on me.”

“Like a godsend”

The vast majority of nurse managers come from the ranks of bedside nurses, who typically work three 12-hour days.

The move to a standard work week can be a deterrent for those considering leadership roles.

“Sometimes I say it was a lot easier at the ER bedside, which sounds crazy,” says Kathryn Dixon, Two Meadow’s nurse manager, who worked in the ER for 15 years before taking her current position .

As a single mother, Dixon says it’s nice to be able to spend a day at home again before her teenage daughter.

“This extra day is like a godsend,” she says.

In a recent study by the American Organization of Nursing Leadership, two-thirds of nurse leaders identified their own emotional health as a major challenge.

It’s no wonder that nurse manager turnover has skyrocketed during the pandemic.

“We’ve seen this across the country. The pandemic has been really, really crippling,” says Barbara Cottrell, AtlantiCare’s chief nursing officer.

Before the pandemic, she said, nurse managers typically stayed on the job for about five years. Cottrell herself did the job for eight hours. Last fall, AtlantiCare nurse managers were staying on average for just two years.

This in turn led to high turnover of bedside nursing staff. Cottrell knew this was a serious problem.

“Ultimately, it would create an unsafe environment for our patients if we don’t stabilize the workforce,” she said.

A popular but hesitant decision

When AtlantiCare decided to launch a four-day work week last September, the reaction from most nurse managers was jubilation.

But not everyone was immediately convinced, including some senior nurse managers.

“Some people were a little nervous,” Cottrell remembers.

Their main concern was that quality might decline.

While enduring such growing pains might be the norm in other workplaces, it would be unacceptable in a hospital.

“People’s lives are in danger,” Cottrell says.

Even today, about a quarter of AtlantiCare’s nurse managers choose to stick with a five-day work week.

Dedicated to making it work

The AlantiCare team put a lot of thought and planning into the move to a shorter work week, learning how other hospitals, including Duke University Hospital and Temple University Hospital, had done it.

“I think our entire team was very, very dedicated to making this work,” DiLella says.

Now, every two months, the nurse managers divide into pairs, sit down with calendars and coordinate the days they want to take off.

Each nurse manager then covers for their partner during those days off, responding to any immediate needs, such as a patient issue that the team can’t solve alone. They remain fully responsible for their own nursing team, including their schedules, payroll, and quality of care.

“I think it made us stronger, because when you cover another person’s team, you have to build relationships with that team. You have to develop trust with this team,” she says. “So it kind of gives you a more holistic perspective of what’s going on in the hospital.”

Having that extra day away from the hospital makes administrative work more feasible, DiLella adds. She has more energy and brain space during the four days she is there.

“You can never fill an empty cup”

DiLella uses her extra day off to catch up on personal tasks, like going to the doctor, getting an oil change or taking her dog to the vet.

“Just those things that you keep putting on the back burner,” she says.

As a caregiver, she says it sometimes feels strange to prioritize herself and her own needs.

But the four-day week brought her to an important realization:

“You can never fill an empty cup,” she says. “It’s actually very beneficial to take a step back and take care of yourself first, so you can do better in taking care of others.”