Schedule Change for Nurse Managers

Recruiting at 1 trial location

Overseen By Jian Li, MD, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Ambulatory care, Less than 30 FTEs, Part time, Less than 5 days, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

50 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how a 4-day work schedule, part of Work Time Schedule Changes, affects the wellbeing and performance of nurse managers. It aims to determine if working fewer days can reduce burnout and improve sleep and activity levels. Researchers are also investigating whether this schedule change impacts job satisfaction and patient care quality. Ideal participants are full-time nurse managers at UCLA hospitals in acute care settings, managing over 40 staff members. Participants will wear an OURA ring to track physical activity and sleep and will complete several online surveys. As an unphased trial, this study allows nurse managers to contribute to innovative research that could enhance workplace wellbeing and patient care.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, since the study focuses on work schedules and wellbeing, it's unlikely that medication changes are required.

What prior data suggests that this schedule change is safe for nurse managers?

In a previous study, a 4-day workweek reduced burnout from 61% to 4% and increased job satisfaction from 71% to 96%. Research has also shown that a 4-day workweek can boost job satisfaction and work-life balance for nurse leaders, with a 45% increase in work-life balance. Another study found mixed results on employee health, but overall, the schedule change improved morale and job satisfaction.

These findings suggest that the 4-day workweek is generally well-received and may enhance well-being. No serious safety concerns appear to be associated with this schedule change. Participants can expect improvements in work satisfaction and balance without significant risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it's exploring a novel approach to improving work-life balance and job satisfaction for nurse managers by changing their work schedules. Unlike the traditional five-day workweek, this trial is testing a four-day workweek, which could potentially reduce burnout and increase overall well-being. If successful, this approach could lead to a significant shift in workplace policies, benefiting not just nurse managers but potentially other professions as well.

What evidence suggests that this schedule change is effective for nurse manager wellbeing?

Research has shown that switching to a 4-day workweek can greatly enhance nurse managers' wellbeing and job satisfaction. In this trial, the intervention group will work only four days a week as a schedule change. One study found that burnout dropped from 61% to just 4%, while job satisfaction increased from 71% to 96%. Another study reported a 45% rise in satisfaction with work-life balance and a 52% decrease in guilt about taking time off. These changes did not compromise patient safety. Overall, evidence suggests that a 4-day schedule can effectively improve both personal and professional life for nurse managers. ^{1 3 4 5 6}

Who Is on the Research Team?

Jian Li, MD, PhD

Principal Investigator

University of California, Los Angeles

Are You a Good Fit for This Trial?

This trial is for nurse managers who are currently working and have not had any recent changes to their work schedule. They must be willing to wear an OURA ring to track health data, use the Oura Ring app, and complete online surveys. Those with a history of altering their work hours or unable to commit to the study's duration are excluded.

Inclusion Criteria

Currently working at either Ronald Regan UCLA Medical Center or UCLA Medical Center Santa Monica

In the acute care setting

Currently employed as a full-time nurse manager

Exclusion Criteria

I work less than 5 days a week.

I work in a place where patients can walk in for treatment.

I work part-time.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Baseline Assessment

Participants complete an initial visit to learn about the study, begin wearing an Oura Ring, and complete the first survey on the REDCap platform.

1 week

1 visit (in-person)

Intervention

Participants begin the assigned work schedule (4-day or 5-day) and continue wearing the Oura Ring, syncing data weekly.

6 months

Remote data collection

Follow-up

Participants complete follow-up surveys online at month 3 and month 6 to assess wellbeing and job performance.

6 months

2 visits (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Work Time Schedule Changes

Trial Overview The study is testing if changing nurse managers' schedules from the standard 5-day week to a condensed 4-day week can improve wellbeing, reduce burnout, enhance sleep quality, increase physical activity levels, and positively affect job satisfaction as well as patient care outcomes.

How Is the Trial Designed?

Group I: Intervention Group Experimental Treatment 1 Intervention

The intervention group will begin working only four days a week as a schedule change.

Group II: Control Group Active Control 1 Intervention

The control group will continue to work five days per week, receiving standard practice for the schedule policies at the participating study sites.

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

Published Research Related to This Trial

A study classified 122 shift systems used by nurses and midwives in large hospitals in England and Wales, focusing on flexibility in rostering and rotation speed between night and day shifts, resulting in nine distinct categories.

The most prevalent shift system identified was a flexible day shift combined with a permanent night shift, highlighting the need for further research to determine which shift features minimize negative impacts on nurses' well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A classification of nursing and midwifery shift systems. Barton, J., Spelten, ER., Smith, LR., et al.[2019]

Female nurses with school-aged children working three-day shift rotations face significant challenges in balancing their professional and parenting roles, leading to feelings of crisis and chaos in their lives.

To improve work-life balance for these nurses, it is essential for policymakers to implement supportive management practices, flexible work systems, and opportunities for professional development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child-rearing experiences of female nurses working three shifts in South Korea: A qualitative study. Yoo, HJ., Shim, J.[2022]

Over 80% of nurses reported satisfaction with their scheduling, but longer shifts (over 13 hours) correlated with increased patient dissatisfaction with care.

Nurses working shifts of 10 hours or longer faced significantly higher rates of burnout and job dissatisfaction, suggesting that extended shifts can harm both nurse well-being and patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Stimpfel, AW., Sloane, DM., Aiken, LH.[2022]

In a study comparing health and performance outcomes among nurses, shift work was not found to be a significant risk factor for health issues or organizational outcomes, suggesting that factors like gender, age, and weight play a more crucial role.

Female nurses reported significantly more sleep disorders than their male counterparts, but those who were non-adaptive to shift work performed just as effectively and safely as their adaptive colleagues, indicating that adaptation to shift work may not be as critical for maintaining health and performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Shift work in nursing: is it really a risk factor for nurses' health and patients' safety? Admi, H., Tzischinsky, O., Epstein, R., et al.[2022]

A year-long trial of a new nursing shift pattern (two 12-hour and two 6.25-hour shifts) received positive feedback from all 24 participating nurses and therapists, indicating high job satisfaction.

The new shift pattern was associated with a significant reduction in sickness rates and the use of agency nurses, suggesting improved health and wellbeing among staff.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Modernising the 12-hour shift. Lea, A., Bloodworth, C.[2019]

This study investigates how both alternative work schedules and nurses' preferred schedules impact their job satisfaction, perceived quality of patient care, and personal life balance.

By focusing on the combined effects of these schedules, the research aims to provide a more comprehensive understanding of how work arrangements affect nurses' overall well-being and professional performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Repercussions of work schedule congruence among full-time, part-time, and contingent nurses. Havlovic, SJ., Lau, DC., Pinfield, LT.[2019]

Implementing fixed scheduling for nursing staff in oncological inpatient care resulted in less overtime and fewer shift change requests, suggesting it may improve resource management.

However, the type of scheduling did not significantly impact patient-reported outcomes, indicating that while fixed scheduling may benefit staff, further research is needed to fully understand its effects on patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changed nursing scheduling for improved safety culture and working conditions - patients' and nurses' perspectives. Kullberg, A., Bergenmar, M., Sharp, L.[2018]

A study comparing 8-hour and 12-hour nursing shifts across 10 wards found that 12-hour shifts resulted in significant reductions in direct patient care.

The increase in unofficial work-breaks during 12-hour shifts suggests that nurses may pace themselves to manage the longer hours, which could negatively impact patient care delivery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The quantity of nursing care on wards working 8- and 12-hour shifts. Reid, N., Robinson, G., Todd, C.[2019]

Over 25% of surveyed nurses typically worked 12 or more hours per day, with more than a third working over 40 hours per week, indicating a prevalence of extended work schedules that could compromise nurse well-being and patient safety.

The study highlights that nearly 40% of nurses had on-call requirements, and a significant number experienced mandatory overtime, raising concerns about fatigue and health risks that could affect both nurses and the quality of patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How long and how much are nurses now working? Trinkoff, A., Geiger-Brown, J., Brady, B., et al.[2019]

The study highlights the importance of innovative scheduling systems for nursing staff, emphasizing that flexibility in work schedules can significantly improve their quality of working life.

Utilizing change theory, the paper describes successful participative management approaches implemented by four nurse managers, which involved staff in the design and evaluation of new scheduling practices, leading to better engagement and responsibility among the nursing teams.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Planning change in scheduling practices: a theoretical perspective. Comack, M., Smith, SD., Bowman, A., et al.[2018]

Working more than 12 hours in a single day and over 40 hours in a week negatively impacts patient outcomes, highlighting the risks associated with excessive nurse work hours.

The review emphasizes the need for better management of nurse work schedules to enhance patient safety and prevent adverse outcomes, based on a systematic analysis of 22 studies from 2000 to 2019.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Relationships between comprehensive characteristics of nurse work schedules and adverse patient outcomes: A systematic literature review. Bae, SH.[2021]

Shiftwork poses significant health risks for healthcare workers, especially as they age and accumulate more shiftwork experience, highlighting the need for well-designed work schedules that consider shift patterns and lengths.

Allowing healthcare workers to choose their shift systems and implementing strategies like self-scheduling and planned on-site napping can improve adaptation to shiftwork and enhance overall job satisfaction and performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Shiftwork: what health care managers need to know. Kilpatrick, K., Lavoie-Tremblay, M.[2019]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40075240/

Reimagining Work-Life Balance: The Impact of a 4-Day ... Results: Burnout decreased from 61% to 4%, job satisfaction increased from 71% to 96%, and joy in work rose from 34% to 86%. No changes in patient safety, ...

2. foxchase.org foxchase.org/news/four-day-workweek-nurse-managers-improves-work-life-balance-fox-chase-cancer-center-study

Four-Day Workweek for Nurse Managers Improves Work ... The authors surveyed participants before and after the center implemented an optional four-day workweek for nurse managers and found the program ...

3. ormanager.com ormanager.com/briefs/4-day-workweek-boosts-job-satisfaction-work-life-balance-for-nurse-leaders/

4-day workweek boosts job satisfaction, work-life balance ... 6% increase in overall job satisfaction · 45% increase in work-life balance satisfaction · 52% reduction in guilt for taking time off · 36% ...

4. dl.acm.org dl.acm.org/doi/10.1145/3742800.3742832

Towards a 4-Day Week in Hospital Care: Exploring Staff ... The results of this change were mainly based on a significant reduction in 57% burnout and an increase in 25% job satisfaction, without a ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12484334/

The consequences of a compressed workweek: a systematic ... Results suggest that a compressed workweek increases sickness absence but also improves shift satisfaction. Predominantly negative health ...

6. apa.org apa.org/monitor/2025/01/rise-of-4-day-workweek

The rise of the 4-day workweek A 2023 systematic review of the literature on 4-day workweeks found support for improvements in morale, job satisfaction, and job turnover, but ...