"Scheduling Is Everything": A Qualitative Descriptive Study of Job and Schedule Satisfaction of Staff Nurses and Nurse Managers.

Abstract

Background: Shift work and scheduling are major contributors to occupational stress for nurses, leading to job dissatisfaction and risk of turnover. Nurse scheduling processes are complex, as they are dynamically linked to nurse staffing and patient demand.

Objective: This study sought to describe barriers and facilitators influencing job and scheduling satisfaction among staff nurses and nurse managers.

Methods: We used a qualitative descriptive design. The sampling frame included staff nurses and nurse managers employed at an urban academic medical center. Participants (N = 16) completed individual semi-structured Zoom interviews from August 2023 to February 2024, which were audio recorded and transcribed. Data were analyzed using content analysis.

Results: The overarching theme identified was "Scheduling is everything," reflecting the importance of scheduling for nurses' satisfaction in and outside of work. Both staff nurses and managers identified tensions between scheduling for patient care needs (e.g., adequate staffing) and scheduling to optimize staff needs (e.g., health, sleep). They also identified staffing shortfalls as a contributor to these scheduling tensions. Staff nurses reported that scheduling challenges compromised their health and well-being, caused work-family conflict, and influenced turnover intentions. Facilitators of scheduling satisfaction included scheduling flexibility, autonomy, and equity. Participants also provided pragmatic ideas for improving scheduling processes.

Conclusions: Our study explored perspectives on job and scheduling satisfaction through the lens of both staff and managers. Scheduling challenges contribute to nurses' job dissatisfaction and turnover intentions. By increasing scheduling flexibility, equity, and integrating nurse-led innovations into the scheduling process, healthcare organizations can potentially increase nurse retention.