Fifteen months after implementation, nursing leaders reported a 6% increase in job satisfaction, a 45% increase in satisfaction with their work-life balance, a 52% improvement in feeling guilty about taking time off and a 36% increase in confidence in the ability of their units to run effectively in their absence, according to a Feb. 17 news release from the cancer center.
Jennie Gilliland, MSN, RN, is the clinical director of infusion services at Fox Chase. She spoke with Becker’s about how the adoption of a four-day workweek has influenced nursing teams at the cancer center.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What inspired Fox Chase Cancer Center to explore the four-day workweek for nurse managers?
Jennie Gilliland: I always have to shout out our chief nursing officer, Anna Rodriguez, MSN, RN. This really came from her shop. It was interesting — one day, there was a big call added to the end of the day. We were all like, “What is this about?”
Anna and Temple Health’s chief nurse executive at the time were on the call and said, “We’re giving you the opportunity to take advantage of a four-day workweek.”
They said, “Make sure you’re visible, your work’s done, and have at it.” We were all silent, staring at the screen because it’s not even something we had been asking for. I had never imagined having a four-day workweek until it was brought to us.
From Anna’s standpoint, I think it was her way of giving back to the leaders that she knows do a tremendous job. We’re always available 24/7. Even when we leave here, we’re always on.
Q: What advice would you give to other hospital and health system leaders considering a similar workweek structure for their nursing leadership teams?
JG: At first, there were no real rules in place. It was hard because as nurses, we love policies, right? My advice to other health systems would be to outline some sort of structure so that people don’t take advantage of it. For example, if you have a day where you’re not answering emails or calls, you need to put in a vacation or sick day.
There needs to be some expectation that you’re not completely off the grid on your remote day. It’s happened to me twice now; The Joint Commission showed up on the day I was going to be home, and of course, I came in. Having that little bit of flexibility built in benefits both sides.
I think it’s also important for people to know that this is a privilege. You can’t do this if you have a leader who is already struggling with visibility or having issues with their team. A four-day workweek would just make all that worse. Health systems have to make sure their teams are ready, that everybody’s in place and that they can handle this change.
Also, ensuring teams are doing some type of daily leadership huddle is important for cohesiveness. Because leaders are all over, we huddle on Teams every day at 9:15 a.m. to see where everyone is for the day.
Q: What challenges did you anticipate before implementation?
JG: For me and a couple of my colleagues, we wondered what the staff were going to think.
I was definitely anxious about that, but I chose to just have a staff meeting and tell them about the opportunity, and that I was always available to them, that they could always contact me and that there would always be backup coverage. I think they just needed to see that what I was saying was true.
Q: How has the four-day workweek influenced recruitment of nurse leaders at Fox Chase?
JG: It’s hard to recruit a nurse leader, especially a really good one. At least for me, when I have an open position, I always see if I can make it a flexible schedule before posting it. I would get killed trying to hire a five-day-a-week person who’s really talented and who wants to stay.
The four-day workweek incentivizes people to apply and take the job, and then hopefully stick around, which supports the whole team and community, because everyone kind of feels respected.
For this younger generation, it’s going to be really hard to recruit and keep really good nurse leaders without the flexibility that people want.
Q: What benefits have you seen since the four-day workweek was implemented?
JG: It has definitely boosted morale. It was eye-opening too, because I think that people felt like their units couldn’t run well without them. Having one remote day empowered the staff and the nurse leaders to establish that level of trust, knowing the team is going to be okay if the leader isn’t there.
As a nursing leadership team in general, we have become so tight-knit. It’s made the leadership team so much stronger because we’re always willing to support one another with whatever is happening because we want our colleagues to be able to take that remote day.
We have a big text group, and there have been times when a nurse manager will reach out on their remote day to ask, “Would one of the leaders mind running to my area if there are any emergencies?” And of course, we will, because we want her to be able to have her day. We’ve really bonded as a leadership team — we feel like a cohesive family.
