April’s story: Nursing is inflexible and hostile to mothers

April Abbott writes: I wrote this to highlight the difficulties I face as a mother of two young children returning to work. I’m shocked at the inflexibility of our system and the overt attempts to push mothers out of the workplace. More importantly, I wrote it to show that this is an issue that affects all Australians, because if we don’t act now we risk losing a valuable section of our nursing population. I hope my colleagues will read it and understand that it’s not about mums wanting the best shifts or choosing to be difficult. It is simply that many of us are faced with the choice of fighting for roster stability or leaving. Can we sit by and watch?

Let’s face it; the future of healthcare in Australia looks bleak. As a society we’re getting older and sicker and we keep expecting more of a system that just can’t keep up with the demand. When you add an ageing nursing population and the very real prospect of a healthcare workforce shortage, the picture looks pretty grim. So why is it that, in the midst of a national debate about health care funding, a Registered Nurse (RN) with over seven years experience in Intensive Care and an extra three in other areas of nursing can’t get a permanent job in a hospital? The answer – because I’m a mother. 

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April and her family.

I’ve always known that being a nurse is about sacrifice. And like all mothers, I understand that working takes away from time with my family, and that’s fine. It’s not just about the money, I love my job. I love knowing that I make a difference, that I can spot when a patient is about to deteriorate and take action to stop it. But I can’t be available 24 hours a day any more and that means I can’t work a rotating 24/7 roster. That means I can’t get a job.

Let me share a conversation I recently had with a Nurse Unit Manager of an ICU unit who was advertising for RN positions. I highlighted my fairly extensive experience and explained I was looking for a job closer to home following a period of maternity leave. Her immediate response was “I don’t allow any of my staff to work regular shifts so you will have to work a fully rotating roster”. I explained that was impossible due to child care requirements and her response was “The rule applies to everyone”. Effectively – Do Not Apply.

So here I was, the perfect candidate for the position but for one small detail, I needed to work the same shifts each week. This isn’t a one-off for me, I was bullied in my previous position for being too “needy” with my shifts, and I’m not alone. One colleague tells of how she is forever swapping afternoon shifts because they don’t work for her family and has seriously considered leaving the profession. Another talks about the lack of childcare for shift workers, saying:

“It’s a struggle [arranging childcare] and it takes a great deal of planning and patience before I even get to my job, which takes even more out of me.”

Lastly, one woman I spoke to says that although her employer knows she is available between Wednesday and Saturday, her one shift per week is regularly rostered on a Sunday to Monday.

How can we possibly justify this?

I need to put it out there: these issues aren’t exclusive to nurses. No matter what the job, every mother faces challenges trying to find a work-life balance, but shift workers are particularly at risk of facing this difficulty. There are, however, a few differences for nurses. Firstly, we are notoriously selfless and rarely complain in any significant way about our working conditions. Secondly, we are more likely to suffer from health problems than people of other professionals at the same age, probably because we are so willing to sacrifice our own needs for the job, not to mention our higher than average exposure to illness. Thirdly, and most importantly, we simply cannot afford to lose our experienced nurses!

childcare kids painting

I made the decision to switch to practice nursing and I love working at a local medical centre. I had to take a 25 percent pay cut, I’m working casually, some weeks all my pay goes to childcare and it’s a shame that my years of intensive care experience aren’t being utilised, but that’s the price I pay to ensure my kids are looked after while I’m at work. And it would seem that I’m a minority, others in my situation are leaving the profession altogether or putting up with the inflexibility, but at what cost?

We need to tackle this issue now. Nursing was always known as a family-friendly profession that supports mothers. Now it has become inflexible and even hostile, and it must stop. If we continue to push away our experienced nurses we will be left with a serious skill shortage in 10-20 years. We will be left without the most valuable nurses, the Clinical Nurse Specialist, the Team Leader, the Senior Nurse on a night shift who you know you can count on in an emergency. And we will be left with a junior workforce who haven’t been given the opportunity to learn from the more experienced and specialised nurses. Even if we don’t see a continuation of the trend for nurses to leave the profession, the stresses of the job and trying to balance it with family life are just too high.

We need to value our nurses. We need better legislation and, more importantly, better support from hospital management. We need to change the culture of expecting nurses to put up with it or leave. What we can’t do is close our eyes and hope the problem goes away.

So how can make things better and retain nurses in the future? Well, you might not like it, but the answer is providing nurses who are mothers of young children with ‘Special Treatment’. Yes, you read that right, Special Treatment for working mothers. Do we want it? Not really. Do we feel entitled to it? Huh! You think I became a nurse for all the entitlements? The truth is, nurses who are mothers of young children need special treatment and Australia needs us to work.

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We can make it happen by providing mums with regular shifts for the short time during their career that they have dependent children. It’s not necessarily pick and choose, it’s a collaboration that works for everyone, not just the manager and roster team. We can provide child care in hospitals to suit shift workers and ease the financial burden of childcare on shift-workers.

Most importantly, we can stop labelling working mums as “selfish”, “difficult” and “entitled” or lump the responsibility of establishing a work-life balance solely onto the mother because “she chose to have children”. These statements show that, as a society, we place little value on the care of young children or their role as our future workforce.

Some of the best nurses I know are mothers. They are patient, empathetic and highly skilled at multi-tasking. They love their work, they are passionate about the profession and they are in the unique position of being involved on both sides of the nursing station, with frequently sick children. Please let’s not toss these nurses aside because it’s too hard to make the roster work! With only a few small changes we can ensure that our future nursing leaders remain in the workforce and remain at the forefront of a world-class health care system.

What do you think? Do you share April’s experience? Are you a manager who insists on everyone working rotating shifts? Please leave your comments below.

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15 Responses to April’s story: Nursing is inflexible and hostile to mothers

  1. Natasha says:

    Thank you for writing this piece. I am a student nurse (2nd year) who at 40 is changing careers to become a nurse. At the start of my degree I was appalled at the university’s head of nursing’s attitude to working mothers. We were told ‘if you are looking for flexibility then you are in the wrong industry’, ‘if your child’s sick, not our problem’ and so on. Which was a total contradiction to what I believed nursing was and had been told from other nurses – that it was a wonderful flexible caring industry. We were told over and over at uni that nursing is a caring and empathetic industry, however their actions and words did not seem to align – the caring simply did not apply to each other. I too will need flexibility, so I do hope it is just a view of a minority and not majority.

  2. Ailsa says:

    This is not new! After my second child I left my role as a NUM at a major teaching hospital as I felt full time work was not going to work with the family and my closest family support was over 150km away. That was 19 years ago. I went “back to the floor” at another hospital within the area onto permanent part time nights. Initially working one eight hour shift a week, but now the kids are grown up, up to seven 10-hour shifts a fortnight. I adapted and would plan way in advance with any kids activities, yes I have missed some things but they forgave me and my husband usually was there (he’s Mon-Fri 8-4!). The flexibility needs to be both sides, not just the organisation.
    As to the ageing nursing population, I’m one of those, I have been nursing now for over 35 years and am still going!

  3. Emma says:

    Well I’m one of those 2nd class citizens who isn’t a mother and I had a major eye roll (admittedly schoolgirl moment I’m not proud of) at your post initially ….

    First of all, you aren’t necessarily a better nurse because you’re a mother, although for a lot of people, being a parent does make you a good nurse. I’ve seen both my parents die of cancer at a young age and had to deal with that, which I personally think has helped me become a more empathetic, patient person with a lot more common sense and practical ability, as a lot of life experiences do (people who’ve suffered can be kinder people, for example).

    FYI: I attempted to start a postgrad degree a few years back as an RN in a major public hospital and was prevented from doing so by not getting my requested days off for exams and uni, despite the fact that I dropped to 5 shifts a fortnight, planned my whole semester out and the fact that it would have benefited my skill set. So I moved into aged care for 2 years, which allowed me that opportunity to study, although it certainly wasn’t an area I’d ever thought of as a 30 year old! I was annoyed because the hospital system let me down initially, but then I just applied for other jobs and got on with it.

    I appreciate that nursing isn’t what it used to be, I hate how nurses are being treated and I’m completely against bullying in any form. However, I personally don’t miss those days of never getting Christmas, weekends or public holidays off because all the mothers automatically received them (this was blatant in quite a few places I worked in). But to expect special treatment if you’re a mother of young kids? What if you’re caring for aging or ill parents or have a chronic illness yourself? How about single parents or parents looking after a child with disability? What about surgeons or senior doctors who have children? what about the fathers out there – do they not have to care for their children? Why do we only ever hear about mothers?

    There are so many people out there who are doing it tougher than you, than any of us. You have to realise also that you’re asking for the shifts that a lot of nurses would prefer, so naturally they’re going to feel resentful.

    I have to ask – if you wanted to be a mother, why did you choose nursing as an occupation instead of a job with more regularly hours? I’m not one of those people who says, well you chose to be a mother, that’s just silly, but surely you could have planned your career a bit more? At some point we all have to take responsibility for our own decisions.

    I’m not being combative, truly, it’s just that there are educated, skilled, good people out there who can’t get jobs now and while I appreciate how difficult it must be to balance having little ones and working, you should perhaps try to understand that it’s a challenge for most of us sooner or later. Nobody can expect special treatment now, those days are over.

    And nobody needs special treatment – I think a lot of workers, including yourself, need more flexibility than is currently offered, which is a far more reasonable expectation (your particular choice of words will always get people’s backs up, I think you know that). Childcare opportunities in the workplace is an excellent idea and I think a lot of countries do this. Australia is behind in a lot of ways when it comes to career/life balance and career flexibility.

  4. It is certainly a difficult situation. For stable hours and set days you may wish to consider clinical research, which is often in a private practice or outpatient setting, therefore reflecting office hours. Even an ICU research role would usually be regular hours.

    I’m interested to hear from nurses who would consider a move to clinical research in a clinical research nurse role. Our group offers part-time research roles for RNs with set days and set hours (office hours).

    Feel free to contact my research group with your CV at the following email address
    retina@eye.usyd.edu.au

  5. RN8 says:

    When my kids were small, I worked casual. Entire problem fixed! I then dictated when I could work and what shifts. Problem solved.

  6. ann m says:

    I began in 1965, registered at 21 after 4 years training and find I have to comment about how it was, motherhood makes you a better nurse etc. Nursing has changed, for many nurses now stay in the profession, whereas years ago when they married they resigned. As a student we were not allowed to marry, most Charge Nurses never married and many lived in the Nurses Home and their ward was their world which they managed with military precision. Nursing was never easy, of the 40 who started in my group 8 of us finished and many of those nurses were a true loss. The retention rate in the 80s and early 90s had improved dramatically and the program was good and then the University program kicked in. Initially it worked, there was commitment and staffing to facilitate/preceptor nurses, then the GFC kicked in and things fell apart.

    Motherhood broadens both your hips and your insight but does not necessarily make you a better nurse (spoken as a grandmother).

    I gave up clinical work 1 year ago, so I have recent experience both in the acute & aged care setting and know the problems firsthand. As a senior I am very concerned about the loss of knowledge and expertise, something that cannot be conjured up on-line and neither can it be bought. We are throwing away a treasure and we’ll pay for it, in fact we already are. Nursing’s inflexibility has always been ridiculous and tragic, the lack of ‘conditioning’ in nursing education programs – what I mean is students are ‘just not there’ nor is there sufficient repetition to engender expertise and confidence. At the risk of engendering angst, some preceptors and facilitators just shouldn’t be in that role, for it’s just a stepping stone to promotion. But on the flip side there are those wonderful dedicated individuals who work so hard without recognition / reward and my concern is always they will burn out.

    Whilst I worked hard to maintain my clinical credibility and am adamant that nurses be competent, prior to my retirement I came up against ‘competencies’, so many skills I had been performing safely for years ie. urinary catheterisation, now had to be assessed by RNs deemed competent who had never even performed some of those skills in the real world.

    I recall being spoken to at an annual ALS program and I quote “I will have to fail you if you don’t stop thinking like a doctor”. At that time I was concurrently teaching in the medical curriculum at a prestigious university. The problem was the scenario presented was congruent with what I was saying, I had seen it too many times. The Ts & Hs deductive reasoning exercise is a great algorithm to facilitate treatment but educators don’t need to batter you over the head with it.

    Nursing is too busy justifying its existence as a profession. What it needs to do is give a little, stop trying for perfection, we’re humans, perfection is a myth, show some kindness and understanding towards colleagues, stop the bullying, it’s so toxic it’s a health hazard, and being a Scot (we’re very canny folk with money) stop trying to use nurses as a cash cow ie. $10,000 re–Entry program, and finally, make MERIT a reality.

    In conclusion, I wish all my colleagues job satisfaction and happiness in their future careers.

  7. ang says:

    While I sympathise with the writer’s situation, I feel I must comment that not all of us find it that way.
    I am a mother of two and returned to work in a busy CCU when my son was 6 months old. My NUM was incredibly flexible and basically let me write my roster when I first returned to work. So not all managers are awful and inflexible, some are fabulous and caring. I think she realises that happy staff equals less sick calls and more productive staff. If only all managers were like that.

  8. kim says:

    We all came into nursing knowing that nursing is predominately shift work.
    I have been an ICU nurse for 30 years and had 4 children and work night shift so I could have regular shifts till they were older.
    Why should I work around you or other mothers, which does happen in the unit I am working in now. I have a life, the shift work does not agree with me as it did when I was younger. It causes friction in the units if the rostering not fair. So go casual, that will fix your problem.

    • Kate says:

      I wanted to get back into nursing after I had my 2 children. I did a refresher course and was eager to work. I applied at a major public hospital for part time but they would not have me on unless I worked shift work. I then asked for casual but they said they have enough casuals and need full time staff. I now work as a practice nurse at a medical centre with set days and hours, I love it there but I do miss not using my other nursing skills and my pay is quite low compared to the public sector (around $8/hr less). I found the public hospitals will lose the experienced good workers due to the way they manage staff and have personally seen they will employ nurses coming from overseas who have some difficulty with English.

  9. Sarah E says:

    I am grateful that someone is looking at this issue. Nearly all my working life has been as a shift worker and a nurse. I have gladly swapped shifts for others, especially mothers, and have worked Christmases so that mums can have Christmas with their kids. Now I have my own and I understand the struggles and juggles.

    It seems that the mantra of all clinical departments is’working rotating roster is a requirement of the job and not an option’. I have seen some colleagues return from maternity leave and write in their requests on their request rosters in good faith after having spoken with their managers, only to have the very shifts they didn’t want, that they can’t work due to childcare constraints or babysitting availability or because their partner is working those days (some of us do have partners who are rotating roster workers too). When they speak with the management they get the mantra response or the NUM is apologetic but has to comply with the person above them who changed the roster before approving it on the grounds of ‘fairness to all’. I have experienced this myself. Night shift is problematic for me as my husband, who is a train driver, can start any time from the small hours of the morning or night or be finishing in those hours. His income is the fulltime income while mine is part time and cannot be changed to work around my permanent part time shifts. But I have to work night because rotating roster is ‘non negotiable’.

    I know of mothers having to fight for shifts to suit their family needs. Some women use up their sick leave because there is no one to mind the kids or they don’t want to let their kids down yet again on something they always miss out on. As my children all enter school I am finding myself starting this very fight. Some mothers wish that there could even be some shorter shift times on offer such as four or six hour shift times instead of 8 or 10. This would go a long way to helping with flexibility and staffing. It seems that creativity and empathy are lacking when it comes to creating the roster.

    When I worked in aged care as an AIN I was granted permanent shifts in the mornings or evenings (or nights if I wanted them if a position was available). Why can’t this be for hospitals too? At least there will be a guarantee of an experienced staff member present on the shift in the form of one of these experienced mothers. What about more job share options? Or ‘lifestyle rostering’ allowances? There are staff who do not have kids (or their kids are older and not requiring childcare) who would love permanent shifts to suit their lifestyle. Those who want particular days and shifts can have them while those who like rotating can do so. Why can’t these options be explored? Shift work can rob you of your life and that is one of the reasons why people leave it, apart from having children. Perhaps the potential for some permanent shifts or lifestyle rostering could go a long way towards retention and job satisfaction, leading to a better workplace and better care for patients.

  10. Helen says:

    April, I can sympathise with the difficulties you face working with small children. I was a sole parent with no relatives living close by so the only way I could continue to work was to be employed in nursing homes, where usually nurses work the same shifts. The idea is you start as a casual and put your hand up for the shifts you want which eventually will come your way. Nursing homes survive on this sort of rostering and I am a fan of giving people the shifts they want, then they turn up and don’t take sickies.

    After being away from the public system for many years, I was dismayed to see that someone (probably some person working 9 to 5 office hours) made the decision to do these hellhole rotating rosters, for what reason? To make nurses fatigued and more at risk of travel accidents and work mistakes? What purpose does this messy idea serve? To make everyone unhappy and leave nursing? Sounds like something is broken.

    As an older RN, I cannot work a rotating roster, it’s punishing and fatiguing – I just don’t even know what day it is or whether I am coming or going when working that system.

    Now, I no longer have the worry of bringing up children but I cannot see the point of it. Afternoon shifts alternating with day shifts – that is manageable, but mix it all up with night shifts is a good way to kill off nurses – at work and on the roads travelling to and from work.

    There are times when I worked night shifts when the kids were little, that suited us. Then day shifts suited, now I prefer afternoon shifts, no setting alarm clocks and time to do things in the morning. Talking to other nurses, everyone prefers something different, some people actually Like night shifts or it suits them better, but don’t mix them up with other shifts. Night shift is taxing enough on its own and if you keep working nights you can get into a routine.

    What I think is – give nurses what they want to work, within reason – hospitals were run on that principle for many years until some person had the idea they wanted to punish nurses and make everyone do this murderous rotating thing.

    The old hospital training system was work afternoon and day shifts and then do blocks of night shift for 4 weeks at a time. This at least gave you some time to get into a pattern of some sort. The RNs worked night shifts who preferred that shift. I know people who only want to work night shift – I don’t and hate it but then, each to her own.

    The only other alternative which someone else suggested is work as a casual. Then you have your preferences and say no to unsuitable shifts. You can do this with agencies or with the hospital you work in.

    As far as working mums getting preference for certain shifts – I don’t entirely agree with that, but think everyone should be able to give their preferences which are taken into consideration. I for one would say ‘I don’t want 0700hrs shift – you can have that and you can give me the Xmas Day shift, I’ll take the penalties for that one, mums and dads with kids can have their day off. I’ll do a swap for New Year’s Day – mums and dads, you do that one for your Xmas Day off. School holidays – worst time of the year to have off on annual leave, all those anklebiters hanging around. Mums and dads – you have those off, if you want. Me, the middle aged person, I don’t want them’.

    So if you think of it like this, then usually everyone can get something they want, by agreement – then it’s fair. Weekends, I can work those, no kids around now and I want the penalties for retirement – mums and dads have them off.

    I think if your manager could think about it this way, then they would see that there are different stages in your life when different shifts and days suit your stage in life. Single, married with kids, middle aged and still nursing! We all need something different and it’s all there – all the different shifts.

    April, I don’t think you should expect everyone else to just accommodate you, but if you adjusted the way you think about work and shifts, it may just mean that you have to work somewhere else that is not your preference to fit in with kids.

    After years of working as a sole parent, working one permanent and up to two days per week and making do, my grown up children have told me – ‘Mum, you were always there when we came home’. I never had much money. I have holes in my 50 year old carpet and can see the newspaper underneath, but I came to the conclusion that the most important job for me at the time was bringing up my 2 children and that was my “main” job, and nursing had to go on the backburner for a while, so I did nursing work that fitted in with my family.

    These things are entirely personal choices for nurses to make when they have a family. In a way really, I think nursing fits in with families, if you can get the casual shifts you need to pay the bills, keep your hand in on nursing and your registration and keep your family happy. I would think an ICU trained nurse should be able to get casual shifts to suit you, especially if you live in a city area where there are more workplaces to choose from.

    There is a transition to make to being a working mum and it usually involves accepting things are different now and there are limitations on your time and availability. One thing for sure, life is never the same now you’ve got children. Hope you can find a niche job/s April, to fit in with your family. And looks like someone has already offered you some other avenue in research. So there you go, it may suit you.

  11. DB says:

    Whilst you already have a job, I strongly agree with the sentiment that the easiest thing to do was go casual. True, you may miss some shifts if not required, but certainly handy for preferred shifts for kids and birthdays and holidays and trips to Nan’s and soccer and school interviews etc… and you are not throwing other people out. The flexibility may be required by you also – like evening shifts and as some have done Night duty – all shifts need nurses!

    As someone who does the rostering for our ICU and CCU and with a relatively small unit, I am happy to roster mothers at their request – sometimes it is not 100% easy but we usually manage. We have nurses who will only work M-W night … grandmothers now and baby sitting! They are casual and cancelled if not needed (rarely!) and much appreciated the rest of the time so we don’t have to do the shift. I place them as if permanent staff. Other casuals tell me when but realise if we are overstaffed (or under-patiented!) they will be sent to the ward.

    Some private hospitals have more flexibility. We even have 9am to 3pm shifts for mothers – I might try that myself now I am getting older … and I am often called a mother!
    Best wishes.

  12. Sandra says:

    As a re-entry nurse coming back to work after having my 4 babies, rotating roster has been so hard for me and my family. My kids aged 4-11 would cry as I told them I wouldn’t be there when they got home from school … or they hate having to be quiet in the house coz Mum’s on a night shift … or they hate that I’ve been rostered on 8 Saturdays in a row. I only work 2 days a week on my ward, but I still have a fulltime job at home.

    I know there is a world of fulltime working mothers out there … if it works for them that’s great, but that is not my choice for my family.

    I’m midway through a 2-year scholarship contract and I’m counting how many shifts left till I can go casual…

    But not a week goes by that I don’t wonder if I did the right thing by returning to nursing … a casual job in a supermarket might have been so much easier … it makes me sad to think like that coz I love nursing.

  13. NU_admin says:

    Sandra, you have done the right thing. Although it’s a long way off, your kids will grow up and then, would you rather be working in a supermarket or getting work satisfaction as a nurse? Too often nowadays women are struggling to get back into meaningful careers after having children. And it’s good for your children to see you doing something significant in your job. So hang in there!

    • A m b. says:

      Thanks for the encouragement. I know what you say is true… there just seem to be more days than not when I’m just exhausted at the end of my shift, then come home to my next shift of more work at home.

      And there are more days than not when I feel like I’m making a difference or giving the care that I feel my patients deserve.

      But I know that nursing is what I love and that’s why I fought for two years to get my registration back.

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