Job Flexibility and Psychological Distress among Hospital Nurses

Although nurses are exposed to multiple time-related demands (e.g. fast pace work, shift work), little research has been conducted about flexible work arrangement as a strategy to promote occupational health and safety. We tested whether the usage of flexible options relevant to the nursing workforce (shift modifications and taking/making family-related phone calls) was associated with lower psychological distress among 1,492 hospital patient-care workers, nested in 104 units (work groups). Psychological distress was measured with the K6 questionnaire. Flexible practices were assessed with scores for individuals, units (aggregated means), coworkers’ (average of unit-mates), and intra-unit (individual difference relative to the unit). Between 6% to 15% of the variance of flexible practices was attributable to unit clustering. Individual shift modifications were linked with higher psychological distress (β= 0.04, p<0.05). Individual calls were linked with higher distress (β= 0.07, p<0.05), but coworkers’ calls with less distress (β= -0.10, p<0.05). Nurses with children (0-5 years) at home who reported not being allowed to make/take family phone calls reported higher distress (β=0.32, p<0.05). Although higher unit and coworker-level availability or usage of flexible options predicted less psychological distress, individuals who were more distressed may have utilized more their flexible options, provided they were allowed to do so. The contrast between individual and coworkers’ effects on psychological distress suggests a beneficial effect of organizational policies or practices that support addressing personal or family needs.