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Work Life Balance: Myth or Reality?

Vanore, Marla L. RN, MHA, President, Society of Trauma Nurses

Section Editor(s): Vanore, Marla L. RN, MHA

President's Message

Marla L. Vanore, RN, MHA, is President, Society of Trauma Nurses, Glenview, Ill, and Trauma Program Manager, Children's Hospital of Philadelphia, Philadelphia, Pa.

Corresponding author: Marla L. Vanore, RN, MHA, Children's Hospital of Philadelphia, 1 North Tower, Room 1020, 34th and Civic Center Boulevard, Philadelphia, PA 19104 (e-mail:

How many hours do you spend working during an average week? Do you regularly check your e-mail on the week end; do you keep up with e-mails while you are on vacation because you do not want to come back to hundreds of messages? If you are single or an empty nester, do you think that you might as well work since there are no children at home waiting for you?

More and more people are working longer hours and allowing themselves less down time. Doing a search online easily illustrates that this is a pervasive problem that is even affecting workers outside of the United States. Some companies have been in the news lately because, in an effort to ensure that their employees are taking time off without keeping in touch through e-mail, they are closing for a week at a time, usually between Christmas and New Years. Unfortunately, that is not an option in healthcare.

What drives this need to work constantly? There are numerous causative factors. Increased connectivity, originally thought to be a means to help work life balance, has now become one of the biggest problems. Not only can we check our e-mail from home but we can use our blackberries to check e-mail everywhere that we go. We can be in touch constantly, and now bosses and coworkers have come to depend on always being able to reach us. Connectivity forces us to try to do more all of the time, and essentially, it just means that we are working more hours even when we are at home.

Some of us who have been in the same or similar role for a number of years feel that we need to look outside of our job for more interesting challenges. That may mean publishing, speaking, and being involved in professional organizations. However, all of these activities take more time and is usually done in addition to our usual jobs.

The need for work is fueled by many other demons. All industry including healthcare is trying to be more efficient. The phrases "don't work harder, work smarter" sounds good, but many employees want us to work harder and smarter. As we are all very aware, Trauma Programs are frequently under funded and under staffed, so we all try to do as much as we can with very few resources. Consequently, we feel that we have to work longer hours just to keep up. Some fear that if they do not do that, they will lose their jobs. Although healthcare jobs are numerous in most areas, it may not be the same type of job and most of us do not want to "fail" at our jobs.

Many times we are our own worse enemies. We are insecure about our own abilities and feel that we have to work longer hours in order to survive. Instead of looking for ways to delegate or negotiating with our bosses, we just try to be superhuman and do everything.

The fact that in healthcare we may be dealing with life or death issues makes it all the more harder to leave for the day. Sometimes working longer hours becomes addictive. We start to forget what it is like to relax and we feel as though we are slacking off if we do not work 10 to 12 hours a day. In addition, our bosses begin to expect a certain volume of work from us. Instead of realizing that the volume of patients has doubled in the last 10 years, so the same 3 to 4 people cannot possibly run the trauma program; they get used to expecting more and feel that you are doing just fine.

So what does all of this work do to us? Burnout is still very real. Oddly enough, working all of the time does not really make us better workers. Creativity decreases, productivity decreases, and eventually our health becomes affected possibly causing us to need to take off more sick days. Personally, when I am working too hard for too long, I find difficulty focusing on even the simplest thing. Reading the newspaper or a magazine becomes difficult. I also start to feel down because, as much as I enjoy the work that I do, I also enjoy relaxing, gardening, and visiting museums, but if I work too much, I do not have the time or energy to do any of those things. Many people eat more, eat more convenient junk foods, and dispense with exercise because they do not have time. Stress may interfere with sleep or we may work so many hours or try to balance child or elder care responsibilities so much that we do not even have time to sleep.

Working too hard and not allowing ourselves time for relaxation usually increases stress, which also affects our health and life span. Many times it also has an adverse effect on our relationships and may affect our children, whether young or adolescent, if we are not around when they need us.

What can we do to avoid being caught in this trap? First, I believe that we need to reflect on how we contribute to the problem. What do we get out of always being too busy? Is this a way to avoid certain parts of our life that we do not want to deal with or does our personal life bore us? Do we really believe that our job cannot be accomplished in anywhere close to 40 hours a week? Do we have the personal expectation that we have to work 60 or more hours? Do we not even try to leave work or stop working at a reasonable time?

We need to realize that we are part of the problem and start to take our lives back. A job is only a job. We should not exist to work. Work gives us a paycheck; hopefully, it is fulfilling on a number of different levels, but it should not be our entire life. I have always been a strong proponent of striving to work a comfortable number of hours. I choose what I get involved in very carefully and limit the number of things that I say yes to. When I take on one thing, I am very likely to give up something else. I know that I can only do so much and I always want to excel in what I do but I build in down time. Even as I serve my term as President of the Society of Trauma Nurses, I hold a certain expectation as to how much time I need to invest in my job and this role. I make sure that I preserve time for myself and my friends and family. It is definitely a struggle, and I cannot say that I am always successful but I am closer to that goal since I keep it as a goal. When searching for a job, I have always looked for positions that would respect my work life balance, jobs that had sufficient staff and support. I have always known that I would need to leave a job if this was not possible. I also encourage my staff to keep their lives in balance. I am more likely to reward the employee who does a good job but makes sure to leave and enjoy his or her time away from work rather than the person who is always telling me about the number of hours he or she works.

There are always times when we need to increase the amount that we are working but we need to make these special occasions. It may be right before a trauma site survey or before some other big event, but we must always be vigilant to return to a normal work schedule when this time is past. Therefore, work life balance can be a reality but only we can make it happen for ourselves. Only we can be the gatekeepers of our own time. No one is going to do it for us. However, there is a reward. Maintaining work life balance will make us a better employee and a happier person.

Copyright © 2006 by the Society of Trauma Nurses.