"I need to have a fulfilling job": A qualitative study of surgeon well-being and professional fulfillment.

BACKGROUND: Burnout, often regarded as an individual failing, rather than a systemic one, negatively impacts quality of care, patient safety and healthcare costs. Focusing on improving well-being can help mitigate burnout. This study examined protective factors that promote well-being and professional fulfillment in surgeons. METHODS: Using a purposive sample, 32 semi-structured 30-60-min interviews were conducted with surgeons of varying sub-specialties and rank. Abductive exploratory analysis was used to code and interpret interview transcripts and to build a conceptual model of surgeon well-being. RESULTS: Emergent protective factors were placed into one of three levels of implementation: individual, team-level, and institutional (figure). Individual factors for well-being included autonomy and adequate time to pursue non-clinical endeavors. Team-level factors consisted of adaptability, boundaries, and cohesion. Institutional factors related to diversifying performance evaluations and celebrating and recognizing individual value and contributions. CONCLUSIONS: The conceptual model developed from the results of this study highlights factors important to surgeons' professional well-being. This model can be used to guide quality improvement efforts.

Consultant staffing in UK congenital cardiac services: a 10-year survey of leavers and joiners.

OBJECTIVES: To report the numbers of consultant congenital cardiac surgeons and cardiologists who have joined and left UK practice over the last 10 years and explore the reasons for leaving. METHODS: Retrospective observational questionnaire study completed between 11 June 2019 and 1 July 2020 by UK level 1 congenital cardiac centres of 10-year consultant staff movement and reasons suggested for leaving UK practice. RESULTS: At survey completion there were 218 (202 whole time equivalent (WTE)) consultant cardiologists and surgeons working within level 1 centres made up of 39 (38 WTE) surgeons, 137 (128.5 WTE) paediatric cardiologists, 42 (35.5 WTE) adult congenital heart disease (ACHD) cardiologists. 161 (74%) consultants joined in the last 10 years of whom 103 (64%) were UK trained. There were 91 leavers giving a staff turnover rate 42% (surgeons 56%, paediatric cardiologists 42%, ACHD cardiologists 29%). Of those, leaving 43% moved to work abroad (surgeons 55%, paediatric cardiologists 40%, ACHD cardiologists 67%). Among the 65 reported reasons for leaving 16 were financial, 9 for work life balance, 6 to working conditions within the National Health Service (NHS) and 12 related to the profession in the UK including six specifically highlighting the national review process. CONCLUSIONS: There has been a high turnover rate of consultant staff within UK congenital cardiac services over the last 10 years with almost half of those leaving moving to work overseas. Financial reasons and pressures relating to working in the NHS or the specialty in the UK were commonly reported themes for leaving. This has major implications for future planning and staff retention within this specialised service.

Modifiable factors to improve work-life balance for trauma surgeons.

INTRODUCTION: A balance between work and life outside of work can be difficult for practicing physicians to achieve, especially for trauma surgeons. Work-life balance (WLB) has been associated with burnout and career changes. The specific aim of this study was to investigate factors associated with WLB for trauma surgeons. We hypothesized that trauma surgeons are dissatisfied with their WLB, and there are modifiable factors that can be adjusted to improve and maintain WLB. METHODS: Survey study of AAST members including detailed questions regarding demographics, clinical practice, family, lifestyle, and emotional support. Primary outcome was WLB, while the secondary outcome was surgeon burnout. RESULTS: A total of 1,383 American Association for the Surgery of Trauma members received an email with the survey, and 291 (21%) completed the survey. There was a total of 125 members (43%) satisfied with their WLB, and 166 (57%) were not. Factors independently associated with satisfying WLB included hobbies (2.3 [1.1-4.7], p = 0.03), healthy diet (2.6 [1.2-4.4], p = 0.02), exercise (2.6 [1.3-5.1], p = 0.006), vacation weeks off (1.3 [1.0-1.6], p = 0.02), and fair compensation (2.6 [1.3-5.3], p = 0.008). Conversely, factors independently associated with a poor WLB included being midcareer (0.3 [0.2-0.7], p = 0.002), more work hours (0.4 [0.2-0.7], p = 0.006), fewer awake hours at home (0.2 [0.1-0.6], p = 0.002), and feeling that there is a better job (0.4 [0.2-0.9], p = 0.02]. Risk factors for burnout were the same as those for poor WLB. CONCLUSION: Only 43% of trauma surgeons surveyed were satisfied with their WLB, and 61% reported burnout. Modifiable factors independently associated with a satisfying WLB were related to lifestyle and fair compensation. Factors independently associated with poor WLB and suffering burnout were being midcareer, increased hours at work, decreased awake hours at home, and feeling that there was a better job for yourself. Many factors associated with trauma surgeon WLB are modifiable. Trauma surgeons, as well as trauma leaders, should focus on these modifiable factors to optimize WLB and minimize burnout. LEVEL OF EVIDENCE: Care management, Level III.

From staff nurse to nurse consultant: Survival Guide part 9: Combining parenthood and work.

John Fowler, Educational Consultant, explores how to survive your nursing career.

Gender Discrepancies Related to Pediatrician Work-Life Balance and Household Responsibilities.

BACKGROUND: Physicians must balance career and home responsibilities, yet previous studies on work-life balance are focused primarily on work-based tasks. We examined gender discrepancies and factors related to household responsibilities and work-life balance among pediatricians. METHODS: We used 2015 data from the American Academy of Pediatrics Pediatrician Life and Career Experience Study, a longitudinal study of early-career pediatricians. χ2 tests and multivariable logistic regression were used to examine the effects of gender on household responsibilities, satisfaction, and work-life balance attainment. We formally reviewed responses from 2 open-ended questions on work-life balance challenges and strategies for common themes. RESULTS: Seventy-two percent of participants completed the survey (1293 of 1801). Women were more likely than men to report having primary responsibility for 13 of 16 household responsibilities, such as cleaning, cooking, and routine care of children (all P < .001). All gender differences except budget management remained significant when controlling for part-time work status and spouse or partner work status (P < .05). Women were less satisfied with their share of responsibilities relative to others (52% vs 62%; P < .001), and few women and men report being very successful at achieving balance between their job and other life areas (15% vs 19%, respectively; P = .05). Open-ended responses (n = 1145) revealed many barriers to achieving work-life balance. Strategies to increase work-life balance included reducing work hours, outsourcing household-related work, and adjustments to personal responsibilities and relationships. CONCLUSIONS: Female pediatricians spend more time on household responsibilities than male pediatricians, and gender is a key factor associated with work-life balance satisfaction.

Formal and Informal Work-Life Balance Practices of Athletic Trainers in Collegiate and University Settings.

CONTEXT: Organizational policies for work-life balance exist, but little is known about athletic trainers' (ATs') awareness of and willingness to use them. OBJECTIVE: To explore ATs' formal and informal work-life balance policies in the collegiate and university athletic training setting. DESIGN: Sequential mixed-methods study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: We sent 4673 e-mails to National Athletic Trainers' Association ATs (full-time employment for at least 1 year, nonacademic appointment); 1221 participants began our survey (access rate = 26.1%), and 783 completed the survey (64.1% completion rate). Demographics were as follows: men = 375 (48.0%) and women = 404 (51.7%); age = 36 ± 10 years; experience = 13 ± 9 years; years at current place of employment = 8 ± 8 years; and participants with children or minor dependents = 262 (33.5%). MAIN OUTCOME MEASURE(S): We created a 17-item instrument from an earlier qualitative study. A panel of experts (n = 3; employer, employee, and researcher) completed a content analysis. Variables of interest were confidence (scale = 1-4) and satisfaction (scale = 1-5) with policies. We used Pearson χ2 analyses to compare the effect of undergoing an orientation and the presence or absence of children on the main outcome measures. RESULTS: A majority of participants had experienced formal orientation through the human resources department (n = 522, 66.8%), the direct supervisor (n = 240, 30.7%), or a colleague (n = 114, 14.6%). However, many had received no orientation (n = 184, 23.6%). Those who had undergone orientation indicated greater confidence in knowing about (P < .001) and greater satisfaction with (P < .001) formal workplace policies and benefits. Those with children stated that they had greater confidence in knowing about (P < .001) and greater satisfaction with (P = .013) formal workplace policies and benefits. Those who had been oriented felt greater confidence in knowing about (P = .009) but no difference in satisfaction with (P = .060) informal workplace policies and benefits. We did not identify differences between those with and those without children regarding their confidence in knowing about (P = .653) or satisfaction with (P = .150) informal workplace policies and benefits. CONCLUSIONS: Athletic trainers in the collegiate and university setting were not confident in their knowledge of formal or informal work-life balance policies.

[Keys for well-being and fulfilment at work]. / Des clés pour le bien-être et l'épanouissement au travail.

If organizations seek to be profitable, they have no choice but to help their employees live in harmony, to be serene and creative. Well-being at work is largely linked to our ability to adapt to the moving reality of the company, without losing ourselves. Guides and methods help to live this reality as well as possible.

Moderated mediation between work life balance and employee job performance: the role of psychological wellbeing and satisfaction with coworkers / La mediación moderada entre el equilibrio vida-trabajo y el desempeño laboral: el papel del bienestar psicológico y de la satisfacción con los compañero

This research examined a moderated mediation model for answering how and why work-life balance affects employee job performance, and how satisfaction with coworkers is contingent upon it by enhancing employee’s psychological wellbeing. Data were collected from subordinates and their supervisors in the banking sector (N= 284). Empirical results indicate that psychological wellbeing mediates the link between work-life balance and job performance, and employees’ satisfaction with coworkers enhances job performance by strengthening the effect of work-life balance on psychological wellbeing. This research contributes to personnel management literature by describing moderated mediation mechanisms through which work-life balance influences employee job performance, and guides practitioners by emphasizing that employees with greater work-life balance perform better when their psychological wellbeing is reinforced by their satisfaction with coworkers

Esta investigación examina un modelo de mediación moderada para responder cómo y por qué el equilibrio entre vida personal y laboral afecta el desempeño del trabajo de los empleados y cómo la satisfacción con los compañeros de trabajo influye en ello al mejorar el bienestar psicológico de los empleados. Se recabaron datos de subordinados y sus supervisores del sector bancario (N= 284). Los resultados empíricos indican que el bienestar psicológico media el vínculo entre el equilibrio de vida personal y laboral y el desempeño del trabajo, y la satisfacción de los empleados con los compañeros de trabajo mejora el desempeño del trabajo, fortaleciendo el efecto de este equilibrio en el bienestar psicológico. La investigación contribuye a los estudios sobre gestión de personal mediante la descripción de mecanismos de mediación moderada, a través de los cuales el equilibrio entre la vida personal y la vida laboral influye en el desempeño laboral de los empleados, y sirve de guía a los gestores de personal al destacar que los empleados con mayor equilibrio entre vida personal y laboral obtienen mejor desempeño cuando su bienestar psicológico se ve reforzado por su satisfacción con los compañeros de trabajo

Effects of a Flexibility/Support Intervention on Work Performance: Evidence From the Work, Family, and Health Network.

PURPOSE: To estimate the effects of a workplace initiative to reduce work-family conflict on employee performance. DESIGN: A group-randomized multisite controlled experimental study with longitudinal follow-up. SETTING: An information technology firm. PARTICIPANTS: Employees randomized to the intervention (n = 348) and control condition (n = 345). INTERVENTION: An intervention, "Start. Transform. Achieve. Results." to enhance employees' control over their work time, to increase supervisors' support for this change, and to increase employees' and supervisors' focus on results. METHODS: We estimated the effect of the intervention on 9 self-reported employee performance measures using a difference-in-differences approach with generalized linear mixed models. Performance measures included actual and expected hours worked, absenteeism, and presenteeism. RESULTS: This study found little evidence that an intervention targeting work-family conflict affected employee performance. The only significant effect of the intervention was an approximately 1-hour reduction in expected work hours. After Bonferroni correction, the intervention effect is marginally insignificant at 6 months and marginally significant at 12 and 18 months. CONCLUSION: The intervention reduced expected working time by 1 hour per week; effects on most other employee self-reported performance measures were statistically insignificant. When coupled with the other positive wellness and firm outcomes, this intervention may be useful for improving employee perceptions of increased access to personal time or personal wellness without sacrificing performance. The null effects on performance provide countervailing evidence to recent negative press on work-family and flex work initiatives.

Double- and Triple-Duty Caregiving Men: An Examination of Subjective Stress and Perceived Schedule Control.

Based on the stress process model of family caregiving, this study examined subjective stress appraisals and perceived schedule control among men employed in the long-term care industry (workplace-only caregivers) who concurrently occupied unpaid family caregiving roles for children (double-duty child caregivers), older adults (double-duty elder caregivers), and both children and older adults (triple-duty caregivers). Survey responses from 123 men working in nursing home facilities in the United States were analyzed using multiple linear regression models. Results indicated that workplace-only and double- and triple-duty caregivers' appraised primary stress similarly. However, several differences emerged with respect to secondary role strains, specifically work-family conflict, emotional exhaustion, and turnover intentions. Schedule control also constituted a stress buffer for double- and triple-duty caregivers, particularly among double-duty elder caregivers. These findings contribute to the scarce literature on double- and triple-duty caregiving men and have practical implications for recruitment and retention strategies in the health care industry.

Perceptions of Work-Life Balance Practices Offered in the Collegiate Practice Setting.

CONTEXT: Organizational factors have been identified as barriers to finding work-life balance (WLB) in athletic training. Despite the existence of organizational policies to address WLB, little is known about athletic trainers' (ATs') awareness of these policies that could assist them. OBJECTIVE: To better understand the perceptions of ATs regarding the workplace practices available to them, which may help them achieve WLB. DESIGN: Phenomenologic study. SETTING: Collegiate practice setting. PATIENTS OR OTHER PARTICIPANTS: Twenty-one ATs (women = 10, men = 11) employed at the collegiate level (National Collegiate Athletic Association Division I = 12, Division II = 5, Division III = 4) volunteered for our study. The average age of the participants was 33 ± 9 years. Saturation of the data was met at n = 21. DATA COLLECTION AND ANALYSIS: Participants completed an in-depth, 1-on-1 phone interview, which was then transcribed verbatim. Data were analyzed using a phenomenologic approach. Credibility was determined by member checks, peer review, and researcher triangulation. RESULTS: Our analyses revealed that participants (1) had a limited awareness of formal policies that were offered within their university or collegiate infrastructure; (2) used informal policies to manage their personal, family, and work obligations; and (3) thought that more formal policies, such as adherence to adequate staffing patterns and work schedules, could help establish WLB within collegiate athletic training settings. CONCLUSIONS: Informal workplace policies were more commonly used by our participants and were viewed as a means of creating a supportive atmosphere. Administrators and supervisors should consider creating or endorsing more formal policies specific to the demands of an AT in the collegiate setting to help with WLB.

Work/Family Balancing and 24/7 Work Schedules: Network Analysis of Strategies in a Transport Company Cleaning Service: Concilier travail-famille et horaires 24/7: analyse réseau des stratégies au sein du service de nettoyage d'une compagnie de transport.

Whether or not official work/family balance measures exist within an organization, scheduling accommodations often go through informal channels involving colleagues and superiors and are negotiated within interpersonal relationships. This study examines the relationship dimensions of the scheduling strategies of cleaners working atypical hours in the transport sector through the lenses of ergonomic activity, network, and gender analyses. Using semi-directed interviews, observation, and network analysis, we revealed the effect of gender on relationship dynamics and the influence of these dynamics on work/family balance strategies deployed by cleaners. One of the main contributions of this study is to demonstrate the decisive effect of relationships by revealing inequalities in access to organizational social networks. Creating spaces to discuss work/family balancing and a more equitable circulation of information could contribute to reducing inequalities associated with gender, social status, and family responsibilities and support the work/family strategies developed by workers dealing with restrictive work schedules. Résumé Les accommodements du temps de travail pour la conciliation travail-famille (CTF) passent souvent par des ententes informelles qui s'inscrivent dans les relations entre collègues ou avec des gestionnaires. Notre étude, intégrant l'ergonomie et la communication dans une perspective de genre, porte sur les dimensions relationnelles des stratégies de choix d'horaire d'agentes et agents de nettoyage devant composer avec des horaires atypiques dans le secteur des transports. À partir d'entretiens semi-dirigés, d'observations et d'analyse de réseaux, nous avons pu observer l'influence des dynamiques relationnelles, notamment de genre, sur les stratégies de CTF. Un apport central de cette étude est de montrer l'effet structurant des relations en révélant notamment des inégalités dans l'accès aux ressources facilitant le choix d'horaire, mais aussi dans l'inclusion au sein du réseau de relations. L'article conclut en proposant des pistes de solutions concrètes pour la réduction de ces inégalités.

A proposed surgical training pathway for the 21st century.

Numerous problems have been identified with current UK surgical training. These include the balance between generalist and specialist practice, service provision and training time, and work-life balance. This article proposes modifications to the current training pathway. A three-stage training model is discussed using modular training to clearly identify training aims and endpoints and allow flexibility in training and working practices. This will help with workforce planning and work-life balance and support high quality patient-focused surgical training in the 21st century.