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How flexible scheduling benefits nurses in health care: A closer look

How flexible scheduling benefits nurses in health care: A closer look

Flexible scheduling is revolutionizing the nursing profession, offering significant benefits for both nurses and healthcare institutions. From Singapore’s Tan Tock Seng Hospital (TTSH) to Mercy Health in Ohio and Bon Secours Hampton Roads in Virginia, hospitals are adopting innovative scheduling systems to improve work-life balance, reduce turnover, and enhance patient care.

Tan Tock Seng Hospital: leading with flexibility

Tan Tock Seng Hospital (TTSH) in Singapore is set to implement a flexible work arrangement for all 2,500 nurses in its 27 inpatient wards by the end of 2024. Having piloted the "liquid nursing" initiative in October 2023 with 52 nurses in one ward, TTSH has extended the arrangement to 200 nurses across four wards. Approximately 90 percent of these nurses have opted for flexi-shifts.

Traditionally, nurses at TTSH work three routine shifts a day. However, with the new initiative, they can now choose a mix of routine and flexible shifts each week, provided they fulfill an 80-hour work requirement every fortnight. The flexible shifts range from four hours with variable timing to 12-hour shifts.

Chief Nurse Hoi Shu Yin highlighted that the nature of nursing requires routine shifts with handover processes. However, technology has shortened this process from an hour to about 15 minutes. Nurses on flexi-shifts handle specific duties, while those on routine shifts continue with their full responsibilities. Dr. Hoi believes this flexi-work arrangement will make the nursing profession more attractive and help retain staff, especially after the attrition rates stabilized post-pandemic.

Mercy Health: Creative shifts in Ohio

At Mercy Health-St. Rita's Medical Center in Lima, Ohio, the traditional scheduling demands for nurses have been replaced with "creative shifts." This centralized staffing and scheduling system allows the hospital to offer unconventional schedules while maintaining staffing levels.

The flexible shifts include 12-hour shifts starting at any time, 9 a.m. to 5 p.m. schedules, and tailored schedules for new mothers. Nurses also have the flexibility to choose their weekend shifts. Chief Nursing Officer Cory Werts emphasized that this system helps match organizational needs with individual priorities, significantly reducing nurse turnover from 23% during the pandemic to 12.5% today.

The flexibility has also bridged the experience gap between seasoned nurses and new entrants, ensuring experienced nurses remain to mentor the next generation.

Bon Secours Hampton Roads: Autonomy and float schedules

For three years, Bon Secours Hampton Roads in Virginia has embraced flexible scheduling with autonomous scheduling and float shifts. This system has helped retain nurses and reduced the need for agency staff.

The Accelerated Clinical Experience (ACE) program supports newly graduated nurses through their first year, helping them gain confidence and improve their skills. The float schedules allow nurses to work across different units or hospitals, enhancing their experience and flexibility.

The hospital offers completely autonomous scheduling, where nurses approve their own time cards and shifts, with oversight from a staffing optimization center. Schedulers create new schedules every month, ensuring a balance of new and experienced nurses in each unit. This approach has reduced open shifts, overtime, and the need for agency nurses.

Real-life impact: Improved work-life balance

The impact of flexible scheduling is evident in the stories of individual nurses. At TTSH, Senior Staff Nurse Tan Jia Hui opted for two rotational shifts a week to spend more time with her two-year-old son, avoiding night shifts. Similarly, Ms. Manjares Melody Blag, a Filipino senior staff nurse, chose flexi-shifts to balance work with caring for her eight-month-old son, improving her quality of life.

At Mercy Health, the creative scheduling has allowed new mothers to transition back into the workplace smoothly, while at Bon Secours Hampton Roads, autonomous scheduling has enabled nurses to tailor their work hours to their personal needs.


Flexible scheduling in healthcare not only enhances the work-life balance for nurses but also improves retention rates and patient care quality. As hospitals like TTSH, Mercy Health, and Bon Secours Hampton Roads demonstrate, such innovative approaches are key to addressing the challenges in the nursing profession and ensuring a sustainable workforce for the future.

Source: The Straits Times, Becker's Healthcare


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