Yes to leisure, no to idle time
In healthcare, the idea of anyone having idle time at work would likely be met with a laugh. Our collective wisdom indicates that American workers are terribly busy, whether they are working in a nursing home, a school or in a corporate role. We pride ourselves on never having a free moment.
But if you dig into it, American workers are spending enough idle time that they are costing employers around $100 billion per year, according to Harvard Business School researchers.
In “Downside of Downtime: The Prevalence and Work Pacing Consequences of Idle Time at Work,” six studies examined pacing in a cross-occupational survey. In 29 occupations studied, 78% of employees had some kind of idle time. Results appeared in Journal of Applied Psychology.
What they found is when workers expect idle time following a task, they slow down, causing work pace to decline and task completion time to increase. Workers act to avoid idle time, which is different from leisure time or procrastination.
Idle time is when employees are available and supposed to be working but can't. Sometimes this is because of equipment might have broken down, or, in the case of a healthcare environment, it can be a shift scheduling problem, where too many workers are scheduled during “busy” times and not enough during other hours. Workers hate to be bored, so they might slow down their tasks if they know idle time awaits.
The other challenge with shift scheduling in a nursing home is that it is literally based on hours, whereas the authors note managers should evaluate employees based on outcomes rather than hours worked. It's also a challenge in a nursing home to introduce the use of leisure time rather than idle time. We'd all have the idea that the moment we told an employee, “If you finish this paperwork, you can surf the internet” is the moment when a surveyor will walk through the door.
But I do see a way to think about this study, and idle time, in a way that makes sense for the industry. Access to leisure time doesn't need to distract from productivity, the authors note. For example, when an employee finishes a task, a manager could encourage him or her to take a break and visit a favorite resident, read or go for a walk. Managers also can create a public leisure space separate from work.
That also brings us to breaks and how needed they are. There's good evidence breaks are necessary, especially in nursing. Without them, workers become physically and mentally tired, not only leading to a slower pace of work but worse decisions and greater likelihood of errors. There's also, of course, a perverse pride in not “needing” breaks. While nurses may say there's no one else to take over, “there is also often a culture of martyrdom, where nurses expect and are expected to deny their own needs for the sake of their work,” wrote Frieda Paton, RN, in NursesLab in 2016.
The concept of idle versus leisure time also may lead to a “physician heal thyself” moment for administrators. I suspect many of us who spend a lot of time writing or in meetings may find ourselves struggling to pace our work, meeting deadlines with a laser focus but other times chugging through a task that should take us a fraction of the time.
We're not robots, of course. But breaking down idle time, leisure time, and how staff meets deadlines may lead to a more productive nursing home.
Follow Senior Editor Elizabeth Newman @TigerELN.