WORK LIFE BALANCE OF NURSES WITH SPECIAL REFERENCE TO

PRIVATE HOSPITAL

1
 CHAPTER I
INTRODUCTION
An organization needs to attract and retain valued employees in a highly
competitive labour market is a strong motivating factor for increased organizational
awareness and action with regard to human resource policies and practices that
address work life balance. Work life balance is an important area of human resource
management that is receiving increasing attention from government, researchers,
management and employee representatives and the popular media ( Pocock, Van
Wanrooy, Strazzare and Bridge, 2001; Russell and Bowman, 2000).
In 1986, work-life balance was first used to describe the trend of individuals
spending more time on work and less time on other aspects of their lives (Lockwood,
2003). The term ‘Work Life Balance’ has been used to describe the balance between
an individual’s work and personal life and feeling comfortable with both work and
non work commitments. Early interest in work life balance was driven by the erosion
of the ‘male bread winner model’, due to increased entry of women in the labor
market. Since the second half of 20th century the nature of work has changed and
concerns regarding quality of life are increasing which has made work life balance a
hot topic of research among the policy makers and researchers.
Work-life balance has been defined differently by different scholars. In order
to broaden our perspectives, some definitions are presented. Greenhaus (2002)
defined work –life balance as satisfaction and good functioning at work and at home
with a minimum of role conflict. Felstead et al. (2002) defines work-life balance as
the relationship between the institutional and cultural times and spaces of work and
non-work in societies where income is predominantly generated and distributed
through labor markets. Aycan et al. (2007) confined the subject only with work and
family and put forward the concept of “life balance” with a more whole perspective.
Clark (2000) defines balance as “satisfaction and good functioning at work and at
home with a minimum of role conflict”.
According to Fisher (2001) work life balance, includes both work/personal life
interference as well as work/personal life enhancement and gives three dimensions of
work life balance, i.e.,
• Work interference with personal life
• Personal life interference with work

2
 • Work/Personal life enhancement
The following are working definitions of terms used regarding work/life balance:
• Work/family: A term more frequently used in the past than today. The current
trend is to use title that include the phrase work/life, giving a broader work/life
connotation or labeling referring to specific areas of support (e.g., quality of life,
flexible work options, life balance, etc.)
• Work/life conflict: The push and pull between work and non work
responsibilities.
• Work/life balance from the employee viewpoint: The dilemma of managing
work obligations and personal/family responsibilities.
• Work/life balance from the employer viewpoint: The challenge of creating a
supportive company culture where employees can focus on their jobs while at
work.
• Family-friendly benefits: Benefits that offer employees the latitude to address
their personal and family commitments, while at the same time not compromising
their work responsibilities.
• Work/life programs: Programs (often financial or time-related) established by
an employer that offer employees options to address work and personal
responsibilities.
• Work/life initiatives: Policies and procedures established by an organization
with the goal to enable employees to get their jobs done and at the same time
provide flexibility to handle personal/ family concerns.
• Work/life culture: The extent to which an organization’s culture acknowledges
and respects the family responsibilities and obligations of its employees and
encourages management and employees to work together to meet their personal
and work needs.

Work life balance refers to the effective management of multiple

responsibilities at work, at home, and in the other aspects of life. It is an issue that is
important both to the organizations and to employees. Work life balance are the
employee feelings that they are freely able to use flexible work hours program to
balance their work and other commitments like, family, hobbies, art, travelling,
studies and so forth, instead of only focusing on work. This shows that provision of
good work - life balance leads to the activities that lead to satisfaction of employees

3
and make them a good contributor in the organizational performance. Good work life
balance is defined as a situation in which workers feel that they are capable of
balancing their work and non - work commitment. Improving the quality of work life
balance facilities not only helps in improving the productivity but also helps in
increasing employee loyalty and job satisfaction.
Work life balance has important consequences for employee attitudes towards
their organizations as well as for the lives of employees. The belief that organization
cares about employee well being has a positive impact both for employee and the
employers, that are employee satisfaction, and the organizational commitment and
intention to remain with the organization.
The study of work-life balance includes an insight into the factors which
contribute to a proper Work Life Balance, the relationship between Work Life
Balance and job satisfaction, stress and Work Life Balance, benefits of an effective
Work Life Balance, the policies adopted by organizations towards balancing work and
personal life and the awareness and preference of employees towards it. The positive
effect of proper Work Life Balance are motivation towards work, positive job
satisfaction, improving employee morale and productivity, enough time for personal
and family life, improved health condition etc.
The negative effect of an imbalance in work life is associated with a myriad of
indicators such as job stress, work-life conflicts, absenteeism, high attrition rate,
burnouts, job switching , work alcoholism, health issues etc. When the work-life
balance is not achieved, the concept of work-family conflict is raised, which describes
a type of interrole conflict, wherein at least some work and family responsibilities are
not compatible and have a resultant effects on each domain (Greenhaus & Beutell,
1985). This conflict could possibly impact productivity, turnover, satisfaction,
motivation, morale, and organizational commitment of employees.
Work life balance of an employee is influenced by individual related variables,
work related variables and family related variables. Individual related variables
include gender, age, marital status, emotional intelligence, etc. Work related variables
include task variety, task autonomy, task complexity, role conflict, work schedule
flexibility, number of hours worked etc. Family related variable include spouse
support, spouse work hours, couple’s employment status, number of children, parental
responsibilities, home responsibilities etc.

4
The consequences of employee work-life imbalance
Previous research studies show that work life imbalance results in grave
consequences for employers, employees and organization. Personal and societal
consequences of work-life imbalance, according to Hobson, Delunas and Kesic (2001)
include:
• Increased level of stress and stress-related illness.
• Lower-life satisfaction.
• Higher rates of family strife, violence, and divorce.
• Rising incidence of substance abuse.
• Growing problems with parenting and supervision of children and adolescents.
• Escalating rates of juvenile delinquency and violence.

The continuous inability of employees to balance work and life responsibilities

according to Hobson, Delunas and Kesic (2001) can have the following organizational
consequences:
• Higher rates of absenteeism and turnover.
• Reduced productivity.
• Decreased job satisfaction.
• Lower levels of organizational commitment and loyalty.
• Rising healthcare cost.

The benefits of work-life balance

Positive work-life outcomes for employees are key ingredients of a successful
business strategy. Where the right balance is found and sustained, both the employee
and the employer gains.
Benefits for the employee :
Many factors improve where the employee is able to find the right balance.
Some of these factors, according to Vlems (2005) include:
• Increased employees happiness: Employees would be happier when they are
able to balance their work and life demands.
• Improved relations with management: Perceived support of management
towards employees work-life balance fosters a good relationship between the
workforce and management which itself improves effective communication
within the company.

5
• Improved employee’s self-esteem, health, concentration, and confidence.
• Employee loyalty and commitment: These increases with opportunities for
work-life balance. Employees are more likely to stay with an organization when
there are opportunities for achieving work-life balance.
• Tasks are managed better, increased motivation, and reduction in the level of
stress among employees.

Benefits for the employer

Generally, the following factors, as Vlems (2005) notes, improve for the
employer:
• Maximized available labour: The workforce will be very motivated and so the
employer can benefit from maximized available labour. Every employee will give
their very best during the working hours.
• The balance makes employees feel valuable: Implementing work-life balance
programmes gives an impression that the organization cares about the employees.
Thus, they will feel more valuable and work harder as a result.
• The work environment will be less stressful: Which means less stress related
illnesses and decreased health care costs.
• Employer of choice: The presence of work-life balance programmes in an
organization makes it attractive to a wider range of candidates when it comes to
recruitment.
• Increased loyalty and decreased absenteeism: The workforce will be more loyal
and motivated, absenteeism will be reduced and productivity of the organization
will increase.

Work Life Balance Options

Work-life balance programmes (WLBPs) are those institutionalised and
procedural arrangements, as well as formal and informal practices that make it easier
for employees to manage the often conflicting worlds of work and non- work.
Work-life balance initiatives designed to help employees balance their work
and personal lives are not only an option, but also a necessity for many employers
today.

6
 There is a need for organizations to adopt human resource strategies and
policies that accommodate the work-life needs of a diverse workforce in the current
business environment.
As Vlems (2005) notes, when organizations decide to facilitate their
employees’ work-life balance, they choose from a wide array of options that include:
(a) Flexi-time
Flexi-time is a scheduling policy that allows full-time employees to choose
starting and ending times within guidelines specified by the organization. It works
well for full-time office staff, but not in shift patterns or in a production line. Flexi-
time allows an employee to attend to non-work demands without having to take time
off work.
(b) Compressed working hours
This is a system of a four day working week. An employee can work his total
number of agreed hours over a shorter period. For example, an employee can work his
or her hours over four days in a week instead of five, and thus, gains a day for himself.
(c) Job-sharing
Job-sharing is a system where two people share a job. They both have the same job,
but split the hours, so that each employee has a part-time position. Apart from
splitting the hours, they also split the payments, holidays and benefits. The idea is to
afford employees ample time to attend to non-work activities so as to be able to
achieve a good measure of work-life balance.
(d) Breaks from work
By taking breaks from work once in a while, the right balance between work
and life can be achieved. These breaks should not only be about maternity, paternity
and parental leave, but also time off for career breaks and sabbaticals.
(e) Self-rostering
Employees can roster their hours the way they want to. The organization
checks every day the number of staff and skills required and lets the employees then 8
decide which of hours they would like to work. Employees are thus able to schedule
their time conveniently between work and non-work activities.
(f) Teleworking
Employees, with the aid of modern communication technology carry out their
jobs without necessarily having to be at the office. Often, they can work from home or
in satellite offices (telecentres) rented by the organization close to where they live.

7
Teleworking allows employees to attend to family or non-work issues so long as it
does not affect their output or the quality.
(g) Child care
People with families do not have the luxury to stay at home anymore and take
care of the children. The trend is towards dual-earning families as life has become too
expensive to let a potential money-maker stay at home. Thus, the demand for child
care options as a means of helping employees achieve work life balance is becoming
increasingly important (Vlems, 2005). Some popular child care options include
Crèche, Day-nursery, after school child care etc.

Job Satisfaction
Job satisfaction is the most studied variable in organizational research (Spector,
1997). The most-used research definition of job satisfaction is by Locke (1976), who
defined it as “a pleasurable or positive emotional state resulting from the appraisal of
one’s job or job experiences”. Balzer, et al. (1997) defines job satisfaction as the
feelings a worker has about his or her job experiences in relation to previous
experiences, current expectations, or available alternatives. Job satisfaction is simply
how people feel about their jobs and different aspects of their jobs.
The attitude and feelings of the people towards their work has a direct bearing
and reference to ‘job satisfaction’. Positive attitude towards the job signifies job
satisfaction and vice versa. Job satisfaction does not depend on any particular aspect
of the job. The level of job satisfaction is affected by intrinsic and extrinsic factors,
the quality of supervision, social relationships with the work groups and the degree to
which individuals succeed or fail in their work. It also refers to the extent to which an
individual’s needs are satisfied.
Job satisfaction can be influenced by variety of factors. Opkara (2002)
described that “factors such as pay, the work itself, supervision, relationships with co-
workers and opportunities for promotions have been found to contribute to job
satisfaction.” Working hours and nature of work both are the primary contributors to
job satisfaction. Flexibility in schedule of work is important for job satisfaction as
flexible time table and shorter hours of work allow employees to balance work and
family life better.
Similar to European and western countries, India has witnessed several
changes in the work force demographics, like rising number of women(Census of

8
India, 2001), escalating number of dual income families and nuclear families (Bharat,
2003; Buddhapriya, 2009). These rapid transitions have put substantial strain on men
and women to balance their work-life and family-life. How individuals can be
successful in their working lives without sacrificing their personal lives is a debatable
issue (Lewis and Cooper, 2005). As a result of intensification of work demands, there
seems to be a continuous focus on work-life balance.
The debate on the issues of job satisfaction has been in discussion for a long
time but its relationship with Work Life Balance (WLB) gained importance in the
recent past. Providing Work Life Balance facility creates a cooperative atmosphere
between the employer and the employee.
Nowadays, the studies of job satisfaction and work life balance go hand in
hand. Previous researches have indicated that organizations which provide various
work life balance practices to their employees experience improved productivity and
reduced turnover. Employees of such organizations are motivated and satisfied with
their personal and professional life.

Work Life Balance

Do we live to work or we work to live? Research has shown that work and
home (or family) are the two most important domains in the life of an employed
individual. While some may argue that we realise ourselves through work – being
able to self-actualise – attaining unto the very zenith of our chosen career, a truly all
encompassing self actualisation however, will integrate both our work and life (family,
personal life, community service). When an individual is thus employed in an
organisation, he does not give up his life in exchange for work rather he attempts to
maintain a balance between them. This balance is necessary for a healthy life.
For many employees, the day is not over when they go home. Often, a second
day of work starts at home and for most working mothers, they come home to the
second shift (assuming the inescapable role of a wife and a mother). The challenge of
balancing work and family (non-work) demands is one of today‟ s central concerns
for both individuals and organisations. People who have better balance have a greater
job satisfaction and perform better in their position.
They have a bigger loyalty and a higher level of trust. In many of today’s
workplaces, employers are cutting cost mainly through lay-offs and are placing more
demands on the lean staff left behind. The excuse is to stay afloat in the wake of a

9
global economic recession. The implication however, is that the more time and energy
employees give to work, the less they have to give to the other important aspects of
their lives, thus creating a work-life balance problem with its attendant negative
consequences for both the employee and the organisation.
When an individual maintains a balance between his personal and professional
life, the phenomenon is called Work-Life Balance. This expression holds worth a lot
because it is very important to have a balance between personal and professional life.
Work life balance is at the forefront of the world of work. Kaizen, the Japanese
philosophy for continuous improvement, along with the role of information
technology (IT) helps and guides the management people, to get the maximum output
with the help of available resources.
The balance between personal and professional life vary from person to person
and the organization where he or she is working. When an individual does not
maintain a balance and works too much in the organizational setting, this may cause
him some medical, psychological and behavioral consequences, as a result his or her
productivity will also be low. Studies have shown that work life stress is harmful to
the employees.
Late sitting and working too much can cause imbalance in an individual's
personal and professional life; however there are some techniques to manage the work
life stress e.g. time management, task management, relaxation, flexible working hours,
working from home and exercise etc. Work life balance improves individual's health,
job satisfaction, commitment, involvement and reduces absenteeism and presenteeism
(state of physical presence but not productive). Despite of the progress in the
betterment of maintaining work life balance, there is still more to be done.
One important factor is the degree to which work life balance are generally
applicable across the whole hierarchy of the organization. Those lower down the
organizational hierarchy are some times not entitled for some benefits or uninformed
about relevant company policies. Work life balance can assist employers and
employee to be healthy and productive in their personal and professional life.

"Balance is not better time management, but better boundary management.

Balance means making choices and enjoying those choices." - Betsy Jacobson.

10
 For some people spending more time in the organization is more important
than the time they spend at home. However, there are people who give priority to the
personal and family life. In this technological era, some organizations also offer
flexible working hours. One can carry laptop, PDA, black berry and is connected with
suppliers, venders through internet 24 hours a day. The moment he gets any query, he
responds to it. There are some work-alcoholics who take their laptops and PDAs to
the vacation and face the annoyance of their wives while checking the emails.
People are more interested in looking for a job that gives them flexibility at
work. Necessary arrangements for work life balance are required by all workers at
different times in their lives because balance is instrumental in quality initiatives by
preparing an individual to deal with the change. An individual can give his best only
in a conducive environment e.g. students want to study and work at the same time;
parents want to have time with their children and the older worker approaching
retirement to have the opportunity to stay in the workforce on reduced hours. Mostly
the employers and the employees agree that organizational objectives are more
important, so it is the obligation of the employer to help people in work life balance.

Managing Work Life Balance

A valuable quality of leadership is the ability to balance work and life. They
make it clear that this is an aspect they value in others, too. Individuals establish a
pattern for their personal life - whether it's being home for dinner four nights a week,
attending choir practice, or being a part of their kids' school activities. Whether
through unpaid leave or flexible scheduling, they provide people with the opportunity
to lead productive personal lives. Consequently, elevated trust levels are inspired
throughout the members of the organization.

Nurses
Nurses are one of the most diverse and largest workforces in the health care
system. The word “nurse” originated from Latin word “Nutricius” which means
someone who nourishes, fosters and protects. The role of nurses in the health care
system is expanding and changing. Their role is not just limited to institutional care
but also involves delivery of services at various levels of the health care system. The
nurses are one of the strongest pillars of the health care delivery system in providing
safe, affordable and quality services to the people. Mortality, morbidity and disability

11
reduction, health promotion through healthy lifestyles are positive health outcomes in
which nurses have a pivotal role.
They play a major role in maintaining health status and also in achieving the
health related targets of the country. The various cadres in the health system make
nurses an important health workforce from the community to higher levels in the
health care delivery system. The auxiliary nurse midwives and public health nurses
are the major players in the community. Health promotion, prevention, institutional
care and rehabilitation services are essential contribution of nurses to the health care
system. Despite their vital role within the health care system, nurses remain as the
invisible workforce of health care delivery system.
Today, nursing profession is facing numerous challenges. These challenges
are causing major hurdles in the development of nursing. Shortage of trained nursing
personnel in the health care system is one challenge which is a global concern. There
is lack of adequate number of trained nursing personnel in the health care delivery
system, or an imbalance between the required number of nurses and actual availability
of nurses on the ground. However, nursing shortage is more complex and multifaceted
and arises not only due to the inadequate number of qualified nurses but also due to
the non-availability of nurses who are willing to work under the present conditions.
The nurse density/ nurse-population ratio is one of the indicators to assess the
number of nurses available to deliver the services. It is defined as the number of
nurses and midwives per 10,000 populations. The major limitation is the
unavailability of an optimal nurse-to population ratio. The nurse density of India
reported in the World Health Statistics report 2012 is 10 per 10,000 population which
is less than the global average figure 28.1 per 10,0004.
Migration is also a major factor which is contributing to shortage. Trained
nurses are migrating to Western countries since they are offered better working
conditions, recognition and salary. Nursing shortage leads to poor quality of care to
the patients which may play a major role in poor health outcomes.
Career development opportunities available to nurses are limited. Also, they
are excluded from participating in major health care decisions and developments. The
number of positions in the system for the nurses is less as compared to the
recommended standards. The facilities and remuneration in the government and
private sector are very different with the government sector offering better
remuneration in general. The recognition and status of nurses in the health care

12
system in poor which is very disappointing. The participation of professional
organisations of nurses in the development of nursing as well as in the health care
system is very limited.
Poor quality of nursing care delivery is another major challenge in nursing.
Most of the nurses in the system are qualified with diploma in nursing which
highlights that the fact there are only limited nurses with graduation or post
graduation in the clinical settings. There are often no demarcations in terms of the
work responsibilities between better and less qualified nurses. There are also several
categories of nurses working with overlapping roles and responsibilities. The
utilization of research and evidence based nursing is narrow in nurses especially in
clinical settings.
Since the demand for nurses increased globally, a greater number of nurses are
attracted to the profession. But unfortunately the quality of nursing education is
deteriorating due to the increased number of institutions with limited facilities.
Therefore the number of qualified nurses with all necessary competencies is
decreasing in India which is a matter of concern.
Quality of nursing care is considered as an important aspect in evaluating the
quality of health care. The quality of nursing and health care is directly interlinked to
levels of job satisfaction among nurses and on the quality of nurse’s work life. The
rapidly changing health care environment has had an impact on the nursing work
environment, workload and quality of nursing work life. Studies have shown that
work environment has an impact on the patient outcomes and nursing work life.
Evidence shows that nursing shortage, poor quality of nurse’s work life, job
dissatisfaction and poor patient outcomes are directly linked to lack of healthy work
environment.

13
 CHAPTER II
REVIEW OF LITERATURE
Work Life Balance
Work–life balance is the term used to describe the balance that an individual
needs between time allocated for work and other aspects of life. Areas of life other
than work-life can be, but not limited to personal interests, family and social or leisure
activities. The term ‘Work Life Balance' is recent in origin, as it was first used in UK
and US in the late 1970s and 1980s, respectively. More recently the term has drawn
on some confusion; this is in part due to recent technological changes and advances
that have made work and work objectives possible to be completed on a 24-hour cycle.
The use of smartphones, email, video-chat, and other technological innovations has
made it possible to work without having a typical "9 to 5 work day". There are several
theories that seek to explain the relationship between work and family. However,
these theories have not been integrated into a comprehensive theory that can serve as
a guide to research on work-family issues. The academic body of knowledge depends
on different theoretical approaches with regard to work-family interface.
A good work-life balance, on the other hand, is profitable for both employees
and employers. A case in point is the rise in output of factories in the 19th century
when work hours were reduced to 10, and later, eight hours a day. There is growing
concern that the quality of home and workers’ life is declining thereby causing poor
worker contributions and performances at work. Where employees are unable to
suitably balance work and family life, they tend to find it difficult to manage tasks at
the workplace and this subsequently shrinks productivity. Lack of work flexibility,
elevated work pressures and long working hours; a situation that decreases their job
performance and productivity.

Causes of Work Life Balance

There are three moderators that are correlated with work-life imbalance:
Gender, time spent at work, and family characteristics.
Gender differences could lead to a work-life imbalance due to the distinct
perception of role identity. It has been demonstrated that men prioritize their work
duties over their family duties to provide financial support for their families, whereas
women prioritize their family life.

14
 Spending long hours at work due to "inflexibility, shifting in work
requirements, overtime or evening work duties" could lead to an imbalance between
work and family duties. It has been demonstrated "that time spent at work positively
correlate with both work interference with family and family interference with work,
however, it was unrelated to cross-domain satisfaction". This could be due to the fact
that satisfaction is a subjective measure. This being said, long hours could be
interpreted positively or negatively depending on the individuals. Working long hours
affect the family duties, but on the other side, there are financial benefits that
accompany this action which negate the effect on family duties.
Family characteristics include single employers, married or cohabiting
employers, parent employers, and dual-earning parents. Parents who are employed
experience reduced family satisfaction due to their family duties or requirements. This
is due to the fact that they are unable to successfully complete these family duties. In
addition, parent workers value family-oriented activities; thus, working long hours
reduces their ability to fulfill this identity, and, in return, reduces family satisfaction.
As for the married and/ or dual-earning couples, it seems that "not only require more
time and effort at home but also are a resource for individuals to draw from, both
instrumentally through higher income and emotionally through increased empathy
and support."
These theoretical frameworks includes spill-over, compensation, work-family
conflict, resource drain, enrichment, congruence, segmentation, integration and
ecological theories. In addition to the above mentioned theories, researchers in recent
years have tried to explain work-family relationship through theories like border
theory, boundary management theory, gender inequality theory, work-life
management theory etc. All these theories provide insights into the relationship
between work and family domains. The Role theory has been considered as the most
common perspective for explaining the nature of work-family relationship which is
evident in the literature. The Role theory has been discussed from two different
perspectives - the scarcity perspective (also known as conflict perspective) and the
enrichment perspective.

15
 Conflict Theory
Work-family conflict occurs when demands of work life create problems in
fulfilling the demands of family life. Work-family conflict has been defined in terms
of inter-role conflict in which role pressures from work and family domains are
mutually incompatible in some respect, that is, participation in work role is made
more difficult by virtue of participation in the family role. Originally, work-family
conflict was considered as unidimensional but it is now conceptualised as
bidimensional, that is, work interfering with family and vice-versa. Most research on
work-family conflict showed that its greater prevalence was among employees, thus a
greater focus was on the extent of work interference with family.
Three types of work family conflict were identified and studied by Greenhaus
and Beutell (1985). These are time-based conflict, strain-based conflict and
behaviour-based conflict. When the time demands on one role make it difficult to
participate in another role, it is known as time-based conflict. The second type of
conflict which is known as strain-based conflict occurs when psychological symptoms
(anxiety, fatigue and irritability) generated by work/family demands spill-over or
intrude into the other role, making it difficult to fulfil the responsibilities of that role.
Both strain-based and time-based conflicts are believed to share a number of sources
despite being conceptually distinct.
Behaviour-based conflict takes place when expected or appropriate behaviour
in the family role (expressiveness, emotional sensitivity etc.) is considered to be
dysfunctional or inappropriate in the workplace. Like a strain-based conflict, a
behaviour based conflict demonstrates a negative spill-over from one domain to
another where behaviour in one domain is influenced by the behaviour desired and
developed in another domain where by inhibiting role performance in that latter
domain simultaneously. For instance, in a family setting wherein a warm, nurturing
and cooperative approach is desired, an assertive and confrontational behaviour may
be considered inappropriate or out of place. In terms of job factors, the amount of
working time is regarded as the most powerful and enduring predictor that influences
work-family conflict. In other words, the highest incidence of work-family conflict
results from long working hours.

16
 Enrichment Theory
Another perspective of the work-family relationship, that is, the enrichment
perspective has been investigated by researchers in recent years. Work-family
enrichment argues that the activity in one domain can enrich the experiences in the
other domain instead of depleting energy from the other domain. The positive side of
combining work and family responsibilities has been examined from the enrichment
perspective. Different terms such as facilitation, enhancement and spill-over are
associated with work-family enrichment.
However, these concepts vary in their emphasis of received benefits,
experiences and improvement of role performance. For instance, work-family
facilitation refers to a form of synergy when resources such as affect, skills, self-
esteem etc., from one role makes it easier to participate in the other role. The positive
spill-over refers to experiences such as skills, moods, values and behaviours
transferred from one role to another.
The work-family enrichment is the direct opposite or contrast of work-family
conflict and it refers to the extent to which experiences in one role improves the
quality of life in the other role. There are multiple benefits resulting from participating
in different roles such as status security, personality enrichment, role privileges, status
enhancement, which is revealed by initial research on work family enrichment.
However, later research mentioned that different types of positive spill-over such as
mood, skills, behaviour and value spill-over still exist.
The transfer of one emotional status from one domain to another is known as
mood spill-over while value spill-over occurs when what is valued at work is also
demanded in the family domain. It has been pointed out that when the skills and
abilities gained in one domain can be applied to another domain, it is referred to as
affective enrichment.
For example, conflict solving skills learned at the workplace can be applied to
resolving conflicts at home. Flexibility and psychological, physical, social capital and
material resources are considered as other instrumental benefits.

17
 Spill-over and Cross-over Theory
Apart from the conflict and enrichment perspective, there are other theories
which explain the relationship between work and family domain. One of these
theories is the notion of spill-over between domains. Spill-over is said to occur when
one domain impacts the other domain in the same way, despite having established
boundaries between an individual’s family and work domain.
Spill-over can be explained as a process by which work and family affects one
another, which in turn, generates similarities between the two domains. Both affective
and instrumental types of spill-over have been identified by the Affective spill-over is
defined as “work-related moods or attitudes are carried to home or family-related
moods or attitudes are carried to work”. On the other hand, specific skills and
behaviours which are carried from one domain to another and which results in
positive or negative consequences is known as instrumental spill-over. Spill-over can
take place in both directions.
Cross-over is defined as “the reaction of individuals to the job stress
experienced by those with whom they interact regularly”. Cross-over is also described
as “a bi-directional transmission of positive and negative emotions, mood and
dispositions between intimately connected individuals such as spouses or
organisational team members”.
Three pathways have been suggested by literature through which cross-over
can take place. The first path occurs when the stress experienced by one partner
creates an empathic reaction in the other partner resulting in the increase of their own
stress. The second path takes place when heavy demands on one partner decreases the
leisure time they have as a couple which in turn leads to negative feelings such as
emotional exhaustion or stress.
The final pathway occurs through social undermining process wherein stress
and time pressure causes a partner to engage in negative behaviour such as criticism
or negative affect toward the other partners, which in turn results in increasing the
stress of the other partner.

18
 Boundary and Border Theory
The Boundary theory is considered as an important theoretical contribution
providing a strong starting point for literature exploration relating to work-life
boundaries. This theory differentiates blocks of space and time in its most basic form,
each block is covered by frames and can be attributed to differing roles in one’s life
environment. The Boundary theory has been defined as a way in which individuals
create and maintain boundaries as a means of simplifying and ordering the
environment.
This theory has been refined by another theory known as the Border theory
which focuses on various forms of boundaries surrounding work and non work
domains. Three types of borders have been identified which individuals maintain
between their personal and work lives. These are temporal, physical and
psychological borders. Temporal boundaries refers to actual times within which work
activities versus personal activities takes place. For instance, an employee may set a
time-based boundary of 6 pm to end their day at work in order to collect their children
from day care. Physical boundaries refer to actual locations in which personal and
work activities take place. This location may be home versus office or for people who
work from home, it may be the area where they perform their work role, i.e., study or
separate area. Lastly, psychological boundaries may be characterised by the
perceptions associated with the activities of work and home roles.
For example, the psychological boundary can be referred to an employees’
interpretation of attending a work-related meeting in the evening as a social activity
with friends from work. The Border and Boundary theories assert that less conflict
will be experienced when an individual manages work and non-work separately.
However, the transitions between these roles is likely to be easier when these roles are
integrated.
In addition, depending on the characteristics which are unique to the
individual and the environment, the Border and Boundary theory suggest that
segmentation and integration of work and home roles can result in positive outcomes
such as their preferences for integration or segmentation and contextual factors like
work environment which allows conditions of work to match or fail preferences of
employees.

19
 The contention that these unique characteristics can influence work-life
outcomes has been supported by research. For instance, Chen et al (2009) in their
study of managerial level employees in the United States of America found that the
congruence between employee preference for segmentation or integration of work and
non-work roles was positively related to time and strain-based work-family conflict.
Likewise, the ability of employees to successfully manage their professional
and personal lives’ boundary have been impacted by the organisational context in
terms of “formal policies, job design, social support for work-family strategy choices
and prevailing cultural expectations”. It was suggested by their framework that in
order to classify effects of policies on managing work and family roles, research on
policy should be enriched by greater reliance on work-family integration theories, that
is, direct spill-over, indirect spill-over, segmentation.

Separate Sphere Theory

This theory considers work and family as distinctive systems wherein family
is a domestic haven for women and work is a public arena for men. Generally, this
theory asserts system independence although according to the proponents of the
Separate sphere theory, there are some structural connections at the broadest level.
The family is understood as distinctive sex typed traits and is characterised by
different domains.
Erikson identifies an inner sphere for women as wives and homemakers and
an outer sphere for men as decision-makers and bread-winners in psychoanalytic
theory while separate gender roles (instrumental and expressive) have been identified
in Sociology by Parsons.
Parsons considered work as a public sphere mainly for the man who is
supposed to fulfil instrumental and materialistic needs. On the other hand, the family
was understood as a private sphere for women who is asked to provide expressive and
emotional support. This type of division of labour based on gender leads to sex-typed
labour market where women are confined to low-paying jobs which are considered as
extensions of their domestic duties.
The Separate sphere theory asserts that family and work domain should be
separated so that they can function properly for the stability of the society and in order
to avoid conflict, sexual division of labour should be maintained. With regard to the
labour market, the work which women perform for the family is not considered as a

20
form of production with exchange value. However, on the other hand, men are
considered as the only links as producers through which family is connected to the
economic system.
In addition, society has placed high value to productive activities in the public
sphere rather than to the domestic activities in the private sphere. Male domination
and female subordination results due to differential allocation of rewards, resources
and opportunities.
In addition, the social structure is embedded with primacy of instrumental over
expressive, of father over mother, of producer over reproducer.

Scope of the Study

The study on work life balance throws light on the balance maintained by the
employees between their work and lifestyle. Work and life are two most important
priority of any person and problems arise when there is an imbalance between these
two. If work and life is not properly balanced it can adversely affect each other and
can increase job dissatisfaction, affect family relations, stress related diseases and also
productivity of the firm.
The study can help the private Hospital in improving the work life balance of
nurses and thereby advance their overall performance and production. When the
hospital takes more care about the work life balance of the nurses, they may improve
their performance and thus the goodwill of the hospital increases. Also the nurses can
understand more about the importance of balance between work and lifestyle.

21
Objectives of the study:
• To determine the quality of nursing work life among nurses working in selected
private hospitals in Kovilpatti Town.
• To compare the quality of nursing work life among nurses working in the
government and private hospitals in Kovilpatti Town.
• To find out the factors influencing the quality of nursing work life among nurses.

Objectives of the study:

• To determine the quality of nursing work life among nurses working in selected
private hospitals in Kovilpatti Town.
• To compare the quality of nursing work life among nurses working in the
government and private hospitals in Kovilpatti Town.
• To find out the factors influencing the quality of nursing work life among nurses.

Sample population
The sample population consisted of registered nurses working in selected
private hospitals in Kovilpatti and it’s surroundings.

Sampling method
About 50 percent of the sample came from the General Hospital Kovilpatti
and the remaining were selected in equal proportion from the outer area of Kovilpatti.
The sample from the private sector is selected randomly for the list of registered
members of the Indian Nurses Association provided by the association.
The main limitation of the sample from private sector is that this sample of
nurses may not be representative of all private sector nurses, because it was drawn
from the list of Indian Nurses Association members who appear to be younger.
However it was not possible to draw samples from each of the twelve private
hospitals because of time constraints and the delays that may be involved in getting
permission from twelve different institutions.

22
Sample Size
This refers to the number of items to be selected from the universe to
constitute a sample. The size of sample should neither be excessively large, nor too
small. It should be optimum. An optimum sample is one which fulfills the
requirements of efficiency, representativeness, reliability and flexibility.
The size of population variance needs to be considered as in case of larger
variance usually a bigger sample is needed. The size of population must be kept in
view for this also limits the sample size. The parameters of interest in a research study
must be kept in view, while deciding the size of the sample. Costs too dictate the size
of sample that we can draw. As such, budgetary constraint must invariably be taken
into consideration when we decide the sample size.
The whole number of sample unit on which survey is conducted is known as
sample size. In this survey the sample size is 100 employees(nurses).

Type of Data Used

Primary Data - Definition
Primary data are that which are collected fresh for the first time and thus happens to
be original in character. It is the first hand information that an investigator himself
collects from the respondent.

Sources of Primary Data

Most of the data collected is primary data through questionnaire method, where the
information or data is collected from the respondent.

Secondary Data - Definition

Secondary data is the information collected from those data which have already been
obtained by some other researcher or author. It is the second hand information. It is
the data obtained from various published sources.

Sources of Secondary Data

The secondary data is mainly collected from various text books, websites, journals
and hospital reports.

23
Tools Used For Data Collection
Data collection is an important aspect of any type of research study.
Inaccurate data collection can impact the results of a study and ultimately lead
to invalid results.
In this research the tool used for data collection is questionnaire. This method
of data collection is quite popular, particularly in case of big enquiries. It is being
adopted by private individuals, research workers, private and public organisations and
even by governments. In this method a questionnaire is given to the persons
concerned with a request to answer the questions and return the questionnaire.
A questionnaire consists of a number of questions printed or typed in a
definite order on a form or set of forms. The questionnaire is given to respondents by
person or through e-mail. The respondents have to answer the questions on their own.

Limitations of the Study

• The main limitation of the study was the lack of time end of the study.
• The nurses hesitate to give some information due to the fear that losing the
relationship with the hospital.
• Since the respondents were employees and the study was conducted mainly
during the working hours, employees could not respond properly.

24
 CHAPTER III
INDUSTRY PROFILE
Healthcare industry
The healthcare industry (also called the medical industry or health economy)
is an aggregation and integration of sectors within the economic system that provides
goods and services to treat patients with curative, preventive, rehabilitative,
and palliative care.
It includes the generation and commercialization of goods and services
lending themselves to maintaining and re-establishing health. The modern healthcare
industry includes three essential branches which are services, products, and finance
and may be divided into many sectors and categories and depends on the
interdisciplinary teams of trained professionals and paraprofessionals to meet health
needs of individuals and populations.
The healthcare industry is one of the world's largest and fastest-
growing industries. Consuming over 10 percent of gross domestic product (GDP) of
most developed nations, health care can form an enormous part of a country's
economy.
Healthcare has become one of India’s largest sector, both in terms of revenue
and employment. Healthcare comprises hospitals, medical devices, clinical trials,
outsourcing, telemedicine, medical tourism, health insurance and medical equipment.
The Indian healthcare sector is growing at a brisk pace due to its strengthening
coverage, services and increasing expenditure by public as well private players.
Indian healthcare delivery system is categorised into two major
components public and private. The Government, i.e. public healthcare system,
comprises limited secondary and tertiary care institutions in key cities and focuses on
providing basic healthcare facilities in the form of primary healthcare centres (PHCs)
in rural areas. The private sector provides majority of secondary, tertiary, and
quaternary care institutions with major concentration in metros and tier I and tier II
cities.
India's competitive advantage lies in its large pool of well-trained medical
professionals. India is also cost competitive compared to its peers in Asia and Western
countries. The cost of surgery in India is about one-tenth of that in the US or Western

25
Europe. India ranks 145 among 195 countries in terms of quality and accessibility of
healthcare.

The health care industry consists of the following nine segments:

Hospitals:
Hospitals provide complete medical care, ranging from diagnostic services, to
surgery, to continuous nursing care. Some hospitals specialize in treatment of the
mentally ill, cancer patients, or children. Hospital-based care may be on an inpatient
(overnight) or outpatient basis. The mix of workers needed varies, depending on the
size, geographic location, goals, philosophy, funding, organization, and management
style of the institution. As hospitals work to improve efficiency, care continues to
shift from an inpatient to outpatient basis whenever possible. Many hospitals have
expanded into long-term and home health care services, providing a wide range of
care for the communities they serve.

Nursing and residential care facilities:

Nursing care facilities provide inpatient nursing, rehabilitation, and health-
related personal care to those who need continuous nursing care, but do not require
hospital services. Nursing aides provide the vast majority of direct care. Other
facilities, such as convalescent homes, help patients who need less assistance.
Residential care facilities provide around-the-clock social and personal care to
children, the elderly, and others who have limited ability to care for themselves.
Workers care for residents of assisted-living facilities, alcohol and drug rehabilitation
centers, group homes, and halfway houses. Nursing and medical care, however, are
not the main functions of establishments providing residential care, as they are in
nursing care facilities.

Offices of physicians:
About 37 percent of all health care establishments fall into this industry
segment. Physicians and surgeons practice privately or in groups of practitioners who
have the same or different specialties. Many physicians and surgeons prefer to join
group practices because they afford backup coverage, reduce overhead expenses, and

26
facilitate consultation with peers. Physicians and surgeons are increasingly working as
salaried employees of group medical practices, clinics, or integrated health systems.

Offices of dentists:
About 1 out of every 5 health care establishments is a dentist’s office. Most
employ only a few workers, who provide preventative, cosmetic, or emergency care.
Some offices specialize in a single field of dentistry such as orthodontics or
periodontics.

Home health care services:

Skilled nursing or medical care is sometimes provided in the home, under a
physician’s supervision. Home health care services are provided mainly to the elderly.
The development of in-home medical technologies, substantial cost savings, and
patients’ preference for care in the home have helped change this once-small segment
of the industry into one of the fastest growing parts of the economy.

Offices of other health practitioners:

This segment of the industry includes the offices of chiropractors, optometrists,
podiatrists, occupational and physical therapists, psychologists, audiologists, speech-
language pathologists, dietitians, and other health practitioners. Demand for the
services of this segment is related to the ability of patients to pay, either directly or
through health insurance. Hospitals and nursing facilities may contract out for these
services. This segment also includes the offices of practitioners of alternative
medicine, such as acupuncturists, homeopaths, hypnotherapists, and naturopaths.

Outpatient care centers:

The diverse establishments in this group include kidney dialysis centers,
outpatient mental health and substance abuse centers, health maintenance organization
medical centers, and freestanding ambulatory surgical and emergency centers.

Other ambulatory health care services:

This relatively small industry segment includes ambulance and helicopter transport
services, blood and organ banks, and other ambulatory health care services, such as
pacemaker monitoring services and smoking cessation programs.

27
Medical and diagnostic laboratories:
Medical and diagnostic laboratories provide analytic or diagnostic services to the
medical profession or directly to patients following a physician’s prescription.
Workers may analyze blood, take x rays and computerized tomography scans, or
perform other clinical tests. Medical and diagnostic laboratories provide the fewest
number of jobs in the health care industry.

Market Size
The healthcare market can increase three-fold to Rs. 8.6 trillion (US$ 133.44
billion) by 2022.
Indian medical tourism market is growing at 18% y-o-y and is expected to
reach US$ 9 billion by 2020. There is a significant scope for enhancing healthcare
services considering that healthcare spending as a percentage of Gross Domestic
Product (GDP) is rising. The Government’s expenditure on healthcare sector has
grown to 1.6% of the GDP in FY20BE from 1.3% in FY16.
Health insurance is gaining momentum in India. Gross direct premium income
underwritten by health insurance grew 17.16% y-o-y to Rs. 51,637.84 crore
(US$ 7.39 billion) in FY20.

Investment
Between April 2000 and September 2020, FDI inflows for drugs and
pharmaceuticals sector stood at US$ 16.87 billion, according to the data released by
Department for Promotion of Industry and Internal Trade (DPIIT). Some of the recent
initiatives in the Indian healthcare industry are as follows:
• In December 2020, a new COVID-19 vaccine delivery digital platform called
'CO-WIN' is being prepared to deliver vaccines. As a beneficiary management
tool with different modules, this user-friendly mobile app for recording vaccine
data, is in the process of establishing the ‘Healthcare Workers’ database, which is
in an advanced stage across all states/UTs.
• As of December 2020, under universal immunization programmes, ~1.54 lakh
ANMs (auxiliary nurse midwives) are operating as COVID-19 vaccinators. For
further expansion of vaccinators, the government plans to take collaborative
effort with states and UTs.

28
• In November 2020, EEPC India and the National Design Institute teamed up to
facilitate and improve design and technology for the medical device industry to
help meet the increasing needs of the country’s health sector, especially
considering the COVID-19 pandemic.
• In October 2020, All India Institute of Ayurveda signed a MoU with Amity
University for Ayurveda Research.

Government Initiatives
Some of the major initiatives taken by the Government of India to promote
Indian healthcare industry are as follows:
• In December 2020, the Union Cabinet approved a memorandum of understanding
for cooperation between the Indian Government and the Ministry of Health of the
Government of the Republic of Suriname in the field of health and medicine.
• The government plans to increase the number of research and COVID-19 RT-
PCR labs to strengthen COVID-19 testing services by making COVID-19 testing
affordable and more accessible to every citizen.
• In November 2020, a mobile COVID-19 RT-PCR lab was launched at the Indian
Council of Medical Research (ICMR) in New Delhi. The laboratory has NABL
accreditation and is accredited by the ICMR.
• In Union Budget 2020 21, Rs. 35,600 crore (US$ 5.09 billion) has been allocated
for nutrition-related programmes.
• The Government has announced Rs. 69,000 crore (US$ 9.87 billion) outlay for
the health sector that is inclusive of Rs. 6,400 crore (US$ 915.72 million) for
PMJAY in Union Budget 2020–21.
• The Government of India aims to increase healthcare spending to 3% of the Gross
Domestic Product (GDP) by 2022.

Achievements
Following are the achievements of the Government:
• The number medical colleges in India increased to >560 in November 2020 from
412 in FY16.
• According to Sample Registration System Bulletin-2016, India has registered a
26.9% reduction in Maternal Mortality Ratio (MMR) since 2013.

29
• On December 14, 2020, eSanjeevani telemedicine service of the Health Ministry
crossed 1 million (10 lakh) teleconsultations, since its launch, enabling patient-to-
doctor consultations from the confines of their home, as well as doctor-to-doctor
consultations.

Kovilpatti Government Hospital gets NAQS certification

• Achieving a new milestone, Kovilpatti District Headquarters Hospital received
the National Quality Assurance Standards (NQAS) certification from the Union
Ministry of Health and Family Welfare recently.
• Chief Minister Edappadi K. Palaniswami felicitated the hospital on July 31, and
the hospital was given a prize of ₹ 24.08 lakh on receiving the certification. Six
other hospitals in the State received the NQAS certification at the time along with
Kovilpatti GH.
• Out of the 18 departments in the hospital, 15 were taken up for assessment. Three
others, laundry, mortuary and kitchen, were excluded, officials said.
• The hospital went through three levels of assessment at internal, State and
national levels to finally receive the certification, said Joint Director of Health
Services Fareeda Shirin.
• Seventy per cent of the prize amount of ₹ 24.08 lakh would be used for
improvement and infrastructure development of the hospital, while 30% would be
given as an incentive to employees at the hospital.
• Further, as part of the certification, ₹ 10,000 would be given per bed at the
hospital. The hospital had 251 beds as per official records. The certification
would be valid for three years, after which assessments would be conducted again,
said officials.
• Meanwhile, Tiruchendur Government Hospital has also applied for the
certification in the district.

30
 CHAPTER IV
ANALYSIS AND RESULTS
Table 4.1(b)
Age of the Respondents

Marital status No. of respondents Percentage

20-25 3 3%
25-30 27 27%
30-35 27 27%
35-40 17 17%
Above 40 26 26%
Total 100 100%

Figure 4.1(b)
Figure showing Age of the Respondents

Interpretation
From the above graph it is clear that the hospital is concentrating more on experienced
young people with age group from 25-35 and the people who are of the age above 40
are the senior staffs of the hospital. Hospital is not encouraging people between 20-25
to work because of less work experience.

31
 Table 4.1(c)
Respondents based on Gender

Gender No. of respondents Percentage

Male 26 26%
Female 74 74%
Total 100 100%

Figure 4.1(c)
Respondents based on Gender

Interpretation
Majority of the nurses working in hospitality sector are female (74%) and the rest
26% are Males. From the above graph we can say that hospitality industry prefer
more female workers as nurses.

32
 Table 4.1 (d)
Marital status of the respondents

Marital status No. of respondents Percentage

Single 18 18%
Married 82 82%
Total 100 100%

Figure 4.1 (d)

Marital status of the respondents

Interpretation
The above table shows that most of the nurses are married (82%) and 18% of nurses
are single. Since most of the nurses are married the working hours of the hospital
should be made flexible so that the nurses can spend time with their family and also
they can maintain a good work life balance which will result in the job involvement of
the nurses.

33
 Table 4.2
Working Hours of the respondents

Working Hours No. of respondents Percentage

Less than 6 hours 0 -

6-8 hours 60 60%
8-10 hours 40 40%
More than 10 Hours 0 -
Total 100 100%

Figure 4.2
Working Hours of the respondents

Interpretation
From the above graph it is clear that 60% of respondents work from 6-8 hours and
40% of respondents work for 8-10 hours. Therefore we can conclude that majority of
the nurses are working during the general hours but there are people who are working
overtime. But nobody is working for more than 10 hours and less than 6 hours.

34
 Table 4.3
Travel time of respondents to reach the Hospital (work place)

Travel Time No. of respondents Percentage

Less than 0.5 hour 77 77%

0.5-1 hour 15 15%
1-1.5 hours 8 8%
More than 1.5 hours 0 -
Total 100 100%

Figure 4.3
Travel time of respondents to reach the Hospital (work place)

Interpretation
Most of the workers (77%) of the hospital are living nearby to the hospital who take
less than 0.5 hour to reach the hospital. But 8% of the workers are coming from
distant places who take 1-1.5 hours to reach the firm and rest of the workers (15%)
has 0.5-1 hour travel. No one is travelling more than 1.5 hours.

35
 Table 4.4
How respondents missing family functions due to work
How Nurses missing
No. of respondents Percentage
Family function
Always 30 30%
Most of the times 28 28%
Sometimes 34 34%
Never 8 8%
Total 100 100%

Figure 4.4
How respondents missing family functions due to work

Interpretation
Around 90% of the nurses says that they miss their family functions due to work.
Among this (30%) staffs are of the opinion that they miss their family functions
always, (28%) most of the times and (34%) sometimes. But on the other hand 8% of
the nurses says that they never miss their family functions due to work.

36
 Table 4.5
Enough time spend by respondents with their family
Enough time spend with
No. of respondents Percentage
their family
Strongly agree 17 17%
Agree 40 40%
Disagree 36 36%
Strongly disagree 7 7%
Total 100 100%

Figure 4.5
Time spend by respondents with their family

Interpretation
The above chart shows that 36% of the respondents disagree that they spend enough
time with their family and 7% of respondents strongly disagree to this. But contrast to
this 40% of the respondents are of the opinion that they spend enough time with their
family and 17% of respondents strongly agree to the statement.

37
 Table 4.6
Involvement of family members in functions conducted
by/for employees
Involvement of family members in
No. of respondents Percentage
functions conducted by/for employees
Always 1 1%
Most of the time 24 24%
Sometimes 41 41%
Never 34 34%
Total 100 100%

Figure 4.6
Involvement of family members in functions conducted
by/for employees

Interpretation
The above table shows that only one of the respondents agrees that the hospital
always encourages the involvement of family members. 41% of the nurses says that
their members are sometimes and 24% of respondents says most of the time they are
involved in the functions conducted by/for nurses. But 34% nurses are opposing this
statement, they are of the opinion that their family members are never encouraged or
involved in the functions conducted by/for nurses.

38
 Table 4.7
Opinion on Counselling facilities offered by the Hospital Management
Opinion on Counselling
No. of respondents Percentage
facilities
Yes 59 59%
No 41 41%
Total 100 100%

Figure 4.7
Opinion on Counselling facilities offered by the Hospital Management

Interpretation
More than half of the workers says that the Hospital Management provide counselling
facility but 41% of nurses disagree to this statement. They are of the opinion that the
counselling that they are providing is not up to the expectations of the employees,
some of them are not able to get anything valuable from the counselling facility that
the hospital is providing.

39
 Table 4.8
Opinion on allowance of flexible working hours
Opinion on allowance of
No. of respondents Percentage
flexible working hours
Yes 67 67%
No 33 33%
Total 100 100%

Figure 4.8
Opinion on allowance of flexible working hours

Interpretation
33% of the respondents agree that the hospital provides flexible working hours,
whereas the rest 67% do not agree to this. By giving more flexible working hours the
nurses will be relived from the monotonous job that they are doing, it will also to
reduce their stress and work load.

40
 Table 4.9
Opinion on allowance of maternity/paternity leave
Opinion on allowance of
No. of respondents Percentage
maternity/paternity leave
Yes 70 70%
No 30 30%
Total 100 100%

Figure 4.9
Opinion on allowance of maternity/paternity leave

Interpretation
70% of the nurses says that they get maternity/paternity leave but 30% of the nurses
are of the opinion that the leave that they get is too short so they are disagreeing with
the statement. This will lead to resignation of nurses from the hospital, therefore in
order to avoid this situation the firm has to give enough maternity/paternity leave to
the nurses.

41
 Table 4.10
Satisfaction level with the leave policy

Satisfaction level with the leave policy No. of respondents Percentage

Highly satisfied 1 1%
Satisfied 28 28%
Dissatisfied 45 45%
Highly Dissatisfied 26 26%
Total 100 100%

Figure 4.10
Satisfaction level with the leave policy

Interpretation
45% of the nurses are dissatisfied with their leave policy, around 28% of nurses are
satisfied on the other hand 26% of the nurses are highly dissatisfied with their leave
policy and one of them is highly satisfied with the leave policy.

42
 Table 4.11
Overtime work done by the respondents

Overtime No. of respondents Percentage

Always 3 3%
Often 27 27%
Sometimes 48 48%
Never 22 22%
Total 100 100%

Figure 4.11
Overtime work done by the respondents

Interpretation
48% of respondents says that they sometimes work overtime, 27% of the respondents
often work overtime, 22% of the respondents says that they never work overtime and
3% of the respondents says that they always work overtime. Overtime work will
affect the work of the nurses so the hospital should avoid the giving the employees
overtime work.

43
 Table 4.12
The effect of longer working hours on job involvement
The effect of longer working
No. of respondents Percentage
hours on job involvement
Strongly agree 0 -
Agree 33 33%
Disagree 27 27%
Strongly disagree 40 40%
Total 100 100%

Figure 4.12
The effect of longer working hours on job involvement

Interpretation
40% of the respondents believe that longer working hours can adversely affect their
job involvement and 33% of the respondents agree to this statement while 27% of
respondents disagree to the statement. Since longer working hours affect the job
involvement the hospital should take alternative measures to adjust the nurses
working hours.

44
 Table 4.13
Work pressure when not working or while travelling to work
Opinion on Work pressure
when not working or while No. of respondents Percentage
travelling to work
Yes 68 68%
No 32 32%
Total 100 100%

Figure 4.13
Work pressure when not working or while travelling to work

Interpretation
Majority of the respondents 68% agree that they experience work pressure when not
working or while travelling to work but 32% of the respondents never experienced it.
Nurses are having stress related problems due to over workload in the hospital. This
shows us how hectic the job is for the nurses.

45
 Table 4.14
Stress related diseases experienced by respondents
Stress related diseases
No. of respondents Percentage
experienced by respondents
Yes 58 58%
No 42 42%
Total 100 100%

Figure 4.14
Stress related diseases experienced by respondents

Interpretation
58% of the nurses are suffering from stress related diseases but 42% of the nurses are
not having any such problems. Stress related diseases such us obesity, heart disease,
Alzheimer's disease, diabetes, depression, gastrointestinal problems and asthma can
be caused due to increased work load and over time work.

46
 Table 4.15
Opinion on Career prospects in the hospital
Opinion on Career
No. of respondents Percentage
prospects in the hospital
Yes 60 60%
No 40 40%
Total 100 100%

Figure 4.15
Opinion on Career prospects in the hospital

Interpretation
60% of the respondents believe that they have good career prospects in the hospital
but 40% of the respondents do not agree to this statement. The management should
provide more career prospects since every nurses working in the hospital is wishing
for a good career and if the management is providing such a hope in the minds of the
nurses it will be visible in the work of the nurses.

47
 Table 4.16
Opinion on the influence of career prospects on work involvement
Opinion on the influence of career
No. of respondents Percentage
prospects on work involvement
Highly influential 23 23%
Influential 40 40%
Less influential 25 25%
Not at all influential 12 12%
Total 100 100%

Figure 4.16
Opinion on the influence of career prospects on work involvement

Interpretation
23% of the respondents believe that career prospects highly influence their work
involvement, when the management is offering good career prospects the nurses will
put their maximum effort for the growth of the hospital. 40% of the respondents
believe that career prospects are influential whereas 25% of the respondents feel that
career prospects are less influential and 12% says that career prospects are not at all
influential.

48
 Table 4.17
The effectiveness of work under stress related to work

Overtime No. of respondents Percentage

Always 2 2%
Sometimes 42 42%
Most of the times 13 13%
Never 43 43%
Total 100 100%

Figure 4.17
The effectiveness of work under stress related to work

Interpretation
42% of respondents sometimes are able to work effectively even under work related
stress and 13% of the respondents can work effectively most of the times while 43%
of respondents says that they cannot work under stress due to work. Nurses cannot
work properly when they are stressed therefore the management should take into
consideration about some stress relieving activities.

49
 Table 4.18
The ability to work effectively under stress due to family

The ability to work effectively

No. of respondents Percentage
under stress due to family
Yes 52 52%
Partially 40 40%
No 8 8%
Total 100 100%

Figure 4.18
The ability to work effectively under stress due to family

Interpretation
52% of the respondents find it difficult to work effectively when they are unable to
fulfil the needs of family or worried about family issues and 40% of the respondents
partially agree to this statement while 8% of respondents are of the opinion that they
never find it difficult to work effectively due to family issues.

50
 Table 4.19
Top most priority of the respondents

Top most priority of the

No. of respondents Percentage
respondents
Career 25 25%
Health 7 7%
Family 54 54%
Hobbies 2 2%
Friendship 12 12%
Total 100 100%

Figure 4.19
Top most priority of the respondents

Interpretation
For 54% of the respondents family is the top most priority, 25% of respondents gives
priority to career, 12% of respondents believes that friendship is more prior, 7% of the
respondents give importance to health and only 2% of the respondents give priority to
hobbies.

51
 Table 4.20
Satisfaction level of respondents with their work life balance
Satisfaction level of respondents with
No. of respondents Percentage
their work life balance
Highly satisfied 8 8%
Satisfied 44 44%
Dissatisfied 30 30%
Highly Dissatisfied 18 18%
Total 100 100%

Figure 4.20
Satisfaction level of respondents with their work life balance

Interpretation
44% of respondents are satisfied with their work life balance and 8% people are
highly satisfied, but 30% of the respondents are dissatisfied and 18% of respondents
are highly dissatisfied with their work life balance.

52
 Table 4.21
Most impact full factor affecting the work involvement of respondents
Most impact full factor affecting the
No. of respondents Percentage
work involvement of respondents
Longer working hours 23 23%
Increased stress 15 15%
Inability to spend time with family 40 40%
Lack of good career prospects 7 7%
Financial problems 2 2%
conflicts with colleagues 13 13%
Total 100 100%

Figure 4.21
Most impact full factor affecting the work involvement of respondents

Interpretation
23% of respondents says that longer working hours has an adverse effect on their
work involvement. For 15% of the respondents, increased stress due to work is a
hindering factor, while for 40% of the respondents it is inability to spend time with
family. Lack of good career prospects acts as a hindering factor for 7% of the
respondents and for 2% it is the financial problems, 13% of the respondents consider
conflicts with colleagues / unhealthy relationship with colleagues as a problem having
adverse effect on their productivity. None of the respondents have other reasons to
share.

53
 CHAPTER V
FINDINGS
The main findings of the study are based on analysis and interpretation of data
obtained from the respondents, by the way of questionnaire. The following are
findings of the study:
• There is a harmonious relation between the informal work group and with other
staff members in the hospitals.
• The hospital is concentrating more on experienced young people with age group
from 25-35 and the people who are of the age above 40 are the senior staffs of the
hospital. Hospital Management is not encouraging people between 20-25 to work
because of less work experience.
• Majority of the nurses working in hospitality sector are female employees and
most of the employees are married.
• Nobody in the hospital work less less than 6 hours and more than 10 hours.
Majority of the nurses are working for the office hours and some of them work
over time.
• Around half of the employees are coming from nearby places which take less
than half an hour to travel nobody is coming from faraway places and the rest of
the nurses take half to one and half hour to reach the hospital.
• Almost all the nurses are of the opinion that they miss their family functions due
to work but contrast to this 8% of the nurses says that they never miss their
family functions due to work.
• Majority of the nurses are not able to spend enough time with their family due to
work.
• Half of the nurses are saying that their family members are sometimes involved in
the functions conducted by/for nurses and on the other hand 45% of the nurses
does not support this and nobody completely agree that the hospital always
encourage family members to participate in hospital functions.
• More than half of the nurses agree that the hospital management provide
counselling facility but the rest of the nurses are of the opinion that the
counselling that the hospital providing is not good so they disagree to that the
hospital provides counselling.

54
• Little over one third of nurses says the hospital does not provide flexible working
hours but two third of nurses are of the opinion that the hospital hospital flexible
working hours.
• Not everybody in the hospital is satisfied with the maternity/paternity leave that
the hospital is providing so they are against the opinion that the hospital is
providing maternity/paternity leave.
• Majority of the nurses are not satisfied with the leave policy of the hospital and
nobody is highly satisfied with the leave policy of the hospital.
• Around 22% of the employees never work overtime rest all the employees work
overtime in the hospital.
• 40% of the employees strongly dis agree that longer working hours can adversely
affect the productivity but contrast to this nobody among the respondents strongly
agree to the statement.
• Majority of the respondents agree that they experience work pressure when not
working or while travelling to work but some of the respondents never
experienced it.
• Many of the employee of the hospital are suffering from stress related diseases.
• 60% of the respondents says that they have good career prospects in the hospital
and the rest are opposing the statement.
• Majority of the employees believes that career prospects will influence work
involvement.
• Around 40% of the employees says they are never able to work effectively when
they were stressed about work related issues but the same percentage of
employees says that sometimes they are able to work.
• Half of the respondents says that they find it difficult to work effectively when
they were unable to fulfil the needs of family.
• For more than half of the respondents family was their top most priority.
• Majority of the respondents are satisfied with the work life balance.
• 23% of respondents says that longer working hours has an adverse effect on their
productivity. For 15% of the respondents, increased stress due to work is a
hindering factor, while for 40% of the respondents it is inability to spend time
with family. Lack of good career prospects acts as a hindering factor for 7% of
the respondents and for 2% it is the financial problems, 13% of the respondents
consider conflicts with colleagues / unhealthy relationship with colleagues as a

55
 problem having adverse effect on their productivity. None of the respondents
have other reasons to share.

SUGGESTIONS
The suggestions for the findings are as follows:
• Awareness programs regarding proper work life balance can be conducted for the
very low percentage of nurses who cannot manage work and lifestyle since work
life balance is an important factor in an nurses life and not all but some of the
nurses who lack work life balance should be given more care through providing
them with facilities like counselling.
• Most of the nurses working in the hospital are married therefore the women
nurses should not be forced to work overtime in the hospital since they have to
take care of the family.
• Therefore the time schedule of the hospital should be set in such a manner that it
is not affecting their work life balance.
• The nurses can also drop unnecessary activities which waste their time such as,
the lunch break of the nurses are around one hour in the hospital, it should be
reduced so that the time can be utilised to do their work and the unnecessary talk
between the nurses also should be stopped because it waste their lot of time.
• The hospital should provide an accommodation to their nurses who are coming
from faraway places which takes up to three hours for travel, this time can be
utilised for the work if they are provided with nearby residence.
• The nurses must be given chances to attend their family functions. This can be
done in such a way that every employee should plan in advance about their
function and he should work over time to complete his work so that he can attend
the function and also he can complete his work on time eve if he takes a leave.
• Most of the nurses working the hospital are married, because of the work load
they are not able to spend time with their family, the hospital should not not give
over work to the nurses which will reduce their time to spend with their family.
As pointed in the above points the hospital should plan their time schedule
accordingly.

56
• The hospital must try to involve the nurses family members also in their official
functions since every employee is expecting to have their family with them, this
will increase their productivity which is profitable for the hospital.
• Counselling should be more effective, since most of the nurses are not satisfied
with the counselling facilities the hospital should find out the right person who is
expert in this field.
• The hospital should give flexible working hours so that the nurses can work
overtime and take leave for their particular reasons.
• Maternity / paternity leave policy of the hospital should be improved by
extending their leave so that the nurses who are not satisfied with the leave policy
will be satisfied.
• Leave policy of the hospital should also be improved by arranging their time
schedule in a way that the nurses can take leave by working accordingly in the
previous days of their leave.
• Some of the nurses work overtime in the hospital this should be changed by
redistributing their work to other nurses so that the work is shared and they can
complete their work during the office time itself.
• When works are distributed among the nurses it will decrease the longer working
hours of the nurses. Longer working hours will affect the productivity of the
nurses therefore longer working hours should be decreased which will increase
the productivity of the nurses resulting in the profit of the hospital.
• Some entertainment programme should be organised among the nurses itself at
least once in a month so that their work pressure will be less since many of the
nurses are suffering from stress related diseases and work pressure.
• The hospital should give the nurses good career prospects by giving them
promotions, increase in salary and other incentives otherwise it will affect the
productivity of the nurses.
• The hospital should try to keep the nurses out of stress by decreasing their work
load and they should be made aware about the work life balance by giving them
classes on work life balance by scholarly persons so that it will increase their
productivity.

57
 CONCLUSION
This project study was helpful to study the practical aspect with theoretical
aspect. From the study conducted, it is clear that the hospital does not believe in
exerting pressure on nurses. The hospital management does not follow a tight
schedule or strict work policies. Through leave policies, welfare measures, flexible
work time and other allowances, the hospital encourages and motivates the nurses and
makes it easy for them to work effectively without pressure.
However the hospital management can also consider the addition of measures
like job sharing and job rotation.
The hospital management should maintain its current policies and working
strategies regarding the work life balance to keep on motivating and retaining the
nurses. Proper work life balance among the nurses can not only increase their job
involvement, but also helps the hospital management achieve its objectives easily.

58
 BIBLIOGRAPHY
 Edwin B Flippo, Personal Management, Mc Graw Hill Publishers, New Delhi,
2000
 C B Gupta, Human Resource Management, Sultan Chand & Publishers, New
Delhi, 2004
 C R Kothari, Research Methodology, Wishwa Prakashani Publication, New Delhi,
2nd Edition Russell Clayton, In Search Of Work Life Balance

59
 QUESTIONNAIRE
WORK LIFE BALANCE OF NURSES WITH SPECIAL REFERENCE TO
PRIVATE HOSPITAL
1. Personal information:
a) Name:
b) Age:
c) Gender: Male  Female 
d) Marital status: Single  Married 
e) Years of experience:

2. How many hours do you work in a day?

Less than 6 hours  6-8 hours  8-10 hours  More than 10 hours 

3. How much time do you travel to reach the Hospital (work place)?
Less than 0.5 hour  0.5-1 hour  1-1.5 hours  More than 1.5 hours 

4. Do you miss family/community functions due to work?

Always  Most of the times Sometimes  Never 

5. Do you agree that you spend enough time with your family?
Strongly agree  Agree  Disagree  Strongly disagree 

6. Does your hospital encourage participation or involvement of your family members

in functions conducted by/for employees?
Always  Most of the time  Sometimes  Never 

7. Does your Hospital Management provide counselling facilities?

Yes  No 

8. Does your Hospital Management provide flexible working hours option?

Yes  No 

9. Does your Hospital Management provide maternity/paternity leaves?

Yes  No 

10. Are you satisfied with the leave policy of your Hospital Management?
Highly satisfied  Satisfied  Dissatisfied  Highly Dissatisfied 

60
11. How often do you work over time?
Always  Often  Sometimes  Never 

12. Do you agree that longer working hours can adversely affect your involvement in
work?
Strongly agree  Agree  Disagree  Strongly disagree 

13. Do you worry about work or have work pressure even when you are not at work
or travelling to work?
Yes  No 

14. Do you suffer from any stress related diseases?

Yes  No 

15. Do you think you have good career prospects in this hospital?
Yes  No 

16. What is the influence of career prospects on work involvement?

Highly influential  Influential  Less influential  Not at all influential 

17. Are you able to work effectively when you are stressed about work related issues
(eg: overtime, pandemic situation etc)?
Always  Sometimes  Most of the times  Never 

18. Do you find it difficult to work effectively when you are unable to fulfil the needs
of family or worried about family issues?
Yes  Partially  No 

19. What is your top most priority among the following?

Career  Health  Family  Hobbies  Friendship 

20. Are you satisfied with the balance you maintain between the work and your
personal priority?
Highly satisfied  Satisfied  Dissatisfied  Highly dissatisfied 

61
21. Which among the following do you think affects your work involvement the most?
Longer working hours  Increased stress  Inability to spend time with
family /inability to fulfil needs of family  Lack of good career prospects 
Financial problems  Unhealthy relationship with colleagues /conflicts with
colleagues 

Other reasons
(specify)………………………………………………………………………...

62