The fact that pay, employer adjustments and flexibility influence the wish to increase FTEs, matches earlier findings (12). It is particularly interesting that professional challenges can motivate an increase of FTE percentage. At the same time, part-time staff are less involved with professional development opportunities, which may not be favourable for patients (12).
Workplaces with a large part-time workforce experience a weaker professional environment (2, 4). If institutions are set up to mainly accommodate full-time working, more employees will tend to ‘choose’ full-time jobs due to the opportunities for professional development. This would have a positive effect on professional standards, levels of pay and pension earnings, as well as gender equality (2, 6, 7, 29).
Some part-timers want to work part time
It is an interesting finding that part-time staff make up two distinct groups, one of which can be influenced by employer adjustments, while the other is less inclined to be thus affected. Those who are less influenced by employer adjustments point out that they are financially secure, and that they value their leisure time.
They also point out that an offer of a higher FTE percentage involves working shifts at undesirable times. Moreover, they would like to look after their children, which is challenging if they often have to work unsociable hours. However, full-time work is not necessarily more stressful than part-time work if individual circumstances are accommodated when rosters are drawn up (2, 14).
The factors that concern job content and contextual circumstances were positively related to full-time work. It is interesting that contextual circumstances were positively related to full-time work. Nurses make different priorities depending on their situation in life. They are weighing up the negatives and the positives, and more unsociable working hours will probably be considered a negative. However, the results were not statistically significant.
Family considerations were inversely related to full-time work, which means that the nurses were more likely not to choose to work full time. The nurses appreciated being able to adjust their own FTE percentage. They made use of this opportunity, which may be considered working part time voluntarily. For some, this opportunity was a motivating factor in their choice of profession. Employers should therefore continue to offer part-time work where this is desirable.
The challenges involved with building a full-time culture
However, we may ask whether this is a genuine choice. A change from part-time to full-time working must be seen in connection with cultural and structural frameworks (21). There is great demand among employers for the expertise offered by RNs, and the trade unions are fighting for full-time jobs. Building a full-time culture requires a range of actions and efforts to tackle the part-time culture, professional norms and attitudes (15).
Those who responded positively to employer adjustments are looking for a smaller workload, which is a challenge considering the shortage of RNs. Wider distribution of unsociable shifts will reduce the load on each individual (30).
The employer can facilitate full-time working
The employer is responsible for maintaining the quality of health services. However, the standard of services may be adversely affected if there is a predominance of part-time nurses. This suggests that full-time jobs should be the norm in order to maintain an overview and secure continuity vis-à-vis patients. The employer’s challenge is to accommodate the nurses’ various preferences.
The employer should prioritise the preferences which were found by the study to be positively related to full-time work: job content and contextual circumstances. The employer should especially focus on job content and ensure that nursing competencies are used to perform nursing tasks. This may influence recruitment as well as the quality of services.
Consideration must be given to how RNs will respond to institutional processes. Both full-timers and part-timers hold the opinion that contextual circumstances, such as pay, are important to their choice of FTE percentage. Similarly, professional challenges motivate acceptance of a higher FTE percentage and benefit the patients (2–5). The employer should consider these factors in order to contribute to the recruitment of new RNs and prevent existing RNs from leaving their profession.
The sample was skewed in that the majority of respondents were working full time. One of the study’s weaknesses is its low response rate. No reminders were issued, and the representativeness of the sample has not been considered. The study was conducted within the bounds of the municipal health service and includes no hospital employees. The findings only apply to the priorities of RNs who work in municipal and private institutions, and to factors that influence their FTE percentage.
Further research should include hospital employees, and barriers to full-time working should be surveyed among various groups of nurses. It is a weakness that FTE percentages were not specified for part-time positions. Additionally, it was not specified whether part-time working was a voluntary choice or an undesirable adjustment. Neither was it made clear what share of the sample work shifts or daytime only.
We devised the questionnaire ourselves due to insufficient familiarity with validated and reliability-tested forms within the field. The form is based on new institutional theory and our knowledge of the field (21). The loadings and Cronbach’s alpha for the total analysis were low. Caution should therefore be taken when drawing conclusions from this analysis, particularly with reference to factors 2 and 3.
Job content, family considerations and contextual circumstances influence the full-time equivalent percentage worked by registered nurses. Sociable working hours and professional challenges are factors that may motivate part-time employees to increase their full-time equivalent percentage.
I am grateful to the informants for their important contributions to this study. I am also grateful to statistician and associate professor Roy Miodini Nilsen for his assistance with the statistical analyses and to professor Oddbjørn Bukve for his input to the manuscript. Both work for the Western Norway University of Applied Sciences.
1. Dolonen KA. 5900 sykepleiere og spesialsykepleiere mangler i helsevesenet. Sykepleien; 05.05.2018. Available at: https://sykepleien.no/2018/05/5900-sykepleiere-og-spesialsykepleiere-mangler-i-helsevesenet (downloaded 12.03.2019).
2. Ingstad K. Hele og delte sykepleiere: En kvalitativ studie av sykepleieres arbeidsvilkår og arbeidstid i sykehjem. (Doktoravhandling.) Trondheim: Norges teknisk-naturvitenskapelige universitet, Fakultet for samfunnsvitenskap og teknologiledelse, Institutt for sosialt arbeid og helsevitenskap; 2011. Available at: https://brage.bibsys.no/xmlui/handle/11250/267842 (downloaded 22.03.2019).
3. Hallandvik JE, Olsen T. Heltid – løsning eller problem? Sluttrapport fra evalueringen av heltidsprosjektet i Kristiansand kommune. Kristiansand: Universitetet i Agder; 2011. Rapport 157/2011. Available at: http://hdl.handle.net/11250/135085 (downloaded 22.03.2019).
4. Moland LE, Bråthen K. Hvordan kan kommunene tilby flere heltidsstillinger? Oslo: Forskningsstiftelsen Fafo; 2012. Report 14/2012. Available at: https://www.fafo.no/index.php/zoo-publikasjoner/fafo-rapporter/item/hvordan-kan-kommunene-tilby-flere-heltidsstillinger (downloaded 22.03.2019).
5. Moland LE. Heltid-deltid – en kunnskapsstatus. Oslo: Forskningsstiftelsen Fafo; 2013. Rapport 27/2013. Available at: https://www.fafo.no/index.php/zoo-publikasjoner/fafo-rapporter/item/heltid-deltid-en-kunnskapsstatus (downloaded 22.03.2019).
6. Ingstad K, Kvande E. Må sykepleieryrket være et deltidsyrke? Nordisk sygeplejeforskning. 2011;1(03):206–18.
7. Nicolaisen H. Løsninger på deltidsutfordringen – ingen «quickfix». Søkelys på arbeidslivet. 2013;30(1–2):151–7.
8. Meld. St. 29 (2010–2011). Felles ansvar for eit godt og anstendig arbeidsliv. Oslo: Arbeids- og sosialdepartementet; 2011. Available at: https://www.regjeringen.no/no/dokumenter/meld-st-29-20102011/id653071/ (downloaded 22.03.2019).
9. Norsk Sykepleierforbund. Kompensasjon for ubekvem arbeidstid og forskjøvet arbeidstid. Oslo; 2018. Available at: https://www.nsf.no/vis-artikkel/113721/17074/Kompensasjon-for-ubekvem-arbeidstid-og-forskjovet-arbeidstid (downloaded 22.03.2019).
10. Egeland C, Drange I. Frivillig deltid – kun et spørsmål om tid? Oslo: Arbeidsforskningsinstituttet; 2014. Report 4/2014. Available at: https://doi.org/10.7577/afi/rapport/2014:4 (downloaded 22.03.2019).
11. Køber T, Vigran Å. Arbeidstid blant helsepersonell, stort omfang av deltidsarbeid. Samfunnsspeilet. 2011;25(2):58–62. Available at: https://www.ssb.no/arbeid-og-lonn/artikler-og-publikasjoner/stort-omfang-av-deltidsarbeid (downloaded 12.03.2019).
12. Moland LE. Ønsket og uønsket deltid – konsekvenser for arbeidstaker, arbeidsgiver og tjenestetilbud. Oslo: Forskningsstiftelsen Fafo; 2009. Report 15/2009. Available at: https://www.fafo.no/index.php/zoo-publikasjoner/fafo-rapporter/item/onsket-og-uonsket-deltid-konsekvenser-for-arbeidstaker-arbeidsgiver-og-tjenestetilbud (downloaded 22.03.2019).
13. Christiansen B, Bjørk IT. Godt – eller godt nok? Hvordan opplever sykepleiere idealer og realiteter i utøvelsen av yrket? Nordisk tidsskrift for helseforskning. 2016;12(1):64.
14. Abrahamsen B, Holte KA, Laine M. Work-family interference: nurses in Norway and Finland. Professions and Professionalism. 2012;2(1):60–74.
15. Ingstad K. Turnus som fremmer heltidskultur. Oslo: Gyldendal Akademisk; 2016.
16. Ingstad K, Kvande E. Arbeid i sykehjem – for belastende for heltid? Søkelys på arbeidslivet. 2011;28(1–2):42–55.
17. Ingstad K, Amble N. En ny ro med langturnus. Less job stress with 12-hour shifts. Nordic Journal of Nursing Research. 2015;35(3):152–7.
18. Harris R, Sims S, Parr J, Davies N. Impact of 12 h shift patterns in nursing: A scoping review. International Journal of Nursing Studies. 2015;52(2):605–34.
19. Bae S-H, Fabry D. Assessing the relationships between nurse work hours/overtime and nurse and patient outcomes: systematic literature review. Nursing Outlook. 2014;62(2):138–56.
20. Dall’Ora C, Ball J, Recio-Saucedo A, Griffiths P. Characteristics of shift work and their impact on employee performance and wellbeing: a literature review. International Journal of Nursing Studies. 2016;57:12–27.
21. Scott WR. Institutions and organizations: ideas, interests, and identities. 4. ed. Thousand Oaks, California: Sage Publications; 2014.
22. Polit D, Beck C. Nursing Research: generating and assessing evidence for nursing practice. 10. ed. Philadelphia: Wolters Kluwer; 2017.
23. Ringdal K. Enhet og mangfold. Samfunnsvitenskapelig forskning og kvantitativ metode. 3. ed. Bergen: Fagbokforlaget; 2013.
24. Bjørndal A, Hofoss D. Statistikk for helse- og sosialfagene. Oslo: Gyldendal Akademisk; 2004.
25. Pett MA, Lackey NR, Sullivan JJ. Making sense of factor analysis: the use of factor analysis for instrument development in health care research. Thousand Oaks, California: Sage Publications; 2003.
26. Pallant J. SPSS survival manual: a step by step guide to data analysis using SPSS. 4. ed. Maidenhead: McGraw-Hill International; 2010.
27. De nasjonale forskningsetiske komiteene. Forskningsetiske retningslinjer for samfunnsvitenskap, humaniora, juss og teologi. Oslo; 2016. Available at: https://www.etikkom.no/forskningsetiske-retningslinjer/Samfunnsvitenskap-jus-og-humaniora/ (downloaded 22.03.2019).
28. World Medical Association. Helsinkideklarasjonen. Fortaleza, Brazil; 2013. Available at: https://www.etikkom.no/forskningsetiske-retningslinjer/Medisin-og-helse/Helsinki-deklarasjonen/ (downloaded 12.03.2019).
29. Moland LE. Større stillinger og bedre drift. Evaluering av programmet ufrivillig deltid. Oslo: Forskningsstiftelsen Fafo; 2015. Report 25/2015. Available at: https://www.fafo.no/index.php/zoo-publikasjoner/fafo-rapporter/item/storre-stillinger-og-bedre-drift (downloaded 22.03.2019).
30. Amble N, Ingstad K. Helgearbeid og heltidskultur. Sykepleien; 16.01.2015. Available at: https://sykepleien.no/meninger/innspill/2015/01/helgearbeid-og-heltidskultur (downloaded 12.03.2019).