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Why nurse managers need to start saying ‘yes’ to flexible working

Flexible working can transform lives, improve care and could help nurses stay in the profession. Why would anyone say no to that?

Flexible working can transform lives, improve care and could help nurses stay in the profession. Why would anyone say no to that?

This is Sarahs story does it sound familiar?

Sarah is really tired.

Shes been on her feet for 12 hours and awake for 14. She hasnt seen her kids for more than an hour in the past two long days shes been working. Everyone needs something from her. She stays later on her shift on her general medical ward because it is busy and she doesnt want to let anyone down. She does an extra two hours in the end. She texts her husband to apologise for being late again and to ask him to give the kids a kiss goodnight from her.

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Flexible working can transform lives, improve care and could help nurses stay in the profession. Why would anyone say no to that?

This is Sarah’s story – does it sound familiar?

Sarah is really tired.

She’s been on her feet for 12 hours and awake for 14. She hasn’t seen her kids for more than an hour in the past two long days she’s been working. Everyone needs something from her. She stays later on her shift on her general medical ward because it is busy and she doesn’t want to let anyone down. She does an extra two hours in the end. She texts her husband to apologise for being late – again – and to ask him to give the kids a kiss goodnight from her.

Sometimes it’s a struggle to keep all the plates in the air Picture: iStock

Sarah is really tired.

She gets home at 10pm and will be back at work at 6am – earlier than she should be, but it is always so busy. She asks to start later tomorrow so she can drop her kids at her mum’s before work. She is told this isn’t possible.

Sarah is really tired.

The plates she is spinning are falling and breaking. She gives her work everything. Sarah puts in a request to work flexibly. Her manager laughs before she tells her no, that this is what nursing is, and if she can’t hack it, well…

Sarah is really tired.

She is at breaking point. She gives her work everything. But it won’t give her anything back.


Sarah is fictional but her story is full of truth. It is an amalgam of experiences we have heard through our NHS flexible working network, which have included someone who was so exhausted they crashed their car on the way home from work. Many of the people we hear from have left nursing – a decision they have found devastating but necessary to balance their personal and working lives.

The long shifts, the extra hours, being too busy to go to the toilet. All this is so familiar in nursing. Add the COVID-19 pandemic and the expectation to be an ‘NHS hero’, and you find Sarah and many more like her. Versions of her story are lived out every day in the UK.

A more positive narrative is possible

But if we take a fresh, blank page we can write a different story for Sarah. One where she takes her breaks, and where she might stay later on some shifts, but it’s not expected or demanded of her. She takes her kids to school twice a week. She’s a professional who wants to progress in her job. She’s a mum and a friend, and a hundred other things. She knows she will need to keep plates spinning. She knows her manager sees this, sees her, and will help her catch a plate that’s wobbling before it falls. She feels like her employer is on her side. Sarah is no longer really tired.

This is the nurse we want caring for us when we are sick, the nurse we want to work with.

How difficult is it to read the first story but then write the second? But it is possible because we are the people who create the environments in which we work.

Making the leap towards flexible working will benefit everyone

If managers want to create a culture that supports staff, they need to be brave enough to say ‘yes’ to different ways of working for our nursing workforce. When we talk to nursing managers about flexible working, we often explore the barriers – fixed handover times, everyone wanting the same day off, a lack of parity in how people work, a complex rota management system. These are all valid and all certainly present challenges to managers who are under pressure to maintain ratios and ensure shifts are covered so that wards, departments and patients remain safe.

Saying yes to flexible working would improve the work-life balance of many nurses Picture: iStock

But if we start with the decision to embrace flexible working – saying yes – a few things happen. The most powerful one is that it normalises conversations about flexible working and supporting staff to balance their professional and personal lives.

More often than not, it’s not a ‘normal’ conversation. If you’re asking your manager to agree to flexible working, or you are making a statutory flexible working application, it’s frequently at a time where you’re feeling vulnerable in some way. Perhaps after having a baby, because a family member is ill and needs care, or because you have a long-term health condition.

We enter these conversations with our managers when we are fragile. We don’t always communicate well, especially when we are anxious and we are having conversations that are so loaded with emotion. Managers don’t always listen well or realise how much something matters to the person in front of them.

Normalising flexible working allows us to sidestep the superhero stereotypes

When we normalise conversations about flexible working – talking about flexibility as a ward team for example or, as leaders, talking about the flexibility we need in our own working lives – it makes it easier for everyone to ask, to negotiate and to get flexibility for individuals while maintaining the stability of the team.

In some of the labels ascribed to nursing – hero, angel, carer – it’s easy to forget the human behind the uniform. The person with needs and a life outside work that must be nurtured and nourished to enable them to be the nurse they want to be and the nurse we need them to be.

‘Sarah’ is a dedicated nurse, but she’s buckling and breaking. She can’t keep every plate spinning. It’s a myth that anyone can. When she reaches out for help and she is told no, something changes. She grows to resent the job that takes so much and gives so little and she leaves the profession. But in the version of her life where she is told yes, she stays. Her managers are able to change her working life, and so the lives of those who depend on her, change for the better too.

There are more than 330,000 nurses and midwives in the NHS. Managers can change the world for everyone like Sarah by creating an environment where you can proudly bring your whole self to work, just by saying yes.

Flexible working: tips for nurses and managers

Make conversations about flexible working and different working patterns part of one-to-ones, team meetings and appraisals. Talk about work-life balance.

If you are asking for flexible working – or you’re a manager considering a request – talk about what is and isn’t possible and why. Negotiate, be willing to try things and review them to see how they are working for everyone.

Don’t assume flexible working means working part-time. Often people want marginal flexibility – the ability to do a school run, or attend doctors’ appointments, or arrive 30 minutes later one day a week. That can be done without reducing hours.

Don’t look to the bank to provide your flexible workforce – the bank is a great solution for some staff, but we should be able to offer flexibility within substantive roles.

Use your HR team – they are there to support every member of staff.

Read your flexible working policies. Become familiar with good practice elsewhere – NHS Employers has a specific toolkit on flexible working for the nursing workforce.

Join our FlexNHS network if you’re interested in championing flexible working in your organisation.


@FlexNHS is a free network set up to champion flexible working for all staff and to amplify the voices of NHS staff working at every level and in every type of role. It aims to debunk flexible working myths and equip organisations and managers with the tools they need to support flexible working. Find us on Twitter and Instagram @FlexNHS


Kate Jarman @KateBurkeNHS is director of corporate affairs at Milton Keynes University Hospital NHS Foundation Trust and co-founder of @FlexNHS

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