Work Time Schedule Changes for Nurse Managers

The goal of this clinical trial is to explore how working a 4-day schedule impacts nurse manager wellbeing and job performance. The main questions it aims to answer are:

* Do those working 4-days have improved wellbeing with reduced levels of burnout and work/family conflict when compared to those in the control group?
* Do levels of sleep, heart rate variability, and physical activity significantly differ between those working the 4-day schedule change and those in the control group?
* Are nurse manager satisfaction, patient satisfaction, and patient quality outcomes different among those working the 4-day schedule change and those in the control group?

Researchers will compare those working the 4-day schedule change to those working the standard 5-day schedule to determine causality between the intervention and the outcomes.

Participants will:

* Complete an initial visit to learn about the study.
* Begin wearing an OURA ring, which will collect data on physical activity, sleep, and heart rate variability. They will need to download the Oura Ring app on their phone and log in weekly to sync data so that the researchers may access it.
* Complete the first survey on the online REDCap platform (baseline).
* Begin the work schedule that was assigned to them.
* Clock in and out of work each shift.
* Take the follow-up survey online (month 3).
* Take the final survey online (month 6).

Researchers are looking to measure the effects of potential worktime schedule changes on a) nurse manager wellbeing (i.e., work/family conflict, burnout) and b) job performance (i.e., nurse manager satisfaction, patient satisfaction, and patient quality outcomes). Informed by the Conservation of Resources (COR) theory, it is hypothesized that working 4 days per week instead of 5 will improve nurse manager wellbeing with reduced burnout and work/family conflict.

Using a randomized control trial design, nurse managers working at UCLA Health will be purposively recruited for the study. All participants will begin by taking a baseline online survey at the initial visit. This survey will collect primary data on wellbeing by measuring work/family conflict and burnout using the scales: Work-Family and Family-Work Conflict Scale + Work-Life Balance scale and the Oldenburg Burnout Inventory. The survey will include demographic questions and qualitative questions to elicit responses from nurse managers on how they believe the schedule changes impacts their wellbeing and job performance, providing additional understanding of results from the quantitative part of the survey. All participants will wear a biotracker, called an Oura Ring, for the study duration, uploading their data weekly via an app. The Oura Ring will provide primary data on sleep, heart rate variability, physical activity of nurse managers, which is hypothesized to mediate the relationship between the schedule change and nurse manager wellbeing. Secondary data will be gathered from UCLA MedNet system, including nurse manager TimeClock information, and de-identified aggregate data on job performance (including nurse manager satisfaction, patient satisfaction, and patient quality outcomes) over the duration of the study.

Participants will be randomized either into the intervention group or the control group at the initial visit. Those in the intervention group will begin working only four days a week as a schedule change, and those in the control will continue working five days per week. All participants will be taught how to input their time clock information on the UCLA Health System for all working days. Follow-up surveys will be completed remotely, occurring at three months and six months. The participants will receive a reminder email to complete the survey. After six months when the final survey is completed, study participation will conclude. Fifty participants are anticipated.

Eligibility Criteria:
Inclusion Criteria:

* 18 years old or older
* Registered nurse
* Currently employed as a full-time nurse manager
* Having a span of control greater than 40 Full Time Equivalent (FTE) Direct Reports
* Currently working at either Ronald Regan UCLA Medical Center or UCLA Medical Center Santa Monica
* In the acute care setting

Exclusion Criteria:

* Those working in ambulatory care settings
* Nurse leaders with less than 30 FTE's
* Working part time
* Working a schedule less than 5 days a week