SINGAPORE – Hospitals here are making flexible work arrangements more accessible to nurses as they continue to look at ways to attract and retain them to ensure a steady flow of nursing manpower to meet the demands of a fast-ageing population.

Traditionally, nurses have three regular shifts a day, whereas flexible work arrangements would include shifts that start and end at different times, part-time employment, and compressed work weeks where nurses work additional hours each shift to get an extra day off that week. 

At the National University Hospital (NUH), for instance, flexible shifts have become a mainstream option.

“Starting from September 2023, we have progressed and formalised FWA (flexible work arrangements) requests as a norm throughout all our inpatient wards,” said Dr Karen Koh, the chief nurse at NUH.

Ms Priscilla Teo, group chief human resources officer of the National University Health System cluster, which also includes Ng Teng Fong General Hospital and Alexandra Hospital, said that about 1,500 nurses, or around 25 per cent of the cluster’s nursing workforce, are already on flexible shifts.

The cluster has more than 50 shift arrangements for nurses to choose from.

Last week, Tan Tock Seng Hospital (TTSH) held a media briefing to say it is scaling up its flexi-work arrangements to all 2,500 inpatient nurses by the end of the year.

TTSH chief nurse Hoi Shu Yin said the preparatory work included a redesign, with nurses on flexi-shifts handling specific duties, and those on routine shifts continuing with full duties.

The hospital also shortened the handover done between each shift, which used to take an hour or more, to around 15 minutes with the use of technology.

While flexible arrangements have always been available for staff when they request it, the key leap for TTSH was to include six new shift options in the rostering system, Dr Hoi added. This way, the nurses can choose from nine shifts, instead of being assigned to only three regular shifts, she said.

Adjunct Associate Professor Yong Keng Kwang, group chief nurse at the National Healthcare Group cluster, said the group is looking at piloting flexi-shifts for ward nurses across all its institutions by the end of 2024.

The cluster includes TTSH, Khoo Teck Puat Hospital, Woodlands Health, Institute of Mental Health, Yishun Community Hospital and National Centre for Infectious Diseases.

At SingHealth, which has close to 13,000 nurses, all nurses are eligible for flexible work shifts, said its group chief nurse, Adjunct Professor Tracy Carol Ayre.

“Nurses in SingHealth work on a monthly roster cycle, and they can request the specific shifts they prefer as long as they can meet their weekly working hours,” she added. Singapore General Hospital, for instance, has 78 flexible shift combinations. 

Prof Ayre said SingHealth had streamlined the shift handover process to allow for more flexibility in work shift patterns, and is in the process of looking into enabling virtual handover processes, which will further enhance the flexibility in shift start times.

The Government has announced various schemes over the years to make nursing a more attractive career, and gone on a hiring spree for the public healthcare sector to make up for the high nurse attrition experienced in 2021 and 2022. 

In February 2024, Health Minister Ong Ye Kung announced a retention incentive scheme for nurses, where each nursing officer can potentially receive up to $100,000 over a 20-year period, or up to the prevailing retirement age, whichever is earlier.

About 24,000, or one-third, of the 65,000-strong healthcare workforce in the public healthcare clusters are nurses.

Meanwhile, SingHealth is also looking to introduce other initiatives such as a structured job-sharing model and a scheme to support its pregnant nurses post-delivery if they require a longer period of leave, said Prof Ayre.

Veteran healthcare union leader K. Thanaletchimi said: “In order to retain healthcare workers, especially nurses, it is no surprise that hospitals are embarking on formulating various shift patterns to accommodate the needs of our nurses.

“In fact, countries like Australia have many more permutations of shift patterns and a lot more flexibility in terms of flexi-time, flexi-load and flexi-place.”

She added: “Our public healthcare institutions are taking flexible work arrangements seriously to help staff manage the demands of work and personal life. This will result in better recruitment and retention of a motivated workforce, and increase morale and productivity with better job satisfaction.”