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To explore the impact of work life balance for hospital-based nurses: A Review of LiteratureII

Nurses as the largest group of health care providers will have a good standard of working life so they can provide their patients with quality treatment. Therefore care should be taken to the working life of the nurses. Work life quality (WLQ) is a dynamic object that is affected by multiple facets of work and personal life, and communicates with them. Brooks argued that QWL has two goals: to increase the consistency of the employees work experience while at the same time increasing the organization's overall profitability. From a nursing perspective, Brooks defined the QWL as “the degree to which registered nurses are able to satisfy important personal needs through their experiences in their work organization while achieving the organization’s goals”. Therefore the idea of employee satisfaction is more than just having a job and a wage for people. It's about giving people a place they feel welcomed, valued and appreciated.


Introduction of the Research:
Value of nursing care is seen as an significant factor of determining health care quality. The quality of nursing and health care is directly related to job satisfaction rates among nurses and to the quality of work life for nurses. The rapidly evolving health care climate has affected the nursing work environment, the workload and the quality of nursing working life. Studies have shown that the work environment impacts the outcomes of patients and the daily life in nursing care. Evidence indicates that nursing shortages, low quality of work life for nurses, job dissatisfaction and low patient outcomes are directly related to lack of a safe work atmosphere.
Quality of work life (QWL) has become an significant issue today, and numerous studies have been published on this topic. The first application of this definition was in the 1930s. This essentially defines the mechanisms by which an organization should maintain an employee's overall well-being, rather than concentrating solely on issues relevant to work. QWL is a mechanism in which the workers and stakeholders of the companies learn how to work together together to improve both the quality of life of the workforce and at the same time the organizational effectiveness. Notwithstanding the significance of this problem, an agreed QWL description has still not been implemented. Moorhead and Griffin have defined the QWL as the ability of employees to satisfy their important personal needs through what they have learned in their organization. Improving QWL is, in fact, a comprehensive process to improve the quality of life of employees at the workplace and is essential for attracting and retaining employees in any organisation.
QWL has been researched in numerous fields, including sociology, psychology, education, management, health care and nursing. QWL has gained growing attention in healthcare settings in recent decades. Health care agencies are one of the largest providers of services in the community. Nurses are the largest group of workers in health care organizations, and enhancing their quality of service has been a priority for health care organizations since the 1970s. Nonetheless, as part of the wider trend of excellence in health care, QWL 's concern for staff growth and well-being has been identified as critical aspects of the success of healthcare organizations. The QWL in health care has been described as strengths and weaknesses in the total work environment.
What's the value of the QWL? It has been argued that QWL affects the efficiency and engagement of workers in various sectors, including health care organizations. High QWL is necessary in order to recruit new workers and maintain a workforce. Health departments are also searching for ways to tackle recruiting and retention problems by maintaining a high degree of QWL. Focusing on enhancing QWL to improve the morale and satisfaction of workers will result in many benefits for employees, companies and customers. Those include enhancing organizational engagement, improving the quality of treatment and increasing the efficiency of both individuals and organizations. According to Sirgy and his colleagues, a happy employee is efficient, dedicated and committed. At the other hand, failure to control these variables may have a significant effect on employee behavioral responses ( e.g., organizational recognition, job satisfaction , work efficiency, attrition plan, organizational attrition and personal alienation) as well as on the organization's outcomes.
Recent studies has demonstrated the effect of career advancement incentives, such as the promotion method, access to graduation programs and continuing education, on nurses' quality of life.
There are few career / professional growth resources open to nurses. They are also exempt from engaging in significant health care decisions and innovations. The number of vacancies in the nurse program is smaller than the minimum requirements. Government and private sector services and remuneration are somewhat different, with the government sector providing greater remuneration in general. The visibility and status of nurses in the health care system is weak and very disappointing. Participation of experts The organization of nurses in the advancement of nursing as well as in the health care system is very small. Hence the researcher desires to study Quality of Work life of Nurses who are working in hospitals and their impact on Professional Development.
Nurses are the backbone of every medical facility or patient treatment in the health sector. Yet in India, this important group of employees is highly exploited, with a lack of respect and integrity at the workplace and, more importantly, with extremely low wages and a lack of job security. Most nurses, mostly from poor backgrounds, have to pay lakhs of ropes to get a nursing degree and hence have to take big loans, leaving them indebted. Yet what really threatens them after graduation is a lack of resources in government-run hospitals. In spite of the shortage of nurses and other staff in government-run hospitals, the government is actively pursuing a completely non-scientific recruitment process, which prevents the majority of applicants from obtaining a position in government services while, at the same time, hiring contractwork nurses at extremely low salaries to fill some of the vacancies. The nursing profession today faces a variety of challenges. Such problems are posing significant barriers to the advancement of nursing. The shortage of qualified nurses in the health care system is a issue of global concern. There is a lack of an sufficient number of qualified nurses in the health care delivery system or an disparity between the necessary number of nurses and the actual availability of nurses on the ground. However, nursing shortages are more nuanced and multifaceted and occur not only because of the lack of trained nurses, but also because of the lack of availability of nurses willing to work under the current conditions. 3. Literature review: Considering the importance of the study, the Researcher desired to conduct a review of literature available on this study.

A job satisfaction scale for nurses. Sik
Hung Ng, china In this paper, the case was posed by the researcher to establish a level of job satisfaction in nursing based on the unique job content and work background of New Zealand nurses and, after review and observations, the researcher concluded that turnover was significantly related to overall job satisfaction, especially career prospects and the relationship with supervisors. 2. Exploring the relationship between obstetrical nurse's work and pregnancy outcomes -Jo Watson, Monica Nicholas, Kelly dobbin. Within this research paper , researchers investigate nurses who work while pregnant. It was the first to begin investigating pregnancy outcomes for obstetric nurses and equate full-time employment with part-time work for 95 nurses. One third of nurses reported pregnancy complications and most nurses encountered work-related and personal stress. Experts also recommended that workers cultivate a safe and secure workplace. Safe workplaces, including meeting the special needs of nurses who work while pregnant. Because if it is not then it specifically impacted adverse pregnancy outcomes, including preterm labor because birth weight. 3. The experience of work engagement, hardy personality, optimism and subjective well being among nurses from china and Spain. Eva Garrosa, Felix, Bernarda For this field work , researchers evaluating crosscultural studies with a group of 154 nurses from Beijing (Chinese) and 164 nurses from Madrid (Spain) who completed the analysis. As a result , researchers concluded on the basis of findings that nurses are commonly found among professionals who show a higher degree of frustration and a significant percentage of them with having to leave the profession in the next 5 years. Therefore, from a cross-cultural perspective, the present study showed the key influence of HP, motivation and SWB, suggesting that nurses from China and Spain are more committed to these personal tools. Further these result contributed to development of nurses in HP, optimism, SWB, promote in increase in engagement and the improvement of working environment, relationship with users and coworkers, mutual help etc.

Demands, resources and the three dimensions
of flow at work. A study among professional nurses. Lara Colombo, Margherita Zito. Within this research paper, researchers explored the effect of some of the personal and employment tools and some of the job demands on the three dimensions (absorption, work enjoyment, work motivation) of workflow. Recognizing that resources have had a positive effect on the dimensions of workflow, in particular work satisfaction, task demands positively influenced absorption and negatively influenced the other two dimensions of workflow. On the basis of these findings, therefore, it was proposed that the HR manager would facilitate workflow in support of the availability of resources and the monitoring of job requirements.
5. Factors related to affective occupational commitment among Japanese nurses. Miho Satoh Through this analysis , researchers have shown that professional autonomy and job satisfaction may improve affective occupational commitment, and further researchers have also indicated that an intervention program targeting specific personal resources such as ability, experience and resilience should be implemented to improve affective occupational commitment. 6. Work life balance: Reality check for the working women of Bangladesh.Mayesha Tasmin, Muhammed Jakir. The goal of the researchers behind this paper is to find the explanation for creating a work life imbalance. And this study focuses on women working in various sectors from Bangladesh and, as per the results , researchers who are able to find the reasons why female workers are facing difficulties are mainly due to long working hours, job rigidity, excess of jobs, child care obligations, sexism and prejudice in the workplace, lack of help from supervisors, so the findings of this study concentrate on formulating. 7. The relationship between time pressure and burnout syndrome: A cross sectional survey among Jordanian nurses. Mohammad W.Darawad, Hani Nawafleh. In this research paper, researchers looked at the level of time pressure and burnout among Jordanian nurses, which was found to be high and consistent. More researchers observed that emotional fatigue, which was the highest component of burnout and personal achievement, had the strongest association with the demographics of the sample. In this study, researchers have proposed that health care managers need to change the nursing work atmosphere in order to be less stressful and more desirable in order to address the cause of the burnout of nurses. This study presents the degree of fear of susceptibility and the level of caregiver burden among Nigerian nurses. Researchers therefore proposed that that the number of nurses working would also decrease their workload and minimize the burden. In addition, researchers have also proposed several other solutions, such as the implementation of a holistic approach to fear reduction. All educational tools, like nurses, should be encouraged to come together and exchange feelings and experiences, thus learning from each other to better understand the role of nursing caregivers. 10.Effect of work environment on level of work stress and burnout among nurses in a teaching hospitals in Nigeria.Guobadia Pouline Ojekou,Odetola Titilayo Dorothy, Nigeria. In this study , researchers found that the stress level among staff nurses who served for only 0 to 3 years was higher. There is also a significant relationship between the work atmosphere, stress and burnout among nurses in the selected unit, and with this study , researchers proposed that hospital management should provide a work environment that is conducive to work, providing the requisite support and sufficient break times to ensure the well-being of staff.

Selected organizational factors affecting performance of professional nurses in North
West bank government hospitals. Mrs. Ahida Saleem Thulth, Dr. Sumaya Sayej. Throughout this study , researchers attempted to determine selected organizational factors (workload, available resources and management support) influencing the performance of nurses. Therefore, the results of this study have shown that improving the performance of nurses, such as supervisors, would ensure an appropriate number of staff and qualifications on a work-related basis and a sufficient number of qualified nurses in hospitals at all times and shifts. 12.Predictors of "quality of work" and "poor health" among primary health care personnel in Catalonia.Evidence based on cross sectional, retrospective and longitudinal design. Simon L. Dolan, Salvador Garcia, Carmen Cabezas, Shay S. Tzafrir. The goal of this paper is to test a theoretically guided model of the relationship between job demands, employee motivation and resources, and supervisory support for the quality of working lives of employees and their general health. Based on empirical results, it has been proposed that taking practical steps to reduce tension, reduce adverse health outcomes and, in large part, improve the quality of the working lives of people in this field. 13.Relationship among stress, positive affectivity and work engagement among registered nurses.Jazreel Hui Min Thian, Premarani Kannusamy, Hong-Gu He, Piyanee Klainin-Yobas. The goal of this study was to identify sources of work stressors among registered nurses and to explore the inter-relationship between stress, positive affectivity and work engagement. Researchers have found that job stressors faced by most nurses are workload, time pressure, insufficient compensation, inadequate patient contact, and unmanageable emotional demands for job. As a result , the researcher proposed that work site strategies should be created to help nurses handle stress, such as seminars, and job opportunities could be provided in health care facilities. 14. Experience of occupational stress among emergency nurses at private hospitals in Bangkok, Thailand.Nuttapol Yuwanich1, Sharareh Akhavan, Walaiporn Nantsupawat, Lene Martin The goal of this research was to investigate the experiences of nurses with occupational stress in emergency departments in private hospitals in Bangkok , Thailand. According to results , researchers found that patients and their families faced primary stressors in private hospitals, as well as disproportionate workloads, other stressors were misunderstandings and disputes between emergency department nurses and other professionals. Finally , the researchers concluded that creating a healthier working atmosphere and a harmony between patients and nurses would minimize the workload and tension that ultimately ensures the health of the patient. 15. A comparative study on "work life balance among nurses" with special reference to government and private hospitals in Tirunelveli.S.Parmeshwari Shobana, S. Kannan. This research paper analyzes the results and concludes that both government and private hospitals in the Tirunelveli district will resolve work-life balance problems and help nurses to manage their job and family life. Temporary shortage of personnel is the key explanation for extra work, loss of leisure time and financial problems, both of which need to be discussed appropriately to researchers. 16. Barriers to work life balance for hospitals nurses. Kathleen Mullen. In this article, the researcher summarized as enhancing the work-life balance requires active and evidence-based approaches for self-reflection and change through practice. Also the researcher believed that awareness would help them as they became productive and efficient at work. 17. Examining the effects of fatigue on decision making in nursing: a policy-capturing approach. Loura Mcclelland. For this research review , the researcher investigating the relationship between exhaustion as a result of shift work and decision-making, also used this study to determine what policies nurses use when making important patient decisions and how such policies adjust as a result of exhaustion felt from the beginning to the end of shift work. Therefore, based on the results of this analysis , the researcher concluded that the participants had become substantially more tired, depressed and less alert from the start to the end of the 12-hour shift. Researchers suggested, therefore, on the basis of nurse's work hours and work areas, to schedule breaks and time off between shifts to ensure patient health and nurse's health. 18. Job stress, job performance and social support among hospital nurses.Raeda Fawzi AbuAlRub. The aim of this study is to investigate the impact of work-related stress on the performance of work and the influence of social support among hospital nurses by staff. As a result of this study, the researcher suggested the essential role of social support from co-workers. The positive effects of social support on work performance may further enhance the quality of patient care. Even more studies found that a work environment with social support and a reduced level of stress results in higher retention rates for nurses. 19. The relationship between job stress and nurses performance in the Jordanian Hospitals: A case study in king Abdullah the founder hospital.Akif Lutfi Al-khasawneh, Sahar Moh'd Futa The purpose of this article is to evaluate the relationship between the five stressors, namely family factors, economic factors, work difficulties, peer competition and organizational environment with performance nurses, i.e. creativity and innovation, problem-solving and decision-making capabilities. And according to the results , the researchers concluded that family factors had no association with the performance of nurses, while 4 other stressors had a positive relationship, as the organizational environment had the most effect on performance than work difficulties and, finally, peer rivalry. At the end of the day, researchers proposed a fundamental change in the organizational environment and an rise in leader support. 20. Changes in decision making during a 12hour day shift.Fred S. Switzer,June J Pilcher The purpose of this research was to establish if a decision-making transition occurred over a 12-hour day shift for registered nurses. From this research study, researchers have examined that nurses have dramatically changed their decision-making practices from the start to the end of the shift and become less alert and more anxious. Based on the findings of the study, therefore, it was concluded that the medical judgment in nurses shifted from the beginning to the end of a 12-hour shift, and even shift work negatively affects results. 21. A study on work life balance of female nurses with reference to multispecialty hospitals, Mysore city. Viveka Marie The goal of this research paper is to highlight issues related to the work-life balance of nurses, as well as to support the physical and mental health, job satisfaction and work-life balance of nurses, because according to the researcher 's findings, incorrect work patterns and long working hours appear to have an adverse impact on the wealth and health of employees. 22. The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Amy Witkoski stimpfel, Douglas M Sloane. In this article researcher investigated the relationship between nurses shift length and patient's assessment of care, researchers found that the longer the shift, the greater the likelihood of adverse nurse outcomes such as burnout. So accordingly, research, researchers concluded that patients are less satisfied when working hours of nurses are more than 13 hours and were more satisfied when nurses working 11 or fewer hours. 23. Work life balance of nurses and lady doctors.Dr. Bindiya Goyal. According to the researchers concerned, the work-life balance is emerging because it affects the productivity of nurses and physicians. The goal of this study is to identify the factor that will help sustain work life balance and, based on findings , the researcher concluded that the provision of work life balance policies and practices by hospitals would enable nurses and doctors to make better use of their capacity. 24. Quality of work life among female nurses in the kottakkal region, Kerala.Hania Hanif, S. Manimaran According to the researchers concerned, the worklife balance is evolving as it affects the effectiveness of nurses and lady doctors. Aim of this study is to identify the factor that will help sustain work life balance and, based on findings, the researcher concluded that the provision of work life balance policies and practices by hospitals would enable nurses and doctors to make better use of their potential. Observation of the study: • The available literature of this study can be an significant step towards improving the quality of the working life of nurses. • This study would indicate that there are no reasons of concern for the quality of working life of nurses. • This research helps health care practitioners to develop strategies to enhance the working environment of nurses and their quality of work life, allowing nurses to provide better care for their patients.
• The purpose of this research is to improve the home and work environments by improving the performance of individuals and organizations and by engaging nurses. • The discovery of this paper, based on the ideas of the respondent, will promote the nursing profession.

Conclusion of the study:
It is undeniable that quality of work life plays an important role in bringing job satisfaction in employees. This study has explored the Quality of work life for an employee i.e. nurses in a hospital set up. Moreover, researcher also highlights some of the gaps quality of work life towards the hospitals where it aims in maintaining peaceful and healthy environment within work place. Since the paper is based purely on review of literature & secondary data, the only practical application of this paper is for formulating the instrument (questionnaire) for data collection further. Following variables were found from the literature review.