In fall 2022, New York City-based Mount Sinai launched its four-day workweek program for nurse managers. More than a year later, the program continues to improve staff engagement, satisfaction and has become an important retention strategy, leaders told Becker’s.

“It’s the nurse manager that retains our staff,” Frances Cartwright, PhD, RN, vice president of nursing at Mount Sinai Health System Oncology Services, told Becker’s. “Our survey told us that nurse managers were most at risk for burnout, and had an inability to go home and forget about work, to decompress. Quite frankly, they’re considered the linchpin of any hospital between keeping staff satisfied, handling patient requests and complaints and supporting physicians. So we put a lot of thought into how to support them.”

Although nurse managers may typically be scheduled to work five days a week, they can end up working more due to being on call. Giving managers the ability to completely disconnect was one of the aspects built into the four-day workweek at Mount Sinai. Each manager works four 10-hour days and has one day completely away from work responsibilities. That day is covered by a different manager. The program also ensures there is a manager presence on the unit on both the morning and night shifts and at the change of shift.

“That panned out really well,” Dr. Cartwright said. “What I’m finding is managers are able to be present and we have rigor in the way that we’re supporting the nurses. But while we’re doing that, we’re also creating more efficient workflows so that they support the nurses and improve infection prevention. We are also seeing improved patient experience.”

Of course, there are guardrails around scheduling to ensure the units are covered as needed, Beth Oliver, DNP, RN, chief nurse executive and senior vice president of cardiac services at Mount Sinai Health System, told Becker’s. 

Nurse managers have the option to work five days, and some managers prefer that schedule because they feel like they cannot complete all their work in only four.

So far the program has been launched in two units at the hospital, with plans to eventually take the four-day workweek to all 51 inpatient units.

The four-day workweek has improved employee engagement and the culture of safety for nurse leaders and nurses, Dr. Cartwright and Dr. Oliver said, who added that the program has received overwhelmingly positive feedback.