Work and Health: A Study of the Occupational and Domestic Roles of Women Registered Nurses and Registered Practical Nurses in Ontario, Canada

Links between work and health are explored in this study of a proportional random sample of 1190 women Registered Nurses (RNs) and 643 women Registered Practical Nurses (RPNs) in the province of Ontario, Canada. First, features of the paid and unpaid work of the RNs and RPNs are outlined. The professional status of RNs is reflected in their greater control, responsibility, accountability and tensions embedded in their relationships with physicians. In contrast, RPNs are frontline workers with fewer career opportunities, less control in their work and lower pay. There are also common elements in their nursing work: heavy workloads, exposure to hazards, and the stress of dealing with death and dying and with violent patients. The main difference with respect to the domestic sphere is the substantially higher mean household income of RNs. Multivariate analysis is then used to explore the combined effects of paid and unpaid work on nurses' health. Exposure to hazards in nursing, time pressures with respect to home responsibilities and overall stress in life were associated with increased health problems. There is also evidence that workload issues are linked with poorer health. Social support in the form of a confiding relationship with a friend is associated with better health. One of the main differences between RNs and RPNs in the variables associated with health is in relation to children; contrary to our expectations, having one to four children is linked with better health for RNs. It is suggested that the higher household incomes of RNs may alter the nature of their home responsibilities and the interaction between the two spheres of work may differ. In conclusion, the findings are set in the context of restructuring in the healthcare sector.