A long-established philosophy for palliative care is still dominant today and constantly drives the care delivered in practice. This philosophy is deeply embedded in enhancing quality of life to ensure the inevitable advent of death is bearable and that life after death for the family is manageable on an emotional level. To achieve these outcomes, community nurses and other healthcare professionals engage in genuine caring which, among other things, involves encountering the intense emotional and psychological needs of patients. It also involves supporting patients to ‘live with the enemy’ (Owen, 2014)—knowing death is on the horizon—which is threatening to their whole existence. In addition, support is extended to the family and those deemed important to the patient. One could surmise that it is because of these demands on an individual in palliative care that the idea of having a work/life balance is believed to be important, and helps to relieve stress and emotional pressure on healthcare professionals.
The idea of work/life balance is welcome, although the practical reality of achieving it poses serious questions. For example, healthcare professionals spend most of their time at work which already suggests an imbalance between work and life. Practically, we have workplaces and homes, and that physical separation might help us to distinguish the two spheres. However, for some whose jobs allows them to work from home, the work/life split can be blurred and they may end up going to the o ce to create this work/life split. Some may not have any option to work from home and adhere to dictates from the institution, despite clear bene ts, such as when we work from home we pollute the environment less and are more e ective. Some who work from home create the work environment in the home in the form of a ‘study room’, enabling them to leave it all there once it is done, as a way of creating this work/life split. Indeed, working from home requires added discipline in order to avoid the blurring of boundaries and to remain focused on the job at hand.
Challenges of work/life balance
The notion of work/life balance creates an important problem in itself because of the assumption inherent in it, that a clear and neatly divisible split between work and life exists or is possible to achieve. To create such balance, we have to be able to control certain desires at work and outside of work. There are so many pressing desires regarding work-related tasks that we need and want to complete, from patient care to admin and documenting what we have done. Similarly, there are pressing desires in life, like being a social being, commenting and posting on social media platforms, spending time with family and those dear to us. At times we have desires to spend time with ourselves alone and that may not always be achieveable.
In palliative care settings we tend to respond to patients' needs and their changing conditions, but a problem arises if we cannot achieve this within the contracted hours of work. It follows that there are often areas of work that we take home and vice versa, and work and life will constantly intrude on each other's sphere, creating only an illusionary split and balance between work and life. It is logical to argue that most of us depend on work in order to maintain our lifestyles, so life can only begin when work has finished for that day or week.
Achieving work/life balance
The individual nature with which we process work and life pressures suggests that we also need to customise any strategies offered in this article. At a conceptual level, we need to realise the romantic idea of a clear visible split between work and life and replace it with a more fluid concept that acknowledges the overlap with each other. However, the real skill is guarding against either work or life overwhelming the other. One way of achieving this is by controlling the amount of work we take on. Managers can also help through allocating duties. However, this is also becoming an illusion due to shortage of staff, exacerbated by institutions wishing to save on salaries, not filling vacancies and redistributing workloads to the few staff left in post.
Second, it is crucial to acknowledge the emotional demands of palliative caring and balance this with the need to enhance quality of life and patient experience, while preserving our own wellbeing.
Third, is self-care, which although stated as third should come first. Everyone should find ways that help minimise work and life pressures. Individuals should understand why they are working in palliative care and be able to control their mind (Owen, 2014), and direct it towards the more helpful and constructive thoughts. This also suggests we understand our strengths and weakness as we encounter patients' emotional needs. It is important that we continue to believe and visualise our purpose in palliative caring, but simultaneously protect ourselves from the overwhelming pressures of that caring.
Conclusion
The philosophy of palliative care makes the idea of work/life balance a crucial component to providing that care. However, the difficulty of achieving this idealistic work/life split demands another way of looking at the concept. It is important that we consider work/life balance as an overlapping of ideas, which requires us to manage them to minimise any predominance of one over the other.