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Take a Break

If you can't remember the last time that you took a "real vacation," listen up. Too few days away from the job can negatively affect your ability to work effectively.

"It can cause irritability, fatigue, insomnia, depression, even memory loss," said Julie Strich, MLIS, CEB, research director at the International Foundation of Employee Benefit Plans. "In the workplace, if you are suffering from irritability, that can jeopardize relationships with colleagues and patients. If you are suffering from fatigue, you tend to slow down, display delayed reaction time, poor decision-making."

It all adds up to something called "presenteeism," Strich said, which is when a worker reports to the job (as opposed to absenteeism), yet is not able to work to full capacity. And it's a career buster.

The antidote to presenteeism? Vacations.

U.S. Vacation Benefits Lagging
"Vacations improve freshness and productivity," said Joe Robinson, author of "Don't Miss Your Life" and a work/life balance speaker, trainer, and strong advocate of regular vacations. "Vacations have been shown to increase your on-the-job performance as much as 40 percent when you return. So having rested employees is really critical for business."

Yet with all of the signposts pointing to the value of leisure time in helping to maintain healthy, productive workers and build fruitful careers, the United States is the only industrialized nation that does not have a minimum paid leave law.

"There are truly only a handful of countries in the world that don't have one," Robinson said. "If facilities don't want to give you a vacation, they don't have to. We're seeing more of that; 25 percent of American workers don't get any vacation," he said, citing the No-Vacation Nation study.

The U.S. mindset goes back to a time when work was more menial and productivity was tied to how many hours you were walking behind your horse pushing a plow, explained Jeffrey Pfeffer, PhD, author and professor of organizational behavior at the Graduate School of Business, Stanford University.

"There is this belief - which is dead wrong - held by some employers that good employees work themselves to death," Pfeffer said. Some misguided bosses send a message either explicitly or implicitly to employees that to take a vacation somehow signals disloyalty or a lack of commitment to the job.

On the other side of the ocean, Europeans are proud of the philosophy, "We don't live to work; we work to live," and their vacation policies reflect this commitment. For example, employees in Sweden are legally entitled to a minimum of 25 work days of vacation time, plus 13 paid public holidays. And if that weren't enough, additional leave, typically five to 10 work days per year, is available for many Swedes simply for the asking. Similarly generous policies dominate most European and Scandinavian countries.

But the vacation status of healthcare providers at one Canadian hospital has them all beat.

Unlimited Paid Vacation?
At Windsor Regional Hospital in Ontario, President and CEO David Musyj implemented an unlimited paid vacation benefit for all staff. And what might have seemed an impossible thing to do at a healthcare facility has been an all-around success story.

"We pride ourselves as being a progressive institution, always looking outside the box and examining what leading trends are, and to see if we can make them work in our facility," Musyj said. "I had read articles about companies with unlimited time off, and I said to myself, 'If IBM can do it, why couldn't we?'"

Recruiting seasoned healthcare providers into the hospital's old benefits system - in which they would have had to work one full year before getting a two-week vacation - wasn't attractive. "Experienced workers might already have had five weeks of vacation time where they were; they weren't anxious to come here and lose it," Musyj explained.

Six Ways to Enjoy a Vacation

    Many Americans, given the gift of additional free time, wouldn't know what to do with it. Most U.S. workers rarely use up the paid vacation time that they have, even as the time they're earning through benefits packages is generally shrinking.
    Such were the findings of a global online survey, Vacation Deprivation, conducted by Harris Interactive for travel website Expedia from September to October 2012. The survey effort questioned more than 8,600 employees, 16 and over, worldwide. It's bad news because prevailing research also shows that forfeiting vacation time can result in over-stressed, fatigued, ineffective workers. That means that adopting this national penchant for skimping on the pleasures of a vacation is not beneficial to you, your employer - or your patients.
    It's time to turn the trend around. Here are some ideas for time-off activities to make the most of whatever time you have.
    1. Get Away Sure, this is the obvious choice. Even the most far-flung destination is usually do-able with planning and careful budgeting. Set a goal by making a top-five list of the places you want to see, and then scratch them off one-by-one. Perhaps you want to see every state capital in the U.S. or the birthplaces of all 38 dead U.S. presidents. Hey, whatever floats your boat.
    2. Try a New Mode of Travel Bus, car, caravan, train, plane or ship - what's your pleasure? They're all fun, and each one carries a benefit in terms of convenience, budget-tending, scenery along the way, or the sheer adventure of doing something different. Remember, vacation can be about the journey rather than the destination.
    3. Experience a Staycation To some, at-home vacations carry a mandatory sentence of attic cleaning or house painting. Change that dynamic. Try indulging in simple pleasures, like mornings in the garden, "doing lunch" with friends, tackling a craft projects with the kids. And who could argue with an afternoon of pampering? If going to a day spa is too rich for your wallet, take an hour for a massage. It won't break the budget, but it will make you feel like a million bucks.
    4. Change Cultures Try a new culture by going to a restaurant rich with exotic cuisine, experience a foreign film at an art theater, or brush up on your high school Spanish with a home-study course. Better yet, how about a week-long language immersion course in a foreign language-speaking country? You'll gain new understanding and a new vocabulary. Enrichment equals enjoyment.
    5. Head to the Nearest City People hit all the tourist spots when they are away from home, but tend to miss out on their hometown's greatest attractions. Consider getting a hotel room in your own city and really seeing it through the eyes of a tourist. Try a walking tour, investigate the museums or gardens, read up on the architecture, indulge in an open-top bus ride or a horse-drawn carriage ride through an historical district. You'll be amazed what a pleasure it can be to see home the way out-of-towners do.
    6. Volunteer Volunteerism is riding up the ranks of vacation preferences. suggests: "Make your next vacation your most impactful one yet. Volunteer internationally, travel the world, get off the beaten path, and enrich your life and the lives of others. You could change everything." The possibilities are endless - from building homes for poor or dislocated families to planting crops. Doing what you do best in a venue where you will be greatly appreciated can sometimes re-ignite the fire of your human passion.

    Valerie Neff Newitt is on staff at
    ADVANCE. Contact:

Now when prospective hires come into Windsor's HR department to interview, their first reaction to the unlimited vacation policy is disbelief. "They say, 'You've got to be kidding.'  We say, 'No, it really is unlimited,'" Musyi said. "It is a great draw. It has had the positive impact that we had hoped for."

Employees Give Back When They Take
At first, some staff at Windsor Regional Hospital were skeptical that unlimited paid vacation could work, Musyj explained. Some thought they would find it impossible to get approval for additional days off; others thought people would abuse the policy. They were all wrong.

"Now we're more than a year into it, and it has been an overwhelming success," Musyj said. "Employees see that the organization trusts them to be responsible for being clearly in control of their own time. What we've seen is that teamwork, which was good before, is even better now. It has increased exponentially because of this. Now when someone wants to take a vacation, very often others will step forward to cover a shift, pitch in, because they know whenever they want to take off others will do the same for them. It's in everyone's best interest to keep everything running smoothly."

Most importantly, Musji wants his staff to be "at the top of their game for patient safety, for quality care. If a worker is tired, exhausted, burned out, then patients are going to suffer," he said. "A staff member who is on the job 52 weeks a year, or who only takes a week off, is of less or no value to the organization."

Combatting 'Compassion Fatigue'
Indeed, reporting to work when a vacation is overdue can lead to conditions that hurt job performance and personal well-being. In nursing, for example, vacations are critical to delivering optimum care.

"When nurses are caring for people with complex physical and/or psychosocial issues, they get what we call compassion fatigue," explained Patricia Gonce Morton, PhD, RN, ACNP-BC, FAAN, professor and associate dean for academic affairs, University of Maryland School of Nursing.  "Compassion fatigue is really a way to cope with overwhelming situations ... to protect yourself from the intense feelings that arise. But it comes across to patients as no longer caring. You'll get surveys back saying, 'The nurse seemed cold and insensitive to my condition .' In reality, it was self-preservation."

Morton recalled experiencing compassion fatigue when she was a new graduate embarking on her first nursing job: "I had to work through the holidays that year. We had 11 patients in our coronary care unit and, one by one by one, between Christmas and New Year, every patient died. I tried to emotionally cope with all of that, as well as cope with being away from family for Christmas. But what do you do with that emotion? How do you recover? In nursing, it is essential to have time away, to renew in body and spirit, so you can give physically and emotionally and provide optimum care."

Vacations' Healing Power
Catherine O'Keefe, MEd, CTRS, an instructor in leisure studies and therapeutic recreation at the University of South Alabama, is associated with Take Back Your Time, an organization that emphasizes the importance of leisure time and vacations.

"How are overworked staff going to have any credibility with patients, telling them how to live a healthier life, when they don't do it themselves?" O'Keefe asked. "And if obesity is an outcome of stress-related poor eating, you only have to look at the population of clinicians working in hospitals to know that too many are not healthy."

Time away from work is good for you on many levels, Robinson agreed. "On the health front, they are as important as watching your cholesterol or getting exercise. Annual vacation cuts the risk of heart attack in men by 30 percent. And women who take more than one vacation a year cut that risk by 50 percent," he said. "There's no health food that can give you that benefit."

And vacations also cure job burnout, the last stage of chronic stress which is difficult to get rid of.  "Vacations have been shown to re-gather crashed emotional resources," Robinson said. "Vacations heal us."

Valerie Neff Newitt is on staff at ADVANCE. Contact:

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Georgette, here is a comment from the author of the article: According to CEO David Musyj, there was a purposeful attempt NOT to create a great deal of policy and procedure around this initiative. He told ADVANCE that the adoption was rather straight-forward: If a staff member needs time off, they take it. Period. It still must be approved by a supervisor (i.e. shifts must be adequately covered). But the number of times a person can take off is unlimited, and remains uncounted. Musyj noted that because other staff are so eager to have the same benefit afforded them, teamwork has hugely improved -- and covering shifts has proven to be absolutely no problem. A detailed description of the program authored by Musyj will appear in ADVANCE's Executive Insight magazine next week. You can access a digital copy at

Lisa Brzezicki,  Co-Editor,  ADVANCEJune 05, 2013

Interesting concept - unlimited paid vacation. I would like to know "how" this was operationalized? What are the policies and procedures to support it?

Georgette Wilson,  Director Operations,  UMMMCJune 05, 2013
Worcester, MA


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