WORKLIFE BALANCE & MARITAL SATISFACTION OF CRITICAL CARE NURSES IN PRIVATE HOSPITALS AT

Health service is one of the industries that provide a continuous service around the clock for the benefit of all citizens in any country. Health service personnel is responsible for provision of health care through application of medical science knowledge, skill and expertise in meeting the health needs of all people within each country. It is therefore expected that a healthy and psychologically balanced workforce provides health care. Nursing personnel are subject to psychological stress as a consequence of shift rotation extended work schedules, and prolonged contact with irritable and depressed patients. Studies on the physical, psychological and medical effects of night work generally agree that if night shift work is regularly performed, it causes negative effects on the health and family life of workers whether male or female. Studies suggest that in consideration of their reproductive function, the night shift should be continuously disallowed for pregnant and nursing mothers and those engaged in strenuous activities. If night work is an unavoidable necessity, workers should be compensated more in terms of social, monetary and health. A person can experience excessive pressure and demands outside work just as much as they can at work. Stress tends to build up over time because of a combination of factors that may not all be work related. WFI is linked with reduced family/marital satisfaction and FWI results in decreased job satisfaction. Life satisfaction is an amalgamation of both family and job satisfaction, and therefore spans both the work and family domains. Generally, spending more time on the job is associated with an increase in workspouse conflict which, in turn, is associated with less marital satisfaction. While some research indicates that wives' increased work hours were associated strongly with a greater likelihood of divorce. So it may be important to consider whether it is husbands' or wives' work hours that are at issue to understand the effects of increased work


HOSPITALS
Hospitals are institutions, which are mainly designed to care for the sick, injured and the well.A striking feature of India's healthcare system is the significant and growing role of the private sector in healthcare delivery and total healthcare expenditures.The private healthcare sector in India accounts for over 75 per cent of total healthcare expenditure in the country and is one of the largest in the world.An estimated 60 per cent of hospitals, 75 per cent of dispensaries, and 80 per cent of all qualified doctors are in the private sector.The number of diabetic patients in India more than doubled from 19 million in 1995 to an estimated 50.7 million in 2010 (International Diabetes Federation, 2009).While the demand for hospital care is rising, public and private hospitals are too few and their geographic distribution too skewed to meet such demand (National Commission of Macroeconomics and Health, 2005).

CRITICAL CARE UNIT
A critical-care unit (CCU) is a specialized department in a hospital that provides intensive-care medicine.Many hospitals also have designated intensive-care areas for certain specialties of medicine, depending on the needs and resources of the hospital.Critical care services are atypical in the wide heterogeneity of their patients.This is in part a reflection of the way in which these services have evolved.The progress of intensive care has been described as 'haphazard', consisting of 'largely unplanned and unevaluated' developments that occurred in reaction to changes in surgical and medical practice.There has been debate about the configuration of critical care services, fuelled by a perception that there are not enough beds in some parts of the country and that existing beds are not in the right places.An ICU is a specially staffed and equipped, separate and self-contained section of a hospital for the management of patients with life-threatening or potentially life-threatening, and reversible or potentially reversible, organ failure.An ICU provides specialist expertise and facilities for the support of patients and their families, utilizing the skills of medical, nursing and other staff trained and experienced in the management of critically ill patients.

WORK LIFE BALANCE
Work-life balance has been defined as "a satisfying, healthy, and productive life that includes work, play, and love; that integrates a range of life activities with attention to self and to personal and spiritual development; and that expresses a person's unique wishes, interest and values.It contrasts with the imbalance of a life dominated by work, focused on satisfying external requirements at the expense of inner development, and in conflict with a person's true desires."While the definition of work-life balance has embraced play besides love and work, much of the previous literature on work-life balance has focused on the work-family interface.Additionally, both poles of the balance-work and life/family-are contested concepts.The term 'life' seems to equate to 'non-paid-work', an expansive grouping that can include such categories as family, friends, pets, leisure, recreation, unpaid home activity, caring for children, and love-motivated activities.Consideration of a wider array of individual life paths is important, because demographic groups such as singles who may have less financial flexibility, male primary caregivers, family members responsible for elder care, collectivist cultures.However, work and family were viewed as women's issues or social issues instead of business issues.They only became business issues when they were introduced into employment policy by human resource professionals in the late 1980s.In the 1990s, the term "work-life balance" (WLB) emerged and replaced discussions of "work and family".This implies that worklife issues are no longer only just women's issues or family issues.Work-life debates are now concerned with the needs of both genders, and the needs of those with family responsibilities as well as those without family obligations.There is a growing amount of evidence that these states are not inevitable.A good proactive mental attitude to shift work or internal locus of control is an asset in coping with unusual working hours.In the 1990s, the term "work-life balance" (WLB) emerged and replaced discussions of "work and family".This implies that work-life issues are no longer only just women's issues or family issues.Work-life debates are now concerned with the needs of both genders, and the needs of those with family responsibilities as well as organizational need.

MARITAL SATISFACTION
Marital satisfaction refers to an individual's subjective experience of the marriage.Individuals are usually satisfied when their needs are being met, and when the individuals expectations and desires are being satisfied.Marital Satisfaction is the degree to which an individual's needs, expectations, and desires are being satisfied in their marriage.A marital satisfaction is a subjective condition which can only be described by the individual spouse.An individual's personal evaluation of their marriage overall and the most similar to the concept of marital happiness because only the individual is able to say how happy or satisfied they are.Marital Satisfaction is not; a quality of the relationship a measurement of the relationship Predictive of relationship success (i.e., stability).
The ways to achieve and maintain a sufficient level of marital satisfaction assures marital success.Marital satisfaction is a unique measure because it refers to: Marital satisfaction is how you rate your marital satisfaction; Since marital satisfaction is subjective, no one else can tell you how satisfied you are with your marriage!marital satisfaction refers to the condition of your marriage as you experience it; and Marital satisfaction is a highly complex and personal experience.Feeling satisfied is related to our childhood, to our ability to feel satisfied, it is influenced by our parent's marriage, our previous relationships, the nature of our interactions with our mates, and the environment in which we live.

Major Work factors influence marital dissatisfaction:
Work hours.Generally, spending more time on the job is associated with an increase in work-spouse conflict which, in turn, is associated with less marital satisfaction.This is especially so when people are working more hours than they desire.The conflict also intensifies when people are working more hours than their spouses would prefer.

Work schedule.
The scheduling of hours plays a significant role in marital satisfaction and divorce.Generally, research suggests that traditional Monday-through-Friday daytime jobs lend themselves to greater marital satisfaction and stability than do other schedules.However, other research suggests that individuals with flexible schedules have greater marital satisfaction.

Control over scheduling.
Much of the research on job flexibility finds an association between increased flexibility in work arrangements and less work-spouse conflict.Having control over when and where one works also can greatly decrease the conflict between work and marital responsibilities.Job flexibility has been linked with positive outcomes for both family life and work

Job commitment.
Studies suggest that the combination of job commitment and a level of control in one's job can serve as a predictor of marital satisfaction.People who were highly committed to both their jobs and their marriages had little workspouse conflict if they felt that they had control in their jobs.However, individuals who were committed to their jobs but felt that they had little control over their work showed higher levels of work-spouse conflict.
In more comprehensive studies it was found that those who were maritally satisfied had more problem-solving communication, more and better leisure time together, more effective communication, less conflict over childrearing, less sexual dissatisfaction and fewer financial disagreements.These are all factors that are likely to be linked to workplace demands and expectations.Locke (1951), Hill 1988& Hill 1988: proposed that partners who spend more leisure time together are more likely to have satisfying relationships.MacEwen, K. E. & Barling, J. (1988); Academic research has also shown that work/family conflict and job stress are associated with lower levels of marital satisfaction for women and withdrawal from marital interactions by both women and men.White and Keith (1990); In a large-scale longitudinal study of shift work was found to reduce marital quality and increase the probability of divorce (while the effects are significant, they are relatively small).Moreover, findings indicated that shift work has an impact on all aspects of marital quality: marital happiness, marital interaction, disagreements, marital problems and sexual problems.Two work demands that are especially likely to have this impact are: extended hours of work and working at unsocial times.Wilson (2002); reports that, "several studies have shown that shift workers often feel isolated from their family and friends and less able to fill their domestic roles.This is seen to manifest itself in low self-esteem, anxiety and irritability," however they do not reference the research.While this likely affects both male and female shift workers.Shift work can lead to increased work-family conflict because marital responsibilities and family activities can be severely disrupted due to the shift worker being out of alignment with the routines of their family.Hill (2005); workers that were supported by both a familyfriendly organizational culture and supportive coworkers were more likely to report higher levels of family satisfaction, while having an understanding supervisor increased marital satisfaction.For women, being employed in a high stress job leads to increased perceptions of overall stress, which in turn negatively spill over into perceptions of their relationship wellbeing.For women and men with jobs characterized by challenging work, decision-making latitude, and supportive supervisors, relationships with the spouse were more supportive behaviors with less disruptive husband-wife interactions.

ANALYSIS & INTERPRETATION Partners Comments about the Work Nature of the Respondent:
The table 1 describes classification based on the partner's comments about the work nature of the respondent.The partners comments about the work nature of the respondent is classified as Always, Often , Sometimes, Rarely and Never.It is concluded that the majority of the respondents have high experience towards "Partner Adaptability with me" as an experience with Partner.

Personal Factors and the Partner Description
Hypothesis: There is no significant difference between the personal classification of respondents and the Partner Description.
The table 3 describes the results of ANOVA in terms of personal factors, Source of Variations, degrees of freedom, sum of squares, mean sum of squares, F value, p value and its significance on the Partner Description.It is found from the table 3 that the hypothesis is rejected (Significant) in three cases and in other three cases the hypothesis is accepted (Not Significant).It is concluded that there exists significant differences between the personal classifications such as Nature of Job, Monthly Income (Rs) & Hours of Work /day in respect of the Partner Description.

FINDINGS
This chapter includes conclusion and suggestions based upon the findings of the study.• Shift systems: As per the current duty roster the critical care nurses work for 48 hours a week.This is as per norms.However, the nurses have no choice with regard to changing the shift timings for their personal emergencies.This is a matter of great discontent.

RECOMMENDATIONS
There are a number of steps an employer can take to make life easier for the shift worker.When workers feel awake, alert and satisfied these recommendations include: restricting successive evening or night shifts to three shifts; avoiding permanent night work; using forward or clockwise rotation in rotating systems, (morning to evening to night rather than backward or counterclockwise rotation) Providing adequate resting time (greater than 11 hours) between shifts; and limiting weekend work.with their jobs, both safety and productivity will benefit,

CONCLUSION
There is a relatively large literature on possible connections between shift work and several aspects of marital satisfaction.The findings suggest that we still need more high quality studies to resolve some of the questions regarding the marital happiness of shift workers, In particular, we need more studies that distinguish the different types of shift work, that examine the relative impact of different lengths of time spent on a shift work schedule, and that explore the question of whether some individuals are more susceptible than others to negative effects of shift work.We also need more research on the impact of interventions designed to mitigate the adverse consequences of shift work on health.That will require partnerships between workplaces and researchers in testing the potential benefits associated with different interventions.

1 .
A maximum of 38.8% respondent's partner's Sometimes comments about the work nature of the respondent.2. A maximum of 112 (19.3%) of the respondents opined that "Partner adaptability with me" as their experience with their partner.3. The majority of the respondents have high experience towards "Partner Adaptability with me" as an experience with Partner.4.There exists a significant difference between the personal classifications such as Nature of Job, Monthly Income (Rs) & Hours of Work /day in respect of the Partner Description.

Table 3 : Results of ANOVA -Personal Factors and the Partner Description
Provide shift schedules and rotation to workers ahead of time, Certain types of noise help to increase alertness and vigilance.Bright lights can help workers feel more alert, Encourage interaction between workers, Ensure ventilation is adequate and proper lighting, Provide healthy food options that are available at all hours, Provide other services, such as counseling and training, There are a number of steps an employer can take to make life easier for the shift worker, Exercise regularly; Proper diet; Napping during rest time; Marinating social contact; Frequent health check up.