Abstract
Like other Western healthcare systems, Germany faces interlinked challenges (e.g., underfunding, shortages, high workloads), in balancing economic efficiency, professional ethics and patient-centered care. Nurses, mainly women, face poor working conditions in Germany. Shift work, unstable schedules and demanding tasks hinder full-time employment and raise gender equality concerns. A cultural change is needed that integrates ethical responsibility, well-being and regulatory requirements. The four-day workweek (4DW) is a possible social innovation, discussed with and without reduced working hours. However, its implementation raises questions about organizational change and power structures. This paper examines which stakeholders favor different models of 4DW and the limitations and paradoxes that arise when dealing with staff shortages and high workloads. Based on the Cajaiba-Santana (2014) model of social innovation, the macro, meso, and micro levels of the 4DW debate are analyzed by zooming in/out. The paper shows how cultural values, and institutional norms influence change processes. Twenty-seven interviews were conducted in 2024/2025 with stakeholders in the healthcare system. The data were analyzed using Mayring’s (2022) qualitative content analysis. The findings highlight the need to reduce nurses’ workload and implement new working-time models. The 4DW is seen as a possible solution, but views on implementation differ. A compressed 4DW is considered feasible, whereas a reduced 4DW faces financial and structural barriers. Women could benefit, as shift work and inflexible schedules often hinder work-life balance. The 4DW is thus relevant to gender equality and poverty in old-age. However, professional values and altruism make rapid adoption a challenge.
Presenters
Katharina HastResearch Assistant and PhD Student, Social Sciences, TU Dortmund, Nordrhein-Westfalen, Germany
Details
Presentation Type
Paper Presentation in a Themed Session
Theme
The Value of Culture and the Demand of Change
KEYWORDS
Four-Day Workweek, Healthcare System, Social Innovation, Gender Equality
