Two-thirds of nurses and midwives in NSW often consider leaving the industry, while almost half have already started looking for alternative work, a damning new report has found.

Clinicians in the female-dominated industry are struggling to balance unpredictable, high-intensity shiftwork with parenting demands, according to University of Sydney analysis released on Tuesday.

Registered nurse and union delegate Sarah Ellyard’s shifts vary between mornings, afternoons and overnights, with no set pattern in her rotating roster.

The single mother and Annandale resident is on parental leave, and said returning to work on an acute mental health ward next year would be “challenging”, as she balances the emotional labour of helping patients in crisis while also caring for her young son, Finley.

“The current system really doesn’t work very well for a lot of people,” she said. “You can probably manage it for a while, but nurses do get burnt out after years of shift work and a lack of flexibility, sometimes working six or seven shifts in a row.”

The new analysis found 70 per cent of the approximately 2180 nurses and midwives surveyed said they couldn’t recover their energy completely between shifts, while 44 per cent said they sometimes need to take shortcuts in patient care due to time pressure, complex patient needs and chronic understaffing.

The survey was conducted before nurses and midwives were awarded a record pay increase in April, bringing the annual gross salary for a fifth-year registered nurse to just under $99,800 after the industrial court acknowledged the workforce had been historically undervalued.

The report found a lack of flexibility, overwhelming workloads and understaffing created an interrelated cycle of poor job quality.

Associate Professor Josh Healy, who co-authored the report, said nurses and midwives wanted greater choice and control over their hours, saying, “Things like swapping their shifts, being able to change the start or finish times of their workday, the ability to job-share … these are not wildly ambitious asks.”

One enrolled nurse and single mother who took part in a focus group said that simply moving her shift’s start time forward by 30 minutes would help her accommodate school pick-up and stop her reliance on paid assistance and extended family. “It would just make my family life so much … more balanced and less stressful,” she told researchers, “but I’m not allowed to.”

Professor Jenny Sim, the NSW head of the Australian Catholic University’s School of Nursing, Midwifery & Paramedicine, said the report’s findings were “sobering,” but lined up with international evidence.

“Burnout is a major contributor to retention,” she said. “When the workforce loses its most experienced and its most skilled nurses and midwives, then we dilute the clinical expertise that is available in the workplace to help keep patients safe.”

While NSW Nurses and Midwives Association general secretary Michael Whaites acknowledged flexible work could not be implemented overnight, he said, “it has to be doable”, as patient demand and complexity increased, leaving the union “very alarmed” about retention rates.

“The idea that women need to continuously make the sacrifice to make their jobs work, to make their caring responsibilities work, and to sacrifice their own personal time in order to do that, that’s the societal culture of a bygone era,” he said.

Whaites said the union hoped to collaborate with NSW Health to co-design a series of flexible work pilots that were beneficial to both workers and the health system, which he called a “solid investment in the future of the workforce”.

In a statement, NSW Health Minister Ryan Park said his government was committed to working closely with the union.