Staffing needs and scheduling – Flashcards
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Unit Managers responsibilities in meeting staffing needs
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Night, evening, weekend & holiday; inflexible scheduling and extended work schedules; Employee Control (need to know how many nurses will be there or wont); Staffing clerks and computers (assist with the 1st and middle level managers (most important); allow employees to self schedule and help to make policies by being on committees
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Decentralized
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have managers make scheduling decisions; Responsible for : staff absences (nurse managers); Adding staff, preparing monthly unit schedules and preparing holiday and vacation schedules (nurse mgr does this)
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Advantages of Decentralized
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know needs of unit and staff, staff feel more in control, increased autonomy and flexibility Ex. knows need someone who specialized in dialysis (so you staff based on the need)
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Disadvantage of decentralized
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possible inconsistency with treatment of employees, time consuming ( ex. favoritism
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Centralized
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staffing decisions are made by personnel in central office or staffing center
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Advantage of Centralized
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fairer to all employees, cost efficient because of hourly wages (ex. on call(paid more but no benefits) vs full time employee)
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Disadvantage of Centralized
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not very flexible or knows special needs of worker: (ex. don't know credentials of different employees so don't know needs or specialty needs of the floor (unit))
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Managing a diverse staff
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Ethnically or culturally diverse (have to meet the needs of the growing diversity); Dept of health and human services office of minority health ( language assistance :mandatory; written and verbal (services need to be explained ; no extra cost to patient to have interpreter)
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Complying with staffing mandates
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every floor except ER have a mandate for staffing: mandatory staffing requirements and minimum staffing requirements; staffing ratio argument: numbers alone dont prove quality of care ; if nurse has more than mandated (patients) reduces care for patient and nurses and can cause more med errors (Ex. not all RNs have the experience)
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Staffing and scheduling Options
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10-12 hour shifts ; cyclical staffing; Job Sharing; Agency Nurse or travel nurse ;Per diem; Float pool; Flextime ; Self scheduling; Shift bidding
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10-12 hour shift
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10-12 hour shifts (advantage: get hours in and get less days, get to know patients; disadvantage: errors are made (tired)); premium pay for weekend work; part-time staffing pool for weekend shifts and holidays;
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Cyclical Staffing
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(pattern and know in advance advantage: you know ex. 3 on 2 off so can make plans) holidays are not part of the cyclical staffing so you will have to work if you're normally off
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Job Sharing
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split shift
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Agency nurse or travel nurse
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(no benefits, prem. pay);
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Float pool
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(agree to go to different units; excellent pay no benefits);
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Flextime
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(best for employee: easiest; allows employees to pick what would be best for them and still meet floor responsibility;disadvantage: a lot of coming and going);
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Self scheduling
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(you schedule 6 weeks out ; don't always get what you want)
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Shift Bidding
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( allow nurses to bid on shifts instead of mandatory OT; doesn't work for companies; friends can help ea other out to get bids)
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Workload Measurement tools
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Productivity =output / input
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Formula
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NCH/PPD=nursing hours working in 24hrs/patient census (if over 100% in trouble)
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PCS (Patient Classification System)
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Classify patients ex. maybe by what they need done; maybe by acuity(you assign numbers), ex. IV ( if have IV or not), bathing, # of procedures to be done
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Workload measurement systems
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beyond the patients disease; evaluate workload; how long it takes you to do something; look at everything
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Restructuring and reengineering started in 1990s
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Advantages (decrease cost increase efficiency; Disadvantage (a lot more med errors; patient falls; decrease patient satisfaction); low census, floating, assigned by numbers, patient assignments
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Generational considerations for staffing
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veteran generation; Boomer generation; Generation X; Generation Y
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Veteran Generation
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respect authority, support hierarchy (Ex. Nesbitt)
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Boomer generation
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traditional work values/ethics, willing to work long hours (Ex. Ponder)
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Generation X
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more flexible options, define success in own terms (ex Maeker)
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Generation Y
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global, optimistic, upbeat, self confident (ex. Mr. Bell)
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the impact of a shortage of nursing staff upon staffing
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unpredictable (don't know what will happen); Cross training (personnel background to take on tasks beyond scope of practice); Shortages (day to day basis due to call ins, dismissals, acuity); Closed Unit Staffing (don't go other floors; disadvantage- no help; advantage- don't have to go anywhere else); Meet state and federal labor laws and organizational policies (cant make you stay or come in); Staff not demoralized or fatigued; Long term and short term solutions looked in to (ex. Sign on bonus); Patient care not Jeopardized
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Fiscal and Ethical Accountability for staffing
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Based on PCS; Accountability for budget (nurse mgr responsible for); Cutting Personnel (results in lg. savings- if over budget will cut jobs); Increased Staffing (nurse mgr need to know when census increases); Goal (provide safe and effective care economically-pt care to not be jeopardized); Employee rights (right to expect reasonable workload; Effective Managers (nursing duties, job description, look at staffing mix & competencies; try to be an effective and cohesive team)
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Developing staffing and scheduling policies
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Written policies (provide means for fair and consistent); Personnel policies ( should allow flexibilities focus on outcomes; represent standard of action communicated in advance so nurse not caught unaware); Scheduling and staffing policies (reviewed and updated periodically; know your own philosophy); staff input and collaboration (should have your input)
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Integrating leadership roles and management functions in staffing and scheduling
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Astute leader; avoids under staffing and over staffing (know their unit when census will change; involves employees (leader doesn't mind sharing; adopts policies (cant be in violation); redesigns work ( to assure production and staffing needs); Knows changes in community and national trends (online charting); Uses contemporary methods (centralized and decentralized); shows accountability (adequate staffing); Reviews unit policies (if old need to revise in timely fashion); Estabilishes trust with employees to help build a team that will help in time of shortage
