staffing pt 1

why is scheduling so difficult in nursing?

it does not fit traditional business cycle

there is an erratic and unpredictable health care demand

high level expertise is required 24/7

stress of job requires balanced work recreation schedule

staffing mix varies with acuity

although many organizations now use staffing clerks and computers to assist with staffing, the overall responsibility for scheduling continues to be an important function of first and middle level managers

what is the responsibility of proper staffing?

goal: to stay within a staffing budget (fiscal) and meet the needs of patients and staff (ethical)

safe and effective care economically

how are staffing needs predicted?

source of nursing pool/availability

economic climate

historical/future perspective

policy

nursing care model

reimbursement

diversity of patient population

what are the 4 critical elements in staffing decision?

patient, intensity of care, environment, expertise

what is decentralized staffing?

when the unit makes their own schedule over the hospital itself

what are the strengths and weakness of decentralized staffing?

strengths

1. UD has greater control over unit staffing

2. staff can take requests to UD

3. provides greater autonomy and flexibility for individual staff

weaknesses

1. can result in more special pleading and arbitrary treatment

2. may not be cost effective for organization-not viewed holistically

3. more time consuming for UD

what are the strengths and weaknesses of centralized staffing?

strengths

1. organization wide view of staffing optimal utilization of resources

2. staffing policies tend to be employed more consistently and impartially

3. more cost effective

4. UD is free to complete other tasks

weaknesses

1. less flexibility may not take into account specific workers desires or special needs

2. UD may be less responsive to personnel budget control in scheduling and staffing matters

list some simple staffing and scheduling options

job sharing

Flex Time

self scheduling

part time

float pool

lifestyle program

agency staffing or travel nursing

shift bidding

8,10, or 12 hour shifts

what is job sharing?

an employment arrangement where typically two people are retained on a part time or reduced time basis to perform a job normally fulfilled by one person working full time

what is flex scheduling?

starts and ends shift on times that meet ones own need while meeting work responsibilities

responsibilities do not require continual coverage

PRO: great for employee schedule around confined schedule

CON: difficult for UD to coordinate leads to over or under staffing

describe lifestyle program

weekend program

friday 7p to Sunday 7 p

2 weekend shifts a week or 4 in a pay

flat hourly rate (more than base pay): evaluations, raise, education/during the week

PRO: available mon-fri

CON: say goodbye to your personal life

what is internal registry/float pool?

float pool-cross train on multiple units

“tiered” pay

PRO: can work additional hours, less costly than travel agency nurse

CON: must meet CORE comps of each unit

describe external agency/travel nurses

supplemental nursing staff

more money

directly employed by an external broker and work for premium pay (2-3 times hour): can be contracted

benefits offered through broker

PRO: can provide relief high census

CON: expensive, compromise continuity of care, dedication to the organization and people it serves

what is shift bidding?

organization sets the opening price for the shift

nurses bid on the shift

organizations make final decision on coverage

what is self scheduling?

allow employees the opportunity and responsibility to make their own schedules

requires accountability of workers

guidelines: off shifts, weekends, holidays

committee reviews

final approval by UD

what is closed unit staffing?

staff members on a unit make a commitment to over all absences and needed extra help themselves in return for not being reassigned from the unit in times of low census

on call

cancellation

what is full time equivalent (FTE)?

an FTE is the hours worked by one employee on a full time basis. the concept is used to convert the hours worked by several part time employees into the hours worked by full time employees. on an annual basis, an FTE is considered to be 2080 hours, which is calculated as: 8 hours per day

how is staffing calculated?

productive hours - hours worked an are available for pt care

non productive hours: benefits time

1. vacation time

2. sick time

3. education time