Nursing Human Resource Management

Time Scheduling

• Time scheduling is a crucial human resource management function, assigning specific days and hours for workers.
• It's a key element in staff function and a prerequisite for successful nursing operations.
• Work and non-work hours directly influence employee productivity and job satisfaction.

Definition of Time Scheduling

• It involves distributing working hours for each employee within a specific unit and time period.
• It's a planned pattern of on-off duty hours for employees.

Objectives of Time Scheduling

• Ensure patient care needs without overstaffing or understaffing.
• Maximize the use of nursing staff and professional expertise.
• Know anticipated individual schedules in advance.
• Ensure fair treatment of nurses in their distribution of work assignments.
• Achieve a balanced distribution of staff days off.
• Satisfy staff regarding work hours and the perceived sense of fairness.
• Consider nurse and patient needs.

Principles of Time Scheduling

• Schedules are created for 4-8 weeks at a time.
• Head nurses do not have off-duty on Saturdays (the start of the week).
• One day off must be scheduled between the head nurse and assistant head nurse for adequate coverage.
• Night shifts should be followed by days off prior to other shifts.
• No accumulation of consecutive workdays to ensure adequate rest for staff members.
• Overlapping time is needed between shifts for handover.
• Flexibility is needed to accommodate sick leave, vacation time, and holidays.
• Desirable and undesirable work hours should be distributed evenly.
• Reasonable special requests should be honored.
• A nurse should be on duty at all times during a 24 hour period.
• Schedule changes should be kept to a minimum after initial implementation.
• Staff should be notified of upcoming schedule changes well in advance.

Hospital Policies Related to Time Schedule

• Hospital policies for scheduling must be defined when employees are hired.
• The responsible party for scheduling (by title) must be clear.
• The time period covered by each schedule should be defined.
• Dates for posting the schedule should be established.
• The day that starts the work week should be specified.
• Beginning and ending times for each shift should be outlined.
• Specify the meal/break time duration.
• Include the exact number of nurses on each unit.
• Identify the monthly work hours requirement.
• Detail the sequential workdays.
• Detail the sequential days off policy.
• Recognize the number of weekends off per month.
• The number of nurses in the morning shift should exceed those in the afternoon and night shift due to workload.
• Designate the number of paid holidays annually.

Systems of Time Scheduling Development

• The centralized scheduling system is managed by higher-level managers and covers all departments usually via computers, while Decentralized scheduling is managed by the head nurse, focusing on the assigned nurses in a single unit, and Self-scheduling lets staff nurses propose their schedule and wait for the head nurse's approval.

Advantages of Centralized Scheduling

• Centralized control of staff
• Fairness among staff
• Comprehensive view of staffing needs
• Facilitates adjustments in cases of illness, emergencies or changing patient needs.
• Reduces interpersonal contact between head nurses and staff.
• frees the head nurses from time-consuming duties & allows them to focus on other tasks.

Disadvantages of Centralized Scheduling

• Pulling staff from one unit to another can lead to negative reactions.

Advantages of Decentralized Scheduling

• Head nurses can customize scheduling to meet unit-specific needs, based on their knowledge of staff & their unit's needs.
• Staff feel valued and have personalized attention.
• Scheduling for a smaller unit is easier and simpler.

Disadvantages of Decentralized Scheduling

• Individual head nurses may develop their own methods and patterns; this can lead to discontent from staff on different units.
• Staff may feel the head nurse is not unbiased.

Advantages of Self-Scheduling

• Staff feel a sense of autonomy
• Improves job satisfaction
• Boosts staff morale
• Enhances team spirit & collaboration
• Decreases employee absenteeism

Disadvantages of Self-Scheduling

• Time-consuming process
• Bias in scheduling choices

Approaches of Time Scheduling

• Manual approach: One or more individuals develop the schedule for a specific unit, division or the entire institution.
• Computerized approach: Computers maintain the schedules, handle employee choices and holiday/vacation planning. All necessary scheduling data is inputted. Computer systems prove more effective and efficient.

Advantages of Computerized Scheduling

• Saves nurses time spent on scheduling.
• Reduces conflicts between staff and supervisors due to scheduling changes.
• Ensures consistent scheduling and equitable application of policies.
• Helps maintain objectivity in the scheduling process.
• Cost reduction through decreased clerical work and better utilization of professional nurses.

Variables Affecting Staffing Schedules

• Unit hours of operation
• Shift rotations
• Paid time off (vacations, holidays, etc)
• Staffing vacancies
• Automation availability
• Agency personnel use policies
• Part-time employees

Working Hour Scheduling Patterns

• Regular 8-hour shift: 7 AM – 3:30 PM; 3 PM – 11:30 PM; 11 PM – 7:30 AM
• 10-hour shift: 7 AM – 5:30 PM; 1 PM – 11:30 PM; 9 PM –7:30 AM
• 12-hour shift: 7 AM – 7:30 PM; 7 PM to 7:30 AM

Premium Pay for Weekend Work

• Per Diem staff have flexibility to choose when and if they work on weekends.
• Higher pay rate is provided to compensate for flexibility and reduced scheduling options.

Flextime

• Employees select their best scheduling times to meet their personal needs while still fulfilling responsibilities.

Use of Supplemental Staffing

• Increased use of supplemental/external staffing to address high-census periods or staffing shortage issues.
• External staffing includes agency and travel nurses.

Staff Self-Scheduling

• Employees receive 4-6 weeks schedules in advance to fill out.

Shift Bidding

• Newer method to accommodate staff shortages and give nurses more control over scheduling additional shifts.
• Prevents mandatory overtime by allowing staff to bid for extra shifts. The organization sets prices for each shift.

Types of Time Scheduling

• Block Scheduling
• Cyclic Scheduling

Block Scheduling Description

• Work schedule plans for a unit a week at a time (4-8 weeks) with blocks of days. Days worked are scheduled together.

Cyclic Scheduling Description

• Technique that assigns days and time off in repeating patterns, factoring in personnel needs and continuity of care. Schedules are for 4-8 weeks.

Implementing Time Scheduling

• determine schedule type, pattern of on-off days, considering staff experience and capabilities.
• consider the percentage/ratio of staff per shift.
• create a preliminary (rough) schedule
• list staff in order of seniority to assign the appropriate shifts
• assign night shift first, then evening shift, morning shift, lastly off duty hours
• complete schedule and check for errors, confirm accuracy of details like names, holidays, confirm suitable mix of personnel.
• sign the schedule to confirm accuracy
• Obtain necessary approvals to finalize the schedule
• post the schedule several weeks in advance
• daily updates of the schedule if needed.

Criteria for Scheduling Evaluation

• Coverage: Nurse-to-patient ratio, following required minimums.
• Quality: Desirability of the schedule in the eyes of the nurses assigned.
• Stability: Nurses understand future on/off schedules, matching hospital policy.
• Flexibility: System manages changes to work and nurse schedules.
• Fairness: Nurses have equal opportunities in the schedule.
• Cost: Reflects the resources used for scheduling (time, personnel etc).