Staffing and Scheduling in Nursing Management

External Variables that Affect Staffing Plans

• Accreditation agencies standards (e.g. JCAHO, JCIA) require institutions to provide an adequate number of staff members with the experience and training needed to support a unit's unique patient care needs.
• Nursing association standards (e.g. ANA) establish principles for professional nursing practice, including safe staffing.
• Consumer expectations require high-quality nursing care, delivered promptly and efficiently by satisfied nurses.

Internal Organization Variables that Affect Staffing Plans

• Organizational staffing policies and support systems impact staffing plans.
• Scheduling principles aim to distribute the budget personnel appropriately, satisfy individual staff member needs, and meet the care needs of the unit.
• The goal of personnel scheduling is to minimize variability in the ratio of staff size to workload for each shift category.
• The number of permanently assigned nursing personnel for each unit should be calculated based on the expected occupancy rate (often 80%).
• Employees are not freely interchangeable, and non-professional employees should not be expected to perform at the same level as professional employees.
• Work schedules should be posted in advance to permit employees to plan their social and recreational activities around duty hours.

Scheduling Principles

• Distribute the budget personnel appropriately across the day of the week and time of day.
• Satisfy each individual staff member needs (although not always possible).
• Be fair and balanced from the employee perspective.
• Meet the care needs of the unit.

Structure and Philosophy of the Nursing Department

• Staffing plans should allow consistency between the philosophy statement and the observable practice of nursing on units.
• The philosophy statement guides the establishment of the overall structure of the nursing service department and the staffing model.

Staffing Mix

• Staffing mix depends on the intensity of nursing care required by patients, which depends on:
• Severity of patient illness.
• Complexity of nursing care and procedures.
• Degree of patient dependency on the nursing staff.
• Amount of time required to provide patient care.
• Level of technology in the nursing unit.

Changes in Service and Projected Units of Service

• Changes in service that will be offered, such as plans to expand existing clinical services or develop new services or programs.
• Projected units of service.

Strategies for Adding Supplemental Staff to the Unit

• Increasing staff FTEs (e.g. 40 hours per week x 52 weeks per year = 2,080 hours).
• Floating staff (also known as flex staff) from clinical unit to another to fill staffing vacancies.
• Using agency staff.
• Mandatory overtime.

Floating Staff

• Floating nurses from clinical unit to another to fill staffing vacancies.
• Requires experienced nurses with competencies to work on the unit to which they are assigned.
• Potential drawbacks: floating nurses may not have the required competencies, and anxiety levels may increase, leading to errors.

Agency Staff

• Nurses who are hired as independent contractors for shifts, weeks, or longer periods through agencies.
• Advantages: high payment rates, diversity in work environment, exposure to a variety of work teams, and ability to travel.
• Disadvantages: patients may be unable to distinguish agency staff from unit staff, and potential regulatory issues.

This quiz covers the key concepts of staffing and scheduling in nursing management, including the purpose of staffing, definitions, and factors affecting staffing. It also explores scheduling principles, variables, and strategies for adding supplemental staff.