NCMB 419 Lecture Midterm PDF

1 W7: STAFFING - Topics: Focus on evidence-based practices, new technologies, and regulatory requirements, an...

1 W7: STAFFING - Topics: Focus on evidence-based practices, new technologies, and regulatory requirements, and consider specialized training based on “Employee selection is so crucial that nothing else – not leadership, not team building, not training, not pay incentives, not total quality management – can overcome poor departmental needs. hiring decision” 6. Use creative and flexible scheduling based on patient care needs to increase – Gerald Graham productivity and retention Effective employee selection is foundational because it ensures that the right individuals - Patient Care Needs: Use flexible scheduling practices to align staffing with who are capable of aligned with the organization's values and goals are brought on patient care requirements, ensuring adequate coverage during peak times. board to support the success of all other organizational efforts. - Retention Strategies: Consider employee preferences and work-life balance in scheduling to improve job satisfaction and retention rates. Emphasizes the critical importance of making good hiring decision as it suggest that no matter how strong other aspects of an organization are such as leadership and building Nursing Shortage training pay incentives or quality management this elements cannot compensate for the Patient’s safety: The patient safety is compromised if there is a nursing shortage negative impact of poor hiring choices Diminishes hospital’s capacity to treat patients ○ Nursing shortages significantly reduce a hospital's ability to treat patients Resources Management effectively. Physical resources Contributes to emergency department overcrowding Maintain the necessary equipment and facilities to support nursing activities. ○ Insufficient nursing staff contributes to overcrowding in emergency Examples: departments, leading to longer wait times and decreased patient ○ Equipment Maintenance: Regularly servicing and maintaining medical satisfaction. devices (e.g., infusion pumps, ventilators) Reduced number of staffed beds ○ Facility Management: Keeping patient rooms, operating rooms, and ○ Hospitals may have fewer staffed beds available, limiting their capacity to common areas clean and safe admit and care for patients ○ Supply Management: Monitoring inventory levels of essential supplies Cancellation of elective surgeries (e.g., medications, personal protective equipment) ○ A lack of nursing personnel often results in the cancellation of elective surgeries, impacting patient care and hospital revenue. Financial resources Discontinuation of services Allocate budget effectively to support staffing and development initiatives. ○ In some cases, hospitals may need to discontinue certain services due to Able to operate efficiently and sufficiently well to promote success inadequate nursing staff, further affecting patient access to care. Examples: ○ Budget Allocation: Developing a budget that prioritizes staffing levels, How A Manager Should Respond To Shortages training programs, and necessary equipment purchases to improve patient Budget constraints care quality. Strategic Budgeting: Managers should assess and prioritize budget allocations to ○ Cost Analysis: Evaluating the costs associated with various nursing support staffing levels, possibly seeking funding for additional positions or activities and identifying areas for cost savings, such as reducing overtime overtime. expenses through better scheduling. Resource Optimization: Explore ways to optimize existing resources, including ○ Funding for Development: Securing grants or financial support for staff cross-training staff to enhance flexibility. development programs, such as continuing education or leadership training. Type of patient care management used Primary Care Management (FIRST POINT): Focus on preventive care and Human resources wellness, which may require different staffing strategies, emphasizing roles that Ensure the right number and mix of nursing staff to meet patient care demands. enhance patient education and community health. Examples: Secondary Care Management: Ensure adequate nursing staff for acute care ○ Staffing Models: Implementing a staffing model that matches settings by adjusting staffing models to meet immediate patient needs and nurse-to-patient ratios based on patient acuity levels to ensure safe and includes treatments, diagnostics and inpatient and outpatient services effective care. Tertiary Care Management: Address specialized care needs by recruiting staff ○ Recruitment and Retention: Developing strategies to attract and retain with specific expertise, potentially leveraging partnerships with educational qualified nursing staff, such as offering competitive salaries, benefits, and institutions for recruitment; advance medical treatment; referrals came from opportunities for career advancement. secondary and primary ○ Training and Development: Providing ongoing training programs to Education and knowledge level of staff to be recruited enhance nursing skills and knowledge, such as specialized training for critical Targeted Recruitment: Prioritize hiring candidates with the necessary education care or pediatrics. and experience to meet the demands of the facility. Ongoing Training: Invest in continuous education and professional development STAFFING for current staff to enhance skills and retention. 3rd phase of the management process Mentorship Programs: Implement mentorship initiatives to support new hires Ensures that there is an adequate number of nurses with appropriate skills to and improve their integration into the team. provide safe, efficient and high quality care to patient Plays a vital role in patient outcomes. Stuff satisfaction and overall healthcare Recruitment facility performance Is the process of actively seeking out or attracting applicants for existing positions The process of determining and providing the acceptable number and mix of and should be an ongoing process. nursing personnel to produce a desired level of care to meet the patient’s demands In complex organizations, work must be accomplished by groups of people; Recruits, selects, places, indoctrinates personnel therefore, the organization’s ability to meet its = Goals and Objectives = ○ To accomplish goals and objectives, the leader manager indoctrinates Quality Employees Recruitment Methods: personnel. ○ Recruitment and Selection: Identify and attract qualified nursing ○ Employee Recommendations: Leveraging current staff to refer potential personnel. candidates, which can lead to higher quality hires. ○ Placement: Assign staff to roles that match their skills and the ○ Word of Mouth: Encouraging employees to spread the word about job organization’s needs. openings within their networks. ○ Indoctrination: Integrate new employees through orientation and training ○ Advertisements: Utilizing various media (online job boards, social media, programs. professional journals) to reach a broader audience. Promotes personnel development ○ Fliers: Distributing flyers in community centers, schools, and healthcare ○ Focus on ongoing education and professional growth to enhance nursing facilities to attract local candidates. ○ Placement Services: Partnering with recruitment agencies or universities competencies and job satisfaction. ○ Increase the employee engagement and satisfaction thus it will improve to source qualified candidates. retention rates and increase productivity and efficiency The Role of the Recruiter in Nursing Management Should know the needs of the organization Steps Of Staffing Responsibilities The recruiter should have a thorough understanding of the organization’s staffing 1. Determine the number and types of personnel needed to fulfill the philosophy, meet fiscal planning responsibilities, and carry out the chosen patient requirements, goals, and the specific skills needed to fulfill those roles. care delivery system selected by the organization Can represent the institution - Fiscal planning – continuous process that involves decision or choices Effective Communication: They should clearly communicate what makes the about alternative ways of using available resources with the aim of achieving institution a desirable place to work particular goals Can relate well to people 2. Recruit, interview, select, and assign personnel based on established job Building Relationships: A successful recruiter should have strong interpersonal description performance standards skills to build rapport - Induction- staff training and education Relating Well to People: The ability to connect with individuals from diverse 3. Use organizational resources for induction and orientation backgrounds is essential 4. Employee is socialized to organizational values Human resource department - Each employee is adequate socialized, organizational value and uniforms; he or she knows the mission vision, goals, objectives and values The Recruiter 5. Develop a program of staff education If you are Recruiter, you should possess all of the following and technically - Ongoing Training: Implement continuous education programs to enhance assigned to the human resource personnel or human resource department. staff skills, knowledge, and competencies in their roles. – TNA (training need ○ Should know the needs of the organization: What do they lack? Do they assessment) need ward nurses or do they need special nurses with specialization? ○ Can represent the institution and Can relate well to people :)  2 The NURSE Recruiter Greater control over practice Separate entity Safety: to provide safe and competent care in nourishes, personal preferences Independence: The nurse recruiter often operates as a distinct entity within the should be considered in making assignment, so all the nurse are confidently you human resources department, focusing specifically on nursing positions. This abilities are able to demand of hospital specialization allows for a more tailored approach to recruitment. Assigned to Nurse Managers Nurse participation in organizational policy decisions Assigned Roles: Nurse recruiters typically work closely with nurse managers, Inclusive Decision-Making: Involving nurses in organizational policy decisions who provide insights into the specific skills and qualities needed for their teams. ensures that their insights and experiences shape practices that affect their work This collaboration ensures that recruitment aligns with departmental needs. environment. ○ Chief nurse is the one who do interview Decentralization is important Good nurse – physician relationships Decentralized Decision-Making: Decentralization in staffing allows nurse Adaptation of SBAR: managers to have a say in the hiring process, enabling them to select candidates ○ Situation who best fit their team dynamics and patient care requirements. This approach Clearly articulate the current situation or issue at hand. fosters greater ownership and accountability Example: "I am calling to inform you that Mr. Smith’s blood pressure Comes with great responsibility has dropped to 80/50." Impact of Selection: Nurse recruiters bear significant responsibility in the hiring ○ Background process. The choices they make directly affect the quality of nursing staff and, Provide relevant background information to give context to the consequently, patient care outcomes. situation. Reflection on the Department: Negative selection outcomes can have serious Example: "Mr. Smith is a 70-year-old male with a history of repercussions for the department, leading to issues such as increased turnover, hypertension and recent surgery." decreased morale, and ultimately, lower patient satisfaction ○ Assessment Share your assessment of the situation based on your clinical Retention judgment. Begins with how much the organization does or does not value the staff Example: "I believe this drop in blood pressure may be due to blood ○ Recruitment however, is not the key to adequate staffing. loss or a reaction to medication." ○ Because this is how the management value give importance to heard and ○ Recommendation gave voice to the employees Suggest a course of action or what you need from the physician. Happens when the organization is able to create a work environment that makes Example: "I recommend that we administer IV fluids and reassess in staff want to stay 30 minutes." Addressing Issues and Concerns: Facilitating open communication between Nurse Turnover nurses and physicians helps address any issues or concerns promptly, fostering a Groupthink is a phenomenon where people tell to confirm with group decision to collaborative environment. avoid feeling outcast, leading to errors in decision making Enhanced Communication: Strong relationships improve teamwork and the ○ Reduces the probability of groupthink in which all the people in organization overall work environment, leading to higher job satisfaction. share, similar thoughts, processes values and goals and they to stick with impossible if nurse is incompetent what they believe Positive Effects of Nurse Turnover Setting staffing levels skill appropriate to patient acuteness ○ Infusion of Fresh Ideas: While turnover is often viewed negatively, it can Skill-Appropriate Staffing: Ensuring that staffing levels match the skill set bring new perspectives and innovative ideas into the organization. New staff needed for the patient population's acuity promotes better care and reduces nurse may introduce different practices, enhancing the overall quality of care. burnout. This is normally effect desirable because infusion organization with fresh ideas Workload Balance: Adequate staffing helps maintain manageable workloads, ○ Shared Goals and Processes: Alignment in Values: Organizations that which can enhance job satisfaction and retention. experience turnover may benefit from hiring individuals who share similar Adopting zero tolerance policies for abusive behaviors values and goals, fostering a cohesive team environment. ○ Addressing Abusive Behaviors: Implementing zero tolerance policies for abusive behaviors creates a safer and more respectful work environment for Groupthink nursing staff. Expensive ○ Promoting a Positive Culture: Such policies help minimize hostility and Nurse turnover is expensive, costly at the expense of the HR, that foster a culture of mutual respect among staff. Costly Minimize paperwork HR expenses: ○ Streamlining Administrative Tasks: Reducing unnecessary paperwork ○ Recruitment Costs: High turnover rates stemming from poor allows nurses to focus more on patient care, leading to higher job decision-making can necessitate frequent recruitment efforts, increasing HR satisfaction and reduced frustration. expenses related to advertising, interviewing, and hiring. ○ Efficient Processes: Streamlined processes contribute to a more efficient Training: work environment, improving overall staff morale. ○ Continuous Training Needs: When decisions reflect a lack of critical Limiting the use of mandatory overtime analysis, new hires may require additional training to align with updated ○ Work-Life Balance: By limiting the use of mandatory overtime, practices or correct previously established errors, incurring further costs. organizations can promote a healthier work-life balance for nurses, reducing Overtime of existing staff burnout and improving retention. Increased Workload: When new hires leave or when staff turnover is high due ○ Staff Well-Being: Respecting nurses’ time outside of work fosters loyalty to poor decision-making, existing nurses may need to work overtime to maintain and a positive organizational culture. patient care standards, leading to increased labor costs. Burnout Risk: Relying on overtime can contribute to nurse burnout, potentially Nursing managers play a pivotal role in the retention of nurses – (Anthony, resulting in even higher turnover and associated costs. Standing, & Glick, 2005) Lost Revenues “Hospital can lose 5.2 million to 8.1 million annually from nurse turnover” Interview – 2016 National Healthcare Retention & RN staffing report It is the foundation for selecting people for positions Decreased Productivity: Poor decision-making may lead to inefficiencies in Verbal interaction between individuals staffing and care delivery, resulting in decreased productivity and potential lost STRUCTURED revenues for the organization. ○ Definition: A structured interview involves a systematic approach where Patient Retention: If patient care suffers due to groupthink, patient satisfaction specific questions are prepared in advance. may decline, leading to reduced patient retention and negative impacts on the ○ Planning Requirements: This type requires greater planning to ensure organization’s reputation and revenue. that all relevant aspects of the job and candidate qualifications are covered. Increased Nurse – Patient Ratio Job Requirements: Questions are designed to assess how well Impact on Care Quality: A higher nurse-patient ratio, resulting from inadequate candidates meet specific job-related criteria. staffing decisions, can lead to decreased quality of care and increased risk of Skills and Qualities: Evaluates the candidate’s technical skills and adverse patient outcomes. interpersonal qualities relevant to the position. Experience: Explores the applicant’s previous work history and how it Creating Cultures of Retention in Organizations relates to the new role. Providing leadership and management training Willingness and Motivation: Assesses the candidate’s enthusiasm They create more leaders, don’t create followers for the job and alignment with organizational goals. ○ Enhanced Efficiency: According to Tom Peters, when employees feel ○ Usage: Structured interviews are typically utilized for critical positions like leaders in their roles, their productivity and job satisfaction improve, where the right fit is essential for organizational success. leading to better patient care. UNSTRUCTURED Delegating authority to nurse managers, and staff nurses ○ Definition: Unstructured interviews are more conversational and require Nurse Managers and Staff Nurses: By delegating authority to nurse managers little planning, with questions developed on the spot. and staff nurses, organizations can enhance their autonomy and decision-making ○ Planning Requirements: These interviews are flexible and allow for a capabilities. more informal dialogue between the interviewer and candidate and DECISION IS DECENTRALIZATION question are not prepared in advanced Nurse autonomy Common Questions: Increased Nurse Autonomy: Providing nurses with greater control over their "Tell me about yourself." practice allows them to make decisions that directly affect patient care, fostering a "What is your greatest strength?" sense of ownership and accountability. "How will our company benefit by having you as an employee?" :)  3 ○ Usage: Unstructured interviews are generally used for positions that are First Phase of Indoctrination: Induction serves as the first step in helping new not as critical, where a less formal assessment may be sufficient. employees acclimate to the organization and its culture. ○ General information about the organization: Overview: During induction, new hires receive essential information about the organization, including its mission, vision, values, and structure. This foundational knowledge is crucial for understanding the organization's goals and expectations. ○ Developed by the personnel department: Structured Program: The induction program is typically developed by the personnel or human resources department, ensuring that it aligns with organizational standards and practices. Selection Standardized Content: This structured approach helps create a Is the process of choosing from among applicants the best qualified individuals for consistent experience for all new employees, fostering a uniform a particular job or position understanding of the organization. Process Involvement: ○ Signed by new employees: ○ Verification of Qualifications: This includes confirming the applicant’s Documentation and Acknowledgment educational background, certifications, and any required licenses relevant to New employees often sign documents acknowledging their the position. participation in the induction process, which may include ○ Work History Check: Reviewing the applicant’s previous work experiences policies, procedures, and code of conduct helps assess their suitability and readiness for the role. ○ Reference for future use: ○ Assessing Fit: Evaluating whether a good match exists between the materials provided during induction serve as a reference point for candidate’s qualifications and the organization’s culture, values, and employees as they navigate their new roles, reinforcing their expectations is critical for long-term success. understanding of organizational expectations. Complexity of Fit: Determining whether a “fit” exists between an employee and the organization can be challenging. Factors like team dynamics, organizational Orientation culture, and individual personality all play a role. Second Phase of Indoctrination: Orientation follows induction and is aimed at ○ Quote Insight: As stated, “It’s heck a lot easier to hire the right people to familiarizing employees with the organization’s policies, procedures, and culture as begin with than to fix them later,” emphasizing the importance of thorough they relate to their specific roles. selection to avoid potential issues down the line. Corporate values rule and regulations Interview: to learn more about the prospective employee More specific for the position ○ Assessing Compatibility: Through targeted questions and discussions, ○ First Day – Personnel Department: interviewers can gauge the candidate’s fit with the team and organization, as new hires typically meet with the personnel department to complete well as their skills and motivations administrative tasks, receive benefits information, and learn about company policies. The Final Selection You have a tour and you will talk to the HRD. Notification about the applicants’ decision ○ Second Day – Staff Development Department: Timely Communication: It is essential to inform all applicants about the status often focuses on staff development, where employees may receive of their application promptly. This reflects professionalism and respect for their training on skills, professional development opportunities, and time and effort. resources available for their growth. There is fire safety, accident prevention, and others. A timely written of notice to those applications that are eliminated ○ Third Day – Specific Department: Respectful Communication: Candidates who are not selected should receive a new employees meet with their specific department, where they will written notice explaining their elimination from the process. This can help maintain receive detailed training about their role, interact with their team a positive relationship and encourage them to apply for future opportunities. members, and begin to understand the workflows and dynamics of their immediate work environment. Informing of the benefits, compensation and placement You will go to your respective unit. Benefits and Compensation: Successful candidates should be informed about Job Description the specifics of their benefits package, salary, and any other compensation details. ○ Summary of primary duties in a complete fashion This helps them make informed decisions about their acceptance. ○ Examples: Vice president for nursing: description of work Informing of the pre-employment procedures General statement of duties Clarifying Next Steps: Informing new hires about pre-employment procedures, Performs administrative work in planning, coordinating and such as background checks, drug screenings, or required documentation, is crucial directing the nursing service for a smooth onboarding process. Supervision received ○ Works under general direction of the hospital administrator Confirm in writing the intention to accept the position Supervisor exercised Formal Acceptance: New hires should confirm their intention to accept the ○ Supervises assigned personnel as significant part of duties position in writing. This creates a formal agreement and sets the stage for the onboarding process. Socialization Third Phase of Indoctrination: Socialization involves the integration of new Placement employees into the workplace, helping them understand and embody the Assigning an employee to a position and unit within the manager’s sphere organization’s norms, values, and expected behaviors. of authority Acquires the technical skills ○ Scope of Authority: Placement decisions should fall within the manager's ○ Skill Development: During socialization, employees are trained to acquire sphere of authority to ensure that the assignment aligns with departmental the technical skills required for their specific roles. This includes hands-on goals and policies. training and practice in real work scenarios. ○ Collaboration: Managers should work collaboratively with HR and other Knowledge of the kinds of behavior relevant departments to determine the best fit for new hires based on ○ New hires learn about the types of behavior that are encouraged within the available positions and the employees’ qualifications. organization, including interpersonal skills, communication styles, and Interest of specialization teamwork dynamics. ○ Interest and Specialization: Understanding the employee's areas of Attitudes and values that make conformity interest and specialization is vital. Aligning these with the organization's ○ Conformity to Organizational Norms: Socialization helps employees needs can enhance job satisfaction and performance. understand the attitudes and values that promote conformity to the ○ Skills and Qualifications: Assessing the employee’s skills, qualifications, organizational culture. This process may involve: and experiences ensures they are well-suited for the assigned role, Forced Learning: New employees are encouraged, or required, to contributing to their success and the team's effectiveness. adopt new values, skills, attitudes, and social rules that align with the organization. Indoctrination CONFORM: forced to learn new values, skills, attitudes and social rules Adjustment of an employee to the organization Role model or Leadership role ○ This management function is vital for ensuring that employees understand ○ Role management functions to create an effective staff for them to be as and align with the organization's values, norms, and expectations. effective as you are as a nurse manager, you have to lead by. Establish favorable employee attitudes toward the organization, unit, and ○ Role Model department; Worthy of imitation ○ Favorable Employee Attitudes: The goal of indoctrination is to cultivate Experienced employees who exemplify the desired behaviors and positive attitudes toward the organization, the specific unit, and the attitudes serve as role models for new hires. department. This can enhance job satisfaction and overall morale. ○ Preceptor ○ Engagement: By fostering a sense of belonging and alignment with Provides knowledge, emotional support, clarification of role organizational values, employees are more likely to engage fully in their expectations roles. These individuals provide guidance and training, helping new Continues until the employee has been socialized to the norms and values of the employees acclimate to their roles and the workplace environment. work group ○ Mentor Phases of Indoctrination Assist the protégé in attaining expert status Induction :)  4 Mentors offer long-term support and advice, facilitating the new ○ Patient Care Demands: Assess the patient population, acuity levels, and employee's professional growth and helping them navigate their career expected care needs to determine the appropriate number of nursing staff path within the organization. required. Have an appropriate mix of personnel Staff Development: involves organized methods to ensure that employees acquire the ○ Skill Mix Assessment: Evaluate the skill sets and competencies of the necessary knowledge and skills to perform their jobs effectively. nursing staff to ensure a balanced mix of experience levels (e.g., novice, Training: Organized method of ensuring that people have knowledge and skills experienced, and advanced practice nurses). This helps address diverse ○ Simulation: This method provides realistic scenarios where employees can patient needs effectively. practice skills in a controlled environment, enhancing their readiness for real-world situations. Who is responsible for meeting staffing needs? ○ On-the-Job Training (OJT): Employees learn by doing, gaining hands-on First- and middle-level managers experience while performing their tasks under the guidance of experienced First Level Managers colleagues. OJT is effective for practical skill development. ○ Direct Oversight: These managers, often known as team leaders or ○ Lectures: Traditional lecture-style training can be used to convey theoretical supervisors, are responsible for the day-to-day management of staff knowledge and foundational concepts, often delivered by experts in the field. ○ Scheduling: They create work schedules that ensure adequate coverage Education ○ Performance Monitoring: They monitor staff performance and workload ○ Broader Scope: Education in the context of staff development is more Middle Level Managers formal and comprehensive, often including courses or programs that ○ Strategic Planning: Middle managers, such as department heads or enhance professional qualifications and career advancement. nursing managers, are responsible for long-term staffing strategies ○ This can be formal or informal. ○ Recruitment and Retention: They play a key role in recruitment efforts Coaching ○ Resource Allocation: Middle managers ensure that resources are allocated ○ Individualized Support: Coaching involves one-on-one support to help effectively employees develop specific skills or competencies, providing personalized feedback and guidance. Scheduling Team building Centralized ○ Enhancing Collaboration: Team-building activities foster better Scheduling is handled by personnel in a central office or department, often utilizing relationships among team members, improve communication, and promote specialized software. a collaborative work environment. This not only enhances individual skills One person usually the CHIEF NURSE but also strengthens team dynamics Advantages: ○ Fairness: Uniform policies apply to all employees. Why Training & Education are neglected? ○ Relieves Burden: Frees middle managers from scheduling tasks. Institutional barriers: Disadvantages: Load of work ○ Lack of Local Insight: central office may not fully understand the specific ○ High Work Demands: Employees may be overwhelmed with their current needs of each unit, leading to understaffing during peak times (e.g., flu responsibilities, leaving little room for additional training. season in the emergency department). Stress and Burnout: Heavy workloads can lead to employee fatigue, Examples: making them less likely to engage in training sessions. ○ Chief nurses take the responsibility in centralized staffing decision Readiness of the staff to learn ○ A large hospital system may employ a centralized scheduling department ○ Resistance to Change: Some employees may be reluctant to adapt to new that uses software to manage the schedules of nurses across multiple units. learning methods or technologies, fearing disruption to their routines. This ensures that all staff have equal access to shifts based on seniority and Motivation of learning availability, reducing conflicts and perceptions of favoritism. ○ Lack of Incentives: If employees do not see direct benefits or opportunities for advancement related to training, their motivation to Decentralized participate may wane. A unit manager is responsible for creating and managing the schedule for their ○ Unclear Learning Objectives: Without clearly defined goals, employees specific department or unit. may struggle to see the value in training programs. Arranged by a particular unit Time Advantages: ○ Scheduling Conflicts: Employees may find it challenging to carve out time ○ Intimate Knowledge: Unit managers know their team's dynamics and for training amidst their existing commitments, especially in high-demand patient needs. roles. ○ Personal Requests: Accommodates individual scheduling preferences. ○ Inflexible Training Formats: Traditional training methods may not ○ Reduced Attrition: More personalized scheduling can contribute to lower accommodate varied schedules, making participation difficult for some nurse turnover by improving job satisfaction. employees. Disadvantages: Manager’s initiative ○ Inequality: There may be perceptions of unequal treatment among staff, ○ Insufficient Leadership Support: If managers do not prioritize or particularly if certain employees receive preferential scheduling. advocate for training initiatives, employees may perceive them as ○ Subjectivity: Unit managers may inadvertently favor certain staff unimportant. members, leading to perceptions of bias in the scheduling process. ○ Lack of Encouragement: A management culture that does not actively ○ Viewed as granting rewards promote learning can lead to disengagement from training opportunities. Examples: ○ In a small community hospital, the nursing manager for the surgical unit Assessing Staff Development Needs creates the weekly schedule. They consider individual staff preferences TNA or training need assessment should be done for the manager develop training for day shifts or weekends, allowing nurses to swap shifts among and educational programs because they must identify and assess first themselves, which fosters a collaborative team environment. is a critical process that helps managers identify the skills and knowledge gaps ○ Unit manager is often responsible for covering all scheduled staff application, within their teams, enabling them to develop effective training and educational reducing staff during periods of high patient care programs. Here are three key methods for conducting TNA: ○ Performance review Cyclical Objective Evaluation: Performance reviews provide a formal This approach involves creating long-term schedules that provide employees mechanism to assess employee performance against predefined with knowledge of their work shifts well in advance, often for several weeks or criteria months. Feedback Mechanism: Reviews typically include feedback from Cover a designated number of weeks that is called a CYCLE LENGTH supervisors Advantages: Goal Alignment: Through performance reviews, managers can align ○ Predictability: Employees appreciate having advance notice of their individual development needs with organizational goals schedules, which can help with personal planning and reduce stress. ○ Peer evaluation ○ Consistency: Cyclical schedules can create a sense of stability and routine, Collaborative Insights: Peer evaluations allow team members to benefiting both staff and patients. provide feedback on each other’s performance. Disadvantages: Holistic Perspective: Peers often have firsthand experience working ○ Inflexibility: While predictable, cyclical scheduling can be rigid, making it alongside one another, enabling them to identify strengths and areas challenging to accommodate last-minute changes or staff emergencies. for improvement Encouraging Team Development: This method fosters a culture of RA 5901, otherwise known as “The Forty-hour week law”, employee will work open communication and continuous improvement for 40 hours/week: ○ Self – administered checklists According to RA 5901, otherwise known as “The forty-hour week Personal Reflection: Self-administered checklists empower law”employees will work for 40 hours/ weeks: employees to assess their own skills, knowledge, and competencies. ○ For hospitals with 100 bed capacity or more Individual Responsibility: By taking ownership of their learning ○ Community population of at least 1 million Customization of Training: The information gathered from Hospitals, a nurse will render 48 hours/work with only 1 off-duty a week self-assessments if: ○ Hospitals with less than 100 bed capacity Staffing Needs & Scheduling Policies ○ Communities with less than 1 million population Ascertain adequate numbers of nurses Civil Service Commision Memorandum Circular No. 6, Series of 1996 Government employees are granted 3 days which may be spent :)  5 ○ Birthday , Weddings Assessment of Acuity: Evaluate the acuity level and specific care requirements ○ Anniversaries. Funerals (mourning) of each patient. This includes understanding their medical conditions, treatments, ○ Relocation and any special needs. ○ Enrollment/ graduation leave Care Plan: Review the individual care plans that outline the interventions required ○ Hospitalization, Accident leaves for each patient, including medication administration, monitoring, and any Total Number of Working Hours and Non-working days and hours of procedures nursing personnel per year ○ In working 48 hours to 40 hours, they are the same with vacation leave, sick Available staff leave, legal holidays, special holidays, special privileges. Staffing Levels: Assess the number and qualifications of available staff, including ○ While they differ on the off-duties(RA 5901), and continuing education registered nurses (RNs), licensed practical nurses (LPNs), and nursing assistants. program they are the same. Experience and Expertise: Consider the experience levels and special skills of ○ The total non-working days per year for 48 hours per week is 152 while 100 staff members, such as certifications in critical care, pediatrics, or wound care. on working 40 hours per week ○ So the total working days, they also differ. Those who work 48 hours a week Job descriptions have total working days of 213 while those who work 40 hours per week Role Clarity: Ensure that staff members are aware of their specific job have total working days of 265. responsibilities as outlined in their job descriptions. This includes understanding their roles in patient care, documentation, and collaboration with other healthcare team members. Accountability: Clearly define the accountability of each role in relation to patient care and support activities. Scope of practice for licensed nurses Regulatory Guidelines: Be aware of the legal scope of practice for RNs and LPNs as defined by state nursing boards. This determines what tasks and responsibilities each type of nurse can perform. Delegation: Understand the principles of delegation, ensuring that tasks are assigned appropriately based on each nurse's qualifications and the complexity of the patient’s needs. Scope of functions NURSING CARE DELIVERY SYSTEMS Function Clarity: Differentiate between the functions of RNs, LPNs, and nursing Case Method assistants. For example: Total patient care is provided by one nurse on each shift ○ RNs may perform comprehensive assessments, develop care plans, and Functional Nursing administer medications. Personnel of different skill levels are used according to the complexity of the ○ LPNs may provide basic nursing care, administer medications under patient care needs supervision, and assist RNs. Task oriented ○ Nursing Assistants may assist with activities of daily living (ADLs) and Team members under the supervision of HN (RN) basic patient monitoring. Team Nursing Team Collaboration: Encourage teamwork and communication among staff to Care is provided through team effort ensure that all functions are covered and that patient care is coordinated Achievement of goals through group action effectively. Primary Nursing RNs give total patient care to 4 – 6 RA 5901 40: Hours Week Law Patients and has 24 – hour responsibility Employees will work only 40 hours/week for hospitals with 100 bed capacity and Advantages community population of at least 1 million ○ Accountability However, Nurse will render 48 hours per week with only 1 off duty a week if ○ Continuity of care hospital is less than 100 bed capacity and community population is less than 1 ○ Number of errors reduced million ○ Shorter hospital stay Disadvantage National League for Nurses Formula for Staffing ○ Nurse’s talents are confined The National League for Nurses (NLN) provides a formula for determining nursing Case Management staffing levels based on patient care needs. This formula takes into account bed the nurse work across agencies occupancy and nursing care hours required per patient. Interdisciplinary approach is used entire episode of illness is the focus Patient Classification System Group patients according to specific characteristics that measure acuity of illness Where: Category I/ Self Care ○ ABO = Average Bed Occupancy Definition: Patients who are largely independent and require minimal nursing ○ NCH = Nursing Care Hours assistance. ○ # of working hours = 8 Based on RA 5901 (The 40 Working Hours per Week Nursing Care Required: 1 – 2 hours of nursing care per day. Law) Example Patients: Patients recovering from minor surgeries or those with stable chronic conditions. Category II/ Minimal Care Definition: Patients who need some assistance but can manage most of their care independently. Nursing Care Required: 3 – 4 hours of nursing care per day. Example Patients: Patients needing medication management or basic monitoring. Category III/ Intermediate Care Definition: Patients who require more frequent nursing interventions and Distribution per shift monitoring. ○ Morning = 45% = 0.45 Nursing Care Required: 5 – 6 hours of nursing care per day. ○ Afternoon = 37% = 0.37 Example Patients: Patients with moderate complications or those recovering ○ Night = 18% = 0.18 from significant illness. General ward you have 3.5 and the ratio of professional to non-professional is 60:40 Category IV/ Modified Intensive Care So general medicine, medical, surgical, and obstetrics have the same professional Definition: Patients who require close monitoring and significant nursing care due to non-professional ratio. to their unstable condition. ○ Example: 60 percent would be nurses while 40 would be the nursing aids. Nursing Care Required: 7 – 8 hours of nursing care per day. ○ So in medical and surgical we have the same NCH per patient per day. Example Patients: Patients with serious medical issues that require constant ○ In obstetrics we have 3.0 observation and frequent interventions ○ In pediatrics 4.6. So there are higher professionals than the non-professional. Category V/ Intensive Care ○ In pathologic nursery 2.8 so the prof to non-prof is 55:45 Definition: Patients who are critically ill and require continuous nursing attention ○ In ER/ICU or RR 6.0 just like in the Critical Care unit. But the professional to and advanced interventions. non-professional ratio of the ER, ICU and RR is 7:30. Nursing Care Required: 10 – 14 hours of nursing care per day. ○ While in the Critical Care Unit the ratio is 80:20 so there should be 80% Example Patients: Patients in intensive care units (ICUs) or those undergoing nurses and 20% nursing aid. complex procedures Making Patient Assignments Making Patient Assignments: Based On Assignments are based on: Patient needs ○ Patient needs, Available staff and Job description ○ Scope of practice for licensed nurses and Scope of functions :)  6 Staffing for an OB Ward: 30 Beds NIGHT 2 1 Nursing personnel for 24 hours TOTAL 13 8 30/8 X 3.0 = 11 nursing personnel for 24 hours To visualize this data, you could create a bar chart or pie chart. Here’s a suggestion % of Professionals to Non-professionals for what to include in your plotting: Professionals: 11 X 0.6 = 7 Total Nursing Staff: Bar chart showing the total number of nurses per ward. Non-professionals: 11 X 0.4 = 4 Professional vs. Non-Professional Staff: Pie chart showing the distribution of professional and non-professional staff. Shift Distribution: Bar chart showing the number of nurses scheduled for Distribution per shift each shift. SHIFT PROFESSIONALS NON-PROFESSIONALS Staffing for an Pedia Ward: 35 Beds AM 7 X 0.45 = 3 4 X 0.45 = 2 Nursing personnel for 24 hours PM 7 X 0.37 = 3 4 X 0.37 = 1 35/8 X 4.6 = 20 nursing personnel for 24 hours NIGHT 7 X 0.18 = 1 4 X 0.18 = 1 % of Professionals to Non-professionals Professionals: 20 X 0.7 = 14 Summary of Staffing Non-professionals: 20 X 0.3 = 6 SHIFT PROFESSIONALS NON-PROFESSIONALS Distribution per shift MORNING 3 2 SHIFT PROFESSIONALS NON-PROFESSIONALS AFTERNOON 3 1 AM 14 X 0.45 = 6 6 X 0.45 = 3 NIGHT 1 1 PM 14 X 0.37 = 5 6 X 0.37 = 2 TOTAL 7 4 NIGHT 14 X 0.18 = 3 6 X 0.18 = 1 Nursing Personnel for 24 hours = 11 Summary of Staffing SHIFT PROFESSIONALS NON-PROFESSIONALS When computing for the nursing personnel, one should ensure that there is sufficient staff to cover for: MORNING 6 3 All shifts, Off duties , Holidays Leaves, Absence , Time for staff development AFTERNOON 5 2 To compute for relievers needed, the following should be considered: Average number of leaves taken easy year – 15 NIGHT 3 1 ○ Vacation leave – 10 ○ Sick leave – 5 TOTAL 14 6 Holidays – 12 Special privileges – 3 Continuing education program for professionals – 3 Staffing for an Surgery Ward: 40 Beds TOTAL AVERAGE LEAVES – 33 To determine the relievers needed: Nursing personnel for 24 hours 40/8 X 3.4 = 17 nursing personnel for 24 hours 33 (average numbers of days an employee is absent) 213 or 265 (number of working days/ year that each employee serves) = 0.15 (15%) for persons who works 40 hrs/week % of Professionals to Non-professionals Professionals: 17 X 0.6 = 10 = 0.12 (12%) for persons who work 48 hours/ week Non-professionals: 17 X 0.4 = 7 Activity Compute for: Total # of Nursing Service Personnel for 24 hours Distribution per shift % of Professionals to Non-professionals Distribution per shift SHIFT PROFESSIONALS NON-PROFESSIONALS Summarize answers Plotting AM 10 X 0.45 = 5 7 X 0.45 = 3 Staffing for an Medical Ward: 50 Beds PM 10 X 0.37 = 4 7 X 0.37 = 3 Nursing personnel for 24 hours 50/8 X 3.4 = 21 nursing personnel for 24 hours NIGHT 10 X 0.18 = 1 7 X 0.18 = 1 % of Professionals to Non-professionals Summary of Staffing Professionals: 21 X 0.6 = 13 Non-professionals: 21 X 0.4 = 8 SHIFT PROFESSIONALS NON-PROFESSIONALS Distribution per shift MORNING 5 3 SHIFT PROFESSIONALS NON-PROFESSIONALS AFTERNOON 4 3 AM 13 X 0.45 = 6 8 X 0.45 = 4 NIGHT 1 1 PM 13 X 0.37 = 5 8 X 0.37 = 3 TOTAL 10 7 W7: CAREER DEVELOPMENT NIGHT 13 X 0.18 = 2 8 X 0.37 = 1 Career development is essential for maintaining professional growth and job Summary of Staffing satisfaction. It encompasses the skills, networks, and education necessary for advancing one’s career trajectory SHIFT PROFESSIONALS NON-PROFESSIONALS Importance of Career Development Career development leads to enhanced job performance and increased job MORNING 6 4 satisfaction. Professionals who actively manage their career paths are more likely to achieve AFTERNOON 5 3 their goals and adapt to changing job markets. Key Skills for Career Advancement :)  7 Essential skills for career advancement include effective communication, 14. Philippine Nurses Association of the Philippines (PNA) leadership, and problem-solving abilities. Developing these competencies can 15. Philippine Nursing Informatics Association (PNIA) significantly improve one's employability and prospects for promotion. 16. Philippine Nursing Research Society (PNRS) 17. Philippine Oncology Nurses Association (PONA) Networking Strategies 18. Philippine Society of Emergency Care Nurses (PSECN) Building a robust professional network enhances job opportunities and career 19. Renal Nurses Association of the Philippines (RENAP) growth. 20. Society of Cardiovascular Nurse Practitioners of the Philippines (SCVNPPI) Attend industry events, join professional organizations, and utilize social media to connect with industry leaders and peers. Professional Development Opportunities Engaging in professional development opportunities helps nurses stay updated Continuing Education with advancements in healthcare. Access to workshops, certifications, and online Pursuing continuing education ensures professionals remain competitive in their courses can significantly enhance clinical skills and competencies. fields. Online courses, certifications, and workshops provide opportunities to expand knowledge and skills, adapting to industry changes. Setting Career Goals Setting clear career goals is essential for maintaining motivation and guiding Mentorship and Guidance professional growth. SMART criteria-Specific, Measurable, Achievable, Relevant, Mentorship provides invaluable support and insight for career advancement. and Time-bound-should be applied to effectively chart a career path. Engaging with mentors can help professionals navigate challenges, develop key ______________________________________________________________________ skills, and broaden their perspectives on career options. W8: DIRECTING 4th phase of the management process coordinating or activating. The “doing – Career Planning phase” and Manager direct the work of the subordinates Effective career planning employs various techniques to optimize job searches and enhance professional prospects. Understanding these strategies can lead to better Components of Directing opportunities and a more fulfilling career trajectory. Motivation – Force WITHIN the individual that influences and directs the behavior of other Job Search Techniques It plays a pivotal role in influencing how employees perform and interact within the Implementing targeted job search strategies, such as utilizing online job boards, workplace social media platforms, and industry-specific websites, significantly increases the Types of Motivation: likelihood of finding suitable positions. ○ Intrinsic motivation- engage in a behavior because it is personally Tailoring applications to specific roles and leveraging personal networks are also rewarding, not for external rewards. Directly related to a person's level of critical components of a successful job search. aspiration. Cultural background has an influence on intrinsic motivation Examples: passion for nursing and professional development Sources of Job Leads ○ Extrinsic motivation- behavior is driven by external rewards such as Key sources for job leads include professional networking events, industry money, fame, grade and praise associations, job fairs, and referrals from current or former colleagues. Examples: financial incentives and recognition programs Additionally, implementing informational interviews can uncover hidden job Humanistic managers opportunities and provide valuable insights into potential employers. Employees are not seen as economic assets, seen as valued assets primarily for their productivity but seen as people with complex needs and desire for Resume and Portfolio Development meaningful and varied tasks. Crafting a strong resume and portfolio is essential for job applications. Highlighting ○ This approach emphasizes understanding employees' motivations and relevant skills, experiences, and accomplishments in a clear, professional format fostering an environment where they can thrive personally and can effectively capture the attention of hiring managers and showcase one's professionally qualifications for desired positions. Personal and organizational goals are met By recognizing employees as valuable contributors with unique aspirations, Tracking Job Leads humanistic management aligns personal goals with organizational objectives Maintaining an organized system for tracking job leads can streamline the job Motivational theory application process. Workers are being motivated primarily by economic factors. High productivity Utilizing spreadsheets or specialized applications to monitor applications, means greater incentives for the worker follow-ups, and interviews enables candidates to manage their efforts effectively Self Actualization - self fulfillment, achievement of one’s full capacity and stay proactive in their job search. Esteem - self respect, self evaluation, regard by other Love/Belonging - affectionate relationship with others Preparing for Interviews Safety - free from danger, deprivation, threat Thorough preparation is vital for interview success. Researching the company, Physiological - 02, H20, sex, food, sleep practicing common interview questions, and preparing thoughtful questions for interviewers can enhance performance and demonstrate genuine interest in the role, ultimately increasing the chances of being hired. Professional Growth Professional growth encompasses various processes that contribute to career advancement such as managing resignations, planning for succession, and engaging in professional organizations. This section delves into strategic insights for nurturing a successful career trajectory in the nursing field. Resignation Process A well-structured resignation process ensures a smooth transition and maintains professional relationships. Once a need is satisfied it is no longer a motivator Important steps include providing a formal resignation letter, discussing the transition plan with management, and completing exit interviews for constructive B.F. Skinner Operant Conditioning feedback. Behavior is determined by its consequences; true reinforcement or punishment make a behavior Succession Planning more or less likely occur again Succession planning involves preparing for key roles within an organization to Behavior that is rewarded will be repeated ensure continuity- This proactive strategy identifies and develops internal talent, Behavior that is punished is extinguished enhancing workforce stability and leadership readiness for future challenges. ○ Reinforcement: This is any event that increases the likelihood of a behavior being repeated. It can be categorized into: Membership in Professional Nursing Organizations Positive Reinforcement: Introducing a favorable outcome after a Joining professional nursing organizations provides networking opportunities, behavior (e.g., giving a child praise for completing homework). resources for skill enhancement, and advocacy for the profession. Negative Reinforcement: Removing an unpleasant stimulus as a Membership can facilitate access to continuing education, conferences, and result of a behavior (e.g., taking away chores when a child behaves mentorship programs. well). 1. Ang Nars, Inc. ○ Punishment: This involves introducing or removing an outcome to decrease 2. Association of Deans of Philippine Colleges of Nursing (ADPCN) 3. Association of Diabetes Nurse Educators of the Philippines, Inc. (ADNEP) a behavior's occurrence: 4. Association of Nursing Service Administrators of the Philippines (ANSAP) Positive Punishment: Adding an unfavorable outcome to weaken a 5. Association of Private Duty Nurse Practitioners Philippines (APDNPP) behavior (e.g., scolding for misbehavior). 6. Critical Care Nurses Association of the Philippines, Inc. (CCNAPI) Negative Punishment: Removing a favorable outcome to decrease a 7. Gerontology Nurses Association of the Philippines (GNAP) behavior (e.g., taking away privileges). 8. Military Nurses Association of the Philippines (MNAP) 9. Mother and Child Nurses Association of the Philippines (MCNAP) Frederick Herzberg’s Theory 10. National League of Philippine Government Nurses (NLPGN) Employees can be motivated by the work itself and that there is an internal or 11. Occupational Health Nurses Association of the Philippines, Inc. (OHNAP) personal need to meet organizational goals 12. Operating Room Nurses Association of the Philippines (ORNAP) ○ Financial motivation is not necessary; employees can be motivated by 13. Philippine Hospital Infection Control Nurses Association (PHICNA) work itself :)  8 ○ Motivators / Satisfiers: achievements, recognition, possibility for growth, Shared governance, empowerment, participative management can have a direct work itself, responsibility impact on motivation ○ Hygiene / Maintenance factors: this increases the job dissatisfaction Finding joy at work is a shared responsibility: Connections, Love of work, supervision, job security, working conditions, remuneration, Achievement, Recognition interpersonal relations, company policies The attitude and energy level of managers directly affect the attitude and productivity of their employees ○ Lee (2000) states that, “motivation, mentoring, and empowerment aren’t just management jargon: they should be resources you use everyday” Communication The most critical leadership skills; Forms the core of management activities and cuts across all phases of the management process. Must be systematic, have continuity, and be fully integrated into the organizational structure. The most critical leadership skills Necessary for continuity and productivity Victor Vroom: The Expectancy Theory of Motivation Employees' expectations about their environment or a certain event will influence their behavior. Assumes behavior results from conscious choices among alternatives whose purpose is to maximize pleasure and minimize pain. Vroom realized that performance is based on individual factors such as skills, knowledge, personality and abilities Complex exchange of thoughts, ideas and information. If you are the sender, you should determine what receivers see and hear Variables Affecting Organizational Communication: ○ Formal organizational structure ○ People at lower level ○ Characteristics of large organization ○ Spatial Distance ○ Subgroups ○ Relationships David McClelland Achievement Motivation Theory ○ Constant flux People is motivated by three basic needs: Communication Strategies: ○ Achievement – to achieve something ○ Assess organizational communication ○ Affiliation – prefer to being a part of a group; urge person to for ○ Recognize who will be affected by decisions that are made interpersonal relationship ○ Seek for feedback to ensure that the message is understood ○ Power – enhance self – esteem and reputation; influence and hold ○ Ensure that the message is understood- verify or clarify authority over others ○ Utilize multiple communication methods ○ Continually communicate with subordinates and provide necessary information only Channels of Communication Downward communication traditional line of communication; superiors to subordinates Example: A nurse manager, Sasha, informs her team about a new vaccination policy that requires contacting patients to ensure compliance. She communicates this directive during a staff meeting, outlining the steps each nurse must take to implement the change