STAFFING

is the process of assigning competent people to fill the roles designated for the organizational structure
through recuitment, selection and development

STEPS IN STAFFING

1. Determine the number and types of personnel needed is a decision that a manager can reach best not
alone but in consultation with the staff and co-workers. This can be done interviews or daily
observations of needs of dlients.

2. Recruit Personnel it must be carefully and thoughtfully done either through word of mouth or formal
advertisement such as newspaper, radio, television, online internet sites or manpower agency.

3. Interview interviewers must be ready with the background of the prospective employee. Resume or
curriculum vitae with pictures of the faces of the applicants usually help in identifying the interviewees.
Interviews should be scheduled properly and conducted in an environment that would help bring out
the best and worst in the applicant. The qualities and experience desired in the position to be filled up
must be keep in sight.

4. Induct or orient the personnel Such orientation allows both parties to see whether they Would be
able to work with each other, understand the organizational culture and the learn background of the
organization. This allows parties to back-out before any offer can be made.

5. Job Offer When the personnel wll be given an offer and the applicants accepts the offer and is
therfore hired. The would-be employee endures a pre-employment testing and the physical exam
before any contract is assigned by all parties. When pre-employment are accomplished, this is the only
time that the person officilly becomes an employee.

STAFFING PATTERN

is a plan that articulates how many and what kind of staff are needed by shift and day to staff a unit or
department.

How to develop staffing pattern:

1. Benchmarking- is management tool for sseking out the best practices in one's industry so as to
improve performance and be competitive with other productive companies in terms of quality of
servises rendered.

2. Regulatory Requirements- local req. Will be followed as mandated by R.A. 5901

3. Skill Mix- it is the percentage or ratio of professionals to non- professionals (e.g. RN staff etc.)

4.Staff support- is place in necessary for the operations of the unit or department.
5. Historical information-must be kept intact to ensure effective ways of doing tasks. Being
knowledgeable about the presence or absence of equipment and supplies

Factors affecting Time requirements of Nursing Care:

1.Acuity of the patient's illness

2. Degree of patient's dependence on the caregivers

3. Communicability of the ailment

4. Rhabilitation needs of patients and special treatment and procedures.

PATIENT CLASSIFICATION SYSTEM:

- is a measurement tool used to articulate the nursing workload for a specific patient or group of
patient's over a specific period of time.

Patient acquity- the measure of nursing workload that is generated for each patient is called patient
acquity.

Patient care is Classified according to:

Self Care or minimal care patients- are capable of carrying activities of daily living (ADL) (e.g. Hygiene,
meals, exercise, etc.)

2. Intermediate or moderate care- requires some help from the nursing staff with specific treatments or
certain aspects of persobal care (e.g. Patient with V fluids, catheter, respirator)

3. Total patient care- usually those who are bedridden and who lack strength and mobility to do average
daili living (e.g. Patient on complete bed rest, immediate post-op, with contraptions)

4. Intensive care patients- who are critically ill and in constant danger of death or serious injury (e.g.
comatose aptients, bedridden)

NURSING CARE MODELS

this are the framework for nursing care delivery in any setting or design that meots a particular needs of
a group of health care givers and clients.

1. The case Method or Total Patient Care this is acually the original medel of nursing care dellvery in
which the nurse is responsible for all aspect of care of one or more patients. nurse work directly with
patlent, family, physician and other health care staff. The goal is to have one nurse: give all care to the
same patient for the entire shift incudes madication, treatment and NCP this system is typically used in
areas requring a high level of nursing expertise such as in critical units or post anesthesia recovery areas.
2.The Functional Method is also calld "task nursing"

-This method is task and procedure oriented, this is used when there are too many patients in
proportion to available nurses. Nurses learms to work fast because adtivitles are repetitious. Developed
in response to a national shortage in the 1940's in the USA around the time of World war II, due to
shortageof RN's, this gave way to widespread use of licensed practical nurses (LPN'S) and unlicensed
assistive personnel (UAP'S) to deliver nursing care.

- Nurses are assigned to selected functions such as VS,Tx, medication.

3. Team nursing - the RN leades the group group is sauntered through participation efforts personal
work together to identify plan implement and evaluate comprehensive client-centered nursing care
comprehensive nursing responsibility and accountability becomes the responsibility of the entire team.
4. Primary nursing care - it represents total nursing care directed by a nurse on a 24-hour basis from the
moment of admission to discharge with ARA. It is accomplished through the centralization of autonomy
and independently competent nursing care the nurse uses a wide range of skills knowledge and
expertise and develop creativity.

5. Progressive client care - different areas or units provide various levels of care clients are evaluated
transferred and assigned to units with nurses having expertise with respect to the level or intensity of
care needed.

6. Managed care method - it involves unit-based care that is organized to achieve specific patient
outcomes within her stay in the unit.

7. Practice partnership - an rn and an assistant uap lpn or less experienced RN and agree to practice
partners they work together with the same group of patients the senior partner performs selected
patient care activities but delegates less specialized activities to the junior partner.

8. Case management method there is directed by a case manager focus on achievement of outcome and
appropriate time frame and resources the manager and this method does not provide direct patient
care but rather supervises the care provided by the by the registered nurse or the non registered nurse
patient cooperation is vital to the success of this method.

9. Modular method registered nurse provides direct nursing care with assistance of aids this is a
modified team and primary nursing method where registered nurse provides leadership support and
instruction.

Formula to determine staffing patterns.

1. Full-time equivalentequivalent ( FTE) - it is a measure of the commitment of a full-time employee a
full-time employee was 5 days a week or 40 hours per week for 52 weeks a year this amounts to 2080
hours of work time.

The formula is:

X = nursing care x days in a year divided by total annual per hours per 1 FTE.

2. Forty hour week law this formula is based on the national league of nurses of republic act 5901
otherwise known as the 40 hour per week.

The formula is:

ABIxNCH / number of working hours = total number of personal and 24 hours

ABO - stands for average bed occupancy

NCH - nursing care hours

D. 40 hours per week for personal working with 100 bed capacity or over or which are located on a 1
million population

E. 40 hours per week for personal who work in agencies with lesser bed capacity of our which are
located and communities with less than 1 million population.

Job descriptions

- these are specifications of duties conditions and requirements of a particle job prepared through a
careful job analysis these are also called performance descriptions.

Purposes:

1. Recruitment

2.placement and transfer 3.guidance and direction 4.evaluation of performance 5.reduction of conflict
and 6.frustration avoidance of overlapping of duties

7.facilitating working relationship with outside bodies such as professional associations

8.serving basis for the employees salary range

It includes:

1. Job title - namely the position and the necessary qualifications

2. Job relationships - the degree of supervision line and staff responsibilities and reporting mechanisms
imposed on the worker

3. Performance or job description - a catalogue of the assigned task and responsibilities of the worker

Employee discipline

- is the process of generating employee compliance to institutional rules and regulation it creates order
and smooth transition during ship's and breaks it has also nurses to perform their task better and they
are able to care for the client without guesswork.

Principles of discipline

1. Discipline should be done privately promptly and consistently

2. it should be preceded with counseling

3. Disciplinary procedures should be instituted with extreme caution

Disciplinary problems tend to occur when there is methodological weaknesses when the manager lock
skill in interviewing or documentation or when there is a procedural emission such as for application of
discipline.

Steps to addresses disciplinary problems:

1. Coaching is a day-to-day process of helping a ploy improve their performance this dance through
interaction which needs analysis staff development interviewing decision-making problem solving
analytical thinking active listening motivation mentoring and communication skills

2. Confrontation is a communication technique used to address specific issues such as violation of policy
or procedure.

Steps:

1.The NM determine whether the employee is aware of the policy 2.the employees should have receive
policy information at orientation and an updated policy manual should be readily accessible to all
employees

3. the policy should have been in forestry and consistently

4. the NM then describe the behavior that constitutes the violation in a manner that relates the concern
to the employees regarding the issue well avoiding making the interaction of personal issue.
5. The nm should solicit the employees reason for the behavior allowing sufficient time for the employee
to respond.

6. The nm should convey to the employee that she cannot continue breaking an established policy

7. The nm should explore alternative solutions to the problem so that negative outcomes will be avoided

8. The nm and employee should agree on a course of action

9. Dash should set up a reasonable date to follow up in order to check if she is adhering to established
policy.

3. Disciplinary conference - is a means of applying discipline it uses a combination of directive and non
directive technique in order to minimize stress during the interview.

Tools for terminating stuff:

1. Inform the hr department administration before hand

2. State the offending behavior and the reason for termination

3. Explain the proposed termination process

4. Termination must have the approval of the higher authorities

5. Remain calm

6. Arrange for employee to be escorted out

7.report back to the hr department and administration

Directing - is the act of issuing of orders assignment instruction to accomplish the organization's goals
and objectives it involves the process of getting the organization's work done it entails explaining what is
to be done to whom and by whom at what time and why it is to be done. It is the final major step taken
by the nurse manager to ensure that the organization's goals are accomplished she must ensure that she
has assigned the work properly which means that she has gotten the right person for each task that
needs to be accomplished.

Characteristics of good directions:

1. It must be clear concise consistent and complete

2. The person giving directions must be explain the rationale well and make certain that it is understood
3. The word use and giving directions and locate their importance for example the words must shall and
will indicate the directions are mandatory the word may denotes that the action as recommended while
the word should places that directive somewhere between mandatory and recommended action

4. The person giving directions must speak directly and slowly directions must come across as request
not,nd using a specific tone and set of words

5. Avoid giving to many directions at one time

6. Always check to make sure directions have been followed

7. Provide feedback for actions done.

Tools in directing

Nursing care plan - outlines the nursing care to be provided to a patient. It is a set of actions the nurse
will implement to resolve patient problems identified by assessment it guides in the ongoing provisions
of nursing care and assist in the evaluation of care

Characteristics of the NCP

1. It is primarily concerned with the patient needs and problems such as a signs or objective data are
symptoms or subjective data gathered by the nurse through her contact with the patient.

2. It focuses on nursing actions to solve or minimize the patient's existing problem and prevent potential
risk

3. It's to the future actions and interactions

4. It's focus is holistic which include aspect related to physical emotional psychological sociological or
spiritual

5. It aims to meet all needs of the patients in terms of promoting curative rehabilitative and restorative
process of care.

Seven elements of directing

1. Delegation is the act of assigning to someone else a portion of the work to be done with
corresponding ARA. It is also a skill to be learned and mastered beginning learning what cannot be
delegated and what will be delegated and to whom should it be delegated the person dedicated to do
the task remain accountable for a result of the delegate to the work.

Not to be delegated:

1. Overall authority responsibility and accountability

2. Final evaluation of the stuff

3. Correcting and disciplining the stuff

4. Person staff who does not know how are does not want to do because it is unpleasant

Why is there a need to delegate:

1. To save money or and time

2. Helps in building skills of subordinates

3. Motivate people to perform a higher-level task

4. Train people to prepare greater responsibilities

5. Allow next in line stuff to do the job in the absence of the manager

Why managers do not want to delegate:

1. Mistakes in delegation can be costly if failed to deliver the expected task may require additional time
manpower and resources

2. Inability of the employee to do right thing may cause motional and psychological burden on the staff
thereby creating fear in accepting delegated task

3. Fear on the part of the management to fully comprehend that has to be accomplished

4. Fear on losing control of the stuff

5. Fear of failing to get others to do the work the one delegated to do the task will accomplish
everything living others with nothing to do

6. Fear of criticism
2. Supervision is the process of guiding and directing the work to be done it entails motivating and
encouraging the stuff to participate in activities to meet goals and objectives and personal development
and in helping the stuff to do their work better.

Principles on good supervision:

1. Produces positive attitudes when an employee is conscious of the benefits to herself

2. Produces negative attitude when the reaction of workers is resistance to discipline or actual fear of
demotion or discharge

3. It is a cooperatively planned by both management and staff and accept both challenges or change

4. It uses a democratic process to facilitate effective communication respect for the individuality of each
staff member bring about harmonious relationship

5. The ultimate goal of a good supervision is to provide safe effective quality care.

3. Staff development

- is a planned experience to help employees perform effectively and efficiently and to enrich their
competence in practice education administration and research it is returning them for better
performance and areas of knowledge skills and attitude

Functions of staff development

1. Maintain stuff efficiency and effectiveness

2. Create quality employees who can better serve the needs of the clients and the organization who can
assume greater responsibilities help motivate others to perform better and cope up with crisis and
changes

3. Meet the stops needs and addresses their problems such as deficiencies in knowledge skills and
attitude

4. Motivate them and improve their self-confidence knowledge and skills strengthen capability of the
stuff to initiate more activities improve performance boost self-confidence and assurance for
opportunity

5. Help prepare them for greater responsibilities such as promotion to hire post as in management or
administrative position
4. Coordination this activity links the different components of an organization and leads them toward
goal achievement it creates harmony on all activities to facilitate success of work in a well coordinated
organization everything has been delegated to guard against living loose ends.

5. Collaboration the manager and the healthcare stuff together with the other members of the
healthcare team all participated and the decision-making process they joined forces with another
medical group or larger group to fulfilling a different role for this purpose

6. Communication the goal of proper communication is to narrow the gap between the intended and
the receive message as a manager nurse have to frequently communicate these directions have to be
reasonable and understandable so subordinates are likely to comply some of the ways to communicate
v in formal tops plant appointments telephone calls enter office memos letters reports and formal staff
meeting planned conferences mass meetings or general assembly bulletin board notices posters exhibits
displays and visual aids emails online chat web blogs and social media