CS 9: Staffing and Scheduling

Objective 1. Identify the causes of nursing shortage (Textbook pp. 386-399)

1. Define the following:

a. Staffing - is the process of filling position/posts in the organization with adequate and qualified
personal.
b. Scheduling - is the tool used to make sure that qualified staff are assigned in appropriate numbers at
appropriate times to maintain the organization's workflow, and ensure that tasks are completed.

2. List five causes of nursing shortage.

a. Facility restructuring for economic reason.
b. Reasons Budget and staffing cuts.
c. Heavy workloads.
d. Mandatory overtime.
e. Nurse to nurse hostility.

Objective 2. Name strategies to decrease nursing shortage (Textbook pp. 400-413)

1. State six strategies to decrease nursing shortage.

a. Improved scheduling
b. Safer staffing
c. A large voice for nurses in their work
d. Collaborative teaching of doctors and nurses
e. Diversity training
f. Management development
Objective 3. List down the different health care delivery modes and assignment system

1. Complete the table:

Staffing Leadership and Management
Leader function Manager function
1. Should be knowledgeable and accountable about 1. Develop and disseminates fair scheduling policies
staffing and scheduling.

2. Accountable for safe staffing 2. Assumes accountability for fiscal control and
quality of staffing
3. Communicates the need for a staff mix 3. Facilitates discussion of workload issues
4. Enables self-scheduling. 4. Keeps policies in compliance with law

5. Encourages a team approach to staffing. 5. Matches staff to client needs

2. List one advantage and disadvantage of the Various Assignment Systems.
Assignment System Pros Cons
Case method Total patient care is provided by one Different nurses provide care on
nurse on each shift different shifts and different days

1 / L&M Team - RMM

 Functional Nursing Efficiency is increased Nurses do managerial work

Team Nursing Care id provided through team effort Time is needed to coordinate
delegated work

Modular Nursing System is useful when there are few Paraprofessionals perform technical
registered nurses aspects of care

Primary Nursing RNs give total patient care Nurses talents are confined to a
limited number of patients

Managed Care Case management is incorporated Continuity of care is questionable

Case management Critical paths are used Coordination required effort

Objective 4. Describe the different types of staffing schedules (Textbook pp. 400-407)

1. Compare the two types of staffing schedules.

Centralized Scheduling Decentralized

1. Fairness is promoted 1. Managers have authority

2. Cost containment is facilitated 2. Staff get personalized attention

3. Frees some management time 3. Staffing is easier

4. There is no individualized treatment 4. Resources are used less efficiency

2. Complete the table.

Types of Description Advantages
staffing
schedules
1. Self –  Staff scheduling is coordinated by  Change the role of manager from
scheduling staff nurses. supervisor to coach.
 Increases job satisfaction, increase  2. Increase the amount of time staff
professionalism and staff spends on scheduling.
perception of autonomy.

2. Alternating /  Allows rotation of teams.  Affects quality of work.

rotating work  The frequency of rotating between  Leads to high turnover.
shift days and evenings or days and
nights, or rotating between shifts
are varies among institutions.

3. Permanent shift Allows personnel to participate in  Most people want day shift
social activities  Evening and night shifts
 Promotes job satisfaction  Given to new graduates.

2 / L&M Team - RMM

4. Block / cyclical  Sets same schedule repeatedly.  Reduce
scheduling E.g. 6 executive day and then 2 sick time
days off, this repeated every 2  Treat staff
weeks. fairly
5. Variable  A method in which the number  Uses census to determine number and
staffing and mix off staff determine by mix of staff.
patients’ need  Results in little need to call in
unscheduled staff.

Objective 5. State the principles of nurse staffing (Textbook pp. 410-414)

1. Give four principles of nurse staffing.

 Patient need should determine the required clinical competencies
 Nurses need nursing management support, representation
 Clinical support for less proficient RN’s from experienced RN’s should be available.
 Organizational policy should reflect the valuing of employees.

2. Write the staffing formulas.

Number of staff to  The hours of coverage required, Vacation, holiday, absenteeism, and
hire staff development time.
 Coverage 7days (5 days per week) = 1.4 nurses to have 1 nurse on duty
for 7 days.
 2.8 nurses to have 2 nurses on duty.

Step 1: No of vacation days per year x no. of full time people at given
skill level = total vacation days by skill level
Vacation coverage
Step 2: Total vacation days by skill level/ by total days worked per person
per year =No. of fulltime people needed for vacation relief coverage
Step 1: No. of personnel x no. of holidays=No. of holiday relief days
needing coverage
Holiday coverage
Step 2: No. of holiday relief days / no. of days’ work per year per person=
no. of personnel required for holiday coverage per year
Objective 6. Discuss the variables that affect staffing (Textbook pp. 409-410)

1. Identify three variables affecting staffing based on the given factors.

Factors Variables

1. Patient a. Types of patients

b.Their expectation
c. Fluctuation in admissions

2. Staff a. Personal policy

b.Educational and experience
level of staff
c. Job descriptions

3 / L&M Team - RMM

3. Environment a. Floor plan of the unit and
hospital,
b. Number of patients bed,
c. Availability of support
services from other department
and agencies

Objective 7. Identify the principles and steps used in planning the duty roster according to DGNA
(Course Syllabus – Appendix 5)

1. Discuss the principles in planning duty roster according to DGNA.

Principles Definition
Coverage Nursing coverage must be provided 24 hours a day, seven days a week with the
right number and mix of the staff.

Continuity Continuity of quality and quantity of care.

Flexibility The ability of the scheduling system to handle change and to consider individual
preferences as much as possible.

Stability The extent to which nurses know in advance their future days off, on duty, and in
consistent with stable staffing policies.

Cost The ability to assign the needed staff without overstaff and ensuring maximum
effectiveness utilization of nurses‟ time and skills.

2. List the steps in planning duty roster.

Steps Activities

A. A skeleton plan is made in pencil to allow

alterations.

B. The general steps that may be taken when
building up the plan are:-
1. List the names in order of seniority.
2. Put special requests in ink to avoid erasure.
3. Insert days off, noting busier days. It is
important not to have too many nurses off duty
at the same time.
4. When writing in days off, refer to previous
roster so that days off are reasonably spaced
and weekends off are shared.
5. Add the shifts, balancing senior and junior
nurses on each shift, ensuring that there is a
senior nurse on duty to take charge, and that
the trained nurses are evenly distributed.
6. Total the number of staff on duty for each
shift.

4 / L&M Team - RMM

 C. Roster may be planned weekly or monthly
or may be a fixed one.
D. Holidays
3. State the guidelines in compiling duty roster.
Part I
 Use Roster Sheet as provided by M.O.H.
 Do not cut sheets - always use full size
and fill one sheet before going on to new
sheet.
 Compile Roster for one full calendar
month in advance.
 Fill in headings-name of department-
Month-Dates and Days of week.
 Rule lines in RED to divide into complete
weeks, e.g. from Saturday of the previous
week to Friday of the following week.
 Write FULL NAME and designation of
each staff member in left hand column.
 Ensure that the names of all staff
including those on leave and new
members are recorded accurately.
 When staff leave the department through
transfer or resignation, draw two lines in
red through remaining days of the month,
indicating the new department, or
resignation, or end of contract.
 Enter leave by ruling a line between the
agreed dates. e.g. ----------- 24 days A.L.
+ 30 days M.L - 5.10.96 ---------
5 / L&M Team - RMM
1. The charge nurse should be aware of the
holiday allotted to each of the staff nurse, who
should also be fully aware of her holidays,
allotted to her.
2. Nurses should be encouraged to plan for their
holidays.
3. Only a certain number of staff should be
allowed to take their holidays at the same
time. The number is usually agreed between
the charge nurse and nurse administrator.
Part II
 Before starting, check request book for any
special requests.
 All shifts M. (morning) A (afternoon) N.
(night) should be written in blue felt pen.
 D.O. (day off) P.H. (public holiday) should be
written in red felt pen. In the case of
 P.Hs the number taken should be written in
top right corner, e.g. P.H6, etc.
 Asterisk (*) the name of the staff nurse in
charge for each shift.
 Count numbers on each shift according to
grade, total and record on roster.
 Duty roster should be submitted to the nursing
officer for checking and approval one week
before they are due to come into force
 Staffs who resign at any time during the year
are only entitled to the number of P.Hs
occurring up to the date of resignation.
 A copy of the completed roster checked and
signed by the sister and Nursing Officer is to
be submitted to Nursing Administration not
later than 26th / 27th of each month.
6 / L&M Team - RMM