STAFFING

PRESENTED BY:-
HARPREET KAUR.
  
Introduction
• Staffing is a selection, training, motivating and
retaining of a personnel in the organization.
Nurse staffing is a constant challenge for
health care facilities. Before the selection of
the employees, one has to make analysis of
the particular job, which is required in the
organization, then comes the selection of
personnel.
Example of a chart
 Functions in staffing
• Identifying the type and amount of service
needed by agency client.
• Determining the personnel categories that
have the knowledge and skill to perform
needed service measures.
• Predicting the number of personnel in
each job category that will be needed to
meet anticipated service demands.
• Obtaining, budgeted positions for the
number in each job category needed to
service for the expected types and number
of clients.
• Recruiting personnel to fill available positions.
• Selecting and appointing personnel from
suitable applicants.
• Combining personnel into desired
configurations by unit and shift.
• Orienting personnel to fulfill assigned
responsibilities.
• Assigning responsibilities for client
services to available personnel.
• Man power planning may be defined as a
strategy for the acquisition, utilization,
improvement and preservation of the
human resources of an organization.
• This involves ensuring that organization
has enough of the right kind of people at
the right time and also adjusting the
requirements to the available supply.
 THE MAIN OBJECTIVES OF MANPOWER PLANNING

•  Ensuring maximum utilization of the

personnel
• Assessing future requirements of the
organization
• Determining the recruitment sources.
• Anticipating from past records, i.e.
resignations, simple discharge, dismissal
and retirements.
• Determining training requirements for
management’s development and
organizational development.
 Major activities of manpower planning

• Forecasting future manpower

requirements
• Inventorying, present manpower resources
and analysing the degree to which these
resources are employed optimally.
• Anticipating manpower problem by
projecting present resources into the
future and comparing them with forecast of
requirement of requirement to determine
their adequacy, both quantitatively, and
qualitatively
• Planning the necessary program,
recruitment, selection, training,
development, motivation and
compensation, so that future manpower
requirements will be met.
 Steps of manpower planning:
• Scrutiny of present personnel strength.
• Anticipation of man power needs.
• Investigation of turnover of personnel
• Planning job requirements and job
descriptions 
 Steps of staffing
• Determine the number and types of personnel
needed to fulfil the philosophy, meet fiscal
planning responsibilities, and carryout the
chosen patient care management organization
• Recruit, interview, select, and assign
personnel based on established job
description performance standards.
• Use organizational resources for induction
and orientation
• Ascertain that each employee is
adequately socialized to organizational
values and unit norms.
• Use creative and flexible scheduling based
on patient care needs to increase
productivity and retention
• Develop a program of staff education that
will assist employees meeting the goals of
the organization.
• Philosophy of staffing
• Philosophy is a statement encompassing
ontologic claims about the phenomena of
central interest to a discipline, epistemic
claims about how the phenomena came to
be known, and what members of the
discipline value.
• There are three general philosophies of
personnel management. The first is based
on organizational theory, the second on
industrial engineering, and the third on
behavioural science.
 1. The organizational theorist believes that

• Human needs are either so irrational or so

varied and adjustable to specific situations
that the major function of personnel
management is to be pragmatic as the
occasion demands.
• If the jobs are organized in a proper
manner, he reasons, the result will be
most efficient job structure, and the most
favourable job attitudes will follow as a
matter of course.
• 2. The industrial engineer believes that
• The man is mechanistically oriented and
economically motivated and his needs are
best met by attuning the individual to the
most efficient work process.
• The goal of personnel management
therefore should be to concoct the most
appropriate incentive system and to
design the specific working conditions in a
way that facilitates the most efficient use
of the human machine.
• By structuring jobs in a manner that leads
to the most efficient operation, the
engineer believes that he can obtain the
optimal organization of work and the
proper work attitudes.
• 3. The behavioural scientist believes
that
• The behavioural scientist focuses on
group sentiments, attitudes of individual
employees, and the organizations’ social
and psychological climate.
• Personnel management generally emphasizes
some form of human relations education, in the
hope of instilling healthy employee attitudes
and an organizational attitudes and an
organizational climate which he considers to
be felicitous to human values. He believes that
proper attitudes will lead to efficient job and
organizational structure.
• Philosophy of staffing in nursing
• Nurse administrators of a hospital nursing
department should adopt the following staffing
philosophy.
• Nurse administrators believe that it is possible to
match employees’ knowledge and skills to patient
care needs in a manner that optimises job
satisfaction and care quality.
• Nurse administrators believe that the
technical and humanistic care needs of
critically ill patients are so complex that all
aspects of that care should be provided by
professional nurses.
• Nurse administrators believe that the
health teaching and rehabilitation needs of
chronically ill patients are so complex that
direct care for chronically ill patients
should be provided by professional and
technical nurse.
• Nurse administrators believe that patient
assessment, work quantification and job
analysis should be used to determine the
number of personnel in each category to
be assigned to care for patients of each
type( such as coronary care, renal failure,
chronic arthritis, paraplegia, cancer etc)
• Nurse administrators believe that a master staffing
plan and policies to implement the plan in all units
should be developed centrally by the nursing heads
and staff of the hospital.
• Nurse administrators believe the staffing plan details
such as shift- start time, number of staffs assigned on
holidays, and number of employees assigned to each
shift can be modified to accommodate the units’
workload and workflow.
• Objectives of staffing in nursing
• Provide an all professional nurse staff in
critical care units, operating rooms, labour
and emergency room
• Provide sufficient staff to permit a 1:1
nurse- patient ratio for each shift in every
critical care unit
• Staff the general medical, surgical,
obstetrics and gynaecology, paediatric and
psychiatric units to achieve a 2:1
professional- practical nurse ratio.
• Provide sufficient nursing staff in general,
medical, surgical, obstetrics and gynaecology,
paediatric and psychiatric units to permit a 1:5
nurse patient ratio on a day and afternoon shifts
and 1:10 nurse- patient ratio on night shift.
• Involve the heads of the nursing staffs and all
nursing personnel in designing the department’s
overall staffing program.
• Design a staffing plan that specifies how
many nursing personnel in each
classification will be assigned to each
nursing unit for each shift and how
vacation and holiday time will be
requested and scheduled.
• Hold each head nurse responsible for
translating the department’s master
staffing plan to sequential eight weeks
time schedules for personnel assigned to
her/ his unit.
• Post time schedules for all personnel at
least eight weeks in advance. 
• Empower the head nurse to adjust work
schedules for unit nursing personnel to remedy
any staff excess or deficiency caused by census
fluctuation or employee absence.
• Inform each nursing employee that requests for
specific vacation or holiday time will be
honoured within the limits imposed by patient
care and labour contract requirements.
• Reward employees for long term service
by granting individuals special time
requests on the basis of seniority.
 ANA Priciples of Nursing Staffing
(Reference: ANA Website on Safe Staffing)

• The nine principles are:

• Patient Care Unit Related
– Appropriate staffing levels for a patient care unit
reflect analysis of individual and aggregate patient
needs.
– There is a critical need to either retire or seriously
question the usefulness of the concept of nursing
hours per patient day (HPPD).
 – Unit functions necessary to support delivery of
quality patient care must also be considered in
determining staffing levels.
• Staff Related
– The specific needs of various patient
populations should determine the appropriate
clinical competencies required of the nurse
practicing in that area.
– Registered nurses must have nursing
management support and representation at
both the operational level and the executive
level.
– Clinical support from experienced RNs should
be readily available to those RNs with less
proficiency.
• Institution/Organization Related
– Organizational policy should reflect an
organizational climate that values registered
nurses and other employees as strategic
assets and exhibit a true commitment to filling
budgeted positions in a timely manner.
– All institutions should have documented
competencies for nursing staff, including
agency or supplemental and traveling RNs,
for those activities that they have been
authorized to perform.
– Organizational policies should recognize the
myriad needs of both patients and nursing
staff.
 NORMS OF STAFFING( S I U-
staff inspection unit)
• Norms
• Norms are standards that guide, control,
and regulate individuals and communities.
For planning nursing manpower we have
to follow some norms.
• The nursing norms are recommended by
various committees, such as; the Nursing Man
Power Committee, the High-power Committee,
Dr. Bajaj Committee, and the staff inspection
committee, TNAI and INC. The norms has
been recommended taking into account the
workload projected in the wards and the other
areas of the hospital. 
• All the above committees and the staff
inspection unit recommended the norms
for optimum nurse-patient ratio. Such as
1:3 for Non Teaching Hospital and 1:5 for
the Teaching Hospital.
• The Staff Inspection Unit (S.I.U.) is the unit
which has recommended the nursing
norms in the year 1991-92. As per this
S.I.U. norm the present nurse-patient ratio
is based and practiced in all central
government hospitals. 
• Recommendations of S.I.U:
• The norms for providing staff nurses and
nursing sisters in Government hospital is
given in annexure to this report. The norm
has been recommended taking into
account the workload projected in the
wards and the other areas of the hospital.
• The posts of nursing sisters and staff
nurses have been clubbed together for
calculating the staff entitlement for
performing nursing care work which the
staff nurse will continue to perform even
after she is promoted to the existing scale
of nursing sister.
• Out of the entitlement worked out on the
basis of the norms, 30%posts may be
sanctioned as nursing sister. This would
further improve the existing ratio of 1
nursing sister to 3.6. staff nurses fixed by
the government in settlement with the
Delhi nurse union in may 1990.
• The assistant nursing superintendent are
recommended in the ratio of 1 ANS to every 4.5
nursing sisters. The ANS will perform the duty
presently performed by nursing sisters and
perform duty in shift also.
• The posts of Deputy Nursing Superintendent
may continue at the level of 1 DNS per every
7.5 ANS
• There will be a post of Nursing
Superintendent for every hospital having
250 or beds.
• There will be a post of 1 Chief Nursing
Officer for every hospital having 500 or
more beds.
• It is recommended that 45% posts added
for the area of 365 days working including
10% leave reserve (maternity leave,
earned leave, and days off as nurses are
entitled for 8 days off per month and 3
National Holidays per year when doing 3
shift duties).
• Most of the hospital today is following the
S.I.U.norms. In this the post of the Nursing Sisters
and the Staff Nurses has been clubbed together
and the work of the ward sister is remained same
as staff nurse even after promotion. The Assistant
Nursing Superintendent and the Deputy Nursing
Superintendent have to do the duty of one
category below of their rank.
• The Nurse-patient Ratio as per the
norms of TNAI and INC (The Indian
Nursing Council, 1985)
• The norms are based on Hospital Beds.
• Chief Nursing Officer       :1 per 500 beds
• Nursing Superintendent   :1 per 400 beds or
above
• D.NS.                :1 per 300 beds and 1
additional for evcry 200 beds
• A.N.S.               :1 for 100-150 beds or 3-4
wards
• Ward Sister      :1 for 25-30 beds or one
ward. 30% leave reserve
• Staff Nurse       :1 for 3 beds in Teaching
Hospital in general ward& 1  for 5 beds in
Non-teaching Hospital +30% Leave reserve
• Extra Nursing staff to be provided for
departmental research function.
• For OPD and Emergency    :1 staff nurse for
100 patients (1 : 100 ) + 30% leave reserve
• For Intensive Care unit: (I.C.U.)- 1:l or (1:3
for each shift ) +30% leave reserve.
• It is suggested that for 250 beded hospital
there should be One Infection Control
Nurse (ICN).
• For specialised depertments, such as
Operation Theatre, Labour Room, etc.
1:25 +30% leave reserve. norms are not
based on Nursing Hours or Patient's
Needs here.
• Conclusion
• The key to success of any hospital primarily depends
upon its human resource than any other single
factor.The core determinants of staffing in the hospital
organization are quality, quantity and utilization of its
personnel keeping in view the structure and process.
The staffing norms should aim at matching the
individual aspiration to the aims and objectives of the
organization.
 Research Inputs
• 1. Fourteen unit attributes to guide staffing (ref-7)
• Using the nursing executive center’s hospital data base, researchers contacted a
cross section of leading hospitals nationwide, balanced by size, geography, location
and teaching status. For each hospital, the senior most  nursing leader, usually a
chief nurse or vice president of patient care services was asked to participate in a 1
hr interview with center researchers. The fourteen attributes identified includes:
patient at risk for deteriorating rapidly, wide fluctuation in the patients volume,wide
disparity in patient type and treatment, high level of admission, discharge and
transfer, high degree of nursing autonomy(less physician oversight), high proportion
of protocol driven care, complex patient care needs post discharge, premium on
interdisciplinary communication, high percentage of patient with comorbidities,
premium on highly technical skills, high level of ADL transports, Heightened
observational needs, high percentage of obese patients and premium on
multitasking.
• 2. Nurse staffing and patient outcomes (ref-8)
• The authors from the University of Lowa, investigated nurse staffing and patient
outcomes in 42 inpatient nursing care units in a large university hospital. Acute care
unit level data were collected from hospital records to examine the relationships
among total hours of nursing care, RN skill mix, and adverse patient outcomes, which
included medication errors, patient falls, pressure ulcers, patient complaints,
infections and death. They found that the proportion of hours of RN care was
inversely related to the unit rates of medication errors, pressure ulcers, patient
complaints, infections and deaths. An unexpected finding was that as the RN
proportion increased, the rates of adverse outcomes decreased, up to the level of
87.5%, after which adverse outcomes rates also began to increase. Our explanation
may be that better reporting resulted when more RNs were working.
•THANK YOU
VERY MUCH