Unit 7

STAFFING
 Staffing
Definition:
The process of assigning competent people
to fill roles designed for organizational
structure through (recruitment, selection,
and development of personnel) .

The third managerial function: “involves

selection of personnel and assignment systems
and the determination of staffing schedules”.

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- Staffing: concerned with placing right
persons in right positions.

- Adequacy of skilled staff to accomplish

organizational goals is an important
management function

Practical application of designed

organizational structure .
Separate and fundamental function of
management.
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Purposes of Staffing:
1. Assigning qualified people to appropriate
jobs.
2. Assuring adequacy of skilled staff
3. Facilitates the achievement of organizational
goals
4. Fulfill the need to supply enough staff
according to standards and organizational
structure
5. Increase job satisfaction
6. Decrease burn-out, turn-over and frustration
of staff
7. Improving and maintaining the quality of care
8. Providing for cost-effectiveness of work.
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Important criteria to staffing:
Staffing criteria are unique to each organization
A. Organizational Chart:
-Indicate numbers and types of workers
needed to fill the various positions.

- Example: Organization can’t hire an extra

nurse unless this position is mentioned in
organizational plan and through proper
channels

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B. Existing Structure And Standards
- The agency must follow the adopted
professional standards (criteria) in choosing
staff members.
- Example: If a health agency follow professional
standards recruited by the American Nursing
Association (ANA), it must follow these
standards in its model of care, which includes:
- Individualized using care
- Effective communication
- Patient's participate in decisions affecting his
health.
- Provision of continuing education.
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C. Job specifications / Job description:
Clear written list of the functions and
responsibilities of every employee in
practical way to perform the job.
Job description includes: (precise job
content, duties, activities, responsibilities,
and expected results by agency)

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*Pre-employment staffing responsibilities:
Selection of personnel :

I.Recruitment and retention.

II.Screening of staff.
III.Pre-employment testing.
IV. Physical Examination

I.Recruitment and retention:

seeking out or attracting applicants for existing
position
Recruitment strategies or methods:
- Advertising.
- Employee recommendation.
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2. Screening of staff:
a. Application forms: quick way to collect
demographic information, (personal history,
education background, work experience, …
etc.)
- Supervisor should screen out applicants who
don't fit agency.
b. Letters of preference: Letters of
recommendation may be requested from
references.
c. Interview ( selection interview ).
- Verbal interaction between individuals for a
particular purpose.

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Purposes of the interview:
- Obtain information, determine if the applicant
meets the requirements for the position.
- The interview is universally accepted for
selecting individuals for positions.

Limitation of interview:
- Major defect of the interview is subjectivity,
- Supervisors use their own judgments, biases, &
values to make decisions with short interaction
with an applicant in an unnatural situation

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Some of research findings regarding the
validity and reliability of interview:
1. The same interviewer will consistently
rate the interviewee the same. (high
intra-rater reliability).
2. The ratings of two different interviewers
of the same applicant will not be
consistent, (extremely low inter- rater
reliability).
3. Inter-rater reliability is satisfactory if
interview is structured & same format is
used by both interviewers.
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4. If Interview has reliability (measures
same thing consistently), may not
means validity (measures what it is
supposed to measure).
5. High interview assessments are not
related to subsequent high-level job
performance
6. Validity increases when there is a team
approach to the interview.
7. The attitudes and biases of interviewers
greatly influence rate of applicant .
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8. Negative information is weighed more
heavily than positive information about
the applicant
9. Decisions of interviewers of often
formed in the first few minutes of the
interview.
10. In unstructured interviews the
interviewer tends to do most of the
talking, while in structured interviews the
interviewer does about 50 percent of the
talking.

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Overcoming interview limitations:
1- Develop a structured interview format
for each job classification:
Each job has different position requirements,
structured interview is more advantageous.

2- Use scenarios to determine decision

making ability: (to obtaining answers to a
particular set of questions, same set of
scenarios should be used with each
category of employee).
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3- Conduct multiple interviews:
- More than one interviewer for applicant reduces
the bias.
- Most effective interview: applicant should be
interviewed on two separate days.
(This prevents applicants from being accepted or
rejected because they were having a good or bad
day)
4- Use a team approach: use a hiring committee
to interview job applicants.
5- Give training in effective interview: Training
about interview techniques & communication
skills.
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Planning, conducting & controlling the interview:
 Planning the interview is vital to
success, interviewer should be available
at the appointed time & give adequate
time for the interview.
- Before the interview, all interviewers
should review the application,
- Noting questions concerning information
supplied by the applicant.
- Using a planned sequence in the interview
format make spontaneous and smooth
process.
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Planning, conducting & controlling the interview… cont.

1. Introduce self and greet applicant.

2. Make a brief statement about the
company and the available positions.
3. Ascertain the position for which the
person is applying.
4. Discuss the information on the
application, seeking clarification as
necessary.
5. Discuss employee qualifications.

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6. If applicant appears qualified, discuss the
company and the position further.
7. Explain the subsequent procedures for hiring
date. (If the applicant is not hired at this time,
discuss how &when he will be notified of
interview results) .
8. Terminate the interview .
- (you can permit the applicant to ask some
questions)
- If manager has opened well the interview will
usually done smoothly.
- Pause frequently to allow applicant to ask questions
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Methods help reaching goals of the interview:
1. Use open-ended questions that require
more than a yes/no answer
2. Pause a few seconds after when
applicant finished before asking the
next question, to give him chance to talk
further.
3. Return to topics later in the interview that
the applicant offered little information on
initially.
4. Ask only one question at a time.

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5. Restate part of applicant’s answer if you need
clarification.
6. Ask questions clearly, but do not verbally or
nonverbally (body & eyes) indicate correct
answer.
7. The interviewer should always appear
interested, (avoid interruption, criticism &
impatience)
8. More personal questions should come later in
the interview, after a rapport has been
established
9. Use appropriate language for the applicant.

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* Important points regarding interview:
1. Written record should be kept of all
interviews. (Keep note taking to recall the
applicant).
2. Before finishing the interview, interviewer
should be sure that all questions have been
answered. (applicants are not offered a job at
the end of a first interview unless they are
clearly qualified more than others).
3. Interviewers need to analyze their
impressions of the applicant, interviewer
needs to consult with others in the
organization before a job offer can be made.
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4. let qualified applicants know final
outcome without delay, but with not
qualified applicants interviewer must be
extremely tactful‫بق‬II‫ل‬
5. Interviewer should not give false hope
but advise the individual as soon as
possible that he does not have the
proper qualification.
6. The interviewer should maintain records
of the exact reasons for rejection of
applicants.
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:Evaluation of the interview
Interviewers should plan post interview
time to evaluate the applicant’s interview
performance.
Interview notes should be reviewed and
clarified(record the interview final
evaluation)

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III. Pre-employment testing.
- Used as a selection tool.
(Some organizations do post-employment testing
to determine learning needs or skill
deficiencies).
IV. Physical Examination :
- After determining the most appropriate
person to fit the job, manager must be sure
that the same standards are used to evaluate
all candidates
- Final selection should be based on
established & professional criteria.
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Employee Indoctrination:
Begins as soon as a person has been
selected for a position, and continues until
he has been socialized to the norms and
values of the work group
Adjustment of an employee to both the
organization and the work environment.

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* Purposes of indoctrination:
1. Establish employee attitudes toward the
organization, unit, and department.
2. Provide necessary education for success
in the position
3. Enhance feeling of belonging and
acceptance (increase employee
satisfaction & higher productivity).

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 *Phases of indoctrination process:
A- Induction:‫ستقراء‬0‫ا‬
- After the employee has been selected and
before beginning his job role.
- Activities that educate new employee
about the organizational
policies/procedures.

- Ex. employee handbooks, signed by employees,

this signed form placed in the employee’s
personnel file

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B- Orientation:
-The manager introduces the nurse to her/his new
job, agency policies, facilities, and coworkers
- may be critical to his future job satisfaction and
performance
-Includes a tour of the hospital, depts., fire safety,
accident prevention, and health promotion
-Manager may develop orientation schedule
C- Socialization:
- Leader introduces employees to unit values,
attitudes and culture

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Clarifying role expectations:
1- Role models:
- Someone you admire or want to emulate)
-Role models are experienced, competent
employees.
-Increase number of excellent role models
increase possibilities for new employees to
perform well.

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2- Preceptors:
Experienced nurse who provides
emotional support and is a strong clinical
role model for the new nurse,
Preceptor should serve as a role model
and an educator .
3- Mentors
Mentoring is an intense relationship
between a new person and knowledgeable
& wise person in that area
Mentors serve a useful role in adapting
the nurse to the manager role

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The roles of the mentor are:
1. Model: you admire or want to emulate.
2. Envisioner:‫ مبصر‬Someone who can see and
communicate a meaning of professional
nursing and its potential.
3. Energizer: dynamism, stimulates you to take
action
4. Investor:‫ مستثمر‬invests time and energy into
your personal and professional growth.
5. Supporter: offers you emotional support and
builds self-confidence.

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The roles of the mentor ..cont.

6. Standard-prodder:‫ مقياس‬refuses to accept less

than excellence.
7.Teacher-coach: ‫مدرب‬teaches you interpersonal,
technical, or political skills essential for
advancement.
8. Feedback-giver: gives honest positive and
negative Feedback for growth.
9. Eye-opener: broadens your perspective and
gives you new ways of looking at things.
10. Door-opener: can provide you with new
opportunities or experiences.

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11. Idea bouncer: listens to and discuss
your ideas.
12. Problem solver: helps you look at
problems and identify possible
solutions.
13. Career counselor: helps you make
short and long – term career plans.
14. Challenger: encourages you to look at
issues more critically or In greater
detail.

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Assignment systems for staffing
1- Case Method :
- Each pt is assigned to on duty nurse for
total pt care.
2- Functional Method:
- Tasks are divided, with one nurse
assuming responsibility for specific tasks
(e.g. the medication nurse,
catheterizations, and baths and linen
changes)
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* Advantages of functional method:
a. Clinical expertise developed: (accuracy,
efficiency, and quality).
b. Work satisfactorily during critical staffing
shortages
* disadvantages of functional nursing are:
 Problems with continuity
 Absence of a holistic approach in client's care
 Care may become rigid and mechanical
 Communication is difficult
 Registered nurses busy with managerial
duties, while nurses’ aides deliver the pt. care
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3- Team Method:
- Delivery of nursing care by nursing staff
of various educational preparations
- The team is led by a registered nurse and
may include other levels of nurses.
- Team members provide pt care under the
direction of leader.
- leader resolve problems facing team
members
- Leader does the work other members of
the team are not qualified to perform.
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- Leader directs the planning of care,
provides for coverage during absences
such as breaks, meals.. etc.,
- leader coordinates and evaluates team
activities
- feature of team method is the nursing
care conference.
Effective team nursing requires strong
communication skills.

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 Advantages of team method:
1. Satisfaction of pt and staff needs, pt is
treated through using of nursing care
plans
2. Patient care needs requiring more than
one staff member.
3. Work satisfactorily when there are few
registered nurses and increased other
levels.
 A disadvantage of team method is:
- leader spends limited time with pts, and
information on pt status , problems, and
progress comes from team members .
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4- Primary nursing ( method ).
Registered nurse gives total pt care to 4 to 6 pts
while he is on duty and remains responsible for
the care of those pts 24 hours a day throughout
the pt’s hospitalization.
Advantages of primary method:

- Nurses cares for the pt by using the care plan

developed by primary nurse.
- Nurses contact primary nurse regarding changes
in care plan
- Number of assigned pts varies according to
length of hospitalization, complexity of care,
and shift worked.
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- Primary nurse does the admission and
develops nursing care plan, and has
autonomy and authority for the care of his
pts.
- reduces the number of errors that can result
from orders.
- chain of command is short
- More professional staff and low
nonprofessional
- Increased satisfaction of both nurse and pt.
- Pt has the security of knowing his nurse is
available
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:Disadvantages of primary method
1. Primary nursing confines a nurse’s
talents to his own pts only .
2. more professional staff and fewer
nonprofessional staff are required for
successful implementation . so primary
nursing is costly .
3. Complicates physician rounds; (no
single nurse knows all the pts).

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Staffing Schedules
 After staff are appropriately selected and
indoctrinated, the manager must ascertain that
adequate personnel are available to meet
organizational goals
 Staffing schedules are largely influenced by
staffing policies.

Determining staffing policies

you must consider the following questions:
1. What is the best stating - centralized or
decentralized ?
2. Who is responsible for the original scheduling
or daily adjustments?
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.determining staffing policies .. cont

3. Where are nursing hours posted & an accurate

copy kept?
4. For what time will schedules be prepared-1,2,4,
or 6 weeks?
5. How far in advance will personnel know their
work schedule?
6. Will adjustment in staffing based on the patient
needs.
7- Will there shift rotation?
8- in shift rotation, how often-daily, weekly,
monthly?
9-How much time needed between rotated shifts?

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10- What day starts a calendar week?
11- Will there be one or two days off each week.?
12- How often are weekends off guaranteed?
13- What days of a weekend Friday, Saturday,
Sunday?
14- Will days off be split or consecutive? I‫جمع‬III‫ أو ت‬I‫قسم‬III‫ت‬
‫ت‬I‫الجازا‬II‫ا‬

15- What are the maximal and minimal work

weekly?
16- How many holiday and vacation days are
allowed?

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17- How far in advance scheduling should
employees request time off ?I‫ه‬I ‫تلبىل‬II‫جازة ل‬I‫طلب‬II‫ي‬
‫ا‬ ‫ن‬I‫لموظف‬I
‫أ‬ I‫مكنل‬II‫متىي‬

18- Will part-time help be used?‫ا‬I‫له‬II‫ستغال‬I‫مكنا‬II‫اعاتزيادة ي‬II‫وجد س‬II‫هلي‬

19- If so, what is the most economical ratio
between full and part-time personnel?
20- Will part-time help be allowed to specify
when they can and cannot work? ‫الضافية‬II‫لساعاتا‬II‫ايير ل‬I‫وجد مع‬III‫هلي‬
‫لمرضى‬II‫مثلزيادة ا‬

21- Will part-time help be required to work

weekends? If so, how often?
- Decentralized scheduling: done by manager
units.
- Centralized scheduling: done by single office or
staffing center.

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Decentralized staffing:
 The unit manager is often responsible for :
1. Covering all staff absences.
2. Adding or Reducing staff according to
number & types of patients.
3. Preparing monthly unit schedules
4. Preparing holiday and vacation
schedules

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 Advantages of decentralized staffing:
1. Personnel feel of personalized attention
2. Staffing is easier and less complicated
3. Supervisors are freed from staffing
responsibilities.
 Disadvantages of decentralized staffing:
1. Employees will be treated unequally, may
result in a negative staff reaction.
2. Schedules can be used as a punishment-
reward system by head nurse.
3. Very time-consuming, head nurse away from
other duties.
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Centralized scheduling ( individual or a computer)
* Advantages of Centralized scheduling:
1. Fairness to employees through consistent,
and impartial application of policies
2. Freeing head nurses for other activities.

Disadvantages of Centralized scheduling:

1. Low flexibility & interest for the worker.
2. Managers can easily grow unresponsive to
personnel budget control if they have little
to do with staffing.
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Alternating or rotating work shifts:
( scheduling options ).
Rotating work shifts are common for staff
nurses.
The frequency of alternating varies
among institutions. (Some nurses may work all 3
shifts within 7 days)
Alternating create stress for staff nurses,
affecting health of nurses & quality of
their work.

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* Permanent shifts:
- Relieve nurses form stress associated
with alternating .
- Provide social, educational,
&psychological advantages
- Advantages:
1. Sense of belonging to their shifts
developed
2. Job satisfaction
3. Easier to evaluate

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* Block or cyclical scheduling:
- Use the same schedule repeatedly,
personnel are scheduled to work 6
successive days followed by at least 2
days off, schedule repeats itself every
6weeks
- Advantages:
1. Nurses can plan for their life.
2. Decrease absences due to social events
3. Stable work groups, decrease floating
4. Promoting team spirit & continuity of
care
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Variable staffing :
- Method that uses patients needs to determine the
number and mix of staff.
- Shifting hours and no. of working days in a week
Variables affecting staffing:
- Clients factor: types of pts., their expectations,
length of stay, … etc. complicate staffing
- Personnel factor: policies, educational and
experiential levels, job descriptions, absenteeism
and the competition affect staffing.
- Environmental factors: number of pt.'s beds,
availability of supplies and equipment, the
organizational structure, affecting staffing.

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Staff development *
The better trained the staff, the less
numbers required
Staff development then is cost-effective in
increasing productivity
Education &training are two components
of staff development may occur inside or
outside the organization

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