MANAGEMENT FUNCTIONS:

STAFFING in the Nursing Service

Staffing is the most crucial, complex and time-consuming
management function of a nurse manager at every level of the
healthcare organization because the quality of the nursing
personnel and their performance will determine the degree by
which the goals of the nursing service are achieved . Although
the goal of nursing is focused primarily on providing a
competent nursing workforce to achieve the best patient clinical
outcomes at reasonable cost, the healthcare environment has
been becoming increasingly complex.
Rowland (2004) defined staffing as the “process of
determiningnand providing the acceptable number and mix of
nursing personnel to produce a desired level of care to meet the
patient’s demand for care”.

Safety of the patient shall be the fundamental principle to guide

staffing. It is also mostly relevant in the compliance of
minimum requirements for the hospital licensure to ensure
quality and safe delivery of care to patients.
Importance of Staffing
• Recruits competent personnel for various clinical areas based
on patient’s needs.
• Allocate job tasks properly among the nursing personnel
according to their qualifications, and specializations.
• Provides the number and mix of nursing staff needed per
nursing unit.
• Ensure adequate and equitable manpower for efficient and
effective delivery of nursing care.
• Optimize the utilization of nursing human resourceat the least
manpower cost but high on quality nursing care.
• Retains, develops and places the right nursing staff in the right
job positions.
• Improves productivity through role clarity, effective
communication, and teamwork.
Principles of Staffing
The principles of staffing are adapted from the American Nurses
Association as cited by Yoder-Wise (2011).
1. Patient Care Unit Related
• Appropriate staffing levels for a patient care unit must reflect
analysis or individual and aggregate patient needs.
• There is a critical need to either retire or seriously question the
usefullness of the concept of nursing hours per patient day.
• Unit functions necessary to support delivery of quality patient
care must also be considered in determining staffing levels.
2. Staff Related
• The specific needs of various patient’s population 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 registered nurses should be
readily available to those registered nurses with less
proficiency.
3. Institution/Organization Related
• Organizational policy should reflect an organizational climate
that values registered nurses and other employees are 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 traveling
registered nurse for those activities that they have been
authorized to perform.
• Organizational policies should recognize the myriad needs of
both patient and nursing staff.
Factors Affecting Staffing
There are factors affecting staffing that should be considered in
determining the number and mix of nursing personnel. These are as
follows but not limited to:
1. Patient Factors
• Census fluctuations
• Patient acuity
• Level of care/degree of dependence
• Patient age group
• Special treatment and procedure
• communicability
• Rehabilitation needs
• Patient and family care demands/expectations
2. Staff Factors
• Number of nursing staff available
• Ratio of professional to non-professional
• Number of leaves
• Turn-over rate
• Absenteeism rate
• Proficiency level
• Span of supervision
3. Nursing Service Factors
• Nursing care modality in use
• Type of services/patient classification system
• Patterns of work schedule
• Training and staff development programs
• Research activities
4. Healthcare organization factors
• Type of hospital
• Services offered/population served
• Work time policy
• Administrative policy on weekend and holiday duty
• Presence of support services
• Nursing unit architectural design
• Availability of resources like equipment, materials and supplies
• Technology anticipated
• Projected units of services
• Budget limitations