management ch 17 staffing

self-scheduling

- allows nurses in a unit to work together to construct their own schedules rather than have schedules created by management - employees are given 4- to 6-week schedule worksheets to fill out several weeks in advance of when the schedule is to begin

Restructuring and reengineering in hospitals

- cost cutting - decreasing RNs - increasing ancillary staff - development of new practice models

advantages of 12 hr shifts with employers

- fewer benefitted employees and overtime scheduling (only 2 shifts to cover) - fewer shift changes mean more time spent with pts and better communication because of fewer handoffs

scheduling nurses for 12 hr shifts

- shifts >8 hrs leads to more med errors and sentinel events do not get enough sleep - nurses to exceed the safe limits for exposure to a variety of hazards, including ergonomic stressors and chemical agents, increasing the risk for both mental and physical health condition - drowsy driving

generation Y

Also called millennials; (born early 1980s to mid-1990s)

Nursing care hours per pt day (NCH/PPD)

all nursing and ancillary staff are treated equally for determining hours of nursing care, and no differentiation is made for differing acuity levels of pts

cross training

giving personnel with varying educational backgrounds and expertise the skills necessary to take on tasks normally outside their scope of work and to move between units and function knowledgeably

Pt classification systems (workload management or patient acuity tool)

groups pts according to specific characteristics that measure acuity of illness to determine both the # and mix of the staff needed to adequately care for those pts

generation Z qualities

more likely to value security, comfort, and familiar activities and environments

travel nurses

nurses are usually directly employed by an external broker and work for premium pay (often 2-3x that of a regularly employed staff RN), without benefits

closed unit staffing

occurs when the staff members on a unit make a commitment to cover all absences and needed extra help themselves in return for not being pulled from the unit in times of low census

generation X

people born between 1965 and 1978

advantages of travel nurses

provide scheduling relief, especially in response to unanticipated increases in census or patient acuity

summative task

requires the nurse to note the frequency of occurrence of specific activities, txs, and procedures for each pt

centralized staffing

staffing decisions are made by a central office or staffing center

flex time

system that allows employees to select the time schedules that best meet their personal needs while still meeting work responsibilities

advantages of decentralized staffing

· UM understands the needs of the unit and staff intimately · staff feels more in control of their work environment · lead to increased autonomy and flexibility, thus decreasing nurse attrition

generation X qualities

· may lack the interest in lifetime employment at 1 place that prior generations have valued, instead valuing greater work hour flexibility and opportunities for time off · less economically driven than prior generations

veteran generation qualities

· tend to be more risk averse, highly respectful of authority, supportive of hierarchy, and disciplined · these nurses are less likely to question organizational practices and more likely to seek employment in structured settings

boom generation qualities

· traditional work values · tend to be more materialistic and thus are willing to work long hours at their jobs to get ahead · volunteer their time to advance environmental, cultural, or educational causes

disadvantages of per diem nurses

high use of per diem workers may increase risks to pt safety because they are less likely to be familiar with organizational policies and procedures

veteran generation

typically recognized as those nurses from the generation born between 1925 and 1942

critical indicator

uses broad indicators such as bathing, diet, IV fluids and meds, and positioning to categorize pt care activities

per diem nurses

· Choose when they want to work · in exchange for this flexibility, they receive a higher rate of pay but usually no benefits

advantages of centralized staffing

· Provides organization-wide view of staffing needs, which encourages optimal utilization of staffing resources · fair and impartial to employees · frees the middle-level manager · (cost-effective)

mandatory overtime

· employees are forced to work additional shifts, often under threat of being charged with pt abandonment should they refuse to do so · cannot mandate more than 16 hrs

disadvantages of decentralized staffing

· employees will be treated unequally or inconsistently · UM may be viewed as granting rewards or punishments through the staffing schedule · time-consuming · May not be cost-effective

disadvantages of centralized staffing

· manager's role is limited · does not provide as much flexibility for the worker · UM may be less responsive to personnel budget control if they have limited responsibility in scheduling and staffing matters

boom generation

(born 1943 to early 1960s)

shift bidding

Organization sets the opening price for the shift Nurses bid on the shift Organizations make final decision on coverage

generation Z

People born after 2000

decentralized staffing

UM is responsible for covering all scheduled staff absences, reducing staff during periods of decreased pt census or acuity, adding staff during periods of high pt census or acuity, preparing monthly unit schedules, and preparing holiday and vacation schedules

disadvantages of travel nurses

continuous use is expensive and can result in poor continuity of nursing care

float pools

generally composed of employees who agree to cross-train on multiple units so that they can work additional hours during periods of high census or worker shortages