Ch 17: Staffing Needs and Scheduling Policies

It is 2 PM and the nurse-manager is calculating the nursing care hours for the 3 to 11 PM shift. There are three RNs, three nursing assistants, and one ward clerk scheduled and there are 22 clients with the following acuity and nursing care hours allotted for the evening shift: Category I, 4 clients at 2.0 hours Category II, 2 clients at 2.3 hours Category III, 10 clients at 2.8 hours Category IV, 6 clients at 3.4 hours What are the needed hours of nursing care? a. 61 hours b. 52.6 hours c. 68.4 hours d. 48.4 hours

a. 61 hours

The manager of a hospital unit is frustrated that the centralized staffing department does not understand the unique staffing needs of the unit. What is the manager's best action? a. Advocate for a change to decentralized staffing. b. Introduce a self-scheduling system. c. Temporarily increase the use of agency nurses. d. Increase the use of overtime to meet the unit's staffing needs

a. Advocate for a change to decentralized staffing.

The increased use of agency nurses has been proposed by a health-care organization's personnel department. What implications of this practice should be considered? Select all that apply. a. Increased costs b. Consequences of unfamiliarity with the unit c. Liability from the use of unlicensed nurses d. Decreased continuity of client care e. Increased need for overtime

a. Increased costs b. Consequences of unfamiliarity with the unit d. Decreased continuity of client care

A health-care facility is considering whether to move from 8-hour shifts to 12-hour shifts. What potential consequences of this change should be considered? Select all that apply. a. Increased overtime pay b. Increased nurse satisfaction c. Decreased cost d. Increased judgment errors e. Increased need for continuing education

a. Increased overtime pay b. Increased nurse satisfaction d. Increased judgment errors

A community health unit is transitioning from centralized staffing to decentralized staffing. The manager should recognize what possible consequence of this change? a. It carries risks that employees may be treated unequally or inconsistently. b. One individual or a computer will perform the staffing functions c. The manager's role is that of making minor adjustments or providing input. d. The change will increase control over personnel by the organization.

a. It carries risks that employees may be treated unequally or inconsistently.

What is a leadership role associated with staffing and scheduling? a. Role models the use of evidence in making appropriate staffing and scheduling decisions b. Uses patient classification tools to minimize understaffing c. Periodically examines the unit standard of productivity to determine if changes are needed d. Evaluates scheduling and staffing procedures and policies on a regular basis

a. Role models the use of evidence in making appropriate staffing and scheduling decisions

A self-scheduling system has been proposed at a health-care facility. What potential benefit of this system should the manager recognize? a. Self-scheduling increases employees' autonomy over their work lives. b. The manager no longer has to participate directly in staff scheduling. c. Self-scheduling ensures an equitable distribution of benefits to employees who participate. d. Self-scheduling can be more easily implemented and sustained than other alternative systems.

a. Self-scheduling increases employees' autonomy over their work lives.

A nurse-manager's immediate supervisor is a member of the veteran generation. What generational characteristic is the supervisor most likely to possess? a. Strong loyalty to the employer b. A high value on workplace flexibility c. High individualism d. Social consciousness

a. Strong loyalty to the employer

A nurse-manager is in charge of a unit that has a large proportion of recent graduates, most of whom are members of Generation Y (millennials). The manager should anticipate that many of these nurses will have what characteristics? Select all that apply. a. Technologically savvy b. Adept at teamwork c. Loyal to a single, long-term employer d. Comfortable with multiculturalism e. Committed to environmental issues

a. Technologically savvy b. Adept at teamwork c. Loyal to a single, long-term employer d. Comfortable with multiculturalism

A manager is implementing a patient classification system (PCS). Which external and internal variables should the manager address when implementing the PCS? Select all that apply. a. The presence of nursing students on the unit b. The hiring of two graduates as staff c. The increase of scheduled medical students d. Language barriers presented by nursing staff e. The hospital's accreditation status

a. The presence of nursing students on the unit b. The hiring of two graduates as staff c. The increase of scheduled medical students d. Language barriers presented by nursing staff

A nurse-manager works on a unit that has a decentralized self-scheduling system. When managing with this scheduling option, the manager should: a. oversee the system carefully to ensure sufficient staff coverage at all times. b. avoid becoming involved with the system so that staff remain autonomous. c. advocate for the most senior staff to receive the most desirable shifts. d. refer any disputes to the organization's personnel department.

a. oversee the system carefully to ensure sufficient staff coverage at all times.

What goal should the nurse-manager prioritize when organizing staffing and scheduling? a. Schedule staff so there is a minimum of overtime. b. Ensure that there is adequate staff to meet the needs of each client. c. Develop trust in staff by seeing that staffing is carried out in a fair manner. d. Ensure that staff members achieve a healthy work-life balance

b. Ensure that there is adequate staff to meet the needs of each client.

What term identifies a system that allows employees to select among variations in work start-time and end-time schedules to meet their personal needs? a. Self-scheduling b. Flextime c. Decentralized staffing d. Cyclical staffing

b. Flextime

The policies around scheduling and staffing are being amended in a health-care facility. Managers must ensure that the policies to not violate which of the following? Select all that apply. a. Local laws b. Labor laws c. State laws d. Union contracts e. Federal laws f. Local norms

b. Labor laws c. State laws d. Union contracts e. Federal laws

A nurse-manager is working with a team of colleagues to update the organization's staffing and scheduling policies. What principle should the manager follow during this process? a. It is more important to communicate policies verbally than in writing. b. Policies should be written in a way that allows some flexibility. c. Each employee should be given the right to opt into the type of system that he or she wishes. d. Each unit manager should be granted full control over scheduling and staffing.

b. Policies should be written in a way that allows some flexibility.

What is the most fiscally responsible method for determining staffing needs for a hospital unit? a. Maximum patient load capacity of the unit b. Numbers of patients present for an upcoming shift c. An agreed-upon staffing formula based on client acuity d. Total beds on the unit

c. An agreed-upon staffing formula based on client acuity

A nurse-manager is applying the facility's patient classification system (PCS) to the unit's staffing needs before the beginning of a shift. What task should the manager perform first? a. Identify the number of staff members scheduled for the shift. b. Create a preliminary work assignment based on the unit norms. c. Appraise the care needs of each client. d. Assign three clients to each nurse and then adjust according to client needs.

c. Appraise the care needs of each client.

A centralized staffing department is being created at a health-care facility. What attributes of this system should the nurse-manager expect? Select all that apply. a. Increased individual flexibility b. Improved client care c. Cost savings d. Increased consistency in staffing practices e. Increased impartiality in staffing decisions

c. Cost savings d. Increased consistency in staffing practices e. Increased impartiality in staffing decisions

What was the first generational work group that tended to value work hour flexibility and opportunities for time off? a. Veteran generation b. Baby boomer c. Generation X d. Generation Y

c. Generation X

A health-care organization is transitioning from a centralized staffing system to a decentralized staffing system. A nurse-manager should anticipate what outcome of this change? a. Increased fairness to employees through consistent, objective, and impartial application b. Increased cost-effectiveness through better use of resources c. Greater manager autonomy, resulting in an increase in self-esteem and teamwork d. Increased availability of data for monitoring the effect of staffing size and composition, quality of care, and costs

c. Greater manager autonomy, resulting in an increase in self-esteem and teamwork

Which statement is true regarding legislated minimum staffing ratios? a. They are mandated by federal law. b. They are required by 28 states. c. They are proposed to improve client care. d. They are necessary to reduce costs.

c. They are proposed to improve client care.

A hospital unit has an exceptionally high census for several weeks and mandatory overtime is being routinely required. What is the priority consequence of this practice? a. Ethics violations b. Increased continuity of care c. Temporary cost savings d. Decreased client safety

d. Decreased client safety

A health-care organization has achieved a decrease in RN hours in the total nursing care hours per patient-day (NCH/PPD). What is a potential outcome of this change? a. Increased interprofessional collaboration b. Decreased numbers of errors c. Decreased client fall rate d. Decreased client satisfaction

d. Decreased client satisfaction

A busy medical unit has been increasing the use of agency nurses. The nurse-manager should anticipate what consequence of this staffing alternative? a. Increased reliance on unlicensed assistive personnel by nurses b. A need for 8-hour rather than 12-hour shifts c. Short-term cost savings d. Decreased continuity of nursing care

d. Decreased continuity of nursing care

Mandatory minimum staffing ratios are being considered in the jurisdiction where a nurse-manager works. Based on experiences of other states, the nurse should identify what possible result of this legislation? a. There may be a backlash from clients and families. b. Predicted cost savings may take many years to realize. c. Health-care organizations may be more reluctant to hire new graduates. d. Increased numbers of staff may not necessarily improve client care.

d. Increased numbers of staff may not necessarily improve client care.

Which statement about patient classification systems is accurate? a. Classification systems are able to solve staffing problems if applied consistently. b. Nursing care hours assigned to a classification system should remain constant. c. A good classification system can resolve all staffing challenges. d. Internal and external forces may affect classification systems.

d. Internal and external forces may affect classification systems

A health-care organization is changing from a functional nursing model to a team nursing model. How should the nurse-manager best address the impact on staffing and scheduling? a. More unlicensed assistive personnel will need to be hired. b. A self-scheduling system will need to be adopted. c. No changes in scheduling policies will likely be necessary. d. The client assignment method will need to be adjusted.

d. The client assignment method will need to be adjusted.

Which statements are true regarding float pool nurses? Select all that apply. a. They are classified as per diem staff. b. The nurse trades increased personal flexibility for less pay. c. Float pool nurses do not receive usual staff benefits. d. They are crossed-trained on multiple units. e. They are internal, not external, employees

d. They are crossed-trained on multiple units. e. They are internal, not external, employees

A flextime system has been introduced at a health-care facility. The nurse-manager should take what action to address the consequences of this staffing system? a. Limiting flextime to those staff members who have at least 2 years experience on the unit b. Ensuring that overtime can be used to fill times when there is insufficient staffing c. Providing incentives to ensure daytime weekday shifts are sufficiently staffed d. Working to promote continuity of care when there are multiple start times and end times for staff

d. Working to promote continuity of care when there are multiple start times and end times for staff

A nurse manager is in charge of a unit that consists of a generationally diverse group of staff nurses. The nurse manager knows that this type of staffing arrangement will: a. require the baby boomer nurses have more flexibility in scheduling and time off as compared to the generation X nurses. b. create a nursing environment that will be more structured and focused on the use of technology to provide the best care. c. allow generation Y and Z nurses to create a secure and stable work environment. d. establish a diverse working environment based on experience and technology.

d. establish a diverse working environment based on experience and technology.