Ch 17
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?
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?
Advocate for a change to decentralized staffing.
What is the most fiscally responsible method for determining staffing needs for a hospital unit?
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?
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.
Cost savings Increased consistency in staffing practices Increased impartiality in staffing decisions
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?
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?
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?
Decreased continuity of nursing care
What goal should the nurse-manager prioritize when organizing staffing and scheduling?
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?
Flextime
What was the first generational work group that tended to value work hour flexibility and opportunities for time off?
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?
Greater manager autonomy, resulting in an increase in self-esteem and teamwork
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.
Increased costs Consequences of unfamiliarity with the unit Decreased continuity of client 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?
Increased numbers of staff may not necessarily improve 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.
Increased overtime pay Increased nurse satisfaction Increased judgment errors
Which statement about patient classification systems is accurate?
Internal and external forces may affect classification systems
A community health unit is transitioning from centralized staffing to decentralized staffing. The manager should recognize what possible consequence of this change?
It carries risks that employees may be treated unequally or inconsistently.
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
Labor laws State laws Union contracts 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?
Policies should be written in a way that allows some flexibility
What is a leadership role associated with staffing and scheduling?
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?
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?
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.
Technologically savvy Adept at teamwork Comfortable with multiculturalism Committed to environmental issues
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?
The client assignment method will need to be adjusted.
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.
The presence of nursing students on the unit The hiring of two graduates as staff The increase of scheduled medical students Language barriers presented by nursing staff
Which statements are true regarding float pool nurses? Select all that apply.
They are crossed-trained on multiple units. They are internal, not external, employees.
Which statement is true regarding legislated minimum staffing ratios?
They are proposed to improve client care.
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?
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:
establish a diverse working environment based on experience and technology.
A nurse-manager works on a unit that has a decentralized self-scheduling system. When managing with this scheduling option, the manager should:
oversee the system carefully to ensure sufficient staff coverage at all times.
