Roles Functioning in Staffing Scheduling and Workload Chapter

Staffing • The leader–manager recruits, selects, orients, and promotes personnel • Organizations are usually

Question What are some important aspects of diversity to consider in choosing a staff?

Staffing Shortages and the Economy • Nationwide downsizing of hospitals in the 1990 s

Retaining Older Workers • Employers must be able to accommodate aging workers with technology

Factors Affecting Recruitment • Financial resources • The organization’s reputation • Adequate nursing pool

Question By what percentage would the number of graduates from nursing programs need to

Recruitment Methods • Advertisements • The process of actively seeking out or attracting applicants

Retention occurs only when the organization is able to create a work environment that

Turnover • Some turnover is normal and in fact desirable. • It infuses the

Interviewing as a Selection Tool • It is the most common method for employee

Purposes of the Selection Interview • The interviewer seeks to obtain enough information to

Reliability and Validity Issues of the Selection Process • Validity increases with a team

First Impressions • Most decisions about the applicant are made in the first 30

Subjectivity of Interview The major defect of the interview is subjectivity. Copyright © 2012

Question Tell whether the following statement is True or False: Positive information is usually

Overcoming Interview Limitations • Use a team approach. • Develop a structured interview format

Structured vs. Unstructured Interview The structured interview is a much better predictor of job

Common Job Interview Mistakes of Applicants • Arriving so early you appear overanxious •

Tips for the Applicant • Do your homework about the organization you are applying

Practice Interview Questions • Why do you want this job? • What is your

Illegal Interview Inquiries • Age • Marital status • Children • Race • Sexual

After the Interview 1. Send a thank-you note to the interviewer. 2. If offered

Criteria Many organizations have a list of preferred criteria for a position and a

Background Checks Positions should never be offered until information on the application has been

Placement The astute leader is able to assign a new employee to a position

Indoctrination Refers to the planned, guided adjustment of an employee to the organization and

Three Phases of Indoctrination • Induction • Orientation • Socialization Copyright © 2012 Wolters

Orientation • The purpose is to make the employee feel a part of the

Scheduling Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Why Is Scheduling So Difficult in Nursing? • Doesn’t fit traditional business cycle •

Staffing Clerks Although many organizations now use staffing clerks and computers to assist with

Centralized Staffing • Staffing decisions for all units are made by a central office

Decentralized Staffing • Staffing is done at the unit level, frequently by unit manager.

Question Under which model is staffing done at the unit level? A. Centralized B.

Staffing and Decision Making • It is important to remember that centralized and decentralized

Organizational Staffing Policies Need policies that address: 1. Sick leave 2. Vacations 3. Holidays

Sample Staffing and Scheduling Options • 10 - or 12 -hour shifts • 8

Question What are some advantages to an organization of using travel nurses? A. B.

Examples of Staffing Standards • Inpatient units—NCH/PPD • Surgery—minutes per case • Emergency departments

Staffing by Acuity—Using a Patient Classification System • Groupings of patients according to specific

Question Noting how often a patient takes a particular medication is an example of:

The Relationship Between Staffing and Quality of Care • Staffing mix • Staffing ratios

Effect of Decreased Hours A review of the literature consistently and overwhelmingly demonstrates that

Closed-Unit Staffing Closed-unit staffing occurs when the staff members on a unit make a

Mandatory Overtime • Employees are forced to work additional shifts, often under threat of

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Staffing • The leader–manager recruits, selects, orients, and promotes personnel • Organizations are usually labor intensive (i. e. , many employees are required to accomplish organizational goals). • Managers should be alert to the gender, culture, ethnicity, age, and language diversity in the communities served by their organization Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question What are some important aspects of diversity to consider in choosing a staff? A. B. C. D. E. Gender Culture Age Language All of the above Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Staffing Shortages and the Economy • Nationwide downsizing of hospitals in the 1990 s • Aging of the nursing workforce • Accelerating demand for professional nurses • Inadequate enrollment in nursing programs of study • Aging of nursing faculty Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Retaining Older Workers • Employers must be able to accommodate aging workers with technology aimed at reducing physical strain, such as electric beds, bariatric equipment, and mechanical lift devices. • Other strategies suggested for retaining aging nurses include flexible scheduling and benefits, continuing education aid, and wellness programs. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Factors Affecting Recruitment • Financial resources • The organization’s reputation • Adequate nursing pool • The location’s desirability • Competitive salaries • The status of the national and local economy Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question By what percentage would the number of graduates from nursing programs need to increase to address the current shortage? A. B. C. D. 5% 18% 75% 90% Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Recruitment Methods • Advertisements • The process of actively seeking out or attracting applicants for existing positions • Career days • Should be an ongoing process • Literature • Informal use of members of the organization as examples of satisfied employees Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Turnover • Some turnover is normal and in fact desirable. • It infuses the organization with fresh ideas and reduces the probability of groupthink. • However, excessive or unnecessary turnover reduces the ability of the organization to produce its end-product and is expensive. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Interviewing as a Selection Tool • It is the most common method for employee selection used by managers. • It is also the most time-consuming and thus one of the most costly selection tools. • It generally requires an interviewer to use judgments, biases, and values to make decisions based on a short interaction with an applicant in an unnatural situation. Thus, reliability and validity are always suspect. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Purposes of the Selection Interview • The interviewer seeks to obtain enough information to determine the applicant’s suitability for the available position. • The applicant seeks to obtain adequate information to make an intelligent decision about accepting the job, should it be offered. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Reliability and Validity Issues of the Selection Process • Validity increases with a team approach. • Negative information tends to be weighed more heavily than positive information. • The same standards should be used for all applicants. • Selection should be based on established criteria, not value judgments. • Personal bias should be minimized, because negative feelings likely have no relation to the criteria necessary for success in the position. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

First Impressions • Most decisions about the applicant are made in the first 30 to 60 seconds. • Physical appearance often contributes substantially to an interviewer’s opinion about an applicant. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question Tell whether the following statement is True or False: Positive information is usually weighed more heavily than negative information in an interview. A. True B. False Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Overcoming Interview Limitations • Use a team approach. • Develop a structured interview format for each job classification. • Use scenarios to determine decision-making ability. • Conduct multiple interviews. • Provide training in effective interviewing techniques. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Structured vs. Unstructured Interview The structured interview is a much better predictor of job performance and overall effectiveness than the unstructured interview. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Common Job Interview Mistakes of Applicants • Arriving so early you appear overanxious • Saying too much • Wearing a coat/hat during the interview • Wearing psychologically intimidating colors or patterns • Sitting down before the interviewer does or addressing the interviewer by his or her first name • Asking about salary, vacation, or promotions too early in the interview Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Tips for the Applicant • Do your homework about the organization you are applying to. • Practice the interview and rehearse answers to foreseeable questions about your education and experience. • Be prompt on the day of the interview. • Look your best for the interview. Dress conservatively and make sure you are neatly groomed. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Practice Interview Questions • Why do you want this job? • What is your philosophy of nursing? • What strengths and weaknesses do you bring to this job? • Why should we hire you? Why us? • What is your 20 -year career plan? • Can you define professionalism in nursing practice? • What do you know about our organization? Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Illegal Interview Inquiries • Age • Marital status • Children • Race • Sexual preference • Financial or credit status • National origin • Religion Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

After the Interview 1. Send a thank-you note to the interviewer. 2. If offered the job, send a formal letter accepting or rejecting the job. 3. Personally critique the interview experience. Review in your mind what you did well and what you would do differently the next time. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Background Checks Positions should never be offered until information on the application has been verified and references have been checked. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Placement The astute leader is able to assign a new employee to a position within his or her sphere of authority where the employee will have a reasonable chance for success. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Orientation • The purpose is to make the employee feel a part of the team • A well-prepared and executed orientation program educates the new employee about the desired behaviors and expected goals of the organization and actively involves the new employee’s immediate supervisor. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Why Is Scheduling So Difficult in Nursing? • Doesn’t fit traditional business cycle • Erratic and unpredictable health care demand • High-level expertise required 24/7 • Stress of job requires balanced work—recreation schedule. • Staffing mix varies with acuity. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Staffing Clerks Although many organizations now use staffing clerks and computers to assist with staffing, the overall responsibility for scheduling continues to be an important function of first- and middle-level managers. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Centralized Staffing • Staffing decisions for all units are made by a central office or computer. • Tends to be fairer to employees, because policies are implemented more consistently and impartially • Frees manager to complete other functions • Most cost-effective because it maximizes use of human resources organization-wide Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Decentralized Staffing • Staffing is done at the unit level, frequently by unit manager. • Allows person who knows the individual unit the best to make staffing decisions for that unit. • Allows staff to take requests directly to their own manager, which gives them increased autonomy and flexibility • Increases the risk that employee requests may be treated unequally or inconsistently • Time-consuming for unit manager Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Staffing and Decision Making • It is important to remember that centralized and decentralized staffing is not synonymous with centralized and decentralized decision making. • Fair and uniform staffing and scheduling policies must be written and communicated to all staff. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Organizational Staffing Policies Need policies that address: 1. Sick leave 2. Vacations 3. Holidays 4. Call-offs for low census 5. On-call pay 6. Tardiness and absenteeism Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Sample Staffing and Scheduling Options • 10 - or 12 -hour shifts • 8 -hour shifts • Job sharing • Flex time • Self-scheduling • Part time • Per diem • Premium pay for weekend only • External registry or agency staffing • Travel nursing Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question What are some advantages to an organization of using travel nurses? A. B. C. D. They command premium pay. They provide scheduling relief. They offer good continuity of care. All of the above. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Examples of Staffing Standards • Inpatient units—NCH/PPD • Surgery—minutes per case • Emergency departments — total visits • Labor and delivery—number of births • Home health agencies—visits per month Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Staffing by Acuity—Using a Patient Classification System • Groupings of patients according to specific characteristics • Hours of nursing care assigned for each patient classification • Unique to a specific institution • Ongoing review critical • Internal or external forces affecting unit influence classification system. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question Noting how often a patient takes a particular medication is an example of: A. Critical indicator PCS B. Summative task PCS Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Effect of Decreased Hours A review of the literature consistently and overwhelmingly demonstrates that as RN hours decrease in NCHPPD, adverse patient outcomes increase, including increased medication errors and patient falls and decreased patient satisfaction with pain management. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Closed-Unit Staffing 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. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Mandatory Overtime • Employees are forced to work additional shifts, often under threat of patient abandonment. • While mandatory overtime is neither efficient nor effective in the long term, it has an even more devastating short-term impact in terms of staff perceptions of a lack of control and its subsequent impact on mood, motivation, and productivity. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins