Staffing - Process of assigning competent people to fulfill the roles designated for the

organizational structure through recruitment, selection and development, induction and

orientation of the new staff of the goals, vision, and mission philosophy.

Factors Affecting Staffing

1. Type, philosophy, objectives of the hospital and nursing service.

2. Number of patient and severity of illness
3. Availability and characteristic of the nursing staff
4. Standards of care desired which should be available and clearly
spelled out
5. Nursing Unit and resources available
6. Budget
7. Expected hours of works
8. Patterns of work schedule

Patient Care Classification System – Is a method of grouping patients to the amount

and complexity of their nursing care requirements and nursing time and skills they
require.
- Generally, within 24 hours and category of nursing personnel who should provide that
care
The nurse manager must determine the following in order to develop a workable
patient classification system:
1. The number of categories into which the patients should be divided.
- Level I to Level IV
2. The characteristics of patients in each category

A.) LEVEL 1 – SELF CARE OR MINIMAL CARE

Average Amount of NCH (Nursing Care Hours) per patient per day = 1.5 hours
Ratio of professional to non-professional nursing personnel is 55:45 (55 prof : 45
non-prof)

B.) LEVEL II – Moderate Care or Intermediate Care

Average NCH per patient per day = 3 hours
Ratio of professional to non-professional personnel at 60:40

C.) LEVEL III – Total, Complete or Intensive Care

Average NCH / patient / day at 6
Prof to Non-Prof ratio at 65:35

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D.) LEVEL IV – Highly Specialized or Critical Care
Average NCH / patient / day at 6-9 hours or more
Ratio of prof to non-prof at 70:30; 80:20

Computing for the Number of Nursing Personnel Needed

In computing for number of nursing personnel in various nursing unit of the hospital,
ENSURE:
• There is sufficient staff to cover all shifts, off duties, holidays, leaves or
absences and time for staff development programs
* 40 Hours Week Law (RA 5901)
- Employees working in hospitals with 100 bed capacity and up will work only
40 hours per week
- Applies to employees working in agencies with at least 1 million population
- Agencies less than 100 bed capacity or in agencies located in communities
with less than 1 million population will work 48 hours/week

Categories or levels of care of patients, nursing hours needed per patient per day
and ratio of Professionals to Non-Professionals

Staffing Formula

Example:
Find the number of nursing personnel needed for 250 patients in a tertiary hospital.

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 1. CATEGORIZE THE PATIENTS ACCORDING TO LEVELS OF CARE NEEDED.

250(pts) x .30 = 75 pt needing minimal care

250(pts) x .45 = 112.5 pt. needing moderate care

250(pts) x .15 = 37.5 pt. need intensive care

250(pts) x .1 = 25 pt. need highly specialized nursing care

2.) FIND THE NUMBER OF NURSING HOURS (NCH) NEEDED BY PATIENTS AT

EACH LEVEL OF CARE PER DAY.

75 pts x 1.5 ( NCH needed at Level I) = 112.5 NCH/ day

112.5 pts x 3 (NCH needed at Level II) = 337.5 NCH/day
37.5 pts x 4.5 (NCH needed at Level III) = 168.75 NCH/day
25 pts x 6 (NCH needed at Level IV = 150 NCH/ day
___________________
Total 768.75 NCH/day

3.) FIND THE TOTAL NCH NEEDED BY 250 PTS. PER YEAR

768.75 x 365 ( days/ year ) = 280,593.75 NCH/ year

4.) FIND THE ACTUAL WORKING HOURS RENDERED BY EACH NURSING

PERSONNEL PER YEAR

8 ( hrs/ day ) x 213 (working days/year)

= 1,704 (working hours/day)

5.) FIND THE TOTAL NUMBER OF NURSING PERSONNEL NEEDED

Total NCH per year = 280,593.75 = 165

Working hrs/ year 1,704
Relief x Total Nsg. Personnel =
165 x0.15 = 25
Total Nursing Personnel needed
165 + 25 = 190

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6.) CATEGORIZE TO PROFESSIONAL AND NON-PROFESSIONAL PERSONNEL.
RATIO OF PROFESSIONALS TO NON-PROFESSIONALS IN A TERTIARY
HOSPITAL IS 65:35

190 x .65 = 124 professional nurses

190 x .35 = 66 nursing attendants

7.) DISTRIBUTE BY SHIFTS

124 nurses x .45 = 56 nurses on *AM shift

124 nurses x .37 = 46 nurses on PM shift
124 nurses x .18 = 22 nurses on night shift
Total 124 nurses
66 nrsg attendants x.45 = 30 attendants on AM shift
66 nrsg attendants x .37 = 24 attendants on PM shift
66 nrsg attendants x .18 = 12 attendants on night shift
Total 66 Nursing Attendants

DISTRIBUTION BY SHIFT
•
It should be noted that the computed number of personnel are only for in-
patients. Therefore, additional personnel should be hired for those in
supervisory and administrative position and for those in special units such
as OR, DR, ER and OPD.
HEAD NURSE – for every nursing unit
NURSING SUPERVISOR is provided:
a. To cover every shift in each clinical department or area specialty
unit
b. For each geographical area in hospital beyond 100 bed capacity
c. For each functional area such as Training, Research, Infection
Control and Locality Management

ASSIGNMENT FOR STAFFING

1.) Functional Method – in this method hierarchical structure predominates,

implements classic scientific management which emphasizes efficiency, division of
labors and rigid controls.
PROS: Efficiency
CONS: Nurses do managerial work

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2.)Primary Nursing Care – features an RN who give total patient care to four to six
patients, the RN remain responsible for the care of those patients 24 hours per day
throughout the patient’s hospitalization

3.)Team Nursing - under the leadership of a professional nurse, a group of nurses

work together to fulfill the full functions of professional nurses.
• the leader plans, interpret, coordinates, supervises the nursing care group
of a patient.
• the team is made up of nurses and auxiliary nursing staff.
• a main feature of team nursing is the nursing care conference.

Scheduling - A schedule is a time table showing planned work days and shifts for
nursing personnel

FACTORS CONSIDERED IN MAKING SCHEDULES

1.) Different Levels of nursing staff; adequate coverage for 24 hours

2.) Adequate mix of nurses and nursing attendants
3.) Afternoon and night shift requirements for staff are usually lower than in the
morning shift.
4.) Lower staff requirement on Saturdays and Sundays.
5.) Holiday off
6.) Vacations
7.) . Weekends
8.) Problems may also affect schedules:
 busy unit may require additional help
 Unscheduled absences may require a staff to be pulled out from her regular
area of assignment to cover for another unit.

ASSESSING SCHEDULING SYSTEM

1.) Ability to cover the needs of the unit
2.) Fairness to the staff
3.) Stability
4.) Flexibility

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TYPES OF SCHEDULING

1.) Centralized Schedule – one person, usually chief nurse or her designate assigns
the nursing personnel to the various units of the hospital (includes the shifts on
duty and off duty

2.) Decentralized Schedule – the shift and off duties are arranged by the supervising
nurse or head / senior nurse of a particular unit

3.) Cyclical Schedule – it covers a designated number of weeks called the “cycle
length” and is repeated there on
4.) Self Scheduling - Is a system that is coordinated by staff nurses, staff may
negotiate before and after work and during break and lunctime. They may also
write notes to each other and wait for the response.
5.) Rotating Work Shifts - It is desirable that there be equal share of morning,
afternoon and night shifts, as prolonged night shift may affect the health of
personnel.

6.) Eight hour shift in a five day workweek - 5 day, 40- hours workweek

7.) Twelve hour shift in seven day workweek - The better use of personnel lower
staffing requirements; this consequently lowers the cost per patient day. Fewer
communication gaps and better continuity of care

Creating a Motivating Climate

Work Climate – is the prevailing workplace atmosphere as experienced by the

employees.
- A positive work climate leads to and sustains employee motivation high performance
and better result in health care.

TO INFLUENCE A WORKS GROUP CLIMATE MANAGERS NEED TO

1. Understand the three dimension of work climate
2. Assess the climate of their work group
3. Take actions to improve their work group climate.

THREE DIMENSION OF WORK CLIMATE

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 I. Clarity – an environment provides clarity when the group knows its
roles and responsibilities within the over all organization
II. Support – staff members feel that they have the resources and backing
they need to achieve the work groups goal.
III. Challenge - an environment of challenge offers group members
opportunities to stretch their abilities take reasonable risk in solving
problems and discover ways of working to became more effective

UNDERSTANDING WHAT MOTIVATES THE STAFF

I. External Motivation – involves using motivators that come with a job
II. Internal Motivation - comes from within the employees

INDICATIONS OF LOW MOTIVATION AND PERFORMANCE

Signs
 Increasing employee absenteeism and tardiness
 Decreasing employee productivity
 The failure of your work group to meet specific performance targets.
 Poor communication among group members and with you
Complaints

DELEGATION - the process by which a manager assigns specific tasks/duties to

workers with commensurate authority to perform the job.

Two Criteria in Delegation

1. The ability of a worker to carry out the task.

2. Fairness not only to the employee but to the team as a whole.

Principles of Delegation

1. Select the right person to whom the job is to be delegated.

2. Delegate both interesting and uninteresting tasks.
3. Provide subordinates with enough time to learn.
4. Delegate gradually.

Why Nurse Manager Do Not Delegate

1. Lack of confidence in their staff.

2. Felling that only they could do the task better and faster.
3. Fear to loss control if some of their duties are delegated.

Common Delegation Error

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 A. Under Delegating
B. Over Delegating
C. Improperly Delegating

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