Unit 7 part B

STAFFING

Employee indoctrination:
Begins as soon as a person has been
selected for a position, and continues
until he has been socialized to the
norms and values of the work group
Adjustment of an employee to both the
organization and the work
environment.

purposes of indoctrination:
1. Establish employee attitudes toward
the organization, unit, and
department.
2. Provide necessary education for
success in the position
3. Enhance feeling of belonging and
acceptance (increase employee
satisfaction & higher productivity).

Phases of indoctrination process:

A- Induction:
- After the employee has been selected
and before beginning his job role.
- Activities that educate new employee
about the organizational policies and
procedures.
- Ex. employee handbooks, signed by
employees, this signed form placed in
the employees personnel file

B- Orientation:
-The manager introduces the nurse to her/his
new job, agency policies, facilities, and
coworkers
- may be critical to his future job satisfaction
and performance
- Includes a tour of the hospital, depts., fire
safety, accident prevention, and health
promotion
- Manager may develop orientation schedule
C- Socialization:
- Leader introduces employees to unit values,
attitudes and culture

Clarifying role
expectations:
1- Role models:
- (someone you admire or want to
emulate) :
- Role models are experienced,
competent employees.
- Increase number of excellent role
models increase possibilities for new
employees to perform well.

2- Preceptors:
Experienced nurse who provides
emotional support and is a strong
clinical role model for the new nurse,
Preceptor should serve as a role
model and an educator .
3- Mentors
Mentoring is an intense relationship
between a new person and
knowledgeable & wise person in that
area
Mentors serve a useful role in
adapting the nurse to the manager
role

The roles of the mentor are:

1.

2.

3.
4.
5.

Model: you admire or want to emulate.

Envisioner: Someone who can see
and communicate a meaning of
professional nursing and its potential.
Energizer: dynamism, stimulates you to
take action
Investor: invests time and energy into
your personal and professional growth.
Supporter: offers you emotional support
and builds self confidence.

The roles of the mentor ..cont.

6. Standard-prodder: refuses to accept

less than excellence.
7.Teacher-coach: teaches you
interpersonal, technical, or political skills
essential for advancement.
8. Feedback giver: gives honest positive and
negative Feedback for growth.
9. Eye-opener: broadens your perspective
and gives you new ways of looking at
things.
10. Door opener: can provide you with new
opportunities or experiences.

11. Idea bouncer: listens to and

discuss your ideas.
12. Problem solver: helps you look at
problems and identify possible
solutions.
13. Career counselor: helps you make
short and long term career plans.
14. Challenger: encourages you to look
at issues more critically or In greater
detail.

Assignment systems for

staffing
1- Case Method :
- Each pt is assigned to on duty nurse
for total pt care.
2- Functional Method:
- Tasks are divided, with one nurse
assuming responsibility for specific
tasks (e.g. the medication nurse,
catheterizations, and baths and linen
changes)

* Advantages of functional method:

a. Clinical expertise developed: (accuracy,
efficiency, and quality).
b. Work satisfactorily during critical staffing
shortages
* disadvantages of functional nursing are:

Problems with continuity

Absence of a holistic approach in client's

care

Care may become rigid and mechanical

Communication is difficult

Registered nurses busy with managerial

duties, while nurses aides deliver the pt.

3- Team Method:
- Delivery of nursing care by nursing
staff of various educational
preparations
- The team is led by a registered nurse
and may include other levels of
nurses.
- Team members provide pt care under
the direction of leader.
- leader resolve problems facing team
members
- Leader does the work other members

Leader directs the planning of care,

provides for coverage during
absences such as breaks, meals..
etc.,
- leader coordinates and evaluates
team activities
- feature of team method is the nursing
care conference.
effective team nursing requires strong
communication skills.
-

Advantages of team method:

1. satisfaction of pt and staff needs, pt
is treated through using of nursing
care plans
2. Pt care needs requiring more than
one staff member.
3. Work satisfactorily when there are
few registered nurses and increased
other levels.
A disadvantage of team method
is:
- leader spends limited time with pts,
and information on pt status ,
problems, and progress comes from

4- Primary nursing ( method ).

Registered nurse gives total pt care to 4 to
6 pts while he is on duty and remains
responsible for the care of those pts 24
hours a day throughout the pts
hospitalization.
Advantages of primary method:
- Nurses cares for the pt by using the care
plan developed by primary nurse.
- Nurses contact primary nurse regarding
changes in care plan
- Number of assigned pts varies according to
length of hospitalization, complexity of care,
and shift worked.

- Primary nurse does the admission and

develops nursing care plan, and has
autonomy and authority for the care of
his pts.
- reduces the number of errors that can
result from orders.
- chain of command is short
- More professional staff and low
nonprofessional
- Increased satisfaction of both nurse
and pt.
- Pt has the security of knowing his
nurse is available

Disadvantages of primary
method:
1.
2.

3.

Primary nursing confines a nurses

talents to his own pts only .
more professional staff and fewer
nonprofessional staff are required for
successful implementation . so
primary nursing is costly .
Complicates physician rounds; (no
single nurse knows all the pts).

Staffing Schedules

After staff are appropriately selected and

indoctrinated, the manager must ascertain
that adequate personnel are available to
meet organizational goals
Staffing schedules are largely influenced
by staffing policies.

Determining staffing policies

you must consider the following
questions:
1. What is the best stating - centralized or
decentralized ?
2. Who is responsible for the original
scheduling or daily adjustments?

determining staffing policies .. cont.

3. Where are nursing hours posted & an

accurate copy kept?
4. For what time will schedules be prepared1,2,4, or 6 weeks?
5. How far in advance will personnel know
their work schedule?
6. Will adjustment in staffing based on the
patient needs.
7- Will there shift rotation?
8- in shift rotation, how often-daily, weekly,
monthly?
9-How much time needed between rotated
shifts?

10- What day starts a calendar week?

11- Will there be one or two days off each
week.?
12- How often are weekends off guaranteed?
13- What days of a weekend Friday,
Saturday, Sunday?
14- Will days off be split or consecutive?

15- What are the maximal and minimal work

weekly?
16- How many heyday and vacation days are
allowed?

17- How far in advance scheduling should

employees request time off ?

18- Will part-time help be used?

19- If so, what is the most economical ratio

between full and part-time personnel?
20- Will part-time help be allowed to specify
when they can and cannot work?

21- Will part-time help be required to work

weekends? If so, how often?
- Decentralized scheduling: done by
manager units.
- Centralized scheduling: done by single
office or staffing center.

Decentralized staffing:

The unit manager is often responsible

for :

1.

Covering all staff absences.

Adding or Reducing staff according
to no. & types of pts.
Preparing monthly unit schedules
Preparing holiday and vacation
schedules

2.
3.
4.


1.
2.
3.

1.

2.
3.

Advantages of decentralized staffing:

Personnel feel of personalized attention
Staffing is easier and less complicated
Supervisors are freed from staffing
responsibilities and have.
Disadvantages of decentralized
staffing:
Employees will be treated unequally, may
result in a negative staff reaction.
Schedules can be used as a punishmentreward system by head nurse.
Very time-consuming, head nurse away
from other duties.

Centralized scheduling ( individual or a

computer)

* Advantages of Centralized
scheduling:
1. Fairness to employees through
consistent, and impartial application of
policies.
2. freeing head nurses for other activities
* disadvantages of Centralized
scheduling:
1. Low flexibility & interest for the worker.
2. Managers can easily grow
unresponsive to personnel budget

Alternating or rotating work

shifts: ( scheduling options ).
Rotating work shifts are common for
staff nurses.
The frequency of alternating varies
among institutions. (Some nurses may work

all 3 shifts within 7 days)

Alternating create stress for staff

nurses, affecting health of nurses &
quality of their work.

* Permanent shifts:
- Relieve nurses form stress
associated with alternating .
- Provide social, educational, and
psychological advantages
- Advantages:
1. Sense of belonging to their shifts
developed
2. Job satisfaction
3. Easier to evaluate

* Block or cyclical scheduling:

Use the same schedule repeatedly,
personnel are scheduled to work 6
successive days followed by at least
2 days off, schedule repeats itself
every 6 weeks
Advantages:
1. Nurses can plan for their life.
2. Decrease absences due to social
events
3. Stable work groups, decrease
floating
4. Promoting team spirit & continuity of

Variable staffing :
- Method that uses pt needs to determine
the number and mix of staff.
- Shifting hours and no. of working days in a
week
Variables affecting staffing:
- Pts factor: types of pts, their expectations,
length of stay, etc. complicate staffing
- Personnel factor: policies, educational and
experiential levels, job descriptions,
absenteeism and the competition affect
staffing.
- Environmental factors: number of pts
beds, availability of supplies and
equipment, the organizational structure,

* Staff development
The better trained the staff, the less
numbers required
Staff development then is costeffective in increasing productivity
Education and training are two
components of staff development may
occur inside or out side the
organization