Staff in an expansion of the personality of executive which means more eyes

 

Introduction

 

          Staff in an expansion of the personality of executive which means more eyes, more ears, move hands to help the executive in forming and carrying out his plans.  The help vendered by the staff is anonymous.  The staff work means the service of advice or counsel while line work is the function of authority or command.


MEANING OF STAFFING

          Staffing is the systematic approach to the problem of selecting training, motivating and retaining professional and non – professional personnel in any organisation.  Staffing is a logical operation that consists of several interdependent action as given below.

1.        Identifying the type and amount of service needed by agency client.

2.        Determining the personnel categories.

3.        Predicting the number of personnel in each job category.

4.        Obtaining budgeted positions for the number in each job category.

5.        Recruiting personnel to fill  available positions .

6.        Selecting  and appointing personnel from suitable applicants.

7.        Combining personnel into desired configuration by cut and shift.

8.        Orienting personnel to fulfill assigned responsibilities.

9.        Assigning responsibilities for client services to available personnel.


 

PHILOSOPHY OF STAFFING

 

          Nurse administrators of a hospital nursing department might adopt the following staffing philosophy.

·        Nurse administrators believe that it is possible to match employees knowledge and skills to patient care needs in a manner that optimizes job satisfaction and care quality.

·        Nurse administrators believe that the health teaching and rehabilitation needs of chronically ill patients are so complex.

·        Nurse administrators believe that a master staffing plan and policies to implement the plan in all unit should be developed centrally by the nursing heads and the staff of the hospital.

·        Nurse administrators believe the staffing plan should be administrated at the unit level by the lead nurse.

 


OBJECTIVES OF STAFFING

1.   Provide an all professional nurse staff in critical care units, operating room labour and delivery unit and emergency room.

2.   Provide sufficient staff to permit a 1:1 nurse patient ratio for each shift in every critical care unit.

3.   Staff the general medical, surgical, obstetrics and gynecology, pediatrics and psychiatric units to achieve 2:1 professional practical nurse ratio.

4.   Provide sufficient nursing staff in general medical, surgical, obstetrics, pediatric and psychiatric units to permit a 1:5 nurse patient ratio on a day and afternoon shift and 1:10 nurse patient ratio on night shifts.

5.   Involve the head of nursing staff and all the nursing personnel in designing the departments overall staffing programe.

6.   Hold each head nurse responsible for translating the department master staffing plan to sequential eight week time schedules for personnel assigned to her / his units.

7.   Post time schedule for all personnel at least eight weeks in advance.

8.   Empower the head nurse to adjust work schedules for unit nursing personnel to remedy any staff excess or deficiency accused by census fluctuations or employee absence.

9.   Inform each nursing employee that requests for specific vacation or holiday time will be honoured within the limits imposed by patients care and labour contract requirements.

10.               Reward employees for long – term services by granting individuals special time request on the basis of seniority.


FACTORS INFLUENCING STAFFING

          The factors influencing staffing requirements in the nursing service unit are as follows.

1.  The client to be served

          The client is the most important determinant of nursing personnel requirement.  The amount and kind of services required depend on the type of the client.

2. The hospital

          The physical setup of hospital also depends on how the clients are grouped according to nursing care needs.

3. Policies and compositions of medical staff

          The composition of the medical team and the policies concerning with them also play an important role.

4. Use of nursing skills

          The requirement of the nursing personnel is affected by the by the number and type of health team members and the amount of responsibility to be shouldered in planning the therapy for each patient and provide care.

5. Supportive services

          The degree to which supportive services are provided has a significant impact on requirement for nursing team members.

 

6. Administrative Policies

          Administrative policies governing patient and unit management passes leave regulation of visitors, recording and reporting have impact on staffing.

7. Presence or absence of clerical assistance

          The clerical responsibilities are taken up by the nursing staff in the absence of a ward clerk.

8. Allocation of personnel

          The ethical and professional competency required from individual staff also plays and important role.


Staffing PATTERN

          In determining the number of nursing service personnel required to staff a patient unit consideration must be given to the number required on a yearly basis, weekly basis and daily basis.  They are

a.    Computing number of nurses required on a yearly basis.

1.     Find the total number of general nursing hours needed in one year.  Average patient census x average nursing hours per patient for 24 hours x days in week x weeks in year.

2.     Find the number of general nursing hours needed in one year which should be given by registered nurses and the number which should be given by ancillary nursing personnel.

a.   Number of general nursing hours per year x per cent to be given by registered nurses.

b.   Number of general nursing hours per year x per cent to be given by ancillary nursing personnel.

3.     Find the number of registered nurses and ancillary nursing personnel required on a yearly basis

a.   Registered nurse hours needed per year divided by hours given per year by one registered nurse (hours on duty weekly per nurse x weeks on duty during year per nurse).

b.   Ancillary nursing hours needed per year divided by hours given per year by one person (hours on duty weekly per person x weeks on duty during year per ancillary person)

 

b.    Computing number of nurses assigned on weekly basis.

1.     Find the total number of general nursing hours needed in one week.  Average patient census x average nursing hours per patient in 24 hours x days in week.

2.     Find the number of general nursing hours needed in the week which should be given by registered nurses and the number which could be given by ancillary nursing personnel.

a.   Number of general nursing hours per week x per cent to be given by registered nurses.

b.   Number of general nursing hours per week x per cent to be given by ancillary nursing personnel.

3.     Find the number of registered nurses and ancillary nursing personnel required on a weekly basis.

a.   Registered nursing hours needed per week divided by hours on duty weekly per nurse.

b.   Ancillary nursing personnel nursing hours needed per week divided by hours on duty weekly per ancillary nursing employee.

 

c.    Computing number of nurses required on daily basis

1.       Find the fraction of the registered nurse and ancillary nursing personnel regularly assigned to the unit on a weekly basis who are on duty daily.  Days working each week divided by total days in week.

2.       Find the number of registered nurses and the number of ancillary nursing personnel on duty daily.

a.   Number of registered nurses assigned to the unit weekly x fraction of registered nurse personnel on duty daily.

b.   Number of ancillary nursing personnel assigned to the unit on weekly basis x fraction of ancillary nursing personnel on duty daily.

One method for determining the nursing staff of a hospital

To determine the number of nursing staff for staffing a hospital involves establishing the number of work days available for service per nurse per year.  This information is obtained by subtracting holidays, days off, average number of days of sickness and absence for other reasons from the total days of the year.

Example Analysis of how the days are used:

Days in the year                                        365

Days off 1 day / week                               52

Casual leave                                              12

Privilege leave                                            30

1 Saturday / month                                  12

Public Holidays                                         18

Stick leave                                                 08

Total non working days                            132

Total working days per nurse per year    233

 

          The average number of sick / maternity leave days taken can be obtained from administrative records.  In a document issued by the Ministry of Health at the Union or State govt “An Aid to Approximate Future Range of Nursing Staff and their Accommodation”, it was stated that the average absence on account of sickness amongst nursing staff was 14 days per year.

Example:

          To show the amount of nursing time available in a hospital with 20 nurse and 100 patients, i.e., ratio of 1:5 (This is exclusive of administrative, teaching and departmental nursing staff).

1.  Nurse = 233 working days per year

20 nurses = 233 x 20 = 4660 working days per year

To complete the number of nurses available per day, divide 4660 by the number of days in the year

Rounded off to 13

If the 13 nurses each work an eight hour day, they may be assigned as follows

                   Day Shift                       6

                   Evening                         4

                   Night shift                     3

                                                          13

This would show the following ratio of nurses to patients:

Day shift 6 nurses per 100 patients or 1:17

Evening shift 4 nurses per 100 patients or 1:2

Night Shift 3 nurses per 100 patients or 1:33

From this the average amount of time available per patient within a 24 hour period may be computed as follows

Day shift ratio               1:17

Minutes available         1 x 8 x  60 = 480 / 17  = 28 minutes

                                      12 seconds

Evening shift ratio        1:25

Minutes available         1x8x60=480/25=19 minutes 12 second

Night shift ratio             1:33+

Minutes available         1x8x60=480/33=14 minutes 30 second

Time available per patient

In 24 hours period                = 61 minutes 54 seconds.

 Factors of staffing

Important factors of staffing

a.    Quality and quantity of nursing personnel

b.    Utilization

c.    Other factors

c) OTHER FACTORS

i) Acutely ill

          Where the life saving is the priority or bed ridden condition which might required 8-10 hours per patient per day.

ii) Moderately ill

          In this case 3-5 hours per patient per day are required in 24 hours and the nurse patient ratio 1:3.

iii) Mildly ill:

          In this case 1-2 hours per patient per day and for such patients 1:6 or 1:10 nurse patient ratio is to be adequate.

RECRUITMENT

Definition

          Recruitment is a process, of securing applicants to fill vacant positions.  It cares both the filling of new and replacement of previously established posts which fall vacant.

Recruitment policy

        The recruitment policy includes

·        Discovery and cultivation of the employment market for posts / marketing a job in the public or private services.

·        Use of attractive recruitment literature and publicity.

·        Use of scientific tests for determining abilities of the candidate.

·        Tapping capable candidates from within the services.

·        Placement programme which assigning the right man to the right job.

·        A follow up probationary programme as an integral part of the recruitment process.

Recruitment methods

          Health agencies use multiple to recruit needed employees as follows

Advertising

          By giving advertisement in newspaper of local, regional, national and international levels and also journal advertisement.  The advertisement should be designed in such way that arouses the interest of postential candidate.  The media of advertisement should be selected carefully.  It is always better inserted in a newspaper or journal.

 

Career day programmes

          In some places nursing schools and collages herd annual career day programmes during which recruiting officers from local health agencies inform senior students about employment opportunities in those organizations.

 


Open House

          It is showcase of the opening of a new service of educational progrmame.  If health agency is well organized and their setting will be attractive to idealistic, service oriented nurses.

 

Employee referrals

          Is the method in which the present staff recruit their nurse acquaintances i.e, recruiter who wishes to fill positions in a particular nursing unit should ask employees in the unit to recruit nurses with whom they have worked comfortably in other settings.

Selection:

          The steps which constitute the employee selection process are the following.

·        Interview by personnel department.

·        Pre-employment tests.

·        Interview by department head.

·        Recision of administrator to accept or reject

·        Medical examination

·        Check for references

·        Issue of appointment order


Interviewing

          Interviewing is the main method of appraising an applicant’s suitability for a post.

 

Pre employment interviewing

          These tests include

1.    Tests in general ability – intelligence tests.

2.    Test in specific ability – aptitude tests

3.    Tests for achievement trade tests

4.    personality tests

 

Orientation

          Orientation is the process of acquainting a new worker with the work environment so that she or he can relate quickly and effectively to new surroundings.

 

Promotion

          The term promotion refers to a change for better prospects from one job to another job deemed by the employer.


 

CONCLUSION

 

          Staffing should reflect that the planning has taken all the local factors affecting staffing in relation to the quality and quantity of personnel optimum utilization of available nursing personnel needs high level of wisdom, problem solving and human relations skills and above  all a cool mind.  After all there is some limit to human endurance.  To rectify the anomaly, the political will is the need of the day.


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