Nurse Staffing Case Study

1. Discuss TWO of the following staffing/scheduling practices and how they can support patient care:
With the best healthcare organizations, we have today, staffing and scheduling are very challenging issues that these organizations still face. Researchers from the last 10 years or so shows the importance of adequate registered nurse staffing in accomplishing good patient outcomes, safety, and satisfaction. Better RN staffing and not too overworked, have been shown to reduce patient mortality, enhance outcomes, and improve nurse satisfaction. “One study found that for each additional patient assigned to a given nurse, the patient has a 7% increase in the likelihood of dying within 30 days of admission and a 7% increase of failure to rescue.”
(Mensik, 2014).
h. Centralized versus Decentralized scheduling
Centralized scheduling “where staffing decisions are made by personnel in a central office or staffing center. Such centers may or may not be staffed by RNs, although someone in authority would be a nurse even when a staffing clerk carries out the day-to-day activity.”

Decentralized staffing “the unit manager is often responsible for covering all scheduled staff absences, reducing staff during periods of decreased patient census or acuity, adding staff during periods of high patient census or acuity, preparing monthly unit schedules, and preparing holiday and vacation schedules. Nursing management is highly decentralized in most hospitals, with considerable variation found in staffing among patient care units. This means that many nurse–managers have some control over factors that affect cost on their specific units.”

I think that by having centralized and decentralized staffing can help patient care by having enough RN’s to cover each shift.
Centralized staffing is fair, even though manager’s role is limited, the manager can still communicate any needs of staffing to cover patient needs depending on illnesses and patient status changes. For decentralized staffing, the unit manager knows the staff’s need personally as well as professionally which can help the unit manager decide in regards to patient care as well. “Advantages of decentralized staffing are that the unit manager understands the needs of the unit and staff intimately, which leads to the increased likelihood that sound staffing decisions will be
made.”
i.
Overtime
Overtime should be an option offered to nurses. I think when an overtime becomes a mandatory to nurses or any staffs, this results to fatigue, overworked, and resentment. Not everyone can do overtime, but giving it as an option and who wants to do increases the chances of having a happy nurse and a nurse giving its best care possible to patient.
When I worked for a medical group, my manager would leave it to the staff to decide which day(s) in a week they can do overtime and for how long. We had staffs that have kids or single parents and they need to go home right after work. However, if a staff commits to a day or two or more, they need to make sure that they work the day(s) that they have signed up for or find someone to cover for them, if they cannot, it will result to verbal or write up. Which leaves the staff feeling in control of their schedule and I see them happier and willing to work.
2. Discuss organizational policies that help to support fair/equitable staffing practices, including holiday
scheduling.
The necessity to schedule staff(s) for night, evening, weekend, and holiday work that is needed in healthcare organizations that causes stress and frustration for nurses. Managers should do the best they can to accommodate employees scheduling request so they can feel they have some control over scheduling, shift options, and staffing policies. “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. Each organization has different expectations regarding the unit manager’s responsibility in long-range human resource planning and in short-range planning for daily staffing.” Maybe during the holidays, have nurses choose the holidays that they want to work and if there are not enough staffing for certain holidays then seniority should come in as well. Maybe this type of scheduling can make nurses happy as well as not overworked.