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

Phases of indoctrination process: A- Induction:استقراء 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 employee’s 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: Model: you admire or want to emulate. Envisioner:مبصر Someone who can see and communicate a meaning of professional nursing and its potential. Energizer: dynamism, stimulates you to take action Investor:مستثمر 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:مقياس refuses to accept less than excellence. 7.Teacher-coach: مدربteaches 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: Clinical expertise developed: (accuracy, efficiency, and quality). 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. care

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 of the team are not qualified to perform.

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: satisfaction of pt and staff needs, pt is treated through using of nursing care plans Pt care needs requiring more than one staff member. 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 team members .

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 pt’s 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: Primary nursing confines a nurse’s 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).

Determining staffing policies 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: What is the best stating - centralized or decentralized ? 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 prepared-1,2,4, 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? تقسم أو تجمع الاجازات 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?هل يوجد ساعات زيادة يمكن استغلالها 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? هل يوجد معايير للساعات الاضافية مثل زيادة المرضى 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: Covering all staff absences. The unit manager is often responsible for : Covering all staff absences. Adding or Reducing staff according to no. & types of pts. Preparing monthly unit schedules Preparing holiday and vacation schedules

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 punishment- reward system by head nurse. Very time-consuming, head nurse away from other duties.

Centralized scheduling ( individual or a computer) * Advantages of Centralized scheduling: Fairness to employees through consistent, and impartial application of policies. freeing head nurses for other activities * disadvantages of Centralized scheduling: Low flexibility & interest for the worker. Managers can easily grow unresponsive to personnel budget control if they have little to do with staffing.

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: Sense of belonging to their shifts developed Job satisfaction 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: Nurses can plan for their life. Decrease absences due to social events Stable work groups, decrease floating Promoting team spirit & continuity of care.

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 pt’s beds, availability of supplies and equipment, the organizational structure, affecting staffing.

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