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Unformatted text preview: Management Process : Staffing
Staffi ng Le ade r-manager re cr uits, sele cts, places and indoctrinates pe rsonnel to accomplish the goals of t he or ganization Espec ially importa nt; health care or ganizat ion – “labor int ensive ”; require d acc omplishe d goal, many health c are ope n 24 hours a day, 365
days a yea r & client demands & nee ds are oft en are of ten var iable Reflect ; appropria te balance of hig hly s killed, competent pro f sio nals &
ancillary support wo rkers Se quential Steps in Staff ing 1. Determ ine the number & ty pes of perso nnel needed to fulfill the philosophy
meet fis cal planning responsibilities , & carry out the chosen pa tient ca re
delivery sys tem s elect
ed by the organizatio n 2. Recruit, interview select, and as sign personnel based on established job
descri ptio n perfo rmance standards 3. Us e o rganizationa l res ources for induction & orient tion
a 4. A scertain that each employee is adequately s ocialized to organiza tion values
and unit norms 5. Use creative and flexible s cheduling bas ed on patient care needs to increase
productivity a nd retentio n • Accurately predicting staffing needs (cr ucia l management skill)
– – • Enabl es to avoid staffing crises (should know source of nursing poo l,
number of students enrolled in loca l nursi ng schools, usual length o f
emplo yment of newly hired staff, peak staff resignatio n periods, & times
w hen p tient census is highest)
Must consider patient care del ivery sy stem used, education & knowledge
level of needed staff, budget constraints, historical staffing needs &
availa bility, and diversity of patient populati on to be serv ed Selection of Personnel
– Recruitment & Ret ention
• Recruitment : process of actively seeking o ut / attracting applicants for
existing po sitions & should be an ong oing process
M ode s for R ec r uitmen t Em loye e r ec omme dations
W d of mouth
Adve rtise me nt
File r s
Ne wslette r
Bulle tin s
Poste r s
Care e r days
Place me nt se rvice Op en h ouse
Nu rs in g c onve ntions Attraction of qualified applicants is the first step Each institution should have someone who is responsible for recruitment Retention O
ffer flexi ble shifts: option s of 4, 6, & 8 hours as well as job-sharing Cluster pati ent assignments, and keep suppli es & equipment in cen tral locati ons to
avoid extensive walki ng Use lift teams, sp eci al bed s, & equip ment to curtail work- rel ated injuri es & physical
strain Review & adapt ben efits packages to accommodate differen t need s Use older n urses for n onp hysical work, such as patient admission & discharges Move older nurses & other alli ed health p rofessi on als into areas & position , maximi zing
their expertise while minimizing physical stress Use older staff as mentors and preceptors Screening of Staff Application forms & resum es Letters of reference Interview Testing Staff Development Indoctrinat ion : refers t o planned, g uided adj ustment o f an employee to the organization & the work environment; includes 3
phases: In duction ; takes place after employee has bee n selecte d b ut b efore
performing job role ; includes all a ctivities that edu cate n ew
employee about organization , emp loyment, pe rson al p olicies and
procedu res Orientation ; activities are m ore sp ecific for th e p osition Socialization ; part of staff develop me nt & tea m -building p rocess Orientation Is important, the manager who does not take the time to assist a new
employee is making a serious mistake Communicating regulations & exactly what is expected of the nurse
diminishes uncertainty, relieves anxiety & prevents unnecessary
misunderstandings St aff development Goes beyond orientation; continuing liberal education of the whole person to
develop her potential fully May include: orientation, preceptorships, mentorships, skill checklist, internship, in-service education, courses, conferences, seminars, journals,
programmed learning, independent study & refresher courses Preceptorship Used before the student graduate to orient them to the agency before
graduation & are familiar with it. During preceptorship faculty members facilitate, monitor & evaluate
student’s learning Liaisons between student & the agency Mentorship Mentors give their time, energy, & material support to teach, guide, assist,
counsel and inspire younger nurses Nurturing relationship that cannot be forced; mentor is a confidant who
personalizes role modeling& serves as sounding board for decisions Phases of Mentori ng Process: Invita tio na l ; “nurture”
Q ue st ioning ; “ mente e-doubts -ment or ” guidance”- Transitional ; mentee pre pa red to mentor Method of Assignment Pros and Cons of Various Assignment Systems Staffing Schedules St affing po licies largely influence staf fing schedules T determine st aff ing policies, one must consider the following
o questions; What is the best orga niza tion for staffing – centrali zed or decentralized to
clinical areas or nursing units ?
Who is res ponsible for origi nal scheduling or daily adjustment ?
Where are nursi ng hours posted a nd an a ccurate copy kept ?
For what period w ill schedules be prepared – 1, 2, 4 or 6 weeks ?
How fa r in advance w ill personnel know their work schedule ?
Wil l there be a n adjustment in staffi ng based on the identi ficatio n of patient
Wil l there be shi ft rotation ?
If there is s hift rota tion, how often – dail y weekly monthl y ?
How much should el apsed between rotated s hifts ?
What day starts a calendar week – Sunday or Monday ?
Wil l there be 2 days o ff each week or a n average of 2 days each week ? Staffing Schedules St affing po licies largely influence staf fing schedules T determine st aff ing policies, one must consider the following
o questions; What is the best organization for staffing – centralized or decentralized to
clinical areas or nursing units ?
Who is responsible for original scheduling or daily adjustment ?
Where are nursing hours posted and an accurate copy kept ?
For what period will schedules be prepared – 1, 2, 4 or 6 weeks ?
How far in advance will personnel know their work schedule ?
Will there be an adjustment in staffing based on the identification of patient
Will there be shift rotation ?
If there is shift rotation, how often – daily weekly monthly ?
How much should elapsed between rotated shifts ?
What day starts a calendar week – Sunday or Monday ?
Will there be 2 days off each week or an average of 2 days each week ? Centralized & Decentralized Schedules ORGANIZING Delegation Delegation (essential element directing phase)
o Is both an art & a science; includes cognitive, affective & intuitive dimensions
o At its most basic, is empowering one person to act for another
e Note: in response to emerging complexity of delegation in today’s health care arena, where increasing
numbers of unlicensed & relatively untrained workers provide direct patient care; ANA & NCSBN
o ANA : transfer of responsibility from the performance of a task from one person to another.
o NCSBN : transferring to a competent individual the authority to perform a selected nursing task in a selected
e Complex, require insight & judgment – environment & individual involved Reasons for delegating : managers must delegate ;
o Routine task, free to handle problems more complex / require higher level of expertise
o If someone else is better prepared or has greater expertise or knowledge how to solve problem
o Provide learning or “stretching” opportunities for subordinates (contributes – personal & professional
growth) Advantages ; Effective Delegating (strategies)
o Plan ahead
e Identify task (accomplished), assess situation, clear desired outcome
o Identify necessary skills & levels
e Managers should know official job description expected each worker classification in the organization
o Select most capable personnel
e Qualified, best able to complete in term capability & time to do
e Should ask the individual & consider task as important (if he/she is capable), should also validate by
o Communicate goal clearly What is to done (purpose), verify comprehension, desired end product should be specified, vital to
give feedback subordinates & appropriate degree autonomy in decision making (how work
o Empower delegate
o Set deadlines & monitor progress
o Model the role & provide guidance Subordinate with difficulty – manager available “role model” help identify alternative solution &
convey feelings confidence & encouragement Reassuming delegated task last resort (manager) = sense of failure & demotivates (subordinates)
o Evaluate performance o After task completed include positive & negative aspects how person completed task Without feedback = unable to have mutually trusting & productive relationship
Reward accomplishment “Mark of a great leader is when he / she can recognize the excellent performance of someone else
and allow others to shine for their accomplishment” • Barriers ; common delegation errors Delegation is critical skill, must be learned ; nurse must be taught delegation skill both
academe & clinical settings Maintain, decision to delegate should be consistent with steps of nursing process & based
analysis patient’s needs & circumstances
o Underdelegating Frequently stems from managers false assumption that delegation may be interpreted as lack of
ability on his/her part to do the job correctly/completely Managers, desire to complete the whole job; lack trust subordinates Managers, believe needs the experience & can do it better & faster Excessive need to control / perfect
o Overdelegating Poor managers of time (spend of most of it trying to organize)
o Improper delegating Includes ; wrong time, person & reason Delegating task beyond capability person & without adequate information • Steps to successful Delegation Understanding the Principle of Delegation Ability to communicate clearly Capacity to see the value that delegation has in developing others Building trust and self-esteem Recognizing that different personalities & capabilities exist Acknowledging the following :
e Right person
e Right task
e Right circumstances
e Right direction & communication
e Right supervision & evaluation e To delegate or Not : Is this really the question? Various nursing task can be appropriately delegated, after considering: Patient condition; especially stability Patient capacity for self-care Complexity of the task Repetitive nature of the task Technical nature of the task Skills & experience of the UAP Medical technology involved Infection control/safety precautions involved Predictability of outcome RN supervision available Extent of interaction with the patient Environment (ICU vs. Rehab unit) Potential for harm Centralization & Decentralization
◦ Centralized decision making :
e few managers at the top of the hierarchy make the decisions
◦ Decentralized decision making :
e Throughout the organization and allows problems to be solved by the lowest practical managerial
e Means problems can be solved at the level at which they occur = improve quality care outcomes &
increase organizational efficiency
e As a rule, larger organizations benefit from decentralized decision making Team building / development : “Staff Development”
◦ Staff development is a cost–effective method of increasing productivity
e Training : defined, organized method of ensuring that people have knowledge & skills for a specific
purpose and that they have acquired the necessary knowledge (may require increased affective,
motor or cognitive skills) to perform the duties of the job; immediate use
e Education : more formal & broader in scope; design to develop individual in broader scope
Team Building ...
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- Spring '09