STAFFING

The process of determining and providing the acceptable number and mix of
nursing personnel to produce a desired level of care to meet the patient’s demand.
It should be orderly, systematic and based upon sound rationale. It is complex.

GOAL/PURPOSE
To provide each unit with an appropriate and acceptable number of each
category of workers to perform the nursing tasks required.

OBJECTIVES:
•To provide continuous quality nursing care
•Evaluate staffing practice periodically
•Utilize talents and skills

FACTORS AFFECTING STAFFING:

a.Type, philosophy and objectives of the hospital and the nursing service.
b.Population served of the kind of patient‘s served whether pay or charity.
c.Number of patients and severity of their illness.
d.Availability and characteristics of the nursing staff including education, level of
preparation, mix of personnel, number and position.
e. Administrative policies such as rotation weekends and holiday off duties.
f. Standard of care desired.
g. Layout of various nursing units and resources available within the department.
h. Budget including the amount allotted for salaries, fringe benefits, supplies, materials and
equipment.
i. Professional activities and priorities in non-patient activities.
j. Teaching program or the extent of staff involvement in teaching activities.
k. Expected hours of work per annum of each employee.
l. Patterns of work schedule.

STAFFING PROCESS
1. Selection of Personnel
a. Recruitment – method of enlisting personnel for employment
Methods of Recruitment include:
* Advertising
*Word of mouth
* Employee recommendation

b. Screening – applicants submits resume. This helps in determining whether the

applicant is qualified and meets the minimum requirement.
3 PHILOSOPHIES DURING SCREENING PROCESS
Screen out applicants who do not fit the image of the agency
Try to fit the job to a promising applicant
Try to fit the applicant to the job

c. Interview – to obtain further information about the applicant, to give

information and to determine if the applicant qualifies for the position.

During the Interview, observe the applicant:

If he/she show genuine interest in the job
Has willingness to work and assume responsibilities
If he/she well mannered

d. Orientation – introducing the applicant to her new job. It is the process of

becoming familiar with a new environment and adapting well
to it. This would include:
> Tour of the Physical facilities
> Introduction to co-workers
>Description of the organizational structure of the institution
> Information on the Philosophy, goals, policies and the
standards of the institution
> Functions of the members of the health team
> In-service education training program
2. Systems of Assignment

5 Methods of assigning personnel

a.CASE METHOD
♠ Each patient is assigned to a nurse for total patient care

b. FUNCTIONAL METHOD
♠ based on the concept of division of labor where nurses and other
caregivers are assigned to do specific tasks on several patients.

c. TEAM METHOD
♠ based on group approach where staff members work as a team to give
total care to a selected group of patients.

d. PRIMARY METHOD
♠ Is based on the philosophy that patient’s instead of tasks should be the
focus of professional nurse. The primary nurse who is the registered
nurse is given the full responsibility to give total patient care to 4-6
patients. He is responsible for the care of this patient 24 hours a day
throughout the hospitalization. An associate nurse also an RN, cares for
the patient using the care plan designed by the primary nurse while the
latter goes off duty.
e. MODULAR METHOD
♠ It is the combination of the primary and team nursing. The nurse is
assisted by non-nursing members of the health team such as nurse
attendants and assistants to give nursing care to 8-12 patients.

♥ It is the method of grouping patients according to the amount and

complexity of their nursing care requirement, of nursing time and skill they
require.

TO develop a workable patient classification system, the nurse manager

must determine the following:

•The number of categories into which the patients should be divided

•Characteristics of patients in each category
•Type and number of case procedures that will be needed by a typical patient
in each category
•Time needed to perform these procedures that will be required by typical
patient in each category.
CLASSIFICATION CATEGORIES:
a.LEVEL I – Minimal care of self care
b.LEVEL II – Moderate or intermediate care or partial care
c.LEVEL III – Total, complete or intensive care
d.LEVEL IV - Highly specialized care

♦ Categories of Levels of care of patients, Nursing care hour (NCH) needed

per patient per day and ratio of professionals to non-professionals.

NCH needed per Ratio of professional

Levels of Care patient per day to non-professional

LEVEL I
Self care or Minimal care 1.5 55:45
LEVEL II
Moderate or intermediate care 3.0 60:40
LEVEL III
Total or intensive care 4.5 65:35
LEVEL IV 6.0 70:30
Highly specialized or intensive care 7.0 or higher 80:20
♦ Percentage of patients at various levels of care per type of hospital

PERCENTAGE OF PATIENTS IN VARIOUS LEVEL OF CARE

Type of Hospital Minimal Moderate Intensive Highly

care care care special
care

Primary Hospital 70 25 5 -

Secondary Hospital 65 30 5 -

Tertiary Hospital 30 45 15 10

Special Tertiary 10 25 45 20
Hospital
COMPUTING FOR THE NUMBER OF NURSING PERSONNEL NEEDED

♦ Total Number of working and non-working days and hours of nursing

personnel per year:
Rights and privileges given each Working hours / week
personnel / year
40 HOURS 48 HOURS
1. Vacation Leaves 15 15
2. Sick Leaves 15 15
3. Legal Holidays 10 10
4. Special Holidays 2 2
5. Special privileges 3 3
6. Off duties –per RA 5901 104 52
7. Continuing education program 3 3
TOTAL NON-WORKING 152 100
DAYS/YEAR
TOTAL WORKING DAYS / YEARS 213 256
TOTAL WORKING HOURS / YEAR 1,704 2,120
♦ RELIEVERS NEEDED

To compute for the relievers needed, the following should be considered”

a.Average number of leaves taken each year -------------------- 15
♣ Vacation leave --------------- 10
♣ Sick leave --------------------- 5

b. Holidays -------------------------------------------------------------- 12
c. Special privileges --------------------------------------------------- 3
d. Continuing education program for professionals ------------ 3

TOTAL AVERAGE LEAVES---------------------------------------33

To compute for relievers needed:

1.Divide 33 (average number of days an employee is absent / year) by the
number of working days / years that each employees serves (213 or 256)

33 / 213 = 0.15 / person who works 40H/week

33 / 265 = 0.12 / person who works 48H/week

2. Multiply the compound reliever per person by the compound number of

nursing personnel
 ♦ DISTRIBUTION BY SHIFTS
AM SHIFT 45 – 51 %
PM SHIFT 34 – 37 %
NIGHT SHIFT 15 – 18 %

♦ STAFFING FORMULA
3. SCHEDULING
* A time table showing planning work days and shifts for nursing
personnel

OBJECTIVES:
To assign working days and day offs to the nursing personnel so that:

a.Adequate patient care is assured while avoiding overstaffing

b.A desirable distribution of off duty days can be achieved
c.Individual members of the nursing team will feel that they are treated
fairly.
d.They will know their schedule in advance.

FACTORS CONSIDERED in MAKING SCHEDULES

a.Different levels of the nursing staff
b.Adequate coverage for 24 hours, 7 days a week
c.Staggered vacation and holidays
d.Weekends
e.Long stretches of consecutive working days
f.Evening and night shifts
g.Floating
SCHEDULING AND CONTINUING PROFESSIONAL EDUCATION PROGRAMS

Assessing a scheduling system

a.Ability to cover the needs of the unit
b.Quality to enhance the nursing personnel’s knowledge, training and
experience
c.Fairness to the staff
d.Stability
e.Flexibility

TYPES OF SCHEDULING
a.Centralized Schedule
One person usually the chief nurse or her designate prepare the schedule,
assigns the nursing personnel to the various units of the hospital, this includes
the shifts on duty and off-duty.

b. Decentralized Schedule
Shift and off-duties are arranged by the supervising Nurse, Head or senior
nurse of the particular unit.

c. Self scheduling
Staff nurse in a unit collectively decide and implement the monthly work
schedule.
d. Cyclical schedule
An approach which covers a designated number of weeks called cycle
length and is repeated thereon.

ADVANTAGES OF CYCLICAL SCHEDULE

•It is fair to all
•It saves time
•It enables the employee to plan ahead for personal needs preventing
frequent changes in schedule
•Schedule leave coverage are more stable
•Productivity is improved.

ROTATING WORK SHIFTS

3 shifts a day (AM, PM, NOC)

C. Developing Job Descriptions

JOB DESCRIPTIONS
A statement that sets duties and responsibilities of a specific job. It is an
important management tool to make certain that responsibilities are wisely
delegated, that work is efficiently distributed, that talents are fully used,
and morale is maintained.
CONTENTS OF A JOB DESCRIPTION
a.Identifying data
•Position title: Staff Nurse
•Department: Nursing
•Supervisor’s title:Head / Senior Nurse

b. Job Summary
Essential features of the job that distinguishes it from others

c. Qualification requirements
Education, preparation, training, and experience necessary to fill the
position

d. Job relationships – source of workers

e. Specific and actual functions and activities.

USES OF JOB DESCRIPTION

•For recruitment and selection of qualified personnel
•To orient new employee of their new job
•For job placement, transfer or dismissal
•As an aid in evaluating the performance of an employee
•For budgetary purposes
•For determining departmental functions and relationships to help define the
organizational structure
•For classifying levels of nursing functions according to skill levels required
•To identify training needs
•As basis for staffing serves as a channel of communication

Job Description: STAFF NURSE

Position Title: STAFF NURSE / NURSE 1

STAFF NURSE
Is a professional nurse responsible for rendering holistic nursing to
patients in assigned areas, the specific function and responsibilities of
which depend upon the organizational structure of the Nursing service
department / division.

QUALIFICATION REQUIREMENTS:
Education: Bachelor of Science in Nursing
License: Registered Nurse
Job Summary:
Provides direct nursing care to patients towards the promotion of health,
prevention of diseases, restoration of health, alleviation of suffering and
assisting the dying to face death with dignity and peace.
Job Relationships:
•Source of workers: Registered Nurse
•Promoted to: Senior nurse / Nurse II
•Responsible to: Senior Nurse / Nurse II

FUNCTIONS:
A.PATIENT CARE MANAGEMENT
♥ The staff nurse shall initiate and perform nursing care services to meet
the needs of the patient in assigned areas / unit utilizing the nursing
process.

1.Assess the individual’s needs for nursing care based on the patient’s
history, result of physical, diagnostic and laboratory examinations.
2.Infers correct nursing diagnosis
3.Plans/prioritizes nursing care activities considering overall health needs of
the patient the extent of his coping abilities including that of his family and
significant others and his readiness, acceptance and abilities of self care.
4.Institute nursing interventions consistent with overall plans of care with
special considerations for his safety and comfort.
5.Executes written, legal preparations for treatment, therapies and
medications.
6. Provides health teaching to patient, his family and significant others so
that they may understand this illness and participate actively in his care.

7. Coordinate patient’s care services with members of the health team

8. Evaluates / modifies nursing care provided in terms of:
☻ Effectiveness and efficiency of nursing measures rendered
☻ feedback from patients / family / significant others

9. Conducts discharge planning with patient, family and the health team.
Refers to community health agencies as needed.
10. Document accurately observations and services rendered to the
patients.

B. Hospital Nursing service policies and regulations

1.Observes hospital and nursing service rules, regulations and policies.
2.Interprets to patients and family and visitors rules and regulations and
policies that affect them.

C. Learning experiences of Nursing and Midwifery Students

1.Coordinate with clinical instructors the activities of the affiliating students
such as helping select patient assignment to enhance learning experience
particularly on patient care
2. Demonstrate what good nursing is in the way she cares for patients. Act as
a role model to the students.

D. Orientation of Non-professional workers in the unit

Participate in the orientation of new, non-professional nursing personnel

E. Research and studies

Participates in / initiates nursing research and studies. Utilizes results for
improvement of nursing practice.

F. Professional Responsibilities
1.Takes initiative and responsibility for professional organizations and
participates actively in their programs and activities.
2.Keeps self professionally updated through continuing education programs
3.Update professional license.
JOB DESCRIPTIONS OF THE HEAD NURSE /SENIOR NURSE / NURSE II

Position Title: Head Nurse / Senior Nurse / Nurse II

Definition
A head nurse /senior nurse / Nurse II is a professional nurse who assumes
responsibility for managing the human and material resources of a nursing
unit to provide quality patient care and an environment conducive of staff
growth and satisfaction.

Qualification requirements
Bachelor of science in Nursing; registered Nurse; at least 1 year of clinical
Nursing experience; with supervisory development training or training in the
nursing especially of the clinical nursing unit to which he/she is prepared for
promotion; or 9 units to Nursing management and supervision in the
Graduate school as required by RA 7164

Employment variable
Membership to the agency’s nursing association and other professional
associations such as the Integrated Nurses of the Philippines and Philippine
Nurses Association.
Job Relationships
•Source of workers: Nurse I / Staff Nurse
•Promotion to: Nurse III / Supervising Nurse
•Responsible to: Nurse III / Supervising Nurse
•Responsible for: Nurse I / Staff Nurse / Nursing attendant

FUNCTIONS:
A.Management of Care – Assumes responsibility for quality patient care
delivery for the nursing unit.

1.Participates in the development of nursing standards, policies, procedures

regarding patient care and updates these as necessary
2.Promotes / Utilizes Quality Assurance Standards and Programs in the unit
3.Supervises and evaluates the quality of patient care through frequent
rounds.
4.Acts as liason with the Medical staff to coordinate medical and nursing
management of patient care.
5.Serves as resource person to nursing personnel under him/her in
assessing, planning, implementing, and evaluating nursing care provided
6.Assumes the role of patient advocate
7.Coordinated patient care with other members of the health team, other
hospital units, services and divisions
8. Serves as committee member within the department, hospital of
professional organization
9. Keep superiors informed regarding problems / issues in patient care
within the nursing unit.

B. Management of Nursing Personnel

Provides leadership and direction to nursing personnel in accordance
with organization and departmental goals.

1.Participates in the selection of nursing staff to the unit.

2.Schedules staff assignments considering experience, interest and
training
3.Adjusting staff levels / ratio according to the acuity of the patient’s
illness, the number of patients and number of nurses.
4.Advises and/or informs staff regarding new or revised policies and
procedures.
5.Keeps supervising Nurses informed of personnel activities and problems
6.Presents changes or innovations to staff in a positive manner
7.Provides a conducive climate in which the staff will feel free to consult
her/him for problems or assistance.
C. MANAGEMENT OF PATIENT CARE UNITS
Maintains an environment that encourages quality patient care and staff
satisfaction

1.Provides safe, clean, secure environment for patients, visitors and

personnel
2.Requisitions adequate supplies, and equipment needed for patient care
3.Monitors utilization of supplies and equipment through monthly audits and
inventories
4.Cooperates/coordinates with other hospital services/departments for
appropriate support service.
5.Prepares monthly, semi-annual, annual reports of achievements /
problems.
6.Maintains effective communication within the unit / departments and other
services through conferences/meetings.

D. EDUCATIONAL RESPONSIBILITIES
1.Assists in staff development activities
•Coordinates with training staff in planning, implementing, and evaluating
orientation of new nursing personnel.
•Informs training staff of the training needs of nursing personnel under her.
2. Assists clinical instructors of affiliating colleges of Nursing or school of
midwifery in planning, implementing and evaluating the learning
experience of the students.

3. Assumes responsibility for own learning and development needs.

E. Acts as supervising nurse in the absence of one and when so

delegated.