Page 1 : The Master staffing plan considers existing agency, visor, clinical nurse specialist, and nursing service, fessional and technical-head nurse, team leader, super-, policies such as vacations, holidays, hours or work, leaves, 6. Define registered nurse positions (Staff nurse-pro-, 202, Nursing Administration, Promotion, The word "promote" is derived from the Latin expression, defines "promovere" meaning "to move forward", The, dictionary meanings of promote are:, • To excel in a situation, rank or honor, to elevate, to, advance., • To contribute to growth or prosperity for something,, cause to perform further., • To advance from a given grade or class as qualified for, one higher., The term "promotion" refers to a change for better, prospects from one job to another job in deemed by the, employee. The factors which are considered by employees, as implying promotion are:, a. An increase in salary., b. An increase in job prestige, c. An upward movement in the hierarchy of jobs., d. Additional supervisory responsibility, and, e. A better future., The unions generally favor promotions on the basis of, seniority and managements usually favor promotion on, the basis of merits. However, it is an ideal to have following, factors which must be the basis for promotion., a. Outstanding service in terms of quality as well as, quantity., b. Above average achievements in patient care and/or, public relations, c. Experience, d. Seniority, e. Initiative, f. Recognition by employees as a leader., g Particular knowledge and experience necessary for a Computing Number of Nurses Required on a, administrators)., 7. Determine policies regarding these positions and fo, rotation of personnel., of absence, rotation of personnel, and sick time allowan, based on average days of illness., Example, 40 hours work week or 5 days per week., 28 vacation days (4 weeks), 7 legal holidays (1 week), 7 average days of illness or absence (1 week), 52 weeks -6 weeks = 46 working weeks, 46 weeks x 5 days per week= 230 working days per year, (This computation represents only one position)., Difference in personnel policies such as vacation, allowances for ancillary personnel affect the number of, working days. If the policy is 14 days, for example, for this, group, then the available working days would be 244, instead of 230., If absences and reported sick days increase in certain, groups, then this factor, and the difference in policy indicate, the need for separate computations for each position group., Daily complement: Stated rather simply, if the daily comple-, ment for registered nurses ona given unit is two, budgeted, positions would reflect three. This would allow for six days, off and one holiday per week but would not allow for, vacation relief., 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, vacancy, h. Record of loyalty and cooperation., A GUIDE TO STAFFING NURSING SERVICES, Projecting Staffing Needs, In determining the number of Nursing Service Personnel, required to staff a patient unit, a service unit or the nursing, service department, consideration must be given to the, number required on a yearly basis, on a weekly basis, and, on a daily basis. Some steps to be taken in projecting staffing, needs include:, 1. Identify the components of nursing care and nursing, service., 2. Define the standards of patient care to be maintained., 3. Estimate the average number of nursing hours needed, for the required hours., 4. Determine the proportion of nursing hours to be provided, by registered nurses and other nursing service personnel, (licensed practical nurses, aids, and the like)., 5. Determine ancillary nursing service hours to be provided, by ward clerks, messengers, and the like., 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 percent, to be given by registered nurses., b. Number of general nursing hours per year x percent, 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)., 1/3

Page 2 : Computing Number of Nurses Assigned, Staffing 203, on Weekly Basis, Eind 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., Find the number of general nursing hours needed in the, ek which should be given by registered nurses and, the number which could be given by ancillary nursing, 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., personnel., Number of general nursing hours per week x percent, to be given by registered nurses,, h Number of general nursing hours per week x percent, to be given by ancillary nursing personnel., 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., Example: To show the amount of nursing time available in, a hospital with 20 nurses 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., 4660, = 12.8, 365, Rounded off to 13., If the 13 nurses, each work an eight-hour day, they may, be assigned as follows:, Day shift, Evening shift, Night shift, 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., 4., 3, 13, This would show the following ratio of nurses to patients:, Day shift, Evening shift : 4 nurses per 100 patients or 1:25, Night shift, From this the average amount of time available per, patient within a 24, hours period may be computed as, follows:, Day shift ratio, : 6 nurses per 100 patients or 1:17, : 3 nurses per 100 patients or 1:33., 1:17+, 480, = 28 minutes, 12 seconds., Minutes available, 1 x 8x 60=, 17, One Method for Determining the Nursing, Staff of a Hospital, Evening shift ratio, 1:25, 480, = 19 minutes, 25, Minutes available, 1x 8x 60 3D, 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., 12 seconds., Night shift ratio, 1:33+, 480, 1x 8 x 60=, Minutes available, 114 minutes, 33 30 seconds., Time available per patient, in 24 hours period., There is need to have personnel budget for staffing as, =61 minutes 54 seconds., Example: Analysis of how the days are used:, Days in the year, Days off 1 day/week, Casual leave, Privilege leave, 1 Saturday/month, Public Holidays, Sick leave, 365, follows., 52, 12, Personnel Budget, 30, A budget is a plan that uses numerical data to predict the, activities of an organization over a period of time. The, desired outcome of budgeting is maximum use of resources, to meet organizational short and long term needs. The, budget's value is directly related to its accuracy; the more, 12, 18, 132, Total non working days, Total working days per nurse per year, 233, 2/3

Page 3 : nurse's dissatisfaction with staffing. They are overloade, In India, professional nursing education started at, university level in 1946 awarding BSc (Hons). Nursing, midwife, and public health nurse for direct care, super-, Quality and quantity of nursing personnel: This factor depends, prepared for, i.e. professional, skilled, routine or ancilliary, nursing personnel for the kind of service they are being, quality, quantity and utilization of personnel while the, on the appropriate education or training provided to the, Staffing of any set-up is concerned with three factors, 204 Nursing Administration, Important Factors of Staffing, accurate the budget blue print, the better the institution can, plan the most efficient use of its resources. Because, the, budget is at best a prediction, a plan and not a rule, fiscal, planning requires flexibility, ongoing evaluation and, revision., structure and the process are kept in mind., Steps into Budgetary Process, 1. Determine the requirement of the budget, 2. Develop a plan, 3. Analyse and control the operation, 4. Review the plan., work., degree to produce tripple role general professional, ie, visory, teaching, administrative functions., In 1959, Master of Nursing course was initiated by Dolks, University to produce professional nurses for execut, education and research posts., Last 40 years have produced 4,271 BSc (Nursing) degree, and 526 MSc (Nursing) degree nurses (source Indian, Nursing Council, 1986). The number seen like a dropin the, ocean for giant task the professional nurses who ought to, be involved in serious work of situational analysis, decision-making, budgeting, planning and experimenting, variety of strategies for appropriate manpower develop-, Types of Budget, Personnel budget: Most staffing is based on a predetermined, standard. This standard may be addressed in hours per, patient day (medical units), visits per month (community, health agency) or minutes per case (the operating room)., Because the patient census, number of visits, or cases per, day never remain constant, the manager nurse be ready to, alter staffing, which volume increases or decreases. In, addition, sometimes the population and type of cares, change so that the established standards are no longer, appropriate., The standard formula for calculating nursing care hours, (NCH) per patient day (PPD), ment., General nurse midwives and auxiliary nurse midwives, are prepared for skilled and routine work respectively, Their training is controlled by hospital authorities. Since, they are given a meagre stipend during their training, they, are more or less used to compensate the skeleton trained, staff employed. They are exploited as cheap labor under, the name of training. What quality of general nurses and, auxiliary nurse midwives can be expected from majority of, such hospital training? In relation to quantity to provide, staffing for 5.5 lacs of beds, thousands of dispensaries, clinics, private nursing homes, around 2,00,000 of general, nurses are produced and to staff a large infrastructure of, health centers for 600 million population of rural India, around 1,00,000 of ANM/FHW are produced till date., Nursing hours worked in 24 hours, i.e. NCH/PPD=-, Patient census, For census a day is divided into 3 shifts., from last night, 4 staff (SSN + 3SN + ASN) x 8 hours = 32 hours, 11 PM to 7 AM, 7 AM to 3 PM, 7 staff (SSN +3SN + ASN) x 8 hours 56 hours, 3 PM to 11 PM, 6 staff (SSN + 3SN + ASN) x 8 hours = 48 hours, 136 hours, The nursing hour worked on 24 hours in 136 hours. The, second step in solving NCH/PPD requires that you divide, nursing hours worked and the 24 hours by the patient, census, e.g. patient census on the case is 25., Therefore, 1365.44. Therefore, NCH/PPD of particular, day is 5.44 or 6.0., Utilization: With the above mentioned meager quality and, quantity of nursing personnel their optimum utilization, becomes crucial., Utilization means that the nursing personnel must bx, assigned work in such a way that her/his knowledge and, skills learnt are best used for the purpose she was educate, or trained. In addition, she/he is able to maintain a positrv, attitude towards her/his nursing work and the peop, she/he serves., 25, STAFFING IN HOSPITALS AND, COMMUNITY SETTING, Many studies conducted on nurses and nursing reve, Staffing is of deep concern to the nurse managers in the, hospital or community to provide standard patient care to, carry out all the functions allocated to the nursing per-, sonnel., with work, majority of which is non-nursing in nat, lacking supportive, stimulating, challenging or encour, ging environment to work in. This is obvious when major, 3/3