Nursing Schedules and Recruitment

Steps Taken in Effecting New Hiring Directives.

The hiring directive for nurses in the hospital needs to be adopted with new measures in place as well. It is important that the people taking part in the recruitment have put in place measures prior to starting the recruitment process. The nurses that are already working in the hospital have to be prepared to receive new nurses. Beyond new nurses, they are expected to accept that these nurses have to be trained further on the job. So the steps to take in this instance begins with preparing the nurses that are already there to take on nurses for training. In nursing, the experience is very important. It makes the nurses more efficient while at work. My course of action on the second step would be to coordinate with the nurses on the kind of new nurses they expect to get from the recruitment. This information is what the interviewing nurse will use in evaluating what the applicants can bring to the table. The final course of action would be critically vetting the responses of the applicants in relation to what the hospital needs.

Five Recruitment Alternatives

The directive for recruiting nurses with experience of less than two years can be full filled in various ways. The first would be to pick applicants from specific nursing schools. This give the hospital the option of handpicking the students who have topped in their classes in the specific institution. The second method would be to pick the best students from five nursing schools. This gives the hospital the best students to train and make nurses out of. The third method would be to restrict the application to applicants who have had experience of at least one year from a specific region. The fourth method of getting competent nurses would be to take new nurses who are training in government hospitals as per the recommendation of the chief nurse in the hospital. The final method in this instance is to accept student nurses and retain the best five as permanent employees. This five methods ensure that the hospital has the opportunity for getting the best nurses possible to fill the staffing gap.

Orientation and Socialization of New Nurses

In the case where new graduates are to be hired, the orientation will have to be through and may require full time supervision while they get trained. The orientation of new graduates will begin with familiarizing them with a real hospital setting. At this point they need to be made to understand that the hospital setting will require quick learners and dedicated nurses. A real hospital setting gives no room for mistakes seeing that they will be dealing with actual lives of people. The socialization will have to be monitored to ensure that they get positive values from the more experienced nurses. The new nurses need to be socialized into the life of a medical practitioner properly. This entails the new nurses being told of how to manage their time and shifts.

Desired Characteristics of New Nurses

In the search for new hospital staff, I would look for nurses with integrity and dedication. Nurses that are willing to give the best care to patients regardless of the patients’ conditions, cultures and previous health history or underlying conditions. The nurses being recruited have to be people willing to go an extra mile to save lives. The hospital needs staff that can be versatile and serve in more than one area. The nurses operating in the emergency rooms are always trained to operate in all areas of the hospital. The same is expected of the new nurses. They have to be people who can be trained to fit in most areas of the hospital, the willingness to learn is important.

Case Study on John

The responses by John are indicative of an individual who is in a career but is unprepared to deal with all the challenges that come with it. Being a new graduate, the interviewing nurse should have taken some time to evaluate the readiness of John to work in a busy hospital. In this case, the interview was conducted with the expectation that the interviewee has had experience with patient for at least a year. This means that they would know how to handle patients of all kinds without discriminating. Being a nurse in a hospital is a career that does not allow and individual to choose who to treat and how to treat them. Discrimination is not accepted in the nursing profession and John appear to have some traits of discrimination. 

For a new graduate, John should have responded in a manner that suggests his readiness to use his best judgment for the benefit of the patient. He should have responded to the question on cultural beliefs by emphasizing that the patient’s needs will top all other factors inclusive of culture. For instance; where the culture is against operations, he should have said that whatever the primary care giver of the patient decides is what he will go by. A nurse should treat a patient whose primary caregiver is receptive to treatment to the best possible standards. John should also have mentioned the fact that if a patient’s mother has not rejected treatment, the nurse should carry on with the medications and other health care procedures regardless of what the other relatives of the patient insist. 

John should have read and inquired more about general nursing experiences. This would have exposed him to the scenarios that the interviewing nurse posed in the interview. Getting into nursing school and doing all the way to his graduation, he should have been prepared as a nurse to handle all the medical situations that are likely to occur. Going for an interview should have made him research on the most difficult nursing experiences. This would have ensured that the questions he answered less than satisfactorily, did not catch him unprepared. It is also good that he answered as he did because it prevented the hospital from hiring a nurse who lacks passion for the job and has a high probability of judging patients.

John should have used the questions asked during the interview to showcase his readiness to work and gain experience as a nurse. He should have taken the opportunity to show that he knows the care procedures for a HIV positive patient. As a nurse he should have said more that, “it depends on the situation or condition.” Being a nurse takes away the freedom of an individual to choose who they can take care of and who they cannot. A nurse should be ready to deal with the pain and challenges of a patient and at the same time encourage them as they recover. When dealing with the HIV patients, John should have expressed his readiness to encourage the patient to live positively. 

The nursing manager could have interviewed John differently by measuring his current capabilities. He should have asked about John’s experiences in nursing practice and what he feels should have been done differently at the time. The interviewer should have measured how eager to learn John was. If the interviewing nurse saw the potential of making a good nurse out of John, he would have gained a great member in his staff. John’s lack of experience may have contributed to his attitude problem as well. He may have had too many expectations in working for a hospital right after graduation and this may have been his undoing.

Scheduling Nurses with New Members of Staff

Sample size has 30 patients a day for 365 days a year.

The formula is

X=average nursing care hours * days in staffing period * average patient census

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Hours of work per FTE in two weeks

(Effective Leadership and Managemnt in Nursing)

Using this formula requires that the annual FTE is calculated which is 52*40 which gives 2080 hours. This work hours are then multiplied by an average patient census of the hospital. 

Number of patients Acuity Level Associated care hours Total care hours

5 I 3 15

10 II 4 40

15 III 7 105

5 IV 10 50

Total 30 210

Let the sample in this case be 10950. The average nursing care hours for 30 patients per day is 210 is 7 hours. 

Applying this formula;

X= 7*14*30

___________ =2940/80 = 36.75 or 37 FTES

80

When hiring five nurses at once, the whole nursing team in the hospital is shaken up. When hiring nurses with less than two years of experience is even more challenging. For a while they will have to work under the more experienced nurses until they can be left to work on their own. This is a great challenge in a hospital because the lives of people are at stake at all times. In order to deal with this effectively, it is wise to have each hospital unit take one new nurse to spread the burden of training them on real hospital experiences. This exercise is also likely to present scheduling problems. More nurses means that the schedules have to change. The work hours have to be adjusted to accommodate the new staff members. The schedule will be dependent on the number of patients and the level of care they require. When the hospital gets busy and is well staffed the schedules are easy to manage. The rotations have to be done in a way that gives every nurse time to rest and do other things in their lives. 

When creating a schedule that requires nurses to work 12 hour schedules, they work fewer days when compared to the 8 hour shift nurses. For the nurses working 12 hours, they are limited to work a maximum of three days consecutively. They cannot work four days on 12 hour shifts because of the exhaustion and fatigue risks they encounter (Ericksen, 2016). When working eight hour shifts, however, they can work up to five days consecutively because there is enough time to rest between shifts. When working twelve hour shifts, 

On average, the nurses work about 80 hours bi-weekly (Smith , Folkard, Tucker, & Macdonald , 1998). Spreading the eighty hours of work across two weeks means that working twelve hours the nurse works three days a week and for the eight hour shift nurses, it translates to five days of work. The schedules for the hospital after the hiring of new nurses, was able to accommodate a mixed time schedule for nurses in rotation. The nurses could choose their work shifts and the management harmonizes (Smith , Folkard, Tucker, & Macdonald , 1998). This ensures that the management prevents the burn out of nurses caused by working extra-long hours and failure of the nurses to have lives outside of work. The ample staffing has made it easy for the hospital to manage the patient care systems effectively. 

When a hospital has excess staff, the schedules can be adjusted to ensure that all the nurses are in rotation but with lighter shifts. This improves the efficiency of the nurses and patient care as well. Laying of nurses is a risky venture and the hospital would have to ensure that the schedules are comfortable so that when there is a surge in patients, the nurses are ready to respond as opposed to laying of nurses and recruiting new ones when the patient influx is recorded. 

A staff member who always has a problem with their schedule can be dangerous to the patients. Nursing is a delicate profession. When looking at the situation where the nurse is unsatisfied with their schedule, it is important that they are made to understand that no schedules are made in favor of some people and against others. This nurse can be asked to present their ideal schedule and the management can try and fix them where they feel most comfortable from time to time. 

The scheduling process is time consuming. Balancing out the needs of all the patients with the nurses’ available takes time. The nurses’ capabilities have to be taken into consideration to ensure that they can perform to the best of their abilities. The needs of the patients still remain the primary reason for the existence of the hospitals. This means that even when considering the nurses, the patients dictate how the nurses will work.

References

Effective Leadership and Managemnt in Nursing. (n.d.).

Ericksen, K. (2016, August 3). The Nursing Debate: 8- Hour Shifts vs 12- Hour Shifts. Retrieved from Rasmussen College: www.rasmussen.edu/degrees/nursing/blog/nursing-debate-8-hour-shifts-vs-12-hour-shifts/

Smith , L., Folkard, S., Tucker, P., & Macdonald , J. (1998). Work shift duration: A Review Comparing Eight hour and twelve hour shifts. Health Journal, 217-229.