STAFFING
Part 1- Selection and development of
the personnel
• This is the process of personalizing or manning the
organization.
• Management consists of getting work done through other
people, hiring (acquiring) & retaining (keeping) the right
people is one of the managers' most critical
responsibilities. Furthermore, since certain time may
require retaining or relocation at a later date. The staffing
function includes all activities involved in supplying an
adequate number of the types of workers (quantities &
qualities) to each unit on every shift of each day of the
year.
• Selection of personnel : Managers
share responsibility for recruitment and
retention of well- qualified people.
1. They help establish criteria for selection of
personnel.
2. Structure interviews to increase validity
and reliability of recruitment.
• II-Attraction of qualified application:
• The acquisition of qualified people in any
agency is critical for the establishment,
maintenance, and growth of the
organization.
*Therefore active recruitment is very
important, and the attraction of qualified
applicants are the first step in selection of
personnel.
Modes for active recruitment
1. word of mouth, and
2. Advertisement in local news papers, organizations
bulletins, and nursing journals, recruitment literature,
posters,
3. Contact with schools graduation classes.
• Word of mouth can be very effective, but it can also lead
to the hiring of friends and relatives of the current
workforce, this practice may foster nepotism and violate
equal opportunity employment requirements.
• Advertisement provides more opportunities to hire from
minority groups.
• Each institution school has some one
who is responsible for recruitment
called recruiter who should know
employee qualifications and the
needs of the institution. The recruiter
should respond to inquiries
immediately.
• The major sources of personnel are
1. Persons seeking their first job
2.Dissatisfied employees, and
3. The unemployed.
Note : Hiring an unemployed worker who has
been released from a previous job because of
an infraction or a quarrel with the previous
employer demands careful
assessment.
• The recruiters would not want to
hire a nurse who was terminated
because of high absenteeism and
irresponsibility
Retention strategies
It is very important to apply because the cost of
recruitment process. So
1. Continuous surveillance and focus group can be
used to identify and solve problem.
2. Stressors are identified, strategies to reduce
them can be planned.
– It is important to meet personnel's
psychosocial needs for advancement,
responsibility, achievement, and recognition.
– Nurses want input into decision making and
control over their own lives.
III-Screening of Potential staff
There are three underlying philosophies
in the screening process:
1. Screen out applicants who do not fit the
agency's image.
2. Try to fit the job to promising applicants.
3. Try to fit the applicant to the job.
Application forms and resumes
A. Biographical data ;
B. Educational background,
C. work experience and
D. Other pertinent information.
letters of reference; letters of recommendation may be
requested from references listed on the application form,
previous employers or both. it is better to take the
accurate capabilities of the new employee from the
personnel file because of rabid turnover of the nurses or
other health personnel
V- Interview
It is conducted with the most
qualified applicants. The purpose
of interview is to obtain
information, to give Information,
and to determine if the applicant
meets the requirements for the
position.
• The interviewer judges
1. The applicants dependability,
2. Willingness and ability to work with others,
3. Interest in the job,
4. Adaptality,
5.Consistency of goals with available
opportunities…
6.The interviewer answer questions, explains
policies and procedures, and help acquaint the
applicant.
The interview has definite purpose
and
should avoid social chitchat.
The main aim of the interview is
to learn about the prospective
employee.
• $-The manager should not give clauses
about what pleases or not pleases them
• $ -Should not be argumentative and should
try to avoid premature judgment .
• $-Should avoid hallo effect (e.g. judging
upon appearance)
• $-Use the job description in determining the
important functional aspects that considered
as leading questions to detect the employee
capabilities.
• $-Standardizing the flow of interview is
helpful to avoid discriminatory hiring
practice or in case of when more than one
person who conduct the interview
• $-The heading of the form contains the date,
name of the applicants, position desired, and
the interviewers names.
• $- Are applicants cooperative and able to get
along with others and work well as team
members.
• $- The interviewer greets the applicant,
introduces to the applicant, and make brief
comments about the agency and the position
for which the person is applying. The
information in the applicants are discussed..
• $- Discussion through the interview
preferably structure interview format. the
question should non directive questions.
actually the funnel techniques that
incorporates both open ended and closed
ended question is preferable.
VI- Testing
• Personality and interest testing is some
times done but does require a trained
psychologist.
• Ability test rarely used.
• Estimates the rate at which the applicant
can acquire the Knowledge and skills
required for the position.
• VII- Equal opportunity and affirmative:
• 1964 Civil right
• 1972 Education amendments.
• 1963 Equal pay
• 1973 Affirmative action
– Prohibit discrimination because of race,
color, religion, sex, or national origin –
prohibit discrimination because of
handicapped.
• VIII-Job analysis, job description and
job Specification (job design)
• Before it is possible to recruit, select, and
introduce new employees into the
organization, there should be a guide to
indicate what types of skills and training is
required for each job.
• All information regarding the job to be filled and
the persons filling it is obtained through “job
analysis”. involves analyzing each job to come
out with the information required to determine
the “job description” and “job specification”
which consists of Observing and studying a job
to determine its content (duties and
Responsibilities), the conditions under which the
work is performed, its relationship to other jobs,
and the skills, training, attitudes and abilities
necessary to perform the job.
• There are 5 basic ways by which job
information can be gathered for analysis:
• A. Observation.
• B. Questionnaires
• C. Interviews
• D. Literatures
• A combination of two or more of the above
IS MORE RELIBLE
• The information obtained through the job
analysis becomes the source for the
development of the documents on the “job
description” (which describes the person
filling the job).
• X) Job Description : Describes the job itself, it
usually includes:
• job title
• objective of each positions
• Authorities and responsibilities
• Tasks and duties to be performed.
• Relationship between this position and other
positions (superiors , Subordinates and peers).
• Advantages of the job descriptions:
• It is useful for recruitment, placement, and
transfer decision.
• To guide and evaluate personnel.
• Help prevent conflict, frustration, and
overlapping of duties.
• $- Job description should arrange the
duties in
• logical order.
• Separately and concisely
• Use verb to describe the action
• More specific in statements and if it is
• quantitative is more favorable.
Staff Development
Continuing liberal education
of the whole person to
develop there potential fully.
• It include orientation, preceptor ships,
mentorship, skill checklists, internships, in-
service education, courses, conferences,
seminars, journal or book clubs,
programmed learning, and independent
study and refresher courses.
The role of nurse manager
1. Support of staff development and have
responsibility to review the
goals for the programs.
2. To provide budget for those activities.
3. Participate in needs identification.
4. Analyze how education effects change
in nursing service.
5. They must differentiate staff
development needs from
administrative needs.
6. Positive reinforcement through
recognition, such as oral praise on
the unit or acknowledgement of
accomplishments in a newsletter, is
useful.
Orientation
Is the process of informing new
employees about the existing work
environment & their place in it, so that
they can relate quickly to their new
surroundings.
• A. General part, which includes information
given to all new employees to acquaint them
with the overall purpose, function & structure of
the organization as well as introduction to the
rules Policies & procedures that apply to all
employees (induction training). The induction
is the first 2-3 days of orientation, it can be
done by personnel department employee for
all new employees.
• B. Special part ,which relates to the specific
job the employee is to fill (job orientation).
There is considerable variation regarding the
length, from and content of job orientation .In
some institutions it may be a four-week period
in others it may be a four- month period or
even 6-12 months (inter ships) which are
provided to newly graduated doctors and
nurses during job orientation employees
should be adequately informed about their job
description.
• $- It is appropriate to use an orientation
time schedule .and documentation of the
orientation and it can retained in the
personnel file.
• $-Frequent visits to see that the nurse is
comfortable and that the Orientation is
progressing satisfactorily are helpful.
• $- internship programs as in-service education
program for role adjustment as educational and
training session is useful. This will help the new
nurse to built their confidence, lower frustration
level, increase nursing care planning,,,,,,,,, and
then improve job satisfaction then it reduces the
job burnout and turnover.
• Near the end of the probationary period, it is
advisable to adopt a Systematic evaluation this
is considered a big indicative for the Success of
the selection process.
• 11-Preceptor ship:
• It helps recruit, retain, orient, and develop
staff. They may be used before students
graduated to orient them to the agency
and recruit them for hire.
• They evaluate strengths and determine if
they are suitable for employment.
• The preceptor is responsible for the quality
of patient care and facilitates the students
learning.
• Preceptors are liaisons between students
and agency.
* They provide real-life experiences for
students before graduation to help reduce
the difficulties of transition from school to
work.
*The preceptor is responsible for the quality
of patient care and facilitates the students
learning.
* Preceptors are liaisons between students
and agency.
*They provide real-life experiences for
students before graduation to
• Help reduce the difficulties of transition
from school to work.
• Note: the faculty member serves as a
preceptor of preceptors. So they need
practical evaluation tools of the students,
preceptor, and faculty Should be
developed. A workshop to prepare
preceptors is desirable.
• 111.Mentorship gives their time,
energy, and material, support to
teach, guide, assist, counsel and
inspires a younger nurse. it is
consider nurturing relationship
The mentor is a confident who
personalizes role modeling and serves as a
sounding board for decision.
• the mentor is a resource person who
supports the development of the
• younger person through influences and
promotion.
• Mentor ship stages:
• First: Invitational stage; mentors must be
willing to use their time and energy to nurture
some one who is goal directed, willing to learn,
and respectfully trusting of the mentor.
• Second: Period of questioning; manatee
experiences self-doubt and questioning of goals.
Mentors help clarify goals and provides.
• Third: Transitional phase; mentor helps
students personalize learning and become
a ware of own strengths and uniqueness.
after this final stage the manatee is now
prepared to be a mentor.
Career planning: - Deciding what type of
nursing one wants to do and the
geographical area where one wants to
practice, one needs to locate job
openings.
Career mapping
Is a strategic planning for ones formal education,
experience, continuing education, professional
association and net working.
- Nurses need to assess their own values and
define success for themselves.
- Job security, sense of accomplishment, and
opportunities for advancement is after
considered important.
-Other issues are work hours, salary, fringe
benefits, retirement plans, organizational and
geographical climate and location.
• Group process and team development:
It critical for group development, how the
group functions, communicates, and sets
and achieve objectives are all related to
group dynamics. The teams, who typically
form, organize, solve problems, implement
solutions, and disband.
• Forming stage: individuals are likely to
feel anxious, fearful, doubtful, and self
proactive. The leader concentrates on
putting the members at ease, explaining
the purpose, developing a workable
climate, and exerting leadership.
• Storming phase: tension tends to be
higher and resistance is common and
disagreement is obvious. In this phase
the group needs for help and clarification
of misunderstandings and fears.
• Norming: The group is structured and
there purpose becomes clarified and
cohesiveness develops during this
phase.
• Performing: help the group to focus in
issues, behaviors, or problems not in a
person. Help the group members to
maintain constructive relationship, and
take initiative to make things better.
The leader should lead by examples.
until the group resolve the problem and
achieving the objective of the team
forming.
• Adjourn or disbanding: the members may
have positive or negative feeling about
the disbanding. The leader should
express appreciation and give positive
reinforcement.
• *** DAVID CLEMAN…...et al (1995) have
described individualism like
Sprinters who are uncoordinated individuals and
run independent effort for each. While the
coordination level and team and independent
effort is like a relay.
• ONE AUTHER STATED that group dynamics
level is like rowing crew that puts a concerted
effort toward a goal.
• The roles of the manager in building a
team are:
• Show a willingness to help establish the
team
• Set goals and expectations
• Monitor performance.
• Give continuous feed back
5- Build relationship
6-Train and educate team members.
7-Offer resources and time.
8- Documenting and communicating
success
9-Should enhance the concepts of
autonomy
• Planning for staff development program
• Needs assessment: Identify the desired
knowledge and skills and compare the results
with the available knowledge and skills of the
target population. The type of speaker and the
language that is used and the suitable time
should be assessed.
• Identify the appropriate resources that
meet the needs.
• Plan and implement learning strategies.
• Evaluate the results. In terms of
reactions and response to the learning
process, the behavior changed the
impact in the organization.
Notes: 1- Diversity in styles of learning should be
considered (variety in teaching methods). There
are numerous teaching methods and tools
available, including but not limited to lecture,
discussion, role play, case study…….and hand
out.
2-Cultural variable should be considered.
Immediate and specific feed back improves
performance and enhance competency.
Performance appraisal
It is a periodic formal evaluation of
how well personnel have
performed their duties during a
specific period.
• Purposes:
• To determine job competence.
• To enhance staff development and
motivate personnel toward higher
achievement.
• To discover the employees aspirations
and to recognize accomplishment.
• To improve communications between
managers and staff associates and to reach an
understanding about the objectives of the
job and agency.
• To determine training and development needs.
• To select qualified nurses for advancement
and salary increases.
• To identify unsatisfactory employees.
Common errors in evaluation:
• Criteria involving judgments are used for
performance evaluation.
• Hallo error: Is result of allowing one trait to
influence the evaluation of other traits or of
rating all traits on than basis of a general
impression.
• A logical error: Is a rating a nurse
possesses another chch that is logically
related.
• Horns error: the evaluator is hyper
perfectionist may rate personnel lower
than they should.
• Contrast error: Tendency of managers to
rate the nurse opposite from the way
they receive themselves.
• Central tendency error: A small range of
scores was applied in evaluation.
Methods of performance
management
• Anecdotal notes: Are objective description of behavior
recorded on plain paper or a form. The notation include
who was observed, by whom, When, and where. It
comprises a description setting or background and
the incident, and interpretation and recommendations
may be included. Value laden words such as good and
bad should be avoided. It is advisable to make several
brief observations over a time span to allow for
temporary Variables and to identify patterns of
behaviors.
An advantage of anecdotal note readings is that not
coerced into a rigid structure.
Check list: The manager categorically
assess the presence or absence of
desired chch or behaviors. Checklists are
mostly for tangible variables, Such as
inventory of supplies, and may be used to
evaluate nursing skills also.
• Rating scale: It does more than just note the
presence or absence of desirable behavior. It
locates the behavior at a point on a continuum
and notes quantities and qualitative abilities. The
numerical rating scale usually includes numbers
against which a list which a list of Behaviors are
evaluated.
• Ranking: It forces managers to rank the staff in
descending order from highest to lowest even if
they do not think there is deference.
Assignment systems for staffing
• Case Method :
• In the case method each patient is
assigned to a nurse for total patient care
while that nurse is on duty. The patient has a
different nurse each shift and no guarantee
of having the same nurses the next day.
Popular during the 1920s along with private
duty nursing , the case method emphasized
following physicians order.
• Functional Nursing:
• When few registered and only some
practical nurses were available, nurses aides
gave much patient care. The functional method
implements classic scientific management,
which emphasize efficiency, division of labor,
and rigid control. It is an efficient system that is
the least costly and requires few registered
nurses. RNs keep busy with managerial and non
nursing duties, and nurses aides deliver the
majority of patient care..
• Team Nursing
• Team nursing was introduced to improve nursing
services in hospitals and nursing homes by using the
knowledge and skills of professional nurses and to
supervise the increasing numbers of auxiliary nursing
staff. Team nursing is based on a philosophy that
supports the achievement of goals through group action.
each member is encouraged to make suggestions and
share ideas. When team members see their suggestions
implemented, their job satisfaction increases and they
become motivated to give better care.
• Team leader assign team member to patients by
matching patient needs with staff knowledge and
skills. One of the main features of team nursing
is the nursing care conferences. The team
leader is responsible for planning and
conducting the team conferences, which should
be limited in time and scope. Meeting for 15 to
30 minutes at the same time each day helps the
conference become a part of the daily routine.
The nursing care plan is another feature of team
nursing.
• Primary Nursing:
• It is based on the philosophy that patients,
instead of tasks, should be the focus of
professional nurses, primary nursing features an
RN who gives total patient care to four to six
patients. The RN remains responsible for the
care of those patients 24 hours per day
throughout the patient hospitalization. The
associate nurse cares for the patient by using
the care plan developed by the primary nurse
while the primary nurse off duty.
• The associate nurse is expected to contact the
primary nurse regarding changes in the care
plan. The primary nurse does the admission
interview and develops the nursing care plan,
including teaching and discharging planning,
which is shared with the associate nurse.
Primary nurses have the autonomy and authority
for the care of their patients. Consequently,
accountability is placed and continuity of care is
facilitated.
Staffing Schedules
• Centralized scheduling:
• The schedule done by the upper manager for all
nurses in all departments manually or by
computer.
• The advantages:
• fairness to employees through consistent,
objective, and impartial application of policies
and opportunities for cost containment through
better use of resources.
• relieves nurse managers from time-consuming
duties, freeing them for other activities.
• Computer can be used for centralized scheduling. The
advantage of this include cost-effectiveness through
the reduction of clerical staff and better use of
professional nurses by decreasing the time spent in
non-patient care activities; unbiased, consistent
scheduling; equitable application of agency policy;
developed in advance so employees know what their
schedule are and can plan their personal live
accordingly. Disadvantages:
• 1.Lack of individualized treatment of employees is a
chief complaint.
• Decentralized scheduling
• When managers are given authority and assume
responsibility, they can staff their own units through
decentralized scheduling.
• Advantages:
• Personnel feel that they get more personalized attention
with decentralized scheduling.
• Staffing is easier and less complicated when done for a
small area instead of for the whole agency.
• Managers can work together to solve chronic staffing
problems.
• Disadvantages:
• Some staff members may receive
individualized treatment at the expense of
others.
• Work schedules can be used as a punish-
reward system.
• Because it is consuming time, takes
managers away from other duties or
forces them to do the scheduling while
off duty.
• it may use resources less efficiently and
consequently make cost containment
more difficult.
• Self scheduling
• Self scheduling is a system that is
coordinated by staff nurses. Staff may
negotiate before and after work and during
break and lunchtime. They may also write
notes to each other and Waite for
responses.
• Advantages:
1. Help create a climate where
professional nursing can be practiced.
2. Saves the manager considerable
scheduling time and changes the role of
the manager from supervisor to coach.
• Increases staff members ability to
negotiate with each others.
• Increased perception of autonomy,
increased job satisfaction, increased
cooperative atmosphere, improved team
spirit, improved morale, decreased
absenteeism, reduced turnover.
• Alternating or rotating work shifts
• Some nurses may work all three shifts within 7
days.
• Create stress for staff nurses.
• Body rhythms need time to adjust to the
discrepancy between the persons activity cycle
and the new demands of the environment. The
ability of the body functions to adjust varies
considerably among individuals. It may take 2-3
days to 2 weeks for a person to adjust to a
different sleep-wake cycle.
• it effect the health of nurses and the
quality of their work. Anorexia, digestive
disturbances, disruption in bowel habits,
fatigue, and error proneness.
• Permanent shift
• Advantages:
• 1. Permanent shift relieve nurses from
stress and health related problems
associated with alternating and rotating
shifts.
• 2. provide social, educational, and
psychological advantages.
• 3. staff can participate in social activities.
• 4. they can continue their education by
planning courses around their work
schedules.
• 5. child care arrangement can be stable.
• 6. fewer health problems and less
tardiness, absenteeism, and turnover.
• Disadvantages:
• Managers may have difficulty in evaluating
the evening and night shifts.
• the staff of permanent shift not develop an
appreciation for the workload or problems
of other shifts.
• Block, cyclical, scheduling
• Block, or cyclical, scheduling uses the same
schedule repeatedly. The schedule repeat itself
every 6 weeks.
• Advantages:
• personnel know their schedules in advance and
consequently can plan their social live.
• Absenteeism will be less.
• establish stable work groups and decrease
floating, thus promoting team spirit and
continuity of care.
• Variable staffing
• Eight hour shift in a five day workweek
• 5-day, 40-hours workweek
• The shift usually 7am to 3:30pm, 3pm to
11:30pm, and 11pm to 7:30 am and a half
hour overlap time between shifts to
provide fro continuity of care.
• Ten hour shift in Four day workweek
• The main problem was fatigue. The long
weekends and off were attractions. There
is time to finish work, peak work loads can
be covered, and there is decreased
overtime and decreased costs.
• Twelve-hour shift in seven day workweek
• The better use of personnel lower staffing
requirements; this consequently lowers the cost
per patient day. Fewer communication gaps and
better continuity of care. Improved nurse-patient
relations, job satisfaction, and morale. Working
relations are improved. Team development is
possible. No blames for problems. Total time off
is increased, with an increased usefulness fro
other duties. Travel time is reduced. Overtime
pay has been of some concern.
• Staffing to meet fluctuation needs/
• adjustment to workload
• Transfer staff from a less busy area to the
overloaded area.
– economical to the agency, but disrupts the unity of
work groups, causes transferred nurse to feel
insecure, and contributes to job dissatisfaction and
turnover. Some units require specialized knowledge
and skill that not every nurse has(cross training is
helpful).
• Companion floor system, two units relieve each
others.
• Float nurse; full time staff nurses who are
oriented to many areas and like the
challenge of different types of patients
and settings. But all of nurse prefer
stability.
• fulltime staff work a double shift.
• Over time.
• part time staff.
• temporary help for the summer to give relief fro
vacations.
• External temporary help agencies are available
in some areas.
• Mandatory overtime is requiring staff to stay on
duty after their scheduled shift ends. Some
managers are believe on that using a tired
nurse is better than no nurse at all.
1. Declining inpatient activity and
changing patient care patterns have
caused some to right size or down
size.