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					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.

				
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