UNIVERSITY OF REGINA CARMELI

Catmon, City of Malolos

ORGANIZING
&
STAFFING

Submitted by:
Arceo, Joanna Rose S.
Chico, Jenelyn L.
De Leon, Joseph Rommel B.
Evangelista, Jenalyn M.
Mendoza, Angelica D.
Robles, Lady Anthea T.
Santos, Baby Richelle S.
Surban, Katrina D.
Umali, Joemar T.
Viray, Regina B.

BSN 4C-2

Submitted to:
 Rosalina Punzalan RN

January, 2010
ORGANIZING

Organization consists of the structure and process which allow the agency
to enact its philosophy and utilize its conceptual framework to achieve its goals. It
refers to a body of persons, methods, policies and procedures arranged in a
systematic process through the delegation of functions and responsibilities for
the accomplishment of purpose.

Organizing is the process of establishing formal authority. It involves

setting up the organizational structure through identification of groupings, roles
and relationships, determining the staff needed by developing and maintaining
staffing patterns and distributing them in various areas as needed. It includes
developing job descriptions by defining the qualifications and functions of
personnel.

An organizational chart is a line drawing that shows how the parts of an

organization are linked. It depicts the formal organizational relationships, areas of
responsibility, persons to whom one is accountable and channels of
communication.

Elements of Organizational Structure

Setting up the Organizational Structure

The creation of an organizational compatible system with the philosophy,

conceptual framework, and goals of the organization provides the means for the
accomplishment of an organization’s purpose.

Understanding the organizational structure as a whole facilitates the

development of roles and relationships to enable the achievement of goals. The
organizational structure refers to the process by which a group is formed, its
channel of authority, span of control and lines of communication.
Departmentalization and division of work provide orderliness in administration.
Through a breakdown of activities each individual becomes responsible for a
specified set of activities and performs such.

The successful setting up of the organizational structure enables an organization

to achieve its purposes:

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It informs members of their responsibilities so that they may carry them out.

1. It allows the manager and the individual workers to concentrate on his/her

specific role and responsibilities.
2. It coordinates all organizational activities so there is minimal duplication of
effort and conflict
3. It reduces the chances of doubt and confusion concerning assignments.
4. It avoids overlapping of functions because it pinpoints responsibilities.
5. It shows to whom and for whom they are responsible.

The organizational structure of the Nursing Service should be updated,

reviewed, approved and documented by the proper authority. Date of last review
should be documented.

Staffing

The process of determining and providing the acceptable number and mix
of nursing personnel to produced a desired level of care to meet patient’s
demand.

The purpose of all staffing activities is to provide each nursing unit with an
appropriate and acceptable number of workers in each category to perform the
nursing tasks required. Too few or an improper mixture of nursing personnel will
adversely affect the quality and quantity of work performed. Such situation can
lead to high rates of absenteeism and staff turn-over resulting in low morale and
dissatisfaction.

Scheduling

A schedule is a timetable showing planned work days and shifts for

nursing personnel.

The objective in scheduling is to assign working days and days off to the
nursing personnel so that adequate patient care is assured. A desirable
distribution of off-duty days can be achieved and the individual members of the
nursing team will feel that they are treated fairly. They will also know their
schedule in advance.

Developing Job Description

A job description is a statement that sets the duties and responsibilities

of a specific job. It includes the needed characteristics or qualifications of the
individual to perform such duties successfully. 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.

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Principles of Organizing

In designing the organizational structure of the nursing department /

service / division, certain organizational principles must be observed.

1. Unity of Command – although employees may interact with many different

employees in the performance of their duties, they should be responsible
to only one superior. This is to avoid confusion, overlapping of duties and
misunderstanding.
2. Scalar Principle or Hierarchy – authority and responsibility should flow in
clear unbroken lines from the highest executive to the lowest. The other
term for this is “chain of command”, usually a military term. Proper
definition and delegation of authority and responsibility facilitate the
accomplishment of work. In this connection, the following must be
observed:
a. When responsibility for a particular job is delegated to a
subordinate, the latter should have authority over resources needed
to accomplish the task;
b. When a particular function is delegated to a subordinate, the
superior’s own responsibility is in no way diminished; and
c. When a person is bestowed the authority for action, he is
accountable for his actions to the person that bestowed him such.
The conscientious nurse exhibits accountability toward her
employing hospital, the patient, the government, her profession,
and to God.
3. Homogenous Assignment or Departmentation- workers performing similar
assignments are grouped together for a common purpose.
Departmentation promotes the specialization of activities, simplifies the
administrator’s work, and helps maintain effective control.
4. Span of Control – the number of workers that a supervisor can effectively
manage should be limited, depending upon the pace and pattern of the
working area. it also refers to span of managerial responsibility and the
number which one supervisor can assist, teach and help to reach the
objectives of their own jobs. If the workers are highly skilled and are
working near each other, their number may be increased. At the top level
of the structure, a 1:6 ratio of supervisor-worker is common, while at the
base of the organization, a 1:10 ratio is common.
5. Exception Principle – Recurring decisions should be handled in a routine
manner by lower-level managers whereas problems involving unusual
matters should be referred to the higher level. This will enable
subordinates to learn how to make decisions at their own level and free
executives from being bogged down by routine details that can be handled
as well by subordinates.
6. Decentralization or Proper Delegation of Authority – Decentralization is the
process of conferring specified decision making to the lower levels of the
organization. Basic top level decisions and policies must receive attention

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 at the top levels. The amount of skills and competence of subordinates
and executives determines the success of any program of
decentralization. Executives should be developed to handle situations
delegated to them. This delegation of authority is still subject to the
supervision and control of the delegating superior.

Distribution of necessary information about critical issues is vital to any

delegation process. An executive should have sufficient

Prepared by: Robles, Lady Anthea

***

ORGANIZATIONAL STRUCTURE

RESTRUCTURING

– A significant modification made to the debt operations or structure

of a company. This type of corporate action is usually made when
there are significant problems in a company, which are causing
some form of financial harm and putting the overall business in
jeopardy. The hope is that through restructuring, a company can
eliminate financial harm and improve the business.

REDESIGNING

– make a design of; or a systematic planning

– to change the design of (something).
– Reorganize, Rearrange, Recast, Reshape

REENGINEERING

– Is the radical redesign of an organization's processes, especially its

business processes. Rather than organizing a firm into functional
specialties (like production, accounting, marketing, etc.) and looking
at the tasks that each function performs.

• Restructuring and reengineering deals with the entire organization’s

structure to improve its functioning and productivity.
• It naturally follows organizational affiliations, mergers, consolidations, and
integrations. Downsizing or right sizing by cutting the number of positions
is also restructuring requiring redesign.

The role of the Nurse Manager through 3 R’s Involves: (Sullivan And Decker,
2001)

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 • Team Building
• Coaching
• Mentoring
• Initiating change
• Reducing cost
• Improving quality of care
Purpose of Organizational Structure
• The primary purpose of an organizational structure is to facilitate the
accomplishment of the institution’s mission.

Types of Organizational Structure

1. Informal Structure
– It is based on personal relationship rather than on respect for
positional authority. It helps member meet personal objectives and
provide social satisfaction.

2. Formal Structure
– The organizational structure furnishes the formal framework in
which the management process takes place. It should provide an
effective work system, network of communication, and identity to
individuals and the organization and should consequently foster job
satisfaction.

3. Pun Line Organization

4. Line and Staff Organization

– Line and Staff Organization develops when a simple line structure
is altered to provide support line authorities.
– The line functions are command and control.
– The Staff functions are separate from chain of command. Involves
specialization, and a supportive to line authorities.

Functions of Staff
• Do what the executives do
• Serve the line organization
• Submerge personal interest to champion the executive’s long
range objectives.
• Manages policies and procedures

5. Functional Line and Staff Organization

– Staff have some authority over line executive.
– Staff expert responsible for specific management function, such as
staffing, staff development , or quality improvement.
– Has authority to command line executives to implement staff plans.

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 6. Matrix or Free form Organization
– Matrix organizational design try combine the advantages of the
project and the functional structures.
The functional line organization provide support for the project line
organization. The functional manager has the authority to determine and
rate goals, select personnel, determine pay and promotion, make
personnel, and evaluate personnel and the project.

– In a matrix organization the functional manager shares those

responsibilities with the project manager . Initially, the functional
manager may experience a sense of loss in status, authority and
control.
– Therefore it is important for the managers to be able to persuade
others by using their personal qualities and knowledge of the
program.

Characteristics of matrix
• decision making as far down in the organizational structure
• Most decisions are made at the middle management level
• More decentralized with fewer levels of decision making
• Increases the amount of contact among individuals & its
complexity makes conflict inevitable.

7. Adhocracy or adaptive or organic model

– Adhocracy or organic models are newer organizational frameworks
that are more free form, open, flexible and fluid than older
bureaucratic models. Boundaries separating internal & external
relationships are more easily penetrated.
– Adhocracy comes from an ad hoc committee. Its structures are
loosely structured project organizations.

Prepared by: Umali, Joemar

***

ORGANIZATIONAL CHART

Is a line drawing that shows how the parts of an organization are linked. It
depicts the formal organizational relationships, areas of responsibility, persons to
whom one is accountable and channels of communication.

Purposes
• They can contribute to sound organizational structures
• Show formal lines of communication
• Help employees understand their assignments, especially in relation to
other.
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Organizational Concepts and Structures

Figure 1 Vertical Chart

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Figure 2 Horizontal Chart

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Figure 3 Circular Chart

Prepared by: Viray, Regina

***

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LINE AND STAFF RELATIONSHIP
• Line authority is the simplest and most direct type in which each position
has general authority over the lower positions in the hierarchy in the
accomplishments of the main operations of the organization. The unit
head has direct responsibility for the work of a unit.
• Staff personnel provide advice, counsel or technical support that may be
accepted altered or rejected by the line officer.
GUIDELINES IN ORGANIZING
1. Supply Market

- It is important that the local supplier capacity is properly researched

prior to organizing a business seminar to ensure that goods and
services are relevant to the needs.

2. Invitations

- The invitation should indicate the types of suppliers that will be

attending the seminar.

3. Frequency

- Due to limited resources, and in order to be fair to all countries,

generally only participate in one major supplier event per country
per year.

4. Facilities

- The organizing entity should ensure that the facilities are available
for business seminars.

5. Agenda

- The agenda for the business seminar should be agreed with other
participating organizations and the organizing entity.

6. Individual meeting with suppliers

- A program should be prepared in advance by the organizing entity.

Each supplier meeting should be scheduled to last for no longer
than 15 minutes.

7. Expenses

- Organizing entities in developed countries are expected to cover

the travel expenses, hotel and meals for all participants.

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 8. Supplier fees

- Any fees charged to suppliers for participating should be kept to a

minimum and aim to only cover costs incurred.

9. Travel, Accommodation & other practical information

- The organizing entity is responsible for making the necessary

accommodation arrangements for participants.
Prepared by: Arceo, Joanna Rose
***
STAFFING

• Is the process of determining

• providing the acceptable number
• mix of nursing personnel to produce a desired level of care to
meet the patients demand.

Purpose of staffing

• to provide each nursing unit with an appropriate and acceptable number of

workers in each category
• to perform the nursing tasks required too few or an improper mixture of
nursing personnel will adversely affect the quality and quantity of work
performed
• such situation can lead to high rates of absenteeism and turn-over
resulting in low morale and dissatisfaction

Factors affecting staffing

Factors affecting staffing include:

1. the type, philosophy, and objectives of the hospital and the nursing
service;
2. the population served or the kind of patients served whether pay or
charity;
3. the number of patients and severity of their illness-knowledge and ability
of nursing personnel are matched with the actual care needs of patients;
4. availability and characteristics of the nursing staff, including education,
level of preparation, mix of personnel, number and position;
5. administrative policies such as rotation, weekends and holiday off-duties;
6. standards of care desired which should be available and clearly spelled
out. institution may utilize the ANSAP’s standard of nursing practice; PRC-
ANSAP’s standards of safe nursing practice and/ or the hospitals
themselves may formulate/develop their own standards;

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 7. layout of the various nursing units and resources available within the
department such as adequate equipment, supplies, and materials;
8. budget including the amount allotted to salaries, fringe benefits, supplies,
materials, and equipment;
9. professional activities and priorities in nonpatient activities like
involvement in professional organizations, formal educational
development, participation in research and staff development;
10. teaching program or the extent of staff involvement in teaching activities;
11. expected hours of work per annum of each employee. this is influenced by
the 40-hour week law; and
12. patterns of work schedule-traditional 5 days per week, 8 hours per day; 4
days a week, ten hours per day and three days off; or 3 ½ days of 12
hours per day and 3 ½ days off per week.

Selection of personnel

• Recruitment and Retention

“if a man proceeds confidently in the direction of his dreams and

endeavors to live the life he has imagined, he will meet with success
unexpected in common hours” ------henry david Thoreau

 The acquisition of qualified people in any agency is critical for the

establishment, maintenance and growth of the organizational. Therefore active
recruitment is important, and the attraction of qualified applicants is the first
step in selection of personnel.

Modes for active recruitment include:

• employee recommendations and word of mouth

• advertisement in local newspaper, nursing organization
bulletins, and nursing journal
• recruitment literature, such as fliers and newsletter
• posters
• career days
• job fairs
• contract with schools graduating classes
• placement service
• open houses
• nursing conventions

 Recruiters should know nursing qualifications and the needs of the institution.

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Major sources of personnel

• persons seeking their first jobs

• dissatisfied employees
• unemployed individuals

 These classifications are important for all categories indicate types of

information the nursing manager should obtain and they influence the selection
process.

• Screening of Potential Staff

• investment in well-qualified nurses can produce a high rate of return and

errors
• whether they be failure to hire a promising nurse or hiring someone who
fails to achieve the organizations expectations
• can be expensive mistaken.

There are three underlying philosophy the screening process:

1. The manager should screen out applicants who do not fit the agency’s
image.
2. The manager should try to fit the job to a promising applicant.
3. Usually the manager should try to fit applicant to the job.

Application forms and resumes

 Data in the personal history educational background, work experience,

and other pertinent information----can be used to the following:

• determine whether the applicant meets minimal hiring requirements, such

as minimal educational level or minimal job experience
• furnish background data useful in planning the selection interview
• obtain names of references who may be contracted for additional
information about the applicant’s work experience and general character
• Collect information for personnel administration, that is, social security
number, number of dependents, and so forth.

• Interview

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  A preemployment interview to predict job success should be conducted
with the most qualified applicants

Purposes of the interview

• to obtain information
• to give information
• to determine if the applicant meets the requirements for the position

 One of the main purpose is to learn about the prospective employee.

 The interview answers questions, explains policies and procedures, and

helps acquaint the applicant with the position.

 Finally, the interviewer must predict whether the applicants overall

performance will be satisfactory.

• Orientation

 Induction is the first 2 o 3 days of orientation. It can be done by personnel

department employees for all new employees.

It includes a history of the

• organization
• the vision
• purpose
• structure
• working hours
• holiday time
• vacation
• sick time
• paydays
• performance standards
• parking facilities
• eating facilities
• health services
• education opportunities

 Orientation is important, and the manager who does not take the time to
assist a new employee is making a serious mistake.

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  Because of the information overload, induction and further orientation should
be conducted over time. a checklist for orientation that indicates the content,
time frame, and who is responsible to teach it can be helpful.

Prepared by: Chico, Jenelyn

***
ASSIGNMENT SYSTEM FOR STAFFING:

 Changes in assignment systems are a response to changing needs.

• shortage of nurses
• manage competition
• care to patient through primary nursing

System Used in Staffing

Case Method
• Each patient is assigned to a nurse for total patient care
while that nurse is on duty.
Functional Nursing
• Hierarchical structure predominant
• Efficient system that is least costly and requires few RNs
Team Nursing
• Group or Team action
• Led by a professional or Technical Nurse who:
 Plan
 Interprets
 Coordinates
 Supervise
 Evaluates
• Team member is encourage to make suggestion and
ideas
Primary Nursing
• Patient should be the focus of professional nurses
instead of task
• The RN remains responsible for the care of the patient 24
hrs per day throughout the patient hospitalization
Modular or District Nursing
• Modification of Team and primary nursing
• Uses smaller team who are grouped geographically
Managed Care
• Focused from acute care to promotion of health and
disease management of chronic and terminal care
Case Management
• Focused on chronic long term outpatient
(Psychiatry and social work)

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 Collaborative Practice
• Interdisciplinary team
• Nurse-physician interaction in practice or nurse-physician
collaboration on care giving

Advantages and Disadvantages of Assignment System

SYSTEM Advantages Disadvantages
Case Method Total patient care Different nurse, different shifts,
different days

Functional Efficiency Nurses do managerial work

Nursing Nurses’ aides do patient care
Time needed to coordinate
delegated work.

Team nursing Team effort Time needed to coordinate

Frees patient care delegated work
coordinator to manage the
unit
Nursing care conferences
help problem solve and
develop staff
Nursing care plan

Modular nursing Useful where there are few Paraprofessionals do technical

RNs aspects of care
RNs plan care

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Primary Nursing RNs give total patient care Confines nurse’s talents to a
Primary nurse has 24-hour
limited number of patients
responsibility
Associate nurse works with Associates nurse may change
patient while the primary
care plan without discussing
nurse is off duty
Accountability in place with primary nurse
Continuity of care is
facilitated
Reduces number of errors
from relay of orders
Fewer patient complaints
Shorter hospitalization

Managed Care Incorporates case Questionable continuity of care

management
Can be used with any
nursing care deliver system
Standard critical paths
Increases efficiency
Reduces costs
Case Focuses on entire episode Effort to coordinate
Management of illness
Emphasizes achievement
of outcomes
Care is coordinated by a
case manager
Second-generation primary
nursing
Critical paths
Variation analysis
Intershift reports
Health care team meeting
Interdisciplinary

Prepared by: Evangelista, Jenalyn

***

Staffing Schedules for Productivity

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SCHEDULING
· - is the process of deciding how to commit resources between a
variety of possible tasks. Time can be specified or floating as part of a
sequence of events.

TYPES OF SCHEDULING:

• Centralized Schedule- one person, usually the chief nurse or her designate,
assigns the nursing personnel to the various units of the hospital. This
includes the shifts on duty and off-duty.

• Decentralized Schedule- the shift and off duties are arranged by the
supervising nurse or head or senior nurse of the particular unit.

• Self Schedule- it is a system that is coordinated by staff nurses. It is a

process by which nurses and other staff collectively develop and implement
work schedules, taking policies and variables affecting into consideration.

Prepared by: Mendoza, Angelica

***
Patient Care Classification System

The patient care classification system is a method of grouping patients

according to the amount and complexity of their nursing care requirements and
the nursing time and skill they require. This assessment can serve in determining
the amount of nursing care required, generally within 24 hours, as well as the
category of nursing personnel who should provide that care.

To develop workable patient classification system, the nurse manager must

determine the following:

1. The number of the categories into which the patients should be divided;
2. The characteristics of the patients in each category;
3. The type and number of care procedures that will be needed by typical
patient in each category; and
4. The time needed to perform these procedures that will be requires by a
typical patient in each category.

The number of categories in the patient classification may range from

three to four, which is the most popular, to five or six. These classes relate to the
acuity of illness and care requirements, whether minimal, moderate, or intensive
care. Other factors affecting classification system would relate to the patients
capability to meet his physical needs to ambulate, bathe, feed himself, and other
instructional needs including emotional support.

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 Patient care classifications have been developed primarily for medical,
surgical, pediatrics, and obstetrical patients in acute care facilities.

Classification Categories

The various units may develop their own ways of classifying patient care
according to the acuity of their patient’s illnesses. Following is an example of a
patient care classification in medical- surgical unit.

LEVEL I- Self Care or Minimal

Patient can take a bath his own, feed himself, feed and perform his
activities of daily living. Falling under this category are patients about to be
discharged. Those in non-emergency, those newly admitted, do not exhibit
unusual symptoms, and requires little treatment/ observation and / or instruction.
Average amount of nursing care hours per patient per day is 1.5. Ratio of
professional to non- professional nursing personnel is 55:45.

LEVEL II- Moderate Care or Intermediate Care

Patients under this level need some assistance in bathing, feeding, or
ambulating for short periods of time. Extreme symptoms of their illness must
have subsided or have not yet appeared. Patients may have slight emotional
needs, with fluids or blood transfusion; are semi-conscious and exhibiting some
psychosocial or social problems; periodic treatments, and/ or observation and/ or
instruction. Average nursing care hours per patient per day is 3and the ratio of
professional non-professional personnel is 60:40.

LEVEL III- Total, Complete or intensive Care

Patient under this category are completely dependent upon the nursing
personnel. They are provided complete bath, are fed, may or may not be
unconscious, with marked emotional needs, with vital signs and therapy, and with
chest or abdominal tubes. They require close observation at least every 30
minutes for impending hemorrhage, with hypo or hypertension and / or cardiac
arrhythmia. The nursing care hour per patient per day is 6 with a professional to
non-professional ratio of 65:35.

LEVEL IV- Highly Specialized Critical Care

Patients need maximum nursing care with ratio of 80 professionals to 20
non-professionals. Patients need continuous treatment and observation; with
many medications, IV piggy back; vital signs every 15-30 minutes; hourly output.
There are significant changes in doctor’s orders and care hours per patient per
day may range from 6-9 or more, and the ratio of professionals to non-
professionals also range from 70:30 to 80:20.
Prepared by: Surban, Katrina
***

Republic Act 5901 – The Fourty – Hour Week Law

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 - Provides that employees working in the hospitals with 100 bed
capacity and up will work only 40 hours a week.

- Employees working in agencies with less than 100 bed capacity

or in agencies located in communities with less than one million
populations will work 48 hours a week and therefore will get only
one off- duty a week.

Civil Service Commission as per Memorandum Circular No.6, series of 1996

- Granting of the three-day special privilege to government
employees.

- Which may be spent for Birthdays, weddings, anniversaries,

funerals (mourning), relocation, enrolment or graduation leave,
hospitalization, and accident leaves.

Rights and Privileges Working hours per Working hours per

given each personnel week week
per year 40 hours 48 hours
1. Vacation leave 15 15
2. Sick leave 15 15
3. Legal holidays 10 10
4. Specials holidays 2 2
5. Special privileges 3 3
6. Off – duties as per 104 52
R.A. 5901
7. Continuing 3 3
education program
Total non-working days 152 100
per year
Total working holidays per 213 265
year
Total working hours per 1,704 2,120
year
Total number of working and non-working days and hours of nursing personnel
per year
SCHEDULED METHOD PROS CONS
SELF-SCHEDULING - coordinating by staff -increases amount of
nurses time staff spends on
-saves manager scheduling
scheduling time
-helps develop
accountability
-increases perception of
autonomy

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 -increased job
satisfaction
-improved team spirit
-improved morale
-decreased absenteeism
-reduced turnover
-effective for recruitment
and retention
ROTATING WORK -can rotate teams -rotate among shifts
SHIFTS -increased stress
-affect health
-affect quality of work
Disrupt development of
works group
-high turnover
PERMANENT SHIFTS -can participate in social -most people want day
activities shift
-job satisfaction -new graduates
-commitment to the predominantly staff
organization evening and nights
-few health problem -difficulty evaluating
-less tardiness evening and night shift
-less absenteeism -nurses may not
-less turnover appreciate the workload
or problems of other shift
BLOCK, OR CYCLICAL -same schedule -rigidity
SCHEDULING repeatedly
-nurses not so exhausted
-sick time reduced
-personnel know
schedule in social events
-decreased time spend
on scheduling
-staff treated fairly
-helps establish stable
work groups
-decreased floating
-promotes continuity of
care

VARIABLES STAFFING -use census to determine

number and mix of staff
-little need to call in
unscheduled staff

ALTERNATING OR ROTATING WORK SHIFTS

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 - The frequency of alternating between days and evening, or days
and nights, or rotating through all three shifts may vary among
institutions. Some nurses may work all three shifts within 7
days.

- Alternating and rotating work shift create stress for staff nurses,
environmental cues, such as: sunrise and sunset, fluctuate in a
predictable cycle.

- Instrument s that designate hours, minute, and seconds

correspond to the natural daily cycle and allow knowledge of
one’s location in that cycle.

- The ability of the body function to adjust varies considerably

among individuals; it takes 2 to 3 days to 2 weeks for a person
to adjust to a different sleep-awake cycle.

PERMANENT SHIFTS
- Permanent shifts relieve nurses from stress and health-related
problem associated with alternating and rotating shift.

- When nurses are able to choose the shift that best suits their
personal life, they can participate in social activities, even when
they require regular attendance.

- In studies conducted with MONTREAL NURSES, those working

permanent shifts had higher average on psychological scales
such as: mental health, job satisfaction, social involvement, and
commitment to the organization.

BLOCK OR CYCLICAL SCHEDULING

- Uses the same schedule repeatedly. With a 6-day forward
rotation, personnel are scheduled to work6 successive days
followed by at least 2 days off. The scheduled repeats it every 6
weeks.

- Personnel can be scheduled with every other weekend off and 1

day during the week so that there are more than 4 consecutive
days of are not exhausted by working too many consecutive
days, sick leave can be reduced.

TEN – HOURS PER DAY, FOUR-DAY WORK PER WEEK

- A cyclical scheduled allowed at least 14 hours off between shifts
and a 4-day weekend every 6 weeks for those who rotated.

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 - The work week began on Sunday and the weekend was
Saturday and Sundays for all shifts.

Variables staffing PROS CONS

8 hours Traditional
10 hours Time to complete work,
Long weekends,
Extra days off,
Decreased overtime,
Cover peak workloads,
Decreased costs
12 HOURS Lower staffing
requirements,
Lower cost per patient
day,
Increased knowledge of
patients,
Get new admission
settled,
Not so rushed,
Better continuity of care,
Team development is
possible,
Less daily to do staffing,
Reduced travel time,
Less personal expenses
for gas, meals,
babysitting
Prepared by: Santos, Baby Richelle
Longer workday,
Fatigue,
Overlap,
Difficult to find substitute
Overtime,
Exhaustion increases at
end of workweek,
Tension increased at the
end of workweek,
Increased in minor
accident,
Increased medication
errors,
Home and social life
suffer the week worked.

***

Determination of Number of Nursing Personnel

In computing for the number of nursing personnel in the various nursing
units of the hospitals, one should ensure that there is sufficient staff to cover all
shifts, off-duties, holidays, leaves, absences, and time for staff development
program.

Steps in Computing Number of Nursing Personnel

1. Categorize the patients according to the levels of care needed. Multiply

the total number of patients by the percentage of patients at each level
of care (whether minimal, intermediate, intensive or highly specialized).

2. Find the total number of nursing care hours needed the patients at
each category level.

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 a. Find the number of patients at each level by the average number of
nursing care hour needed per day.
b. Get the sum of the NCH/day needed at the various levels. .

3. Find the actual number of nursing care hours needed by the given
number of patients. Multiply the total nursing care hours needed per
day by the total number of days in a year.

4. Find the actual number of working hours rendered by each nursing

personnel per year. Multiply the number of hours on duty per day by
the actual working days per year.

5. Find the total number of nursing personnel needed.

a. Divide the total number of nursing care needed per year by the
actual number of working hours rendered by an employee per year.
b. Find the number of relievers. Multiply the number of nursing
personnel needed by 0.15 (for those working 40 hours per week) or
by 0.12 (for those working 48 hours per week).
c. Add the number of relievers to the number of nursing personnel
needed.

6. Categorize the nursing personnel into professionals and non-

professionals. Multiply the number of nursing personnel according to
the ratio of professionals to non-professionals.

7. Distribute by shifts.

Reference Table

Table 1. Percentage of patients at various levels of care per type of

hospital.

Percentage of Patients in Various Levels of Care

Type of Hospital Minimal Moderate Intensive Highly
Care Care Care Spl.
Care

Primary Hospital 70 25 5 -
Secondary Hospital 65 30 5 -
Tertiary Hospital 30 45 15 10
Special Tertiary 10 25 45 20

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 Hospital

Table 2. Categories or levels of care of patients, nursing care hours needed

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

Level of Care NCH Needed Ratio of Prof.

Per Pt. Per Day to Non-Prof.
Level I 1.50 5:45
Self Care or Minimal Care

Level II 3.0 60:40

Moderate or Intermediate Care

Level III 4.5 65:35

Total or Intensive Care

Level IV 6.0 70:30

Highly Specialized or Critical Care 7 or higher 80:20

Table 3. Percentage of personnel needed in every shift.

Distribution by Shifts
Shift Nursing Personnel
Morning Shift 45-51
Afternoon Shift 34-37
Night Shift 15-18

Prepared by: De Leon, Joseph Rommel

***

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