Human Resource in Health

HUMAN RESOURCE
MANAGEMENT
RECRUITMENT OF
STAFF
Glossary
Management: It relates to the activities
needed to plan, organize, motivate, and
control the human and material resources
needed to achieve the outcomes.
Organization: Group of people working
together to achieve a purpose

Glossary
Personnel: Individuals employed in an
agency or department
Employee: Member of staff
Employer: Company boss, owner or
manager
Recruitment: The process of enlisting
personnel for employment
Retention: Capacity to retain employees
once they are hired

Glossary
Cultural diversity: Variations among
cultures in communication style, sense of
personal space, social organization, sense of
time, environmental control, and biologic
characteristics.
Orientation: Familiarization with and
adaptation to an environment
Glossary
Job analysis: The study of a position to
determine what knowledge, skills, aptitudes,
and personal characteristics are needed to
carry out certain responsibilities.
Job evaluation: The process of measuring
the remunerative worth of a job in
relationship to that of other positions.
Glossary
Job design: Specification of what the job
requires, job methods, and the relationship
among the organizational, social and
personal needs of the worker.
Job rotation: A horizontal job enlargement
technique.
Job enrichment: A vertical approach to job
design that uses more of the abilities and
skills of personnel.

Glossary
Job descriptions: Specifications that are the
requirements for given jobs.
Career ladder: Vertical clinical or
management advancement.
Staff development: Education of
employees.
Preceptor: A teacher or instructor.
Mentor: A wise and faithful counselor.

Glossary
Career: Progressive achievement throughout
a persons professional life.
Career mapping: A strategic plan for ones
career.
Group process: How the group functions.

Unit 3
Management Process
Human Resource Management
Recruiting
Selecting
Deployment
Retaining
Promoting
Superannuation
HUMAN RESOURCE MANAGEMENT
Introduction:
Important responsibilities of the personnel
department is to recruit and select the right
persons for the right jobs.
Organizations are particularly dependant
upon 3 factors
HUMAN RESOURCE
MANAGEMENT
Employees and their commitments,
Consumers
Impressed and concerned sympathetic
attitude and attention of the personnel
Recruitment, selection and induction are
crucial, complex and continuing functions
of the personnel department.
HUMAN RESOURCE
MANAGEMENT
Every organization should pay maximum
attention to evolve
Attractive staffing polices,
Quality of its human resources.
As its success depends on the same
RECRUITMENT
Recruitment is a process to discover the
source of manpower to meet the requirements
of the staffing schedule and to employ
effective measures, attracting the manpower
in adequate numbers to facilitate effective
selection of an efficient working force. Yoder
& others

RECRUITMENT
Recruitment is a process of securing
applicants to fill vacant positions.
It covers both the filling of new and
replacement of previously established posts
which fall vacant.
Unless the right type of people are hired even
the best plans, organizational charts and
control systems fail.

FACTORS AFFECTING RECRUITMENT

Recruitment differs according to:
1. Size of the organization
2. Employment condition in the community.
3. Effect of past recruitment efforts.
4. Working conditions, salary and other
benefits.
5. Rate of growth of organization.
6. Cultural, economical and legal aspects.
ELEMENTS OF SOUND RECRUITMENT
POLICY
1. Discovery and cultivation of the employment
market for posts/marketing a job in the
public/private services.
2. Use of attractive recruitment literature and
publicity.
3. Use of scientific tests for determining abilities
of the candidates.
Contd
ELEMENTS OF SOUND RECRUITMENT
POLICY
4. Tapping capable candidates from within the
services.
5. Placement programme which assigns the
right man to the right job.
6. A follow up probationary programme as an
integral part of the recruitment process.
PURPOSE OF RECRUITMENT
Ideally the purpose of recruitment is to
1. Locate and attract enough qualified
applicants
2. To provide a pool from which the required
number of individuals can be selected.
Proper management can serve as the best
recruiting
tool.
STEPS IN RECRUITING PROCESS
According to FAMUTARO it involves 5 steps.
1. Recruitment policy
2. Recruitment organization
3. Forecast of manpower
4. Development of sources of recruitment.
5. Different techniques used for utilizing the
sources and method of assessing
recruitment programme.
HUMAN RESOURCE
MANAGEMENT
Once manpower requirements have been
determined recruitment is the next step in
the staffing process.
Selection Process
Adequate applicant pool

Pre-employment screening

Completion of application

Reference checks Pre-employment
Testing

Physical examination Employment
interview

Employer decision

Notification of applicants
ESSENTIAL ELEMENTS IN
RECRUITING STRATEGY
Four essential elements in recruiting strategy;
1. Where to look?
2. How to look?
3. When to look?
4. How to sell the organization to potential
recruits?
1. WHERE TO LOOK?
For most health care institutions,
1. Own geographic area.
2. National searches.
The state board of Nursing

2. HOW TO LOOK?
Recruiting sources :
1. Internal
2. External
Internal sources include the
Promotion and Transfer of employees
within an organization to fill a vacancy.
MERITS -RECRUITING INTERNAL
SOURCES
a. It helps to build loyalty, ensure stability,
creating a sense of security among the
employees.
b. Improves the morale of the employees.
c. Helps employer in better evaluation.
d. Little training is required.
e. Can rely upon as they are tried people.
f. Less costly.
DEMERITS -RECRUITING INTERNAL
SOURCES
a. Leads to inbreeding and discourages entry of
new people.
b. Difficult to find the requisite personal from inside.
c. Innovations cannot be made.
d. As promotion is based on seniority, able hands
may not be chosen.
e. Chance for biased selection.

RECRUITING EXTERNAL SOURCES
The management authorities should use
external sources of recruitment whose
specifications cannot be met by the present
personnel.
They may include:
a. Young mostly inexperienced potential
employees.
b. Unemployed with skill and ability.
c. Retired experienced person.
d. Unmarried women and people from minority
group.
These sources include:
a. Door applicants.
b. Govt. employment exchange
c. Private employment exchange
d. Advertisement
From other organizations.
Unsolicited applicants
Teaching institutions
Internal circulars for vacancies.
Referral from:
Employers
Ex-employers
Political leaders
Govt. Officials
Religious bodies

3. When to look?
Careful planning is necessary to ensure that
recruitment begins well in advance of
anticipated needs
4. How to sell the organization?
The final issue in developing a recruiting
strategy is communicating with job
candidates.
A more balancing recruiting message, which
includes honest communication and
personal contact, is preferable presenting
the job requirements.
And rewards improves job satisfaction.
HUMAN RESOURCE MANAGEMENT-
RECRUITMENT METHODS:1. Advertising:

A post is advertised to:
- Attract Suitable Persons
- Get Adequate Number of Applicants.
- Discourage Unsuitable Persons From
Applying
- Project a Good Image of The organization
Important points to be kept in mind:

1. The advertisement should be designed in
such a way that it arouses the interest of
potential candidates.
It should state:
The job title, Briefly outline the duties,
Qualification, Previous experience, Salary
payable conditions,
Any particular features about the job
Important points to be kept in mind:
2. The media of the advertisement should be
selected carefully.
3. It should be display advertisement not a
classified advertisement (Small
advertisement)
4. Repeated advertisement for the same post
should be avoided.
RECRUITMENT METHODS: 2. Career day
programme:

In some places colleges held, annual career
day
programmes during which recruiting officers
from
Local agencies inform senior students about
Employment opportunities.
Campus interview
RECRUITMENT METHODS:
3. OPEN HOUSE:

It is showcase of the opening of a new
service or educational programme.
Invitation to an open house may be sent to
individuals, group of specialty candidates,
final year students and alumnis of colleges.
EMPLOYEE REFERRAL :
Recruiter can inform the employees in the
unit so, information exchanges contributes to
successful
selection
It works in 2 ways:
An enterprise provides applicants with an
objective description of the company and
the position.
The applicants provide information about
their capabilities.
SELECTION
The job application form is one most
important tool in the selection process.
It can supply enough information about a
candidate. This will help for the short listing of
the candidates.

SELECTION
A. Evaluation of the applicant: Through
application form, curriculum vitae, written
recommendations and transcript.
B. Job application form includes: Name,
fathers name, present and permanent
address, sex, age, religion, weight, height,
physical deformity if any, educational
qualification, experience, participating in
extra curricular activities, etc.
POINTS TO BE NOTED WHILE PREPARING
JOB APPLICATION
1. Form should be large to provide enough
space.
2. Should be printed on good paper.
3. Wording should not be ambiguous.
4. Include questions about previous
employers of the candidate to find out his
stability at work.
5. At the end there should be a space for
signature.
The signature should follow 2 statements:
1. I have no objection if any enquiry is made
from my past of present.
2. I hereby certify that all the information given
by me in the form is correct and complete to
the best of my knowledge and belief.
Different job application forms are prepared for
Different categories of employers.
Main purposes of job application forms are:
1. It enables the hospital authorities to weed out
unsuitable candidates.
2. It acts as a frame of reference for the interview.
3. It forms the basis for the personal record file of
successful candidates
The selection process starts when applications are
received
And screened in the personal dept.
The steps of employee selection process are the
following:
1. Interview by personnel department.
2. Pre-employment tests-written, oral, practical.
3. Interview by department head.
4. Decision of administrator to accept or reject
5. Medical examination
6. Check of references
7. Issue of appointment form
The personnel manager does not select anyone.
His job is to screen and recommend the potential
candidates to the department head.
For senior posts, the personal manager should
preferably form a selection board which should
include the
Chief executive,
Department head,
Personnel manager and
An Expert from outside if needed.
Interviewing:
The employment interview is aimed at obtaining
certain basic information.
It is normally conducted by the personnel manager
and the concerned department head.

Interviewing:
The candidate is asked about his education, job
experience, minimum salary acceptable etc.
In the case of lower positions, there is no need to
call a candidate for final interview with the
administrator, as the final selection is made by the
head of the department and personal
management jointly.


In case of senior posts, where the selection is
decided by a selection board, all the candidates who
are found eligible during secreting are referred to the
board for interview.
These candidates are interviewed and a list is made
of the first 3 candidates found suitable for the post by
the board.


The personal manager implements the decision of
the board by sending an appointment letter to the
1st. candidate.
In case the offer is turned down by the 1st candidate
it is sent to the 2nd candidate.
MAIN OBJECTIVES OF AN INTERVIEW
For the employer to obtain all the information.
To give the candidate a complete picture of the
job.
To demonstrate fairness to all candidates.

THE INTERVIEW LETTER :

When calling a candidate for an interview,
The time, data and place must be specifically
mentioned.
Other conditions such as requirements of
passport size photos, certificates, testimonials,
payment of traveling allowance etc. Should
also be mentioned
PREPARATION BEFORE THE INTERVIEW
Plan carefully.
Inform receptionist so that candidates are correctly
directed to the place of interview.
Make sure that waiting arrangements are
satisfactory.

PREPARATION BEFORE THE INTERVIEW
Ensure that there are no interruptions during
interview.
Decide in advance the information to be collected
and provided.
Prepare a list of characteristics to be observed
and evaluated, i.e., general appearance,
language, intelligence etc.
THE RESPONSIBILITIES OF PERSONNEL
MANAGER
To screen the application
To give information about: general nature of
work hours of work pay scale allowance, other
benefits leave, policy etc.
To discover any difference in the expectations
of the expectations of the hospital and those of
candidates
THE RESPONSIBILITIES OF DEPARTMENT
HEAD
To review the job applications to check pertinent
data on experience.
To assess the professional competence of the
candidate.
To give a detailed picture of the job requirement.
To advise the personal manager if he thinks that
previous training and experience justifies a higher
starting salary.
OPENING THE INTERVIEW
The interviewer should start on time.
Give a warm friendly welcome.
Introduce him.
Ask the applicant his preferred name
Objective is to establish an open atmosphere and
rapport.
During the interview
Encourage the candidate to talk freely.
Privacy should be maintained.
Discussion should be relevant to the topic.
Establish rapport with applicant.
Make a written approval of the applicant.
Questions during the interview
It can be structured
Semi structured
Unstructured
Concluding the interview
Once the interviewer has secured a clear idea of
the applicants
Basis strengths and limitations, he should
conclude it by summarizing and giving
indications about the next step.
Interviewer should fill up the evaluation form.
Say goodbye and thank applicant for coming.
PRE-EMPLOYMENT TESTS:
These tests can be classified into 4 types:
1. Tests of general ability-intelligence tests.
2. Tests of specific abilities aptitudes tests
3. Tests of achievement trade tests
4. Personality tests-tests of emotional stability,
interest, value, traits.
Final approval of the head of the hospital
APPOINTMENT
In some hospitals, the selection committee consists
of
one person from the personnel department,
the department head and
one representative of the head of the hospital.
After interviewing the selection committee submits
its recommendations for approval to the head of
the hospital that is generally the hiring and firing
authority.
a. REFERENCES
The references provided by the applicant should
be
Cross-checked to ascertain his past
performance and
To obtain relevant information.
b. MEDICAL EXAMINATION:
The selection of the right type of employee
requires a thorough knowledge of
his physical capacities and handicaps.
No employee should be placed on the job
unless he has been declared medically fit.
c. THE PURPOSE:
For the protection of the applicant himself, to
know whether that job will suit him.
Protection of other employees from
communicable diseases.
To avoid selecting a wrong person.
Letter of appointment, to the candidate and a copy to
the administrator of the nursing unit.
Joining report by the employee: The employee
should be given an appointment letter, his job
description, and a hand book of the hospital. He
should be asked to submit his joining report.
Letter of thanks to the recruiting agency and rejected
applicants should be sent as soon as the vacancy is
filled.
D. INDUCTION:
This helps the employee to overcome his sense of
strangeness and to develop a sense of belonging.
1. The general orientation lecture.
2. General tour.
3. Employee hand book which covers brief history of
hospital, his aims and objectives; conditions of
employment etc.
4. Buddy system now employee is introduced to an
old employee who can share the general information.
CONFIRMATION, EXTENTION, PROBATION,
TERMINATION
During probation period, a close watch should be
kept on the employee.
If a new employee is properly groomed by his
immediate supervisor, and head of the department,
he will prove to be an assets for the organization.
The probationary report should be given by
department head, 15 days prior to the completion of
probation period, which should be just and fair.
PROMOTION:
This means to excel in a situation, change for better
aspects
etc.
The factors which are considered by employers as
implying promotion are:
1. An increase in the salary.
2. An increase in job prestige.
3. Upward movement in the hierarchy of the job.
4. Additional supervisory responsibility.
5. A better future.
FACTORS WHICH MUST BE THE BASIS FOR
PROMOTION ARE
1. Outstanding service in terms of quantity and
quality.
2. Above average achievements, experience,
seniority; initiative.
3. Knowledge
4. Record of loyalty and co-operation.
On the basis of employees probation report a
decision to terminate or confirm or to extent his
extension period has to be taken.
Either a confirmation letter or a termination letter or a
letter showing extension of probation is given
Demotion refers to the lowering down of the status,
salary, and responsibility of an employee.
It is used as punitive measure when there are serious
breeches of duty of the part of employee.

Transfer is a lateral shift causing movement of
individuals from one position to other usually
without involving any marked change in duties.
It is a horizontal or lateral movement from one job to
another or any sections, department, shift, plant or
another place where his salary is same.
Dismissal is the termination of the services of an
employee by way of punishment, for some
misconduct or for unauthorized and prolonged
absence from duty.
Suspension is a serious punishment, during
which employer receives a subsistence allowance.
Turnover is the rate of change in working staff of
a concern during a definite period, either due to
resignation or dismissal.
JOB REQUISITION:
Once a department head knows that there is a
vacancy,
he fills up a job requisitionship and submits it to
the personnel department for necessary action.
A job-requisition form should be designed very
clearly.
DEPLOYMENT :
Deployment means arrange, manage or give
position to their employees.
Deployment in Nursing: Staff nurses having the
qualification of B.Sc. (N), M.Sc(N) being deployed in
school and colleges in nursing as sister tutor means
re-designation staff nurse to sister tutor. High
position is given to them.
RETAINING
Retaining means Possession of employees by
employer.
It is necessary to every organization to retain their
employees to achieve the laid down objectives of
the institution.
RETAINING
Otherwise, chaos will be there and institution will
fail. It will lead to high turnover of the employees.
For Retaining of the employees, every
organization has own policies, so that skilled
managers and competent workers be retained.
CERTAIN AVENUES OF RETAINNING ARE
1. Promotion of the employees.
2. Good living and working conditions.
3. Employees welfare services.
4. Motivation
5. Incentives
6. Fair and equitable wages
7. Effective supervision
CERTAIN AVENUES OF RETAINNING ARE
8. Fair system of performance appraisal
9. Loan facilities
10.Effective redressed system for employees
grievances.

SUPERANNUATION
Superannuation means pension given to the
employees after retirement.
Pension:
A pension is a steady income to a person usually
after retirement.
Pensions are the payments made in the form of a
guaranteed annuity to a retired or disabled
employee.
Some retirement plan designs accumulate a cash
balance that a retire person can draw upon at
retirement, rather than promising annuity payments.
These are often called as pensions.
In some cases, a pension is created by an
employer
Labour unions, the govt., or other organizations
may also fund pensions.
Many pensions also contain an insurance aspect,
since they often pay benefits to survivors.
Superannuation is 15% of basic and gratuity is
4.81% of the basic.
Superannuation can be optional.
Superannuation is claimed whenever you leave the
company.
NURSING
ADMINISTRATION
Human Resource Health -
Staffing
PREPARED AND PRESENTED
BY

MRS.S.ANUCHITHRA
RADHAKRISHNAN,
VICE PRINCIPAL CUM HOD OBG NURSING,
P.D.BHARATESH COLLEGE OF NURSING,
HALAGA, BELGAUM.
INTRODUCTION

Staffing is a selection, training, motivating and
retaining of a personnel in the organization.
Nurse staffing is a constant challenge for health
care facilities.
Before the selection of the employees, one has to
make analysis of the particular job, which is
required in the organization, then comes the
selection of personnel.

DEFINITION OF STAFFING
Staffing is the function by which managers
build an organization through recruitment,
selection and development of individuals as
capable employees.
Mc Farland

Staffing is defined as filling positions in the
organization structure through identifying
workforce requirements, inventorying the
people available, recruitment, selection,
placement, promotion, appraisal,
compensation and training of needed
people.
Harold Koontz and Cyril O
Donnel
Staffing is the process of determining and
providing the acceptable number and mix of
nursing personnel to produce a desired level
of care to meet the patients demand.

PURPOSE OF STAFFING
To establish and maintain sound personnel
relation at all levels of the organization.
To make the effective use of personnel to attain
the objectives of the organization.
PURPOSE OF STAFFING IN
NURSING
To provide each nursing unit with an appropriate
and acceptable number of workers in each
category to perform the nursing task required .
Too few or improper mixture of nursing
personnel will adversely affect the quality and
quantity of the work performed.
It leads to staff absenteeism and turn-over
resulting in low morale and dissatisfaction.

NATURE OF STAFFING
1. Staffing is an important managerial function
2. Staffing is a pervasive activity
3. Staffing is a continuous activity
4. The basis of staffing function is efficient
management of personnel.
5. Staffing helps in placing right men at the right
job.
6. Staffing is performed by all managers

SIGNIFICANCE OF STAFFFING

Staffing provides man power which is the key
input of an organization.
It helps in discovering and obtaining
competent personnel for various jobs
It makes for higher performance by placing
right persons on the right job


It improves job satisfaction and morale of
employees through objective assessment
and fair compensation of their
contributions.
It facilitates optimum utilization of human
resources and in minimizing costs of
manpower.
Contd

It ensures the continuity and growth of
organization through the development of
organization.
It enables an organization to cope with the
shortage of executive talent.

NEED FOR STAFFFING

1. Increasing size of organization
2. Advancement of technology
3. Lang range need for manpower
4. High wage bill
5. Trade unionism
6. Human relations movement

FUNCTIONS IN STAFFING

Identifying the type and amount of service
needed by agency client.
Determining the personnel categories that
have the knowledge and skill to perform
needed service measures.
Contd

Predicting the number of personnel in each
job category that will be needed to meet
anticipated service demands.
Obtaining, budgeted positions for the number
in each job category needed to service for
the expected types and number of clients.
Contd

Recruiting personnel to fill available
positions.
Selecting and appointing personnel from
suitable applicants.
Combining personnel into desired
configurations by unit and shift.
Contd

Orienting personnel to fulfil assigned
responsibilities.
Assigning responsibilities for client services
to available personnel.

CHARACTERISTICS OF
STAFFING

Staffing is a universal function. It is the
responsibility of every management.
Staffing is a dynamic function
Staffing cannot be entrusted fully to
personnel department or any other service
department.
Contd
CHARACTERISTICS OF
STAFFING

Staffing helps in the accomplishment of
organizational goals through team spirit and
optimum contribution from every employee.
Staffing is concerned with the management of
managers
Staffing is a difficult function with
extraordinary problems of social,
philosophical and psychological in nature.
ESSENTIALS OF A GOOD
STAFFING POLICY

A good staffing policy should possess the
following characteristics
It should take into account the interest of
both employer and employees
It should be complete in every aspect
It should be simple and precise
Contd
ESSENTIALS OF A GOOD
STAFFING POLICY

It should be reasonably stable and permanent
It should be flexible
It should be responsive to prevailing trends in
industry and society.
It should take into account variations in the
capabilities, interest and attitudes of
employees

ELEMENTS OF STAFFING

The elements of staffing are
1. Procurement
2. Development
3. Compensation levels
4. Integration
5. Maintenance

1.PROCUREMENT
Procurement involves
Manpower planning
Recruitment
Selection
Placement
2.DEVELOPMENT
Training perform job efficiently
Proper development of personnel
Development involves
Orientation socializing process
Counseling-
Training improving the knowledge and
skills

3.COMPENSATION LEVELS
Determining adequate and equitable
remuneration
Monetary and nonmonetary rewards
Compensation involves
Job evaluation determining the worth of job
Performance appraisal- evaluation of
performance against certain standards
Promotion rewards with transfer

4.INTEGRATION
It is developing sense of belonging to the
enterprise
Sound communication system is required-
keep harmony and team spirit
Quick and satisfactory redressal of problems
and grievances
Motivation of employees towards
accomplishment of goals
Discipline and labour relation are important

5.MAINTANANCE
Facilities and services to maintain the
physical and mental health of employees
Includes measures for health, safety and
comfort of employees
Provision of cafeteria, restrooms, group
insurance, recreation club, education of
children of employees

HR MANAGEMENT ACTIVITIES
HR MANAGEMENT
ACTIVITIES
Internal

External

HR MANAGEMENT ACTIVITIES -
INTERNAL

Strategic HR Management
Equal employment opportunity
Staffing
HR development
Compensation and Benefits
Health, Safety and Security
Employee and labour relations

EXTERNAL

Global
Environmental
Cultural/Geographic
Political
Social
Legal
Economic and Tecnological

INTERNAL

Strategic HR Management
HR Planning
HR Measurement
HR Technology

INTERNAL

Equal employment opportunity
compliance
Affirmative action
Diversity

INTERNAL

Staffing
Job analysis
Recruiting
Selection

INTERNAL

HR development
Orientation
Training
Employee development
Career planning
Performance management

INTERNAL

Compensation and Benefits
Wage / Salary Administration
Incentives
Benefits

INTERNAL

Health, Safety and Security
Health and Wellness
Safety
Security

INTERNAL

Employee and labour relations
Employee rights and privacy
HR Policies
Union / Management relations

THE MAIN OBJECTIVES OF MAN
POWER PLANNING

1. Ensuring maximum utilization of the
personnel
2. Assessing future requirements of the
organization
3. Determining the recruitment sources.
4. Anticipating from past records, i.e.
resignations, simple discharge, dismissal
and retirements.
5. Determining training requirements for
managements development and
organizational development.

MAJOR ACTIVITIES OF
MANPOWER PLANNING

Forecasting future manpower requirements
Inventorying, present manpower resources
and analysing the degree to which these
resources are employed optimally.
MAJOR ACTIVITIES OF
MANPOWER PLANNING

Anticipating manpower problem by projecting
present resources into the future and
comparing them with forecast of requirement
of requirement to determine their adequacy,
both quantitatively, and qualitatively
Planning the necessary program,
recruitment, selection, training, development,
motivation and compensation, so that future
manpower requirements will be met.

STEPS OF MANPOWER
PLANNING

1. Scrutiny of present personnel strength.
2. Anticipation of man power needs.
3. Investigation of turnover of personnel
4. Planning job requirements and job
descriptions

STEPS IN STAFFING
PROCESS

Human Resource planning
Recruitment
Selection
Induction and orientation
Separation
Performance appraisal
Employment decisions
STEPS OF STAFFING

1. Determine the number and types of personnel
needed to fulfil the philosophy, meet fiscal
planning responsibilities, and carryout the chosen
patient care management organization
2. Recruit, interview, select, and assign personnel
based on established job description
performance standards.
3. Use organizational resources for induction and
orientation

STEPS OF STAFFING

4. Ascertain that each employee is adequately
socialized to organizational values and unit norms.
5. Use creative and flexible scheduling based on
patient care needs to increase productivity and
retention
6. Develop a program of staff education that will
assist employees meeting the goals of the
organization.

PHILOSOPHY OF STAFFING

There are three general philosophies of personnel
management. It based on
1. Organizational theory,
2. Industrial engineering,
3. Behavioural science.

1. THE ORGANIZATIONAL
THEORIST BELIEVES THAT

Human needs are either so irrational or so
varied and adjustable to specific situations that
the major function of personnel management is to
be pragmatic as the occasion demands.
If the jobs are organized in a proper manner, he
reasons, the result will be most efficient job
structure, and the most favourable job
attitudes will follow as a matter of course.

2. THE INDUSTRIAL ENGINEER
BELIEVES THAT

The man is mechanistically oriented and
economically motivated and his needs are best
met by attuning the individual to the most efficient
work process.
The goal of personnel management therefore
should be to concoct the most appropriate
incentive system and to design the specific
working conditions in a way that facilitates the
most efficient use of the human machine.

2. THE INDUSTRIAL ENGINEER
BELIEVES THAT

By structuring jobs in a manner that leads to
the most efficient operation, the engineer
believes that he can obtain the optimal
organization of work and the proper work
attitudes.

3. THE BEHAVIOURAL SCIENTIST
BELIEVES THAT

The behavioral scientist focuses on group
sentiments, attitudes of individual employees,
and the organizations social and
psychological climate.

3. THE BEHAVIOURAL SCIENTIST
BELIEVES THAT
Personnel management generally emphasizes some form
of
Human relations education,
In the hope of instilling healthy employee attitudes
and an organizational attitudes and
An organizational climate which he considers to be
felicitous to human values.
He believes that proper attitudes will lead to efficient
job and organizational structure.

PHILOSOPHY OF STAFFING IN
NURSING

Nurse administrators of a hospital nursing
department should adopt the following staffing
philosophy.
Nurse administrators believe that it is possible to
match employees knowledge and skills to patient
care needs in a manner that optimizes job
satisfaction and care quality.

PHILOSOPHY OF STAFFING IN
NURSING

Nurse administrators believe that the technical and
humanistic care needs of critically ill patients are so
complex that all aspects of that care should be
provided by professional nurses.
Nurse administrators believe that the health
teaching and rehabilitation needs of chronically ill
patients are so complex that direct care for
chronically ill patients should be provided by
professional and technical nurse.

Philosophy of staffing in nursing

Nurse administrators believe that patient
assessment, work quantification and job analysis
should be used to determine the number of
personnel in each category to be assigned to
care for patients of each type( such as coronary
care, renal failure, chronic arthritis, paraplegia,
cancer etc)
Philosophy of staffing in nursing

Nurse administrators believe that a master staffing
plan and policies to implement the plan in all units
should be developed centrally by the nursing heads
and staff of the hospital.
Nurse administrators believe the staffing plan details
such as shift- start time, number of staffs assigned on
holidays, and number of employees assigned to each
shift can be modified to accommodate the units
workload and workflow.

Objectives of staffing in nursing

Provide an all professional nurse staff in critical
care units, operating rooms, labour and
emergency room
Provide sufficient staff to permit a 1:1 nurse-
patient ratio for each shift in every critical care unit
Staff the general medical, surgical, obstetrics and
gynecology, pediatric and psychiatric units to
achieve a 2:1 professional- practical nurse ratio.

OBJECTIVES OF STAFFING IN
NURSING

Provide sufficient nursing staff in general, medical,
surgical, obstetrics and gynecology, pediatric and
psychiatric units to permit a 1:5 nurse patient ratio
on a day and afternoon shifts and 1:10 nurse-
patient ratio on night shift.
Involve the heads of the nursing staffs and all
nursing personnel in designing the departments
overall staffing program.


Design a staffing plan that specifies how many
nursing personnel in each classification will be
assigned to each nursing unit for each shift and how
vacation and holiday time will be requested and
scheduled.
Hold each head nurse responsible for translating the
departments master staffing plan to sequential eight
weeks time schedules for personnel assigned to her/
his unit.


Post time schedules for all personnel at least eight
weeks in advance.
Empower the head nurse to adjust work schedules
for unit nursing personnel to remedy any staff excess
or deficiency caused by census fluctuation or
employee absence.


Inform each nursing employee that requests for
specific vacation or holiday time will be honored
within the limits imposed by patient care and
labour contract requirements.
Reward employees for long term service by
granting individuals special time requests on the
basis of seniority.

ANA PRINCIPLES OF NURSING
STAFFING (REFERENCE: ANA
WEBSITE ON SAFE STAFFING)
1. Patient Care Unit Related
2. Staff Related
3. Institution/Organization Related

1. PATIENT CARE UNIT
RELATED

Appropriate staffing levels for a patient care unit reflect
analysis of individual and aggregate patient needs.
There is a critical need to either retire or seriously
question the usefulness of the concept of nursing
hours per patient day (HPPD).
Unit functions necessary to support delivery of quality
patient care must also be considered in determining
staffing levels.
2. STAFF RELATED

The specific needs of various patient populations
should determine the appropriate clinical competencies
required of the nurse practicing in that area.
Registered nurses must have nursing management
support and representation at both the operational level
and the executive level.
Clinical support from experienced RNs should be
readily available to those RNs with less proficiency.

3. INSTITUTION/ORGANIZATION
RELATED

Organizational policy should reflect an organizational climate
that values registered nurses and other employees as
strategic assets and exhibit a true commitment to filling
budgeted positions in a timely manner.
All institutions should have documented competencies for
nursing staff, including agency or supplemental and traveling
RNs, for those activities that they have been authorized to
perform.
Organizational policies should recognize the myriad needs of
both patients and nursing staff.

NORMS OF STAFFING( S I U-
STAFF INSPECTION UNIT)
Norms are standards that guide, control, and
regulate individuals and communities.
For planning nursing manpower we have to follow
some norms.
The nursing norms are recommended by various
committees, such as;

The nursing man power committee,
The high-power committee,
Dr. Bajaj committee, and
The staff inspection committee,
TNAI and INC.
The norms has been recommended taking into
account the workload projected in the wards and the
other areas of the hospital.

All the above committees and the staff inspection unit
recommended the norms for optimum nurse-patient
ratio. Such as
1:3 for Non Teaching Hospital and 1:5 for the Teaching
Hospital.
The Staff Inspection Unit (S.I.U.) is the unit which has
recommended the nursing norms in the year 1991-92.
As per this S.I.U. norm the present nurse-patient ratio is
based and practiced in all central government hospitals.

RECOMMENDATIONS OF
S.I.U
The norms for providing staff nurses and nursing
sisters in Government hospital is given in
annexure to this report. The norm has been
recommended taking into account the workload
projected in the wards and the other areas of the
hospital.

RECOMMENDATIONS OF
S.I.U
The posts of nursing sisters and staff nurses have
been clubbed together for calculating the staff
entitlement for performing nursing care work which
the staff nurse will continue to perform even after
she is promoted to the existing scale of nursing
sister.

Recommendations of S.I.U
Out of the entitlement worked out on the basis of the
norms, 30%posts may be sanctioned as nursing
sister. This would further improve the existing ratio of
1 nursing sister to 3.6.
Staff nurses fixed by the government in settlement
with the Delhi nurse union in may 1990.

The assistant nursing superintendents are
recommended in the ratio of 1 ANS to every 4.5
nursing sisters. The ANS will perform the duty
presently performed by nursing sisters and perform
duty in shift also.
The posts of Deputy Nursing Superintendent may
continue at the level of 1 DNS per every 7.5 ANS
There will be a post of Nursing Superintendent for
every hospital having 250 or beds.

There will be a post of 1 Chief Nursing Officer for
every hospital having 500 or more beds.
It is recommended that 45% posts added for the
area of 365 days working including 10% leave
reserve (maternity leave, earned leave, and days off
as nurses are entitled for 8 days off per month and 3
National Holidays per year when doing 3 shift
duties).

Most of the hospital today is following the S.I.U.
norms.
In this the post of the Nursing Sisters and the Staff
Nurses has been clubbed together and the work of
the ward sister is remained same as staff nurse even
after promotion.
The Assistant Nursing Superintendent and the
Deputy Nursing Superintendent have to do the duty
of one category below of their rank.

THE NURSE-PATIENT RATIO AS
PER THE S.I.U. NORMS

1. General Ward 1:6
2. . Special Ward - ( pediatrics,
burns, Neuro surgery, cardio
thoracic, Neuro medicine, nursing
home, spinal injury, emergency
wards attached to causality)
1:4
3. Nursery 1:2
4. I.C.U. 1:1(Nothing mentioned about the
shifts)
5. Labour Room 1:l per table
6. O.T.
Major - 1 :2 per table
Minor - 1:l per table

7. Casualty-
a. Casualty main attendance up
to 100 patients per day thereafter
b. for every additional
attendance of 35 patients
c. Gyanec/ obstetric attendance
d. thereafter every additional
attendance of 15 patients.

3 staff nurses for 24 hours,
1:1per shift.
1:35

3 staff nurses for 24 hours, 1:1/
shift
1:15

8. Injection room OPD Attendance up to 100 patients
per day 1 staff nurse
120-220 patients: 2 staff nurses

9. OPD - NAME OF THE DEPARTMENT
1. Blood bank
2. Paediatric
3. Immunization
4. Eye
5. ENT
6. Pre anaesthetic
7. Cardio lab
8. Bronchoscopy lab
9. Vaccination anti rabbis
10. Family planning

1
2
2
1
1
1
1
1
1
2

9. OPD - NAME OF THE DEPARTMENT
1. Medical
2. Dental
3. Central sample collection centre
4. Orthopaedic
5. Gyne
6. Xray
7. Skin
8. V D centre
9. Chemotherapy
10. Neurology
11. Microbiology
12. Psychiatry
13. Burns

1
1
1
1
2
2
3
2
2
2
1
2
1
PER THE NORMS OF TNAI AND
INC (THE INDIAN NURSING
COUNCIL, 1985)

The norms are based on Hospital Beds.
Chief Nursing Officer :1 per 500 beds
Nursing Superintendent :1 per 400 beds or above

The Nurse-patient Ratio as per
the norms of TNAI and INC (The
Indian Nursing Council, 1985)

D.NS. :1 per 300 beds and 1 additional for
every 200 beds
A.N.S. :1 for 100-150 beds or 3-4 wards
Ward Sister :1 for 25-30 beds or one ward.
30% leave reserve


Staff Nurse :1 for 3 beds in Teaching Hospital
in general ward& 1 for 5 beds in Non-teaching
Hospital +30% Leave reserve
Extra Nursing staff to be provided for
departmental research function.

For OPD and Emergency :1 staff nurse for 100
patients (1 : 100 ) + 30% leave reserve
For Intensive Care unit: (I.C.U.)- 1:l or (1:3 for each
shift ) +30% leave reserve.
It is suggested that for 250 bedded hospitals there
should be One Infection Control Nurse (ICN).

FACTORS INFLUENCING
STAFFING
External factors
Legal factors
Socio-cultural factors
External influences
Internal factors
Organizational business plan
Size of organization
Organizational image

Factors affecting staffing
The type, philosophy, objectives of the hospital
and the nursing service
The population served or kind of patients served
whether pay or charity
The number of patients and severity of their
illness-knowledge and ability of nursing personnel
are matched with the actual care needs of
patients
Availability and characteristics of the nursing staff,
including education, level of preparation, mix of
personnel, number and position.
The administrative policies such as rotation,
weekends, and holiday off duties.
Standards of care desired which should be
available and clearly spelled out.
Layout of various nursing units and resources
available within the department such as adequate
equipment, supplies and materials.
Budget including the amount allotted to salaries,
fringe benefits, supplies, materials and equipment.
Professional activities and priorities in non-patient
activities
like involvement in professional organizations, formal
educational development, participation in research and
staff development.
FACTORS AFFECTING
STAFFING
Teaching program or the extent of staff involvement in
teaching activities
Expected hours of work per annum of each
employee. This is influenced by 40 hour week law.
Patterns of work schedule
Traditional 5 days per week, 8 hrs/day
4 days per week, 10 hrs/day and 3 days off
3
1/2
days of 12 hrs/day and 3
1/2
days off/wk

JOB DESCRIPTION AND JOB SPECIFICATION
Job descriptions are derived from job analysis
and are affected by job evaluation.
It is written record of principle duties and scope of
responsibility for a particular job, together with the
required employee characteristic and the
relationship of the workers with other personnel in
the organizational structure.
There is a need for job descriptions,
because it is learnt that
most workers function in a mechanical fashion
and are not conscious of the role assigned to
them
and also leads to various problems particularly
in functioning.
Job description is a summary of primary duties in
a complete but not detailed fashion.
It facilitates employment, recruitment, selection,
placement, orientation, supervision and evaluation
of employee that is it:
1. Assist in interpretation to the authorities of the type of
person needed for the job.
2. Provides a basis for orientation for the individual
employed and for other personal so that all are familiar
with what is expected of each one.
3. Provides basis for supervision of evaluation
JOB SPECIFICATION
It is the final product of job analysis.
It can be defined as a list of various qualities
which the person doing the job should possess.
It is prepared by analyzing the job description.
Well laid-out job specification will enable the
management to identify the right man needed to
do the required job efficiently.
JOB DESCRIPTION SHOULD BE DEVELOPED
ON THE FOLLOWING BASIS:
a. Based on the needs of the service.
b. Based on the facilities of resources & personnel
available;
c. Based on the organizational structure.
d. Should be specific
e. Should arrange duties in a logical order, stating
them separately, concisely and using verbs to
describe the action.
JOB SPECIFICATION
Job specifications includes the
Requirements of the job,
Major duties and responsibilities and the
organizational relationship of a given position,
The title of the job indicates the major
responsibilities and sets that job apart from
others.
A PATTERN OR JOB DESCRIPTION FOR
NURSING TUTOR
TITLE : NURSING, TUTOR
EDUCATIONAL QUALIFICATIONS:
General- as prescribed for staff nurse.
Professional- B.Sc. or M.Sc Nursing
Registration Registered with state nursing
council
Experience Minimum 5 years.
Standard norms According to Indian Nursing
Council
Job summary:
She is teacher in nursing school, Responsible to
the vice principal and Responsible for planning
and implementation of teaching programme and
Assists in administrating of school of nursing.
A. Academic function:
Responsible for planning and implementation of
teaching programme.
Teaching subjects in the curriculum.
Overall supervision of clinical teaching programme
of subjects in hospital/ community health setting.

Maintain classroom equipments, supplies and
teaching aids.
Conduct test for (theory and practical) and
evaluation of students assignment and
performance.
Preparing teaching materials and implementing
it under the guidance of the other teachers.
Helping the students with extracurricular
activities.

b) Administration and evaluative functions
Assisting in the administration of the school of
nursing.
Supervision of student health, welfare and
security.
Assisting the selections of students and
administration.
Assisting in examination tests.
Supervision of student in hostel.
Assist in teaching of other categories of
personnel in the hospital and community.

b) Administration and evaluative functions
Assisting in procurement of school supplies or
equipments.
Assisting in the library work.
Assisting in the maintaining school records.
Planning, implementation evaluation of
specification courses.
Shall carry out any other duties assigned by the
principal or head of the department in the interest of
education.
JOB ANALYSIS
a. Definition:
The generally accepted definition is a scientific
study and statement of all the facts about a job
which reveals its content and the modifying
factors which surround it.
b. Purposes:
1. It is necessary to receive a suitable number of
desirable and qualified individuals to perform the
work.
2. It is equally important as a basis for selection,
rating, transfer and promotion.
3. It plays a role in determination of rates of pay,
work methods, improvement etc.
4. For the setting up of personnel specification.
1. Mental requirements
2. Physical requirements
3. Skill requirements
4. Responsibilities
5. Working conditions
C. THE FACTORS WHICH ARE
RESPONSIBLE FOR JOB ANALYSIS
ARE:

If a job analysis is to be a success, it cannot be a
superficial procedure.
It requires detailed examination of jobs, and this
work should be done and supervised by persons
with training and experience in this field.
The two preliminary steps in a programme of job
analysis are the preparation of

1) Job descriptions and of
(2) Job specifications.
The former is a written summary of the most
important features of a job, and it is usual to
compile this by making a factual record of the way
in which each employee spends his or her working
day.
A JOB DESCRIPTION FORM FOR AN
INDIVIDUAL MUST REQUIRE
INFORMATION REGARDING
Title of the job
Place of the job
General description of duties
Lists of records and reports to be completed
List of equipment and supplies used.

Proportion of time spent in standing, sitting,
walking etc.
Supervision given and received Working
conditions
Employees opinion of difficulties attached to work
NURSING
ADMINISTRATION
Human Resource Health
Categories Of Nursing
Personnel Including Job
Description Of All Levels
JOB DESCRIPTIONS OF TEACHING AND
NON TEACHING PERSONNEL:
Introduction:
The international council of nurses observes with great
concern the trend in many countries to erode functions
and to undermine the quality of nursing.
International council of nurses believes that the
nursing profession must define the nursing service
role, nursing education and nursing service to be
planned and directed by qualified nurses.
JOB DESCRIPTIONS OF TEACHING AND
NON TEACHING PERSONNEL
International council of nurses urges its member
associations to promote these positions in order to
protect standards of nursing care given to the
patients.
Professional education and experience required
for various posts in nursing profession, approved
by the Indian nursing council in its meeting held on
27th March 1985.
JOB DESCRIPTION OF TEACHING PERSONNEL:
PRINCIPAL, COLLEGE OF NSG
Responsible for formation of educational
objectives and administrative policies.
Principal is administratively responsible to the
secretary of the institution.
Responsible for maintaining a satisfactory
organization of staff activities.
Directs the entire educational programme offered
by the college and the management of hostel
attached to the college.
Determines the staff required and initiates the
procedure for obtaining the staff.
Works with appropriate officers of the university
and affiliating institutions and the nursing council in
regard to all maters relating to them.
Conducts regular faculty meetings and
departmental meetings.
Maintains close working relationship with nursing
superintendents of the hospital and the officers in
charge of the health centers.
Provides opportunity for continuing education for
the staff through in service education, attending
conference, workshops and refresher courses.

Checks the staff for that the facilities and
equipment are obtained as needed for satisfactory
performance.
Directs and assists the faculty in formulation and
implementation of curricula.
Responsible for planning and coordinating
schedules for classes and clinical practice.
Directs and assists the faculty in evaluating the
educational programme.
Initiates the administrative procedure for
admission of students and participates in their
selection.
Makes arrangements for the financial assistance
available for nursing students.
Check that provision is made for the social,
physical and emotional welfare of the students.
Has overall responsibility for the management of
the hostel through the wardens
Responsible for the required records of the
students are satisfactorily maintained by teachers
and that transcripts are supplied as requested.
Keeps the required record of the staff and submits
it to the controlling authority.
Prepares the annual administration report and
submits it to the controlling authority or officers.
Maintains proper communication with the
controlling authority.
Responsible for the preparation of college calendar
and prospectus for the various courses.
Prepares annual budget.
Has over all responsibility of all financial
transactions and maintaining of financial records.
Responsible for the ordering and purchasing of
items needed and the maintaining of registers.
VICE PRINCIPAL OF COLLEGE OF
NURSING
Essential qualification is masters degree in
specialized field of nursing.
Desirable independent published work of standard
or doctorate degree, salary, should be as per
U.G.C. scales or as per teachers of medical
colleges.
FUNCTION:
Directly responsible to the principal of the college
and works as head of Department.
Assist the principal for formulation of educational
objectives and administrative policies.
Maintains a close working relationship with nursing
superintendents and other staff of hospitals.
Assist principal in planning for the staff welfare
programme e.g. In-service Education.
Responsible for planning and coordinating schedules
for classes.
Directs and helps the faculty in evaluating the
educational programme.
Assist the principal in initiating the administrative
procedures for admission of students.
Assist the principal in the participation of college
calendar and prospectus for various courses.
Assist the principal in preparing the annual
administration report.
Assist the principal to plan and conduct
examinations, both internal and university.
Motivate faculty for conducting seminar, symposium
etc.
Motivate the staff and students for research project.
Guide and counsel the students in conditions of their
crises.
Guide the students in various extracurricular
activities
Help the principal for annual physical verification of
inventories in the college.
Job description of Lecturer, College of Nursing
Responsible to the principal of college of nursing.
Striven for the academic intellectual development
of the students.
Keeps in touch with changes and development in
his/her subjects by referring to books and
attending in service training programmes.

Job description of Lecturer, College of Nursing
Assists the principal and professor in carrying out
their official responsibilities.
Acts as liaison between students and the
principal of the college.
Makes use of available material, teaching aids to
facilitate learning.
Conducts seminar, presentations, debates etc. to
increase the students knowledge.

Evaluates the examination paper/assignment,
making sure the students understand their weak
points.
Ensures that discipline is maintained in the
classroom.
Make sure that syllabus of students is covered
before exams.
Maintains non partial atmosphere with the staff and
students.
Evaluates the progress of the student
continuously.

Plans the activities of the college and encourages
and guides the student to participate in them.
Participates and heads various committees of the
college e.g.: magazine, entertainment, curriculum,
sports and library.
Guide and counsel the students when the need
arises.
Help the students in academic matters.
CLINICAL INSTRUCTOR, COLLEGE OF
NURSING
I. AS A TEACHER:
Directly responsible to the principal college of
nursing.
Acts as a liaison between students and principal of
the college.
Assists the principal, professors and lecturer in
carrying out their official responsibilities.
Carries out all instructions given by the higher
authorities

Teach students and clarify their doubts.
Gives proper assignment and makes necessary
corrections.
Directs the students to different aspect of study
materials.
Gives frequent test papers and makes them
understand their weak points.
Checks that all necessary things are ready for the
students at the time of their admission and starting
of each semester.
Conducts seminars, group discussion,
presentations, debates etc., for upgrading the
students knowledge.
Attends regular staff meetings.
Carries out examination duties and other
modalities of examination.
Responsible for maintaining attendance register
and other records of the students up to date.
Ensures that students maintain proper discipline in
the college and clinics.
II AS A SUPERVISOR:
Makes rotation plan and posts the students to
various clinical areas.
Supervises the students in clinical area i.e.
community and hospital.
Acts as a liaison between students, college and
higher authorities of hospital and community.
Gives frequent assignments, points out their
mistakes and correct it.
Demonstrates various nursing procedures and
have to take care of different categories of
patients.
Conducts, bedside clinics, clinical presentations,
ward teaching, nursing rounds etc., for the
students.
III AS A GUIDE AND COUNSELLOR
Guide the students in all activities of the college.
Encourages and guides them to participate in SNA
activities and gives proper directions.

Works as a guide in various committees of the
college like magazine committee, entertainment
committees, curriculum committee, sports
committee, library committee etc.
Guide and counsel the students in condition of their
crisis.
Guide the students in various extra curricular
activities.
Guide the students in conducting community
camps. Seminars etc.

IV AS AN INCHARGE OF DIFFERENT
LABORATORIES
Takes the charge of different laboratories of college
like nursing arts laboratory, microbiology,
biochemistry, community etc.
Responsible for equal physical verification of
inventories.
Issues articles to the students in time of practical.
Ensures to the cleanliness and maintenance of
laboratory and its premises.
CATEGORIES OF HOSPITAL
NURSING PERSONNEL
INCLUDING JOB
DESCRIPTION OF ALL
LEVELS
STAFFING HOSPITAL NURSING
SERVICES IN DIFFERENT UNIT

INTRODUCTION
Nursing profession is considered a caring profession
to begin with, it was an art and a vocation.
Now it is considered a scientific profession nursing
care is defined as
the care of the patient with regard to nursing needs,
with he ever increasing dimension of medical sciences
quantitatively and qualitatively nursing care is becoming
more and more complex with its management services.

Nursing Services:-
Nursing service is the part of the total health
organization which aims at satisfying the nursing
needs of the patients/community.
In nursing services, the nurse works with the
members of allied disciples such as dietetics,
medical social service, pharmacy etc. in supplying a
comprehensive program of patient care in the
hospital.

Definition of Nursing Services:-
WHO expert committee on nursing defines
The nursing services as the part of the total health
organization which aims to satisfy major objective of
the nursing services is to provide prevention of
disease and promotion of health.

ORGANISATION OF NURSING
SERVICES
CHIEF NURSING OFFICER
|
NURSING SUPDT
|
DY. NURSING SUPDT.
|
ASSTT. NURSING SUPDT.
|
WARD SISTER-CLINICAL SUPERVISOR
|
STAFF NUIRSE ----STUDENT NURSE
OBJECTIVE OF NURSING IN
WARD
1. Maximum comfort and happiness by way of
pleasant surroundings.
2. Qualitative/comprehensive care to the patient.
3. Care based on the patients needs.
4. Accurate assessment of illness.
5. Adequate material resources at all times.
6. Health education to the patient and attendants.
7. Managerial skills as and when required.
8. Privacy at all levels.

OBJECTIVE OF NURSING IN
WARD
EFFECTIVE NURSING:-
An effective nursing is always based on nursing
process which is an organized and systematic
approach to nursing care, that prioritizes patient
assessment and management.
Entire nursing process consists of four phases

FACTORS TO BE CONSIDERED
IN PLANNING HOSPITAL
NURSING SERVICES

1. Number and type of patient.
2. Number of beds and type of ward.
3. The services required.
4. Procedures/techniques necessary for care.
5. Number and type of personal needed to perform
care effectively.
6. Physical facilities.
7. Provisional of equipment and supplies.

S.I.U NORMS

1 Nursing sister for 3:6 staff nurses.
1 ANS for 4:5 nursing sisters.
1 DNS for 7:5 ANS.
1 Nursing supdt for 250-500 beds.
1 CNO for 500 or more beds.

PROBLEMS AND CHALLENGES
FACED BY THE NURSING
ADMINISTRATOR
Lack of adequate training.
Problem of personnel management.
Inadequate number of nursing staff.
Shortage of trained manpower.
Lack of motivation.
No involvement in planning.

PROBLEMS AND CHALLENGES
FACED BY THE NURSING
ADMINISTRATOR
No career mobility.
Poor role model.
Non-nursing activities.
No research scope.
No proper authority.
Professional risk/hazards.
No autonomy in nursing activities.

CONSTRAINS AND BARRIERS
IN NURSING SERVICES
ADMINISTRATION
Planning of nursing manpower.
Management and development.
Staff development.
Development/awards.
Nursing legislation.
Trained nurse managers.

CONSTRAINS AND BARRIERS
IN NURSING SERVICES
ADMINISTRATION
Diversification in nursing profession.
Leadership inadequacy.
Lack of strength, weakness, opportunity and threat.
Lack of awareness to meet social, economic and
technical changes in the society and consumer
protection act.
Lack of communication.
Nursing care audit.

DAY TO DAY PROBLEM IN
NURSING SERVICES
Shortage of nurses.
Lack of motivation.
Negative attitude.
Lack of training.
Lack of team approach.

DAY TO DAY PROBLEM IN
NURSING SERVICES
Inactive participation of programs.
Lack of I.P.R.
Less involvement in patients care by the
nursing supervisors.
Lack of supervision.

FORSEEN FOR BETTER
NURSING SERVICE
ADMINISTRATION IN THE NEXT
MILLENIUM:-

Accountability.
Autonomy of professional activities.
Independent nursing practices.
Renewal of licenses based on education and
examination.

FORSEEN FOR BETTER
NURSING SERVICE
ADMINISTRATION IN THE NEXT
MILLENIUM:-

Specialty nursing
Nursing care audit.
Qualitative nursing care.
Separate nursing budget.
Diploma in nursing management.
Nursing research.

CNO (CHIEF NURSING
OFFICER)

SHE/HE WILL OR WILL BE
Responsible for efficient running of nursing services
of the main hospital and various centers.
Assist the director in formulating broad policies
concerning nursing services.
Disseminate the aim, objectives and policies
regarding patient care to all cadres of nursing
services.
Implement policies and procedures of institute
regarding nursing services.

CNO (CHIEF NURSING
OFFICER)

Plan future requirements of nurses and carry out
recruitment of nurses from time to time.
Plan and disseminate programmes for continuing
education re-orientation programmes for nurses.
Closely interact with other hospitals regarding
improvement of patient care.

CNO (CHIEF NURSING
OFFICER)

Encourage research by nurses in their work areas.
Guide and counsel the sub-ordinate nursing staff.
Keep herself abreast of latest happenings in nursing
care by attending national / international
conferences.
Strive to implement standard nursing practices and
maintain highest quality of care.

CNO (CHIEF NURSING
OFFICER)

Strive to implement standard nursing practices and
maintain highest quality of care.
Critically analyze the budgets for nursing services
from main hospital and various centers before being
forwarded to director.

CNO (CHIEF NURSING
OFFICER)

Evaluate confidential reports of higher level nursing
officers and recommend for promotion.
She will be assisted in her duties by nursing
Supdt.s, of Main Hospital and from the centers.
She will keep the Director informed about the
happening concerning the hospital.

Nursing Superintendent
Is responsible to the C.N.O. for planning
organisation and development of nursing services in
the hospital in consultation with Medical Supdt./Chief
of centers.
1. Responsible and overall in-charge of nursing
services in a hospital or specialized centers
irrespective of the number of beds.
2. Responsible to the medical supdt. Or addl. MS or
chief of centers of the hospital or centre as the case
may be.

3. Responsible for implementing hospital/centre
policies amongst various nursing units.
4. Assist the CNO in formulation of hospital policy,
particularly concerning nursing services.
5. Officiate as CNO in the absence of CNO (the
senior most amongst the ns will do so).

6.Officiate as CNO in the absence of CNO (the senior
most amongst the NS will do so).
7.Recommend personnel and material requirement for
nursing various nursing service departments of the
hospital.
8.Assist MS/addl. MS or chief of centers in recruiting
nursing staff.

9.Carry out regular rounds of the hospital.
10.Accompany MS/addl. MS while making hospital
rounds.
11. Prepare budgets for nursing services.
12. Be a member of various condemnation boards for
Linen and other hospital stores.
13. Be responsible for counseling and guidance of
sub-
ordinate staff.

14.Attend hospital/intra hospital meetings and
conferences.
15.Investigate all complaints regarding nursing care
and personnel, and take suitable corrective action.
16.Initiate and encourage research in nursing
services.
17.Evaluate confidential reports of her sub-ordinate
staff and recommend for promotion, higher studies
etc.

18.Maintain cordial relations with patients and medical
social workers.
19.Periodically interact with clinical heads to discuss
problems in patient care.
20.Educate nursing staff of all categories by
conducting awareness programme on universal
precautions.

DEPUTY NURSING
SUPERINTENDENT

Deputy Nursing Superintendent is responsible
to the Nursing Supdt. and assist her in the
administration of nursing services in the hospital.
A. NURSING ADMINISTRATION
B. EDUCATIONAL ACTIVITIES
C.GENERAL DUTIES

DEPUTY NURSING
SUPERINTENDENT

A. NURSING ADMINISTRATION: SHE/HE WILL OR
WILL BE
Supervise the nursing care given to the patients in
various departments by taking regular round of her
area.
Act as a liaison officer between Nursing Supdt. and
the nursing staff of the hospital.
Interpret the policies and procedures of the Nursing
service department to sub-oradinate staff and
others.
Attend the emergency calls concerning nursing
services or hostel problems.

DEPUTY NURSING
SUPERINTENDENT

WILL BE
Receive evening and night reports from the Assistant
Nursing Supdt./Supervisors.
Keep records and reports of Nursing Services.
Maintain the records of attendance of nursing staff
and leave of any kind.
Conduct regular physical verification of hospital
stocks, i.e. drugs, equipments etc.

DEPUTY NURSING
SUPERINTENDENT

WILL BE
Initiate procedure for condemnation and
procurement of hospital equipment/linen etc.
Maintain the confidential report and records of
nursing personnel.
Assist the nursing supdt. in making master duty
roster of nursing personnel.
Assist the nursing superintendent in Recruitment of
nursing staff.

DEPUTY NURSING
SUPERINTENDENT

WILL BE
Assist the nursing supdt. on planning and organizing
nursing services in the hospital.
Officiate in the absence of nursing supdt.
Attend the official meetings.
Keep the senior nursing Officials (CNO & NS)
informed of the happenings in the wards.

DEPUTY NURSING
SUPERINTENDENT

B. EDUCATIONAL ACTIVITIES:- SHE/HE WILL OR
WILL BE
Assist in planning/organizing and implementing staff
development programmes.
Ensure clinical experience facilities for student
nurses in various clinical areas of the hospital.
Provide guidance and counseling to nursing staff.

DEPUTY NURSING
SUPERINTENDENT

B. EDUCATIONAL ACTIVITIES:- SHE/HE WILL OR
WILL BE
Arrange orientation programmes for new nursing
staff.
Maintain discipline among nursing personnel.
Organize educational programmes for graduate/post
graduate students from different hospitals with the
co-ordiantion of clinical instructor/lecturer college of
nursing.

DEPUTY NURSING
SUPERINTENDENT

C. GENERAL DUTIES:- SHE/HE WILL OR WILL BE
Escorts special visitors, Nursing Superintendent,
Medical Superintendent for hospital rounds.
Arranges and participates in professional and social
functions of the staff and students.
Maintains good public relations.
Any other duties assigned to her from time to time.

ASSISTANT NURSING
SUPERINTENDENT
Asstt. Nursing Supdt, is responsible to Deputy
Nursing Supdt.
A. NURSING CARE
B. WARD MANAGEMENT
C.TEACHING AND SUPERVISION

ASSISTANT NURSING
SUPERINTENDENT
A. NURSING CARE
Assist the total needs of patients in the unit and
prepare planned nursing care.
Demonstrate and Supervise the nursing care of
patients in the unit.

ASSISTANT NURSING
SUPERINTENDENT
A. NURSING CARE
Attend regular round in the unit with the medical
and nursing personnel.
Reviewing reports from Sr. Gr. I regarding the
nursing care of patients in each shifts.
Give counseling and health education to the
patients and their attendants.

ASSISTANT NURSING
SUPERINTENDENT
B. WARD MANAGEMENT:-
Plan and arrange duty for nursing personnel posted
under her.
To ensure availability of adequate nursing staff in all
shifts.
Maintain cleanliness of unit its annexes and
environment.
Interact with the engineering service department for
proper up keep of the unit.

ASSISTANT NURSING
SUPERINTENDENT
Keeping Deputy Nursing Supdt., Nursing Supdt.
informed of the needs of the patient care areas and
bring it to their notice any special problems.
Guide the Sister Grade-I to ensure supplies and
equipments of different stores, and re-checking their
use and care.

ASSISTANT NURSING
SUPERINTENDENT
Daily check of emergency and dangerous drugs, life
saving equipments i.e. monitors, ventilators,
defibrillators, suction machines and O2 points etc., to
ensure their proper functioning.
Periodical check of all stocks and supplies.
Maintain good inter-personnel relationship with all
categories of staff, patients and their relatives.

ASSISTANT NURSING
SUPERINTENDENT
Maintain good public relation with patients relatives
and the public, and project positive image of the
hospital.
Maintain disciple of nursing and domestic staff.
Interpretation of Hospital policies, rules and
regulations.
Daily check of attendance and reporting the lapses.

ASSISTANT NURSING
SUPERINTENDENT
Investigate complaints if any.
Work evaluation and confidential reports.
Guidance and counseling of nursing staff in the unit.
Project the annual requirements of drugs supplies
and equipments for the units.
Take care of legal aspects and report about the
medico legal cases in the ward.

ASSISTANT NURSING
SUPERINTENDENT
C. TEACHING AND SUPERVISION:
Plan and implement a proper orientation programme
for new nursing staff, student nurse and domestic
staff.
Participate in In-service education of nursing
personnel and attend the meetings.

ASSISTANT NURSING
SUPERINTENDENT
Give incidental and planned teaching to nursing
personnel in the unit, as well as domestic staff.
Participate in clinical teaching for student nurses in
Co-operation with the nursing tutor.
Perform any other duties assigned to her for time to
time.

NURSING SISTER GRADE-I
The Nursing Sister Grade-I is responsible to the
Assistant Nursing Superintendent or the total care of
patients in the wards and supervision of the Nursing
Sister Grade-II, student nurses and Domestic staff.
She would also be assisted by Nursing Sister Grade-
II, Clinical and Domestic staff.

The main aim of the sister Grade-I should be to
foster team spirit in her area of works as a team
leader.
A. NURSING CARE OF PATIENTS
B. WARD MANAGEMENT
C. TEACHING AND SUPERVISION

Assess the total needs of patients and prepare plan
of nursing care.
Admission and discharge of patients.
Demonstrate and carry out efficient nursing care,
taking care of personal comfort and toilet of patients,
administration of drugs and treatment, observation
and recording of vital parameters.

Supervise patients diet.
Attending rounds with Medical/Nursing personnel.
Assist Medical staff in examination of patients and
treatment.
Participate and help with clinical
investigations/procedures.
Demonstrate and carry out preoperative and post-
operative care of patients.

Maintenance of patients records.
Care of patients personal effects in accordance with
hospital rules.
Giving and receiving reports.
Follow prescribed rules in case of accident or death
of a patient.

Give information and health education to patients
and their attendants.
Intimation to nursing supervisors of any emergency
or unusual occurrence in the ward.

B. WARD MANAGEMENT:
Handing over and takeover charge of patients at the
end of the shift.
Assignment of work to nursing sister grade-II and
domestic staff.
Co-ordinate and facilitate work of other staff, e.g.
physical therapist, social worker, dietitian, voluntary
worker etc.

B. WARD MANAGEMENT:
Maintaining good inter personal relationship among
all categories of staff and with patients and their
relatives.
Maintain cleanliness of ward, its annexes and
environments. Proper upkeep and repairs of linen
and ward equipment.
Make indents for drugs, surgical supplies, stores and
issue.

B. WARD MANAGEMENT:
Keep custody of dangerous drugs and record of their
administration.
Daily check of emergency drugs and life savings
equipments.
Maintenance of stock registers, inventories.
Investigate complaints if any.

Orientation of new staff and student nurses.
Participate in service education of nursing
personnel and attend staff meetings.
Impart planned and incidental teaching.
Supervise sister grade-II and student nurses.

Supervise domestic staff.
Consult and co-operate with nursing tutor in
arranging clinical teaching.
Perform any other duty as may be specified from
time to time.

NURSING SISTER GRADE-II

Nursing sister grade-II is directly responsible to
Nursing Sister Grade-I (Ward In-Charge) for total
nursing care of the patient assigned to him/her.
A. DIRECT PATIENTS CARE
B. WARD MANAGEMENT

A. DIRECT PATIENTS CARE:
Admission and discharge of the patients.
To maintain the personal hygiene of the patients,
including bathing, care of mouth, back, nails, hair
etc.
Care of pressures points as needed.
To assist the patient in elimination, offering and
removing the bed pans and Urinals.
Bed making.


Assist in feeding the weak and debilitated patients.
Writing of diet sheet, Supervision and distribution of
diets.
Assist in physiotherapy, ambulation and
rehabilitation.
Carry-out patients teaching and demonstration
according to the need.
Counseling the patients, and relatives.


Care of the dying and dead.
Administration of Medicines and Injections to the
patients.
Assist in administration of intravenous injections,
infusion and Transfusion.
Observing, recording and reporting of vital signs e.g.
T.P.R. and Blood pressure.


Carry out technical procedures, such as Naso-
gastric intubation, Gastric Gavage and Lavage,
Oxygen Therapy, Dressing and Irrigation, Enema,
Catheterization hot and cold applications, suction
etc.
Collecting, labeling and dispatch of specimens.
Preparation for and assistance in clinical tests and
medical/surgical procedures.


Urine testing for sugar, and albumin.
Observation, recording and reporting of all
procedures and tests.
Escorting serious patients to and from the
department/wards for investigations.


B. WARD MANAGEMENT:
Handing over and taking over charge of patients,
and ward inventory in each shift.
Maintenance of therapeutic environment in the
ward.
Keeping the ward clean and tidy.
Routine care and cleaning of dressing trolleys,
cupboards apparatus, mackintosh etc.
Maintenance of therapeutic environment in the ward.

B. WARD MANAGEMENT:
Handing over and taking over charge of patients,
and ward inventory in each shift.
Keeping the ward clean and tidy.
Routine care and cleaning of dressing trolleys,
cupboards apparatus, mackintosh etc.
Care of clean and soiled linen.
Disinfection of linen, beds, floor and bed pans, and
fumigation of rooms etc.

B. WARD MANAGEMENT:
Preparation of room, trolleys, and sets for
procedures.
Preparation of surgical supplies.
Maintaining interpersonal relationship with patients,
relatives and health team members.
Orientation of new staff/students.
Demonstration and guidance to student nurses.

B. WARD MANAGEMENT:
Participation in staff education and staff meetings.
Participation in professional activities.
Demonstration and supervision of domestic staff.

B. WARD MANAGEMENT:
Report about the medico legal cases if any admitted
in the ward. To keep the senior nursing officials
informed of the happenings / in the ward like fire,
absconding patients, theft etc.
Any other duty that may be assigned by sister grade-
I from time to time.
Nurses referred by
Informal methods (friends) tend to remain with an
organization longer than those recruited by formal
methods and also tend to be more productive.
Nurses referred by
Because nurses coming from informal sources of
referral are likely to have more realistic information
about the job and the institution and their
expectations more closely fit the reality.
Others may with unrealistic expectations experience
dissatisfaction.

Human Resource in Health

Încărcat de

Informații document

Descriere originală:

Titlu original

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

Human Resource in Health

Încărcat de

Drepturi de autor:

Formate disponibile

HUMAN RESOURCE

S-ar putea să vă placă și