Staffing

1. Staffing Dr. Belal Hijji, RN, PhD November 15, 2011

2. Learning Outcomes At the end of this clinical day, students will be able to: • Calculate the number of full time equivalent (FTEs) needed as basic staff (RNs, LPNs, and nursing assistants) to staff a hospital ward each shift.

3. Scenario • You are a nurse manager of a male medical ward with 32 beds. The average daily census (ADC) of the ward is 29 patients. Each patient needs, on average, 6 hours of care per 24 hours. The workday is 8 hours. One full time equivalent (FTE) is one person working full time (40 hours) or several persons who together work a total of 40 hours/ week. Determine the following: • Total hours of care needed on the average day to meet these standards. 29*6 = 174 hours. • Total number of FTEs needed to staff the ward 24 hours. 174/8 = 21.75 FTEs staff are needed. • Number of 8-hour shifts needed per week. 21.75*7 = 152.25 shifts. • Number of FTEs needed as basic staff. 152.25/5 = 30.45 staff.

4. We need also to determine the number of nursing personnel to cover sick leave, vacations, or any other absences and add these to the basic staff. • If the ratio of registered nurses (RNs) to other nursing personnel is 1:1, how much of the basic staff of 30.8 should be RNs? One half of the total, which would be 15.4 and 15.4 others (licensed practical nurses “LPNs”, nursing assistants). • We need to determine how many nursing personnel are needed each shift. Experts in nursing management recommend the following proportions: day, 47%; evening, 35%; and night, 17%. This means that for a total 30.8 personnel, 14.48 would be at day, 10.77 at evening, and 5.24 at night.

5. Finally, we need to add the number of complementary nursing personnel to the basic staff of 30.8. The recommendation is 1 RN, 1 LPN, and 1 nursing assistant. These could be in parenthesis [أقواس]. • We can now tabulate the data to look as follows: Basic staffing plan for 32-Bed Male Medical Ward Category Day Evening Night Total RNs 7.24 + (1) 5.39 2.62 15.40 + (1) LPN 3.62 2.69 + (1) 1.31 7.70 + (1) Nursing Assistants 3.62 2.69 1.31 + (1) 7.70 + (1) Totals14.48 + (1) 10.77 + (1) 5.24 + (1) 30.8 + (3)

6. What Should You Do Next • Based on this teaching session, you need to apply the knowledge you obtained to the hospital ward you are assigned to next Tuesday. Of course you need to work with your clinical instructor who should help you by providing approximate information about the ADC, average number of hours of nursing care provided to each patient on daily basis, and the ratio of RNs to other nursing personnel. • You should be able to build a table, similar to the one on the previous slide, if you understood the calculations performed during today’s session.