The Healthcare Situation: Staffing for What Is vs. What If

Healthcare Training Resource
March 18, 2014 — 1,585 views  
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There’s a real danger of the nation staring at a huge nursing shortage in the near future. According to a US Bureau of Labor handbook, the country will have a requirement of nurses for 581,500 vacancies by 2018. The problem of the nursing shortage seems to have temporarily eased, but hospitals and health care providers are finding it increasingly difficult to walk the fine line when it comes to staffing and scheduling.

Scheduling has to be in line with patient demands. Does a healthcare unit’s nursing staff stick to a specific schedule or do nurses show flexibility with their shifts? Often, there are enough nurses to meet patient demands, but the scheduling goes wrong. Hospitals also need to focus on getting the ratio of staff for contingencies and staff for regular day-to-day functioning right. This ratio, of course, differs from one unit to another depending on what kind of healthcare the unit provides.

Mandated ratios or flexible ratios?

There have been several legislations that have sought to control nursing staff ratios in many states across the country. In February 2014, legislation was sought in Florida which ensures that the ratio of nurse-to-patient would be one registered nurse to five patients in rehabilitation. In an emergency, operating room, or in more serious cases, it would be one patient to one registered nurse. However, the American Nurses Association is for legislations that need hospitals to chalk out staffing as per their specific requirements. It seeks flexibility rather than a mandated ratio.

What is vs. what if

Meanwhile, most administrators or supervisors of nurses would explain that hospitals don’t staff for scenarios that are ‘what ifs’ and instead staff for ‘what is’. What if scenarios are contingency situations, those you think might happen; preparedness is important here. ‘What is’ scenarios are based on current demand. The latter is mostly for financial or practical reasons, because it is easier for nursing staff to be scheduled on the number of patients at the end of a particular shift. When units staff for scenarios based on ‘what is’, it means there are fewer nurses left to take care of a sudden admission of patients. This situation creates immense pressure on the scheduled nurses and their supervisors, apart from posing dangers to patients.

In a ‘what if’ scenario, there is always room to accommodate more patients, and there is less pressure on supervisors and nurses. However, a ‘what if’ situation requires adequate planning and forecasting to get the schedule correct.


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