Staff Scheduling at an Inpatient Nursing Unit

Staff Scheduling at an Inpatient Nursing Unit

Introduction

This paper presents an analysis of the scheduling models that should be considered for planning purposes by the hospitals. It also assesses barriers or challenges that should be considered when implementing any changes in staff scheduling.

Discussion

Work-family policies were addressed to employees with specific needs (e.g., child care), which were seen as unrelated to decisions about how the work itself should be organized. In contrast, the new focus on work-life integration reflects the belief that every aspect of work affects all employees' ability to have meaningful nonwork lives and that an effective work-force is one that is not compelled to choose between meeting the demands of the workplace and those of the home (Allison et al., 2009). Here the focus shifts from benefits directed at certain employees to workplace practices that affect the way work gets done by all employees (Batten & Susan, 2008). To develop such practices, hospitals need a new model, one that challenges stereotypic views of men and women and takes into account the complex lives today's employees lead.

This model differs from its predecessors in that

the operative unit is the worker's work-life system, not the individual worker;

the work-life system is conceptualized as including persons (whether traditionally defined as “family” or not), organizations, or activities to which the employee has responsibilities;

the employee's well-being is seen as dependent on the quality of her or his work and nonwork (i.e., life) experiences;

work-life decisions are no longer seen as pitting one person's needs against another's; and

Such decisions are made to optimize the well-being of the system (Mary & McDermott, 2005).

This new systems perspective is referred to as the “work-life integration” model. To implement this work-life integration model, hospitals will have to introduce a range of new policies. Importantly, these policies would not be seen as benefits for which only certain employees could apply, but rather as basic entitlements open to all employees (Batten & Susan, 2008). For example, except in times of crisis, employers could eliminate all before- and after-hours meetings as well as all last-minute travel (Bunting, 2004). Under such circumstances, employees could arrange their child care schedules and make family or other non-work commitments free of the anxiety that last-minute disruptions might result in their failure to fulfill these obligations (William, 1999).

In addition, if performance were evaluated more on output than visible input (i.e., face time), and then nurses would have more control over when they did their work (Allison et al., 2009). These policies would increase workers' control over critical aspects of their lives, leading, in turn, to decreased distress and heightened well-being. Such an approach has been tried on an experimental basis at several large employers (Batten & Susan, 2008). For example, recent research at Xerox and Fleet Bank suggests that changes in the way work gets done (e.g., job redesign) and changes in informal corporate culture (e.g., training for supervisors) may have such positive indirect effects on work life as reducing work-family conflict and improving ...