Expectations key to per diem success
December 1, 1997 3 minutes read
Expectations key to per diem success
Plan to get the most out of your floaters
How does an award-winning hospital with an all-RN model of care not use a nursing registry?
Three years ago, the University of California, Davis Medical Center created and implemented its own supplemental staff pool in order maintain a consistently high-quality RN staff, says Aida Calpo, MS, RN, nurse manager for the patient care resources unit at the Sacramento facility.
Calpo, along with all nurse managers, oversees hiring, scheduling, and evaluation of about 300 RNs who work as "per diem" nurses. Although some work full-time and others part-time, their minimum requirement includes at least three 12-hour shifts a month and at least two of the shifts must be on a weekend, she explains.
The key to the program’s success starts with the interview process and orientation, and continues through evaluation. "We also explain they’ll be evaluated as necessary as well as receiving annual evaluations as career staff."
Calpo sends the per diem nurses’ evaluations to three managers with whom they have worked in the previous year. Then she does a composite evaluation that uses the same criteria as for regular staff.
Candidates for the supplemental staffing pool must also have worked in a similar nursing environment for at least three years, one of which must be in the specialty area they’ll be working in at UC Davis.
The assignment is first based on the the nurse’s primary areas of expertise, followed by the secondary areas of clinical knowledge, explains Calpo.
Once a floater is hired, he or she receives an orientation on the unit as well as a "buddy" or resource person for that shift, Calpo adds. The nursing supervisors also check on the nurse at least once during the shift.
New floaters must complete a three-page evaluation of their experience on a unit. "It asks them to indicate whether or not they were familiar with certain setups and routines, or not familiar but given adequate assistance, or not given adequate assistance. This gives us good insight into any potential quality improvement areas," explains Calpo.
She modified a form published several years ago in the American Journal of Nursing that includes these elements:
• supplies and equipment;
• unit routine;
• medication administration;
• patient treatments;
• transcription of orders;
• charting;
• communication with house staff and attending physicians.
Calpo is in close contact with the unit to check on the new floater, as well. "If anything negative arises, I go up to the unit," she says. Calpo also insists that unit managers put any problems in writing. "It’s just not enough to call down and say, We don’t want that nurse back.’ They must explain why on paper." Coupled with the floater’s evaluation, Calpo then has enough information to make an informed decision about whether to continue the per diem’s employment.
Yet such cases don’t arise often, she stresses. As one of the few healthcare systems left on the West Coast with an all RN model of care, UC Davis is perceived as desirable place to work. "The competition is keen. We only hire the best," Calpo says.
Actually her biggest problem is keeping the supplemental staff. "We’re our biggest competitor because many of them end up being hired here full time," Calpo says.
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