Faulty assumptions can roil holiday scheduling
When scheduling time off for holidays, either underestimating or overestimating the projected unit census for a future date can sink the even best-laid holiday scheduling plans.
Nevertheless, managers and charge nurses repeatedly fudge their projected census and end up frantically calling in last-minute help to cover empty nursing assignments. That’s the view of several veteran managers, including Gina Bergmooser, RN, MSN, an administrative supervisor at Grace-Sinai Hospital in Detroit.
Bergmooser, who completed her graduate thesis on nurse staffing issues over a cross-section of acute-care departments, says that while there’s no magic bullet to save you from covering all your bases during holidays; it’s wise to consider the subtle factors behind staffing.
"Planning ahead is key to the process," she advises. Yet, advanced planning is only as good as the set of assumptions you make regarding your future staffing needs.
Bergmooser advocates assuming maximum census for the unit on Thanksgiving, Christmas, and New Year’s. But more importantly, keep a short list of contingency plans in the wings for unanticipated occurrences. Projected census figures are available from hospital occupancy data. It’s reasonable to anticipate that patient census in the unit will remain consistent from December to December, she says. Weather factors, patient acuity, and seasonal variables that account for illnesses and admissions — such as pneumonia outbreaks — are also generally predictable.
Routine unit activities such as transfers and admissions also set consistent, predictable patterns, that can help managers staff appropriately and give individuals time off on the basis of seniority or compromise, says Nancy Molter, RN, a clinical nurse educator at St. Luke’s Baptist Hospital in San Antonio.
Give the nursing staff flexibility to determine their staffing levels. "Fortunately, most nurses are a dedicated bunch, and they’ll follow through when given the responsibility," Bergmooser says. "And remember, plan far ahead."
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