A couple of weeks ago, I wrote about the troubling exposé in the Los Angeles Times regarding temporary nursing agencies in California that fail to perform thorough background checks on nurses they add to their roster of staff, and even ones who repeatedly send nurses out for jobs, despite those nurses being banned from facilities for poor behavior, incompetence, or stealing.
Since then, I've been thinking about ways hospitals can reduce their dependence on temporary and travel nurses, which led me to learn a lot about the complicated world of nurse scheduling, an onerous task that usually falls to the unit's nurse manager.
Nothing causes more arguments among staff nurses on a unit than the schedule. Filling the shifts is a task that causes many new nurse managers to wonder what on earth they have got themselves into when they tackle it for the first time. Nurse managers have to deal with issues such as whether seniority means having to work fewer weekends, or how far in advance staff must plan vacations to ensure they get the time.
While nurse managers on every unit have to work out the scheduling criteria that work best for them, one issue remains constant: there will always be holes in the schedule, and it's their job to fill them.
In most hospitals, the process goes something like this: the nurse manager gets on the phone and begs and pleads his or her staff to take on more shifts. With the gaps that remain, they turn to options such as float pools or agency staff, or traveler nurses for long-term shortages.
Using agency staff is expensive, requires effort to organize, and can sometimes lead to resentment among the permanent staff, who question why their hospital is willing to pay twice as much to agency nurses to fill open shifts as it pays to its own loyal staff.
Many organizations use new technology to solve this problem, investing in software that allows them to offer open shifts to staff, decreasing nurse managers' workloads and increasing flexibility for nurses.
Different systems are available from a variety of companies. In August, University Health Systems of Eastern Carolina implemented a management program called ShiftSelect, developed by Concerro, Inc., at six of the system's eight hospitals.
UHS calls the program Flexwork, and it allows nurse managers to post open shifts online. Nurses system-wide can view and request available shifts. They see only the shifts that they're qualified to fill.
Linda Hofler, interim CNO of the system's flagship facility, Pitt County Memorial Hospital, says the software is extremely easy to use for the system's nurses and they enjoy the flexibility it gives them in planning their work schedules.
"People are giving us more hours than they were in the past because they have this tool," says Hofler. "They can wake up today, decide they want to work tomorrow, sit in their pajamas, and request an open shift. They don't even have to make a phone call. It's so much more convenient for people."