Scheduling Alternatives for Administrators

Abstract

HE alarming growth in the shortage of nurses T across the nation has both the health industry and potential patients worried. Competing with traditional health care institutions for nursing staff are a growing number of home health care agencies, hospice agencies, health maintenance organizations, and temporary employment agencies. Yet, with the increase in technology and the increase in patient acuity, there is a growing need for nurses to work within health care institutions.

Analysis of Alternative Scheduling Policies for Hospital Nurses

“…Therefore, turnover should improve when hospitals increase their nurse/patient ratios to satisfactory levels. Several empirical studies lend credence to this hypothesis (Fraser 1972;Gulack 1982;Jones and Brown 1986;Prescott 1986;Braddy 1987;Capozzi, Glahn, and Phan 1990;McKibbin and Boston 1990). Unfortunately, accomplishing this goal often aggravates another problem linked to nurse turnover: unattractive work schedules.…”

“…Since about 1940, full-time nurses have nominally worked 40 hours per week, usually five shifts of 8 hours each (American Journal of Nursing 1940). To distribute unattractive work hours fairly among the nursing staff, however, a nurse may be scheduled to work at different times each day (rotating shifts), during one-half of all holidays, and three-fourths of all weekends (Braddy 1987;Helmer and M&night 1989). These traditional scheduling practices are common but not universal.…”

“…Most ALTOUR scheduling patterns in use today involve shifts of 8, 10, 12, or 16 hours. These shifts are combined to form tours with a variety of days-off patterns and compensation schemes ( Mallison 198 1;Braddy 1987 ) . At least seven distinct ALTOUR scheduling patterns, described in Table 1, have appeared in the literature.…”

“…Table 1 summarizes each of these policies, reporting the number of distinct schedules or tours that each policy allows, the number of monthly (28 days) paid hours and working hours for each pattern, and a ratio that reflects relative wage rates. Braddy ( 1987 ) , Mallison ( 198 1) , and Price ( 198 1) describe the policies summarized in Table 1, which are named for the hospitals that developed them, in greater detail.…”

“…The features of attractive nurse scheduling policies are frequently discussed in the literature (see Mallison 198 1;Price 198 1;Braddy 1987). Some attractive policies use traditional 5-day 40-hour per week schedules, with new restrictions on shift rotations and work stretches, wage premiums for night and weekend work, and more frequent offduty weekends.…”