1. STAFFING

2. Definition of Staffing
Staffing is the systematic approach of selection, training,
motivating and retaining of a professional and non-
professional personnel in Any organization.

3. Philosophy of staffing
• Match the employee’s knowledge and
skills to patient needs that optimizes job
satisfaction and quality of care.
• Professional nurses should provide
technical and humanistic care for
critically ill patients.

4. • Complex activities like; health teaching, rehabilitation needs, direct care should
be provided by the specialized nurses.
• Determine the number of staff in each category and the quantity of work.
• Development and Implementation of master staffing plan and policies by head
of the nursing department
• Changes could be done based upon the work flow and burden

5. Objectives
• To ensure maximum utilization of the personnel.
• To assess future requirements of the organization.
• To anticipate the need and demand of staff from past records.
• Ex: resignations, transfers, dismissals, and retirement

6. Functions
• Identifying the type and amount of service needed by agency.
• Determining the categories of personnel based on the knowledge and skills to perform needed
service.
• Predicting the number of personnel in each job category that will be needed to meet anticipated
service demands
• Recruiting personnel to fill available position.
• Selecting and appointing personnel from suitable applicants.
• Making personnel into desired configurations by unit and shift.
• Orienting personnel to fulfill assigned responsibilities.

7. Steps of staffing
• Step 1: Determine the number and types of personnel needed to fulfill the
required roles.
• Step 2: Interview, select, Recruit, and assign personnel based on the job
descriptions.
• Step 3: Utilize organizational resources effectively to support the newly
appointed personnel in their role.
Step- 4: Use creative and flexible scheduling based on patient care needs
Step- 5: Develop a programme of staff education that will assist employees in
meeting the goals of organization

8. Staffing study and norms
• Norms are standards that guide, control and regulate individuals and
communities.
• The nursing norms are recommended by various committees, such as; the nursing
man power committee, the high power committee, Dr. bajaj committee and the
staff inspection committee, TNAI and INC.

9. Staff inspection unit
• The SIU is the unit which has recommended the nursing norms in the year 1991-92
• The SIU recommended the norms for optimum nurse-patient ratio, such as 1:3 for non
teaching hospital and 1:5 for the teaching hospital
• As per SIU norm the present nurse-patient ratio is based and practiced in all central
government hospitals
Recommendations of SIU
• Staff nurse should continue to perform even after the promotion to the existing scale.
• According to established norms, 30% of the posts are sanctioned for nursing sisters.
This adjustment would enhance the current ratio from 1 nursing sister to every 3.6 staff
nurses.

10. • Assistant nursing superintendent are recommended in the ratio of 1
ANS to 4.5 nursing sisters
• Deputy nursing superintendent are recommended in the ratio of 1
DNS to 7.5 ANS.
• 1 nursing superintendent for hospital having 250 beds

11. • 1 chief nursing officer for hospital having 500 or more beds
• 45% posts added for the area of 365 days working includes 10% leave reserve
includes maternity leaves, earned leaves, days off etc. [8 days off per monthand 3
national holidays per yearduring 3 shift duties]

12. 1. General ward 1:6
2. Special ward
(pediatrics,burns,neuro
surgery,cardio thoracic,neuro
medicine,nursing home,spinal
injury,emergency wards
attached to casuality)
1:4
The Nurse Patient Ratio As Per SIU Norms

13. 4. I.C.U 1:1
(No shifts mentioned)
5. Labour room 1:1 per table
6. O.T major - 1:2 per table
minor - 1:1 per table

14. 7.Casualty
a.Casualty main attendance upto 100
patients per day thereafter
3 staff nurses for 24 hours,1:1 per shift
b.For every additional attendance of 35
patients
1:35
c.Gynae/obstetric attendance 3 staff nurses for 24 hours,1:1 per shift
d.Thereafter every additional attendance
of 15 patients
1:15

15. 8. Injection room OPD Attendance upto 100 patients per
day : 1 staff nurse
120 - 220 patients : 2 staff nurses
221 - 320 patients : 3 staff nurses
321 - 420 patients : 4 staff nurses

16. 9. OPD
Name of the department
Blood bank
Pediatric
Immunization
Eye
ENT
Pre anaesthetic
1
2
2
1
1
1

17. Cardio lab
Bronchoscopy lab
Vaccination anti rabies
Family planning
Medical
Surgical
Dental
Central sample collection
1
1
1
2
1
1
1
1

18. Orthopaedic
Gynae
Obstetric
Skin
VD Centre
Chemotherapy
Neurology
Microbiology infection control
Psychiatry
Burns
2
2
3
2
2
2
1
2
1
2

19. Bajaj committee
An “Expert Committee for Health Manpower Planning, Production and Management”
was constituted in 1985 under Dr. J.S. Bajaj, professor at AIIMS, Delhi.
Recommendations:
1. Formulation of National & Health Educational Policy.
2. Formulation of National Health Manpower Policy.
3. Establishment of an Educational Commission for Health Sciences (ECHS) on the
lines of UGC.
4. Establishment of Health Science Universities in various states and union territories.

20. 5. Establishment of health manpower cells at centre and in the states.
6. Vocationalisation of education at 10+2 levels as regards health related fields with
appropriate incentives, so that good quality paramedical personnel may be available
in adequate numbers.
7. Carrying out a realistic health manpower survey

21. Hospital Nursing Services
1. Nursing superintendents - 1:200 beds
2. Deputy nursing superintendents - 1:300 beds
3. Ward nursing - 8:200 + 30% leave reserve supervisor/sisters
4. Staff nurse for wards - 1:3 (or 1:9 for each shift) + 30 leave reserve
5. For OPD, Blood Bank, X-ray, Diabetic clinics, etc. 1:100 (1:5 OPD ) +30% leave
reserve
6. For intensive units 1:8 (1:3 for each shift ) (8beds ICU/200 beds) +30% leave reserve
7. For specialized depts And clinics, OT, Labor room- 8:200 +30% leave reserve

22. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION
(1987-1989)
High Power Committee on nursing and nursing profession was set up by the
government of India in July 1987, under the chairmanship of Dr. Jyothi former vice-
chancellor of SNDT Women University, Mrs. Rajkumari sood, Nursing Advisor to
Union Goverment as the member-secretary and CPB Kurup, Principal, Goverment
College of Nursing, Bangalore and then President. TNAI is also one among the
prominent members of this committee. Later on the committee was headed by Smt.
Sarojini Varadappan, former Chairman of central social welfare board

23. Recommendations of high power committee
• Employment : uniformity in employment procedures
• Job description : it is to provide guidelines
• Work load : adopted as recommended by the committee
• Working hours : weekly working hours should be reduced to 40 hours per
week and extra working hours should be compensated by leaves or emollients
• Pay and allowances : uniformity of pay scales of all categories with additional
allowances[I.e uniform allowance, laundry and mess allowances etc]
•

24. • Promotional opportunities : should be given depends upon education and experience
• Career development : provision of deputation for higher studies after 5 years of regular
service
• Accommodation : prior allotment of accommodation
• Transport : transport facilities with safety and security
• Special incentives : interest of awards and increments
• Occupational hazards : incase of occupational hazards, medical services should be provided
to all nursing personnel
• Other Services : provide welfare measures like; creche, children education allowances etc..

25. Norms recommended for nursing service in hospital
1. Nursing Supdt -1: 200 beds (hospitals with 200 or more beds).
2. Dy. Nsg. Supdt. - 1: 300 beds ( wherever beds are over 200)
3. Asst. Nsg . Supdt - 1: 100
4. Ward sister/ward supervisor - 1:25 beds 30% leave reserve
5. Staff nurse for wards -1:3 ( or 1:9 for each shift ) 30% leave reserve
6. For nurses OPD and emergency etc - 1: 100 patients ( 1 bed : 5 out patients) 30%
leave reserve
7. For ICU -1:1(or 1:3 for each shift) 30% leave reserve For specialised depts such as
operation theatre, labour room etc- 1: 25 30% leave reserve

26. Indian nursing council
The Indian nursing council is an autonomous body under the government of
India and was constituted In 1947.
Recommendations:
a) Principal cum Professor– 15 years experience with M.Sc (N) out of which 12
years should be teaching experience with minimum of 5 years experience in
collegiate programme,Ph.D (N) is desirable.
b) Vice – Principal cum Professor– 12 years experience with M.Sc (N) out of
which 10 years should be teaching experience with minimum of 5 years
experience in collegiate programme. Ph.D (N) is desirable.

27. c) Professor - 10 years experience with M.Sc (N) out of which 7 years should be
teaching experience. Ph.D (N) is desirable.
d) Associate Professor / Reader - M.Sc(N) with 8 years including 5 years teaching
experience. Ph.D(N) is desirable.
e) Assistant Professor / Lecturer – M.Sc(N) with 3 years teaching experience.
Ph.D(N) is desirable.
f) Tutor / Clinical Instructor - M.Sc (N) or B.Sc (N) / P.B.B.Sc (N) with 1 year
experience.

28. Staff Pattern as Per INC in College
S.NO Designation B.Sc.(N) Students
61 - 100
P.B.B.Sc.(N)
Students 20 - 60
1 Professor Cum
Principal
1
2 Professor Cum Vice
Principal
1
3 Professor 1
4 Associate Professor 4
5 Assistant Professor 6
6 Tutor 19 - 28 2 - 10
Teacher - Student
Ratio To Be
Maintained is 1:10

29. S.NO Designation M.Sc.(N) Students
10 - 25
1 Professor And Programme
Co-Ordinator
1
2 Associate Professor 1
3 Assistant
Professor/Lecturer
2

30. The Trained Nurses Association of India (TNAI)
The Trained Nurses Association of India (TNAI) is a professional organization representing
trained and qualified nurses in India.
Recommendations:
• Improved Working Hours: TNAI suggests that nursing staff should work in shifts,
ensuring that they do not exceed the prescribed working hours.
• Adequate Staffing: to ensure that nurses are not over burdened with excessive workload,
allowing them to provide quality care to patients.
• Provision of Adequate Infrastructure: Suitable working environment, including
appropriate facilities and equipment would enable nurses to perform their duties efficiently
and comfortably.

31. • Fair Salary and Benefits: TNAI advocates for competitive and fair compensation for
nursing staff in line with their qualifications and experience.
• Continuous Professional Development: TNAI suggests that nurses should have access
to ongoing training and education opportunities to enhance their skills and knowledge.
• Occupational Health and Safety Measures: TNAI recommends the implementation of
strict measures to ensure the occupational health and safety of nursing staff.
• Mental Health Support: TNAI recommend the provision of counseling services and
regular mental health check-ups to address work-related stress and burnout.

32. The nurse-patient ratio as per the norms of TNAI AND INC [1985]
1. chief nursing officer : 1/500 beds
2. Nursing Superintendent : 1/400 beds or above
3. Deputy Nursing superintendent : 1/300 beds and 1 additional for every 200 beds.
4. Assistant Nursing superintendent : 1 for 100-150 beds or 3-4 wards
5. ward sister : 1 fir 25-30 beds or one ward with 30% leave reserve
6. Staff nurse : 1 for 3 beds in teaching hospital in general ward and 1 for 5 beds in non teaching
hospital +30% leave reserve.
7. Extra nursing staff to be provided for departmental research function.
8. For OPD and emergency : 1 staff nurse for 100 patients + 30% leave reserve.
9. For intensive care unit : 1:1or 1:3 for each shift +30% leave reserve.
10. It is suggested that for 250 bedded hospital there should be one infection control nurse For
specialized departments, such as; OT,labor room etc.,1:25+30% leave reserve

39. Staff Requirement Calculation On a
Yearly Basis For 100 Patients
Example:
• Days in a year : 365
• Days off weekly : 52
• Earned leaves : 30+1 Saturday/month
[12]
• Casual leaves : 12
• Public holidays: 18
• Sick leaves: 10
Total working days 365 – leaves 122 =
243 days
1 nurse : 243 days per year
Example :
• Suppose 20 nurses work for 243 days
20 × 243 = 4860 days
• To compute the number of nurses available per
day, divide 4860 with number of days in a year
4860/365 =13.31
Round off = 13 nurses
If 13 nurses work 8 hours / day, Then they may be
assigned
• Morning shift = 6 [1:17]
• Evening shift = 4 [1 :25]
• Night shift = 3 [1:35]

40. SCHEDULING
• Scheduling is defined as time based plan of events with staff.
• These include: key steps and considerations

41. Evaluate patient needs: Assess the number and acuity of patients requiring nursing
care. This will help determine the required number of nurses per shift.
Determine workload: Consider the specific tasks and responsibilities of nursing
staff during each shift. These may include administering medications, conducting
assessments, providing direct patient care, and coordinating with other healthcare
professionals.
Steps & considerations of scheduling

42. Understand staff availability: Take into account the availability and preferences
of each staff member. Nurses may have specific days or times when they are
unavailable due to personal commitments or part-time work arrangements.
Consider nurse-to-patient ratio guidelines: Refer to nursing standards and
regulations to determine the recommended nurse-to-patient ratio for different
units and patient populations. Adhere to these guidelines while creating the
schedule.
Address staffing requirements: Make sure to have appropriate staffing levels to
meet patient needs and maintain a safe work environment. This includes
accounting for different shifts, weekends, holidays, and fluctuations in patient
volume.

43. Utilize scheduling software: IT can help automate the scheduling process, taking into account
various factors such as; shift preferences, labour laws, and overtime regulations.
Balance workload: Distribute the workload evenly among nursing staff by considering their
experience level, skills, and capabilities to avoid burden.
Communicate effectively: Maintain open communication with nursing staff to ensure their
availability provide notice of their assigned shifts.
Allow flexibility: Incorporate a system that allows nurses to request shift swaps or time-off requests,
provided it can be accommodated without compromising patient care.
Monitor and adjust: Continuously monitor the effectiveness of the nursing staff schedule and make
adjustments as necessary. Evaluate patient outcomes and feedback from the nursing team to identify
any areas for improvement or adjustment in the schedule.

44. Types of staff scheduling
Fixed Staff Scheduling: nurses are assigned to a fixed schedule that remains the
same week after week. This can be helpful for nurses who prefer a consistent work
schedule.
Rotating Staff Scheduling:
nurses work through a series of shifts that include days, evenings, and nights. This
type of scheduling ensures that nurses have experience working in different shifts
and helps distribute the workload evenly.

45. Self-Scheduling:
Self-scheduling allows nurses to have some control over their work schedule. They can
choose their preferred shift and days off based on the availability and the needs of the
unit.
On-call Staff Scheduling: Nurses who are on-call are not assigned a fixed schedule
but are available to be called in to work when needed. This type of scheduling is often
used for emergency situations or to cover unexpected absences.

46. Part-Time Staff Scheduling: Some nurses prefer to work part-time and have a
reduced number of hours compared to full-time nurses. Part-time scheduling allows
flexibility for nurses in working hours.
Split-Shift Staff Scheduling: Split-shift scheduling involves dividing nurse’s shifts
into two or more parts during a day with a break in between. This can be useful for
providing coverage during peak hours or when there is a need for extended service.
Furlough Staff Scheduling: Furlough scheduling refers to temporarily reducing or
suspending staff due to unforeseen circumstances or budget constraints. This may
involve rotating staff members or reducing work hours for a specific period.

47. Team Nursing Staff Scheduling: team of nurses are assigned to specific units or
patients. Each team works together to provide care for the assigned patients, leading
to effective collaboration and shared responsibilities.
Agency Staff Scheduling: In some cases, healthcare facilities may require additional
staff to cover shortages or to meet increased patient demand. Agency staff scheduling
involves hiring temporary nurses from nurse staffing agencies to fill in these gaps.
Floating Staff Scheduling: Floating scheduling involves transferring nurses from
one unit or department to another based on the needs of the facility. This helps ensure
that all areas of the hospital or healthcare facility are adequately staffed.