Grohar-Murray TIF
Chapter 14: Managing Resources: The Staff
Learning Objective 1
Explain the staffing process.
1. The nurse manager examines data to assist in determining the correct staffing plan for
the night shift. Which of the following information will be useful? Select all that apply.
1. The unit’s client occupancy rate has been between 97 and 100% over the
last 2 months.
2. The average client length of stay has been 3.4 days.
3. Over the last 2 months, 24–32% of the clients have required a Foley
catheter to be inserted.
4. One month ago, the unit started accepting postoperative laparoscopic
cholecystectomy surgical clients.
5. During the last 2 months, 76% of the clients have required a dressing
change.
2. The nurse manager is evaluating the staffing patterns for the unit over the last 3 months.
Which of the following statements by the nurse manager is the best description of the way the
nurse manager should approach staffing?
1. “The Joint Commission on the Accreditation of Healthcare Organizations is the most
knowledgeable regarding hospital staffing needs, and they should be consulted
regarding unit staffing activities.”
2. “The American Association of Nurses can be consulted to help the nurse manager
determine a staffing plan for the unit.”
3. “The health care organization’s administrators dictate the staffing plan that is to be
used throughout the organization.”
4. “The nurse manager must use the principles set forth by the American Association of
Nurses and the Joint Commission on the Accreditation of Healthcare Organizations to
help determine staffing on the unit, but must take into account the specific client
population on the unit.”
3. Determine the nursing staff productivity index. The unit standard is 8 nursing hours per
patient day (NHPPD). There are 22 patients. 9 RNs are staffed for 24 hours. Patient days
= 10 days. Round your answer to a whole percentage point.
4. The nurse supervisor is studying the staffing schedules of four different units. Based on the
client acuity classification system, which of the following units is most likely to have the highest
NHPPD (nursing hours per patient day)?
1. Outpatient ambulatory clinic
2. Critical Care Unit
3. Medical–Surgical Unit
4. Oncology Unit
Learning Objective 2
Examine the staffing methodologies.
5. The nurse manager determines that four registered nurses are needed to adequately
provide care for 16 clients on the unit during the night shift. Which of the following
statements indicate that the nurse manager is utilizing descriptive methodology to
determine staffing needs?
1. “I use client data like the average unit census and the average length of stay. I
plug these data into a formula and that’s how I determine staffing.”
2. “I include information that we learned about how long it takes to perform
certain nursing tasks to determine staffing needs.”
3. “After I take a look at the client acuity levels on the unit, I usually rely on my
‘gut instinct’.”
4. “We use information that comes from the nurse supervisors to determine
staffing needs based on how we care for clients on our unit.”
6. A nurse manager needs to supplement the staff for the next schedule. The nurse
manager examines the unit’s operating budget. Which of the following is the most costly
to the health care organization?
1. Personnel from the general float pool
2. Personnel from the unit-based float pool
3. Per diem staff
4. Utilizing the shared staffing help list
7. One of the nurses scheduled to work in the Critical Care Unit has called in to report
that the nurse is unable to work due an illness. The nurse manager is deciding how to
cover the shift with another nurse. Which of the following nurses most likely will be able
to provide the unit with continuity of care?
1. Per diem nurse
2. Unit-based float pool nurse
3. General float pool nurse
4. A nurse from any area with a decreased census
8. The nurse manager has open shifts on the Medical–Surgical unit. The manager listed the open
shifts on the hospital’s intranet system. There is a central staffing manager who helps fill open
shifts with nurses who are willing to work extra shifts. This is an example of which type of
scheduling?
1. Shared staffing help list
2. The Baylor plan
3. Job sharing
4. Combination plan
Client Need: Safe, Effective Care Environment
Cognitive Level: Comprehension
9. The Neurology Unit has an increased client occupancy rate. The nurse manager has decided to
use staff members from the unit-based float pool. Which of the following statements by the nurse
manager is the best example of this concept?
1. “I’m going to call and see if some our normal staff members on this unit will help me
cover the open shifts.”
2. “I think I’m going to use the specific Neurology float pool to cover these shifts.”
3. “An Intensive Care Unit nurse could work on this unit easily.”
4. “I’m going to contact the shared staffing help list to cover these shifts.”
10. The nurse managers are discussing the various staffing methodoligies that can be used
to develop a staffing plan. Which of the following statements about these concepts is the
most accurate?
1. “The industrial engineering methodolgy seems to be based mostly on the
nurse manager’s insight and experience about what will work best for the
unit.”
2. “The management engineering methodolgy uses only work sampling and
time-and-motion studies to help determine a staffing plan.”
3. “It’s really difficult to rely totally on the industrial engineering methodology
because sometimes we need to use some subjective information to staff our
units well.”
4. “Descriptive methodology uses an expert panel to examine staffing patterns
throughout the organization.”
11. The full-time nurses on the unit and the nurse manager are discussing the use of a
combination plan to schedule nurses on this unit. Which of the following statements by a
nurse is most commonly applicable to the traditional 8-hour shift, 40-hour work week?
1. “I am always so tired after I work this shift. I don’t know how long I can keep
it up.”
2. “It seems like my whole day is spent working.”
3. “It seems like I’m always at work.”
4. “I have a lot of free time each week.”
12. The nurse manager decides to use the Baylor plan to staff the unit. Which of the
following statements by the nurse manager indicates that further teaching is required?
1. “It’s going to be nice to have everyone working a 12-hour shift throughout
this 30-day schedule.”
2. “This will be nice for the people who don’t want to work the weekend.”
3. “I think this is going to be easy. I have people working 12 hours on the
weekend and 8 hours through the week.”
4. “This will be good for people who like to travel through the week and would
rather work the weekend.”
Learning Objective 3
Describe management’s role in the staffing program.
13. Nurses on the unit are discussing their current staffing pattern on the day shift, how it
relates to legislation in California, and relevant research about this subject. Which of the
following statements by the nurse indicates that further education regarding this subject is
required?
1. “These research studies can positively impact our ability to provide safe and
effective client care.”
2. “Plenty of meaningful research studies have already been done on this subject,
and they all validate the need for very specific nurse-to–client ratios.”
3. “Research studies are currently being conducted to determine how staffing
patterns affect specific client outcome data.”
4. “It will be interesting to examine the results of the studies to see how well
specific nursing interventions affect client outcomes.”
14. A new Neonatal Intensive Care Unit has been developed, and staffing for the unit currently is
being determined by the nurse supervisor and nurse manager. Rank the following steps of the
staffing plan in order.
____ They examine the health care organization’s policies and procedures. They select the
management engineering methodology and determine that the unit needs to hire 11
registered nurses and two unlicensed staff members.
____ They develop a policy regarding staff tardiness after analyzing data from area hospitals
regarding their Neonatal Intensive Care Units.
____ They develop a statement regarding unit-specific standard of care and types of services
that will be provided on this unit.
____ They begin to develop a staff-assignment pattern to meet the needs of clients who will be
on the unit.
Answer:
15. The nurse manager’s unit has been very short-staffed due to an increased number of
employee health issues. The nurse manager began enforcing mandatory overtime for the
remaining staff to cover open shifts. The nurse manager is examining a recent set of incident
reports that occurred on the unit. Which of the following employee incidents might be related to
these staffing issues? Select all that apply.
1. Sixteen units of regular insulin were ordered for the client, but the nurse gave 61 units
of regular insulin.
2. All of the clients under the nurse’s care received their 9 a.m. medications after 11:30
a.m.
3. The nurse slipped on a wet floor after the client spilled his water on the floor.
4. The nurse was injured while attempting to turn a 420-pound person alone.
5. The nurse gave the client another client’s medications.
