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Chapter Four

- Distribution of work among nursing staff members

. Objectives of distributing work to the nursing staff

These goals include the following:

  • Giving good and continuous nursing care to patients
  • Using the skills and information of each level of the nursing staff
  • Allow sufficient time for training and orientation for new nurses
  • Raising the level of nursing performance according to work requirements, taking into account the development that occurs
  • Prepare a master plan for distributing nursing personnel to the hospital or unit based on an assessment of the needs of patients or service beneficiaries
  • Raising employee morale

:Factors that affect the distribution of work among nursing staff

These factors include the following:

  • Constant change in the number of patients
  • Absences, vacations, and vacations among nurses
  • Poor distribution of nurses
  • Nursing staff performing non-nursing work
  • Job dissatisfaction

Factors that help the head of nursing staff when distributing nursing work:

When distributing nursing work to members of the nursing staff, factors specific to nurses, patients, tools, machines, and the work environment must be taken into account, which include the following:

  • Full awareness and knowledge of the nature of work
  • Taking into account the individual differences and abilities of workers, for example: when a nurse is new, she must be trained to develop skills
  • Developing appropriate work plans to develop employees
  • Clearly define each individual's responsibilities and distribute the work in writing, making sure they do not overlap
  • Arranging and organizing the various parts of the work distribution plan in writing
  • Ensure that each individual knows the work assigned to him
  • Anticipate emergencies and prepare for them
  • Observing, directing and evaluating employees’ performance
  • Giving direct orders when needed and emergency
  • Get the group's opinion to volunteer to perform a specific job
  •  Giving directions in the form of a request, not an order

:Methods of distributing work

There are three ways to distribute work to nurses: 

1. Functional method:

This method depends on assigning one or more specific nursing activities to each member of the nursing staff to carry out for all patients, for example carrying out treatment - wound dressings...etc.

Advantages of this method:

  • You need fewer nurses
  • time saving
  • The nurse gains skill in this activity

Disadvantages of this method:

  • Segmentation of nursing care for the patient among nurses
  • Do not give an opportunity to observe the patient and educate him about his health

2. Status method

          This is an ideal method as it gives complete nursing care to the patient by one nurse, and it is often used with patients who need special care.

Advantages of this method:

  • Strengthens the relationship between patient and nurse
  • Makes it easier to observe the patient's condition
  • It helps to acquire multiple nursing skills.

Disadvantages of this method:

  • Expensive
  • You need a large number of nurses

3. Team method:

          In this method, all patients are assigned to a number of nurses, and activities and tasks are distributed according to their scientific and practical abilities and according to the patients’ needs. The team consists of a qualified nurse/nurse assistant/student, and the purpose here is to benefit from all experiences.

Advantages of this method:

  • Take responsibility
  • Creating good working relationships between employees
  • Giving the opportunity to develop
  • Using employees' skills and abilities efficiently
  • Facing different work situations

Disadvantages of this method:

  • Conflicts occur between team members
  • Needing more time to complete the work
  • Failure to limit liability

Examples of schedules for distributing nursing activities to hospital nursing staff members:

Table (1): Distribution of nursing activities among nursing staff members, following the case method

 Name of the nurse in charge

 Nursing and medical activities to be implemented

 Diagnosis

Patient name


Table (2): Distribution of nursing activities among nursing staff members, following the job method:

Nursing and medical activities to be implemented

Nurse's name



Table (3): shows the distribution of nursing activities among nursing staff members, following the team method:

Name of the nurse in charge

Nursing and medical activities to be implemented

 Diagnosis

Patient name

Bed number


Functional rates

Good planning includes having a vision of the workforce for optimal performance of tasks, and this includes determining the required types in addition to numbers. The following example shows planning the functional rates of the nursing staff in public and central hospitals:

The strength required of the nursing staff

Section

Head of nursing staff

  Two agencies (one for training and continuing education and the other for administrative work)

 Infection control team, training team with a nursing assistant for training

Quality Team: Each team consists of at least 2 nursing specialists and may increase depending on the size of the hospital

Nursing Administration

 Nursing specialists are distributed as supervisors and unit heads to all units over a 24-hour period, and a periodic evaluation is conducted for all supervisors to determine the extent of their leadership capabilities and their ability to change.

  Development (experience required)


Nursing specialists


A nurse for each clinic except clinics that have intervention, such as (surgery 2 - women 2)

Clinics

External

All reception rooms are covered by nursing staff evenly 24 hours a day to ensure continuous service

For emergency patients

 Reception operations

3 nurses in each operating room

 Nurse for every 2-4 machine

Hemodialysis

 Nurse for every 1-2 cases

 Intensive care

 A nurse for a ventilator case - a nurse for every 4 cases of jaundice in the blood

Nurseries

One nurse for every 7-9 inpatient cases

Internal departments


Note from the previous example:

  • The working unit of the internal department was considered to be 2 beds
  • A 1% reserve is added for each type of service to cover vacations and absences
  • Added to each unit is a specialized service, such as intensive care, artificial kidneys, and premature infants. There are 3 nursing specialists for each unit + 1 nursing technician for every 1 bed in each shift.
  • These rates were calculated on the basis that the family occupancy rate is 1%.