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Improve Scheduling To Boost Nurse Satisfaction

Karla Schnell, for HealthLeaders Media, June 8, 2010

A major concern in healthcare today is the nursing shortage, which promises to get worse as the number of people choosing this profession declines while demand for their services continues to grow.

During my career as a registered nurse, I experienced the lifestyle of these caregivers. While nursing is very rewarding, it comes with struggles: long hours, unexpected overtime, and erratic schedules. This can make nurses' lives emotionally and physically draining.

If we could normalize nursing schedules, not only could we make their lives a little less stressful, we could maximize staffing efficiency for providers, lower their personnel costs, and perhaps contribute to the long-term viability of this important profession.

Here are some of the steps to take to improve conditions for nurses:

  • Don't let scheduling be an afterthought. Make sure there is a structure in place so that administrative scheduling doesn't fall on nurses who should be providing care. Be ready for last-minute changes and have a system in place so that everyone knows what to expect.
  • Provide staff schedules in advance. Scheduling problems can make it challenging for nurses to manage family commitments and maintain a satisfying quality of life. Nurses often work long hours and inconsistent shifts, leading to burnout, fatigue, and health problems. Some are given their schedules just two weeks in advance and are frequently asked to work overtime shifts without notice, which makes it hard for them to take care of the day-to-day activities we all take for granted. Hospitals that offer nurses regular schedules, months in advance, will be more successful at recruiting and retaining them. This gives a hospital the upper hand in an industry where there is a shortage of talent and constant competition for the best.
  • Increase continuity of care. Continuity of care, when nurses provide care for a patient for consecutive days, allows nurses to get to know their patients, their conditions, and their treatment plans much better than if they are assigned to a different patient every day. This can improve patient safety and patient satisfaction. An efficient staff-scheduling process can have a major effect on the ability to provide maximum continuity of care.

Every healthcare organization should step back and evaluate the scheduling process for nurses. While this may seem like a small issue on the surface, it can have a serious effect on a company's bottom line. The largest expenditure for a hospital is its nurses. While it is expected that the nursing staff will naturally have some overtime, approximately 2%-3% of the budget, most hospitals are experiencing unnecessarily high overtime, around 6%-8% of the budget. By harnessing this overspending, a hospital can save a significant amount of money, and free funds to be reinvested into patient care, equipment to improve overall care and efficiency, or other strategic projects.

The potential to provide a safer patient experience is reason enough to pursue the goal of a more balanced scheduling approach, but the additional opportunity to take care of precious and scarce human and financial resources drives the issue to the forefront. We have an opportunity to make a very positive impact on all involved by managing our staff scheduling process better.


Karla Schnell is a consultant with North Highland and works with major national providers throughout the United States. She began her career as a nurse in Canada more than 20 years ago and quickly moved up the ranks to become one of the youngest nursing directors in the Province.
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