You are the manager of a medical-surgical unit. The unit has 32 beds and an occupancy rate of 75%. The desired staffing mix consists of four RNs, two LPNs/LVNs, and two nursing assistants on the 7 AM to 3 PM shift; three RNs, one LPN/LVN, and two nursing assistants on the 3 PM to 11 PM shift; and two RNs, one LPN/LVN, and one nursing assistant on the 11 PM to 7 AM shift. Determine how many FTEs of each category of employees will be necessary to cover the staffing expectations. Remember, this division will operate 24 hours every day, including weekends and holidays. FTE information can be found on page 370 in Chapter 20.

Activity 13-1

Using the formulas in Box 13-6, the32-bed unit just described, determine (a) to what average daily census (ADC) a 75% occupancy rate equates. Now assume that the actual number of patient days in the past month was 836. Using the formula in Box 13-6 of the text, (b) calculate the real ADC. Finally, assume that during the past month, 102 discharges occurred. (c) Determine the average length of stay.

a.

b.

c.

Activity 13-2

You have called a staff meeting and have encouraged the staff to bring concerns regarding staff satisfaction. The focus of this meeting is to consider a new approach of self-scheduling. Before looking at how such an approach could actually be implemented, you want staff to consider the pros and cons of the current approach (a managerial function) versus the pros and cons of the potential approach (a self-scheduling approach). Complete the following chart to illustrate and clarify the dilemmas, benefits, issues, and problems associated with each.

Positives to Self-Scheduling	Negatives to Self-Scheduling
1.	1.
2.	2.
3.	3.
4.	4.
5.	5.
Positives to Managerial Scheduling	Negatives to Managerial Scheduling
1.	1.
2.	2.
3.	3.
4.	4.
5.	5.

Now assume that you and your group decide to initiate self-scheduling on a trial basis. Before initiating this new approach, you will need to write some guidelines for self-scheduling. Review the chart above for ideas.

Guidelines for Self-Staffing (Proposed)

1.

2.

3.

4.

5.