8 Nursing Staffing Models to Try

How to offer secure and effective patient care AND meet the changing needs of nurses? Innovative models of nurses’ employment will be the answer. Committing to finding and implementing recent staffing models is an amazing method to show nurses that you simply support their well-being and exertions.

“Organizations are getting very creative when it comes to all kinds of out-of-the-box solutions,” said Carol Boston-Fleischhauer, managing director and director of nursing research at The Advisory Board Company.

Great motivation for change

The data shows an urgent must modernize existing staffing models. ABOUT one third A recent McKinsey & Company study shows that nurses are planning to go away their current positions. In a 2013 report by the American Association of Critical Care Nurses (AACN). over 9,000 nurses were surveyedonly 24% said that they had adequate staff greater than 75% of the time. According to a different, a majority of nurse leaders (92%) expect nursing shortages to worsen report.

“We know this for the next decade – literally decade – providing enough nurses for the growing number of people needing care will be a challenge,” said Claire Zangerle, DNP, MBA, RN, NEA-FC, FAONL, FAAN, chief nursing officer at Allegheny Health Network (AHN ).

It could also be helpful for nurse leaders to think about nurse shortages as a chance to leave outdated staffing models. “The current health care environment provides a unique impetus for research innovative approaches” said Cynde Gamache, DBA, RN, NEA-BC, vice chairman and chief nursing officer at Southeast Georgia Health System.

Innovative models of nurses’ employment

Why are nurses leaving? They might want a unique role or care setting, a more flexible schedule, or a break from direct care. “If we only did one thing, we wouldn’t be successful,” Zangerle said.

Nurses tackle recent roles at Ann & Robert H. Lurie Children’s Hospital of Chicago:

• Education authorities (to support newer night shift nurses)
• Mentors of clinical excellence in cardiology departments
• Shared inpatient and outpatient roles inside specialties (e.g., hematology/oncology, where nurses work in each inpatient units and outpatient infusion centers)
• Support staff of their roles as needed (e.g. admission and discharge nurses)
• Asthma specialists (to coach patients before discharge from hospital)

“We allowed each department to determine what works for their team and patient population,” said Karen Richey, DNP, MBA, RN, NEA-BC, associate chief nursing officer for hospital services at Ann & Robert H. Lurie Children’s Hospital of Chicago.

Diverse HR solutions

Nursing leaders are moving away from a one-size-fits-all workforce mindset. Nurses are succeeding with these progressive employment models.

LPN use in acute care

Many Licensed Practical Nurses/Licensed Vocational Nurses (LPN/LVN) seek employment in postoperative care settings (nursing homes, expert nursing facilities, assisted living facilities) or outpatient settings. “We are working with local vocational schools to invite LPNs participating in these programs to work in acute care,” Zangerle said.

LPN/LVN scope of practice varies by state and must be included on this model. At a minimum, the workload relief that an LPN/LVN can provide includes patient care tasks corresponding to changing dressings and documenting admission and discharge. “This allows the RN to continually assess the patient, communicate with the care team, and use other key skills that allow RNs to practice at the highest level of licensure,” Zangerle explained.

Team care

The Covid-19 pandemic has highlighted the importance of cross-training nurses to work beyond their specialties to fulfill care needs. “Every member of care teams must be fully engaged to optimize patient care and outcomes,” said Stacey Chappell, director of advocacy and external communications for the American Organization of Nurse Leadership (AONL).

Approximately 40% of AHN hospital departments have moved to a team model, by which a gaggle of patients is cared for by a team of nurses. Nurses can cover for one another, allowing for breaks to eat or use the lavatory. “We are seeing extraordinary results in patient safety, experience, quality and, especially, employee engagement and well-being,” Zangerle said.

Flexible schedule

“We kind of got out of our way when it came to nursing and threw away some of our rigid schedules,” Zangerle said. Instead of offering strict 12-hour shifts, nurses may match in four-hour blocks, eight-hour shifts, only on weekends, or only at night. Another incentive: Nurses receive extra pay for working off-shifts.

“Hybrid” positions.

The goal is to increase the careers of direct care nurses who want less stress. Nurses may match part-time in direct care and part-time in one other role (e.g. research nurse or care manager). “This gives them one of the best of each worlds. This is a highly regarded solution amongst our nurses,” Zangerle said.

Internal human resources

In the summer of 2022, Southeast Georgia Health System established a Nursing Resource Pool. So far, the program has employed 47 nurses. “Flexibility is expected in this role,” Gamache said. Nurses agree to work full-time at the pool for 26 weeks and are assigned to whichever hospital needs them. “The staff is permanent and nurses receive a higher rate of pay,” she added.

I will employ nursing students as nursing assistants

To support their nursing staff, some organizations include nursing students in their workforce. “This prepares them to start working as a new graduate nurse in a nurse residency program,” Richey said.

Own employment agencies

“This is a growing trend for larger systems,” Boston-Fleischhauer said. Nurses receive logistical support in terms of travel and accommodation. Compensation depends on the degree of flexibility the nurse is willing to accept. Internal agency employees are viewed as permanent employees who support the system’s mission, vision and culture. “This is a stark contrast to the situation in which RNs from outside agencies take on temporary employment with a specific institution,” Boston-Fleischhauer said.

Virtual care

Over 40% nurses provided care virtually in 2021. AHN hospital nurses collaborate with a virtual nurse via iPad to discharge patients. “This same process is intended to relieve staff nurses of some of the hospital admission-related tasks,” Zangerle said.

Remote support can reduce the burden of care that doesn’t require physical presence. “This allows the nurse practitioner to focus on physical assessment, medication administration and mobility,” said Sarah A. Delgado, MSN, RN, ACNP, clinical practice specialist at AACN.

Maximize your success

Changing existing staffing models is difficult. This is typically seen as disrupting skilled, organizational and cultural norms. “Engaging frontline workers in model design is critical, as is investing in staff training, change management and coaching,” Boston-Fleischhauer said.

Regardless of which progressive nurse staffing model you are trying, it’s important that nurses are involved in the method. “Provide direct care nurses with paid time to participate in or lead each stage of development and implementation,” Delgado advises.