Nursing administration

Introduction
UNIT V
HUMAN RESOURCESFOR HEALTH
1. STAFFING METHODS AND PHILOSOPHY
Organization is the formal structure of authority calculated to define, distribute and
provide for the co-ordination of the tasks as contribution to the whole. When the aims of
the organization properly design the planning of its institutions and its functional standard,
it will have identified the kind and numbers of personnel it needs.
The nurse executive or head of the institution will be the top of the organization. His/ her
powers and duties have, therefore, to be all-embracing and he has to develop a great share
of theirs to his subordinates, but even after doing so, he has to supervise, control and co-
ordinate that work.
Kind of staff:
The concept of Line and Staff, developed first in military organization was
barrowed from there and applied to civil organization and administration. Line refers to
the officers and units that assist the chief and other executives in their function of
planning, organization, direction, co-ordination, control, etc.,
There are three kinds of staff services and units- General Staff, Technical Staff and
Auxiliary Staff.
General staff: is the staff which helps the chief or other highly placed executive in his
administrative work generally, by advice, collection of information, research and shifting
of the important from unimportant ones, which is to go up to him, i.e. they act as filter and
funnel.
Technical staff: Consists of the technical officer who are qualified in their own field, like
engineers, doctors, nurses and experts etc.
Auxiliary staff: Consists of officers or units which perform certain duties and functions
common to the various departments but which are incidental in character, i.e. not directly a
part of those department main activities.
Terminologies
Staffing: Staffing is the systematic approach to the problem of selecting, training,
motivating and retaining professional and non professional personnel in any organization.
Promotion: To excel in a situation , rank or honor , to elevate or to advance from a given
grade or class as qualified for on higher.
Budget : A budget is a plan that uses numerical data to predict the activities of an
organization over a period of time.
Utilization : This means the nursing personnel must be assigned work in such a way that
her/his knowledge and skills are learnt best used for the purpose she/he was educated or
trained.
Responsibility : It is the obligation to account for‘s ones conduct with respect to our
assigned talk.

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STAFFING
Definition
Staffing is the systematic approach to the problem of selecting, training, motivating
and retaining professional and non professional personnel in any organization.
It involves manpower planning to have the right person in the right place and avoid
―Square peg in round hole‖.
Staffing Philosophy
Staffing is certainly one of the major problems of any nursing organization,
whether it is a hospital, nursing home, home health care agency, ambulatory care agency
or another type of facility.
Nurse staffing methodology should be an orderly, systematic process, based upon sound
rationale, applied to determine the number and kind of nursing personnel required to
provide nursing care of a predetermined standard to a group of patients in a particular
setting. The end result is prediction of the kind and number of staff required to give care to
patients. Aydelotte.
Components of the staffing process as a control system include a staffing study, a
master staffing plan, a scheduling plan, and a nursing management information system
(NMIS).
NMIS includes these five elements;
1. Quality of patient care to be delivered and its measurement.
2. Characteristics and care requirements of patients.
3. Prediction of the supply of nurse power required for components 1 &2.
4. Logistics of the staffing program pattern and its control.
5. Evaluation of the quality of care desired, thereby measuring the success of the
staffing itself.
Philosophy of staffing in nursing
Nurse administrators of a hospital nursing department might adopt the following
philosophy.
1. Nurse administrators believe that it is possible to match employee‘s knowledge
and skills to patient care needs in a manner that optimizes job satisfaction and
care quality.
2. Nurse administrators believe that the technical and humanistic care needs of
critically ill patients are complex that all aspects of that care should be
provided by professional nurses.
3. Nurse administrative believe that the health teaching and rehabilitation needs
of chronically ill patients are so complex that direct care for chronically ill
patients should be provided by professional and technical nurses.
4. Should believe that believe that patient assessment, work quantification and job
analysis should be used to determine the number of personnel in each category
to be assigned to care for patients of each type (such as coronary care, renal
failure, etc.,).
5. Should believe that a master staffing plan and policies to implement the plan in
all units should be developed centrally by the nursing heads and staff of the
hospital.
6. Should the staffing plan should be administrated at the unit level by the head
nurse, so that can change based on unit workload and workflow.

3
Mr. Channabasappa.K.M. PCON.
Staffing Policies
A policy is a predetermined and accepted curse of thoughts and actions established
as a guide towards accepted goals and objectives. Policies are generally framed by the
board of directors or the higher management while procedures are framed by high
officials.
Personnel policies serve as a guide toward the organizational purposes and assist in
preventing decisions contrary to its objective. Personnel policy is a total commitment of
the organization to act in the specified ways.
Personnel Policies gives
1. This is a predetermined course of rules or actions.
2. Policies guide the performance of objectives.
3. Policies provide the standard or ground for the decision.
The process of developing personnel policies involves the assessment of following factors:
 Identification of the purpose and objectives, which the organizations wish to attain
with regard to its work force.
 Analysis of all the factors under which the organization‘s personnel policy will be
operating.
 Examining the possible alternatives in each area in which the personnel policy
statement is necessary.
 Implementation of the policy through the development of procedures adapted to
the entire organization.
 Auditing the policy so as to reveal the necessary change.
 Continuous re-evaluation and revision of policies to meet the current needs of the
organization.
Objectives of staffing in nursing
1. Provide an all professional nurse staff in critical care units, operating rooms, labor,
delivery unit, emergency room.
2. Provide sufficient staff to permit a 1:1 nurse-patient ratio for each shift in every
critical care unit.
3. Staff the general medical ,surgical ,Obsteritic and gynecology, pediatric and
psychiatric units to achieve a 2:1 professional –practical nurse ratio.
4. Provide sufficient nursing staff in general medical, surgical, Obsteritic, pediatric
and psychiatric units to permit a 1: 5 nurse-patient ratio on a day and after noon
shifts an d1:10 nurse –patient ratio on the night shift.
5. Involves the head of the nursing staff and all nursing personnel in designing the
department overall staffing programme.
6. Design a staffing plan that specifies how many nursing personnel in each
classification will be assigned to each nursing unit for each shift and how vacation
and holiday time will be requested and scheduled .
7. Hold each head nurse responsible for translating the department master staffing
plan to sequential eight week time schedules for personnel assigned to her / his
unit.
8. Post time schedules for all personnel at least eight weeks in advance.

4
9. Empower the head nurse to adjust work schedules for unit nursing personnel to
remedy any staff excess or deficiency caused by census fluctuation or employee
absence.
10. Inform each nursing employee that request for specific vacation holiday time will
be honored within the limits imposed by patients care and labor contract
requirements .
11. Reward employees for long term services by granting individuals special time
requests on the basis of seniority.
Unit checklists of employee staffing policies
1. The person responsible for the staffing schedule and the authority of the
individuals if it is other than the employee immediate supervisor.
2. Type and length of the staffing cycle used
3. Rotation policies , if shift rotation is used
4. Fixed shift transfer policies , if fixed shifts are used.
5. Time and location of schedule posting
6. When shifts begins and end
7. Day of week schedule begins
8. Weekend off policy.
9. Tardiness policy
10. Low census procedures
11. Policy for trading days off
12. Procedure for days off request
13. Absenteeism policies
14. Policy regarding rotating to other units
15. Procedures for vacation time requests
16. Procedure for holiday time requests
17. Procedures for resolving conflicts regarding requests for days off, holidays, or
requested time off.
18. Emergency requested time off
19. Policies an procedures regarding requesting transfer to other units.
Staffing study
A staffing study should gather data about environmental factors within and outside the
organization that affect staffing requirements.
Aydelotte listed four techniques drawn from engineering to measure the work of nurses,
all of which involve the concept of time required for performance.
1. Time study and task frequency
a. Tasks and tasks elements (procedure )
b. Point and time started
c. Point and time ended
d. Sample size
e. Average time
f. Allowance for fatigue , personal variation and unavoidable standby.
g. Standard time = step 1.5 + step 1.6

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h. Frequency of task × standard time = volume of nursing work.
2. Work sampling ( variation of task frequency and time ); the procedure is as follows
a. Identify major and minor categories of nursing activities
b. Determine number of observation to be made
c. Observe random sample of nursing personnel performing activities.
d. Analyze observations: frequency occurring in a specific category = percentage
of total time spent in that activity. Most work sampling studies sample direct
care and indirect care to determine ratio.
3. Continuous sampling (variation of task frequency and time). Technique is the same
as for work sampling except that,
a. Observer follows one individual in the performance of a task.
b. Observer may observe work performed for one or more patients if they can be
observed concurrently.
4. Self-reporting ( variation of task frequency and time )
a. The individual records the work sampling or continuous sampling on himself
or herself.
b. Tasks are logged using time intervals or time tasks start and end.
c. Logs are analyzed.
According to West, ―There are three cardinal rules forecasting staffing requirements‖. The
first is to staffing projections on past staffing history; data sheet collected census report
and other data needed are sick time, overtime, holiday and vacation time.
The second cardinal rule for staffing is to review current staffing levels. Review of future
plans for the institution is the third cardinal rule. Clinical nurses who are involved in
staffing plans will have confidence in the plans. These staffing studies can be made with
electronic spreadsheets.
Staffing Methods/ Procedure
Staffing modules
Cyclic scheduling
It is one of the best ways of staffing to meet the requirements of equitable distribution of
hours of work and time. A basic time pattern for a certain number of weeks is established
and then repeated in cycles. Advantages of cyclic scheduling include the following;
 Once developed , it is a relatively permanent schedule, requiring only temporary
adjustments.
 Nurses no longer have to live in anticipation of their time off-duty, because it may
be scheduled for as long as 6 months in advance.
 Personal plans may be made in advance with a reasonable degree of reliability
 Requests plans may be made in advance with a minimum.
 It can be used with rotating, permanent or mixed shifts and can be modified to
allow fixed days off and uneven works periods , based on personnel needs and
work period preferences
 It can be modified to fit known or anticipated periods of heavy workloads of heavy
workloads and can be temporarily adjusted

6
Because cyclic scheduling relatively inflexible, it works only with a staff that rotates by
policy and personal choice. Personal who need flexible staffing to meet their personal
needs, such as those related to family and educational pursuits do not generally accept it.
An infinite number of basic cyclic patterns can be developed and tailored to suit the needs
of each unit. Patterns should reflect policy, workload, and staff preferences. Nursing
personnel may use a staffing board to develop a pattern and cycle satisfactory to them.
The staffing board is used to show the number of number of nursing personnel required for
each day of the week for 6 weeks.
Self scheduling
Self scheduling is an activity that may make a staff happier, more cohesive and more
committed. It should be planned carefully on a unit basis. Planning may use either a self-
directed work team or a quality circle technique approach. Self scheduling matches staff to
individual preferences.
It has been found to shorten scheduling time; increase retention and job satisfaction; and
reduce conflicts, illness time, voluntary absenteeism and turnover.
Self scheduling leads to more responsible employees. It meets personal goals such as
family, social life, education, childcare, and commuting. It is an example of participatory
management with decentralized decision-making. The planning must include the givens,
or rules, to be followed. These rules should be minimal to meet legal and professional
standards.
Patient Classification Systems
Patient classification system( PCS) ,which quantifies the quality of the nursing care, is
essential to staffing nursing units of hospitals and nursing homes. In selecting or
implementing a PCS , a representative committee of nurse manager can include a
representative of hospital administration, which would decrease skepticism about the PCS.
The primary aim of PCS is to be able to respond to constant variation in the care needs of
patients.
Characteristics
 Differentiate intensity of care among definite classes
 Measure and quantify care to develop a management engineering standard.
 Match nursing resources to patient care requirement .
 Relate to time and effort spent on the associated activity.
 Be economical and convenient to repot and use
 Be mutually exclusive , continuing new item under more than one unit.
 Be open to audit.
 Be understood by those who plan , schedule and control the work.
 Be individually standardized as to the procedure needed for accomplishment.
 Separate requirement for registered nurse from those of other staff.
Purposes
 The system will establish a unit of measure for nursing, that is , time , which will
be used to determine numbers and kinds of staff needed.
 Program costing and formulation of the nursing budget.
 Tracking changes in patients care needs. It helps the nurse managers the ability to
moderate and control delivery of nursing service
 Determining the values of the productivity equations

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 Determine the quality: once a standards time element has been established, staffing
is adjusted to meet the aggregate times. A nurse manager can elect to staff below
the standard time to reduce costs.
Components: The first component of a PCS is a method for grouping patients categories
.Johnson indicates two methods of categorizing patients. Using categorizing method each
patient is rated on independent elements of care, each element is scorded , scores are
summarized and the patient is place din a category based on the total numerical value
obtained.
The second component of a PCS is a set of guidelines describing the way in which
patients will be classified, the frequency of the classification, and the method of reporting
data.. The third component of a PCS is the average amount of the time required for care of
a patient in each category. A method for calculating required nursing care hours is the
fourth and final component of a PCS .
Patient Care Classification
Patient Care classification using four levels of nursing care intensity
Area of care Category I Category II Category III Category IV
Eating Feeds self Needs some
help in
preparing
Cannot feed self
but is able to
chew and
swallowing
Cannot feed self
any may have
difficulty
swallowing
Grooming Almost entirely
self sufficient
Need some help
in bathing, oral
hygiene …
Unable to do
much for self
Completely
dependent
Excretion Up and to
bathroom alone
Needs some
help in getting
up to bathroom
/urinal
In bed, needs
bedpan / urinal
placed;
Completely
dependent
Comfort Self sufficient Needs some
help with
adjusting
position/ bed..
Cannot turn
without help, get
drink, adjust
position of
extremities …
Completely
dependent
General health Good Mild symptoms Acute symptoms Critically ill
Treatment Simple –
supervised,
simple
dressing…
Any Treatment
more than once
per shift, foley
catheter care,
I&O….
Any treatment
more than twice
/shift…
Any elaborate/
delicate
procedure
requiring two
nurses, vital
signs more
often than every
two hours..
Health
education and
teaching
Routine follow
up teaching
Initial teaching
of care of
ostomies; new
diabetics;
patients with
mild adverse
reactions to
their illness…
More intensive
items; teaching
of apprehensive/
mildly resistive
patients….
Teaching of
resistive
patients,

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Calculating Staffing Needs
The following are the hours of nursing care needed for each level patient per shift:
Category I Category II Category III Category IV
NCHPPD for
Day shift
2.3 2.9 3.4 4.6
NCHPPD for
P.M (Evening)
shift
2.0 2.3 2.8 3.4
NCHPPD for
night shift
0.5 1.0 2.0 2.8
A guide to staffing nursing services
1. Projecting Staffing Needs
Some steps to be taken in projecting staffing needs include:
1. Identify the components of nursing care and nursing service.
2. Define the standards of patient care to be maintained.
3. Estimate the average number of nursing hours needed for the required hours.
4. Determine the proportion of nursing hours to be provided by registered nurses
and other nursing service personnel
5. Determine polices regarding these positions and for rotation of personnel.
2. Computing number of nurses required on a Yearly Basis
1. Find the total number of general nursing hours needed in one year. Average
patient census X average nursing hours per patient for 24 hours X days in week
X weeks in year.
2. Find the number of general nursing hours needed in one year which should be
given by registered nurses and the number which should be given by ancillary
nursing personnel.
a. Number of general nursing hours per year X percent to be given by
registered nurses.
b. Number of general nursing hours per year X percent to be given be
ancillary nursing personnel.
Computing number of nurses assigned on weekly basis
1. Find the total number of general nursing hours needed in one week. Average
patient censes X average nursing hours per patient in 24 hours X days in week.
2. Find the number of general nursing hours needed in the week which should be
given by registered nurses and the number which could be given by ancillary
nursing personnel.
a. Number of general nursing hours per week X percent to be given by registered
nurses.
b. Number of general nursing hours per week X percent to be given by ancillary
nurses.

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2. STAFF INSPECTION,BAJAJ COMMITTEE, HIGH POWER
COMMITEE AND INDIAN NURSING COUNCIL
INTRODUCTION:
Nurse staffing is a constant challenge for health care facilities. Before the selection
of the employees, one has to make analysis of the particular job, which is required in the
organization, then comes the selection of personnel.
TERMINOLOGIES:
1. Staffing: Selecting and training individuals for specific job functions, and charging
them with the associated responsibilities.
2. Norms: Formal rule or standard laid down by legal, religious, or social authority against
which appropriateness (what is right or wrong) of an individual's behaviour is judged.
3. Manpower: Power in terms of the workers available to a particular group or required
for a particular task.
4. Vocationalization: Relating to, providing, or undergoing training in a special skill to be
pursued in a trade.
5. Budget: A budget is a plan that outlines an organization's financial and operational
goals.
6. Reciprocity: Mutual action; give and take.
7. Myriad: Innumerable
8. Gazetted: Gazetted is a status symbol and makes a person recognizable all over.
DEFINITION:
Staffing is a selection, training, motivating and retaining of a personnel in the
organization.
ANA PRINCIPLES OF NURSING STAFFING
The nine principles are:
I. Patient Care Unit Related
a) Appropriate staffing levels for a patient care unit reflect analysis of individual and
aggregate patient needs.
b) There is a critical need to either retire or seriously question the usefulness of the
concept of nursing hours per patient day (HPPD).
c) Unit functions necessary to support delivery of quality patient care must also be
considered in determining staffing levels.
II. Staff Related
a) The specific needs of various patient populations should determine the appropriate
clinical competencies required of the nurse practicing in that area.
b) Registered nurses must have nursing management support and representation at
both the operational level and the executive level.
c) Clinical support from experienced RNs should be readily available to those RNs
with less proficiency.

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III. Institution/Organization Related
a) Organizational policy should reflect an organizational climate that values
registered nurses and other employees as strategic assets and exhibit a true
commitment to filling budgeted positions in a timely manner.
b) All institutions should have documented competencies for nursing staff, including
agency or supplemental and travelling RNs, for those activities that they have been
authorized to perform.
c) Organizational policies should recognize the myriad needs of both patients and
nursing staff.
STAFF INSPECTION UNIT (S.I.U)
The Staff Inspection Unit was set up in 1964 with the object of effecting economy
in manpower consistent with administrative efficiency and evolving performance
standards and work norms in Government offices and Institutions wholly or substantially
dependent on Government Grants. Its officers also serve as Core Member on the
Committees appointed to scrutinize manpower requirements of Scientific and Technical
Organisations.
NORMS OF STAFFING (S I U- staff inspection unit)
Norms
Norms are standards that guide, control, and regulate individuals and communities.
For planning nursing manpower we have to follow some norms. The nursing norms are
recommended by various committees, such as; the Nursing Man Power Committee, the
High-power Committee, Dr. Bajaj Committee, and the staff inspection committee, TNAI
and INC. The norms has been recommended taking into account the workload projected in
the wards and the other areas of the hospital.
All the above committees and the staff inspection unit recommended the norms for
optimum nurse-patient ratio, such as 1:3 for Non Teaching Hospital and 1:5 for the
Teaching Hospital. The Staff Inspection Unit (S.I.U.) is the unit which has recommended
the nursing norms in the year 1991-92. As per this S.I.U. norm the present nurse-patient
ratio is based and practiced in all central government hospitals.
Recommendations of S.I.U:
1. The norms for providing staff nurses and nursing sisters in Government hospital
has been recommended taking into account the workload projected in the wards
and the other areas of the hospital.
2. The posts of nursing sisters and staff nurses have been clubbed together for
calculating the staff entitlement for performing nursing care work which the staff
nurse will continue to perform even after she is promoted to the existing scale of
nursing sister.
3. Out of the entitlement worked out on the basis of the norms, 30%posts may be
sanctioned as nursing sister. This would further improve the existing ratio of 1
nursing sister to 3 staff nurses fixed by the government in settlement with the Delhi
nurse union in May 1990.

11
4. The assistant nursing superintendents are recommended in the ratio of 1 ANS to
every 4 nursing sisters. The ANS will perform the duty presently performed by
nursing sisters and perform duty in shift also.
5. The posts of Deputy Nursing Superintendent may continue at the level of 1 DNS
per every 7 ANS
6. There will be a post of Nursing Superintendent for every hospital having 250 or
more beds.
7. There will be a post of 1 Chief Nursing Officer for every hospital having 500 or
more beds.
8. It is recommended that 45% posts added for the area of 365 days working
including 10% leave reserve (maternity leave, earned leave, and days off as nurses
are entitled for 8 days off per month and 3 National Holidays per year when doing
3 shift duties).
Most of the hospital today is following the S.I.U. norms. In this the post of the Nursing
Sisters and the Staff Nurses has been clubbed together and the work of the ward sister is
remained same as staff nurse even after promotion. The Assistant Nursing Superintendent
and the Deputy Nursing Superintendent have to do the duty of one category below of their
rank.
The Nurse-patient Ratio as per the S.I.U. Norms
1. General Ward
2. Special Ward - ( pediatrics, burns, neuro
surgery, cardio thoracic, neuro medicine,
nursing home, spinal injury, emergency
wards attached to casuality)
1:6
1:4
3. Nursery 1:2
4. I.C.U. 1:1(Nothing mentioned about the shifts)
5. Labour Room 1:l per table
6. O.T. Major - 1 :2 per table
Minor - 1:l per table
7. Casualty-
a. Casualty main attendance up to 100
patients per day thereafter
b. For every additional attendance of 35
patients
c. Gynae/ obstetric attendance
3 staff nurses for 24 hours, 1:1per shift.
1:35
3 staff nurses for 24 hours, 1:1/ shift

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d. Thereafter every additional attendance
of 15 patients.
1:15
8. Injection room OPD Attendance upto 100 patients per day 1
staff nurse
120-220 patients: 2 staff nurses
9. OPD
NAME OF THE DEPARTMENT
· Blood bank
· Paediatric
· Immunization
· Eye
· ENT
· Pre anaesthetic
· Cardio lab
· Bronchoscopy lab
· Vaccination anti rabies
· Family planning
· Medical
· Dental
· Central sample collection centre
· Orthopaedic
· Gyne
· X-ray
· Skin
· V D centre
· Chemotherapy
· Neurology
· Microbiology
· Psychiatry
· Burns
1
2
2
1
1
1
1
1
1
2
1
1
1
1
2
2
3
2
2
2
1
2
1
2

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In addition to the 10% reserve as per the extent rules, 45% posts may be added
where services are provided for 365 days in a year/ 24 hours.
The Nurse-patient Ratio as per the norms of TNAI and INC (The Indian Nursing
Council, 1985)
The norms are based on Hospital Beds.
Chief Nursing Officer: 1 per 500 beds
Nursing Superintendent: 1 per 400 beds or above
D.N.S.: 1 per 300 beds and 1 additional for every 200
beds
A.N.S.: 1 for 100-150 beds or 3-4 wards
Ward Sister: 1 for 25-30 beds or one ward. 30% leave
reserve
Staff Nurse: 1 for 3 beds in Teaching Hospital in general ward& 1 for 5 beds in Non-
teaching Hospital +30% Leave reserve.
Extra Nursing staff to be provided for departmental research function.
For OPD and Emergency: 1 staff nurse for 100 patients (1: 100) + 30% leave reserve
For Intensive Care unit (I.C.U.) - 1:1 or (1:3 for each shift) +30% leave reserve.
It is suggested that for 250 bedded hospitals there should be One Infection Control Nurse
(ICN).
For specialised departments, such as Operation Theatre, Labour Room, etc. 1:25 +30%
leave reserve. Norms are not based on Nursing Hours or Patient's Needs here.
The key to success of any hospital primarily depends upon its human resource
than any other single factor. The core determinants of staffing in the hospital organization
are quality, quantity and utilization of its personnel keeping in view the structure and
process. The staffing norms should aim at matching the individual aspiration to the aims
and objectives of the organization.
MAN-POWER PLANNING:
Man power planning may be defined as a strategy for the acquisition, utilization,
improvement and preservation of the human resources of an organization. This involves
ensuring that organization has enough of the right kind of people at the right time and also
adjusting the requirements to the available supply.
The main objectives of man power planning
1. Ensuring maximum utilization of the personnel
2. Assessing future requirements of the organization
3. Determining the recruitment sources.
4. Anticipating from past records, i.e. resignations, simple discharge, dismissal and
retirements.

14
5. Determining training requirements for management‘s development and
organizational development.
Major activities of manpower planning
1. Forecasting future manpower requirements
2. Inventorying, present manpower resources and analysing the degree to which these
resources are employed optimally.
3. Anticipating manpower problem by projecting present resources into the future and
comparing them with forecast of requirement of requirement to determine their
adequacy, both quantitatively, and qualitatively
4. Planning the necessary program, recruitment, selection, training, development,
motivation and compensation, so that future manpower requirements will be met.
Steps of manpower planning:
1. Scrutiny of present personnel strength.
2. Anticipation of man power needs.
3. Investigation of turnover of personnel
4. Planning job requirements and job descriptions
BAJAJ COMMITTEE, 1986
An "Expert Committee for Health Manpower Planning, Production and
Management" was constituted in 1985 under Dr. J.S. Bajaj, the then professor at AIIMS.
Manpower is one of the most vital resources for the labour intensive health services
industry. Health for all (HFA) can be achieved only by improving the utilization of these
resources.
Major recommendations are:-
1. Formulation of National Medical & Health Education Policy.
2. Formulate on of National Health Manpower Policy.
3.Establishment of an Educational Commission for Health Sciences (ECHS) on the lines
of UGC.
4.Establishment of Health Science Universities in various states and union territories.
5.Establishment of health manpower cells at centre and in the states.
6.Vocationalisation of education at 10+2 levels as regards health related fields with
appropriate incentives, so that good quality paramedical personnel may be available in
adequate numbers.
7.Carrying out a realistic health manpower survey.
In relation to nursing, the Bajaj Committee recommended staffing norms for nursing
manpower requirements for hospital nursing services and requirements for community
health centres and primary health centres on the basis of calculations as follow:

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Hospital Nursing Services-
1. Nursing superintendents. 1:200 beds
2. Deputy nursing superintendents 1:300 beds
3. Departmental nursing 7:1000 + 1 Addl:1000 beds
(991 x 7 + 991)
4. Ward nursing 8:200 + 30% leave reserve
supervisors/sisters
5. Staff nurse for wards 1:3 (or 1:9 for each shift)
+30 leave reserve
6. For OPD, Blood Bank, X-ray,
Diabetic clinics, CSR, etc 1:100 (1:5 OPD)
+30% leave reserve
7.For intensive units 1:8 (1:3 for each shift)
(8 beds ICU/200 beds) + 30% leave reserve
8. For specialized deptts and
clinics, OT, Labour room 8:200 + 30% leave reserve
Community Nursing Service
Projected population - 991,479,200 (medium assumption) by 2000 AD
1 Community Health Centre - 1,000,00 population
1 Primary Health Services - 30,000 population in plain area
1 Primary Health Services - 20,000 population in difficult areas
1 Sub-centre - 5000 population in plain area
1 Sub-centre - 3000 population for difficult area
It also requires nursing manpower to cater to the needs of the rural community as follows:
Manpower requirements by 2000 AD:
 Sub-centre ANM/FHW 323882
 Health supervisors /LHV 107960
 Primary Health Centres PHN 26439

16
 Community health centre Nurse-midwives 26439
 Public health nursing supervisor 7436
 Nurse-midwives 52,052
 District public health nursing officer 900
In additional to the above, 74361 Traditional Birth Attendants will be required.
HIGH POWER COMMITTEE ON NURSING AND NURSING
PROFESSION(1987-1989)
High power committee on nursing and nursing profession was set up by the
Government of India in July 1987, under the chairmanship of Dr. Jyothi former vice-
chancellor of SNDT Women University, Mrs. Rajkumari Sood, Nursing Advisor to Union
Government as the member-secretary and CPB Kurup, Principal, Government College of
Nursing, Bangalore and the then President. TNAI is also one among the prominent
members of this committee. Later on the committee was headed by Smt. Sarojini
Varadappan, former Chairman of Central Social Welfare Board.
The terms of reference of the Committee are:
 To look into the existing working conditions of nurses with particular reference to
the status of the nursing care services both in the rural and urban areas.
 To study and recommend the staffing norms necessary for providing adequate
nursing personnel to give the best possible care, both in the hospitals and
community.
 To look into the training of all categories and levels of nursing, midwifery
personnel to meet the nursing manpower needs at all levels o health services and
education.
 To study and clarify the role of nursing personnel in the health care delivery
system including their interaction with other members of the health team at every
level of health service management.
 To examine the need for organised nursing services at the national, state, district
and local levels with particular reference to the need for planning service with the
overall health care system of the country at the respective levels.
 To look into all other aspects, the Committee will hold consultations with the State
Governments.
ECOMMENDATIONS OF HIGH POWER COMMITTEE ON NURSING AND
NURSING PROFESSION
Working conditions of nursing personnel

17
1. Employment
Uniformity in employment procedures to be made.
Recruitment rules are made for all categories of nursing posts. The qualifications and
experience required or these be made thought the country.
There should not be a bond for nursing students as some of the states do not give them
employment during the stipulated period. Keeping in view of the shortage of nurses in
hospitals and community health field states should create posts and appointment these
nurses in the appropriate positions.
2. Job description
 Job description of all categories of nursing personnel is prepared by the central
government to provide guidelines.
3. Working hours
The weekly working hours should be reduced to 4o hrs per week. Straight shift should be
implemented in all states. extra working hours to be compensated either by leave or by
extra emoluments depending on the state policy .nurses to be given weekly day off and all
the gazetted holidays as per the government rules.
4. Work load/ working facilities
 Nursing norms for patient care and community care to be adopted as recommended
by the committee.
 Hospitals to develop central sterile supply departments, central linen services, and
central drug supply system. Group D employees are responsible for housekeeping
department.
 Policies for breakage and losses to be developed and nurses not are made responsible
for breakage and losses.
5. Pay and allowances
Uniformity of pay scales of all categories of nursing personnel is not feasible. However
special allowance for nursing personnel, i.e.; uniform allowance, washing, mess allowance
etc should be uniform throughout the country.
6. Promotional opportunities
For promotion to the post of ward sister, post basic B.Sc. Nursing is made an essential
qualification. The principle of possessing higher qualification than the category to be
supervised, should apply for all levels and categories of nursing personnel in the rural and
urban areas. The committee recommends that along with education and experience, there
is a need to increase the number of posts in the supervisory cadre, and for making
provision of guidance and supervision during evening and night shifts in the hospital.
-Each nurse must have 3 promotions during the service period.
-Promotion is based on merit cum seniority.
-Promotion to the senior most administrative teaching posts is made only by open
selection.
-In cases of stagnation, selection grade and running scales to be given.

18
7. Career development
-provision of deputation for higher studies after 5 yrs of regular services be made by all
states. The policy of giving deputation to 5 -10 % of each category be worked out by each
state. Every nursing personnel must have an opportunity to attend at least one refresher
course every 2 years.
8. Accommodation
As far as possible, the nursing staff should be considered for priority allotment of
accommodation near to work place. Hospitals should not build nurse's hostel for trained
nurses. Apartment type of accommodation is built where married/unmarried nurses can be
allowed to live. Housing colonies for hospital s must be considered in long run.
9. Transport
During odd hours, calamities etc arrangements for transport must be made for safety and
security of nursing personnel.
10. Special incentives
Scheme of special incentives in terms of awards, special increment for meritorious work
for nurses working in each state/district/PHC to be worked out.
11. Occupational hazards
Medical facilities as provided by the central govt. by extended by the state govt to nursing
personnel till such times medical services are provided free to all the nursing personnel.
Risk allowance to be paid to nursing personnel working in the rural $ urban area.
12. Other welfare services
Hospitals should provide welfare measures like crèche facilities for children of working
staff, children education allowance, as granted to other employees, be paid to nursing
personnel.
Additional Facilities for Nurses Working In the Rural Areas
 Family accommodation at sub centre is a must for safety and security of ANM's
/LHV.
 Women attendant, selected from the village must accompany the ANM for visits to
other villages.
 The district public health nurse is provided with a vehicle for field supervision.
 Fixed travel allowance with provision of enhancement from time to time.
 Rural allowance as granted to other employees is paid to nursing personnel.
NURSING EDUCATION
Nursing education to be fitted into national stream of education to bring about uniformity,
recognition and standards of nursing education. The committee recommends that;
1. There should be 2 levels of nursing personnel - professional nurse (degree level) and
auxiliary nurse (vocational nurse). Admission to professional nursing should be with
12 yrs of schooling with science. The duration of course should be 4 yrs at the
university level. admission to vocational /auxiliary nursing should be with 10 yrs of
schooling .The duration of course should be 2 yrs in health related vocational stream.

19
2. All school of nursing attached to medical college hospitals is upgraded to degree
level in a phased manner.
3. All ANM schools and school of nursing attached to district hospitals be affiliated
with senior secondary boards.
4. Post certificate B.Sc. Nursing degree to be continued to give opportunities to the
existing diploma nurses to continue higher education.
5. Master in nursing programme to be increased and strengthened.
6. Doctoral programme in nursing have to be started in selected universities.
7. Central assistance be provided for all levels of nursing education institutions in
terms of budget( capital and recurring)
8. Up gradation of degree level institutions be made in a phased manner as suggested in
report.
9. Each school should have separate budget till such time is phased to degree/vocational
programme. The principal of the school should be the drawing and the disbursing
officer.
10. Nursing personnel should have a complete say in matters of selection of students.
Selection is based completely on merit. Aptitude test is introduced for selection of
candidates.
11. All schools to have adequate budget for libraries and teaching equipments.
12. All schools to have independent teaching block called as School Of Nursing with
adequate class room facilities, library room, common room etc as per the
requirements of INC.
13. Adequate accommodations are provided to students. A maximum of 3 students to
share a room. Rooms to be furnished with light, study table , chair etc. Adequate
dining room, toilets and bathrooms facilities to be provided in each hostel as per
norms recommended.
14. Students should learn under supervision in the wards. Tutors/clinical instructors must
go to the ward with students. Students should not be used for the service of the
hospital.
15. Community nursing experience should be as per INC requirements. Necessary
transport and accommodation at PHC be made available for safety, security and
meaningful learning of students.
16. INC requirements for staffing the schools and meeting the minimum requirements are
followed by all schools as these are statutory requirements.
17. Speciality courses at post-graduate level be developed at certain special centres of
excellence eg; AIIMS.

20
18. Institutes like National Institute of Health and Family welfare, RAK College of
Nursing and several others may develop courses on nursing administration for
senior nursing leading to doctorate level.
19. Provision for higher training abroad and exchange programme is made.
Continuing Education and Staff Development
 Definite policies of deputing 5-10% of staff for higher studies are made by each
state. Provision for training reserve is made in each institution.
 Deputation for higher study is made compulsory after 5 yrs.
 Each nursing personnel must attend 1 or 2 refresher course every year.
 Necessary budgetary provision be made.
 A National Institute for Nursing Education Research and Training needs to be
established like NCERT, for development of educational technology, preparation of
textbooks, media, / manuals for nursing.
NURSING SERVICES: HOSPITALS/INSTITUTIONS (URBAN AREAS)
Definite nursing policies regarding nursing practice are available in each institution.
These policies include:
a) Qualification/recruitment rules
b) Job description/job specifications
c) Organizational chart of the institutions
d) Nursing care standards for different categories of patients.
1. Staffing of the hospitals should be as per norms recommended.
2. District hospitals /non teaching hospitals may appoint professional teaching nurses in
the ratio of 1; 3 as soon as nurses start qualifying from these institutions.
3. Students not to be counted for staffing in the hospitals
4. Adequate supplies and equipments, drugs etc be made available for practice of
nursing. The committee strongly recommends that minimum standards of basic
equipment needed for each patient be studied , norms laid down and provided to
enable nurses to perform some of the basic nursing functions . Also there should be
a separate budget head for nursing equipment and supplies in each hospitals/ PHC.
The NS and PHN should be a member of the purchase and condemnation committee.
5. Nurses to be relieved from non -nursing duties.
6. Duty station for nurses is provided in each ward.
7. Necessary facilities like central sterile supplies, linen, drugs are considered for all
major hospitals to improve patient care. Also nurses should not be made to pay for
breakage and losses. All hospitals should have some systems for regular assessment
of losses.
8. Provision of part time jobs for married nurses to be considered. (min 16-20hrs/week)

21
9. Re-entry by married nurses at the age of 35 or above may also be considered and
such nurse be given induction courses for updating their knowledge and skills before
employment.
10. Nurses in senior positions like ward sisters, Asst. nursing superintendents, Deputy
NS; N.S must have courses in management and administration before promotions.
11. Nurses working in speciality areas must have courses in specialities. Promotion
opportunities for clinical specialities like administrative posts are considered for
improving quality nursing services.
The committee recommends that Gazetted ranks be allowed for nurses working as ward
sister and above (minimum class II gazetted). Similarly the post of Health Supervisor
(female) is allowed gazetted rank and district public health nurse be given the status equal
to district medical/ health officers.
Community Nursing Services
 Appointment of ANM/LHV to be recommended.
- 1 ANM for 2500 population (2 per sub centre)
- 1 ANM for 1500 population for hilly areas
- 1 health supervisor for 7500 population (for supervision of 3 ANM's)
- 1 public health nurse for 1 PHC (30000 population to supervise 4 Health
Supervisors)
- 1 Public Health Nursing Officer for 100000 population (community health
centre)
- 2 district public health nursing for each district.
 ANM/LHV promoted to supervisory posts must undergo courses in administration
and management.
 Specific standing orders are made available for each ANM/LHV to function
effectively in the field.
 Adequate provision of supplies, drugs etc are made.
 Recording system be simplified.
 Posts of public health nurses and above are given gazetted status
Norms recommended for nursing service and education in hospital setting.
1. Nursing Superintendent -1: 200 beds (hospitals with 200 or more beds).
2. Deputy Nursing Superintendent. - 1: 300 beds ( wherever beds are over 200)
3. Assistant Nursing Superintendent - 1: 100
4. Ward sister/ward supervisor - 1:25 beds 30% leave reserve
5. Staff nurse for wards -1:3 ( or 1:9 for each shift ) 30% leave reserve
6. For nurses OPD and emergency etc - 1: 100 patients ( 1 bed : 5 out patients) 30%
leave reserve

22
7. For ICU -1:1(or 1:3 for each shift) 30% leave reserve
For specialized departments such as operation theatre, labour room etc- 1: 25 30% leave
reserve.
INDIAN NURSING COUNCIL (INC)
The Indian Nursing Council is an Autonomous Body under the Government of
India and was constituted by the Central Government under the Indian Nursing Council
Act, 1947 of parliament. It was established in 1949 for the purpose of providing uniform
standards in nursing education and reciprocity in nursing registration throughout the
country. Nurses registered in one state were not registered in another state before this time.
The condition of mutual recognition by the state nurses registration councils, called
reciprocity was possibly only if uniform standards of nursing education were maintained.
Functions of Indian Nursing Council.
 To establish and monitor a uniform standard of nursing education for nurses
midwife, Auxiliary Nurse-Midwives and health visitors by doing inspection of
the institutions.
 To recognize the qualifications under section 10(2)(4) of the Indian Nursing
Council Act, 1947 for the purpose of registration and employment in India and
abroad.
 To give approval for registration of Indian and Foreign Nurses possessing
foreign qualification under section 11(2) (a) of the Indian Nursing Council Act,
1947.
 To prescribe the syllabus & regulations for nursing programs.
 Power to withdraw the recognition of qualification under section 14 of the Act
in case the institution fails to maintain its standards under Section 14 (1)(b) that
an institution recognized by a State Council for the training of nurses,
midwives, auxiliary nurse midwives or health visitors does not satisfy the
requirements of the Council.
 To advise the State Nursing Councils, Examining Boards, State Governments
and Central Government in various important items regarding Nursing
Education in the Country.

23
THE EXISTING NORM BY INC WITH REGARD TO NURSING STAFF FOR
WARDS AND SPECIAL UNITS:
Staff nurse Sister(each
shift)
Departmental sister/ assistant nursing
superintendent
Medical ward 1:3 1:25 1 for 3-4 weeks
Surgical ward 1:3 1:25 1 for 3-4 weeks
Orthopedic ward 1:3 1:25 1 for 3-4 weeks
Pediatric ward 1:3 1:25 1 for 3-4 weeks
Gynecology ward 1:3 1:25 1 for 3-4 weeks
Maternity ward
including newborns
1:3 1:25 1 for 3-4 weeks
ICU 1:1(24 hours) 1
CCU 1:1(24 hours) 1
Nephrology 1:1(24 hours) 1 1 department sister/assistant nursing
superintendent for 3-4 units clubbed
together
Neurology &
neurosurgery
and 1:1(24 hours) 1
Special wards-
ENT etc.
eye, 1:1(24 hours) 1
Operation theatre 3 for 24 hours
per table
1 1 department sister/asst nursing
superintendent for 4-5 operating
rooms
Casuality
emergency unit
and 2-3 staff nurses
depending on the
number of beds
1 1 department sister/assistant nursing
superintendent
Staffing pattern according to the Indian Nursing Council (relaxed till 2012)
Collegiate programme-A
Qualifications and experience of teachers of college of nursing-
1. Professor-cum-Principal
 Masters Degree in Nursing
 Total 10 years of experience with minimum of 5 years of teaching experience

24
2. Professor-cum- Vice Principal
 Masters Degree in Nursing
 Total 10 years of experience with minimum of 5 years in teaching
3. Reader/Associate Professor
 -Masters Degree in Nursing
 Total 7 years of experience with minimum of 3 years in teaching
4. Lecturer
 Masters Degree in Nursing with 3 years of experience.
5. Tutor/Clinical Instructor
 M.Sc.(N) or B.Sc. (N) with 1 year experience or Basic B.Sc. (N) with post basic
diploma in clinical specialty
For B.Sc and M.Sc nursing:
Annual intake of 60 students for B.Sc (N) and 25 for M.Sc (N) programme
B.Sc (N) M.Sc (N)
Professor cum principal 1
Professor cum vice
principal
1
Reader/Associate
professor
1 2
Lecturer 2 3
Tutor/clinical instructor 19
Total 24 5
One in each speciality and all the M.Sc (N) qualified teaching faculty will participate in
both programmes.
Teacher-student ratio = 1:10
GNM and B.Sc. (N) with 60 annual intake in each programme
Professor cum principal 1
Professor cum vice
principal
1
Reader/Associate
professor
1

25
Lecturer 4
Tutor/clinical instructor 35
Total 42
Basic B.Sc (N)
Admission capacity
Annual intake 40-60 61-100
Professor cum principal 1 1
Professor cum vice
principal
1 1
Reader/Associate
professor
1 1
Lecturer 2 4
Tutor/clinical instructor 19 33
Total 24 40
Teacher student ratio= 1:10 (All nursing faculty including Principal and Vice principal)
Two M.Sc (N) qualified teaching faculty to start college of nursing for proposed less than
or equal to 60 students and 4 M.Sc (N) qualified teaching faculty for proposed 61 to 100
students and by fourth year they should have 5 and 7 M.Sc (N) qualified teaching faculty
respectively, preferably with one in each specialty.
Part time teachers and external teachers:
1. Microbiology
2. Bio-chemistry
3. Sociology.
4. Bio-physic
5. Psychology
6. Nutrition

26
7. English
8. Computer
9. Hindi/Any other language
10. Any other- clinical discipliners
11. Physical education
The above teachers should have post graduate qualification with teaching experience in
respective area
School of nursing-B
Qualification of teaching staff-
1. Professor cum principal M.Sc. (N) with 3 years of teaching experience or
B.Sc.(N) basic or post basic with 5 years of teaching
experience.
2. Professor cum vice
principal
M.Sc. (N) or B.Sc. (N) (Basic)/Post basic with 3 years of
teaching experience.
3. Tutor/clinical instructor M.Sc. (N) or B.Sc. (N) (Basic) / Post basic or diploma in
nursing education and Administration with two years of
professional experience.
For School of nursing with 60 students i.e. an annual intake of 20 students:
Teaching faculty No. required
Principal 1
Vice-principal 1
Tutor 4
Additional tutor for interns 1
Total 7
Teacher student ratio should be 1:10 for student sanctioned strength.

27
Conclusion:
Staffing is the process of determining and providing the acceptable number and mix of
nursing personnel to produce a desired level of care to meet the patients‘ demand
The purpose of all staffing activities is to provide each nursing unit with an appropriate
and acceptable number of workers in each category to perform the nursing tasks required.
Too few or an improper mixture of nursing personnel will adversely affect the quality and
quantity of work performed.
Journal Abstract:
Modern organizations struggle with staffing challenges stemming from increased
knowledge work, labor shortages, competition for applicants, and workforce diversity.
Yet, despite such critical needs for effective staffing practice, staffing research continues
to be neglected or misunderstood by many organizational decision makers. Solving these
challenges requires staffing scholars to expand their focus from individual-level
recruitment and selection research to multilevel research demonstrating the business
unit/organizational-level impact of staffing. This review provides a selective and critical
analysis of staffing best practices covering literature from roughly 2000 to the present.
Several research-practice gaps are also identified.
BIBLIOGRAPHY:
1. BT Basavanthappa. Community health nursing. 1st edition. New Delhi: Jaypee brothers;
2003
2. BT Basavanthappa. Nursing administration. Ist edn. New Delhi: Jaypee brothers; 2000.
3. Function of nursing management- Nursing management- open access articles on
nursing management
http://currentnursing.com/nursing_management/staffing_nursing_units.html
4. High power committee on nursing in India
http://nursingplanet.com/nr/blog6.php/2009/11/21/high_power_committee_nursing_ind
ia
5. Staff Inspection Unit
http://finmin.nic.in/the_ministry/dept_expenditure/staff_inspection_unit/index.html
6. Indian Nursing Council
http://www.indiannursingcouncil.org/pdf/Resolution-circular-12-03-2007.pdf
7. Staffing in nursing management
http://www.scribd.com/doc/16245136/Staffing-in-Nursing-Management

28
3. ESTIMATION OF NURSING STAFF REQUIRMENTS-ACTIVE
ANALYSIS AND RESEARCHSTUDIES
INTRODUCTION
Staffing is certainly one of the major problems of any nursing organization,
whether it be a hospital, nursing home, health care agency, or in educational organization.
Estimation of staff requirements is important for rendering good and quality nursing care
Patient Classification Systems
Patient classification system (PCS), which quantifies the quality of the nursing
care, is essential to staffing nursing units of hospitals and nursing homes. In selecting or
implementing a PCS, a representative committee of nurse manager can include a
representative of hospital administration, which would decrease skepticism about the PCS.
The primary aim of PCS is to be able to respond to constant variation in the care
needs of patients.
Characteristics
 Differentiate intensity of care among definite classes
 Measure and quantify care to develop a management engineering standard.
 Match nursing resources to patient care requirement .
 Relate to time and effort spent on the associated activity.
 Be economical and convenient to repot and use
 Be mutually exclusive , continuing new item under more than one unit.
 Be open to audit.
 Be understood by those who plan , schedule and control the work.
 Be individually standardized as to the procedure needed for accomplishment.
 Separate requirement for registered nurse from those of other staff.
Purposes
 The system will establish a unit of measure for nursing, that is , time , which will
be used to determine numbers and kinds of staff needed.
 Program costing and formulation of the nursing budget.
 Tracking changes in patients care needs. It helps the nurse managers the ability to
moderate and control delivery of nursing service
 Determining the values of the productivity equations
 Determine the quality: once a standards time element has been established, staffing
is adjusted to meet the aggregate times. A nurse manager can elect to staff below
the standard time to reduce costs.
Components: The first component of a PCS is a method for grouping patient‘s categories.
Johnson indicates two methods of categorizing patients. Using categorizing method each
patient is rated on independent elements of care, each element is scorded , scores are
summarized and the patient is placed in a category based on the total numerical value
obtained.

29
Johnson describes prototype evaluation with four basic category for a typical patient
requiring one –on- one care. Each category addresses activities of daily living , general
health, teaching and emotional support, treatment and medications. Data are collected on
average time spent on direct and indirect care.
The second component of a PCS is a set of guidelines describing the way in which patients
will be classified, the frequency of the classification, and the method of reporting data..
The third component of a PCS is the average amount of the time required for care of a
patient in each category. A method for calculating required nursing care hours is the fourth
and final component of a PCS.
Patient Care Classification
Patient Care classification using four levels of nursing care intensity
Area of care Category I Category II Category III Category IV
Eating Feeds self Needs some
help in
preparing
Cannot feed self
but is able to
chew and
swallowing
Cannot feed self
any may have
difficulty
swallowing
Grooming Almost entirely
self sufficient
Need some help
in bathing, oral
hygiene …
Unable to do
much for self
Completely
dependent
Excretion Up and to
bathroom alone
Needs some
help in getting
up to bathroom
/urinal
In bed, needs
bedpan / urinal
placed;
Completely
dependent
Comfort Self sufficient Needs some
help with
adjusting
position/ bed..
Cannot turn
without help, get
drink, adjust
position of
extremities …
Completely
dependent
General health Good Mild symptoms Acute symptoms Critically ill
Treatment Simple –
supervised,
simple
dressing…
Any Treatment
more than once
per shift, foley
catheter care,
I&O….
Any treatment
more than twice
/shift…
Any elaborate/
delicate
procedure
requiring two
nurses, vital
signs more
often than every
two hours..

30
Health
education and
teaching
Routine follow
up teaching
Initial teaching
of care of
ostomies; new
diabetics;
patients with
mild adverse
reactions to
their illness…
More intensive
items; teaching
of apprehensive/
mildly resistive
patients….
Teaching of
resistive
patients,
Calculating Staffing Needs
The following are the hours of nursing care needed for each level patient per shift:
Category I Category II Category III Category IV
NCHPPD for
Day shift
2.3 2.9 3.4 4.6
NCHPPD for
P.M (Evening)
shift
2.0 2.3 2.8 3.4
NCHPPD for
night shift
0.5 1.0 2.0 2.8
A guide to staffing nursing services
3. Projecting Staffing Needs
Some steps to be taken in projecting staffing needs include:
6. Identify the components of nursing care and nursing service.
7. Define the standards of patient care to be maintained.
8. Estimate the average number of nursing hours needed for the required hours.
9. Determine the proportion of nursing hours to be provided by registered nurses
and other nursing service personnel
10. Determine polices regarding these positions and for rotation of personnel.
4. Computing number of nurses required on a Yearly Basis
3. Find the total number of general nursing hours needed in one year. Average
patient census X average nursing hours per patient for 24 hours X days in week
X weeks in year.
4. Find the number of general nursing hours needed in one year which should be
given by registered nurses and the number which should be given by ancillary
nursing personnel.

31
c. Number of general nursing hours per year X percent to be given by
registered nurses.
d. Number of general nursing hours per year X percent to be given be
ancillary nursing personnel.
Computing number of nurses assigned on weekly basis
3. Find the total number of general nursing hours needed in one week. Average
patient censes X average nursing hours per patient in 24 hours X days in week.
4. Find the number of general nursing hours needed in the week which should be
given by registered nurses and the number which could be given by ancillary
nursing personnel.
c. Number of general nursing hours per week X percent to be given by registered
nurses.
d. Number of general nursing hours per week X percent to be given by ancillary
nurses.
One method for determining the nursing staff of a hospital
1. To determine the number of nursing staff for staffing a hospital involves
establishing the number of work days available for service per nurse per year.
Example : Analysis of how the days are used;
Days in the year 365
Days off 1 day/week 52
Casual leave 12
Privilege leave 30
1 Saturday /month 12
Public Holidays 18
Sick Leave 8
Total non-working days 132
Total working days /nurse/year 233
So
1 nurse = 233 working days /year
Example, 20 nurse means 20X233= 4660 hours
4660/365= 12.8 (13).
2. Work load measurement tools
Requirement for staffing are based on whatever standard unit of measurement for
productivity is used in a given unit. A formula for calculating nursing care hours
per patient day (NCH/PPD) is reviewed.
NCH/PPD = Nursing hours worked in 24 hours

32
Patient Census
As a result, patient classification systems (PCS), also known as workload management or
patient acuity tools, were developed in the 1960s.
Important Factors of staffing
There are 3 factors: quality, quantity, and utilization of personnel.
Quality and Quantity:
This factor depends on the appropriate education or training provided to the nursing
personnel for the kind of service they are being prepared for i.e., professional, skilled,
routine or ancillary.
Utilization of personnel: Nursing personnel must be assigned work in such a way that
her/his knowledge and skills learnt are based used for the purpose she was educated or
trained.
Other factors affecting staffing
1. Acutely Ill : Where the life saving is the priority or bed ridden condition which
might require 8-10 hours / patient /day ie., direct nursing care in 24 hours or nurse
patient ratio may have to be 1:1, 2:1,3:1…
2. Moderately Ill: here 3.5 HPD are required in 24 hours or nurse patient ration of 1:3
in teaching hospitals and 1:5 non-teaching hospitals.
3. Mildly Ill: this required 1-2 HPD and for such patients 1:6 or 1:10.
4. Fluctuation of workload: workload is not constant.
5. Number of medical staff: In PHC , 30,000 to 50,000 population getting care from 3
to 4 medical staff but only 1 PHN gives care for all… like in hospital the ratio is
vary from medical and nursing staff.
Modified approaches to nurse staffing and scheduling
Many different approaches to nurse staffing and scheduling are being tried in an
effort to satisfy needs of the employees and meet workload demands for patient care.
These include game theory, modified workweeks (10 or 12hours shifts), team rotation,
premium day, weekend nurse staffing .Such approaches should support the underlying
purpose, mission, philosophy and objectives of the organization and the division of
nursing and should be well defined in a staffing philosophy, statement and policies.
Modified work week: This using 10 and 12 hour shifts and other methods are common
place. A nurse administrator should be sure work schedules are fulfilling the staffing
philosophy and policies, particularly with regard to efficiency. Also, such schedules
should not be imposed on the nursing staff but should show a mutual benefits to employer,
employees and the client served.
 One modification of the worksheet is four 10 hour shifts per week in organized
time increments. One problem with this model is time overlaps of 6 hours per 24 –
hour day. The overlap can be used for patient –centered conference, nursing care
assessment and planning and staff development. It can be done by hour or by a
block of 3-4 hours. Starting and ending time for the 10 hours shifts can be

33
modified to provide minimal overlaps, the 4- hour gap being staffed by part-time
or temporary workers
 A second scheduling modification is the 12 hour shift, on which nurses work even
shifts , on which nurses work seven shift in 2 weeks: three on , four off: four on,
three off . They work a total 84 hours and are paid of overtime. Twelve hour shifts
and flexible staffing have been reported to have improved care and saved money
because nurses can better manage their home and personal lives.
 The weekend alternatives: another variation of flexible scheduling is the
weekend alternative. Nurses work two 12 hour shifts and are paid for 40 hours plus
benefits. They can use the weekdays for continued education or other personal
needs. The weekend scheduled has several variations. Nurses working Monday
through Friday have all weekends off.
 Other modified approaches: team rotation is a method of cyclic staffing in which
a nursing team is scheduled as a unit. It would be used if the team nursing
modality were a team practice.
 Premium day weekend: nursing staffing is a scheduling pattern that gives the
nurse an extra day off duty, called a premium day, when he/she volunteers to work
one additional weekend worked beyond those required by nurse staffing policy.
This technique does not add directly to hospital costs.
 Premium vacation night: staffing follows the same principle as does premium
day weekend staffing. An example would be the policy of giving extra 5 working
days of vacation to every nurse who works a permanent night shifts for a specific
period of time , say 3, 4, or 6 months.
 A flexible role: this programme has enabled the hospitals to better meet the
staffing needs of units whenever workload increases. Since establishment of the
resources acuity nurse position, nurses position, nurse‘s morale has improved
because they know short-term helps is more readily available and will be more
equitably distributed among units.
 Cross training: It can improve flexible scheduling. Nurses can be prepared
through cross-training to function effectively in more than one area of expertise.
To prevent errors and incidence job satisfaction during cross training nurses
assigned to units and in pools require complete orientation and ongoing staff
development.
Scheduling with Nursing Management Information Systems
Planning the duty schedule does not always match personnel with preferences.
This is one major dissatisfaction among clinical nurses. Posting the number of nurses
needed by time slot and allowing nurses to put colored pins in slots to select their own
times can improve satisfaction with the schedule.
Hanson defines a management information system as ―an array components designed to
transform a collective set of data into knowledge that is directly useful and applicable in
the process of directing and controlling resources and their application to the achievement
of specific objectives‖.

34
The following process for establishing any MIS:
1. State the management objective clearly.
2. Identify the actions required to meet the objective.
3. Identify the responsible position in the organization.
4. Identify the information required to meet the objective.
5. Determine the data required to produce the needed information.
6. Determine the system‘s requirement for processing the data.
7. Develop a flowchart.
Productivity
Productivity is commonly defined as output divided by input. Hanson translates this
definition into following:
Required staff hours
Provided staff hours
Example
×100
380 hours
400 hours
X 100 = 95% productivity
Productivity can be increased by decreasing the provided staff hours holding the required
staff hours constant or increasing them.
Measurement
In developing a model for an MIS, Hanson indicates several formulas for
translating data into information. He indicates that in addition to the productivity formula,
hours per patient day (HPPD) are a data element that can provide meaningful information
when provided for an extended period of time.
HPPD is determined by the formula
Staff hours
Patient days
For example,
52000
2883
Answer = 18 HPPD
Another useful formula
1. Budget utilization

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Provided HPPD
X 100 = budget utilization
Budgeted HPPD
Example
18.03 % so, answer is 112.7% Budget utilization.
16
2. Budget adequacy
Budgeted HPPD X100, this is known as Budget adequacy
Required HPPD
16/18.03= 88.74% budget adequacy.
Nurse Staffing, Models of Care Delivery, and Interventions
Nurse Staffing
Measure
Definition
Nurse to patient ratio Number of patients cared for by one nurse typically specified by
job category (RN, Licensed Vocational or Practical Nurse-LVN or
LPN); this varies by shift and nursing unit; some researchers use
this term to mean nurse hours per inpatient day
Total nursing staff or
hours per patient day
All staff or all hours of care including RN, LVN, aides counted per
patient day (a patient day is the number of days any one patient
stays in the hospital, i.e., one patient staying 10 days would be 10
patient days)
RN or LVN FTEs per
patient day
RN or LVN full time equivalents per patient day (an FTE is 2080
hours per year and can be composed of multiple part-time or one
full-time individual)
Nursing skill (or staff)
mix
The proportion or percentage of hours of care provided by one
category of caregiver divided by the total hours of care (A 60%

36
RN skill mix indicates that RNs provide 60% of the total hours of
care)
Nursing Care Delivery
Models
Definition
Patient Focused Care A model popularized in the 1990s that used RNs as care managers
and unlicensed assistive personnel (UAP) in expanded roles such
as drawing blood, performing EKGs, and performing certain
assessment activities
Primary or Total
Nursing Care
A model that generally uses an all-RN staff to provide all direct
care and allows the RN to care for the same patient throughout the
patient's stay; UAPs are not used and unlicensed staff do not
provide patient care
Team or Functional
Nursing Care
A model using the RN as a team leader and LVNs/UAPs to
perform activities such as bathing, feeding, and other duties
common to nurse aides and orderlies; it can also divide the work by
function such as "medication nurse" or "treatment nurse"
Magnet Hospital
Environment/Shared
governance
Characterized as "good places for nurses to work" and includes a
high degree of RN autonomy, MD-RN collaboration, and RN
control of practice; allows for shared decisionmaking by RNs and
managers Jean Ann Seago, Ph.D.,RN
NORMS OF STAFFING( S I U- staff inspection unit)
Norms
Norms are standards that guide, control, and regulate individuals and communities.
For planning nursing manpower we have to follow some norms. The nursing norms are
recommended by various committees, such as; the Nursing Man Power Committee, the
High-power Committee, Dr. Bajaj Committee, and the staff inspection committee, TNAI
and INC. The norms has been recommended taking into account the workload projected in
the wards and the other areas of the hospital.
All the above committees and the staff inspection unit recommended the norms for
optimum nurse-patient ratio. Such as 1:3 for Non Teaching Hospital and 1:5 for the
Teaching Hospital. The Staff Inspection Unit (S.I.U.) is the unit which has recommended
the nursing norms in the year 1991-92. As per this S.I.U. norm the present nurse-patient
ratio is based and practiced in all central government hospitals.

37
Recommendations of S.I.U:
1. The norms for providing staff nurses and nursing sisters in Government hospital is
given in annexure to this report. The norm has been recommended taking into
account the workload projected in the wards and the other areas of the hospital.
2. The posts of nursing sisters and staff nurses have been clubbed together for
calculating the staff entitlement for performing nursing care work which the staff
nurse will continue to perform even after she is promoted to the existing scale of
nursing sister.
3. Out of the entitlement worked out on the basis of the norms, 30%posts may be
sanctioned as nursing sister. This would further improve the existing ratio of 1
nursing sister to 3.6. staff nurses fixed by the government in settlement with the
Delhi nurse union in may 1990.
4. The assistant nursing superintendent are recommended in the ratio of 1 ANS to
every 4.5 nursing sisters. The ANS will perform the duty presently performed by
nursing sisters and perform duty in shift also.
5. The posts of Deputy Nursing Superintendent may continue at the level of 1 DNS
per every 7.5 ANS
6. There will be a post of Nursing Superintendent for every hospital having 250 or
beds.
7. There will be a post of 1 Chief Nursing Officer for every hospital having 500 or
more beds.
8. It is recommended that 45% posts added for the area of 365 days working
including 10% leave reserve (maternity leave, earned leave, and days off as nurses
are entitled for 8 days off per month and 3 National Holidays per year when doing
3 shift duties).
Most of the hospital today is following the S.I.U.norms. In this the post of the Nursing
Sisters and the Staff Nurses has been clubbed together and the work of the ward sister is
remained same as staff nurse even after promotion. The Assistant Nursing Superintendent
and the Deputy Nursing Superintendent have to do the duty of one category below of their
rank.
BIBLIOGRAPHY:
8. BT Basavanthappa. Community health nursing. 1st edition. New Delhi: Jaypee brothers;
2003
9. BT Basavanthappa. Nursing administration. Ist edn. New Delhi: Jaypee brothers; 2000.
10.Management and leadership for nurse managers, second edition, russel
c.swansburg
11.Function of nursing management- Nursing management- open access articles on
nursing management
http://currentnursing.com/nursing_management/staffing_nursing_units.html

38
12. Staff Inspection Unit
http://finmin.nic.in/the_ministry/dept_expenditure/staff_inspection_unit/index.html
13. Staffing in nursing management
http://www.scribd.com/doc/16245136/Staffing-in-Nursing-Management
14. Staffing in the 21st Century: New Challenges and Strategic Opportunities
http://jom.sagepub.com/content/32/6/868.abstract
VARIOUS RESEARCH STUDIES
Intensive Care Med. 1998 Jun;24(6):582-9.
Estimation of direct cost and resource allocation in intensive care: correlation with
Omega system.
Sznajder M, Leleu G, Buonamico G, Auvert B, Aegerter P, Merlière Y, Dutheil M, Guidet
B, Le Gall JR.
Department of Public Health & Medical Information, Hôpital Ambroise Parè, Boulogne,
France.
Comment in:
 Intensive Care Med. 1999 Feb;25(2):245-6.
Abstract
OBJECTIVE: An instrument able to estimate the direct costs of stays in Intensive Care
Units (ICUs) simply would be very useful for resource allocation inside a hospital,
through a global budget system. The aim of this study was to propose such a tool.
DESIGN: Since 1991, a region-wide common data base has collected standard data of
intensive care such as the Omega Score, Simplified Acute Physiologic Score, length of
stay, length of ventilation, main diagnosis and procedures. The Omega Score, developed
in France in 1986 and proved to be related to the workload, was recorded on each patient
of the study.
SETTING: Eighteen ICUs of Assistance Publique-Hôpitaux de Paris (AP-HP) and
suburbs.
PATIENTS: 1) Hundred twenty-one randomly selected ICU patients; 2) 12,000
consecutive ICU stays collected in the common data base in 1993.
MEASUREMENTS: 1) On the sample of 121 patients, medical expenditure and nursing
time associated with interventions were measured through a prospective study. The
correlation between Omega points and direct costs was calculated, and regression
equations were applied to the 12,000 stays of the data base, leading to estimated costs. 2)
From the analytic accounting of AP-HP, the mean direct cost per stay and per unit was
calculated, and compared with the mean associated Omega score from the data base. In
both methods a comparison of actual and estimated costs was made.
RESULTS: The Omega Score is strongly correlated to total direct costs, medical direct
costs and nursing requirements. This correlation is observed both in the random sample of
121 stays and on the data base' stays. The discrepancy of estimated costs through Omega
Score and actual costs may result from drugs, blood product underestimation and
therapeutic procedures not involved in the Omega Score.

39
CONCLUSIONS: The Omega system appears to be a simple and relevant indicator with
which to estimate the direct costs of each stay, and then to organise nursing requirements
and resource allocation.
PMID: 9681780 [PubMed - indexed for MEDLINE]
Health Econ. 1995 Jan-Feb;4(1):57-72.
The impact of nursing grade on the quality and outcome of nursing care.
Carr-Hill RA, Dixon P, Griffiths M, Higgins M, McCaughan D, Rice N, Wright K.
Centre for Health Economics, University of York, UK.
Abstract
The large industry which has grown up around the estimation of nursing requirements for
a ward or for a hospital takes little account of variations in nursing skill; meanwhile
nursing researchers tend to concentrate on the appropriate organisation of the nursing
process to deliver best quality care. This paper, drawing on a Department of Health funded
study, analyses the relation between skill mix of a group of nurses and the quality of care
provided. Detailed data was collected on 15 wards at 7 sites on both the quality and
outcome of care delivered by nurses of different grades, which allowed for analysis at
several levels from a specific nurse-patient interaction to the shift sessions. The analysis
shows a strong grade effect at the lowest level which is 'diluted' at each succeeding level
of aggregation; there is also a strong ward effect at each of the lower levels of aggregation.
The conclusion is simple; you pay for quality care.
Impact of shift work on the health and safety of nurses and patients.
Berger AM, Hobbs BB.
College of Nursing, University of Nebraska Medical Center, Omaha, USA.
aberger@unmc.edu
Abstract
Shift work generally is defined as work hours that are scheduled outside of daylight. Shift
work disrupts the synchronous relationship between the body's internal clock and the
environment. The disruption often results in problems such as sleep disturbances,
increased accidents and injuries, and social isolation. Physiologic effects include changes
in rhythms of core temperature, various hormonal levels, immune functioning, and
activity-rest cycles. Adaptation to shift work is promoted by reentrainment of the
internally regulated functions and adjustment of activity-rest and social patterns. Nurses
working various shifts can improve shift-work tolerance when they understand and adopt
counter measures to reduce the feelings of jet lag. By learning how to adjust internal
rhythms to the same phase as working time, nurses can improve daytime sleep and family
functioning and reduce sleepiness and work-related errors. Modifying external factors
such as the direction of the rotation pattern, the number of consecutive night shifts
worked, and food and beverage intake patterns can help to reduce the negative health
effects of shift work. Nurses can adopt counter measures such as power napping,
eliminating overtime on 12-hour shifts, and completing challenging tasks before 4 am to
reduce patient care errors.

40
At the Presbyterian hospital of Dallas , a study reveled that more time was spend on
clerical functions, telephone calls, and reporting patient conditions to other care givers
than on direct patient care. Several action were taken to change this;
 A FAX machine network was instituted between nursing units and pharmacy,
which reduce telephone calls and medication errors.
 A key less narcotics system that included a personnel pass code was installed. The
main control was in the pharmacy, but nurses could enter their personnel pass code
at the narcotics cabinet. This reduced time wasted in searching for keys and also
produced an audit trail.
 A unit beeper system with 8 beepers was purchased at a local store for $375
.beepers given to every staff members at the beginning of each shift made nursing
assistants feel valued.
 These changes improved productivity greatly
Am J Nurs. 2008 Jan;108(1):62-71; quiz 72.
Nurse staffing and patient, nurse, and financial outcomes.
Unruh L.
Department of Health Professions, University of Central Florida, Orlando, FL, USA.
lunruh@mail.ucf.edu
Comment in:
 Am J Nurs. 2008 Apr;108(4):13.
Abstract
Because there's no scientific evidence to support specific nurse-patient ratios, and in order
to assess the impact of hospital nurse staffing levels on given patient, nurse, and financial
outcomes, the author conducted a literature review. The evidence shows that adequate
staffing and balanced workloads are central to achieving good outcomes, and the author
offers recommendations for ensuring appropriate nurse staffing and for further research.
Policy Polit Nurs Pract. 2009 Nov;10(4):240-51.
An applied simulation model for estimating the supply of and requirements for
registered nurses based on population health needs.
Tomblin Murphy G, MacKenzie A, Alder R, Birch S, Kephart G, O'Brien-Pallas L.
Dalhousie University, Halifax, Nova Scotia, Canada, University of Toronto, Toronto,
Ontario, Canada. gail.tomblin.murphy@dal.ca
Abstract
Aging populations, limited budgets, changing public expectations, new technologies, and
the emergence of new diseases create challenges for health care systems as ways to meet
needs and protect, promote, and restore health are considered. Traditional planning
methods for the professionals required to provide these services have given little
consideration to changes in the needs of the populations they serve or to changes in the

41
amount/types of services offered and the way they are delivered. In the absence of
dynamic planning models that simulate alternative policies and test policy mixes for their
relative effectiveness, planners have tended to rely on projecting prevailing or arbitrarily
determined target provider-population ratios. A simulation model has been developed that
addresses each of these shortcomings by simultaneously estimating the supply of and
requirements for registered nurses based on the identification and interaction of the
determinants. The model's use is illustrated using data for Nova Scotia, Canada.
J Public Health Manag Pract. 2009 Nov;15(6 Suppl):S56-61.
Health human resources planning and the production of health: development of an
extended analytical framework for needs-based health human resources planning.
Birch S, Kephart G, Murphy GT, O'Brien-Pallas L, Alder R, MacKenzie A.
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton,
Ontario, Canada. birch@mcmaster
Comment in:
 J Public Health Manag Pract. 2009 Nov;15(6 Suppl):S62-3.
Abstract
Health human resources planning is generally based on estimating the effects of
demographic change on the supply of and requirements for healthcare services. In this
article, we develop and apply an extended analytical framework that incorporates
explicitly population health needs, levels of service to respond to health needs, and
provider productivity as additional variables in determining the future requirements for the
levels and mix of healthcare providers. Because the model derives requirements for
providers directly from the requirements for services, it can be applied to a wide range of
different provider types and practice structures including the public health workforce. By
identifying the separate determinants of provider requirements, the analytical framework
avoids the "illusions of necessity" that have generated continuous increases in provider
requirements. Moreover, the framework enables policy makers to evaluate the basis of,
and justification for, increases in the numbers of provider and increases in education and
training programs as a method of increasing supply. A broad range of policy instruments is
identified for responding to gaps between estimated future requirements for care and the
estimated future capacity of the healthcare workforce.
Is your nursing staff ready for magnet hospital status? An application of the revised
Nursing Work Index.
Wagner CM.
College of Nursing, University of Iowa, Iowa City, IA, USA. c.wagner@mchsi.com
Abstract
There has been a slow, steady exodus of nurses from the acute care setting. However,
magnet hospital status is closely correlated with increased retention of nursing staff. The
author outlines an assessment plan for nursing staff to determine if magnet status
application efforts may be successful for an organization.

42
4. RECRUITMENTCREDENTIALING, SELECTION, LACEMENT&
RETENTION
I. INTRODUCTION:
Personnel management is the most important assets of an organization.
Planning for human resources is the important managerial function. It ensures
adequate supply, proper quantity and quality as well as effective utilization of
human resources. There is generally shortage of suitable persons. The organization
will determine its manpower needs and then find out the sources from which the
requirements will be met.
II. TERMINOLOGY:
1. Recruitment: It is a process in which the right people for the right post is
procured.
2. Selection: It is the process of choosing from among applicants the best qualified
individuals.
3. Administration: It is the organization and direction of human and material
resources to achieve desired ends.
4. Admission: The right or permission to enter
5. Student: A person who studies, especially at college, university etc
6. Discipline: A training in an orderly way of life, order kept by means of control.
7. Turnover: The number of staff that leave a cost centre annually.
RECRUITMENT
INTRODUCTION:
Recruitment is an important function of health manpower management,
which determines, whether the required will be available at the work spot, when a
job is actually to be undertaken. Recruitment procedures include the process and
the methods by which vaccines are notified, post are advertised, applications are
handled and screened, interviews are conducted and appointments are made.
Recruitment of nurses are major concern. Recruitment means finding out of the
further workers. It is process of searching for prospective employees and
stimulating them to apply for job in an organization.

43
MEANING:
In a simple term, recruitment is understood as the process of searching for
and obtaining applicants for job, from among whom the right people can be
selected.
DEFINITION:
1) According to B Flippo: ―Recruitment is defined as the process of searching for
prospective employees and stimulating them to apply foe job in the organization‖.
2) According to IGNOU Module: ―It is a process in which the right person for the
right post is procured‖.
3) According to Yoder: ―Recruitment is a process to discover the sources of
manpower to meet the requirements of the staffing schedule and to employ
effective measures for attracting that manpower in adequate numbers
to facilitate effective selectionof an efficient working force.‖
TYPES OF RECRUITMENT:
There are three types of recruitment:
1. Planned: arise from changes in organization and recruitment policy
2. Anticipated: by studying trends in the internal and external organization.
3. Unexpected: arise due to accidents, transfer and illness.
LIKAGES OF REQUIREMENT TO HUMAN RESOURCE ACQUISITION
The requirement process is concerned with the identification of possible
sources of human resources supply and tapping those resources, the total process
acquiring and placing human resources in the organization. Requirement fails in
between different sub process like:
Planned
Anticipated
Unexpected

44
BASIC ELEMENTS OF SOUND RECRUITMENT POLICY:
 Discovery and cultivation of the employment market for post in the public
service
 Use of the attractive recruitment literature and publicity
 Use of the scientific tests for determining abilities of the candidate
 Tapping capable candidates from within the services
 Placement program which assigns the right man to the right job.
 A follow up probationally program as an integral process.
PURPOSES AND IMPORTANCE:
 Determine the present and future requirements of the organization in
conjunction with the personnel planning and job analysis activities
 Increase the pool of job candidates with minimum cost
 Help increase the success rate of the selectionprocess reducing the number
of obviously under qualified or over qualified job applicants.
 Help reduce the probability tat the job applicants, once recruited and
selectedwill leave the organization only after short period of time.
 Meet the organization‘s legal and social obligations regarding the
composition of its work force
 Start identifying and preparing potential job applicants who will be
appropriate candidates
 Increase organizational and individual effectiveness in the short and long
term.
 Evaluate the effectiveness of various recruiting techniques and sources for
all types of job applicants.
Manpower
planning Recruitment
Selection Placement
Job analysis

45
OBJECTIVES OF RECRUITMENT:
To attract people with multi-dimensional skills and experiences that suit the
present and future organizational strategies
To induct outsiders with new perspective to lead the company
To infuse fresh blood at all levels of organization
To develop an organizational culture that attracts competent people to the
company
To search or heat hunt/ head pouch people whose skills fit the company‘s
values
To devise methodologies for assessing psychological traits
To seek out non-conventional development grounds of talent
To search for talent globally and not just within the company
To design entry pay that competes on quality but not on quantum
To anticipate and find people for positions that does not exist yet.
PRINCIPLES OF RECRUITMENT:
Recruitment should be done from a central place. Eg: Administrative
officer/Nursing Service Administration.
1) Termination and creation of any post should be done by responsible officers,
eg: regarding nursing staff the Nursing superintendent along with her
officers has to take the decision and not the medical Superintendent.
2) Only the vacant positions should be filled and neither less nor more should
be employed.
3) Job description/ work analysis should be made before recruitment.
4) Procedure for recruitment should be developed by an experienced person
5) Recruitment of workers should be done from internal and external sources
6) Recruitment should be done on the basis of definite qualifications and set
standards.
7) A recruitment policy should be followed
8) Chances of promotion should be clearly stated
9) Policy should be clear and changeable according to the need.

46
SOURCES OF RECRUITMENT:
The sources of recruitment are:
I) Internal sources:
Internal sources include present employees, employee referrals, former
employee and former applicants.
Present employees: promotion and transfers from among the present employees
can be good source of recruitment. Promotions to higher positions have several
advantages. They are:
o It is good public relations
o It builds morale
o It encourages competent individuals who are ambitious
o It improves the probability of a good selection, since information
of the candidate is readily available
o It is less costly
o Those chosen internally are familiar with the organization.
However promotions can be dysfunctional to the organization as the advantage of
hiring outsiders who may be better qualified and skill is denied. Promotions also
results in breeding which is not good for the organization.
Another way to recruit from among present employees is the transfer without
promotion. Transfers are often important in providing employees with a broad
based view of the organization, necessary for the future.
Employee referrals: this is the good source of internal recruitment. Employees can
develop good prospects for their families and friends by ac quainting with the
advantages of a job with the company, furnishing cards introduction and even
encouraging them to apply. This is very effective because many qualified are
reached at very low cost. Most employees known from their own experience about
DIRECT
SOUR CES
SOURCES OF
RECRUITMENT
INDIRECT
SOURCES

47
the recruitments for the job what sort of person is looking for? A major concern
with the employee recommendation is that referred individuals are likely to be
similar type (e.g. race and sex) to those who are already working for company.
Former employees: some retired employees may be willing to come back to work
on a part-time basis or may recommend someone who would be interested in
working for the company. An advantage with these sources is that the performance
of these people is already known.
Previous applicants: although not truly an internal source, those who have
previously applied for jobs can be contacted by mail, a quick and inexpensive way
to fill an unexpected opening.
Evaluation of internal recruitment:
Advantages:
 It is less costly
 Organizations typically have a better knowledge of the internal candidates‘
skills and abilities than the ones acquired through external recruiting.
 An organizational policy of promoting from within can enhance employees‘
morale, organizational commitment and job satisfaction.
Disadvantages:
 Creative problem solving may be hindered by the lack of new talents.
 Divisions complete for the same people
 Politics probably has a greater impact on internal recruiting and selection
than does external recruiting.
II) External sources:
Sources external to an organization are professional or trade associations,
advertisements, employment exchanges, college/university/institute placement
services, walk-ins and writer-ins, consultants, contractors.
 Professional or trade associations: many associations provide placement
services for their members. These services may consist of compiling
seekers‘ lists and providing access to members during regional or national
conventions.
 Advertisements: these constitute a popular method of seeking recruits as
many recruiters; prefer advertisements because of their wide reach. For
highly specialized recruits, advertisements may be placed in professional/
business journals. Newspaper is the most common medium.

48
Advertisement must contain the following information:
 the job content ( primary tasks and responsibilities)
 a realistic description of working conditions, particularly if they are unusual
 the location of the job
 the compensation, including the fringe benefits
 job specifications
 growth prospects and
 To whom one applies.
Employment exchange: employment exchanges have been set up all over the
country in deference to the provisions of the Employment exchanges (Compulsory
Notification of Vaccination) Act, 1959. The Act applies to all industrial
establishments having 25 workers or more. The Act requires all the industrial
establishments to notify the vacancies before they are filled. The major functions of
the exchanges are to increase the pool of possible applicants and to do preliminary
screening. Thus, employment exchanges act as a link between the employers and
the prospective employees.
Campus recruitment: colleges, universities and institutes are fertile ground for
recruitment, particularly the institutes.
Walk-ins, write-ins and Talk-ins: write-ins those who send written enquire.
These job-seekers are asked to complete applications forms for further processing.
Talk-in is becoming popular now-in days. Job aspirants are required to meet the
recruiter (on an appropriated date) for detailed talks. No applications are required to
be submitted to the recruiter.
Consultants: ABC consultants, Ferguson Association, Human Resources
Consultants Head Hunters, Bathiboi and Co, Consultancy Bureau, Aims
Management Consultants and The Search House are some among the numerous
recruiting agents. These and other agencies in the profession are retained by
organizations for recruiting and selecting managerial and executive personnel.
Contractors: Contractors are used to recruit casual workers. The names of the
workers are not entered in the company records and to this extent, difficulties
experienced in maintaining permanent workers are avoided.
Radio Television:
International Recruiting: Recruitment in foreign countries presents unique
challenges recruiters. In advanced industrial nations more or less similar channels
of recruitment are available for recruiters.

49
MODERN SOURCES OF RECRUITMENT:
 Walk-in
 Consult in
 Tele recruitment: Organizations advertise the job vacancies through World
Wide Web (WWW)
RECRUITMENT PROCESS / STEPS:
As was stated earlier, recruitment refers to the process of identifying and
attracting job seekers so as to build a pool of qualified job applicants. The process
comprises five inter-related stages, via:
FACTORS EFFCTING RECRUITMENT:
All organization, whether large or small, do engage in recruiting activity,
though not to the same extent. This differs with:
1) The size of the organization
2) The employment conditions in the community where the organization is
located
3) The effects of past recruiting efforts which show the organization‘s ability to
locate and keep good performing people
4) Working conditions an salary and benefit packages offeredby the
organization- which may influence turnover and necessitate future recruiting
5) The rate of growth of organization
Strategy
development
STEPS
Searching
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