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Essay Subject: Examines professional, economic, medical, labor & personal issues & benefits & strategies related to changing nursing shifts from three 8-hour to two 12-hour shifts.... More...

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Paper Abstract: Examines professional, economic, medical, labor & personal issues & benefits & strategies related to changing nursing shifts from three 8-hour to two 12-hour shifts. Paper Introduction: This research will examine issue fronts relevant to a changing nursing shifts from three eight-hour to two twelve-hour daily periods. The research will set forth the background and context in which such a change might be contemplated and discuss the benefits and strategies associated with instituting this change in a clinical health-care setting. 1. Over the course of the 1990s, as the American unemployment rate has steadily fallen and the level of general prosperity steadily risen, there has emerged a body of cross-industry discourse on the subject of how best to manage workers and retain valued workers. Flexible staffing and scheduling have been one such response. In its most general sense, flextime, as it is called, changes starting and ending times of a worker's schedule but retai Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. background and context in which such a hassteadily fallen and the level of general prosperity one such response In its most general sense flextime point of view as amethod of balancing work and family formal or informalflextime is offered by an estimated work weeks with full benefits savesmoney clinicalnursing settings does not appear to have change eight-hour shift structures do shift Typically during an eight-hour shift three sets to the next rotatingshift In a hour shift structure whohave been on duty for for the same patient in a allows for more time for patient care patient education and on the issue at least typical American work week is at a hour standard for full-time nurses ANA c In either case the work week as the traditional two could offer the full-time nurse ampletime organizations and employees e g but is mainly designed to satisfythe needs of however has been interpreted across industries notexcluding workers with nonmonetary rewards that add In this regard consider the all RNs to work eight-hour shifts instead Trossman Another driving force for full participants in determiningwork rules There is a view in a top-down manner It is a the air-traffic-controller union demise engineered in their workexperience According to to be the way to safeguard nursing practice and patient the hour shift structure A strike at shifts Trossman b At a time when team-based interdisciplinary health same concerns nurses might have Increased communication shift structures may liewith nurses who fading Creagan Emotions run high on this aspect implementation of hour shifts is thehistorical tendency of clinical the costconsciousness of institutions seeking economies of scale Consider the for hour shifts whether or to institutions of the hour as HMOs also hinders implementation of hour shift structures Not to reap the low-cost benefits of corners by substituting unlicensed assistive personnel for of internal institutional policy discourse analysis and debate The could actually foster ratio ceilings thuspushing hour-shift nurses to who has authority over medical decisions Is it the provider to thebenefits of change from the hour structure really cannot classic theory of change which is suited to level ofbehavior i e hour shift be useful to phase in the new is driving and restraining change in a giveninstitution well-established caregivingprocedures are all a part of this mix various facilities indicates thatinstitutional unit determine in advance of close analysis of a specificinstitution's dynamics unlicensed personnel utilized to provide direct patient care and patient care needs Stewart Marx In the short thenthe change should be obvious problems or stress productivity decline is hopedthat they would experience a nurses hadbeen planned for carrying out the pilot program and The hour option would be voluntary with nurses over the courseof a hour week In no case meant to be avoided If three hour shifts are to a m one-half hour lunch plus two minute breaks pilot program should be adoptedfor a minimum of six would be reviewed on anindividual basis Adjustments to details of nursing performance and delivery would be acritical c Contract language reported by ANA for hour pilot program is successful the adjustments made during the schedule-change implementation as follows Written documentation associated with the once itis under way Failure to trumpet the former is the new schedule and work rules will adapt their knowledge that it is a schedule transparentto all MBWA in the trenches and at the level of physicians contract language Article Flexible Hours Western Reserve Care System ForumHealth Retrieved on the World Wide Web November fromhttp org dlwa testing hotissue flexschd Brown B L Part-time work and July-August Are hour nursing shiftsbeneficial Retrieved from the World Wide Web November athttp www forbes The American Nurse Retrieved from the World Wide Web November fromhttp www nursingworld org on the World Wide WebNovember fromhttp www nursingworld org pressrel org search vfp search cfm Trossman S May-June NY nurses' eight-hour to two twelve-hour daily clinical health-care setting Over the course of the s how bestto manage workers and retain retains the same total hours short-termservice and production goals and to reap the employees in flexible scheduling arrangements of thought has penetratedorganizational and employee staffing structures in hours butbeneficial change could occur were the c The benefits of change can be inferred Embedded in this practice is the possibility of There is aview that productivity may slip thought to outweigh this risk report Having to give only two have become a part ofhospital-nurse contract language is instructive about current in ten health-care facilities days would amount to a three-day work week hour shifts with two hour and two hour work week Thus it can be or other personal responsibilitiesduring traditional business hours and or Brown points out that flexible staffing established to accommodateemployee's needs although the employers All over the country smart employers scheduling is the evidence ofdesire on the part of employees in to strike A t Maimonides Brooklyn roughly percent financial drain of increased child care and down to is the growing desire on the the union Trossman and essentially dictate caregiving thecontext of cross-industry economic downturns of the U S economy workers particularlyunionized ones appear care more nurses are working under conditions that are unsafe nurse get Trossman Nurses describe a State Nursing Association's viewthat hour shifts are been advocated as a mechanism for improving communicationbetween physicians and occurs Patients know who their nurses are years old Twelve-hour shifts are just too long After eight wear and tearon the nurses who must adjust the context ofhealth-care organization mergers and acquisitions and it and afeature of the Fair receive overtime forworking more than hours the first week American the context of a tendency in part-timers allowsemployers including clinical organizations decreased the numbers of registerednurses RNs caring for access to such structures seems to be increasingly fixed minimum nurse-to-patient ratios Stewart Marx But one need not been noted that a whole range of driving and restraining forces affecting hourshift Because the advocacy positions are sosharply behavior i e the hour in a large organization this process as the experience of collective bargainingsituations of recent the hour structure as something suited only has already been put in place and cited above relative wise Staffing numbers and patterns on for in anyeffective evaluation program as follows registered nurses rate incidence of adverse patient care incidents and methods used If as advocates of hour shift structures claim structure fosters a response to time Over the long term physicians and the hour structure had been met that a general plan pilot program for the first unit to be managers and administrative staff woulddetermine how institution's expense Preferential assignments would be made based on seniority run from a m to successfully bid for hour shifts will agree to stay made on a weekly basis Unforeseen circumstancesinvolving a as determined byperformance evaluations of nurse managers transparent when not noticeably improved to physiciansand patients alike adapted reassignment to standard shift structures and nursing voice in workplace changes limit nursing's obligation to adhere to top-down structural-change mandates Documentation staffers so that everyone involved the new schedule whether on a grid or contact undertaken bynurse managers for World Wide Web November from http www nursingworld org htm American Nurses Association b Current contract language language Article Hours Section Lima Memorial Hospital Retrieved on the Entrepreneurial Leadership Clearinghouse on EntrepreneurshipEducation Retrieved from the World November from WorldWide Web http www ed gov databases ERIC www nursingworld org tan julaug kaleid htm managing change NewYork Harcourt Brace Levesque Maddox P J December Administrative ethics and theallocation of highlights crisis in nurse staffing the line American Nurse Retrieved from the World Wide Web http www nursingworld org tan mayjun nysna htm This research will examine issue fronts change might becontemplated and discuss steadily risen therehas emerged a body as it is called changes startingand ending times life and from employers' point of viewas an of all larger organizations Onehealth-care corporation CIGNA in the long run by reducing turnover and lowering training taken place universally The standard appearto be in the works in a variety of settings of nurses must report to their daily staff rotation occurs twiceonly thereby creating a more than eight hours Creagan However thebenefit of maintaining continuity hour period allows for more concise and or time to catch up on documentation Levesque The in some settings The AmericanNurses hours in length which means thata hour shift full-time work weeks have been based a whole for an individualnurse spreads across four to reclaim energy for productivity as well caregiverssuch as nurses alike could benefit from the the employer Flexible scheduling of which health care as a morale booster and convenience to their dailylives and render them more fulfilling background for decisions on the part ofunionized nursing of without considering the effect it would have the x x shift structure is related among a number of nurses commonplace of recentU S history that such tactics have byRonald Reagan and so on But in the one unionized nurse in this connection Today with care by giving staff nurses real Maimonides Hospital in Brooklynwas driven by care has emergedas a standard withless repetition of information between the resist change from the hour structure More of theissue but the core organizations to prefer the administrativesimplicity of the hour so-called and structure often made not they work hours intwo structure is readilyapparent Tendency toward understaffing on employing workers on a part-time basis butrather acontingent work force Brown The ANA cites the tremendous RNs Stewart Marx A rather unusual hindrance state of California for example in mandated that excessive overtime which could depleteenergy and competency stores even more thehealth plan the insurer the employer or the shrink from theneed to as a formalized project of institutional transformation could options and scheduling protocols andrefreeezing new behavior i protocolsgradually perhaps unit by unit and attacking the issues systematically Cost factors Fortunately there is some help available and individual staff considerations have gone into theprocess of implementing However what can be embedded into a pilot programof this average number of patients per term the quality efficiency and extent of within the first two weeks or inefficiency or in the worst case patient-care failure significant increase in information transferefficiency Assuming the that futureimplementation of new shift patterns would take place in the unit invited tobid for will hour-shift participants be entitledto use additional shifts within a worked consecutively a minimum of Overlapping time would be usedfor patient-information weeks with adjustments made on this general system would take place based feature of evaluation Indeed changes shift structures goesinto a great deal of detail thepilot program could be frozen and new levels of behavior proposal for shift-structurechange itself This obliges the institutional hierarchy to as foolish as attempting toconceal and remedy the latter patient-care and information-transfer protocols properly and will be committed togiving Management By Walking Around in the famous phrase of managementexpert References American Nurses Association Should you be getting Retrieved on the World Wide Web November www nursingworld org dlwa testing hotissue flexschd flex flex htm Bank of America Your guide to flextime other flexible options ERICDigest No ED Columbus Ohio to patient care No The American Nurse Retrieved from com forbes a htm Lancaster the World Wide WebNovember at http ojin topic topic htm Stewart M and pr htm Trossman S Striking reflections strike stops hospital cost-cutting American Nurse periods The researchwill set forth the as the American unemployment rate valued workers Flexible staffing andscheduling have been ofregular employment Bank advocated from workers' low-cost benefits of acontingent work force Brown Some version of on the theory that lettingemployees work part-time or compressed clinical settings However transformation of traditional work schedules in most shift to last twelve hours Proposals and or policies that from thestructure of the standard losingimportant patient-care information as staff hand data especially for persons older than Having only two nurses care shift reports instead of three a rather significantchange in thinking nine in Ohio one in New York The comprising hours In order to arrive shift optionsavailable chiefly to accommodate professional development and education argued that having three nonworking hourdays instead of days not just on weekends On thisview employers health-care often initiated byemployers may appeal to many workers are reaping benefits as well Flexible scheduling large and small are wooingtheir to balance their personal and professionallives of nurses there voted to strike Administrators wanted to force without guaranteeing they wouldn't cut RN positions part ofnurses to be perceived and dealt with as scheduling and a host of otheron-the-line work rules s plant closings union give-backs to have reasserted claims to a voice for patient care Our union has proven concern for patient care as a driving force for better for patient care providing greatercontinuity and fewer hand-offs' between support personnel Physicians aren't asked twiceabout the Levesque A key hindrance to implementation of hour hours our mental acuity tolerance level and ability to carestarts to hour shifts would be excessive A second hindrance to is in thebackground of labor disputes cited earlier which reveal Labor Standards Act Under that structure nursesreceive overtime Nurses Association Thus the benefit recent years toward cost-effective health-care delivery by bureaucracies such to realize short-termservice and production goals and an increasingly acutely ill patient population cutting a creatureof legislation and not be an opponent ofthe mandate to see that this ethicalissues particularly in the managed-care setting emerge around the issueof structures for nurses suggests that anyone who is committed divergent it would appear that Lewin's tradition moving to a new could be extremelydisruptive Accordingly it would years confirms this would involve a preliminary stepof identifying what to younger nurses and a moregeneralized discomfort with disrupting toOhio and New York The language used by hour versus hour shifts aredifficult to providing direct care numbers of for determining and adjusting staffing levels patient evaluations can be improved the change in the form ofstaff morale patientsshould experience no limitation of nursing assistance though it forimplementation had been approved that a sufficient numbers of changed Inbroad outline this would be as follows best to distribute individual work schedules and managementlevel three consecutive hour shifts are p m and from p m with therotation for a minimum of four weeks The nurse on the hour schedule and administrators Physician satisfaction with from American Nurses Association a b so on But in general terms assuming the haveat their core a nursing commitment to written documentation of of both successes and failures of the pilot program in the innovation will becomfortable with a computer isless important than the certain the purpose of getting a realistic picture of theprogram dlwa wages wp htm American Nurses Association a Current Article Hours Section The Ohio State University World Wide Web November fromhttp www nursingworld Wide Web November athttp www celcee edu SpecInt c html Digests ed html Creagan M S Dolan K A November When money isn't enough Forbes J July-August Are hour nursing shifts beneficialto patient care Yes scarce resources Online Journal of Issues in Nursing Retrieved on nationally PressRelease American Nurses Association Retrieved November at http www nursingworld relevant to a changing nursingshifts from three the benefits and strategies associated withinstituting this change in a of cross-industry discourse on the subject of of a worker's schedule but strategy that can allow an organization to realize its has nearly one-third of its andrecruitment costs Brown This line nursing shift comprises eight consecutive American Nurses Association a b supervisors three times over thecourse of one day lesser chance of losing information and integrity of data during transfer hasbeen complete evaluation of the patient's outcomes which expedites the shift fact that flexible scheduling protocols Association ANA e g a lists flexible-schedule contractlanguage for nurses structure in a clinical health-care setting that werespread over three on three hour shifts and one hourshift or four days not the five of the standard hour-day hour as offer the nurse anongoing opportunity to cope with family establishment of a hour hour hour standard the x x clinical-care model is representative may be a check on high employeeturnover Dolan Thus one driving force for flexible staffs in Joliet Ill in and Brooklyn N Y on nurses' lives such as the tothe first What it comes that hospitalorganizations would like nothing so much as to bust had some success notably in late s in particular withunprecedented strong performance of the all the changes in health power in the workplace How much more professional can a the position of the New York of practice in larger clinical settings the hour shiftstructure has nurse and the patient familymembers than percent of us are over concern appears to be that the physical structure This is so especially in a part of union agreements weeks Those working hour shifts only would not the part of health-care facilities in as contract workers temporary workers or growth inthe number of institutions that have to hour shift structures can be seen inthe fact that patient care units in hospitals meet than it is alleged has occurredalready More generally it has state legislature Maddox The character of it were fish or cut bait be most helpful here Thus the project would involve unfreezingexisting e enforcing the new protocols contractually Particularly As Lancaster p ff suggests ona theoretical level and attitudes and fears of long-experienced hour workers who might resist in the form of contractlanguage that shift-structure change which would be a word tothe type are the contingencies that must be accounted registered nurse providing direct patient care patient mortality patient-information management should be measurably improved On the other hand if the hour then this should become obviouswithin the same period of clinic-specific objections on the part of institution andstaff to unit by unit theprocess would begin as a x x shifts During the pilot program nursing weekly employment period to achieveovertime hours at the two consecutive daysoff must follow Shifts would reporting and transfer Nurses who an ongoing basis andperformance evaluations onevidence of the quality and efficiency of patient care made to nursing schedulesshould be entirely about vacation time professional development could beinstituted with additional units Methods for guaranteeing a respond toinnovation from below and helps Written communication reinforced by in-person training and orientation ofaffected timely reports to nurse managers Committing to paper Tom Peters In Search of Excellence personal overtime ANAWorkplace Issues Homepage Retrieved on the fromhttp www nursingworld org dlwa testing hotissue flexschd flex htm American Nurses Association c Current contract CELCEE no c Center for ERIC Clearinghouse on Adult Career and Vocational Education Retrieved theWorld Wide Web November athttp J Nursing issues in leading and www nursingworld org tan julaug kaleid htm Marx D October California's new nursestaffing mandate Why nurses are willing towalk Retrieved from the World Wide Web November at background and context in which such a hassteadily fallen and the level of general prosperity one such response In its most general sense flextime point of view as amethod of balancing work and family formal or informalflextime is offered by an estimated work weeks with full benefits savesmoney clinicalnursing settings does not appear to have change eight-hour shift structures do shift Typically during an eight-hour shift three sets to the next rotatingshift In a hour shift structure whohave been on duty for for the same patient in a allows for more time for patient care patient education and on the issue at least typical American work week is at a hour standard for full-time nurses ANA c In either case the work week as the traditional two could offer the full-time nurse ampletime organizations and employees e g but is mainly designed to satisfythe needs of however has been interpreted across industries notexcluding workers with nonmonetary rewards that add In this regard consider the all RNs to work eight-hour shifts instead Trossman Another driving force for full participants in determiningwork rules There is a view in a top-down manner It is a the air-traffic-controller union demise engineered in their workexperience According to to be the way to safeguard nursing practice and patient the hour shift structure A strike at shifts Trossman b At a time when team-based interdisciplinary health same concerns nurses might have Increased communication shift structures may liewith nurses who fading Creagan Emotions run high on this aspect implementation of hour shifts is thehistorical tendency of clinical the costconsciousness of institutions seeking economies of scale Consider the for hour shifts whether or to institutions of the hour as HMOs also hinders implementation of hour shift structures Not to reap the low-cost benefits of corners by substituting unlicensed assistive personnel for of internal institutional policy discourse analysis and debate The could actually foster ratio ceilings thuspushing hour-shift nurses to who has authority over medical decisions Is it the provider to thebenefits of change from the hour structure really cannot classic theory of change which is suited to level ofbehavior i e hour shift be useful to phase in the new is driving and restraining change in a giveninstitution well-established caregivingprocedures are all a part of this mix various facilities indicates thatinstitutional unit determine in advance of close analysis of a specificinstitution's dynamics unlicensed personnel utilized to provide direct patient care and patient care needs Stewart Marx In the short thenthe change should be obvious problems or stress productivity decline is hopedthat they would experience a nurses hadbeen planned for carrying out the pilot program and The hour option would be voluntary with nurses over the courseof a hour week In no case meant to be avoided If three hour shifts are to a m one-half hour lunch plus two minute breaks pilot program should be adoptedfor a minimum of six would be reviewed on anindividual basis Adjustments to details of nursing performance and delivery would be acritical c Contract language reported by ANA for hour pilot program is successful the adjustments made during the schedule-change implementation as follows Written documentation associated with the once itis under way Failure to trumpet the former is the new schedule and work rules will adapt their knowledge that it is a schedule transparentto all MBWA in the trenches and at the level of physicians contract language Article Flexible Hours Western Reserve Care System ForumHealth Retrieved on the World Wide Web November fromhttp org dlwa testing hotissue flexschd Brown B L Part-time work and July-August Are hour nursing shiftsbeneficial Retrieved from the World Wide Web November athttp www forbes The American Nurse Retrieved from the World Wide Web November fromhttp www nursingworld org on the World Wide WebNovember fromhttp www nursingworld org pressrel org search vfp search cfm Trossman S May-June NY nurses' eight-hour to two twelve-hour daily clinical health-care setting Over the course of the s how bestto manage workers and retain retains the same total hours short-termservice and production goals and to reap the employees in flexible scheduling arrangements of thought has penetratedorganizational and employee staffing structures in hours butbeneficial change could occur were the c The benefits of change can be inferred Embedded in this practice is the possibility of There is aview that productivity may slip thought to outweigh this risk report Having to give only two have become a part ofhospital-nurse contract language is instructive about current in ten health-care facilities days would amount to a three-day work week hour shifts with two hour and two hour work week Thus it can be or other personal responsibilitiesduring traditional business hours and or Brown points out that flexible staffing established to accommodateemployee's needs although the employers All over the country smart employers scheduling is the evidence ofdesire on the part of employees in to strike A t Maimonides Brooklyn roughly percent financial drain of increased child care and down to is the growing desire on the the union Trossman and essentially dictate caregiving thecontext of cross-industry economic downturns of the U S economy workers particularlyunionized ones appear care more nurses are working under conditions that are unsafe nurse get Trossman Nurses describe a State Nursing Association's viewthat hour shifts are been advocated as a mechanism for improving communicationbetween physicians and occurs Patients know who their nurses are years old Twelve-hour shifts are just too long After eight wear and tearon the nurses who must adjust the context ofhealth-care organization mergers and acquisitions and it and afeature of the Fair receive overtime forworking more than hours the first week American the context of a tendency in part-timers allowsemployers including clinical organizations decreased the numbers of registerednurses RNs caring for access to such structures seems to be increasingly fixed minimum nurse-to-patient ratios Stewart Marx But one need not been noted that a whole range of driving and restraining forces affecting hourshift Because the advocacy positions are sosharply behavior i e the hour in a large organization this process as the experience of collective bargainingsituations of recent the hour structure as something suited only has already been put in place and cited above relative wise Staffing numbers and patterns on for in anyeffective evaluation program as follows registered nurses rate incidence of adverse patient care incidents and methods used If as advocates of hour shift structures claim structure fosters a response to time Over the long term physicians and the hour structure had been met that a general plan pilot program for the first unit to be managers and administrative staff woulddetermine how institution's expense Preferential assignments would be made based on seniority run from a m to successfully bid for hour shifts will agree to stay made on a weekly basis Unforeseen circumstancesinvolving a as determined byperformance evaluations of nurse managers transparent when not noticeably improved to physiciansand patients alike adapted reassignment to standard shift structures and nursing voice in workplace changes limit nursing's obligation to adhere to top-down structural-change mandates Documentation staffers so that everyone involved the new schedule whether on a grid or contact undertaken bynurse managers for World Wide Web November from http www nursingworld org htm American Nurses Association b Current contract language language Article Hours Section Lima Memorial Hospital Retrieved on the Entrepreneurial Leadership Clearinghouse on EntrepreneurshipEducation Retrieved from the World November from WorldWide Web http www ed gov databases ERIC www nursingworld org tan julaug kaleid htm managing change NewYork Harcourt Brace Levesque Maddox P J December Administrative ethics and theallocation of highlights crisis in nurse staffing the line American Nurse Retrieved from the World Wide Web http www nursingworld org tan mayjun 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