The holidays are just around the corner. As hot summer days transition into cooler fall days, hospital administrators and healthcare managers have one thing on their minds: nurse staffing challenges.
Why? Because holiday months often increase hospital patient census and require adequate levels of nurses on staff to keep everyone safe and healthy.
Any hospital administrator will tell you that there is no one correct approach for ensuring enough medical staff during the holidays on shift. However, there are some tips for staffing managers that can make handling nurse scheduling a more streamlined process. So, if you are a nurse scheduler or staffing coordinator, you can stop nervously biting on your lower lip right now (believe us when we say we get it). Keep reading to learn six holiday staffing tips can help resolve nurse staffing issues:
1. Be Realistic about Holiday Healthcare Staffing Shortages
When it comes to hospital staffing during the holiday, 'tis the season to be jolly can feel like a ton of bricks. In other words, if you are in charge of scheduling nurses around significant fall and winter holidays, it's best to ensure you are well prepared. This means being realistic about nurse shortages that often occur during peak holidays. According to data by the Consumer Product Safety Commission (CPSC), over 6,000 people visit emergency departments on average between Christmas and December 31st due to significant injuries caused by holiday activities or products. This spike in patients can influence the typical number of days a patient receives care at a hospital over a specific period, documented in a hospital census.
What Is a Hospital Census?
- A hospital census, or patient census, represents the current number of individuals a facility provides care for. Patient censuses are used at general hospitals, university hospitals, and any category of healthcare facility that provides acute care. Patient census fluctuations are typical and expected, especially during holidays. An increase in patient census and the fact that many nurses prefer to have time off during holidays can lead to a shortage of available staff. Additionally, some nurses may call in sick or take unexpected leave, making it even harder to find replacements. This can lead to overworked nurses, lower-quality patient care, and increased patient and staff stress levels.
The Solution? Nursing managers and staffing coordinators should not underestimate the number of nurses needed for safe patient-to-nurse ratios around the holidays. The best way to ensure enough nurses on staff is to overestimate, rather than underestimate, how many nurses a hospital will need to enhance patient safety and deliver appropriate care. This could entail having a surplus of nurses scheduled around the holidays, which can help manage unexpected spikes in patient volume.
2. Offer Healthcare Staff Incentives for Working on the Holidays
"I'll be home for the holidays" may not be the tune every nurse sings because hospitals are busy and must be staffed adequately during the season. This could mean that, alongside other holidays, many nurses are scheduled to work on Christmas Eve or Christmas Day. This can put nursing staff at risk of resentment, fatigue, and burnout. Per diem nurses enjoy the liberty of deciding if they want to work on the holidays or not.
The Solution? Although the Fair Labor Standards Act does not regulate or mandate holiday compensation, some studies have shown that nurses could be more motivated to perform better by offering rewards. Therefore, one method that hospital administrators and nurse managers could utilize to help maintain good staff ratios is to offer incentives such as monetary bonuses or rewards to nurses willing to work on major holidays. Similarly, a nurse manager could lift the spirits of their nursing staff by handing out gift cards and gift baskets and considering hosting holiday activities at the hospital.
At the same time, it's essential to remember that monetary incentives should only be used as a short-term solution. Paying more money for nurses to work longer hours and extra days over the holidays can also cost a hospital more money. To balance this, hospital executives and human resources should incorporate other non-monetary incentives to boost staff morale and ensure staffing levels are consistent around the holidays. By using per diem nurses via a healthcare marketplace such as Nursa, staffing managers can often source local per diem nurses without having to pay the extra incentive for a holiday - or if they are in a pinch - they can also increase their pay rate within the app for last-minute coverage.
3. Implement a Fair Holiday Scheduling System
Scheduling nurses on holidays can be challenging for several reasons. Not only do hospitals often witness an increase in patient admissions and emergencies, but many nurses prefer to spend holidays with their families and loved ones. This can make finding available staff willing to work during those times challenging.
The Solution? A fair scheduling system that facilitates prior planning of nurse shifts and removes scheduling uncertainty should be used. For example, an advanced pre-scheduling system enables nurses to sign up for or exchange shifts with colleagues in real time. Once a nurse requests a shift, this is usually followed up by management consent and acceptance of the requested shift.
Additionally, a nursing holiday rotation schedule can assist nurse staff in selecting the holidays they wish to work or not work by requesting days off well in advance—in some cases, up to one year. This might imply that one year, a nurse decides to work Christmas Eve, Thanksgiving Day, and July 4th and then switches to working other holidays the following year. Since a nursing holiday rotation schedule keeps track of what holidays nurse staff worked and didn't work, this can eliminate both emotional and complex scheduling conflicts in the future among the hospital employees.
4. Prioritize Requests Off by Senior Staff (But Don't Overdo It)
Having senior staff on the nursing floor is crucial to maintaining team leadership and ensuring high-quality patient care. Yet, senior nursing staff generally have more accumulated vacation time than newer nursing staff. As a result, senior staff may request more time off during popular holiday times. So, while nurse staffing coordinators should prioritize paid time off (PTO) and requests off by senior nursing staff, having enough senior staff scheduled around the holidays is essential.
The Solution? Simply ask. That's right. Asking a senior nursing staff member directly—and, of course, well in advance—is the best method for a nursing manager or staffing coordinator to determine whether they are willing to work on a holiday. Fortunately, many experienced nurses are willing to step up and work on holidays since they are aware of the spike in hospital admissions that may happen at this time of year. At the same time, a nursing manager should also prioritize enough time off requests from senior nursing staff, as this will likely impact their motivation to work when next year's holidays roll around.
5. Be Upfront Scheduling and Stick to a Plan
Healthcare can be unpredictable, especially in a hospital setting around the holidays. For the manager responsible for coordinating and attending all nursing shifts, being as straightforward as possible is the key to having enough staff for the holidays.
The Solution? To reduce ambiguity when scheduling enough nurses around the holidays, make a plan and stick to it. Plan all nursing shifts well in advance. This includes using pre-scheduling systems and nursing rotation systems, as mentioned above. Once a holiday shift has been requested and approved, it should not be changed. This can help avoid confusion and last-minute changes that negatively impact staff and patients. Likewise, nurse staffing coordinators should always be upfront and clear about the shifts they need their staff to work. Offering predictability and sticking to a plan can significantly reduce schedule conflict and understaffing issues around the holidays.
6. Schedule Per Diem Nurses on Demand
Even with all of the techniques above in place, there will often be gaps in coverage over the holidays. That's because a nursing shortage has been imminent for decades, and COVID-19 pushed it over the edge. As a result, no matter how hard a scheduling manager works to maintain nurse-staff ratios, there will be occasions when there are not enough nurses to schedule.
The Solution? One of the best ways to find a "coverage cushion" during peak holiday times is to hire per diem nurses. Per diem nurses can fill shifts that require extra coverage, often at the last minute. Hence, when there are labor shortages or significant increases in patient load, per diem nurses can be a quick and effective solution for hospitals needing coverage. The best part is that per diem nurses tend to have ample flexibility and can be scheduled on-demand and in real-time when a hospital needs it most.
Bottom Line: Avoid Holiday Stress by Keeping Your Hospital Staffed
Nobody likes a holiday headache, even if it's caused by eggnog, and it's much worse if nurse scheduling issues cause it. If you are in charge of ensuring that the nursing floor is adequately staffed this season, you can take a sigh of relief. As you can see, there are plenty of strategies for keeping your hospital well-staffed this time of year..
Implementing a comprehensive scheduling system, considering nurse availability, and hiring a few (or a lot) of per diem nurses can help hospital managers prepare for staff shortages during the holidays. These tactics will not only ensure that patients are effectively cared for but will also help reduce burnout and raise the morale of nursing staff as a whole.