Implementing nurse block scheduling in healthcare facilities

Are your nurses asking for more control over their schedules? 

You don’t have to say no to them. Consider block scheduling. Contrary to what you might think, block scheduling isn’t just a healthcare trend for travel nurses or contract nurses. It can be an effective scheduling strategy that benefits your in-house nursing staff as well. Let’s dive in.

What is block scheduling in nursing?

Block scheduling is also sometimes called block booking. Consistency, organization, and planning are at the heart of this strategy. A facility scheduler can group shifts into blocks, either as consecutive or alternating days, and have your nurses choose different blocks.

Block scheduling vs. traditional nurse scheduling

Block scheduling can be done monthly or even a quarter at a time instead of the shorter one- to two-week nurse schedules you may traditionally plan.

How does block scheduling work?

It’s perhaps best explained by some examples. 

In this first nursing block schedule example, the nurse may prefer a rest after two consecutive 12-hour shifts. So the schedule may look something like this:

• Monday: Off
• Tuesday: Off
• Wednesday: On
• Thursday: On
• Friday: Off
• Saturday: Off
• Sunday: On

Others may prefer consecutive shifts for a longer break, such as the following:

• Monday: Off
• Tuesday: Off
• Wednesday: Off
• Thursday: On
• Friday: On
• Saturday: On
• Sunday: Off

Additionally, many nurses prefer to block their three days per week consecutively with the preceding and following week, in order to work four to six days in a row. This block scheduling allows them to have a week or more off at a time. A two-week view of this type of block scheduling might look something like this:

• Week One
  
  • Monday: On
  • Tuesday: On
  • Wednesday: On
  • Thursday: Off
  • Friday: Off
  • Saturday: Off
  • Sunday: Off
• Week Two
  
  • Monday: Off
  • Tuesday: Off
  • Wednesday: Off
  • Thursday: Off
  • Friday: On
  • Saturday: On
  • Sunday: On

“I always prefer to work a minimum of four days in a row to allow more consecutive days off. When facilities allow me to block schedule, it increases my workplace satisfaction. There is nothing worse than the schedule being released and feeling disappointed. Most nurses I know, especially those who work the night shift (NOC), are bummed out if they get scheduled for one day on and then one day off, as it never feels like they had a day off.” - Miranda Belcher, RN and Content Administrator for Nursa

You may have some who are happy to forego the idea of a long break and simply want to work alternating days, like this:

• Monday: On
• Tuesday: Off
• Wednesday: On
• Thursday: Off
• Friday: On
• Saturday: Off
• Sunday: Off

5 Benefits of block scheduling

Why should you consider block scheduling? 

Yes, this form of scheduling may mean reworking the way you do things, but it’s not without some serious advantages. The following are five top benefits for your facility if you decide block scheduling is worth a try:

1. Nurse autonomy: If you let your nurses request their own blocks, you’re giving them control over their schedules. This control can lead to a better work-life balance for them, which means healthier nurses for you.
2. Fewer requests off: When your nursing staff has time to plan in advance, they can arrange more of their personal obligations to fall outside of their shift schedules.
3. Better relationships: Frequent denials for requested time off create bad feelings for both sides. Denied requests can create tension at best and animosity at worst. Better relationships with your nursing staff are good for work culture, attitude, and recruitment.
4. Advance notice of shift gaps: When the schedule is planned at least a month out, your scheduler will have advance notice of coverage problems, giving them more time to address these problems.
5. Staffing efficiency: Shift predictability can lower the likelihood of last-minute shuffling and improve staffing efficiency.

Challenges in block scheduling to consider

The potential benefits of block scheduling are pretty enticing, but like any other strategy, it’s not without flaws. Block scheduling isn’t particularly flexible, which means adjustments for patient census peaks, paid staff leave, or last-minute call outs can create challenges. However, incorporating Nursa’s PRN healthcare staffing solutions to help out in those situations can help your facility adapt. Here’s how:

• Patient census peaks: Instead of paying in-house staff overtime or—worse—shuffling around the schedule, source PRN nurses and nursing assistants to augment your staffing ratios for select shifts.
• Paid staff leave: Post the shifts that your staff nurse has requested off on the Nursa platform so that local nurses can pick them up. Posting the PRN shifts will allow you to approve the time off.
• Last-minute call outs: Emergency staffing needs can be quickly posted to the platform, and notifications will be sent out to PRN clinicians in the area for last-minute coverage.

6 Steps for implementing nurse block scheduling at your facility

If block scheduling is a change you’re seriously considering, be thoughtful and do it right. 

Here are the six steps you can take to implement the change.

1. Assess your unique staffing needs

Block scheduling will be different for a healthcare facility that needs nursing staff 24 hours a day, seven days a week, than for a facility that keeps office hours, like a physician’s practice. Consider how your facility schedules nursing clinicians and analyze how much you currently spend on overtime.

Are shifts eight hours, 10 hours, 12 hours, or a mix? 

Do you need nurses at all times?

Be sure to review your facility’s policies on scheduling and requests for time off. If you implement block scheduling, some changes may be required.

2. Solicit feedback from your nursing staff

Check in with your nursing staff, explain what a block schedule is, and find out how interested they are in the idea.

• What kind of blocks are they interested in?
• Do they want consecutive shifts and then long breaks?
• Do some want rest days between shifts?

Ask them for their ideas on policies and implementation as well. This is an opportunity to show your nursing staff that you value their input.

3. Design your block schedules

Provide a mix of options for your clinicians to choose from, taking into consideration their feedback. Some may prefer blocks with consecutive shifts, while others may prefer alternating with time off between shifts.

4. Clarify your block scheduling policies

Block scheduling won’t entirely stop requests for time off. People get sick and still want to take vacations. Be ready to have an answer and a policy about handling requests for time off that fall during a block and requests for shift trading. 

• Will you allow shift trades? 
• Who has to be notified?
• How will requests for time off be handled?

You’ll also need clear instructions regarding the timeframe for staff members to turn in their block requests before they are automatically assigned a block and the schedule is finalized.

5. Test the program on a small scale

Block scheduling is potentially a big change. Start small and pick a unit to test it on. This will help you work out any inconsistencies in messaging, timing, block designs, and policy changes. It will also allow your scheduler to adjust.

Testing the program on a small scale has the added benefit of gaining nurse buy-in for when it comes time to do a full rollout. 

6. Review and act

Engage with your test unit nursing staff to find out how block scheduling is working for them. Ask them for specific feedback and opinions about the timeframes, the block options, and the policies.

Find out what your scheduler has to say as well. Was it helpful for them to have a month planned out in advance?

Review the impact that block scheduling has had on the unit and decide whether you need a full rollout, further testing, or to end the test pilot.

Explore more facility support resources on Nursa

Block scheduling is an interesting strategy that can be applied in almost any healthcare setting. It offers nurses the autonomy to choose their schedules, which can have a ripple effect of several benefits, and it gives schedulers a long view to plan and prepare.

The lack of flexibility this strategy inherently has is a valid concern, but it may be offset with clear policies regulating shift trades and leveraging our PRN staffing platform to respond to last-minute call outs and sudden surges in the patient census.

Learn more about how Nursa can help with on-demand nurse staffing regardless of your scheduling strategy.