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Best Practices: Scheduling
Effective scheduling policies are clearly dependent on adequate staffing levels. Nevertheless, it is important for hospital administrators to adopt scheduling systems that go as far as possible toward accommodating the needs of both younger and older RNs. In the original magnet hospitals, "directors of nursing acknowledged that the scheduling of work hours is one of the most critical factors in the work situation."190 Indeed, these hospitals proudly touted their innovative scheduling practices: "Staff nurses have the opportunity to participate with their head nurses in planning their work schedules and ... consideration is given to arranging their hours of work to accommodate family needs, educational programs, and other personal activities and preferences. ... Several nurses note that the introduction of flexible hours has resulted in increased staff retention in their hospitals in recent years."191 For this reason, the American Hospital Association urges its member hospitals to adopt policies minimizing, if not eliminating, shift rotation and allowing creative and flexible staffing arrangements that are tailored to meet staff needs.192
Specific Proposals for Scheduling
The original magnet hospitals upheld a set of policies that now seem beyond the reach of most hospitals but that might prove a significant boon to recruitment and retention efforts. Most nurses in magnet hospitals never worked weekends. Others worked a maximum of one weekend per month. In still other cases, hospitals hired nurses who were paid a full week's salary and benefits in return for working two 12-hour shifts each weekend. Many of these hospitals adapted similarly creative policies for the regular workweek. Options included 7/70 — work seven 10-hour days and then have seven days off — or work three consecutive 10-hour days for 40 hours pay and benefits, followed by four days off.
The original magnet hospitals also promoted internal float pools to avoid using agency nurses. More recently, executives were asked to rank the effectiveness of various retention strategies on a scale of one through five, with five representing those policies with the greatest impact on retention. Instituting unit float pools was rated a four. Weekend options, where nurses work two or three 12-hour shifts per weekend, paid at a premium rate, while all other staff work only Monday-Friday, was rated a three. The continuing importance of such arrangements for nurses is evident in the efforts of the most ambitious unions to re-create the earlier magnet practices. In 2001, for example, the United Nurses of Pennsylvania (AFSCME) negotiated a contract that revives the practice of weekend-only shifts providing premium pay and full health benefits.193
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