1. Ensure accurate data is used to determine staffing levels. Although VA inpatient RNs are required to input patient data into the VA’s patient classification system (PCS), the data generated is not used because it “does not accurately capture the severity of patients’ illnesses or account for all the nursing tasks currently performed on inpatient units,” says the GAO. “Because of the shortcomings of VA’s PCS, nurse managers use data from a variety of sources to help set RN staffing levels for their inpatient units.” This lack of accurate data and, therefore, standardization often result in either over- or under-staffing. The former often leads to the next key issue.
2. Let RNs focus on clinical patient care. Inpatient RNs reported that they spend too much time performing non-nursing duties, such as housekeeping and clerical tasks, according to the report. Using lower-wage workers for these duties, in concert with appropriate staffing levels, could save an institution money in addition to increasing nurse retention. In addition, “Nursing officials and RNs noted other factors affecting retention such as reliance on supplemental staffing strategies for example, RN overtime and insufficient professional development opportunities.”
3. Utilize flexible work schedules. Only about 1 percent of surveyed inpatient units offered alternate schedules, and less than 1 percent of RNs actually worked these schedules, according to the GAO. Among the possibilities for flexible work schedules “that are generally desired by nurses”: working three12-hour shifts within a week that would be considered full-time for pay and benefits purposes, and working eight 10-hour shifts over a two-week period.
