human resource-2 in nursing management I

human resource-2 in nursing management I

1. Human resource for health.. cont’d

2. INTRODUCTION: Recruitment is an important function of health manpower management, which determines, whether the required will be available at the work spot, when a job is actually to be undertaken. Recruitment procedures include the process and the methods by which vaccines are notified, post are advertised, applications are handled and screened, interviews are conducted and appointments are made. Recruitment of nurses are major concern. Recruitment means finding out of the further workers. It is process of searching for prospective employees and stimulating them to apply for job in an organization. RECRUITMENT

3. MEANING: In a simple term, recruitment is understood as the process of searching for and obtaining applicants for job, from among whom the right people can be selected. DEFINITION: According to B Flippo : ―Recruitment is defined as the process of searching for prospective employees and stimulating them to apply for job in the organization. According to IGNOU Module: ―It is a process in which the right person for the right post is procured

4. There are three types of recruitment: Planned: arise from changes in organization and recruitment policy Anticipated: by studying trends in the internal and external organization. Unexpected: arise due to accidents, transfer and illness. TYPES OF RECRUITMENT:

5. The requirement process is concerned with the identification of possible sources of human resources supply and tapping those resources, the total process acquiring and placing human resources in the organization. Requirement falls in between different sub process like LINKAGES OF REQUIREMENT TO HUMAN RESOURCE ACQUISITION Recruitment Selection Placement Job analysis Manpower planning

6. Internal sources External sources Internal sources: Internal source of recruitment are the most obvious sources within the organisation itself which includes.. Present employees: promotion and transfers from among the present employees can be good source of recruitment. Promotions to higher positions have several advantages. They are: It is good public relations It builds morale It encourages competent individuals who are ambitious It improves the probability of a good selection, since information of the candidate is readily available It is less costly Those chosen internally are familiar with the organization. SOURCES OF RECRUITMENT:

7. Former employees: some retired employees may be willing to come back to work on a part-time basis or may recommend someone who would be interested in working for the company. An advantage with these sources is that the performance of these people is already known.

8. Advantages of internal sources: It is less costly Organizations typically have a better knowledge of the internal candidates‘ skills and abilities than the ones acquired through external recruiting. An organizational policy of promoting from within can enhance employees‘ morale, organizational commitment and job satisfaction. Disadvantages of internal sources: Creative problem solving may be hindered by the lack of new talents. Promotions may be based on seniority rather than merit results in unqualified persons in more responsible positions Politics probably has a greater impact on internal recruiting and selection than does external recruiting.

9. Most of the organisations cannot fill their manpower needs from within and hence they must look for outside sources. The outside pool of potential candidates includes: Active files of potential candidates kept at the organisation. Employment agencies. Professional associations. Military processing units. Employee referrals. Foreign consulates. Open house. Campus recruitment. Radio Television. Tele recruitment. ( through web.) Walk-ins and gate hiring Advertisements External sources:

10. These constitute a popular method of seeking recruits as many recruiters; prefer advertisements because of their wide reach. Objectives of advertising: Attract the suitable candidates. Get adequate number of candidates. Discourage unsuitable persons from applying Project a good image of the organisation. Advertisement must contain the following information: the job content ( primary tasks and responsibilities) a realistic description of working conditions, particularly if they are unusual the location of the job the compensation, including the fringe benefits job specifications growth prospects and To whom one applies. Advertisements:

11. INTRODUCTION Credentialing is the process of establishing the qualification of licensed professionals, organizational members or organizations, and assessing their background and legitimacy. Many health care institutions and provider networks conduct their own credentialing, generally through a credentialing specialist or electronic service, with review by a medical staff or credentialing committee. It may include granting and reviewing specific clinical privileges and medical or allied health staff membership. CREDENTIALING

12. Someone’s credentials are their previous achievements, training and general background which indicates that they are qualified to do something. A letter or certificate that proves their identity. “ Credentialing is the process by which selected professionals are granted privileges to practice within an organization. In health care organizations this process has been largely confined to physicians. Limited privileges have been granted to psychologists, social workers and selected categories of nurses, such as nurse anaesthetists, surgical nurses, and midwifes. Russell C Swan‘s burg MEANING AND DEFINITION

13. PURPOSE OF CREDENTIALING The purpose of credentialing is: To prevent a problem before it happens. To research the qualifications and backgrounds of individuals and companies. Credentialing is also the process of reviewing and verifying information. LEGAL PROTECTION It is a good idea to have credentialing process to protect you and your business from a lawsuit or other legal problems. For instance, let‘s say you hire a teacher to work in your day care centre, and this person is a sex offender. The credentialing process could have prevented this through a background check. PROFESSION Almost all professions require, to a certain degree, some sort of credentials. Police departments, Fire fighters, lawyers, accountants and nurses all need credentials. You need credentials to drive a car or semi-truck. All states require citizens to take a driving test.

14. HEALTH CARE CREDENTIALING DEFINITION: Health care credentialing is a system used by various organizations and agencies to ensure that their health care practitioners meet all the necessary requirements and are appropriately qualified. The credentials may vary depending on the specified area of the practitioner. For example: An X-ray technician may have different credentialing forms than an osteopathic physician.

15. WHO IS CREDENTIALED? Practitioners: Medical Doctors (MD), Doctor of osteopathy (DO), Doctor of Podiatric Medicine (DPM), Doctor of Chiropractic (DC), Doctor of dental Medicine (DMD), Doctor of Dental Surgery (DDS), Doctor of Optometry (OD), Doctor of Psychology (PhD) and Doctor of Philosophy (PhD). Extenders: Physician of assistant (PA), Certified Nurse Practitioner (CRNP), Certified Nurse Midwife (CNM). Facility and Ancillary service Providers: Hospitals , Nursing Homes, Skilled Nursing Facilities, Home Health, Home Infusion Therapy, Hospice, Rehabilitation Facilities, Freestanding Surgery Centres, Freestanding Radiology Centres, Portable X-ray Suppliers, End Stage Renal Disease Facilities, Clinical Laboratories, Outpatient Physical therapy and Speech Therapy providers, Rural Health Clinics, Federally Qualified Health Centres Orthotic and Prosthetic providers and Durable Medical Equipment (DME) providers.

16. PRINCIPLES OF CREDENTIALING ACCORDING TO (ANA) A report of the Committee for the study of Credentialing in Nursing was made in 1979. It included fourteen principles of credentialing related to: Those credentialed. Legitimate interests of involved occupation, institution, and general public. Accountability A system of checks and balances Periodic assessments Objective standards and criteria and persons competent in their use Representation of the community of the interests Professional identity and responsibility An effective system of role delineation An effective system of program identification Coordination of credentialing mechanisms Geographic mobility Definitions and terminology Communications and understanding.

17. INTRODUCTION: Placements are a credit bearing part of a degree course and all placements optional. If a student opts out of a placement or there is no placement available, this means that placement is not guaranteed. DEFITION: State of being placed or arranged. PLACEMENT TEAM: Our current placement team consists of a placement coordinator & four academic tutors, each with specialist knowledge relevant to the degree courses you under the supervision are studying. These tutors advice and support you throughout your preparation for placement. PLACEMENT

18. IMPORTANCE OF SELECTION AND PLACEMENT: To fairly and without any element of discrimination evaluate job applicants in view of individual differences and capabilities To employee qualified and competent hands tat can meet the job requirement of the organization To place job applicants in the best interests of the organization and the individual To help in human resources man power planning purposes in organization To reduce recruitment cost that may arise as a result of poor selection & placement exercises.

19. INTRODUCTION: The promotion policy is one of the most controversial issues in every organization. The management usually favours promotion on the basis of merits, and the unions vehemently oppose it by saying that managements resort to favouritism. The unions generally favour promotions on the basis of seniority. It is hence essential to examine this issue and arrive at an amicable solution. DEFINITION: A change for better prospects from one job to another job is deemed by the employee as a promotion. PROMOTION

20. FACTORS IMPLYING PROMOTION: The factors which are considered by employees as implying promotion are: FACTORS IMPLYING PROMOTION An increase in salary An upward movement in the hierarchy of jobs Additional supervisory responsibility A better future An increase in prestige

21. NATURE AND SCOPE OF PROMOTION: Seniority versus merits: There has been great deal of controversy over the relative values of seniority and merit in any system of promotion. Seniority will always remain a factor to be considered, but there be much greater opportunity for efficient personnel, irrespective of their seniority, to move up speedily if merit is used as the basis for promotions. It is often said that at least for the lower ranks, seniority alone should be the criterion for promotion. One cannot agree with this. The quality of work is more important in the lower ranks as in the higher.

22. There are some who argue against this plea and advocate the merit policy for the following reasons: They believe that mere length of service evidence only of continued service but are surely no indication of vast experience. Promotion on the basis of seniority saps the initiative of the employees. Once they realize that promotions in the organization are on the basis of seniority alone, they lose all enthusiasm for showing better performance. Therefore, in terms of getting the best out of employees, the merits of the individual employee will have to be considered. There are individual differences amongst persons working o the same of them are most efficient, some barely average and some below average. If their differences are not distinguished and they are uniformly rewarded, all individual will gradually sink to the level of the below-average employee.

23. The promotion policy is one of the most controversial issues in every organization. The management usually favours promotion on the basis of merits, and the unions vehemently opposite by saying that management resort to favouritism. However, in practice, both seniority and ability criteria should be taken into consideration; but in order to allay the suspicious of the trade unions, there should be written promotion policy which should be clearly understood by all. PROMOTION POLICY:

24. charts and diagrams clearly distinguish each job and connect various jobs by lines and arrows showing the channels to promotion. These lines and arrows are always based on analysis of job duties. There should be some definite system for making a waiting list after identification and selection of those candidates who are to be promoted as and when vacancies occur. All vacancies within the organization should be notified so that all potential candidates may complete. Promotion policy may include the following:

25. The following eight factors must be the basis for promotion: Outstanding service in terms of quality as well as quantity Above average achievement in patient care and for public relations Experience Seniority Initiative Recognition by employee as a leader Particular knowledge and experience necessary for a vacancy and Record of loyalty and cooperation

26. From a scientific management view point, a sound promotion policy has many advantages. It provides an incentive to employee to work more and show interest in their work. They put in their best in their best and aim for promotion within the organization. It develops loyalty amongst the employees, because a sound promotion policy assures them of their promotions if they are found fit. It increases satisfaction among the employees. It generates greater motivation as they do not have to depend on mere seniority for that advancement. A sound promotion policy retains competent employees, and provides them ample opportunities to rise further It generally results in increased productivity as promotion will be based on an evaluation of the employee‘s performance. Finally, increases the effectiveness of an organization ADVANTAGES OF A SOUND PROMOTION POLICY:

27. DEFINITION: Staff choose to stay for long periods within a cost centre, turnover is under is 10% annually. IMPORTANCE OF STAFF RETENTION: The advantages of staff retention are fairly clear. Most importantly perhaps, key skills, ideas, knowledge and experience remain within your organization. Client relationships and networks are also preserved in conjunction with all the income that these areas generate. Conversely, losing your key employees lays open the possibility that these people will than assume roles with your direct competitors. As a result those invaluable skills, ideas, knowledge, experience, relationships and networks are all transferred to another organization. RETENTION

28. On top of all these there are also direct costs involved in losing key employees. The cost of replacing such an individual includes advertising, recruitment agency fees and the time spent conducting actual interview process. Further more it is also worth considering the time and expense spent on the induction new employees and lost revenue during the recruitment and bedding in process. All though an element of employee churns is both inevitable and healthy. It is nevertheless clear that retention brings substantial benefits to your organization. Whilst attrition involves significant direct and indirect financial costs

29. Respectful collegial communication and behaviour Communication-rich culture A culture of accountability The presence of adequate numbers of qualified nurses The presence of expert, competent, credible, visible leadership

30. Shared decision-making at all levels The encouragement of professional practice and continued growth/ development Recognition of the value of nursing‘s contribution Recognition of nurses for their meaningful contribution to the practice

31. Norms Norms are standards that guide, control, and regulate individuals and communities. For planning nursing manpower we have to follow some norms. The nursing norms are recommended by various committees, such as; the Nursing Man Power Committee, the High-power Committee, Dr. Bajaj Committee, and the staff inspection committee, TNAI and INC. The norms has been recommended taking into account the workload projected in the wards and the other areas of the hospital. NORMS OF STAFFING

32. STAFF INSPECTION UNIT (S.I.U) The Staff Inspection Unit was set up in 1964 with the object of effecting economy in manpower consistent with administrative efficiency and evolving performance standards and work norms in Government offices and Institutions wholly or substantially dependent on Government Grants. Its officers also serve as Core Member on the Committees appointed to scrutinize manpower requirements of Scientific and Technical Organisations. The Staff Inspection Unit (S.I.U.) is the unit which has recommended the nursing norms in the year 1991-92. As per this S.I.U. norm the present nurse-patient ratio is based and practiced in all central government hospitals.

33. Recommendations of S.I.U: The norms for providing staff nurses and nursing sisters in Government hospital has been recommended taking into account the workload projected in the wards and the other areas of the hospital. The posts of nursing sisters and staff nurses have been clubbed together for calculating the staff entitlement for performing nursing care work which the staff nurse will continue to perform even after she is promoted to the existing scale of nursing sister. Out of the entitlement worked out on the basis of the norms, 30%posts may be sanctioned as nursing sister. This would further improve the existing ratio of 1 nursing sister to 3 staff nurses fixed by the government in settlement with the Delhi nurse union in May 1990.

34. The assistant nursing superintendents are recommended in the ratio of 1 ANS to every 4 nursing sisters. The ANS will perform the duty presently performed by nursing sisters and perform duty in shift also. The posts of Deputy Nursing Superintendent may continue at the level of 1 DNS per every 7 ANS There will be a post of Nursing Superintendent for every hospital having 250 or more beds. There will be a post of 1 Chief Nursing Officer for every hospital having 500 or more beds. It is recommended that 45% posts added for the area of 365 days working including 10% leave reserve (maternity leave, earned leave, and days off as nurses are entitled for 8 days off per month and 3 National Holidays per year when doing 3 shift duties).

35. An "Expert Committee for Health Manpower Planning, Production and Management" was constituted in 1985 under Dr. J.S. Bajaj, the then professor at AIIMS. Manpower is one of the most vital resources for the labour intensive health services industry. Health for all (HFA) can be achieved only by improving the utilization of these resources. BAJAJ COMMITTEE, 1986

36. Major recommendations are:- Formulation of National Medical & Health Education Policy. Formulate on of National Health Manpower Policy. Establishment of an Educational Commission for Health Sciences (ECHS) on the lines of UGC. Establishment of Health Science Universities in various states and union territories. Establishment of health manpower cells at centre and in the states. Vocationalisation of education at 10+2 levels as regards health related fields with appropriate incentives, so that good quality paramedical personnel may be available in adequate numbers. Carrying out a realistic health manpower survey.

37. High power committee on nursing and nursing profession was set up by the Government of India in July 1987, under the chairmanship of Dr. Jyothi former vice-chancellor of SNDT Women University, TNAI is also one among the prominent members of this committee. Later on the committee was headed by Smt. Sarojini Varadappan , former Chairman of Central Social Welfare Board. The terms of reference of the Committee are: To look into the existing working conditions of nurses with particular reference to the status of the nursing care services both in the rural and urban areas. To study and recommend the staffing norms necessary for providing adequate nursing personnel to give the best possible care, both in the hospitals and community. HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION (1987-1989)

38. To look into the training of all categories and levels of nursing, midwifery personnel to meet the nursing manpower needs at all levels o health services and education. To study and clarify the role of nursing personnel in the health care delivery system including their interaction with other members of the health team at every level of health service management. To examine the need for organised nursing services at the national, state, district and local levels with particular reference to the need for planning service with the overall health care system of the country at the respective levels. To look into all other aspects, the Committee will hold consultations with the State Governments.

39. Employment Uniformity in employment procedures to be made . Recruitment rules are made for all categories of nursing posts. The qualifications and experience required or these be made thought the country. Job description Job description of all categories of nursing personnel is prepared by the central government to provide guidelines. Working hours The weekly working hours should be reduced to 4o hrs per week. extra working hours to be compensated either by leave or by extra emoluments depending on the state policy .nurses to be given weekly day off and all the gazetted holidays as per the government rules. RECOMMENDATIONS OF HIGH POWER COMMITTEE ON NURSING AND NURSING PROFESSION

40. Work load/ working facilities Nursing norms for patient care and community care to be adopted as recommended by the committee . Pay and allowances Uniformity of pay scales of all categories of nursing personnel is not feasible. However special allowance for nursing personnel, i.e.; uniform allowance, washing, mess allowance etc should be uniform throughout the country. Promotional opportunities The committee recommends that along with education and experience, there is a need to increase the number of posts in the supervisory cadre, and for making provision of guidance and supervision during evening and night shifts in the hospital. -Each nurse must have 3 promotions during the service period. -Promotion is based on merit cum seniority. -Promotion to the senior most administrative teaching posts is made only by open selection.

41. Career development provision of deputation for higher studies after 5 yrs of regular services be made by all states. The policy of giving deputation to 5 -10 % of each category be worked out by each state. Every nursing personnel must have an opportunity to attend at least one refresher course every 2 years. Accommodation As far as possible, the nursing staff should be considered for priority allotment of accommodation near to work place. Hospitals should not build nurse's hostel for trained nurses. Apartment type of accommodation is built where married/unmarried nurses can be allowed to live. Housing colonies for hospital s must be considered in long run. Transport During odd hours, calamities etc arrangements for transport must be made for safety and security of nursing personnel.

42. Special incentives Scheme of special incentives in terms of awards, special increment for meritorious work for nurses working in each state/district/PHC to be worked out. Occupational hazards Medical facilities as provided by the central govt. by extended by the state govt to nursing personnel till such times medical services are provided free to all the nursing personnel. Risk allowance to be paid to nursing personnel working in the rural $ urban area. Other welfare services Hospitals should provide welfare measures like crèche facilities for children of working staff, children education allowance, as granted to other employees, be paid to nursing personnel.

43. INDIAN NURSING COUNCIL (INC) The Indian Nursing Council is an Autonomous Body under the Government of India and was constituted by the Central Government under the Indian Nursing Council Act, 1947 of parliament. It was established in 1949 for the purpose of providing uniform standards in nursing education and reciprocity in nursing registration throughout the country. Nurses registered in one state were not registered in another state before this time. The condition of mutual recognition by the state nurses registration councils, called reciprocity was possibly only if uniform standards of nursing education were maintained. Functions of Indian Nursing Council. To establish and monitor a uniform standard of nursing education for nurses midwife, Auxiliary Nurse-Midwives and health visitors by doing inspection of the institutions.

44. To recognize the qualifications under section 10(2)(4) of the Indian Nursing Council Act, 1947 for the purpose of registration and employment in India and abroad. To give approval for registration of Indian and Foreign Nurses possessing foreign qualification under section 11(2) (a) of the Indian Nursing Council Act, 1947. To prescribe the syllabus & regulations for nursing programs. Power to withdraw the recognition of qualification under section 14 of the Act in case the institution fails to maintain its standards under Section 14 (1)(b) that an institution recognized by a State Council for the training of nurses, midwives, auxiliary nurse midwives or health visitors does not satisfy the requirements of the Council. To advise the State Nursing Councils, Examining Boards, State Governments and Central Government in various important items regarding Nursing Education in the Country.