Session: All Hands-on-Deck—How to Justify Your Staffing Needs and FTEs

Editor's Note

In this comprehensive session on nurse workforce management, The Valley Hospital speakers Jacqueline Gardocki, MBA, MSN, BSN, CNOR, CASC, nurse manager Luckow Pavilion same day services & pain management, and DeAnna Kearney, BSN, RN, CAPA, manager of endoscopy, highlighted the critical role of budgeting, staff tracking, cross-training, and leadership when creating a sustainable and efficient healthcare work environment. Key takeaways from the discussion revolve around monitoring staffing budgets, utilizing effective tracking systems, advocating for staff, fostering a culture of caring leadership, and implementing retention strategies.

On budget and staffing management, the speakers mentioned:

• Tracking budget variances. Nurse leaders must closely monitor budget variances and justify any discrepancies. One speaker shared their method of creating a simple daily tracking chart that accounted for patient volume, staffing levels, and budgeted staffing hours. This system allowed for proactive management of expenses by adjusting shifts, floating staff, or using per diem staff strategically.
• Productivity and workforce needs. They emphasized using data-driven projections to determine full-time equivalent (FTE) needs based on patient volumes. Projections should include buffer considerations for unexpected leaves, seasonal volume fluctuations, and retirements.
• Variable vs fixed staffing. Recognizing the difference between variable (RNs and techs) and fixed (supervisors, materials coordinators, etc) staffing needs is crucial in making informed workforce decisions. Perioperative leaders must adjust staffing based on case volumes while maintaining efficiency.
• Cross-training and shared resources. Establishing partnerships between similar units (eg, endoscopy and same-day surgery) allows nurses to be cross-trained for roles they can safely perform, reducing staffing shortages and optimizing resources. The speakers stressed using downtime for orientation in sister units to build workforce flexibility.

On retention and employee engagement strategies, the speakers discussed having:

• A caring leadership approach. Retention is directly linked to a caring leadership style. Nurse leaders must establish trust, be visible on the unit, engage staff in decision-making, and demonstrate appreciation.
• Workplace culture and recognition. Initiatives such as gratitude boards, informal appreciation events, and organization-wide recognition programs (eg, Daisy Awards) enhance morale.
• Flexible scheduling and per diem utilization. The speakers encouraged creative staffing solutions, such as per diems working strategic hours (eg, 10 am to 2 pm or closing shifts) and offering variable start times rather than only low-census options at the end of the day.
• Retention data and measurement. The implementation of Caring and Retention Rounds tracks employee engagement, career aspirations, and workplace concerns, leading to informed staffing decisions. Data analysis of sick time, turnover rates, and overtime provides insight into staffing effectiveness.

And on leadership development and staff growth, the session explored:

• Mentoring future leaders. Perioperative leaders must actively mentor and support their supervisors to develop leadership skills and optimize staffing. Engaging supervisors in tracking staffing trends ensures a proactive approach to budgeting and workforce planning.
• Shared governance. Encouraging nurses to participate in governance structures empowers them to contribute to decision-making and fosters professional growth.
• Educational support and career development. Promoting tuition reimbursement, certification programs, and professional development ensures staff engagement and long-term retention.

By balancing financial responsibility with a people-centered leadership approach, perioperative leaders can optimize workforce efficiency while maintaining high levels of patient care and staff satisfaction, the speakers concluded.