Managing the nursing workforce

Recent data indicate that, although the nursing shortage eased slightly in 2003, hospitals continue to experience difficulty filling nursing positions. In addition to the more chronic concerns related to the nursing shortage, hospitals must also address shorter term staffing dilemmas. The seasonal fluctuations of hospital census, patient acuity, and staffing challenges all impact nurse leaders' ability to maintain a safe staffing balance. The Florida Hospital Association's most recent survey of its hospitals found that the following options were most commonly used in filling vacancies and/or changing service needs: overtime, contract/travel nurses, on-call staff, in-house staffing pools, and temporary staffing agencies. After Fawcett Memorial Hospital, FL, began implementing seasonal strategies for dealing with staff fluctuations, significant cost savings and increases in staff satisfaction were documented.