STAFFING PATTERN IN NURSING SERVICE UNITThe nursing service, which is normally constitutes the largest single group

of hospital personnel and is the mainstay of the organization, is responsible for providing comprehensive and continous nursing care to all patients in colloboration with other health care personnel. Good nursing care is the result of coordinated administrative and clinical planning.

ORGANIZATION

Although positions in the nursing service heirachy vary from hospital, one can usually see the following nursing positions in most hospitals.

Governing board

Chief executive officer

Director of nursing/ Chief nursing officer

Deputy nsg officer/Asst director Deputy nsg officer/Asst director

Headnurse/ward sisters

Head nurse/ward sisters

Head nurse/ ward sisters

Head nurse/ Ward sisters

Asst nsg off/superv/dept sisters

Asstnsg off/superv/dept sisters

Asstnsg off/superv/dept sisters

Asstnsg off/superv/dept sisters

Staffnurses,ANM,ward boys, clerks, ayahs

Staffnurses,ANM,ward boys, clerks, ayahsStaffnurses,ANM,ward

boys, clerks, ayahsStaffnurses,ANM,ward boys, clerks, ayahs

Listed in descending order of responsibility are director of nursing (or nursing superindent), assistant director of nursing (asst nsg sprdt), supervisor (dept sister), charge nurse (ward sister, head nurse), senior staff nurse and staff nurse. There may be specialist supervisory staff or dept sisters for paediatrics , maternity, psychiatry, operating rooms, CCU, and ICUs. The head nurse or ward sister who is the next in the heirachy is in charge of the ward or unit is responsible for nursing in her respective unit or ward. There is generally a night supervisor and a supervisor of in service education in large hospitals.

STAFFING PATTERN

The complement of nurses required for a hospital, generally referred to in terms of nurse-bed ratio as stipulated by Indian Nursing Council is as follows

For a 150- bed hospital:

Nursing superindent – 1 (for minimum of 150 beds) Deputy nursing superindent – 1 Assistant nursiing superindent – 2

For every additional 50 beds one more assistant nursing superindent.

Staff nurse Sister (each shift)

Dept sis/asst nsg sprt

Medical ward 1:3 1:25 1 for 3-4 wardsSurgical ward 1:3 1:25 1 for 3-4 wardsOrthopedic ward 1:3 1:25 1 for 3-4 wardsPediatric ward 1:3 1:25 1 for 3-4 wardsGynecology ward 1:3 1:25 1 for 3-4 wardsMaternity (newborn) 1:3 1:25 1 for 3-4 wardsIntensive care unit 1:1 (24 hrs) 1Coronary care unit 1:1 (24 hrs) 1Nephrology 1:1 (24 hrs) 1 1 dept sis/asst nsg

spr for 3-4 units clubbed together

Neurology & 1:1 (24 hrs) 1

neurosurgerySpecial wards- Eye, ENT

1:1 (24 hrs) 1

OT 3 for 24 hrs per table

1 1 dept sister/asst nsg spr for 4-5 operating rooms

Casuality & emergency unit

2-3 staff nurses depending on no. of beds

1 1 dept sis/asst nsg spr for emergency, casuality etc;

The existing norm stipulated by INC with regard to nursing staff for wards and special units (excluding outpatient department)

In addition with regard to staffing pattern the Nursing Council recommends 30% leave reserve posts because a nurse is entitled to 30 days of earned leave, 10 to 12 days of casual leave and a certain number of days of sick leave and maternity leave, and in some hospitals, 24 days off duty in a year in addition to one or one -and- a-half days a weekly off.

Fluctuations in census and mix of patients needing various degrees and kinds of nursing care often pose problems to patients. To overcome those problems, hospitals must adopt a system of classifying patients by grading them according to the amount of nursing time and skill they require. The patients are classified on the basis of acuity of illness and the care required such as minimal, partial, moderate and intensive and on the patients part, his or her capability to meet physical needs to ambulate , bathe amd feed one self. The classification is also used to determine the category of personnel – registered nurse, ANM, or Nurse aide-who should provide the required care.

Category I – A patient who requires only minimal amount of nursing care- an average of 2.8 of nursing per 24 hrs.

Category II – A patient who requires an average amount of nursing care- an average of 4.3 hrs of nursing per 24 hours.

Category III – A patient who requires an average amount of nursing care- an average of 5.8 hrs of nursing per 24 hours.

Category IV – A patient who requires maximum nursing care- an average of 8.6 hrs of nursing per 24 hrs.

ORGANIZATION OF M S RAMAIAH MEDICAL TEACHING HOSPITAL

Introduction

Organizational structure refers to levels of management within a hospital. Levels allow efficient management of hospital departments.

The structure helps one understand the hospitals chain of command. Organizational structure varies from hospital to hospital Large hospitals have complex Organizational structures Smaller hospitals tend to have much simpler organizational structures

Organizational chart for MSRMTH

Medical Superindent

Deputy Medical Superindent

Nursing Superindent

Grade I Grade II Grade II Grade II Grade II Grade II

Block I Block I I Block III Block I V Block VBlock VI

Medical Surgical Ortho Gynaec OPD Emergency &Ward Ward Ward Ward Ward Casuality and ICU

Ward inch ward inch ward inch ward inch ward inch ward incharge nurseNurse nurse nurse nurse nurse

Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse Staff nurse

Student nurse Student nurse Student nurse Student nurse Student nurse Student nurse

Class IV emp Class IVemp Class IVemp Class IVemp Class IV emp Class IVemp

STAFFING PATTERN OF NURSING INSTITUTION ACCORDING TO INDIAN NURSING COUNCIL

TEACHING FACULTYBASIC B.SC. NURSING

  Admission Capacity  Annual Intake 25-50 51-100 Professor-cum-Principal 1 1Professor-cum-Vice Principal 1 1Reader/Associate Professor 1 2Lecturer 5 10Tutor/Clinical Instructor 14 28Total 22 42Teacher Student Ratio= 1:10

B.Sc.: NURSING (POST BASIC) Minimum-30 Annual Intake  Minimum-30 Maximum-50 Professor-cum-Principal 1 1Professor-cum-Vice Principal 1 1Reader/Associate Professor 1 3Lecturer 5 7Total 8 12 Teacher Student Ratio=   1:10

BASIC: B.Sc. NURSING & B.Sc. NUSING (POST BASIC)Annual IntakeB.Sc. Nursing (Basic) 50 or less B.Sc. Nursing (Post Basic) 30 or less

Professor-cum-Principal 1Professor-cum-Vice-Principal 1Reader/Associate Professor 2Lecturer 6Tutor/Clinical Instructor 18Total 28Teacher Student Ratio= 1:10

BASIC: B.Sc. NURSING, B.Sc. NURSING (POST BASIC) & M.Sc. NURSING

Annual Intake PIONB.Sc. Nursing (Basic) 50 or less 60B.Sc. Nursing (Post Basic)

30 or less 75

M.Sc. Nursing 10 or less 25Professor-cum-Principal 1 1Professor-cum-Vice-Principal

1 1

Reader/Associate Professor

5 3

Lecturer 7 3Tutor/Clinical Instructor 18 10Total 32 Teacher Student Ratio: Basic & Post Basic B.Sc. Nursing

1 : 10 M.Sc. Nursing 1 : 5

18

BASIC: B.Sc. NURSING & M.Sc. NURSINGAnnual Intake B.Sc. (N)Basic 50 or less M.Sc. Nursing 10 or less 10 or less Professor-cum-Principal 1Professor-cum-Vice-Principal 1Reader/Associate Professor 5Lecturer 5Tutor/Clinical Instructor 14Total 26Teacher Student Ratio:  M.Sc. Nursing 1 : 5

Basic B.Sc. Nursing 1 : 10

Part time Teachers/External Teachers 1. Microbiology 2. Bio-Chemistry 3. Bio-Physics 4. Psychology 5. Nutrition 6. English 7. Computer 8. Hindi/Any other language 9. Any other- clinical disciplines NOTE:

1. Minimum one M.Sc. faculty for each specialty i.e. Medical Surgical Nursing, Pediatrics, Obstetrics, Community Health Nursing, Psychiatry is required for basic programme.

2. No part time nursing faculty will be counted for calculating total no. of faculty required for a college.

3. Irrespective of number of admissions, all faculty positions (Professor to Lecturer) must be filled.

4. Irrespective of number of admissions all faculty positions (Professor to Lecturer) must be filled.

5. Proportional ratio of tutor/clinical instructor as per student intake.

6. For M.Sc. (N) programme appropriate number of M.Sc. faculty in each specialty be appointed subject to the condition that total number of teaching faculty ceiling is maintained.

7. All nursing teachers must possess a basic university or equivalent qualification as laid down in the schedules of the Indian Nursing Council Act, 1947. They shall be registered under the State Nursing Registration Act.

8. Nursing faculty in nursing college except tutor/clinical instructors must possess the requisite recognized postgraduate qualification in nursing subjects.

9. Holders of equivalent postgraduate qualifications, which may be approved by the Indian Nursing Council from time to time, may be considered to have the requisite recognized postgraduate qualification in the subject concerned.

10. All teachers of nursing other than Principal and Vice-Principal should spend at least 4 hours in the clinical area for clinical teaching and/or supervision of care every day.

(Number of staff to be increased as per the number of programs and students) S.N

.Post Qualification & Experience

1. Professor-cum-Principal

 − Masters Degree in Nursing− 14 years experience after M.Sc. (N) in college of Nursing. − 3 years experience in administration (Years of experience is relaxable if suitable candidate is not available) (If a candidate is not available, minimum 5 years of experience in college of nursing with an aggregate of 14 years teaching experience)

Desirable: Independent published work of high standard/doctorate degree /M.Phil. 2. Professor-

cumVice Principal

− Masters Degree in Nursing − 14 years experience after M.Sc. (N) in college of Nursing − 3 years experience in administration (years of experience is relax able if suitable candidate is not available) (If a candidate is not available, minimum 5 years of experience in college of nursing, with an aggregate of 14 years teaching experience)

Desirable: Independent published work of high standard/doctorate degree/M.Phil. 3. Reader/

Associate Professor

− Master Degree in nursing − 10 years experience after M.Sc. (N) in a college of Nursing. (If a candidate is not available, 5 years of experience in College of Nursing with an aggregate of 10 years teaching experience.

Desirable: Independent published work of high standard/doctorate degree/M.Phil. 4. Lecturer − Master Degree in Nursing.

− 3 years teaching experience after M.Sc. (N)

5. Tutor/Clinical Instructor

− Master Degree in Nursing OR B.Sc. (N) Degree (5) years experience after B.Sc. (N)

BIBLIOGRAPHY

1. BT Basavanthappa. Nursing Administration. 2nd edition, Jaypee Med Publishers. New Delhi; 2009.

2. www.indiannursingcouncil.com

3. Cedric BF, Sharma DK, Goyal RC. A practical Guide to Hospital

Planning and Management. Voluntary Health Association of India . New

Delhi: 1999.

4. Kunders GD. Hospital facilities Planning and Management. Tata

McGraw Hill Publishing Company Limited; New Delhi: 2008.p.1-56.

5. http://www.chempharmindia.com