Question

Susan is the number manager in charge of a 25-bed medical unit at St. Eligius Hospital. She is currently preparing the nurse staffing plan for the next fiscal year. Hospital management has provided all nurse managers with a list of assumptions for staff planning, most of which are to use last year's numbers as first estimates for next year. Susan has assembled the following data for last year:

1. The percentage of productive nursing hours was 83%

2. Fifty-two percent of nursing staff worked days, and 48 percent worked nights.

3. The nursing staff was made up of 74% RNs, 16% LPNs, and 10% unlicensed nursing personnel NAs

4. At St. Eligius Hospital, 1.0 FTE= 2,080 hours.

Susan also assembled the following informationfrom the hospital's patient classification system, for last year:

Patient Classification Level          Historical Patient Days       Historical Average Care Hours per pt day    HistoricalTotal Unit workload

1                                                           1,000                                  4                                                        4,000

2                                                           2,000                                  6                                                        12,000

3                                                           3,000                                  10                                                      30,000

4                                                           2,000                                  14                                                      28,000

5                                                           1,000                                  18                                                      18,000

Total                                                     9,000                                                                                           92,000

However, Susan is an experienced managerand is aware of several changes that will affect the nursing unit in the next year. More specifically, Dr. Smith, a senior physician who accounted for a large proportion of the unit's admissions, has just retired. In recent years, Dr. Smith has limited his practice to simpler medical cases, referring more complex cases to specialists who do not admit to the medical unit.

Dr. Jones just started at the hospital; she was recruited to replace Dr. Smith. Dr. Jones is a recent graduate who intends to care for many of the complex patients whom Dr. Smith previously referred to other specialists. Although the hospital projects that the unit's patient days will not differ from historical patient days, Susan is projecting a change in the mix of patients because of the arrival of Dr. Jones: 500 Level 1 patient days, 1,500 Level 2 days, 3,000 level 3 days, 2,500 Level 4 days, and 1,500 Level 5 days.

Susan also knows that Dr. Jones plans to do more complex treatments during the day, which will (1) increase the nursing staff who work days to 57% and reduce the staff who work nights to 43% and (2) increase the nursing staff who are RNs to 78%, who are LPNs to 14%, and who are NAs to 8%.

Questions:

1. Based on Susan's projection of patient days, what is the projected total unit workload by patient classification level? What differences do you notice between the projected and the historic total unit workload?

2. Calculate the historical number of FTEs by staff type and by shift. Based on Susan's projection of patient days, calculate the projected number of FTEs by staff type and shift. What differences do you notice between the projected and historic FTEs?