Over the past decade nurse staffing has been a challenge for hospitals. One response has been to use a nursing resource team, an innovative transformation of the float pool of the past. Resource teams consist of staff employed by the organization to cover vacancies and absences and to respond to increases in the numbers of patients or the seriousness of their conditions.
The McMaster study explored the nursing resource team (NRT) at Hamilton Health Sciences (HHS) from the first two years of its implementation, September 2002 until June 2004.
Researchers and clinicians from McMaster's Nursing Health Services Research Unit (NHSRU) and HHS found that the NRT offered a competitive advantage for the organization through its ability to recruit, retain, and maximize the use of nurses during a time of shortage.
Prior to the establishment of the NRT, nursing human resources management had become problematic. Insufficient nursing capacity meant using agency nurses, sanctioning overtime, and leaving nursing teams short-staffed. Limited staffing capacity created stress for nursing staff who felt overworked and under-supported.
Resource management teams are usually managed centrally. Resource staff are managed and deployed by a central staffing office that assigns nurses to areas in need of personnel across the entire hospital. The difference between a traditional float pool and a modern resource team is the range of units to which an individual nurse can be assigned. In a traditional float pool, a nurse is regarded as a generic worker who is able to work with various patient populations and utilize many skill sets. In resource teams, however, nurses' specialized skills are recognized and used. Nurses work in their area of clinical expertise and preference, developing in-depth knowledge of particular clinical populations.
The study, funded by the Nursing Secretariat of the Ontario Ministry of Health and Long-Term Care, found the NRT is also a vehicle for staff development and it provides excellent orientation and integrates nurses into the organization in a manner that recognizes their unique abilities and employment needs.
Dr. Andrea Baumann, Principle Co-Investigator and Co-director of NHSRU, says the NRT proved to be a more efficient means of providing appropriate staff coverage and has facilitated the discontinuation of agency use.
"The NRT supports the efficient allocation of staff and is considered to provide safer, more productive, and higher quality staff than agencies. The use of a nursing resource team provides a way for an organization and its employees to work together to benefit nurses and management, and ultimately improve patient care."
The implementation of the resource team at HHS was considered a success by all study participants. In contrast to traditional float pools, resource teams recognize nursing expertise, create opportunities for full-time work, and provide nurses with opportunities for professional development.
The nursing resource team at Hamilton Health Sciences:
- Provided a recruitment strategy offering full-time employment to new and experienced nurses internal and external to the organization.
- Capitalized on nursing expertise by deploying members to clinical areas where they were competent to practice and could use their specialist skills and expertise.
- Represented a "just-in-time approach" to clinical needs. It provided a flexible and adaptive mechanism for dealing with fluctuations in patient census, for covering nurse absenteeism, and reducing overtime.
- Provided a pool of skilled nurses that could be recruited into specialist nursing areas as jobs become available.
Participants in the NRT study included nurses, business clerks, managers, and administrators. A total of 101 individuals took part through 24 interviews, nine focus groups, and direct observation. Front line nurses, comprising 23 NRT nurses and 20 unit-based charge nurses, were the largest group, representing 42.6 percent of the sample.
The report is available on the Nursing Health Services Research Unit web site www.nhsru.com.
For further information or interviews, please contact:
Theresa Noonan
Knowledge Broker, Nursing Health Services Research Unit
McMaster University
Phone: 905-525-9140, ext. 22698
E-mail: noonant@mcmaster.ca