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STAFFING PATTERN IN NURSING SERVICE UNIT

The 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

Asst nsg off/superv /dept sisters

Asstnsg off/superv /dept sisters

Asstnsg off/superv /dept sisters

Asstnsg off/superv /dept sisters

Headnurse/ ward sisters

Head nurse/ward sisters

Head nurse/ ward sisters

Head nurse/ Ward sisters

Staffnurses,ANM,w ard boys, clerks, ayahs

Staffnurses,ANM,ward boys, clerks, ayahs

Staffnurses,ANM,ward boys, clerks, ayahs

Staffnurses,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 shift)

(each Dept sis/asst nsg sprt

Medical ward Surgical ward Orthopedic ward Pediatric ward Gynecology ward Maternity (newborn) Intensive care unit Coronary care unit Nephrology

1:3 1:3 1:3 1:3 1:3 1:3 1:1 (24 hrs) 1:1 (24 hrs) 1:1 (24 hrs)

1:25 1:25 1:25 1:25 1:25 1:25 1 1 1 1 1 1

1 1 1 1 1 1

for for for for for for

3-4 wards 3-4 wards 3-4 wards 3-4 wards 3-4 wards 3-4 wards

1 dept sis/asst nsg spr for 3-4 units clubbed together

Neurology & 1:1 (24 hrs) neurosurgery Special wards- Eye, 1:1 (24 hrs) ENT OT 3 for 24 hrs per table

1 dept sister/asst nsg spr for 4-5 operating rooms Casuality & 2-3 staff nurses 1 1 dept sis/asst nsg emergency unit depending on no. spr for emergency, of beds 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 carean average of 2.8 of nursing per 24 hrs.

Category II A patient who requires an average amount of nursing carean average of 4.3 hrs of nursing per 24 hours. Category III A patient who requires an average amount of nursing carean 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 VI

Block I

Block III

Block I

Block V

Medical & Ward

Surgical Ward

Ortho Ward

Gynaec Ward

OPD Ward

Emergency Casuality and ICU

Ward inch ward inch ward incharge nurse Nurse nurse Staff nurse Staff nurse Staff nurse

ward inch nurse Staff nurse

ward inch nurse Staff nurse

ward inch 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 IVemp

Class IV emp

STAFFING PATTERN OF NURSING INSTITUTION ACCORDING TO INDIAN NURSING COUNCIL TEACHING FACULTY
BASIC B.SC. NURSING
Annual Intake Professor-cum-Principal Professor-cum-Vice Principal Reader/Associate Professor Lecturer Tutor/Clinical Instructor Total Teacher Student Ratio= Admission Capacity 25-50 1 1 1 5 14 22 1:10 51-100 1 1 2 10 28 42

B.Sc.: NURSING (POST BASIC) Minimum-30


Annual Intake Professor-cum-Principal Minimum-30 1
Maximum-50 1

Professor-cum-Vice Principal Reader/Associate Professor Lecturer Total Teacher Student Ratio=

1 1 5 8

1 3 7 12 1:10

BASIC: B.Sc. NURSING & B.Sc. NUSING (POST BASIC)


Annual Intake B.Sc. Nursing (Basic) B.Sc. Nursing (Post Basic) Professor-cum-Principal Professor-cum-Vice-Principal Reader/Associate Professor Lecturer Tutor/Clinical Instructor Total Teacher Student Ratio= 50 or less 30 or less 1 1 2 6 18 28 1:10

BASIC: B.Sc. NURSING, B.Sc. NURSING (POST BASIC) & M.Sc. NURSING
Annual Intake B.Sc. Nursing (Basic) 50 or less B.Sc. Nursing (Post 30 or less Basic) M.Sc. Nursing 10 or less Professor-cum-Principal 1 Professor-cum-Vice1 Principal Reader/Associate 5 Professor Lecturer 7 Tutor/Clinical Instructor 18 Total 32 Teacher Student Ratio: Basic & Post Basic B.Sc. Nursing 1 : 10 M.Sc. Nursing 1 : 5 PION 60 75 25 1 1 3 3 10 18

BASIC: B.Sc. NURSING & M.Sc. NURSING


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

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 Masters Degree in Nursing cumVice 14 years experience after M.Sc. (N) in Principal 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 Master Degree in nursing Professor 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)

S.N Post . 1. Professor-cumPrincipal

Qualification & Experience Masters Degree in Nursing

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