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Nurse Scheduling – A Complex but Crucial Issue

At Celayix, we understand the complexities of nurse scheduling. We examine how staff scheduling software can help you care organization.

How many times have you tried to create the perfect nurse schedule for your Long Term Care Facility?

Our guess? Countless times. It can be frustrating right?

Nurse Scheduling is Complex

nurse scheduling

Nurse and Long Term Care (LTC) staff scheduling has many moving pieces. This makes it one of the hardest industries to make easy scheduling decisions. This reality makes it difficult to create the perfect schedule manually. Unlike standard day-to-day staff scheduling, many variables need to be considered when scheduling a Nurse or LTC staff member. These include business needs, client needs, government regulations, hour thresholds, mandatory break periods, and more. Combine that with running operations 24/7, 365? This makes the job of creating efficient and accurate schedules daunting, time-consuming, error prone. 

Nurse Qualifications

One of the many items that you consider when creating a Nurse Schedule is the qualifications/certifications that each nurse holds. A lot of LTC facilities hire a variety of nurses and staff members with different levels of qualifications and certifications. These include Licensed Practical Nurses (LPNs), Registered Nurses (RNs), Advanced Practice Nurses (APNs) and Certified Nursing Assistants (CNAs), among others. All of these come with different levels of education, training and authority. Managing these different staff categories efficiently can be difficult. It often leads to excessive time spent scheduling as schedulers have to ensure that there is sufficient coverage from qualified nurses.

Handling Nurse-Patient Staffing Ratios

In the United States, federal legislation (i.e. Nursing Home Reform Act (1987)) has considerably low minimal standards for staffing: it requires “sufficient staff” to meet resident needs. LTC facilities must have “licensed practical nurses (LPNs) on duty 24 hours a day; a registered nurse (RN) on duty at least 8 hours a day, 7 days a week; and an RN director of nursing in place” (Omnibus Budget Reconciliation Act of 1987, 1987). Although State legislation varies and tends to have higher staffing standards; this has also been criticized by experts as inadequate. These unclear standards often mean that LTC facility managers are left with minimal staff to handle all of their shifts. This can also lead to nurse burnout and lower than intended patient care standards.

Complex Medical Conditions Create Complex Schedule Issues

Many LTC residents have complex medical conditions and depend on staff assistance for their daily activities. Now consider this, on top of the regular duties of a care staff member. You can really start to see how difficult schedule management is.


Let’s take registered nurses for example. In a typical eight-hour shift, a registered nurse is expected to:

  • Distribute medications at least twice per shift (within a two-hour time frame)
  • Monitor blood sugars and give insulin
  • Check vital signs
  • Manage CNAs
  • Watch and coordinate mealtimes
  • Perform wound care
  • Receive and transcribe physician’s orders
  • Complete incident reports
  • Complete documentation
  • Arrange transportation, diagnostic testing, and schedule appointments

RNs also often take on the responsibility of keeping resident’s physicians and family members up to date on their health situation, which in itself is a huge undertaking. Comparing the huge workload of LTC nurses against the often-taxing Nurse-Patient ratios truly highlights the gap in understanding of how Nurse Scheduling works.

Lack of Resources

Tying into the struggle of managing staff resources, LTC facility managers have to handle this extremely complex issue with minimum scheduling resources. Managers often work with basic scheduling tools or manual processes. These do not take into consideration all of the factors we’ve just mentioned. That puts the entire burden on the manager, who has to struggle with this task for every shift. Naturally, human errors occur, nurses get double-booked or shifts are understaffed. Now, we start to see the impact that nurse scheduling can have on overall patient care.

Care Staff Schedules Directly Effect Patient Care

patient care is affected by nurse scheduling

Studies have proven that understaffed facilities with inefficient scheduling have a much lower quality of care. Staff are often unable to give each resident adequate attention, and become overworked and stressed. Being overworked and stressed is not the ideal scenario for anyone. Particularly for a nurse or care staff who is responsible for administering medication and caring to residents. So, rather than worrying about how to improve patient care, you should first be focusing on improving your scheduling process. Aim to limit the stress and manage the load, without increasing your bottom line.

Can Employee Scheduling Software Help?

The answer is yes.

It’s really very simple; well-made schedules lead to happier, healthier nurses. Happier, healthier nurses provide better care.

Having looked at all of the complexities that contribute to nurse scheduling, it is clear to see that there is a solution: Employee Scheduling Software for your Long Term Care nurses and staff members. Removing the guesswork of scheduling and using scheduling software can help with the issues we’ve already mentioned and greatly contribute to your LTC organization in so many ways.  Let us show you some ways that scheduling software can make a difference that not only improves the experience of your staff but also increases efficiency and overall workforce management.

With scheduling & time and attendance software, you can take the burden off of the schedule manager. For example, here at Celayix, our clients use us to automate the scheduling process from schedule creation, assignment, and communication to staff members. Our Artificial Intelligence (AI) powered scheduler ensures all shift requirements, including nurse qualifications and even nurse-patient ratios. Our software even has the ability to review patient history and schedule accordingly, again taking the responsibility off of the manager who shouldn’t be expected to effectively manage so much information. To keep up with the dynamic changes that may happen, Celayix AI will continue to learn the more you use it, continually improving schedule quality, and in turn improving patient care.

caregiver employee schedule animation

Adhere to Legal/Union Requirements

There are countless rules, guidelines and requirements that need to be followed when setting nurse schedules. With rules-based scheduling software, you won’t have to worry about remembering and adhering to all of them. The software can monitor things like overtime thresholds and back-to-back shifts with legally required breaks without the scheduler having to think twice. Compliance can be a huge concern within LTC facilities so using shift scheduling software that takes this into consideration is one more step you can take to manage it with ease.

Make life easier for your nurses and care staff

A scheduling software system will significantly reduce the amount of time you spend setting schedules. This leads to schedules being created much further in advance, yet still be accurate. If you can provide schedules to your nurses further in advance, they will be much happier in the work place and have a better work-life balance. They will appreciate the extra time to plan their lives around their shifts, and you will likely see a drop in missed shifts and sick calls.

Not only will you be able to deliver schedules faster, but you will also be able to manage time-off requests with ease and efficiency. It’s common for nurses and care staff to request time off months in advance, and that can be difficult to keep track of as a lot of basic scheduling tool cannot handle time-off requests too far into the future. Keeping this in mind, we have created Celayix so that users can submit their time off requests and have them approved with any window into the future as set up by the admin. Managers receive requests and once a request is approved, that nurse cannot be scheduled for that time period avoiding any situations where the wrong person is scheduled.

improved Nurse Autonomy

It’s no secret that nurses are prone to burnout and poor work-life balance. As a scheduler, you might be directly contributing to these issues with your scheduling practices! However, with nurse scheduling software like Celayix, you can offer flexible scheduling options to improve nurse autonomy. We allow schedulers to provide both self-scheduling and shift bidding options. Nurses can also input their availability to the system, meaning they can plan ahead, and schedulers won’t assign them to shifts on days they cannot work! Self scheduling allows nurses to choose shifts they want to work on a first come, first save basis. Shift bidding allows nurses to express interest in open shifts, and schedulers then assign shifts in whatever way works best for them.

For both of these options, schedulers can decide which nurses have access to which shifts based on qualifications, seniority or any other factor they decide. With improved autonomy, nurse wellbeing will increase which will improve patient care across the board!

payroll and billing reporting and tracking

Improved Billing & Tracking

Scheduling aside, using shift scheduling software contributes to other areas of your LTC organization and can improve basic processes. For LTC facilities with more than one location, shift scheduling software can help you keep track of your nurses and care staff, and who has worked, where and when. You can also manage and track tasks done on shift ensuring that crucial tasks are carried out in each shift and that you have a record of those completed tasks.

To learn more about how scheduling software can help your organization, contact our team of solution advisors. Whether you run a public or private LTC facility, Celayix shift scheduling, time, and attendance software keeps a record of which nurses worked with each patient. Track hours worked for improved billing and payroll, saving you money and time. You can use that extra time to improve processes elsewhere in your organization or allow managers more time to work with care staff and patients on the floor. You can then use the savings to hire extra staff, purchase new and improved equipment or even just improve your bottom line.

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