What are nursing schedules?
Nursing schedules are shifts that are typically 10 hours to 12 hours long. You may also have nurses working on pro re nata (PRN) or “as needed” shifts. These nurses can choose the hours and days that they work. When developing these schedules, it is helpful to evaluate your unit’s requirements, any organizational changes and how these elements affect the schedule.
“It is especially important for managers to provide schedules for high-demand shifts like weekends and holidays with as much notice as possible. Some organizations may schedule holidays 6-12 months in advance or even have a set, rotating schedule for coverage. This allows employees to make plans well in advance for travel or family time.”
—Michelle Hensley, DNP, APRN, CPNP-PC, PMHS
Understand your unit’s needs
Before creating a nursing schedule, it is useful to understand your unit’s needs. This can include the number of patients you typically get and the number of nurses who have requested time off.
It is also important to think about whether there are any organizational changes that affect staffing levels. For example, if hospital administrators plan to close an inpatient unit for renovations, your unit may have to care for more patients than usual.
One thing that makes creating schedules for nurses so challenging is that it can be difficult to plan ahead when you work in a hospital. If you work in a medical office, you can assess your scheduled appointments book to evaluate how many patients you should anticipate each week.
In hospitals, the number of patients can change every day. Consider checking the hospital census when you arrive at work in the morning and before you leave at night. When you know how many patients are currently admitted to your unit, you can make more informed nurse scheduling decisions.
Determine available nursing shifts
To attract experienced nurses, many facilities may offer multiple scheduling options. For example, a hospital may have eight-hour shifts or 12-hour shifts. It can also be common to offer part-time work, per-diem shifts and rotating shifts. Consider the length and type of shifts your employees have been hired for, so you can balance staff shift requirements while ensuring adequate staffing.
Enter requests for time off as soon as you receive them
If you accept requests for time off, consider entering them as soon as you receive them. Also, think about creating a streamlined process for requesting time off. If your unit does not have a process in place yet, consider this ready-made paid time off (PTO) policy.
Last-minute changes can cause stress for your nursing team. Therefore, let the nurses on your unit know how far in advance they should submit their time off requests. Many large organizations have hospital-wide policies for time-off requests. As a manager, ensure you know and enforce these established rules.
Use scheduling technology
Using scheduling software and other tools can significantly streamline your process of creating effective nursing schedules. If you work in a hospital, you may already have these resources or be required to use tools available on your unit. Medical offices and private clinics may offer more flexibility, especially if you’re a practice manager or nursing supervisor.
Once you choose a tool, learn how to use it efficiently. Some companies offer in-depth training as part of their customer onboarding processes, while others provide access to a knowledge base full of instructional guides. Either way, take time to learn what scheduling software features are available. Determine if there are any shortcuts to help you save time or reduce the risk of errors.
Publish schedules as far in advance as possible
The nursing field can have last-minute schedule changes. You never know when you’ll get a critical patient or have your census increase without much notice. That said, publishing schedules as far in advance as possible is often important.
When nurses have advanced notice of their work hours, it’s easier for them to maintain a good work-life balance. Providing a schedule in advance helps them avoid guessing when they’ll be free.
This reduces the risk that someone will tell you they can’t work a scheduled shift because they’ve already made plans. It can also allow nurses plenty of time to swap shifts with co-workers if needed, thereby reducing the likelihood that the nurse will call off work, leaving the unit short-staffed.
Use overtime shifts carefully
Assigning overtime shifts is common, especially when census increases unexpectedly, but avoid making overtime a central component of your staffing plan. Frequent overtime shifts can reduce morale and strain staffing budgets, as many organizations offer overtime differentials.
If overtime shifts are needed, allow nurses to volunteer for these shifts. This is because some may appreciate the extra hours and pay. Consult with human resources about setting up on-call shifts or hiring per-diem nurses to cover as needed.
Your state may also have laws limiting the number of hours worked per shift or per week. Make sure you are aware of how state laws or any organizational nursing unions impact staffing.
Monitor shift swapping
Allowing nurses to swap shifts is an effective way to give them greater control over their schedules. For example, if one nurse needs time off, they can switch shifts with another nurse instead of requesting the day off.
Although allowing shift swaps offers benefits, it also carries potential con. You may have an experienced nurse swap with someone new to nursing, leaving you with several inexperienced nurses on the same shift.
If you decide to allow shift swapping, set some ground rules. The first step is to require nurses to let you know if they want to switch. This allows you to determine if the swap might interfere with your staffing plans for that shift.
Consider verifying that a shift swap won’t affect your staffing budget or cause you to violate your state’s overtime laws. For example, a highly experienced nurse may make much more per hour than a nurse with just one or two years of experience. Allowing them to trade shifts could cause you to exceed your weekly budget.
Before creating a nursing schedule, consider your unit’s needs, determine the budget and identify the available shifts. Use scheduling technology, set budgets for overtime and encourage nursing staff to record time off to manage schedules more effectively.
FAQs about scheduling nurses
Do nurses pick their own schedules?
It all depends on the facility. When a hospital, private practice or outpatient clinic has an opening for a nurse, the recruiter typically advertises a specific shift, such as day or evening.
There may be some flexibility, such as allowing the nurse to choose two days off each week or allowing nurses to submit scheduling preferences. Still, employers typically make final decisions based on staffing needs and expect nurses to work during specific hours.
How often can nurses take off?
The amount of time off a nurse receives depends on the facility and the type of position they hold. For example, nurses working for larger organizations may accrue time off in a bank over time. Other facilities may set a limit on how many days a nurse can take off per year.
Many facilities also grant time off based on a nurse’s length of service. For example, a nurse with 20 years of experience at an organization may have more time off than a new-grad nurse.
Do nurses work three days in a row?
Full-time nurses working 12-hour shifts generally work three days a week. Some nurses prefer these shifts to be consecutive, while others prefer them spread throughout the week. Try to honor nurse preferences, but you may have to schedule based on staffing needs. In private practices and outpatient clinics, it’s more typical to work every weekday and have time off on weekends.
