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Centralized and Decentralized Nurse Staffing Policy

Staffing policy is a very important issue for the quality of nurses’ services. Centralized and decentralized staffing policy could be applied in the hospital. Each of these two systems has its advantages and disadvantages. Besides, staff schedule and regulation is very important for nurses’ work management. As it was shown by the example of Susan’s case, the accurate staff schedule is essential to avoid possible incidents. Thus, it could be claimed that the appropriate staffing policy and accurate schedule might determine the quality of nurses’ services.

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Centralized and Decentralized Staffing

Nursing units design (centralized, decentralized or combined) affects both nurses’ psychological state and quality of their work. Centralized staffing policy implicates the centralized nursing station which contains all the patient information from the local stations. Nurses have access to the information and could interact and consult with each within the system. According to Parker, Eisen, & Bell (2012), centralized staffing advantages are efficient communication and consultations with other nurses and social support. These benefits increase the level of job satisfaction and reduce the level of stress. Consequently, the quality of nurses’ services increases. However, centralized nurse unit design has some limitations, comparing with decentralized stuffing. In particular, nurses face difficulties due to special technologies use and required additional teaching. Besides, demands of technology might increase the costs of nurses’ services. Authors concluded that the most efficient staffing would be centralized coupled with decentralized (Parker et al., 2012).

American Nurses Association provides rules and regulations of all the aspects of nurses’ work, including staffing policy. In the ANA Nursing: Scope and Standards of Practice, the guidance of staff management is provided. The standards answered the question about benefits and limits of the centralized system and provided possible solutions for the most effective application of it. According to the book, efficient staffing is essential for the patients’ safety and the high quality of nurses’ services (“Scope and standards of practice,” 2017).

Staff Schedule: Susan’s Case Study

Susan’s case introduces the widespread problem with the lack of qualified nurses. This situation leads to inappropriate schedule, job stress and dissatisfaction increase and, subsequently, the quality of nurses’ services decrease. The possible serious consequences of this situation are nurses’ errors occurring and incidents happening (Lin, Kang, Liun, & Deng, 2014). In Susan’s case, the nurse manager (Susan) was responsible for nurses’ schedule. Due to the lack of qualified nurses for night shifts, Susan decided to increase the number of patients per a nurse. This led to several serious incidents. Susan was considered to be guilty and was fired.

According to the“Scope and standards of practice” (2017), employers corrects nurses’ schedule due to current urgent requirements. It is a widely used practice, and it is a commonly spread reason for nurses’ job leaving. Effective shift schedule should be based on the particular hospital human resources and some personal circumstances which also should be taken into account (Lin et al., 2014). Thus, Susan’s responsibility and guilt could be considered to be doubtful. The hospital administration should take the whole responsibility and solve the urgent problem of the lack of qualified staff. However, the nurse manager’s guilt also exists. In particular, Susan should not make this decision without discussing it with the hospital administration and nurses’ staff members.


In conclusion, nurses staffing policy is very important for the staff members’ job satisfaction and the quality of their work. Nowadays, the healthcare system faces a significant problem of the lack of nurses. Thus, particular efforts should be directed to attract qualified human resources to hospitals. To achieve this goal, comfortable workplaces should be created for nurses, including nurse units design and appropriate shifts schedule policy. These efforts might decrease the job stress and increase the quality of nurses’ services.


Lin, C. C., Kang, J. R., Liu, W. Y., & Deng, D. J. (2014). Modelling a nurse shift schedule with multiple preference ranks for shifts and days-off. Mathematical Problems in Engineering, 2014, 1-10. Web.

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Parker, F., Eisen, S., & Bell, J. (2012). Comparing centralized vs. decentralized nursing unit design as a determinant of stress and job satisfaction. Journal of Nursing Education and Practice, 2(4), 66-76. Web.

Scope and standards of practice. (2017). Web.

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