The changing composition of the British hospital nursing workforce 1962-1984

The United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) recently undertook a major project aimed at identifying the most appropriate future nurse staffing patterns. The results presented here were produced at the request of the UKCC in order that the recommendations stemming from their deliberations could be set against a wider backcloth. It proved possible to secure nurse staffing data from three of the countries of the United Kingdom, namely, England, Wales and Scotland. Most were secured from government publications but the appropriate government agencies also provided valuable assistance. The main trends emerging from a processing of the data are a steadily falling ratio of student nurses and midwives to their qualified counterparts and a steadily increasing contribution by state enrolled nurses. A number of other ratios are presented pictorially accompanied, where appropriate, by a commentary. The actual growth in whole time equivalent nurses is seen to be somewhat less than many people imagine when account is taken of the reduction in both the number of weeks and the number of hours per week worked. Indeed, there has been a levelling off of this last figure over the past few years.

Downsizing: a challenge for the eighties and beyond

Downsizing of the workforce is now a reality in the rapidly changing healthcare environment. The effective manager must understand this complex subject and the able to identify its cause and effect relationship on the radiology department. The result of implementation can be new opportunities that will allow the manager to maximize what otherwise could be a negative aspect of the industry.

Hospital employment under revised Medicare payment schedules

A preliminary study of the employment effects of medicare payments based on Diagnosis Related Groups suggests that cost-cutting responses by hospitals will result in smaller, more highly skilled staff and a higher proportion of clerical to health care workers.

Technologist shortage in hospitals: what's going on here?

In many parts of the United States, the current economic and political environment has created a shortage of qualified radiologic technologists willing to work in hospitals. This article discusses the causes, effects and suggested remedies for this shortage.

National survey of hospital pharmacy facilities: adequacy of facilities and changes planned

The adequacy of existing space allocations for hospital pharmacy facilities and planned changes are described. A 12-page questionnaire was sent in July 1982 to the chief pharmacists in a random sample of 1846 hospitals in the United States stratified by 10 hospital types. The respondents in each hospital type and size were categorized by their perceived adequacy of existing space for pharmacy facilities and their plans for adding pharmacy functions and staff. Changes in pharmacy facilities that would improve pharmaceutical services were identified, as were planned changes in facilities. The amount of proposed space approved and not approved for pharmacies in hospitals of each type were determined. The response rate was 45.6%, and the respondents were representative of the population. Forty-nine percent of the respondents reported having adequate space. Only 35% of the respondents indicated that no changes could be made in facilities to improve pharmaceutical services. Forty-one percent of respondents planned one or more changes of some kind in pharmacy facilities; this ranged from 14% for long-term, nonprofit hospitals to 50% for long-term, for-profit hospitals. Sixty-six (8%) of the 843 hospitals had additional floor space approved and funded for the pharmacy; 71% had proposed space that was not approved. Sixty-three percent of all respondents planned new pharmaceutical functions; 56% and 42% planned an increase and no change, respectively, in the number of pharmacy staff members. Adding more space may be one way to improve hospital pharmacy facilities, but more attention also should be directed toward better use of existing space, equipment, and fixtures.

Organizational downsizing: streamlining the healthcare organization

Organizational downsizing is a proven technique for restructuring a hospital's organization in response to a severe decline in occupancy. This process involves the traditional microanalysis of staffing used in productivity studies, with a macroanalysis of the hospital's organization and operation. Organizational downsizing is designed to assist hospitals to identify and achieve substantial reductions in staffing. Therefore, it is most appropriate for hospitals that have experienced such severe occupancy declines that traditional productivity methods are not sufficient for achieving necessary staffing reductions.

The economic environment of resident physicians

We examined the financial, working, and educational environment of resident physicians, using mail surveys of residents conducted in 1979 and 1983. Variables examined include annual residency salary, fringe benefits, educational debt, moonlighting income, hours and types of work, and perceived problems with the residency programs. Three conclusions are drawn from the surveys. First, the rapid increases in resident salaries prevalent in the late 1960s and early 1970s have been replaced by more modest advances. Second, resident physicians are not indicating great concern about their current financial status. Third, resident physicians work long hours, but teaching hospitals have not increased their use of residents. These findings illustrate the dual nature of residency training: residents are both students and employees.

Punch out the time clocks

Today's work environment is full of contradictions. On the one hand there aren't enough jobs to go around and on the other some people who have jobs would trade pay for time off. Some managers, at least managers of one-fifth of the labor force, are resolving this contradiction with an elegantly simple solution. They are installing some version of alternative work schedules: flexitime, permanent part-time jobs, job sharing, compressed workweeks, and work sharing, which give employees more control over their professional and personal lives and give employers, for instance in an economic downturn, a way, a way to keep experienced workers on the job without straining budgets. The authors of this article, both of whom have helped develop alternative work schedules, describe the five forms and how numerous employers across the country are adapting them to their purposes. They predict that eventually most U.S. employees will be working under some form of the new schedules.