RN - MED/SURG TELE - DAYS

For FY25, R1 is budgeted for 31.9 RN FTEs for an average daily census (Client) 32. Current fill rate *** FTE; includes 9.0 FTE hired to start 7/7, expected to be productive 10/5/2025 and 0.9 FTE on orientation, expected to be productive 7/13/25. Despite being filled to ~70%, a functional vacancy of as high as 20.5 FTE (64%) remains through October 2025 to account for orientation and training of new graduate RNs.

Background:

Remaining vacancies, 10.6 FTE, are posted and leaders are actively working with talent acquisition to recruit and fill vacant positions. In the interim, while recruiting, hiring, and training are in process, gaps are mitigated with staff working over scheduled and incentivized hours, floats are being utilized from other departments and the float pool.

Nursing Supervisors are frequently capping unit census to accommodate staffing constraints. The last 4 PP, Client=18.8 on average, outside of budgeted productive WHPUOS census points.

Assessment:

Per Strata, PI YTD is 88%, and PP21 is 87%. Investigation has revealed the following:

1. As stated above, Nursing Supervisors have capped census based on staffing limitations. The Client for R1 for PP21 was 22.5 (budgeted Client=32, max census 36). This is down due to significant staffing restrictions.
2. Of the 14 days the last PP, 93% were outside targeted budgeted productive WHPUOS census points as identified by the FY25 staffing grid.
3. Ongoing work to improve productivity includes the following:
4. Reducing cancelled meal deductions
5. Reducing early clock-ins and late clock outs
6. Working with Nursing Supervisors to limit the number of staffed, unoccupied beds to 4 per shift
7. Working with charge RNs and Nurse Administrators to staff CNAs to grid 100% of the time.

Recommendation:

9.9 FTE RNs hired for summer 2025 are anticipated to be productive in October 2025. During the time which the newly hired staff are orienting and training (through 10/5/25) functional vacancy increases to 19.6 FTE (61.4%). Additional RN FTEs are required to staff R1 to meet and/or exceed budgeted Client. Vacant RN positions are posted to fill to budgeted FTE. As an interim solution until hiring and onboarding is completed contract labor is requested to maintain R1s capacity and operationalization.