Children’s Hospitals Reorganizes Nursing Staff, Adds 40-50 Jobs

Some of the hospital system’s inpatient nursing units will grow and some will shrink as part of a “rebalancing” act that aims to ensure that each shift is at the optimal staffing level—but the reorganization is predicted to result in a net gain of 40 to 50 positions.

Children’s Hospitals and Clinics of Minnesota is about to make some major changes to its nursing staff—and they are expected to result in 40 to 50 new positions.

After Chief Nursing Officer Roxanne Fernandes joined the local hospital system roughly a year ago, she noticed that some nursing shifts were overstaffed—and there weren’t enough workers scheduled for others. Rather than letting a shift go understaffed, Children’s was paying a significant amount in overtime to correct the shortages.

“What we did is we undertook a real thorough analysis” of patient volumes and levels of sickness, as well as nursing schedule patterns, Fernandes told Twin Cities Business. “In conclusion, we came to a place where we said, ‘We need to rebalance some units.’”

Consequently, some of the hospital system’s more than a dozen inpatient nursing units will grow and some will shrink as part of a “rebalancing” act that will take place throughout July. Fernandes said her primary goal is to ensure quality care for patients by having an optimal number of nurses for each shift. She estimates that the reorganization will result in a net gain of 40 to 50 positions—which translates to between 30 and 35 full-time equivalents, as the majority of nurses opt not to work full time. Children’s now employs about 1,600 nurses.

In addition to boosting staff, the reorganization is also expected to reduce overtime pay for nurses by about $6 million to total $4 million annually.

Slightly more than 300 nurses at Children’s—which has campuses in both Minneapolis and St. Paul—received letters on Wednesday, asking if they’d like to take a temporary leave of absence, reduce their hours, or take an early retirement package if they’re eligible based on age and years of service.

The affected nurses who remain will then have the opportunity to rebid for other positions. Nursing employment is based on seniority, so the senior-most nurses will be able to take their pick from all nursing jobs at both Children’s campuses, including those that aren’t part of the restructuring. Less-senior individuals whose jobs are claimed or were eliminated will then make their bids among positions that are still open.

The contract between Children’s and the Minnesota Nurses Association, which represents its nursing staff, does not allow the hospital system to simply assign nurses to new shifts and units as it sees fit—which is why Children’s has planned this type of rebidding process.

Although there will be more than enough jobs to go around for all current nurses, some will need to change shifts and/or units in order to stay employed.

Minnesota Nurses Association (MNA) President Linda Hamilton, who’s also a nurse at Children’s, told Twin Cities Business that having the appropriate staff ratios to meet patient needs is a goal that her organization and the hospital system share.

“Nurses have fought for ratios for 20 years,” she said. “I’ll applaud them for looking at that.”

She’s also happy about the boost in jobs that will result from the restructuring, adding, “We could definitely use the help.”

However, Hamilton would have liked the hospital system’s first step in the reorganization process to have involved reaching out to all 1,600 nurses to ask if any were interested in moving to the shifts and units that are short on workers.

“I think they’ll find that there are [takers],” she said. “If we do this on a voluntary basis, everybody wins.”

The “float teams” at Children’s represent one area in which staffing will increase over the next month. Nurses on those teams are trained in several areas within a certain specialty, and for each shift, they are assigned to the area in which there is the greatest staff need. For example, the neonatal float pool might include a nurse qualified to work in the neonatal intensive care unit, the special care nursery, and an infant care center. That nurse could be assigned to any one of those areas each time he or she works.

Fernandes said that staff nurses recommended boosting the float teams. They now collectively include about 140 nurses, but that figure will grow to 170 next month.

“It will increase our flexibility,” Fernandes says.