I love puzzles: jigsaw puzzles, logic puzzles, day-to-day what-are-we-going-to-do-now puzzles. Once the initial shock of starting a new job wore off and I started to settle into life on the PPCU (pediatric progressive care unit) I began to pay attention to the very interesting puzzle that is the schedule. Suzan, a gem of a nurse, had done the schedule for years; and she had done such a good job of navigating unit needs and staff wants, everyone still loved her. I was intrigued, wondering if I would be able to figure out the complexities it required. Hesitantly, I asked if she needed help. Once she knew I was serious she welcomed me on board. I have been doing the schedule every other month for 3 years now. I love it.
THE PAST
When I started working on the PPCU there had been a management implemented, short-lived, supremely unsuccessful, much hated attempt to out-source and computerize the scheduling system. Nobody was happy and before I was off orientation it had been scrapped. The scheduling reverted to the paper, pencil, Suzan version that had worked for decades.
THE PRESENT
Still in place, this system works as follows:
- Approximately 2 months ahead of time a four week skeleton is placed in the schedule book.
- Staff fill out their requested shifts based on their availability and preference.
- After 2 - 3 weeks the skeleton is pulled and the penciled in requests are in-putted into a spreadsheet and the puzzle begins.
- Once we have moved people around in order to have the necessary numbers for each shift (a process where we both add the all important human element because we know home situations, preferences, and personalities), and it has been approved by our unit manager, the schedule is emailed to staff and a hard copy is placed in the schedule book

This scheduling process looks and sounds like a nightmare of a puzzle. In my previous work environment, I could go onto a scheduling website and pick the days/evenings I wanted to work. Everything was controlled over the hospital scheduling software. If I wanted to request off, plan a vacation, or switch shifts I would have to do all of these requests from the website. I can see how having the paper on the unit can be beneficial because people can easily make changes to it without having to worry about figuring out how to navigate a confusing webpage or worry about connectivity issues. When writing on the scheduling paper, I would imagine it can be hard to read people's handwriting, it can be lost or damaged( have to love coffee stains), and there can be human error like you mentioned. While we hope most people will be honest and trustworthy, there is also a chance someone can change other people’s chosen options. If new technology for scheduling is implemented, there needs to be a transition stage. Education and training are a must so that staff have enough time to understand how to use scheduling websites compared to a paper scheduler. If additional training is needed for certain staff, they should be able to take an online course to reinforce their and also feel comfortable to openly discuss issues with their manager. Handouts with instructions and instructions posted by computers are also ways to help staff in the transition. Technology can make a difference because it helps mitigate human error and allows individuals to put in schedule on a computer without having to find the paper/ risk losing it. If the technology in the past was traumatizing for a majority of staff, then this was an organizational failure and better scheduling technology/training should be put into place. The paper could still be available to show what shifts specifically need to be covered on a unit, but this should also be indicated over the scheduling website.
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