Self-scheduling for hospital nurses: an attempt and its difficulties.

AIM: To describe a pilot project on self-scheduling (self-rostering) for hospital nurses and assess its potential values and difficulties in implementation.
BACKGROUND: Self-scheduling is one aspect of the effort to make the hospital nursing environment more accommodative of nurses' lives. It is part of the good employment practices that nurses want and that can help recruitment, retention and--possibly--patient care.
METHOD: A self-scheduling programme was implemented on one nursing floor for a year. Its effect on nursing perceptions was gauged by an informal questionnaire, and its effect on the nurse manager was gauged by counting change requests and sick calls, as well as her time spent on scheduling and her perceived annoyance in doing it.
FINDINGS: During the time of the pilot project nurses felt that they had better control of their time and were able to give better patient care. Also, change requests decreased, as did the time spent by the nurse manager and her sense of annoyance. But since the nurses did not adhere to the rules of the programme, despite repeated efforts by the nurse manager, the attempt floundered.
CONCLUSION: Self-scheduling can have positive results for nurses and benefit the nurse manager. But if nurses see this as an individual entitlement instead of a balance between individual and unit benefit, everyone loses. This experience may be of use to others trying to implement a self-scheduling system.