Nine Empty Chairs in Fourteen Operating Rooms: A Workforce Forecast and Recruitment Plan for a Perioperative Services Director
[Student Name]
University of Phoenix
NSG/547: Human Resources Management
Week 1 Assignment
[Instructor Name]
[Date]
The hospital, its department and all figures are a composite written for a model paper.
I direct perioperative services at a 300-bed regional hospital: 14 operating rooms, a 16-bay recovery unit and a preoperative area that prepares about 55 surgical patients a day. The department budgets 64 registered nurse positions. Nine are vacant. Traveling nurses fill most of the gap at about twice the hourly cost of staff nurses, and two operating rooms close on some afternoons because there is no one to staff them. This paper forecasts the department's needs and sets out a recruitment plan.
Forecasting Demand
Demand begins with volume. Surgical cases have grown 4% a year for three years, and the hospital's strategic plan adds a fifteenth operating room for orthopedic and robotic surgery in eighteen months. Staffing each operating room requires a circulating registered nurse for every hour the room runs, plus coverage for breaks, call and time off. Using the department's current staffing model, the added room and growth in cases will require about six additional registered nurse positions over two years, bringing the budget to 70.
Measuring Supply and Loss
Supply is the other side. The department's first-year turnover among new hires over three years was 24%, and overall registered nurse turnover last year was 14%. Nationally, a long-term panel study of new nurses found that about 17.5% leave their first job within a year (Kovner et al., 2014), so the department's first-year loss is worse than the national figure. Exit interviews named three reasons: insufficient orientation for nurses new to the operating room, the burden of weekend and overnight call and a sense that experienced staff did not welcome new colleagues. The call burden is not only a retention issue; schedules with long hours and little time away from work have been associated with worse patient outcomes (Trinkoff et al., 2011). The age profile adds a warning: 19 of the department's 55 employed nurses are 55 or older, and several have said they plan to retire within five years.
The Gap
Putting demand and supply together, the department will need to hire roughly 30 registered nurses over two years: 9 to fill current vacancies, 6 for growth and about 15 to replace expected turnover and retirements. A department that hires 30 nurses to stand still will never catch up unless it also reduces how many leave. Recruitment and retention must therefore be planned together; this paper focuses on recruitment, and Week 4 addresses retention.
Why Positions Are Hard to Fill
The diagnosis shapes the plan. Few nursing programs offer more than a brief operating room observation, so new graduates rarely consider perioperative nursing and are not prepared for it. Experienced operating room nurses are scarce locally, and competing hospitals offer sign-on bonuses. And the department's reputation for difficult call schedules and an unwelcoming culture has spread among local nurses.
Recruitment Channel 1: Grow Our Own
The strongest long-term channel is training new graduates and nurses from other specialties. The plan creates a structured perioperative residency of six months with classroom modules, simulation and precepted clinical practice, taking cohorts of six twice a year. It also offers a student perioperative elective in partnership with the local nursing school, so students see the operating room before graduation. Cost: about $38,000 per resident in paid orientation time and educator support, less than a year of traveler premiums for one position.
Recruitment Channel 2: Internal Transfers
Nurses in the hospital's surgical units, intensive care units and emergency department already know the hospital and its systems. The plan advertises the residency internally and offers transfer without loss of seniority. Cost: minimal, though transfers create vacancies elsewhere, so the plan is coordinated with other directors.
Recruitment Channel 3: Experienced Operating Room Nurses
Experienced hires fill the department fastest. The plan uses a referral bonus for current staff, targeted digital advertising within a 60-mile radius and a professional association job board, and it adjusts the call structure described in Week 3 so the department competes on schedule, not only pay.
Recruitment Channel 4: Converting Travelers
Several traveling nurses have worked in the department for more than a year. The plan offers them staff positions with a conversion incentive, since they are already oriented and known.
Selecting Well
Recruiting more applicants helps only if the department selects well among them. Research on selection methods has found that structured interviews with job-related questions predict later performance better than informal conversations (Schmidt & Hunter, 1998), so the plan pairs expanded recruitment with a structured selection process, described in Week 2, to avoid filling residency places with candidates likely to leave.
Partnerships
The plan depends on partners. The local nursing school must agree to the student elective and schedule it; surgeons and anesthesia providers must accept students and residents in their rooms; and human resources must support referral bonuses and traveler conversion. Each partner has been approached, and the surgeons' leadership has agreed to host residents after reviewing the residency's safeguards, such as a preceptor always present during the first months.
Risks
Three risks could undercut the plan. Residents may leave after training, which Week 4's retention plan addresses. Competing hospitals may raise bonuses; the plan competes on training and schedule rather than bonuses alone. And a cohort may not fill; the internal transfer channel provides a buffer.
What Recruitment Must Not Promise
Advertising will describe the call schedule and orientation honestly. Realistic job information helps applicants decide whether the job fits, and a recruit who leaves after three months because the job was not as described costs more than a vacancy left open a little longer.
Costs and Budget
The plan's first-year cost, including residency time, referral bonuses and advertising, is estimated at $610,000. Traveler spending last year was about $1.4 million. If the plan fills 12 positions with staff in the first year and reduces traveler use by half, it pays for itself within the year.
Measures
The plan will be measured by vacancy rate, with a target of under 5% within two years; time to fill, currently 94 days, with a target of 60; first-year turnover of new hires, from 24% toward the national benchmark of about 17.5%; traveler hours, down 50% in a year; and the number of residents completing the program and still employed at one year.
Legal and Fairness Considerations
Recruitment must comply with equal employment opportunity law, and advertisements, referral programs and selection criteria will be reviewed with human resources so that they do not screen out applicants based on protected characteristics. Week 2 will address selection in detail.
Conclusion
The department needs about 30 registered nurses over two years because of vacancies, growth, turnover and retirements. Because experienced operating room nurses are scarce, the plan relies most on growing its own through a residency and student elective, adds internal transfers, targeted experienced hiring and traveler conversion and measures results against clear targets. Recruitment alone will not close the gap, which is why the plan is paired with retention work later in the course.
References
Kovner, C. T., Brewer, C. S., Fatehi, F., & Jun, J. (2014). What does nurse turnover rate mean and what is the rate? Policy, Politics, & Nursing Practice, 15(3-4), 64-71. https://doi.org/10.1177/1527154414547953
Schmidt, F. L., & Hunter, J. E. (1998). The validity and utility of selection methods in personnel psychology: Practical and theoretical implications of 85 years of research findings. Psychological Bulletin, 124(2), 262-274. https://doi.org/10.1037/0033-2909.124.2.262
Trinkoff, A. M., Johantgen, M., Storr, C. L., Gurses, A. P., Liang, Y., & Han, K. (2011). Nurses' work schedule characteristics, nurse staffing, and patient mortality. Nursing Research, 60(1), 1-8. https://doi.org/10.1097/NNR.0b013e3181fff15d
How this NSG 547 Week 1 example is structured
The NSG/547 description begins with the nurse administrator's responsibility for recruitment. This paper treats recruitment as the end of a planning process: it forecasts demand, measures supply and turnover, diagnoses why positions are hard to fill and only then chooses channels, each with a cost and a measure, so the plan can be judged against results. Students search this week as NSG 547 Week 1, NSG547 Wk 1 or NSG/547 Wk 1; all three are the same assignment.
NSG/547 Week 1 questions, answered
What does NSG/547 Week 1 usually ask for?
The course description begins with the nurse administrator's responsibilities for recruitment. Many sections ask students to analyze staffing needs and propose a recruitment plan for a nursing department.
Why is operating room nursing hard to recruit for?
Most nursing programs provide little perioperative experience, so few new nurses are prepared for the role, and experienced operating room nurses are in demand. Many hospitals must train their own.
How is recruitment success measured?
Common measures include vacancy rate, time to fill, cost per hire, first-year turnover of new hires and the share of positions filled by agency or traveling nurses.
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