Self-scheduling has emerged as an increasingly popular option for hospitals and health systems to provide nurses with greater flexibility. However, the concept is not entirely new.
Self-scheduling was first documented at London-based St. George's Hospital in 1963, according to a 2007 study published in the Journal of Nursing Management. In the 1980s and 90s, the practice gained popularity in the U.S., alongside the rise of Magnet organizations, according to Jennifer Mensik Kennedy, PhD, RN, president of the American Nurses Association.
Though the American Nurses Credentialing Center created the formal Magnet Recognition Program we know today, its roots tie back to research from the American Academy of Nursing. In fact, the academy first coined the term "Magnet" in the early 1980s to describe hospitals that could successfully recruit and retain nurses during a national staffing shortage, according to research from Sacramento, Calif.-based UC Davis Health and The Journal of Nursing Administration.
At the time, these hospitals likely recognized self-scheduling as a valuable strategy to increase nurse satisfaction and retention amid a competitive hiring landscape — a recognition strikingly similar to one health systems are making today.
While it's difficult to form a definitive answer as to why self-scheduling's popularity faded at the turn of the century, one theory is that nurse leaders may have sunsetted the practice after finding it to be too complicated to set up and manage via paper scheduling processes, according to Dr. Mensik Kennedy. Another theory is that the prevalence of self-scheduling may have dwindled as the available supply of nurses increased, allowing hospitals to be more rigid with their staffing and scheduling models.
"My guess is that at times when there was an abundance of nursing staff, potentially management had more ability to take harder lines and maybe were more interested in business needs and less interested in staff autonomy," said Alicia Potolsky, DNP, RN, associate chief nursing officer of Mountain View, Calif.-based El Camino Health.
Today, nurse leaders are highly focused on creating healthy work environments that promote flexibility and employee satisfaction. As part of this effort, El Camino Health is preparing to pilot nurse self-scheduling in two units this fall, with future plans for expansion.
No national data exists to quantify how many hospitals and health systems are now using nurse self-scheduling capabilities, but anecdotal evidence suggests the practice is seeing a resurgence, driven by the rise of electronic scheduling systems and young nurses' demands for more flexibility.
"I do think it's surged in recent years," Dr. Mensik Kennedy said. "Nurses are more satisfied when they self-schedule — period. It gives them a voice and freedom to make their own decisions. It increases their own control and flexibility."
For nurses managers, self-scheduling is also a win-win, she said. The practice allows them to spend less time scheduling and processing change requests and more time on needle-moving activities such as rounding or mentoring staff. The practice can also decrease absenteeism since staff members are setting their own hours.