Nursing costs account for over 50% of Health Service Organizations budgetary expenses. In a financially contracting Healthcare market that is amidst the focus of current National and International economic concerns and political agenda, here a counter-intuitive method to minimize exposure to rising nursing costs. Healthcare’s conundrum is marked by rising nursing costs, growing patient population, rising uninsured rates and decreasing insurance reimbursements. Participants traditionally focus on nurse staffing to minimize costs, but in its inextricable link to scheduling, budgets are often inaccurately projected as compared to actual staffing quantities and costs; this is largely due to front-line staffing policies and unpredictable nursing rates. This paper presents a nationwide experimental and empirical study of ten healthcare participants in a cross market “Hedging” application in Nursing Services as an approach to reduce exposure to rising nursing costs based on nursing rate volatility notwithstanding nursing quantity needs and day-to-day staffing decisions, and considering Options as a primary hedging approach to reduce budget disparity and yield nursing expense savings. Nursing monthly costs and demand were collected for all participants over varying range of time periods. A correlation analysis indicated that total nursing costs are highly correlated to nursing rate change, differing across participant types. Additionally, the data was analyzed for “asset” and “options” applicability, as well as tested for appropriateness of the Black-Scholes model for options pricing. The analysis concluded that nursing service qualifies as an underlying asset for options as a hedging technique and may be priced using the Black-Scholes model. The approach was tested on one of the participants, and indicated a savings of over 11% in nursing expenses and a decrease in budget disparity of approximately 14%. Hypothetical application across the non-tested participants alludes that the implementation results are likely to be sustainable across participant with dissimilar demographics.

This essay is a qualitative interview study that investigates what enables motivation for publicly employed nurses and how this affects their choice to be publicly employed in front of the alternative of becoming staffing nurses. As analysis tools, the sociological concepts of valuerational and rational-purposeful actions, idealization and identity work is use in conjunction with the psychological theoretical model Self-determination theory. The results of the study shows that publicly employed nurses experience a continuity in their work situation, which they imagine that they could not experience to the same extent if they were staffing employees. Continuity enables them, through their competence, to satisfy their intrinsic interests and motivations - to meet people and make something meaningful for others. / Denna uppsats är en kvalitativ intervjustudie som undersöker vad som möjliggör motivation hos sjuksköterskor inom landstinget, och hur detta påverkar deras val att vara landstingsanställda framför alternativet att bli bemanningssjuksköterskor. Som analysverktyg används de sociologiska begreppen värderationellt och målrationellt handlande, idealisering och identitetsarbete i samverkan med den psykologiska teoretiska modellen Self-determination theory. Undersökningens resultat visar att landstingsanställda sjuksköterskor upplever en kontinuitet i sin arbetssituation som landstingsanställda, vilket de föreställer sig att de inte skulle kunna uppleva i samma utsträckning om de vore bemanningsanställda. Kontinuiteten möjliggör för dem att genom sin kompetens tillfredsställa sina inneboende intressen och motivationer - att möta människor och göra något meningsfullt för andra.