Staffing the unit with nurses: the role of nurse managers Adelaide Maria Ansah Ofei, Yennuten Paarima, Theresa Barnes and Atswei Adzo Kwashie Department of Research, Education and Administration, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana Abstract Purpose – To explore the staffing practices of nurse managers at the unit. Design/methodology/approach – Introduction: Ensuring that units are staffed with adequate nurses to render quality nursing care to clients has become increasingly challenging for most hospitals. There is growing evidence linking best patient outcomes and fewer adverse events to the presence of nurses at the bedside. Hospitals require to attract and retain nurses in the units to address the issues of quality, staff and patient safety. Methods: The study used a descriptive phenomenological design to purposively select 15 nurse managers (NMs) and 47 nurses for in-depth interviews and focus group discussions respectively. Findings – The study found that the demand for nurses to work in the unit was not scientific. Nurses affirmed their frustration of inadequate numbers of staff in the unit especially, at the periphery hospitals. Time can be used as a source of motivation for nurses and nurses should be involved in the development of the duty roster to enable effective compliance. Compensation for additional duties is relevant in nursing. Research limitations/implications – The research was carried only in one region in Ghana, and the findings may not be the same in the other regions. Practical implications – Inadequate staffing level has serious implications on patient safety, quality of care and staff outcomes. This situation necessitates the implementation of health sector staffing norms to ensure the right calibre of mix staff are recruited and retained. Originality/value – This study is the first in Ghana that we aware of that explore staffing practices at the unit that identifies factors that impact staff schedules for effective care. Keywords Staffing practices, Nurse managers, Work unit, Qualitative method Paper type Research paper Introduction The unit is the most important segment of the hospital and staffing it with adequate Registered Nurses (RNs) to render quality nursing care to clients is essential. Keen responsiveness of quality issues, staffing and patient safety emphasize the quest to attract and retain RNs in the units (Paulsen, 2018) as there is increasing evidence linking best patient outcomes and less adverse events to the presence of RNs at the clinical areas (Bridges et al., 2019). The increasing aging workforce, changing workplace climate, increasing workloads and the image of nursing as a challenging and financially unrewarding profession continue to drive the inadequate nursing staffing (Ulrich et al., 2005) in most hospitals. Pivotal in determining the numbers and mix of RNs for the unit is the nurse manager. Nurse managers should be able to logically suggest the requisite number of nurses who would objectively give care to clients without any challenges. The study, therefore, seeks to explore nurse managers staffing practices at the unit level. Staffing the unit with nurses The authors wish to sincerely thank the management of hospitals and all the nurse managers and nurses who participated in the study. Funding: No funding was received either from individuals, not-for-profit organizations or commercial entities. Competing interests: No competing interest. The current issue and full text archive of this journal is available on Emerald Insight at: https://www.emerald.com/insight/1477-7266.htm Received 17 April 2020 Revised 18 January 2021 11 April 2021 Accepted 17 April 2021 Journal of Health Organization and Management © Emerald Publishing Limited 1477-7266 DOI 10.1108/JHOM-04-2020-0134