By Pradeep Pandey · Co-Founder · 9 min read · Updated
What Is a Nurse Staffing Relief Factor? How to Calculate It
Keeping two nurses on nights every night takes about 4.2 full-time equivalents (FTEs) before anyone takes time off. Once vacation, holidays and sick days are counted, it takes about 4.8. The relief factor is the multiplier that covers the difference.
Key Takeaways
- A nurse staffing relief factor is the multiplier that turns the hours your schedule must cover into the number of full-time equivalents (FTEs) you need, once paid time off is counted.
- The Veterans Health Administration calls it a replacement factor: the share of time staff are “away from the unit not performing direct patient care duties,” such as sick leave, annual leave and education.
- One FTE, a full-time equivalent, is 2,080 paid hours a year. The relief factor is those 2,080 hours divided by the hours a nurse actually works after time off.
- In an illustrative example, keeping 2 nurses on nights every night takes 4.21 FTEs if nobody takes time off. If each FTE takes 250 hours of time off a year, it takes 4.79 FTEs.
- There is no current published “typical” relief factor. Calculate your own from payroll, once a year.
Table of Contents
- What Is a Nurse Staffing Relief Factor?
- How Do You Calculate a Relief Factor?
- What Does a Relief Factor Look Like for a 25-Bed Hospital?
- Is There a Standard Relief Factor for Nursing?
- Why Is a Nurse on Three 12-Hour Shifts Not a Full FTE?
- How Does SimpleScheduleAI Use a Relief Factor?
- What to Do This Week
- Frequently Asked Questions
Your staffing grid says two nurses on nights, every night. That tells you what the schedule needs. It does not tell you how many nurses to budget for, because every nurse on that schedule will take vacation, holidays and sick days during the year, and someone has to cover those shifts too. The relief factor is how you account for that time before it turns into overtime, whether you build the schedule by hand or with nurse scheduling software.
What Is a Nurse Staffing Relief Factor?
A nurse staffing relief factor is a multiplier that tells you how many extra staff you need to cover time nurses are paid but not working. You multiply the FTEs your schedule needs by the relief factor to get the FTEs you should budget and hire.
The Veterans Health Administration uses the term replacement factor. Its staffing methodology directive defines it as “an estimated forecast of staff replacement to ensure nurse staffing targets are consistently met.” It says the factor “calculates the percentage of time staff is away from the unit not performing direct patient care duties.” Its examples include “sick leave, annual leave, leave without pay, military leave, union steward official time, continuing education and committee work.”
Paid time away is often called nonproductive time. A 2018 article in Nursing Management describes nonproductive hours as “those hours paid to staff members when they haven’t worked, including PTO; sick days; holidays; and time for funerals, jury duty, and so on.”
How Do You Calculate a Relief Factor?
Divide the paid hours in one FTE by the hours that FTE actually works. One FTE is 2,080 paid hours a year, 40 hours a week for 52 weeks. If a nurse is paid for 2,080 hours but spends 250 of them on vacation, holidays and sick time, they work 1,830 hours. The relief factor is 2,080 ÷ 1,830, which is about 1.14.
The 2,080-hour figure is the standard FTE. An article on staffing plans in Nursing Management describes a full-time employee as working “80 hours per 14-day pay period or for a total of 2,080 hours per year.”
The same article uses a percentage method. It says to “divide the average number of nonproductive hours per FTE by 2,080 hours,” and “The resulting number is the percentage of lost time.” You then add that percentage to each clinical position.
The two methods give slightly different answers. In our example, 250 ÷ 2,080 is 12%, so the percentage method adds 12%. The ratio method, 2,080 ÷ 1,830, adds about 13.7%. The ratio is a little higher because the nurses covering for others also take time off. Either is far better than budgeting no relief at all.
What Does a Relief Factor Look Like for a 25-Bed Hospital?
Here is an illustrative example for the night shift at a 25-bed hospital. It is not a benchmark or a result from any hospital. The staffing grid and the hours of time off are choices made for the example, so replace them with your own.
| Step | Calculation | Result |
|---|---|---|
| Hours to cover on nights | 2 nurses × 12 hours × 365 nights | 8,760 hours |
| FTEs with no time off | 8,760 ÷ 2,080 | 4.21 FTEs |
| Hours an FTE actually works | 2,080 − 250 hours of time off | 1,830 hours |
| Relief factor | 2,080 ÷ 1,830 | 1.14 |
| FTEs to budget | 8,760 ÷ 1,830 | 4.79 FTEs |
The 250 hours of time off in this example could be, say, three weeks of vacation, several holidays, a few sick days and some education time. Use the actual paid time off from your own payroll instead.
The gap between 4.21 and 4.79 is about half a nurse. If you budget 4.21 FTEs for nights, that half-nurse of coverage still has to come from somewhere, usually from overtime or a per diem nurse. Our guide to per diem nurse scheduling covers one way to fill it. Overtime that runs on for months can also cost you the nurse; our guide to the cost of losing a nurse at a rural hospital covers that side.
The same method works for days and nights together. Two nurses around the clock is 2 × 24 × 365 = 17,520 hours, which is 8.42 FTEs before anyone takes any time off. With 250 hours of time off per FTE, it is 17,520 ÷ 1,830, or about 9.6 FTEs.
Is There a Standard Relief Factor for Nursing?
No. We found no current published “typical” relief factor for nursing. The Veterans Health Administration’s 2017 staffing directive set a floor of 1.2 for its own hospitals, but that version was replaced in 2023, and the current directive gives no number.
A missing standard is the right answer for a small hospital anyway. The Nursing Management staffing-plan article recommends that you “calculate the nonproductive percentage for your individual department once a year at budget time to determine the exact number.” Your nurses’ vacation policy, holidays and sick time decide the number, not an average from somewhere else.
Why Is a Nurse on Three 12-Hour Shifts Not a Full FTE?
A nurse who works three 12-hour shifts a week works 36 hours, not 40, so they are 0.9 FTE. The Nursing Management staffing-plan article shows the math. It reads: “12 hours per day × 6 days per pay period = 72 hours per pay period/80 hours = 0.9 FTE.” It also warns that “A common mistake is to count the 12 hours per day, 6 days per pay period employee as 1.0 FTE.”
This matters when you turn FTEs into people. In the example above, 4.79 FTEs of nights at 0.9 FTE per nurse is about 5.3 nurses. In practice that means 5 night nurses plus per diem cover, or 6. Keep FTEs and headcount separate in your budget, or the gap shows up later as overtime. Our 12-hour nurse schedule guide shows how the 36-hour week plays out on the schedule.
How Does SimpleScheduleAI Use a Relief Factor?
One honest limitation: SimpleScheduleAI does not calculate a relief factor or set your FTE budget. That stays with the nurse manager and finance. SimpleScheduleAI is an AI-native nurse scheduling service for critical access hospital scheduling: AI builds your schedule, our scheduling team checks it, you approve.
What it does is schedule the nurses you have. It never places a nurse on a day of approved leave. Any shift it cannot cover from your roster comes back marked, with the reason. If your relief factor is too low, those marked shifts are where it shows up. The full cycle is on how it works, and our guide to AI nurse scheduling explains how the drafts are built.
Our Take
A staffing grid with no relief factor is a plan to run on overtime. At a small hospital, half a nurse short on nights is the difference between a schedule that holds through vacation season and one that breaks every summer. Work out the number from your own payroll once a year, and budget for it before the gaps appear.
What to Do This Week
- Pull last year’s paid time off for your nurses from payroll: vacation, holidays, sick time and education.
- Divide it by the number of FTEs to get average hours of time off per FTE.
- Work out your relief factor: 2,080 divided by 2,080 minus that average.
- Multiply the FTEs your staffing grid needs by the relief factor, and compare the answer with the FTEs in your budget.
- Convert FTEs to people at 0.9 FTE for each nurse on three 12-hour shifts, and check the headcount against your roster.
A schedule built from the nurses you actually have
SimpleScheduleAI never schedules a nurse on approved leave, and shows you any shift your roster cannot cover, with the reason.
See how it works →Frequently Asked Questions
Q: What is a good relief factor for nurses?
There is no current published standard. The Veterans Health Administration’s 2017 directive set a floor of 1.2 for its hospitals, but the 2023 version removed any number. Calculate your own from payroll: 2,080 divided by 2,080 minus the average hours of paid time off per FTE.
Q: What is the difference between an FTE and a nurse?
An FTE is 2,080 paid hours a year. A nurse is a person, who may work more or less than that. A nurse on three 12-hour shifts a week is 0.9 FTE, so 4.5 FTEs takes 5 such nurses. Budget in FTEs, then convert to people.
Q: Does the relief factor include regular days off?
No. In nursing, the relief factor covers paid time away from work, such as vacation, holidays, sick time and education. Regular days off are already built into the 2,080-hour FTE, which counts 40 hours a week, not seven days.
Sources
- VHA Directive 1351, Staffing Methodology for VHA Nursing Personnel, January 18, 2023. U.S. Department of Veterans Affairs
- Hunt PS. Developing a staffing plan to meet inpatient unit needs. Nursing Management, 49(5):24-31, May 2018. Nursing Management
- Hunt PS, Hartman D. Meeting the measurements of inpatient staffing productivity. Nursing Management, 49(6):26-33, June 2018. Nursing Management
Pradeep Pandey is the co-founder of SimpleScheduleAI, an AI-native nurse scheduling service built for Critical Access Hospitals in Texas. He serves as Deputy General Manager of Operations at Apollo Hospitals and holds an MBA from IIM Trichy. LinkedIn →
