The budgeting process at CHOMP is varied and requires that nursing managers and department heads keep a close eye on the daily activities of staff. It is described as a structured process that begins with planning meetings in August with the financial services department. The department director and the Vice President sign off on the budget in December, and then all budgets are reviewed by the President's Advisory Committee which includes the CEO and the Vice Presidents. Department directors also have to sign off on their budget in November or December. Budgeting decisions are made by each nursing department. The budget is generally two to three million dollars, including wage and non-wage budgets. The budget is flexible. Nurses need to stay between 95-105% for productivity with an aim of 100%. The budget is averaged so on days when full time employees exceed the hours budgeted based on patient numbers they can be averaged for days when the budget was within the budget standards.

The nursing manager's role in determining budgets is fixed. The nurse manager is responsible for staying within his or her budget. The staffing budget is set at 18.92 hours per patient day. Other unites generally have between eight and eleven hours budgeted. The total budget for the year for staff hours is approximately 2,080.

The nurse manager role could be developed in a number of ways with regard to budget determination. Budgeting is a vital component of any management process, and for nurses to be successful participating in budgeting affairs they must first better understand what exactly a budget is and the role that budgeting plays essential to their ability to carry out the strategic goals and relevant to management's responsibilities (Ward Jr., 1994). To that extent nurses should be more involved in the planning and organizational...

At CHOMPA the budget is decided based on historical detail. The hospital has continually expanded its budget since its inception date, thanks largely to the contributions and donations made by community members (CHOMPA, 2005). Wise budgeting practices and cost containment measures will enable the hospital to continue to serve its community in the future.
In order to enable better service and in order for CHOMPA to continue any expansion programs it has established for the future, nursing managers will need to keep a close eye on the budget to ensure that expenditures remain reasonable and are justifiable over time. Thus, in the future it would benefit nurse managers to be advised of cost containment measures so they have the ability to determine when and where cuts can be made without sacrificing quality service (Schmaedick, 1993). Cost containment measures shouldn't be restrictive, but instead should ensure that quality and service are provided within the scope of the hospital's ability to finance and pay for them. CHOMPA seems at this time to have a strong handle on this and is able to balance out days when the budget is stressed with days when less burden is placed on budgetary affairs.