Imagine you are a nurse manager and record ways of terminating an employee.
Terminating an employee is often a progressive process. The first step is an informal reprimand or a verbal admonishment. The second step is a formal reprimand or written admonishment. If the undesirable behavior is still not corrected, the third step is suspension from work with or without pay for a brief time. The last step is involuntary termination or dismissal. The steps do not have to be followed chronologically. For example, for gross mistreatment of a patient, dismissal may be the only acceptable option. Use of intoxicants while on duty would be another cause for immediate dismissal.
If I had to terminate an employee, I would probably take that employee into my office privately. I would explain to the employee the reasoning behind my decision. If I thought that the employee may react violently, I would have another supervisor and/or a member of security present for the meeting. I would try to follow the progressive process as much as possible, but I would follow the policies of my institution and protect the safety of the patients above all else.
Tuesday, March 22, 2011
Lesson 11: The Nurse Manager's Role in Quality Control
What do you consider elements of quality care when receiving health care services? What do you consider elements of quality care as a professional nurse? Are the two similar or different?
Elements of quality care when receiving health care services include receiving caring, compassionate treatment utilizing the most current proven knowledge while taking in to account the cost of those services. A practitioner providing quality care would provide me with the knowledge to let me make my own decision while helping me to weigh the pros and cons of the decision to be made. A practitioner providing quality care would take financial cost into consideration because offering certain treatments that I can not afford to pay for and can not get someone else to pay for would be out of my reach and, therefore, useless. I would still want to know about them regardless.
Elements of quality care as a professional nurse include providing caring and compassionate service utilizing the most current proven knowledge. As nurses, many of us try to take some financial concerns into account, but we could do better when it comes to trying to save the patient money and still provide quality care. Educating the patient so that the patient can make their own decision is also important in quality care.
There are differences and similarities with my own perception regarding receiving and providing health care services. Differences include the emphasis on financial cost. I want the best services offered to me at the lowest prices possible that do not compromise quality. As a nurse, I want to offer the highest quality services at a reasonably low cost, but I know that there are times in the past when I could have improved upon that. For example, my choice in some dressing change supplies may have been altered somewhat if I had known the cost of some of those supplies. There are basic supplies that are not terribly expensive, such as a standard 4X4 gauze, and there are other supplies that were fancier but not necessary. The end result of wound healing would have been the same had I used the more expensive dressing or the 4X4. The physician could have been contacted to change the dressing order to save the patient some money. Also, when I worked on a Med-Surg unit, I would often send patients home with a weeks worth or more of dressing change supplies. This costs the hospital money, which over time raises the price of services for everyone. Similarities include the intent behind the attempt at quality, caring and compassionate treatment, utilization of the most current knowledge, and trying to save money.
Elements of quality care when receiving health care services include receiving caring, compassionate treatment utilizing the most current proven knowledge while taking in to account the cost of those services. A practitioner providing quality care would provide me with the knowledge to let me make my own decision while helping me to weigh the pros and cons of the decision to be made. A practitioner providing quality care would take financial cost into consideration because offering certain treatments that I can not afford to pay for and can not get someone else to pay for would be out of my reach and, therefore, useless. I would still want to know about them regardless.
Elements of quality care as a professional nurse include providing caring and compassionate service utilizing the most current proven knowledge. As nurses, many of us try to take some financial concerns into account, but we could do better when it comes to trying to save the patient money and still provide quality care. Educating the patient so that the patient can make their own decision is also important in quality care.
There are differences and similarities with my own perception regarding receiving and providing health care services. Differences include the emphasis on financial cost. I want the best services offered to me at the lowest prices possible that do not compromise quality. As a nurse, I want to offer the highest quality services at a reasonably low cost, but I know that there are times in the past when I could have improved upon that. For example, my choice in some dressing change supplies may have been altered somewhat if I had known the cost of some of those supplies. There are basic supplies that are not terribly expensive, such as a standard 4X4 gauze, and there are other supplies that were fancier but not necessary. The end result of wound healing would have been the same had I used the more expensive dressing or the 4X4. The physician could have been contacted to change the dressing order to save the patient some money. Also, when I worked on a Med-Surg unit, I would often send patients home with a weeks worth or more of dressing change supplies. This costs the hospital money, which over time raises the price of services for everyone. Similarities include the intent behind the attempt at quality, caring and compassionate treatment, utilization of the most current knowledge, and trying to save money.
Tuesday, March 15, 2011
Lesson 10: Conflict Resolution Collective Bargaining, Unionization and Employment Law
Record an example of conflict you experienced in your reflective journal and describe how you would handle the situation as a nurse manager.
I was working as a licensed practical nurse at a hospital in a different state. There was tension between myself and one of the nurse techs. I needed some information from the nurse tech regarding one of my patients, so I went to her to get the information. She was with a patient, so I asked her to speak to me when she was done. She came to the door of that patient's room, very loudly and in a vulgar manner told me that she was tired of my behavior, and that she was not going to take it any more. She also verbally threatened me physically. I considered her behavior to be highly unprofessional and unacceptable, so I went to the assistant nurse manager on the floor in order to have her mediate between the two of us. Upon meeting in the office, the nurse tech proceeded to profusely compliment the assistant manager, which obviously pleased her. I mentioned that the nurse tech yelled at me and threatened me in front of a patient. The nurse tech fully admitted to her actions. She was not disciplined or even told not to behave in that manner. That was the day I started looking for employment elsewhere.
If I had been the nurse manager, I would have addressed the problem immediately. There is no reason to physically threaten another person in the work environment, and yelling to another staff member in front of a patient is unacceptable. At the very least, a written warning would have been warranted, as well as anger management training for the nurse tech. Also, mediating between the two employees may have also been helpful.
I was working as a licensed practical nurse at a hospital in a different state. There was tension between myself and one of the nurse techs. I needed some information from the nurse tech regarding one of my patients, so I went to her to get the information. She was with a patient, so I asked her to speak to me when she was done. She came to the door of that patient's room, very loudly and in a vulgar manner told me that she was tired of my behavior, and that she was not going to take it any more. She also verbally threatened me physically. I considered her behavior to be highly unprofessional and unacceptable, so I went to the assistant nurse manager on the floor in order to have her mediate between the two of us. Upon meeting in the office, the nurse tech proceeded to profusely compliment the assistant manager, which obviously pleased her. I mentioned that the nurse tech yelled at me and threatened me in front of a patient. The nurse tech fully admitted to her actions. She was not disciplined or even told not to behave in that manner. That was the day I started looking for employment elsewhere.
If I had been the nurse manager, I would have addressed the problem immediately. There is no reason to physically threaten another person in the work environment, and yelling to another staff member in front of a patient is unacceptable. At the very least, a written warning would have been warranted, as well as anger management training for the nurse tech. Also, mediating between the two employees may have also been helpful.
Tuesday, March 8, 2011
Lesson 9: Creating a Motivating Climate Organizational, Interpersonal and Group Communication
Record your thoughts concerning motivation. Include an example of when you felt motivated/not motivated as a result of a manager’s actions. Thoughtfully record a personal career development plan.
My current thoughts regarding motivation revolve around the fact that I have so little of it at the moment when it comes to getting all of the worthless papers that are required for this semester done. I think that it is important to be motivated. I must have some motivation left. After all, I am still submitting these blogs, and I am still getting my work done. Anyway, positive motivation in the workplace is important. For many people, workplace motivation is financial. For others, it involves recognition. Motivation is often a combination of many different factors that are unique to the individual.
I have felt both motivated and not motivated simultaneously as a result of a manager's actions. I recall a time when I worked on a busy Med-Surg unit as an LPN. I had a problem and went to the manager in hopes of reaching a resolution. This particular manager was terrible at her job in general, and did nothing to help me with my situation. I was motivated to remember her terrible management style, to never emulate it, and to find another job. I was not motivated to stay there and continue to work on that unit. In fact, at that point I was not motivated to want to be a nurse any more! Luckily, future experiences taught me that the entire profession of nursing cannot be judged based upon one negative working environment.
I am no longer sure of my personal career plan. I thought that I was six months ago. I know that I want to eventually continue my education. I know that I would like to continue to work in public health. I do not know if I want to become a family nurse practitioner or not. I have considered pursuing an administrative degree or perhaps a master's degree in public health. I definitely want to make sure that whatever degree I choose, I have many career options open. I know of one nurse who got a master's degree in alternative medicine. I do not think that such a degree would be very versatile. Higher education is very expensive, and I have a tendency toward frugality. I want to make sure that I get the most bang for my buck, especially if I will have to go in to debt to finance it. Ultimately, I want to do what is best for my family. I am just not sure what that is anymore!
My current thoughts regarding motivation revolve around the fact that I have so little of it at the moment when it comes to getting all of the worthless papers that are required for this semester done. I think that it is important to be motivated. I must have some motivation left. After all, I am still submitting these blogs, and I am still getting my work done. Anyway, positive motivation in the workplace is important. For many people, workplace motivation is financial. For others, it involves recognition. Motivation is often a combination of many different factors that are unique to the individual.
I have felt both motivated and not motivated simultaneously as a result of a manager's actions. I recall a time when I worked on a busy Med-Surg unit as an LPN. I had a problem and went to the manager in hopes of reaching a resolution. This particular manager was terrible at her job in general, and did nothing to help me with my situation. I was motivated to remember her terrible management style, to never emulate it, and to find another job. I was not motivated to stay there and continue to work on that unit. In fact, at that point I was not motivated to want to be a nurse any more! Luckily, future experiences taught me that the entire profession of nursing cannot be judged based upon one negative working environment.
I am no longer sure of my personal career plan. I thought that I was six months ago. I know that I want to eventually continue my education. I know that I would like to continue to work in public health. I do not know if I want to become a family nurse practitioner or not. I have considered pursuing an administrative degree or perhaps a master's degree in public health. I definitely want to make sure that whatever degree I choose, I have many career options open. I know of one nurse who got a master's degree in alternative medicine. I do not think that such a degree would be very versatile. Higher education is very expensive, and I have a tendency toward frugality. I want to make sure that I get the most bang for my buck, especially if I will have to go in to debt to finance it. Ultimately, I want to do what is best for my family. I am just not sure what that is anymore!
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