This PowerPoint presentation was created by Christi Renner and Jamie Saltkill for the Socialization into Nursing II course of College of Central Florida’s ADN program in October 2011.
Before the evaluation obtain peer reviews from the employee’s co-workers encouraging honesty and fairness. By gathering these before the evaluation you will have time to review them and get a good picture of the nurse’s performance from a peer’s point of view.There should be no surprises revealed in an evaluation. For example a nurse has been filling out a form the wrong way for months, it would be unfair as well as inefficient to just mention it at evaluation time. If you use good communication and inform them of the error when it first happens then that nurse can correct the problem and do it right instead of feeling like they are being reprimanded unfairly for something they did not know they were doing wrong. Reviewing incidents before the evaluation helps you to remember what has occurred with the nurse you are evaluating.Many rating systems use word like Excellent, Good, Fair, and Poor. These descriptive words are open for interpretation. What one person considers good might be considered to be excellent by someone else. Instead use a system that uses words that are clear and universally understood. Such as acceptable, unacceptable and needs improvement.
There are many errors that the nurse manager—or any manager—may make when judging a nurse or employee. In an effort to be fair and accurate in evaluating the nurse, the nurse manager should be aware of these common errors and be able to identify when he or she may be making them.A contrast error occurs when the manager compares the nurse to his or her coworkers, and NOT to the job description or established performance expectations. First impression errors occur when the nurse manager rates the employee based on his or her very first impression of the nurse—be it good or bad. If the first impression was a good one, the nurse manager may overlook faults. If the first impression was a bad one, the nurse manager may judge the nurse harshly and unfairly due to personal dislike, and ignore accomplishments.The recency effect is the tendency to give more weight to a nurse’s more recent behavior than what the nurse was like earlier in the evaluation period. This may be appropriate in situations where behavior is improving, but in general you should look at the nurse’s work and behavior throughout the entire length of the evaluation period.The Halo and Devil Effects occur when a nurse manager sees only a person’s strengths (Halo) or weaknesses (Devil) and is unable to fairly assess both the nurse’s strong points and weak points fairly.The Similar-To-Me Effect the tendency to judge people with similar backgrounds to yours with more favorable or positive evaluations. The more similar you are, the more favorably you may look at the person. This mixes up personal attributes with the nurse’s work habits and behaviors. This is also why it is difficult to evaluate your friends fairly.Central Tendency occurs when your evaluation of a person tends to stick to the center of the spectrum—if they are consistently get 4’s, 5’s, and 6’s on a scale of 1-10, this may be a problem. These types of reviews are not helpful to the nurse, because s/he is not encouraged with knowing what s/he does right, and s/he is also not made aware of problem areas. If someone is truly average in an area, a middle rating may be necessary, but if you find yourself giving 5’s all the way down, you need to assess yourself and make sure you are judging this person fairly and recognizing their strengths and pinpointing their areas of weakness.Much as the name implies, Negative and Positive Leniency are when the nurse manager is either much too hard on the nurse (Negative) or much too soft on him/her (Positive).
Believe it or not, nurse managers might not be looking forward to evaluations with any kind of enthusiasm. This is because they know they may be delivering negative feedback, and many people don’t take this type of criticism well. On page 84 of Essentials of Nursing Leadership and Management, Box 6-6 offers guidance on how to deliver negative feedback with the TACTFUL mnemonic. Therapeutic communication is not only something we need to use with our patients, but also with other nurses as well, and even people in general.
When writing your evaluation, objectivity is the most important thing to keep in mind to avoid the errors mentioned previously and to do the best service that you can for your employees: helping them to identify strengths and weakness to help them succeed.Throughout the evaluation review meeting, maintain a positive focus and be professional, even if the nurse is not. At the start of the meeting, acknowledge your employee’s nervousness by saying something like “I know this sort of thing can be nerve-wracking, but there’s no reason to be anxious.” That’s because nothing that you say in that meeting should be a shock to the nurse, so long as you have kept good communication in day-to-day management, especially if the nurse’s behavior has not been satisfactory. Make sure to recognize all employee’s accomplishments, no matter how small, as this builds confidence!During the meeting, involve the nurse, inviting him or her to ask questions and discuss. Emphasize that the nurse manager and the nurse will be working together to identify problem areas, set goals for improvement, and implement a plan to reach those goals. The nurse manager is there to facilitate the nurses, not to make life more difficult for them! Lastly, express your confidence that you think the nurse can reach those goals.
Maintaining good communication helps prevent any surprises to the employee about their performance.Explaining that the nurse was evaluated by peers and management shows objectivity and fairness.
Many nurses who have never had a performance evaluation, and even those who have, are often anxious about exactly what the meeting with their nurse manager will entail. The manager may first explain the purpose of evaluation to the nurse, especially if he or she is new to the company or a newly graduated nurse. The manager will then review his or her evaluation with the nurse, taking the time to explain any rating systems or rubrics that may be used. During this review or afterwards, the nurse will be invited to give input on the evaluation, including the causes of any areas of poor performance. Together, the nurse manager and the nurse will set goals with the intent to improve areas of weakness by the time of the next evaluation. They will then discuss and decide on actions that will assist the nurse the achieve those goals, and towards the end of the meeting the manager (possibly with input from the nurse) will set a time frame for meeting those goals, often arranging a follow-up meeting to evaluate progress.
The purpose of evaluation is to compare the employee’s job performance against the job description and the standards of expected performance for that job. This is where the nurse manager may review the job description or requirements with the nurse, to make sure s/he is familiar with the standards s/he is being evaluated against. It is important that in areas where the job requirements are not being met, the nurse manager use critical incidents and specific behaviors to validate their evaluation. For example, if a nurse is not meeting safety standards, the nurse manager may support her evaluation of “Not Meeting Standards” with the example of Mr. Smith falling on her shift (a critical incident) and the nurse frequently being observed not raising bedrails (a specific behavior).Evaluation identifies an employee’s strengths and weaknesses so that they know where they are excelling and where they could use improvement. Evaluation may be the basis for promotion or demotion, pay raises, or termination. A fair and balanced evaluation system is the best way for a company to determine who is going to be a good investment, someone they want to keep in the company, and who is going to be a bad investment, who will put them at risk for loss of money or even legal action.
Instead of focusing on what has happened in the past try to only spend 20-30% of your time reflecting on past performances. If you keep communication open and have addressed problems as they occur then the evaluation only needs to be a summary of these issues. Spend 70-80% of the time on projection or looking forward to the future. You can’t change the past but you can look forward and encourage change for the better.Providing recognition when an employee does a good job boosts self esteem which in turn can boost job performance.Show confidence in the employees ability to perform well. This will help give them to confidence to try to improve where improvement is needed.
During the evaluation review, the nurse manager should ask the nurse for his or her input and discussion. Prior to hearing the manager’s evaluation, the nurse may be asked to evaluate his or herself. The nurse may be asked what she thinks are her own strengths and weaknesses. The nurse may also be asked to evaluate his own overall performance. If the manager perceives certain problem areas, the nurse may be asked about those areas in particular.The nurse’s evaluations may more or less agree with those of the manager, or she may be harder or easier on herself than the manager was. If the nurse offers valid reasons for poor performance, the nurse manager should listen to these reasons closely and objectively, as they may offer important insights to issues in the workplace that the manager was previously unaware of. Issues such as inadequate staffing, lack of training, misunderstandings about expectations, physical issues such as poorly-maintained equipment, or lack of knowledge with new equipment or procedures are often reported in evaluations. These issues may truly be outside the nurse’s control and may impact job performance negatively.
Keeping goals simple make them easier to understand what needs to be done. Goals must be measurable in order to be able to evaluate progress. You must be sure that the goal is attainable or the nurse will become discouraged. The same goes for keeping it realistic, if the goal is unrealistic the nurse might not even try to attain the goal. Set a time frame for attaining the goal that is also realistic, giving adequete time to achieve to goal. Discuss goals with the employee and come to a mutual agreement on goals for improvement. By doing this you increase awareness and motivation to attain the goal.
Once goals are agreed upon by both the nurse manager and the nurse, they should work together to make a list of actions to be taken to make those goals attainable. Much like the “interventions” of a nursing care plan, these actions should be specific to the goals, achievable by the nurse, and should ideally have some kind of time frame. Large projects might be broken into smaller milestones. Remember that as the nurse manager, you are providing the nurse with the tools to succeed and improve performance!Depending on the goals, these interventions may include education or inservices, where the nurse or several nurses are taught, or re-taught, about a particular subject, equipment, or policy/procedure. For instance, a nurse who is not providing adequate pressure ulcer prevention for patients may be required to attend an inservice on prevention techniques.If a nurse’s performance problems are related to personal issues such as family stressors or depression, the nurse manager may suggest counseling. Many companies, both within healthcare and in other fields, provide counseling at no or reduced cost as a service to its employees through Employee Assistance Programs. As nursing students at the College of Central Florida, we have a Student Assistance Program through BayCare that provides three free therapy or counseling sessions to students dealing with any kind of personal or emotional issues that may affect their performance.If inadequate supplies or equipment are a reason for lowered job performance, the nurse manager should address these issues. The nurses can’t be expected to use Chux pads with every patient if the facility is always running out of them, and vital sign checks can’t easily be done on a particular time schedule if there is only one Dynamap for the unit! Similarly, inadequate staffing should be remedied wherever possible and patient-staff ratios should always be maintained at a level that is both legal and safe. Conflicts between staff members needs to be addressed as well, either through mediation between the nurses, or arranging their schedules so they don’t work together or on the same unit.As always, communication is an essential part of planning interventions. The nurse manager should make him or herself available to all of the staff as much as possible, and foster positive and open communication. To reduce workplace frustration, the nurse manager may be a “listening ear” for the staff. Once the staff understands that the manager is fair and communicates therapeutically with both staff and patients, a trusting relationship can be built between manager and nurse.
Set up an appointment for review of the progress that has been made. Allow time for some progress to be made, review if any goals have been reached and how this was done. Review what goals have not been reached and what can be done to achieve those goals.Making consequences clear allows for no surprise if poor results continue.
Here is a sample category of performance evaluation, “Dedication to Job/Work,” along with possible comments that the nurse manager may write depending on the nurse’s job performance. Note the specific behaviors and incidents that the nurse manager might site—the Exceeds Expectations nurse studied lab values on his own time to increase his understanding and improve his patient’s care. The Needs Improvement nurse took personal phone calls frequently at work. The Unacceptable nurse missed 5 out of 10 meetings. These are specific things that justify the nurse manager’s evaluation and can forestall complaints that “the nurse manager just hates me so she’s giving me a bad evaluation” as well as refute complaints by other nurses of favoritism towards one particular nurse.
Tool 1This tool is excellent in comparing the job description expectations to the nurse’s actual job performance.Tool 2This tool shows the importance of having a measurable and fair scale, such as their scale of Role Model, Key Contributor, and Below Standards.
In conclusion, the nursing evaluation process is really a lot like the nursing process. Your “assessment” is what you’ve observed in the nurse’s work and behavior, including critical incidents and specific behaviors that demonstrate strengths and weaknesses. Your “analysis” is an identification of areas of weakness that need to be discussed and a plan needs to be made to improve them. Your “planning” is your goals, and much like care plan goals, the evaluation goals should be mutually agreed upon by both the nurse manager and the nurse, and should be Specific, Measureable, Attainable, Realistic, and have a Time Frame (SMART). Your “implementation” are the actions that you as the nurse manager are taking to help the nurse reach his or her goals. And “evaluation” is determining whether the goals were met or not, and to modify the plan based on the nurse’s progress towards his or her goals.Remember to be objective in rating your employees’ performance, and not to make any of the errors mentioned earlier in the presentation. Always keep a positive attitude, looking towards the future instead of dwelling on the past. Stay professional—even if the nurse becomes upset or angry at you for what you have to say. Above all, use therapeutic communication techniques such as the TACTFUL way of presenting negative feedback, and be sure to listen therapeutically as well to the nurse’s concerns, as this may identify areas that the unit or facility can improve upon as well!Remember, evaluations don’t have to be stressful for the nurse manager, or for the nurse!
Nursing evaluations ppt
NURSING EVALUATIONS Christi Renner & Jamie Saltkill
BEFORE THE EVALUATION Peer reviews No surprises Have documentation of incidents on hand and review before the evaluation Use a clear rating system Review ratings with your immediate supervisor to make sure they are justifiable and fair
ERRORS IN EVALUATION Contrast Error First Impression Error Recency Effect Halo & Devil Effects Similar-to-Me Effect Central Tendency Negative & Positive Leniency
PROVIDING NEGATIVE FEEDBACK T—Think before you speak. A—Apologize quickly if you make a mistake. C—Converse, do not patronize or be sarcastic T—Time your comments carefully. F—Focus on behavior, not on personality. U—Uncover hidden feelings. L—Listen for feedback.
TIPS FOR A SUCCESSFUL EVALUATION Evaluate objectively Maintain a positive focus Be professional Acknowledge nervousness Provide recognition for accomplishments Involve the nurse, invite questions & discussion Emphasize that you will be working together towards a solution
TIPS FOR A SUCCESSFUL EVALUATION Maintain good communication during the evaluation period Explain what was evaluated Ensure that the nurse knows how they are being evaluated and understands the rating system being used
WHAT WILL HAPPEN DURING THE EVALUATION Manager Explains Purpose to Nurse Manager Reviews Evaluation w/ Nurse Explains rating system when used Nurse Gives Input/Reflection on Evaluation Compares Performance to Expectations Manager and Nurse Set Goals Manager and Nurse Decide on Actions to Achieve Goals Manager and Nurse Set A Time for Progress Review
PURPOSE OF EVALUATION Actual vs. Expected Performance Critical incidents & specific behaviors Identify Strengths & Weaknesses Promotion vs. Demotion
REVIEWING THE EVALUATION Time spent looking back vs. looking forward 20-30% - reflection, 70-80% on projection Stay positive Therapeutic communication Provide recognition Show confidence
NURSE’S INPUT ON EVALUATION Self-Evaluation strengths/weaknesses overallperformance perceived problem areas Response to Evaluations valid reasons for poor performance
SETTING GOALS Keep it SMART Simple Measurable Attainable Realistic Time Mutual agreement –discuss and come to a mutual agreement on goals for improvement.
“INTERVENTIONS” FOR SUCCESS Providing tools for meeting goals May include… Education/Inservices Counseling Supplies/Equipment Staffing Communication
EVALUATING PROGRESS Set a time to review progress towards goals Make consequences of continued poor results clear (discipline, demotion, termination)
EXAMPLES OF PHRASES FOR EVALUATIONS Dedication to Job/Work Outstanding Is self-motivated, taking on projects without being asked Works overtime whenever asked Exceeds Expectations Assumes personal responsibility Studied lab values to further own understanding Meets Expectations Dedicated to goals Obeys policies Needs Improvement Leaves work for the next shift Frequently engages in personal phone calls Unacceptable Missed 5 out of 10 team meetings Charting is very slow and inaccurate
EXAMPLE EVALUATION TOOLS Click the links below to see samples of very different types of nursing evaluation tool! Both are in PDF form. Tool 1 Tool 2
IN CONCLUSION… Nursing evaluation is a lot like nursing process Objectivity Positivity Reaching Goals Therapeutic Communication and Listening Evaluations don’t have to be stressful
REFERENCES Max, D., & Bacal, R. (2003). Perfect phrases for performance reviews. Madison, WI: McGraw Hill. Payne, O., & Payne, S. (1998). Adams management basics, the how-to guide for managers. Adams Media. UM health system - human resources:UMHHC performance management system. (2011). Retrieved from http://www.med.umich.edu/umhshr/ supervisor/performance-planning.html Whitehead, I. K., Weiss, S. A., & Tappen, R. M. (2009). Essentials of nursing leadership and management. (pp. 82-89). F A Davis Co.