This document discusses various personal and personnel problems that may arise in nursing management including absenteeism, uncooperative employees, immature employees, clinical incompetence, emotional problems, chemical dependency, and incivility. It provides strategies for approaching these issues such as clarifying role expectations through oral and written reminders, progressive discipline steps, counseling, and thorough documentation of issues and interventions. The goal is to address problems, ensure patient safety, and work with employees to improve performance or determine if termination is necessary.

1. Chapter 24Chapter 24
Managing Personal/PersonnelManaging Personal/Personnel
ProblemsProblems
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.

2. 22Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
ObjectivesObjectives
 Differentiate common personal/personnelDifferentiate common personal/personnel
problems.problems.
 Relate role concepts to clarification ofRelate role concepts to clarification of
personnel problems.personnel problems.
 Examine strategies for approaching specificExamine strategies for approaching specific
personnel problems.personnel problems.

3. 33Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
ObjectivesObjectives (cont’d)(cont’d)
 Prepare specific guidelines for documentingPrepare specific guidelines for documenting
performance problems.performance problems.
 Value the leadership aspects of the role ofValue the leadership aspects of the role of
the novice nurse.the novice nurse.

4. 44Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
How can a manager dealHow can a manager deal
fairly with employees whofairly with employees who
fail to meet establishedfail to meet established
standards of care?standards of care?

5. 55Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Personal/Personnel ProblemsPersonal/Personnel Problems
 AbsenteeismAbsenteeism
 Uncooperative or unproductiveUncooperative or unproductive
 ImmatureImmature

6. 66Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Personal/Personnel ProblemsPersonal/Personnel Problems
(cont’d)(cont’d)
 Clinical incompetenceClinical incompetence
 Emotional problemsEmotional problems
 Chemical dependencyChemical dependency
 IncivilityIncivility

7. 77Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
AbsenteeismAbsenteeism
 Linked to role stress and role strainLinked to role stress and role strain
 May lead to:May lead to:
• Staff conflictsStaff conflicts
• Decreased moraleDecreased morale
• Increased absences among staffIncreased absences among staff
• Patient safety issuesPatient safety issues

8. 88Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Uncooperative or UnproductiveUncooperative or Unproductive
EmployeesEmployees
 Potential influencing factors:Potential influencing factors:
 MotivationMotivation
 AbilityAbility
 EducationEducation
 TrainingTraining

9. 99Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Immature EmployeesImmature Employees
 Identified through:Identified through:
 DefianceDefiance
 ““Testing” of workplace guidelinesTesting” of workplace guidelines
 Passivity or hostilityPassivity or hostility
 Negative judgments of any management decisionNegative judgments of any management decision

10. 1010Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Clinical IncompetenceClinical Incompetence
Consider Exercise 24-2:Consider Exercise 24-2:
A nurse comes to you, the nurse leader, andA nurse comes to you, the nurse leader, and
states that one of the other nurses is tying astates that one of the other nurses is tying a
knot in the air vent (pigtail) of nasogastricknot in the air vent (pigtail) of nasogastric
tubes. This nurse does not know how totubes. This nurse does not know how to
approach the employee to discuss theapproach the employee to discuss the
problem.problem.
What would you do?What would you do?

11. 1111Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Chemical DependencyChemical Dependency
 Early recognitionEarly recognition
 Employee must go into treatment.Employee must go into treatment.

12. 1212Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Chemical DependencyChemical Dependency (cont’d)(cont’d)
 If chemical dependency is suspected, theIf chemical dependency is suspected, the
manager MUST intervene to ensure patientmanager MUST intervene to ensure patient
safety.safety.

13. 1313Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Employee Assistance ProgramEmployee Assistance Program
 Nurse manager should not be a therapist.Nurse manager should not be a therapist.
 Consult HR regarding implications for theConsult HR regarding implications for the
Americans with Disabilities Act.Americans with Disabilities Act.
 Consult/refer to Employee AssistanceConsult/refer to Employee Assistance
Program.Program.

14. 1414Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Emotional Problems?Emotional Problems?
The nurse leader must be aware that certain
behaviors, such as poor judgment, increased
errors, increased absenteeism, decreased
productivity, and a negative attitude, may be
manifestations of emotional problems in
employees.

15. 1515Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Incivility/Lateral ViolenceIncivility/Lateral Violence
 Disruptive behavior or communication thatDisruptive behavior or communication that
creates a negative work environment thatcreates a negative work environment that
interferes with quality care and safetyinterferes with quality care and safety
Simpson, 2008Simpson, 2008

16. 1616Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Steps to Clarify RoleSteps to Clarify Role
ExpectationsExpectations
 Oral reminderOral reminder
 Policies and proceduresPolicies and procedures
 Personal accountabilityPersonal accountability
 Written and oral remindersWritten and oral reminders
 Statement of the problemStatement of the problem
 Goals with which manager and employee agreeGoals with which manager and employee agree

17. 1717Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Steps to Clarify Role ExpectationsSteps to Clarify Role Expectations
(cont’d)(cont’d)
 Day of decisionDay of decision
 Day off with pay to arrive at a decision aboutDay off with pay to arrive at a decision about
future actionfuture action
 Pay is given so it is not interpreted as punishment.Pay is given so it is not interpreted as punishment.
 TerminationTermination
 If employee decides not to adhere to standards,If employee decides not to adhere to standards,
he has made his decision.he has made his decision.

18. 1818Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Steps in Progressive DisciplineSteps in Progressive Discipline
 CounselCounsel
 ReprimandReprimand
 SuspendSuspend

19. 1919Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
Steps in Progressive DisciplineSteps in Progressive Discipline
(cont’d)(cont’d)
 Return to work with written stipulationsReturn to work with written stipulations
 Termination if problem recursTermination if problem recurs

20. 2020Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
DocumentationDocumentation
 Document any coaching about the aboveDocument any coaching about the above
issues.issues.
 Document the following in writing:Document the following in writing:
 Date, time, and who was involvedDate, time, and who was involved
 Brief description of the eventBrief description of the event
 Notation about what intervention or coaching wasNotation about what intervention or coaching was
donedone