Chapter 20: Feedback and Coaching, Disciplining, and Terminating Staff

guidelines for effective discipline

1. carefully and thoroughly obtain the facts -cause can be a series of events -verify policies and procedures about progressive discipline and at what level 2. check in with your supervisor or human resources, as you work culture requires -ask for advice and clarify if your expectations are reasonable 3. never act while angry 4. be consistent in the application of discipline across all staff 5. discipline in private -neutral and behavioral terms, make the offense clear -specify what appropriate behavior is and give examples 6. get to the other side of the story, but set a limit and avoid excuses 7. create an action plan for remediation -let the employee know what potential future consequences will be if the behavior continues 8. ask the employee to reflect on past behaviors and describe a personal view of the interview and what must change 9. document the interview and place it in the employee file -many organizations will have the employee sign the anecdotal note 10. circle back with your supervisor or human resources -give them feedback on how the interview went while reflecting on your performance as a manager

steps in confronting behavior

1. prepare before the meeting 2. in a neutral voice, objectively describe the behavior without attacking the person -tie the behavior to the consequences for the patients, organization, or employee 3. solicit and openly listen with empathy to the employee's reason for the behavior 4. explain why the behavior cannot continue, and ask for suggestions in solving the problem -if none are offered, suggest solutions; agree on steps each will take to solve the problem 5. place an anecdotal note in the file, noting the issue and employee response, and set and record a specific follow-up date -ask the employee to reflect back on the conversation and make sure you are both on the same track

keys to successful feedback

1. timely and ongoing 2. goal-referenced 3. constructive and positive 4. tangible and transparent 5. respectful, encourages reflection

step 4 (in confrontation)

Explain why the behavior cannot continue, and ask for suggestions in solving the problem -If none are offered, suggest solutions. Agree on steps each will take to solve the problem. ex: In the future, you will need to notify both the clinic manager and the hospital supervisor if you cannot come in. Can you do this?

step 2 (in confrontation)

In a neutral voice, objectively describe the behavior without attacking -Tie the behavior to the consequences for the patients, organization, or employee. ex: Jane did you know that clinic policy is to notify both the clinic manager and the hospital supervisor when you will be absent from work? Not only were we worried about you, but we had to reschedule patient procedures because we did not have the staff to attend to both clinic appointments and special procedures

step 5 (in confrontation)

Place an anecdotal note in the file, noting the issue and employee response, and set and record a specific follow-up date -Ask the employee to reflect back on the conversation and make sure you are both on the same track. ex: Jane since this is concerning, I am going to put a note in your file. Let's set a date to meet in a month and see how you are doing. If you don't folly the policy about call-ins during this period of time, we'll talk sooner. Can you tell me, in your own works why this is so important and what you are going to do about it?

step 1 (in confrontation)

Prepare before the meeting. -is the employee aware of the policy and procedure? Desired behavior? -has the policy/procedure been consistently enforced? -how will the employee react? -seek advice or role play the meeting if uncertain of approach

step 3 (in confrontation)

Solicit and openly listen with empathy to the employee's reasons for the behavior ex: Can you tell me why you didn't notify someone about your absence

coaching

a collaborative relationship between a coach and a willing individual that supports continuing personal, professional, and career development through the acquisition of skills, actions, and abilities that are crucial to professional practice -an interactive, interpersonal process that is usually time limited and focused on achievement of goals, it lets the nurse learn and thereby change performance for it to be effective, the nurse must be: -*ready*: psychologically able to accept this (this is not therapy or counseling) -*willing*: open to the process, interested in changing, motivated to improve performance (want to improve) -*able*: capable of changing performance (have the right aptitude to learn the new process) the manager is not always in this role in the relationship -coaches may be a peer expert or a nurse off the unit -may involve a path of education, a connection with a mentor, or partnering with a person from another discipline

feedback

day-to-day process of helping employees evaluate and improve their performance -both positive and constructive -can address minor and major issues in performance -minor: a new nurse who texts on the job or publicly flirts with the medical student -major: sleep impairment, examples of poor judgement, recurrent absenteeism or tardiness, poor sterile technique, unsafe clinical care -nurse manager is only one point of view in providing ______________ -best _____________ is comprehensive and includes _____________ from peers, colleagues, and sometimes patients -collecting info about an employee and providing is the most difficulty responsibilities of a manager

what is discipline

discipline is NOT punishment -it is a consequence of employee behavior -it is a warning -it is not designed to embarrass discipline is NOT personal -not about whether an employee is liked or not -it is about addressing the behavior -it can provide a course correction for an employee, a wake-up call, leading to improvement or it can lead to termination

discipline

fact of life in management -calls the employee's attention to behavior that is not appropriate and must be corrected -advises how to correct the behavior -the process of this is progressive and highly dictated by organizational policies and procedures -the manner in which this is delivered is as important as the process

feedback (comparison to coaching)

focuses on behavior that has occurred -assesses performance against standard and alerts the staff member -constructive with consequences -positive with rewards -this without coaching may not result in a change in behavior

progressive discipline

formal process of communicating increasingly severe warnings for repeated violations that can lead toward termination -moves in a stepwise fashion unless the infraction is egregious, life threatening, or deadly -may being and end with a precursor: an oral warning -the formal steps in this process are verbal warning and written warning (verbal warning is still documented--step one in formal disciplinary process) -manager builds a case that begins with notes about performance that document feedback and includes the employee response to feedback and plan of action (should include coaching or remediation)

coaching (comparison to feedback)

future forward; creates a trajectory for future performance -improves and/or develops performance -may include remediation through skill development and always includes behavior modification -may include career advancement or development, through further or continuing education

verbal warning in progressive discipline

given for unacceptable behavior that is repeated or serious behavior that occurs one time ex: manager may give this to a staff member who has a pattern of calling in sick on the weekend

oral warning in progressive discipline

is a call to action for the staff members -beyond feedback and draws attention to behavior that should not continue

confrontation

is a more serious level of interaction -should put the employee on high alert -manager must carefully document the process -if a staff member has been given feedback on a behavior and that behavior does not change, the manager moves to another level of interaction -a manager who has never conducted and interview with this might seek coaching from a professional colleague or a contact in human resources

discipline in general

is often a gray area and open to interpretation -best to discuss the plan of action with an experienced supervisor and acquire input -at each stage in the disciplinary process, documentation is essential and equitable treatment of all staff is expected on the unit

written warning in progressive discipline

manager may jump to this if a staff member falls asleep on the job and seriously jeopardizes patient care

when the progressive discipline system is bypassed

occurs in some cases -swift action may be required to protect patient safety or the workplace environment -seriousness of the behavior may be grounds for immediate termination or suspension -these serious behaviors may include theft of equipment or drugs, violating patient privacy by assessing the records of the patient, bring a firearm to work, administering the wrong drug resulting in patient fatality, or substance abuse on the job

termination

the process that ends employment -a serious and difficult management responsibility with emotional, legal, and financial consequences -_____________________ without due process, with poor documentation, or outside of hospital policy can be fuel for an employee grievance or lawsuit -it often becomes part of a permanent record, so it must be conducted carefully, objectively without emotion, and in concern with hospital policy -nurse manager must maintain close contact with the organization's HR dept and nursing administration--they must discuss this and seek approval for it -each organization will vary in what it does during this time (employee access to email is stopped during or immediately before the interview and ID badges/entry cards or keys are collected -usually a devastating event to an employee and should be conducted in a firm manner but with compassion -manager should document the incident and reaction of the staff member in the personal file

preparation for termination

this before terminating an employee is essential to do this consider the following: -review the employee file; do you have a track record of documented conversations with the employee about the specific issues that are leading to termination -do you give employees on the unit feedback on a regular basis -are you being consistent in the application of performance standards against all employees in your span of control -did you offer remediation of coaching to addressing the performance issues -how might the employee challenge the termination; prepare for this -is your supervisor aware of and behind your decision to terminate; is human resources aware and behind your decision to terminate