Fundamentals - Leadership, part 6: Employee Performance Appraisal, Disciplinary Action

  • 0:00 What to Expect - Employee Performance Appraisal & Disciplinary Action
  • 00:19 Employee Performance Appraisal
  • 3:48 Disciplinary Action
  • 8:16 Quiz Time!

Full Transcript: Fundamentals - Leadership, part 6: Employee Performance Appraisal, Disciplinary Action

Hi, I'm Meris, and in this video, I'm going to be talking to you about employee performance appraisal and disciplinary action. I'm going to be following along with flashcards from the leadership section of our fundamentals deck. If you have these, I would encourage you to pull them out and follow along with me. All right. Let's get started. So first up, we're talking about employee performance appraisal, which is basically when you are having your performance review in a job. This is typically a scheduled thing, and it's going to be like 90 days after you start and then annually, typically. It's going to, of course, depend on your facility, but this is going to be done by your unit manager, your clinical nurse manager, whoever is involved in those sorts of things in your facility. And we have sort of a checklist here, a bullet list of how this should go. So first and foremost, we need to collect data throughout the evaluation period overtime for review. So this means I'm not just looking at the last week. I'm not looking at the last month. I'm looking at the whole time since we last did one of these. That's very important because maybe last week I had a really great week, or maybe last week I was having a really tough time and maybe I was sick. I was scatterbrained. That doesn't accurately show my performance as an employee. It shows a snapshot of my performance. We also want the employee to complete a self-appraisal before the performance review, so this is usually a written document where they are able to examine their own strengths and weaknesses. They're able to provide supporting documentation. I just did mine for my emergency room job, and I was able to say, "This is what I think I'm doing well. These are my areas of improvement. Here's documentation to show the times that I have been recognized by members of our team for outstanding work," or whatever that might be so that I can support my subjective view of my performance.

We also want to include peer evaluations from professional staff. So this might mean maybe, "Hey, you've been doing a really great job. The nurses on the floor say that you are an excellent person to work with. You always take time to help out when they are struggling and they really appreciate that," or "We've heard from nurses on the floor too that you often disappear without telling anybody where you're going, that you're playing on your phone a lot." Those sorts of things should be included in the employee's performance appraisal. Now, what we don't want to do though, is we're not comparing my performance to the performance of another person, another staff member. We are comparing my performance to the checklist, right? We're going to compare it to the documented standards of that facility. So the RN should do one, two, three, four, five. Are you doing those things? We have a standardized checklist to be compared against versus we're not pitting RNs against each other. We're not pitting LPNs against each other. We're not saying, "Well, you're all right, but Joe over there, he's stellar." That's not what's happening. We are using the documented standards. And then we want to set realistic, mutually agreeable goals for employee growth and improvement. "So in the coming year, I know you said that you feel weak in your IV skills, so I would love for you to take this IV class that the hospital offers," and blah, blah, blah. We can set those goals together. And then also, that allows us something to look back on at the next employee performance appraisal, right? Very good stuff.

All right. Moving on to disciplinary action. Now, this is just one brief card, but I do want to encourage you to be familiar with these concepts because it's super important. So first, we're talking about chemically impaired employees. So this would be an employee who is using a substance at work. So this could be someone who has consumed alcohol before or during their shift. Maybe some kind of drug use is going on. We're talking about chemically impaired employees. So we need to first and foremost be able to recognize the signs of a chemically impaired employee. So some examples we gave you here: personality changes, rapid mood swings, social isolation. This is your friend who used to be really happy, funny, having a good time, and now they are irritable and anxious and withdrawn. That doesn't mean that they are using substances, but it is a possible red flag. Changes in physical appearance, so the red eyes, a sleepy appearance, slurred speech. I mean, anything that would give you the concern that they are chemically impaired, right? If you have a-- if I'm giving report to the nurse and the nurse is-- "Excuse me. Are you okay?" Again, we need to make sure they're okay. Are they hypoglycemic? Are they having a stroke? All of those things. We're not just going to be like, "I'm sure this is fine." And then job performance issues, so an increase in medication error, excessive absences from work, all of those things could be red flags for chemical impairment.

So now what are we going to do? The priority is to remove them from the work setting. If I think someone is actively chemically impaired at work, my number one priority is to keep my patients safe by removing this employee from the work setting. So as just a staff RN, you would need to report this to the charge nurse. The charge nurse would need to remove them from the work setting. But that is the priority is getting that nurse out of patient care because we need to protect patient safety. We need to provide safe transportation home. So if I think you are under the influence of alcohol and I pull you off the floor, I'm not going to then let you drive home, right? That's not going to be acceptable. And then we need to arrange for a formal meeting to discuss the incident within 24 hours. I can't have that meeting with you when you are chemically impaired, right? You need to go home. But within 24 hours, we're having that meeting. We're discussing what happened, that sort of a thing, okay? Now, your job as the nurse is to report any suspicion that you might have that a coworker is chemically impaired. You need to go to your supervisor and make those concerns known. It is your job to protect your patient's safety even if it is not directly your patient. You are still on team patient, and so you need to be looking out for the patients on your unit.

Now, we also want to talk about a progressive approach to discipline, and this essentially means-- it's the same ideas like the nursing process where we go from least to most restrictive, right? We are not going to just start off by firing somebody for a given offense most of the time. There are some issues, some disciplinary actions that are so egregious that they will require termination. But if we're talking about sort of run-of-the-mill things like tardiness to work or taking breaks longer than you are allowed or something along those lines, we start with an informal reprimand, which is like a verbal reprimand. "Hey, you didn't come back after your lunch. You were gone for a full 60 minutes and you only get 30 minutes for lunch," whatever. "You can't do that anymore." That's a verbal reprimand. Then we're going to move on if that should happen again to a formal written reprimand, so this is going to be a formal write-up. And then after X number of write-ups per your facility policy, we will progress to suspension from work. And then if it should continue to happen, that's when we're going to have involuntary termination of the position. But the point here being, we don't just jump to the most extreme case right away if it is something that is not an egregious threat to our patient. So keep that in mind when you are taking leadership, when you are in that role, we're going to assume, in a sense, give the benefit of the doubt, provide re-education, and give that employee a chance to change their behavior before we move on to more serious kinds of consequences.

All right. Are you ready for some quiz questions? Because I know I am. Let's get into them. While performing an employee performance appraisal, the unit manager compares the work of the RN to the work of other RNs on the floor. Is this an appropriate form of employee performance appraisal? No. The employee's performance should be compared to documented standards of practice, not against the work of other employees. Should peer evaluations be included in an employee performance appraisal? Yes. We should include those peer evaluations, but we are just not comparing the work of an RN to another RN. If a nurse is suspected of being chemically impaired, what is the priority action? Remove the employee from the work setting to protect your patient's safety. How soon following removal of a chemically impaired employee from the work setting should a formal meeting be arranged to discuss the incident? Within 24 hours. That is it for the employee performance appraisal and for different types of disciplinary action. If you've got a great way to remember something, please leave me a comment. You know I want to hear it. I hope this helped. Thanks so much and happy studying.

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