leadership

  • Conflict, Workplace Violence, and Negotiation

    Define conflict and describe the benefits and risks of too much/too little conflict in an organization
    What are the commons sources of conflict in an organization?
    What types of conflict might a nurse see In a healthcare organization?
    What are the stages occurring in conflict resolution?
    What are the anticipated conflict resolution outcomes?
    Name and define with an example of the 6 common resolution strategies
    What are common causes of organizational conflict, as in a healthcare org.?
    What are three strategies in conflict resolution that you have tried or can anticipate in your first nursing job?
    Define bullying and incivility within the nursing profession (Lateral violence—also workplace violence)
    What is negotiation as it relates to concerns in healthcare?
    Name negotiating strategies that lead to conflict resolution
    What are some destructive tactics that can damage a successful negotiation session?
    Name three alternatives to negotiation…how do they work?
    Describe the importance of consensus as a conclusion to conflict management
    Chapter 24—Performance Appraisal
    Describe the performance appraisal process, naming important factors to consider
    Describe the factors influencing an effective appraisal—why are these important?
    Describe salient strategies for a successful performance appraisal—why is implicit bias such an important criterion to master?
    Define the terms associated with errors made in performance appraisals
    Describe different types of performance appraisals—which would you prefer and why?
    Describe the features of a successful performance appraisal session
    Define and describe the management by objectives approach to performance appraisals
    How does peer review work for performance appraisals? What are the potential downfalls?
    Define strategies for being a successful coach to others

  • Chap 25—Problem Employees: Rule Breakers, Marginal Employees and the Chemically or Psychologically Impaired

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    What are the “do’s and don’t’s” of Rules in an organization?
    Define, compare and contrast “Constructive Discipline” and “Destructive Discipline”
    Name the criteria that must be present to make disciple fair and a growthful experience
    Define strategies that create an atmosphere of self-discipline, the best approach to well- functioning organizations
    Name the four common steps in Progressive Discipline
    Describe a successful disciplinary conference for an employee
    Describe the main elements in a termination/separation meeting
    Define the formal grievance process? When is this most often used?
    Define the rights and responsibilities of those involved in the grievance process (be sure to use your ATI reference)
    Define and compare the disciplinary process for unionized employees
    Chemical impairment—define and provide a profile of a chemically impaired nurse
    What are the recommended ways to confront and support a chemically impaired employee?
    What are the reentry guidelines for a previously chemically impaired nurse to return to practice?

Chapter 21
Conflict, Workplace
Violence, and Negotiation

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1

Learning Objectives
1. Describe the stages and categories of conflict (ATI p 15-Stages of Conflict) (ATI p 14-Categories of Conflict) )Text 560-61
2. Identify the function and dysfunctional results of various methods of conflict resolution (ATI p 16—Negotiation strategies) (Text p 561-63)
3. Describe the manifestations of workplace violence, incivility, bullying and mobbing (Text 568-69)
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Learning Objectives
4. Identify strategies that might be used to immediately confront and intervene when workplace violence exists (Text p 570)
5. Describe strategies that can be used before, during, and after negotiation to increase the likelihood that desired outcomes will be achieved (ATI p 16—Negotiation) (Text 570-76)
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Conflict #1
The internal or external discord that occurs as a result of differences in ideas, values, or beliefs of two or more people
Conflict is also created when there are differences in economic and professional values and when there is competition among professionals.

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Conflict #2
Some level of conflict in an organization appears desirable, although the optimum level for a specific person or unit at a given time is difficult to determine.

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5

Relationship Between Organizational Conflict and Effectiveness #1
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Relationship Between Organizational Conflict and Effectiveness #2
Currently, conflict is viewed as neither good nor bad because it can produce growth or be destructive, depending on how it is managed.

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Common Sources of Organizational Conflict
Scarce resources
Restructuring
Poorly defined role expectations
Communication problems
Organizational structure
Individual behavior
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Managerial Response to Conflict
Managers can no longer afford to respond to conflict traditionally (i.e., to avoid or suppress conflict) because this is nonproductive.

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Categories of Conflict
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Stages of Conflict
Latent conflict
Perceived conflict
Felt conflict
Manifest conflict (overt conflict)
Conflict aftermath

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Conflict Resolution Outcomes
Win–Win—optimal goal in conflict resolution
Win–Lose
Lose–Lose
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Common Conflict Resolution Strategies
Compromising
Competing
Cooperating/
accommodating
Smoothing
Avoiding
Collaborating

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Compromising
Each party gives up something it wants.
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Competing
One party pursues what it wants, regardless of the cost to others.
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Cooperating/Accommodating
One party sacrifices his or her beliefs and wants to allow the other party to win.
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Smoothing
An individual attempts to reduce the emotional component of the conflict.
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Avoiding
Parties are aware of a conflict but choose not to acknowledge it or attempt to resolve it.
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Collaborating
An assertive and cooperative means of conflict resolution whereby all parties set aside their original goals and work together to establish a supraordinate or common priority goal

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Common Causes of Organizational Conflict
Poor communication
Inadequately defined organizational structure
Individual behavior (incompatibilities or disagreements based on differences of temperament or attitudes)
Unclear expectations
Individual or group conflicts of interest
Operational or staffing changes
Diversity in gender, culture, or age
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Helpful Tips in Conflict Resolution #1
Focus on the causes of the disagreement and not on personalities.
Try to arrive at solutions acceptable to everyone concerned.
Get all the information possible. Differentiate between facts and opinions.
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Helpful Tips in Conflict Resolution #2
Listen carefully and do not prejudge.
Do not belabor how the conflict occurred. Instead, concentrate on what should be done to keep it from recurring.
Concentrate on understanding and not on agreement.

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Helpful Tips in Conflict Resolution #3
Bullying is abusive conduct that is threatening, humiliating, or intimidating in nature.
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Helpful Tips in Conflict Resolution #4
Incivility is a term used to describe mistreatment or discourtesy to another person. It occurs on a continuum from disruptive behaviors such as eye-rolling and other nonverbal behaviors and sarcastic comments to threatening behaviors, such as intimidation and physical violence.

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Helpful Tips in Conflict Resolution #5
In mobbing, employees “gang up” on an individual.

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Helpful Tips in Conflict Resolution #6
When bullying, incivility, and mobbing occur in the workplace, it is known as workplace violence.
Workplace violence impacts the physical, emotional, and socioeconomic health of employees and threatens patient safety.

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Helpful Tips in Conflict Resolution #7
All organizations should have bullying policies in place with zero tolerance as the expectation.

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Negotiation
Frequently resembles compromise when used as a conflict negotiation strategy
Emphasis is on accommodating
differences between
the parties.
Negotiation is
psychological and
verbal. The effective negotiator always looks
calm and self-assured.

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Negotiation Terminology
The very least for which a person will settle is often referred to as the bottom line.
Trade-offs are secondary gains, often future-oriented, that may be realized as a result of conflict.
The manager also must look for and acknowledge hidden agendas—the covert intention of the negotiation.

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Negotiating Strategies
Use factual statements; listen and keep an open mind.
Discuss issues and not personalities.
Be honest; start tough.
Delay when confronted
with something totally unexpected.
Never tell the other party you are willing to negotiate totally.
Know the bottom line but try not to use it; take breaks if either party becomes angry or tired.
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Destructive Negotiation Tactics
Ambiguous or inappropriate questioning
Gestures of helplessness
Intimidation
Manipulation
Ridicule
Flattery
Aggression

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Negotiation Closure
End on a friendly note
Restate the final decision
Hide astonishment at your success
Make the other party feel that he/she also won
Follow up with a memo
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Types of Alternative Dispute Resolution (ADR)
Mediation
Fact-finding
Due process hearings
Ombudsperson
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Seeking Consensus
It is always an appropriate goal in resolving conflicts and in negotiation.
All parties support, or at least do not oppose, an agreement.
The greatest challenge in consensus building is time.
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Chapter 24
Performance Appraisal

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1

Learning Objectives
1. Identify factors that increase the likelihood that a performance appraisal will develop and motivate staff (ATI p 13—Performance Appraisal, Peer Review/Disciplinary Action) (Text p 657-58)
2. Gather data for performance appraisals in a systematic manner that is fair and objective (ATI p 13—Performance Appraisal and Peer Review) (Text p 659-61)
3. Differentiate between performance appraisal tools such as rating scales, checklists, essays, self-appraisal, and management by objectives (ATI p 13) (Text p 662-67)
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Learning Objectives
4. Identify strategies to help employees complete objective, accurate, and growth-producing self-appraisals as part of the performance appraisal process (Text-Learning Exercise 24.4 p 667)
5. Describe the challenges inherent in implementing peer review for performance appraisal (Text 668-69)
6. Identify strategies that can be used before, during and after the performance appraisal to increase the likelihood of a positive outcome (ATI p 13—Performance Appraisal) (Text 671-74)
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Performance Appraisal #1
The employee performance appraisal is a sensitive and important part of the management process, requiring much skill.
Performance appraisals are used to determine how well employees are performing their job. Therefore, appraisals measure actual behavior and not intent.
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Performance Appraisal #2
Because of past experiences, performance appraisal interviews are highly charged, emotional events for most employees.
However, when accurate and appropriate appraisal assessments are performed, outcomes can be very positive.
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Day-to-Day Feedback
Day-to-day feedback regarding performance is one of the best methods for improving work performance and building a team approach.
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The Opportunity for Positive Feedback
Some employees look at their annual performance review as an opportunity to receive positive feedback from their supervisor, especially if the employee receives infrequent praise on a day-to-day basis.
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Factors Influencing Effective Performance Appraisal #1
Appraisals should be based on predetermined standards.
The appraisal tool must adequately and accurately assess job performance.
Employees should have input into development of the standards.
Employees must know the standards in advance.
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Factors Influencing Effective Performance Appraisal #2
Employee must know the sources of data gathered for the appraisal.
The appraiser should be someone who has directly observed the employee’s work.
The appraiser should be someone who the employee trusts and respects.
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Strategies to Ensure Performance Appraisal Accuracy #1
Develop self-awareness regarding own biases and prejudices.
Use appropriate consultation.
Gather data adequately over time.
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Strategies to Ensure Performance Appraisal Accuracy #2
Keep accurate anecdotal records for the length of the appraisal period.
Collect positive data and identify areas where improvement is needed.
Include employee’s own appraisal of his or her performance.
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Strategies to Ensure Performance Appraisal Accuracy #3
Guard against the halo effect, horns effect, central tendency trap, and Matthew effect!

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The “Recency,” “Halo,” and “Horns” Effect Errors
The recency effect occurs when recent issues are weighed more heavily than past performance.
The halo effect occurs when the appraiser lets one or two positive aspects of the assessment or behavior of the employee unduly influence all other aspects of the employee’s performance.
The horns effect occurs when the appraiser allows some negative aspects of the employee’s performance to influence the assessment to such an extent that other levels of job performance are not accurately recorded.
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Developing Standards for Performance Appraisal
Employees should have some input into developing the standards or goals on which their performance is judged.
If employees believe the appraisal is based on their job description rather than on whether the manager approves of them, they are more likely to view the appraisal as relevant.
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Types of Performance Appraisal Tools #1
Trait rating scales: rates an individual against some standard
Job dimension scales: rates the performance on job requirements
Behaviorally anchored rating scales: rates desired job expectations on a scale of importance to the position
Checklists: rates the performance against a set list of desirable job behaviors
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Trait Rating Scales
A method of rating a person against a set standard, which may be the job description, desired behaviors, or personal traits
Probably the most widely used of the many available appraisal methods
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Types of Performance Appraisal Tools #2
Essays: a narrative appraisal of job performance
Self-appraisals: an appraisal of performance by the employee
Management by objectives: employee and management agree upon goals of performance to be reached.
Peer review: assessment of work performance carried out by peers
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Types of Performance Appraisal Tools #3
Self-appraisal is not easy for many employees because they often undervalue their own accomplishments or feel uncomfortable giving themselves high marks in many areas.

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Pitfalls in Performance Appraisal
Subjectivity is a factor.
Tendency to be lenient
Inadequate record keeping
“Recency effect”

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Planning the Appraisal Interview
Feedback, perhaps the greatest tool a manager has for changing behavior, must be given in an appropriate manner.
Indirectness and ambiguity are more likely to inhibit communication than enhance it, and the employee is left unsure about the significance of the message.
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Effective Performance Appraisals #1
There should be no surprises in the appraisal conference. The effective leader coaches and communicates informally with staff on a continual basis, so there should be little new information at an appraisal conference.

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Effective Performance Appraisals #2
Employees must know in advance what happens if standards are not met.
Employees must know how information will be obtained to determine performance level.

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360-Degree Evaluation
The 360-degree evaluation includes an assessment by all individuals within the sphere of influence of the individual being appraised.
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Management by Objectives #1
The employee and supervisor meet and agree on the principal duties and responsibilities of the employee’s job.
The employee sets short-term goals and target dates in cooperation with the supervisor or manager.
Both parties agree on the criteria that will be used for measuring and evaluating the accomplishment of goals.
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Management by Objectives #2
The employee and supervisor meet regularly to discuss progress.
The manager’s role is supportive, assisting the employee to reach goals by coaching and counseling.
During the appraisal process, the manager determines whether the employee has met the goals.
The entire process focuses on outcomes and results, and not on personal traits.

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Peer Review
Peer review has great potential for developing professional accountability but is often difficult to implement because it requires risk taking to avoid becoming simply an exercise of advocacy.
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Performance Management
Appraisals are eliminated as the manager places his or her efforts into ongoing coaching, mutual goal setting, and the leadership training of subordinates.
The performance management calendar is generally linked to the organization’s business calendar.
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Coaching as Part of the Performance Appraisal Process
The effective manager and astute leader are aware that day-to-day feedback regarding performance is one of the best methods for improving work performance and building a team approach.

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Reflective Practice or Clinical Coaching
In reflective practice or clinical coaching, the manager or mentor meets with an employee regularly to discuss aspects of his or her work.
Both individuals determine the agenda jointly, with the goal of an environment of learning that can span the personal and professional aspects of the employee’s experience.
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Strategies for Becoming an Effective Coach
Be specific, not general in describing behavior that needs improvement.
Be descriptive, not evaluative, when describing what was wrong with the performance.
Be certain that the feedback is not self-serving but meets the needs of the employee,
Direct the feedback toward behavior that can be changed.
Use sensitivity in timing the feedback and make sure employees understand feedback.
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Chapter 25
Problem Employees:
Rule Breakers, Marginal
Employees, and the Chemically
or Psychologically Impaired

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1

Learning Objectives
1. Describe the steps typically followed in progressive discipline (ATI p 15—Steps in Progressive Discipline) (Text p 688-91)
2. Compare how the disciplinary process may vary between unionized and nonunionized organizations; understand components of the grievance process (ATI p 17—Grievances) (Text 694-96; 699-700)
3. Determine appropriate levels of discipline for rule breaking in specific situations (Text p 691)

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2

Learning Objectives
4. Describe the risk factors that result in an increased risk of chemical addiction in the nursing profession (ATI p 45—Impaired Coworkers) (Text 702-705)
5. Identify behaviors and actions that may signify chemical or psychological impairment in an employee or colleague (ATI p 45—Behaviors Consistent with a Substance Abuse Disorder) (Text 205-07)
6. Analyze how personal feelings, values, and biases regarding psychological and/or chemical impairment may alter one’s ability to confront and/or help the psychologically or chemically impaired employee (Text p 707-08)
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3

Learning Objectives
7. Identify steps in the Recovery Process of a Nurse who has experienced Substance Abuse Disorder (SUD) (ATI p 45—Impaired Coworkers
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4

Problem Employees: Rule Breakers, Marginal Employees, and the Chemically or Psychologically Impaired
Managers must be able to distinguish between employees who need progressive discipline and those who are chemically impaired, psychologically impaired, or marginal employees so that the employee can be managed in the most appropriate manner.
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5

Rules #1
As few rules and regulations as possible should exist in the organization.
All rules, regulations, and policies should be regularly reviewed to see if they should be deleted or modified in some way.
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Rules #2
If a rule or regulation is worth having, it should be enforced. When rule breaking is allowed to go unpunished, groups generally adjust to and replicate the low-level performance of the rule breaker.

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7

Rules #3
If a rule is consistently broken, one needs to ask the following:
Whose rule is it?
Do we still need the rule?

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Rules #4
Not disciplining an employee who should be disciplined jeopardizes an organization’s morale.

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Discipline Versus Punishment
Discipline
Involves training or molding the mind or character to bring about desired behaviors
Is often considered a form of punishment but is not quite the same thing as punishment
Punishment
An undesirable event that follows unacceptable behavior, which may have negative consequences but can be a powerful motivator for change
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Constructive Discipline
Helps the employee to grow
Is carried out in a supportive, corrective manner
Employee is reassured that punishment is given because of actions and not because of who he or she is as a person.
Primary focus is to assist employees to be self-directed in meeting organizational goals.
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11

Destructive Discipline
Use of threats and fear to control behavior
Employee always alert to impending penalty or termination
Arbitrarily administered and either unfair in the application of rules or in the resulting punishment
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Self-Discipline
The process by which rules are internalized and become part of the person’s personality
Highest and most effective form of discipline
Self-discipline is possible only if subordinates know the rules and accept them as valid.
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McGregor’s (Hot Stove Rule)
The following four elements must be present to make discipline as fair and growth-producing as possible:
Forewarning
Immediate
consequences
Consistency
Impartiality
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Strategies to Create an Environment of Self-Discipline
Clearly written and communicated rules and regulations
Atmosphere of mutual trust
Judicious use of formal authority
Employee identification with organizational goals

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Four Common Steps in Progressive Discipline #1
Verbal admonishment
Written admonishment
Suspension from work without pay
Dismissal

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Four Common Steps in Progressive Discipline #2
When using progressive discipline, for all but the most serious infractions, the slate should be wiped clean at the conclusion of a predesignated period.

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17

Performance Deficiency Coaching
Manager actively brings areas of unacceptable behavior or performance to the attention of the employee and works with him or her to establish a short-term plan to correct deficiencies.
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18

The Disciplinary Conference
State the problem clearly.
Ask the employee why there has been no improvement.
Explain the disciplinary action to be taken.
Describe the expected behavioral change.
Get agreement to and acceptance of the plan.
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Termination
Termination should always be the last resort when dealing with poor performance but is necessary for employees who continue to break rules despite repeated warnings.
Termination is always difficult for the employee, manager, and unit; however, the cost in terms of managerial/employee time and unit morale of keeping such an employee is enormous.
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The Termination Conference #1
State the facts of the case and the reason for termination.
Explain the termination process.
Ask for the employee’s input and respond calmly and openly.
End the meeting on a positive note, if possible.
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The Termination Conference #2
The grievance procedure is essentially a statement of wrongdoing or a procedure to follow when one believes that a wrong has been committed. All employees should have the right to file grievances about disciplinary action that they believe has been arbitrary or unfair in some way.

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The Formal Grievance Process
The steps are generally outlined in union contracts or administrative policies.
It typically entails progressive lodging of complaints up the chain of command.
If differences are not settled in formal grievance process, the dispute generally proceeds to arbitration.

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Rights and Responsibilities in Grievance
Resolution
Both parties have rights and responsibilities to be heard and to listen.
Employee has not only the right to a positive work environment but also a responsibility to express discontent responsibly.
The manager has a right to expect employees to follow the rules but must make sure employees know and understand the rules.

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Marginal Employees
These employees disrupt unit functioning because the quantity or quality of their work consistently meets only minimal standards.
These employees often make tremendous efforts to meet competencies yet usually manage to meet only minimal standards at best.
Traditional discipline is generally not constructive in modifying their behavior.
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The Disciplinary Process for Unionized Employees
Generally entails more procedural, legalistic safeguards for administering discipline and a well-defined grievance process for employees who believe that they have been disciplined unfairly
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Substance Misuse
Substance misuse is usually defined as maladaptive patterns of psychoactive substance abuse indicated by continued use even when faced with recurrent occupational, social, psychological, or physical problems as well as use in dangerous situations.

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Chemical Impairment
Impairment resulting from drug or alcohol addiction

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Incidence of Chemical Impairment in Nursing
The chemical impairment rate of health professionals is generally acknowledged as being greater than that of the general public.
The majority of disciplinary actions by licensing boards are related to misconduct resulting from chemical impairment, including the misappropriation of drugs for personal use and the sale of drugs and drug paraphernalia to support the nurse’s addiction.

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Profile of Impaired Nurse
May vary greatly
Typically, behavior changes are seen in the following three areas:
Personality/behavior changes
Job performance changes
Time and attendance changes

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Late-Stage Chemical Dependency #1
Tolerance is developed by the employee to the chemical, and the individual needs the chemical in greater amounts and more often to achieve the same effect.
The individual characteristically exhibits high defensiveness.
Employee must continually use the substance even though he or she generally no longer gains pleasure from it.

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Late-Stage Chemical Dependency #2
The manager should not assume the role of counselor or treatment provider or feel the need to diagnose the cause of the chemical addiction. The manager’s role is to clearly identify performance expectations for the employee and to confront the employee when those expectations are not met.

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Confronting the Chemically Impaired Employee #1
Gather as much evidence as possible of employee’s impairment.
Immediate confrontation is necessary if manager suspects employee may be impaired and thus poses a risk to clients.
Denial of the impairment or use of defense mechanisms should be expected; manager should not nurture or counsel the employee.
The manager should outline the plan for the employee to overcome chemical impairment.

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Confronting the Chemically Impaired Employee #2
The goal of a diversion program is to protect the public by early identification of impaired nurses and by providing these nurses access to appropriate intervention programs and treatment services.

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Reentry Guidelines for the Recovering Nurse #1
No psychoactive drug use is tolerated.
The employee should be assigned to day shift for the first year.
The employee should be paired with a successfully recovering nurse whenever possible.
The employee should be willing to consent to random urine screening with toxicology or alcohol screens.

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Reentry Guidelines for the Recovering Nurse #2
The employee must give evidence of continuing involvement with support groups such as Alcoholics Anonymous or Narcotics Anonymous. Employees should be encouraged to attend meetings several times each week.
The employee should be encouraged to participate in a structured aftercare program.
The employee should be encouraged to seek individual counseling or therapy as needed.

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From brainstorming your paper's outline to perfecting its grammar, we perform every step carefully to make your paper worthy of A grade.

Preferred Writer

Hire your preferred writer anytime. Simply specify if you want your preferred expert to write your paper and we’ll make that happen.

Grammar Check Report

Get an elaborate and authentic grammar check report with your work to have the grammar goodness sealed in your document.

One Page Summary

You can purchase this feature if you want our writers to sum up your paper in the form of a concise and well-articulated summary.

Plagiarism Report

You don’t have to worry about plagiarism anymore. Get a plagiarism report to certify the uniqueness of your work.

Free Features $66FREE

  • Most Qualified Writer $10FREE
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  • Unlimited Revisions $08FREE
  • Paper Formatting $05FREE
  • Cover Page $05FREE
  • Referencing & Bibliography $10FREE
  • Dedicated User Area $08FREE
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  • Periodic Email Alerts $05FREE
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Our Services

Join us for the best experience while seeking writing assistance in your college life. A good grade is all you need to boost up your academic excellence and we are all about it.

  • On-time Delivery
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Academic Writing

We create perfect papers according to the guidelines.

Professional Editing

We seamlessly edit out errors from your papers.

Thorough Proofreading

We thoroughly read your final draft to identify errors.

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Delegate Your Challenging Writing Tasks to Experienced Professionals

Work with ultimate peace of mind because we ensure that your academic work is our responsibility and your grades are a top concern for us!

Check Out Our Sample Work

Dedication. Quality. Commitment. Punctuality

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Essay (any type)
Essay (any type)
The Value of a Nursing Degree
Undergrad. (yrs 3-4)
Nursing
2
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It May Not Be Much, but It’s Honest Work!

Here is what we have achieved so far. These numbers are evidence that we go the extra mile to make your college journey successful.

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Process as Fine as Brewed Coffee

We have the most intuitive and minimalistic process so that you can easily place an order. Just follow a few steps to unlock success.

See How We Helped 9000+ Students Achieve Success

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We Analyze Your Problem and Offer Customized Writing

We understand your guidelines first before delivering any writing service. You can discuss your writing needs and we will have them evaluated by our dedicated team.

  • Clear elicitation of your requirements.
  • Customized writing as per your needs.

We Mirror Your Guidelines to Deliver Quality Services

We write your papers in a standardized way. We complete your work in such a way that it turns out to be a perfect description of your guidelines.

  • Proactive analysis of your writing.
  • Active communication to understand requirements.
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We Handle Your Writing Tasks to Ensure Excellent Grades

We promise you excellent grades and academic excellence that you always longed for. Our writers stay in touch with you via email.

  • Thorough research and analysis for every order.
  • Deliverance of reliable writing service to improve your grades.
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