How could you use the Nursing Process to address a staff member’s performance shortcomings?

NURS4455 Nursing Leadership and Management Module 4

DQ2 How could you use the Nursing Process to address a staff member’s performance shortcomings?

Over time, performance problems rarely will go away on their own especially those that involve behavior. Most nurse leaders don’t have problems addressing performance issues when it involves technical skills, role responsibilities and meeting goals. But as in the case described by the manager above, when the problem involves tone of voice, approach, interpersonal skills or motivation, leaders are often more uncomfortable broaching the topic especially with their experienced staff. There are several good reasons why nurse leaders should make this a priority. The first is that other staff do watch how you manage performance problems. If you are lax in what you expect from staff with respect to customer service then this lack of concern can become part of the unit culture. A second good reason is that with reimbursement now clearly tied to customer service and HCAHPS scores, a lack of courteousness or a negative attitude by a staff member could cost the organization both money and customer loyalty.

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NURS4455 Nursing Leadership and Management Module 4
NURS4455 Nursing Leadership and Management Module 4

A Better ApproachNURS4455 Nursing Leadership and Management Module 4

Coaching and staff development is a key part of the nurse leader role. Every staff member has strengths and weaknesses. Poor customer service or a negative attitude can ultimately derail an employee’s career if it is not confronted. These discussions are never easy especially if the staff member is not in touch with how others perceive them. The following are some helpful steps in the process:

1. Prepare for the discussion by gathering information and outlining what you want to say. If it is a serious issue, you may want to have an HR representative present. If your hospital is unionized, the staff member may be entitled to have a union representative present.

2. Select a time for discussion when the incident you will be discussing is still fresh in the mind of the staff member. Arrange the meeting in a private place

3. Clearly explain the performance issue – using very specific examples. Some good tools include:NURS4455 Nursing Leadership and Management Module 4

SBR (Situation, Behavior, and Result): “On your rounds this morning, Mrs Jones asked you a question about her husband. You told her that you were too busy and she needed to ask the doctor. She became very upset and called the patient advocate to complain about your rudeness.”
BFE (Behavior, Feeling, and Effect): “When you become angry at the ED staff for calling to admit a patient at a time not convient for you, you convey an attitude that is not patient-centered. That sets a poor example for the rest of the team.”