“What is causing you to be late?”
“When you are late it throws the pace of the entire unit off and client care suffers.”
“Does it not bother you that your lateness makes everyone else’s job more difficult?”
“You have been late three times this week and that is not acceptable.”
“What are you going to do to avoid being tardy again?”
To punish the guilty
To protect the institution from liability
To set an example for other employees
To encourage the correct behavior
Plan a private meeting for the disciplining.
Wait for one more infraction to occur and discipline immediately afterward.
Make certain that the information regarding policy violations is correct.
Keep the human resources department informed.
“Can we meet this afternoon for about 30 minutes to discuss your progress?”
“I think you need to get different day care that would allow you to be on time.”
“Over the past 6 months the narcotics count has been off on several days that you have worked.”
“Let me show you a method I have found to be effective in making patient assignments.”
“Do you need a class on hand hygiene?”
“Forgetting to perform hand hygiene between clients can spread infection.”
“Why do you refuse to perform hand hygiene?”
“If I hear of any more instances of you not performing hand hygiene, I will write you up.”
When the termination will occur
How to keep the human resources department informed
Accurately documenting all stages of the situation
Whether the termination will adversely affect unit staffing
The nurse manager wrote notes on the expectations discussed during disciplinary sessions.
The terminated employee’s last evaluation discusses problems with performance, but no coaching is described.
When problems with the employee arose, the manager’s average time of intervention was less than 1 day.
There are notes in the employee’s record from human resources indicating the nurse manager had discussed issues with the HR director.
In one note, the manager describes the employee as “petulant, immature, and uncaring.”
Confront the employee.
Check the parking lot each morning.
Discuss the issue at the next employee appraisal.
Provide an education session for all staff regarding parking policy.
Go to the cafeteria and confront the assistant.
Send a message with a nurse going to lunch for the assistant to return to the unit immediately.
Call the cafeteria and ask that they send the assistant back to the unit.
Meet with the assistant and calmly say, “You have been late back from lunch for 3 days this week.”
Anticipate that the assistant will give an explanation for the lateness.
Document the tardy behavior in the CNA's record.
Show the CNA the break hours in the employee handbook.
Warn the CNA tardiness is not tolerated and follow up in 2 weeks.
Warn the CNA that the charge nurse will be timing future meal breaks.
The registered nurse should issue the warning.
The first warning should be verbal.
The assistant should be allowed to discuss the matter.
This type of action should be conducted by the human resources department.
“It is in your job description and your duty.”
“It is your responsibility. In the future, call anesthesia and transfer the call to the primary nurse.”
“It’s not the surgery nurse’s responsibility to call anesthesia!”
“Why was this considered an emergency case?”
Report the meeting to human resources.
Enlist the aid of a more experienced nurse to help monitor the documentation.
Record the specific behavioral steps discussed for future reference.
Tell the nurse that failure to comply with steps discussed will result in a written warning.
Meet with the nurse privately and inquire as to the necessity of personal phone calls.
Meet with the nurse and give a verbal warning.
The manager should inform the nurse the other nurses are complaining about the phone calls.
Tell the complaining nurses to handle the situation with peer pressure.
Tell the nurse to have family call the manager’s office if there is a crisis.
Discuss with the nurse how personal phone calls may affect client care and should be limited.
Inform the nurse the phone calls are causing morale issues among the staff.
Lift the policy against staff carrying personal cell phones for this nurse while the crisis continues.
Ask staff if the visits have decreased.
Arrange a follow-up meeting with the nurse.
Counsel all nursing staff regarding the limitations of personal visitors.
Arrange to be visible on the nursing unit when this nurse is working.
Meet with the ICU nurse to discuss the situation.
Meet with the surgical nurse to discuss the situation.
Give a written warning to the surgical nurse for not following policy.
Give a written warning to the ICU nurse for not following policy.
Meet with the nurses together and issue an informal verbal warning to both.
Provide written instructions for administering the medication.
Remediate the situation with the ICU staff.
Provide a copy of the policy and discuss the rationale for the policy as it relates to client care.
Reprimand the ICU nurse for giving the medication.
Tell the nurse that physician’s attitude is none of the nurse’s business.
Inform the nurse of the policy violation.
Inquire about the physician’s attitude and the staff actions during the incident.
Redirect the nurse to focus on the issue.
“Let’s schedule another meeting for later in the week after you have had time to reflect on the situation a little more.”
“Let’s explore some alternative solutions to what happened.”
“I am going to request a meeting for both of us and the human resources director.”
“As I see it, the problem is your inability to follow the simplest of unit policies and to take direction.”
The nurse may quit.
The nursing staff is a cohesive group and might retaliate.
The manager is not comfortable with confrontation.
The manager does not feel supported by the director.
A written warning
A counseling session
Another verbal warning
The unusual management styles within the department
Confronting the manager’s direct supervisor about allowing this situation to occur
The apparent inconsistencies in discipline within the unit
The potential for litigation that arises from this complaint
The need to terminate this problem employee
Notify the human resources director that the meeting will occur.
Include the chief nurse officer (CNO) in the session.
Ask a manager from another department to sit in on the meeting.
Discuss the issue, concentrate on the issue, and do not make it personal.
Issue a written warning from the CNO.
Place the nurse on suspension pending a new investigation into the complaints.
Terminate the nurse.
Transfer the nurse to another department under another manager.