We did not cover any material this week, but I did read an article discussing clinical risk management and how the selected study came to the conclusion that the facilities included in the study could benefit from increased understanding of risk management and that it would increase safety and quality control within these selected facilities. This made me think about how it could be useful for facilities here to train all employees, not just leaders, about risk management strategies and techniques to help improve safety in the workplace.
This week we discussed risk management and legal responsibilities in certain nursing leadership roles. It was really interesting hearing about and participating in the various ethical/legal dilemmas. We discussed an event where an aggressive drunk man lit himself on fire after being restrained and how we would have reacted to the situation as the ED nurse leader. I remember being frustrated at the idea that the patient could have legally pressed charges for the injuries he received while under our care. I understand that the staff should have conducted more thorough safety checks on the patient, but at what point can the staff be held responsible for the unfortunate decisions made by the patient. I feel like there is a blurry line between allowing for personal freedom and liberty of patients and becoming responsible for their own decisions. When it comes to case studies like this, I become a strong advocate for natural selection. I get it, that doesn’t sound like a great attitude to have. As nurses we should be about protecting and conserving human life, however, I think personal freedom and liberty is more important than protection. Like Benjamin Franklin once said, “Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety”.
This week we discussed motivation and it’s role in the workplace. One of the big challenges for managers and leaders is battling low moral. There are many things that can cause low moral in a hospital setting, such as high patient loads, lack of recognition, contention between coworkers, little or no room for advancement, little or no incentives, poor benefits, etc. I learned that it is important for leaders to always be looking for ways to motivate their peers. In order to do that, leaders need to listen to the needs and concerns of their peers to gain an understanding of what may be causing low moral or a lack of motivation. Providing incentives that interest the employee population can be a great way to motivate employees to improve moral and performance, which can lead to better patient care and higher patient satisfaction rates, which will pay for itself in the end.
This week we participated in a discussion surrounding the topic of bargaining between employee and employer, which gave us insight into the capitalistic relationships between CEO’s and those that they employ. It helped me get a better understanding of the concepts of monetary supply and demand between these two parties and how they can be calculated. We also watched a movie, The Gaudian, and discussed effective and non-effective types of conflict resolution. I reflected on clear communication as an effective method of conflict resolution.
This week we also ensued in the chaos of deciphering a team activity in which we were asked to participate in strategic planning of a new expansion for a healthcare facility in the town of Bionicle Town and Legoville. After getting past the initial frustration that is online team activities, this became a unique experience in which we were able to plan the healthcare operations in a metaphorical setting. Although I do not anticipate this experience having any sort of significant impact on my future career as a nurse or CRNA, it was interesting to have a brief insight as to what CEO’s and high ranked executives deal with and helped me gain a better understanding of how stressful it can be to work with a team and to have to plan so intricately for the most unpredictable future.
The major takeaway from these last two weeks for me was the importance of clear communication. It is so important for us to learn clear communication skills because poor communication can lead to unclear expectations, unnecessary frustration, and a overall decrease in productivity.
This week we had an interview to discuss budgeting and also discussed a lot about change. This was a really interesting and helpful topic for me personally because although I feel that I am flexible, I sometimes have a hard time coping with change. I notice that when I find myself in a new environment, I often close up and try to isolate myself. I guess I just have a smaller bubble than others and it feel safer for me to close myself off, at least until I get to know them or my situation a little bit better. This weeks discussions have helped me to understand myself a little bit better regarding how I react to change and how I can improve. I need to be better at not procrastinating. I need to make every day count, because time is one of our most valuable commodities. I need to go forward with a vision to and be more creative in developing strategies to realize my goals.
This week I interviewed L.S. who works at a new accounting company. The following are the interview questions with her responses:
What is the most common budget constraint you frequently run into and how can it be fixed?
“I am in charge of budgeting and the most common issue I deal with is employees spending company money without permission or before getting approval and exceeding their allowance for certain events.
What is your favorite thing about budgeting at your company?
“Budgeting is not necessarily something I enjoy, it can be quite tedious and often frustrating.”
What is your least favorite thing about budgeting?
“Being the stickler and having to enforce the budget and explain the rules of company spending to other employees.”
What do you find to be the most difficult about planning your budget?
“Trying to anticipate and compensate for unexpected costs.”
How does budgeting affect your employees & customers?
“Budgeting can be a double edged sword. Depending on cash flow and how the company is doing, it can effect work hours for employees which also effects the amount of customers we can assist.
What is the main cause for being over budget?
“Executive employees spending more than they should.”
What is the main cause for being under budget?
“Good sales and not spending excessively.”
How often do you think the little things add up to help you stay under budget?
“The company I work for is a newer start up so we are typically always over budget at the moment.”
Who helps oversee the budget for the company?
“Myself, the owner and co-owner.”
How often do you make changes to your budget?
“We review the budget monthly together to address concerns and make the necessary changes.”
How often do you fire employees as a way of decreasing your budget?
“I am not responsible for firing employees, and as we are a new company no one has been fired as of yet.”
This interview helped me gain a little more insight as to how budgeting can work in a newer company that is still establishing itself. I can imagine how difficult it can be, especially for a new company, to gather data to help keep track of the budget and have a specific plan in mind in regards to actual numbers.
This week we discussed staffing and career development. It was interesting to see what some of my classmates had planned for their future careers. Some wanted to become NP’s, I myself have a goal of becoming a CRNA. It was nice to have the opportunity to reflect on our goals and make sure we had a plan for our future. For me, I know it is not as clear as I imagine it at the moment, because my wife and I have plans for a family that I know will delay my ideal time frame. But to me, family is just as important to prioritize.
It was also interesting discussing scheduling trying to create a schedule for the scenario that we were given. I think it was a helpful insight to the complex skill of scheduling. Scheduling is definitely not as clear cut as some may think, and it is impossible to satisfy everyone’s scheduling preferences.
This week we watched a presentation on the future of nursing practice and discussed our thoughts on the subject. We also continued to work on our professional portfolios.
A thought that stuck out to me this week was the need for better collaboration within the healthcare system as a whole. What I mean by this is the need for a universal system in which every healthcare facility/provider is required to report to. I think this could improve the accuracy of medical records and increase communication between providers, as well as improve patient awareness and involvement in their own healthcare. However, this is so much easier said than done with our current healthcare system. Companies compete heavily to dip their toe in the billion dollar industry of software programming to create systems for the various healthcare corporations. I’m not saying that we need universal healthcare, I believe capitalism promotes innovation. I’m just suggesting a universal medical record system.
Another thought: While I believe that inter-professional collaboration will continue to improve, it will not do so passively. As professionals we need to be continuously be striving to improve the way we communicate, which requires practicing effective communication techniques. We need to familiarize ourselves with these techniques and implement them into our practice. SBAR is just one simple example of this.
This week we discussed budgeting, managing resources, as well as interviewed someone responsible for firing/disciplining employees. I learned a lot about budgeting, and had the chance to get more familiar with how budget reports look like. I now have a better understanding about how complicated budgeting can be and how it can have a huge impact on the everyday mechanics within the workplace. If I am ever to become in charge of budgeting I know that I will have my work cut out for me, but I also am glad that I am now a little more familiar with the concept.
This week I interviewed J.O. who works at Walmart. The following is a list of questions our group created, and J.O.’s answers to these questions:
What are automatic grounds for termination at your workplace?
“Pretty much anything considered illegal like stealing, abusing customers. Things like showing up for work late consistently or poor attitude/customer service can eventually get you terminated, but that is usually over a period of time and not an instant termination.”
What is the process you use to discipline an employee who is constantly late?
“This can vary from case to case. We have some excellent employees who work hard and have great customer service skills, but are often late for work. We are sometimes more lenient with these type of employees. On the other hand, if an employee performs poorly AND is constantly late, they will be the ones we terminate first.” Typically the process goes from verbal warnings, to written warnings, and once they’ve had a couple written warnings they may be suspended or layed off.”
What is the hardest part of disciplining an employee and firing an employee for you?
“I’ve had to let at least two employees whom I would consider close friends, I think that was the hardest thing I’ve had to do.”
- What tactics have you found to be effective when disciplining/firing an employee?
“It’s always important to have someone else in the room to help be a witness/mediator. It’s also important to be sensitive and degrading towards them. It’s a hard thing to get fired.”
- What are good indicators which help you know if your disciplinary actions have been effective or not?
“If they start working harder or show an improvement in behavior. If it was an employee that was always late I would expect them to show up on time.”
- When you need to discipline an employee, do you have someone else there to help be a mediator?
“Unless it’s a serious issue, No. Discipline often consists of a short private meeting where we can share concerns and help resolve the issue.”
- How many “chances” do you give an employee before they are terminated?
“Again, this can depend on the circumstances, but we do sometimes follow the “3 strikes you’re out” rule.”
- What is the main reason why you need to fire an employee?
“Not performing their job duties or treating customers poorly.”
- After firing an employee how does the workplace change/react to the firing?
“After the initial hiccup, ironically, firing a problem employee usually results in more work getting done.”
- When a termination needs to happen due to budget issues, how do you choose which employee it will be?
“I focus on employees who are not performing well in their job duties, or problem employees. Our customers are our greatest source of feedback as to how our employees are performing, so I will fire employees who have numerous complaints first.”
- How do you approach the conversation when firing an employee? Do you explain in depth the reasons why they are being fired?
“Of course, I would be a terrible manager if I fired an employee without first explaining why they were being fired.”
- If your company was really short-staffed but an employee gives countless reasons to be terminated would you proceed with firing them or keep them because you can’t afford to lose an employee?
“I have sometimes hung on to problem employees for longer than I should have because we had a big sale coming up a department needed help. This may have been the wrong choice to make it the end, but I’m not perfect and everyone makes mistakes.”
This interview was interesting and a helpful insight to the political, and sometimes dramatic, aspect of firing and discipline in the workplace. I learned that it’s important to have witnesses for exit interviews, and for managers to be considerate and show empathy for those being disciplined. Being fired can be extremely stressful and it should be done tactfully.