Developing and Evaluating Staff.
Developing and Evaluating StaffJackie, a new nurse manager, is preparing to do a performance appraisal with Julie, a senior staff
nurse. Julie is an expert nurse in the cardiac specialty, who has been a preceptor and mentor for
many years. Recently, “rumblings” have suggested that Julie is “burned out in precepting” and seems
to have “difficulties communicating with new graduates.”
1. What are some important steps that Jackie should do in preparation for her upcoming
appraisal with Julie?
2. Performance appraisals can be positive interactions that help staff develop and grow in new
ways. What are some potential ideas that Jackie could identify proactively in preparation for the
interview?
Chapter 16: Strategic Planning, Goal Setting and Marketing
Kim, director for critical care, feels very strongly that staff should be recognized and rewarded
for the excellent care they provide to their patients/families. The director is interested in
pursuing an application for the Beacon Award. This is a nationally recognized nursing award for
critical care nursing units. Kim has worked with the chief nursing officer to make this part of the
strategic plan for the organization and now needs guidance on how to execute this plan.
1. Apply the SWOT analysis to this scenario. Is this project worth undertaking?
Strengths
Weaknesses
Opportunities
Threats
2. How would you go about establishing the plan for this undertaking?
Chapter 17: Leading Change
Sarah, the director of nursing (RN-DON), has 24-hour accountability for an 80-bed, long-term care
facility. In addition to Sarah, who is an experienced manager and clinician, a full-time geriatric
nurse practitioner just joined the staff a week ago and is being oriented at the facility’s main
offices across town. The facility ensures 24-hour coverage by registered nurses. Licensed
vocational nurses (LVNs) work 12-hour shifts as charge nurses. Most medications are administered by
one of the LVNs. Certified nurse aides, chaplains, housekeepers, and dietary personnel compose the
rest of the staff. A medical director provides on-call services and visits the facility at least
once a week for several hours. Additionally, the facility contracts for services from physical
therapists, occupational therapists, and social workers.
One of the primary concerns that Sarah has is patient safety. In the past 2 months, the medication
error rate has increased. The charts are kept at the nursing station in a secured area and are in
paper format only. The pharmacist reports that more than 700 different medications have been
supplied to the facility during the past month. Review of medication incident reports shows that
most of the errors were caused by the interactions of, or adverse reactions to, medications that
were prescribed by various physicians who have been seeing a large number of residents for the
first time as the result of influenza complications. Pharmacists from a contracted agency visit the
facility once a week to review residents’ charts for the appropriateness of medications prescribed.
The facility has a quality review committee that meets every month to review events of the past
month, including follow-up of any unusual incidents.
1. Is a change needed? What is the perceived problem? What standards will support and guide
any change that may be needed?
2. If you were Sarah, what kind of assessment would you complete? What framework or strategy
would you use initially to collect data comprehensively about the factors in the change situation?
What questions would you ask?
3. At what point would you involve other individuals, and why? How would you apply systems
thinking to this issue?
4. Would you consider this a low- or a high-complexity change situation? What change
management approaches will probably be needed? Justify your selections.
5. Whom do you perceive as potential change agents who will champion patient safety measures
associated with the medication administration system in the facility?
6. What is the role of staff followers in this situation?
7. How will you select appropriate strategies that will relate to the behavioral styles and
responses of the staff and the major players and allow for optimal constructive participation in
this situation?