Conflict Resolution

This was an interesting lesson.  I liked how we learned about several different aspects of conflict resolution and did a couple of activities related to the topic.  The union agreement activity was very interesting, as were the other two activities about conflict.  These lessons taught me the importance of being honest and upfront when a conflict arises.

Motivation

Motivation always has seemed pretty straightforward to me.  I expected this class to cover topics and subjects that I already understood. However, I was surprised to learn about how my expectations about motivation were not always correct.  I was fascinated by the video and results of the surveys regarding motivation. I can apply this to my practice before I am in leadership by using these techniques to motivate my patients and coworkers.  I can also submit suggestions to my managers about motivation. Finally, as a manager or leader, I can use this information to help motivate my employees and have a more effective workforce.

Risk Management

Risk management is an interesting topic that I often ignore.  It was great to hear from a real risk manager about the issues that she faces in her job everyday.  Risk management can be boring or seem unimportant until a major issue arises.  In my current position, risk management is very important.  Children who are psychiatric patients are an extremely vulnerable population.  I have a large number of patients on a daily basis and it is  sometimes difficult to chart everything that happens on a shift.  After listening to the guest speaker, I am more aware of how important documentation can be.  I do so much each shift that there is no way I can remember everything I do each day.  This lecture will also be helpful later in my career as I move into leadership positions.

Future of Nursing

This class was much different than I expected.  I thought we would speak more about where the profession was headed instead of focusing on how we can improve education levels and political impact. I think it was interesting to listen to that doctor talk about the ways that we can improve the profession and help to advance nursing careers.  It was also interesting to speak about ways that we can influence nurses to continue on to the bachelor's degree.  I would like to see more NP programs offered in this state. 

Quality

I expected this class to be boring.  I know that quality is important but I feel like I always hear the same buzzwords and information about quality control.  This class was more informative than other lectures I have heard about quality.  I liked the example of the marbles and the funnel.  I have seen many instances in my workplace where the solutions to the supposed problems actually cause more harm and more problems than the original issue.  It's interesting to think about the many causes and effects of processes and how complicated their interactions are.  I feel like I have learned about how to think about the processes and recognize when issues need to be addressed and when you should leave them alone.  I also liked the M&M activity that helped us look at quality and what actually matters. 

Strategic Planning

I expected to learn about how hospitals move forward with their marketing.  However, strategic planning is about so much more than just marketing for one hospital.  It was interesting to learn about how healthcare organizations market their brand and plan for the future.  The group activity was fun as well.  It's interesting to look at how we could expand our little organization's reach into the other area.  It would have been also interesting to combine this activity with our budget lesson to see how strategic planning and budget work together to advance organizations.  Finally, I liked how this information is coming together for me.  I can see the bigger picture about many of the aspects of healthcare leadership.

Wouldn't that be just like me

For this game, I tried to do at least one thing during the day differently than usual.  I think that the point of this exercise is to see that different ways of doing things are not bad.  It didn't hurt me at all to change up my schedule some.  In fact, I had quite a bit of fun with it.  My kids helped me and we all thought of different things we could change.  One day I let them tell me how to get places in the city, following their directions exactly as given.  Another reason for participating in this type of activity is to help students become more flexible in their thinking.  I like to have a set schedule and do things in a particular order.  The order is usually random with no particular reasoning behind most of my schedule.  This activity helps me to realize that changing up my routine is not going to hurt me.  In fact, I found a few ways of doing things that I actually like better than my original routine. 

Change

The topic of change is always interesting to me.  At first, I thought that we would simply be discussing change in the workplace.  I find it interesting that this topic spreads over to personal life.  If we can adapt to change in our personal life we will do better in the workplace and vice versa.  I struggle with the concept of change.  I usually make myself do the new thing but inside I get annoyed that things have changed.  Over days, weeks, or months, I eventually reconcile myself to the change and it becomes the new normal.  Although I appear adapt well on the outside, I need to work on actually adapting inside as well.  I know that change is a necessary process that may improve aspects of my job and/or personal life but I still want to hold on to what I know works.  This will be helpful as I continue to gain experience as a nurse and learn how to be successful at my job.

Budget Interview

Interview with Barry Prettyman, Cole Surveying Inc.

1. What are your three main budgeting concerns? I worry about making sure I can pay all of my suppliers and get the equipment that I need to run my business.  I also worry about making payroll and covering quarterly taxes.

2. What does your budget cover? Supplies, payroll, equipment, utilities/rent, travel, taxes, and consultation fees

3. What is your budget range? It depends upon the month.  In the winter my budget is much smaller and tighter than in the summer.  Also, it really depends upon the year.  The last few years have been tight due to the poor economy and housing market.  This year has been the best year out of the last five.

4. How often do you make your budget? I sit with my financial advisor at least twice a year to make sure I am doing what I need to do for my taxes.  Then, I meet quarterly with my business partner to make sure we have the same budget goals. 

5. What is your profit margin? It depends upon the season and the year.  Anywhere between 20-40%.  Sometimes more, sometimes less.

6. What is your biggest expenditure after employees? Equipment.  Survey equipment is very expensive, over $100,000 for one device, plus computers, printers, copiers (large size), etc  I run a small business so I don't have a lot of employees.  My crew truck is also expensive to maintain and run. 

I learned about how budget concerns can vary depending on the business.  This owner was more concerned with meeting his equipment budget than with payroll expenditures. He also runs a very seasonal business with his income fluctuating wildly between each season and year to year.  I think that there are some healthcare facilities that operate in the same manner.  It is important for leaders to be able to understand budgets from multiple points of view to ensure good leadership.

Staffing

Staffing is a complex issue that requires much more time than I had previously expected.  I thought that my manager just threw together a schedule in an hour or less and was finished.  Creating a schedule today in class was eye opening and helped me see what the problems are with each type of schedule.  I had never thought about the difficulties of managing the schedules.

I actually learned a lot about the various ways to create a schedule and how difficult it is to arrange.  I hadn't considered the issues of seniority and holidays.  These issues may create problems for managers that makes it difficult to satisfy everyone's requirements.  I also have a better understanding of why scheduling policies need to be strict.  Staffing is complicated enough without allowing a lot of unexcused time off or calling in. 

Budgeting and Healthcare Resources

Budgeting is not something that I was excited to learn about.  I see numbers and tiny writing and my brain starts to hurt and I struggle to think logically about what needs to be done. I was not expecting much from this class.  The group project was definitely valuable when trying to figure out how budgets work and gave me a new appreciation for how difficult it is to work out a budget.  That facility was small...I can't imagine what the larger facilities' budgets would entail. 

I learned how to think about the larger budget picture and to evaluate what is important at the time.  I also learned that if I am serious about taking a leadership position, I need to bulk up my skills in the budgeting area. I need to do more research and seek out more education about this subject. Another aspect that will be important to study is how budget changes affect employee morale.  It's important to consider all of these aspects when budgeting.

Organizational Structure and Power

This was a valuable class for me. I had expected a heated debate about what gender is better at specific jobs but I did not expect to learn about how to communicate more effectively with men (and women) at work. I am the only girl in a family of boys so I have figured out a few of these tricks on my own but I had never tried to apply them at work. It was interesting to hear about brain structure and differences in thinking and the comparison to how we are raised to think in certain ways. It is the nature versus nurture argument all over again. I think that there are aspects of truth to each philosophy and it was fun to listen to each speaker present their own points of view.

Understanding the difference between men and women will help me be more effective in my career. It will help me communicate more effectively and also relate better with my patients. Communication is a very important skill for nurses so I am excited to use this in my practice.

Hiring, Firing, and Discipline Interview

Interview with Adam Anderson, Wasatch Office Supply

1. What qualities do you look for in potential employees?

Mostly I try to figure out if they are a good person, honest, nice, and/or friendly.

2. What are red flags in an interview?

Can't communicate well, dishonesty, negative thoughts about themselves or a previous employer

3. What are the three most common interview questions that you ask in an interview?

What are your interests? What kind of work have you done before? Why do you think you would succeed in this position?

4. What does your interview process look like?

I usually do one interview that lasts about 30 minutes per applicant. I only interview people until I find someone I like.

5. What is your plan of action for disciplinary problems?

I give warnings for bad behavior (anything against my policies) and then if they continue to perform poorly then I will fire them.

6. What kinds of problems have you encountered that led to disciplinary action?

Employees being late, not doing their job (being lazy), and one employee leaving work during the day instead of working.

7. How do you deal with morale and gossip after you discipline an employee?

I have never had an issue with this after a disciplinary action. Usually the other employees are aware of the issue before I am and let me know that something is not happening as it should.

8. Frequency of hiring/firing/discipline?

My business is pretty small, I have a low amount of turnover and discipline issues. Maybe 2 or 3 a year (discipline issues) or less and I have only fired one person in the last two years. I have hired four people in that same time.

9. How do you protect yourself legally when you have to fire someone?

I try to keep my paperwork in order to protect myself. One time, I was sued by a former employee for back wages. I won because of the paperwork I had filed.

10. How do you make the decision to fire someone?

I look at what I hired them to do and evaluate how they are performing their job. I also listen to the supervisors and other employees who are working with the employee. Usually these employees are the ones who bring the issue to my attention.

11. How do you deal with threats from former or disgruntled employees?

I walk them to their car after they are fired but other than that I have never had an issue that has led to really disgruntled employees.

I learned about how different hiring/firing/disciplinary actions are in small vs large companies. Since this company is so small and they hire so few people throughout the year, their processes are not very well defined. I think it leaves them open for legal action and they could benefit from revamping some of their policies. However, I did like how the interview questions were focusing on discovering the character of the applicant. It's important in non-skilled positions to be able to learn this about your potential employees.

Performance Evaluation Interview

Interview with Glen Gardner, Army National Guard

 

1. What is the process for evaluations at your current job?

 

Individuals are rated on values (ethics and ethos), how well the individual performs the job description and any assigned additional duties.  Each person is evaluated by their immediate supervisor (rater), with oversight by the next higher supervisor (senior rater) and reviewed by a third level (reviewer). During the course of the year people are counseled in expectations for current and future levels of performance and discrepancies that exist about every three months.  These counseling sessions are used to produce the final Evaluation Report.

 

2. What system is used to rate employees?

 

Evaluation report consisting of a rating value (Excellence, Success, Needs Improvement (Some), Needs Improvement (Much)) as well as quantifiable bullet points detailing specific attributes, measures, and performance issues, both positive and negative.  Functional areas of the job are reviewed for Competence, Discipline and Fitness, Leadership, Responsibility and Accountability, and Training, as well as a section for personal values which are rated as a yes or no if the person exhibits behavior exemplifying or going against traits of character.

 

3. How often are employees rated?

 

At a minimum all employees are rated annually.  There are other times where a person may be evaluated more frequently, but never for a period of less than 90 days.  Situations that might result in an shorter rating period would be promotion of the individual, promotion of the rater, or a change in position or duty station.

 

4. What are the challenges associated with evaluations?

 

Some raters are not familiar with the individual expertise of the rated individual, meaning that their specialty is in a different field.  In that case you get a more generic rating report dealing more with leadership and responsibility than a complete package including all the functional areas of the job including competence and training.  Often, unless both the individual and the rater keep detailed records of accomplishments it is hard to go back and know exactly what has been done above and beyond the normal scope of duties. Raters also do not always have insight into a person's value system or knowledge of what is important to them at their core.   This can alter the rated individual's focus due to the subjective nature of many management decisions .  What they see as important matters when a decision needs made between two or more courses of action.  They could make decisions that differ from the rater's opinion.  This is where clearly defined expectations are important and should be laid out from the start.

 

5. Do you agree with the theory that rating low encourages better performance? Why or why not?

 

I would agree that if evaluations are timely and used constructively that low-rating a person deserving of a low mark can encourage better performance, provided that specific training or guidance is also implemented to facilitate the growth.  In this organization the methods of rating are not a closely guarded secret.  If an individual is displaying traits that earn a low rating, they likely lack skills in that functional area.  A low rating (needs improvement) is often only given if there have been specific, well documented  cases of repeated offense in an area.  Success is the goal for all employees, while excellence indicates a willingness to go above and beyond the expectations of the position.   A person who is naturally driven to exceed will not be encouraged by a lower mark to exceed more.  I think the best thing to do is rate fairly and accurately, capturing the total picture of that employee as best you can within the areas that are evaluated.

 

I learned a lot about performance reviews through this interview. The system is different than ones I had previously learned. I think it is important to hear different ideas so that I can determine the best way to run my own department. Healthcare does not necessarily have the best or most effective methods in place so I need to take opportunities whenever they are presented to broaden my own horizons.

 

Ethics

Ethics is an important topic in healthcare. Nurses run into ethical problems frequently in the course of their jobs. I know it is valuable but I feel like I have had many lectures on this topic and I was not excited about this lecture. I figured it would be like all the other ethics lectures I have attended. I was certainly mistaken. The idea of creating an ethics committee and letting the class observe them in action was a good one. I saw a different aspect of the topic and was able to understand how ethics committees work. It was interesting to hear the different opinions from the different members of the committee.

I will use this information in my practice when I am faced with an ethical dilemma. It is good practice to get opinions from individuals outside health care so I can be a more effective patient advocate. Working in the nursing field can affect how I view ethical situations. This class has helped me realize that my opinions will be different from others and that opposing views are important when faced with ethical issues.

Performance Appraisals and Problem Employees

I expected this class to be simple. Just call the employee in and fire them! I thought that performance appraisals would be similarly easy. I am not sure I have had a manager or supervisor put that much effort into any of my appraisals. My last one for my 90 day review was left in my box at work. I didn't speak to my manager or even know it had occurred. In my previous experiences I had at least spoken to my supervisor about how I was doing or if I was getting a raise or not.

I actually learned in this class about the legal issues surrounding employee termination. It is interesting to hear about the employed at will law and the requirements that have to be met if there is cause to discipline an employee.  The process is much more complex and requires careful thought and consideration about all the different steps in the process. I like the idea of the paper trail that is created by the verbal and written warnings. It is always good to be able to follow the paper when you can't remember what has been happening with an employee. It's even better to have that trail when lawyers get involved. Performance appraisals are interesting as well. The most interesting thing to me was that I could see how I could improve my performance at work just by learning about how appraisals are completed.  I previously mentioned my last review at work. I received a two on a one to three scale in all areas but two. Both of those areas I would have rated as strengths in my practice had I been rating myself. It was good to see that someone else had noticed that as well. I work nights and weekends so I do not see my supervisors often. Additionally, after receiving those marks I am motivated to keep them. If I were a supervisor, hopefully I would be able to notice good qualities in my employees and point them out so I could build them into high quality assets.

After this class, I am paying more attention to what happens with problem employees and performance appraisals at my facility. I am feeling more motivated to be involved when I see something happening at work that is not appropriate. Usually I keep to myself to stay out of any kind of drama but I can see how that is harmful when something is truly wrong. I need to speak up and give some employee to employee feedback to help make my facility into a better place to work.

Team Building

This class has been my favorite one so far. I thought coming into this day that we would be doing a different kind of team building. In the past, I have done activities that were less challenging and didn't truly require any kind of teamwork or leadership. The activities today allowed us to work together as a team to come up with solutions and then enact them together. I also thought that we wouldn't work well together, as we had not really interacted in that way before.

I actually learned that a team feeling is something that is gained through shared experiences more than sitting next to people in class. It was fun to see the different ways that we interacted with each other in this situation. We encouraged each other to do things that seemed difficult and solved problems as they came up. I can see how this would be beneficial in the workplace, especially if a unit were having difficulties working together. It may be difficult to actually implement but I think it would be worth it to promote teamwork. In my current facility, nursing staff and floor staff (everyday patient care) are separated by several factors and often have miscommunications and issues at work. I think that if the facility had us train together or work in teams we may have fewer communication issues and we would be able to provide better patient care.

Personally, I felt like this was a very valuable experience for me. I think it will be easier to work with my team for the rest of the semester and will help to incorporate our team members who were not in our cohort for the past five semesters. Additionally, it has given me ideas to pass on to my supervisors at work to solve a real problem.

Hiring

Today was an interesting class. I have always considered hiring from the perspective of a job seeker not as an employer. Before class, I had some preconceived notions about how interviews were conducted. In reality, hiring is much more complex and expensive than I had initially thought. I was interested to hear about how expensive the entire hiring/orientation process becomes. It helps me to think about turnover in a different light. A prospective employer must be careful about who they hire in order to keep costs reasonable.

Conducting interviews is much more complicated than I had originally thought. I can come up with great behavioral based questions but I didn't think about what I wanted to learn by asking the question. I also learned about how to prepare an outline for questions so that I could find out what I need to know and then ask the same questions to each applicant. Hopefully I can use these new skills eventually in a manager or leadership role. It also helps me to answer questions in interviews. I can see both sides of the process and hopefully use that to my advantage in the future.

Anything that gives me an edge in the interview process is a good thing for me to learn. I like my current position but I am not going to stay there forever. It's awesome to go to school and learn skills that are immediately applicable to your life. My facility has been discussing allowing staff nurses to help with the interviews. After this class I feel like I can recommend myself to help with that process.

Mock Job Interview

I met with Mr. Felps for my mock job interview on Friday, September 6. I was surprised to learn that it was a group interview format but that was definitely helpful for me. The interview I had for my current position was low key and was not very helpful in preparing me for future interviews. This experience taught me about how to handle myself in a group interview and also helped me realize how to answer questions that were difficult for me. Additionally, it was great to have the instant feedback from Dan so that I could start working on my mistakes immediately. He mentioned that he saw significant improvement in my interview from the beginning of the session to the end. Hopefully this will help me when it is time to find a different position.

Leadership Reflective Journal

Yesterday in class we talked about leadership and leadership theories. As directed, I spoke with my manager about what her expectations were before she started working in her new role. She expected that the hours would be better, she would work less, and that it would be an easy job after working on the floor for so long. The reality was a bit different but she says that she enjoys her job and doesn't regret moving to a leadership role.

I had expected this class to be similar to our Nursing Theory class where we would discuss different theories about leadership. I thought we would talk about specific people and theories about leadership. I actually learned more valuable information about what my own personal leadership style is and how to use the strengths of my own style and improve the weaknesses. I was a little surprised about my leadership styles (I had two only one point apart). I have always thought of myself as a autocratic leader but that was my lowest score. I think I am different at home than I am at work. I tend to be more autocratic at home and more democratic at school or work.

I can use this information in my practice by trying to recognize the weaknesses of my leadership style and working to improve those areas. I can also try to make sure I am using the appropriate style for the occasion. I already have opportunities to lead in my job so I can work on my skills as we learn them in class.

Personally, I am excited about this class. I have been told before that I would make a good leader and I am not really sure that is true. It will be good to learn about this subject and increase my confidence in my leadership abilities. Hopefully it will open up opportunities for me to advance my career in the future.