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.