Emotion intelligence and apathy are often needed within the medical profession. The health care industry overall, has the privilege of dealing with varying degrees and severities of health concerns. Due to this privileged position, practitioners must be cognizant of the emotion extremes that prevail within the environment. Particularly within the nursing profession, stressful situations abound. It is these situations that can cause emotional and physical harm to an individual nurse. Management must therefore be aware of these occurrences and work to remedy them once they are suspected. Management is predicated on leadership. Without it, goals, tasks, and objectives will be difficult to complete. To accomplish goals within the health care environment, teams must work together in unison. This concept is very prevalent with nurses, as they must work in unison to achieve a desired goal. Customer service, timely care, and proper floor coverage are all achieved through teamwork. A nurse struggling in her position is not only a detriment to themselves, but also to the team as a whole. Therefore, to properly address the issue, management should utilize the Coaching Model discussed in chapter 9. Not only is the model intuitive, it is also very easy to implement.

In regards to a job analysis of the struggling nurse, her job is predicated on timely service and knowledge. Within the health care industry, nurses benefit from information asymmetry. Nurses, simply have a better working knowledge than those the serve. This creates an ability to establish both a report and relationships with patients. They ability to effectively communicate is therefore paramount to a nurses job. The nurse must therefore have the appropriate certifications, degrees, and experience to properly demonstrate their working knowledge. A nurse must be able to commit significant amounts of time working within hours that fall outside the typical workday. In many instances, nurses may work 12-hour shifts 4 days a week, during late night hours. It is essential for the nurse to be committed to these shifts as an absence can be detrimental to the entire team. In regard to the job analysis, a nurse must also have certain qualitative skills to be successful. Patience, emotional intelligence, decisions making, and problem solving skills are all needed to perform the necessary tasks well.

The job analysis often correlates well with the mission and vision of the organization as well. In particular, healthcare organizations have a very unique mandate relative to other professions. Caring for the sick is very rewarding. Studies show that outside of money, and individual cares most about their health. How else would they be able to spend money without first having proper health? Therefore, the mission and vision is critical as it relates to the job analysis and work performance of the troubled nurse. The nurse is literally working in the profession that people care about the most. The health of an individual is the foundation for the quality of life that they will experience. Organizations have mission that direct the activity of all those who work within the facility. For example, Intermountain Healthcare has the mission of "Helping people live the healthiest lives possible." Their vision is to be a "Model health system by providing extraordinary care and superior service at an affordable price." The employees who work in this facility must exemplify this mission and vision in all their activities. Likewise, the troubled nurse must therefore exemplify the mission and vision of the facility in which she works. The nurse has the benefit of working with the attribute that most human beings hold dear. As management, I would remind her of the critical role she plays not only in the lives of an individual patient, but with all the people that individual comes into contact with. The rationale behind utilizing a mission statement to guide behavior is that it inspires the correct action. It allows for individuals to better understand the goals of the organization and move in that direction everyday (Kaufman, 2010).

To address the struggling nurse, the proper use of functions, applications, and skill development are needed. These concepts will be implemented alongside the job analysis and mission statement of the facility, both of which were mentioned in detail above. First, the management team must determine the functions of the nursing role and which of these functions is the troubled nurse having difficulty with. Often direct observation, discussions, past evaluation, and peer feedback can often be used to pinpoint these discrepancies. Performance appraisal is often widely used to address performance issues. The assessment of working performance in accordance with applicable standards is paramount to addressing the troubled nurse. Appraisal is important because it provides a dialogue for management and trouble nurse. It should not be used to degrade or belittle the employee. Instead it should serve a means of realizing a mutually beneficial relationship between the employee...

It also provides a means to see what other interests the employee has within the organization as a whole. Often, nurses that are troubled are often experiencing job fatigue. A change of assignment or task may be all that is needed to provide excitement within the troubled nurses work life. This can be determined very quickly through a well-conducted appraisal.
Current Performance

Desired Performance

Strategies to Ensure Commitment to Change

Follow Up Plans

Excessive tardiness

Maximum of 4 late arrivals (late is defined as more that 10 mins. past schedule time)

Reduce tardiness. Management will review time of arrival on a daily basis

Immediately feedback will be given if late

Low customer service scores

High customer service scores (defined as a net promoter score about 80%)

Customer service class at least once a week. Role paly with management to practice varying nursing situations

Review patient feedback and survey results on a quarterly basis

Lack of recent medical knowledge and medical profession practices

Continuing education

Enrolled in continuing education courses once a month

Review completion of courses

Second, goals must be set to provide a means for corrective action on the part of the troubled nurse. After the initial assessment, evaluation, and discussion, corrective action must be taken. Areas of improvement should have been addressed within the evaluation process. Once agreed upon, an action plan must be designed. This action plan should heavily incorporate the troubled nurses strength relative to peers (Maugans, 2015). For example, if the nurse is a strong communicator, the action plan should heavily influence this part of her strength. The action plan could appear as follows:

Action Step

Time

Material, Resources

Earn 3 positive reviews form clients each month

12 months throughout the fiscal year

Patient surveys, individual patient feedback

Reduced tardiness to once per quarter

3 months, 4 quarters within the fiscal year

Punch card review every month

Learn a new skill in an area outside the nursing profession

1 year

Employee Decision

Take on leadership role and train new incoming nurses

1 year

HR handbooks and employee policies manual

Have at least 1 monthly meeting with management to discuss progress

1 year

N/A

Once the action plan is completed and successfully implemented, management should look to provide additional responsibility to the troubled nurse (if the nurse will accept it). This provides a great opportunity for a mentoring relationship that will properly prepare the nurse for her next position. The plan will simply be monthly meetings with the nurse to see how she is progressing towards her goals. In addition, the mentor should be able to put the individual in touch with other members of the organization in an effort to expand the nurse's network and influence.

The Dialogue between the nurse and the manager should be as follows:

Nurse Manager- "Hello Anne, how are you today?"

Nurse Anne- "Good, just starting my nightly shift."

Nurse Manager- "Great, is now a good time to conduct our monthly performance evaluation?"

Nurse Anne- "Yes, I am."

Nurse Manager- "Great. Step into my office so we can discuss everything."

Nurse Anne- "OK"

Nurse Manager- " So, before I begin, how do you think you have performed this past month?"

Nurse Anne- "I've done ok, I think. I was late a few times this month for my shift. I also had one customer service complaint. Everything also is fine. I guess."

Nurse Manager- "Ok well let's start with the tardy arrival. Anne, you have a very important role here at the hospital. You realize that you impact everyone else here when arrive late. People, especially our patients, are all expecting you to arrive on time."

Nurse Anne- "Yeah, I know ... "

Nurse Manager- "Anne, honestly, you are one of my most talented nurses. You have tremendous upside. I'm just not seeing at work. What's going on?"

Nurse Anne- "Honestly, I'm just not fulfilled at work. I don't know why to be honest. I'm just tired of work. Seems like every day I'm just slaving away. It gets a little depressing. I'm seeing people who can't afford health care. I'm seeing people die. This world is a depressing place. I just see the rich get richer while the poor just get by."

Nurse Manager- "Anne, I can definitely relate. I see many of the same things you see. That's why are jobs are so important. We have to help people get the most out of life. That is our mission statement, you know. Our mission is to…