Leadership Chapter 25: Strategies for Managing Problem Employees

A nurse-manager needs to discipline an employee and wants to ensure that it leads to constructive outcomes. What is the primary difference between constructive and destructive discipline?

a. The manager is more empathetic to the employee in constructive discipline than in

destructive discipline, so that their relationship becomes closer.

b. Constructive discipline excludes punishment, but destructive discipline is primarily

focused on punishment.

c. The person who has received constructive discipline always appreciates it, whereas

destructive discipline is always resented.

d. Constructive discipline helps the person grow to meet organizational goals;

destructive discipline focuses more on punishment.

d.

How can a nurse-manager best promote the development of self-discipline in employees?

a. Eliminate punishment from the unit's culture and procedures.

b. Allow employees full autonomy in choosing tasks and the means for carrying out

those tasks.

c. Clearly communicate expectations, rules, and policies to employees.

d. Hire employees who have a history of being compliant and collaborative.

c.

A nurse-manager is updating the unit rules and is trying to ensure that they are fair and effective. What actions should the manager perform? Select all that apply.

a. Make sure all employees know that rule violations will result in discipline.

b. Issue 2 or more warnings before an employee's rule violations are punished.

c. Maximize the number of rules and regulations so employees are clear about expectations.

d. Make sure that discipline for rule violations is consistent and impartial.

e. Administer discipline as soon as possible after a rule is broken.

a, d, e

A nurse-manager is initiating the process of progressive discipline in response to an employee's tardiness. The manager should:

a. write a brief letter of warning to the employee without providing a copy to the

personnel department.

b. write a brief letter of warning to the employee and send a copy to the personnel department.

c. avoid confronting the employee but observe the employee's behavior closely in the near future.

d. privately administer a verbal reprimand to the employee.

d.

An employee is found to have grossly mistreated a client, which the employee has never done before. What consequence should be administered to the employee?

a. Suspension with pay

b. Suspension without pay

c. Termination

d. Written admonishment

c.

What action should a nurse-manager perform when preparing for and conducting a disciplinary conference?

a. Soften criticisms to reduce the employee's defensiveness and emotional response.

b. Schedule the conference in advance at a time agreeable to both the employee and the manager.

c. Ask a small number of trusted employees to join the conference so it can be used as a teaching tool.

d. Adopt a nurturing and counseling role to ensure that the conference ends on a

positive note.

b.

A nurse-manager is preparing to terminate an employee for continuous rule breaking. What is the manager's best action?

a. Arrange for the employee to be escorted from the building by security staff.

b. Collaborate with the employee to work out a 2-week termination period.

c. Describe what, if any, references will be supplied to future employers.

d. Arrange for a meeting between the employee and senior administration.

c.

Which statement is accurate when describing performance deficiency coaching?

a. It is less spontaneous and requires more planning than ongoing coaching.

b. It is a one-time way of solving problems.

c. It requires the manager to assume the role of enforcer rather than supporter or

enabler.

d. It occurs as a component of an employee's annual performance appraisal.

a.

A nurse-manager is working in a unionized health care organization. When administering discipline to employees, the manager should:

a. communicate with the union's attorneys rather than directly with employees.

b. defer to the organization's personnel department rather than administering

discipline directly.

c. assist employees with filing grievances.

d. follow specific steps and penalties within an established time frame.

d.

What event is most likely to result in an employee filing a grievance?

a. A manager and employee have a relationship that precedes an episode of

discipline.

b. An employee knowingly breaks an established rule.

c. An employee wants to have an impartial third party impose a solution.

d. An employee believes that they have been disciplined unjustly.

d.

What action should the manager take when implementing the second step in the progressive disciplinary process?

a. Suspend the employee from work for a specified period of time.

b. Explain in detail the nature of the inappropriate behavior.

c. Complete a formal written reprimand.

d. Verbally instruct the employee not to repeat the infraction.

c.

A nursing aide has been given a formal written warning regarding arguing repeatedly with the team leader about the given assignment. Today, the nursing aide has taken four lengthy personal phone calls during work time. This is the first offense of this nature. How will the manager deal with this disciplinary situation?

a. Provide a verbal warning that includes the rules related to personal telephone calls.

b. Monitor the employee's behavior closely for the next few weeks.

c. Present the employee with a formal written reprimand.

d. Suspend the employee for a week.

a.

A novice nurse-manager admits to feeling nervous about the possibility of disciplining employees. How should the manager be encouraged by superiors to view discipline?

a. As a necessary means for controlling an unmotivated and self-centered workforce

b. As a "big stick" that management can use to eliminate behavior that conflicts with organizational goals

c. As a means of narrowing the power-authority gap

d. As a necessary part of fostering excellence in the organization

d.

What variable should a nurse-manager prioritize when dealing with employees who break the rules?

a. Terminating employment when necessary

b. Modelling empathy

c. Counseling employees to promote their personal and professional growth

d. Ensuring organizational goals are met

d.

When monitoring medication inventories for possible diversion or theft by nurses with a substance use disorder, what medication classifications should the manager monitor most closely? Select all that apply.

a. Anticholinergics

b. Opioid analgesics

c. Central nervous system stimulants

d. Antidepressants

e. Benzodiazepines

f. Nonsteroidal anti-inflammatories

b, c, e

A nurse is uncharacteristically extroverted on today's shift and has an unsteady gait. The manager suspects that the nurse may be chemically impaired. What is the manager's most appropriate action?

a. Document this finding and communicate with the personnel department.

b. Monitor the nurse's behavior closely for the remainder of the shift.

c. Promptly confront the nurse to discuss this suspicion.

d. Ask the other nurses and staff members on the unit if they have noticed the same

thing.

c.

A manager is preparing to confront an employee regarding suspected chemical impairment. What response should the manager anticipate?

a. Emphatic denial and defensiveness

b. Reluctant acceptance

c. Gratefulness for finally being discovered

d. Silence

a.

A nurse-manager is contributing to the plan for the workplace reentry of an employee with a history of substance use disorder. What should be included in the reentry plan?

a. The nurse should have a 50% work assignment for the first several months.

b. Clients and families should be made aware of the nurse's history.

c. Reentry should not occur until the nurse has been chemical-free for at least 18 months.

d. The employee should agree to random urine screening.

d.

What consideration should a nurse-manager prioritize when creating a program to deal with the issue of employees with substance use disorders?

a. The program should emphasize punishment due to the safety risk posed by

impaired employees.

b. The program may be unnecessary because state boards of nursing have authority over this issue.

c. The program should emphasize screening, prevention, and early intervention.

d. For confidentiality reasons, the program should be planned and executed by the

personnel department.

c.

A nurse-manager oversees an experienced employee who is earnest and pleasant, but who struggles to maintain minimum performance standards. What is the manager's best initial approach to this employee?

a. Arrange for the nurse to complete extra continuing education.

b. Provide interventions that will increase the nurse's motivation.

c. Affirm the nurse's strengths in an effort to encourage excellence.

d. Provide coaching that addresses the employee's main deficiencies.

d.

A nurse became frustrated with a client and deliberately damaged the medication cart in a subsequent outburst. How should the nurse-manager discipline this employee?

a. Dismissal

b. Suspension

c. Written admonishment

d. Verbal warning

c.

How should a nurse-manager implement McGregor's hot stove rules when setting standards for employee behavior on the unit?

a. Any rule that is outdated or irrelevant must be eliminated promptly.

b. Rules should be called "norms" in an effort to make them less authoritarian.

c. All employees should be made aware of the rules and associated punishments beforehand.

d. Rules should be reviewed on a regular basis to ensure they are necessary.

c.

What is the principle that guides constructive discipline?

a. Constructive discipline is fair but punitive in nature.

b. The focus of constructive discipline is employee growth.

c. Constructive discipline employs the manager as a counselor and support.

d. Increased motivation is the desired outcome of constructive discipline.

b.

Which is a management function associated with dealing with a problem employee?

a. Applying a discipline model when employee fails to meet standards

b. Ensuring that the rights and the responsibilities of both the manager and the employee are considered in addressing worker grievances

c. Examining the work environment for stressors that contribute to substance use

disorder

d. Understanding group norms and being able to work within those norms to mold

group behavior

a.

A manager is working with a staff member who has twice arrived late for assigned shifts over the past few weeks. What is the fundamental rationale for conducting a disciplinary conference for this employee?

a. This behavior disrupts the efficiency of the nursing team.

b. The tardiness is costing the facility money.

c. This behavior encourages other staff to disregard rules.

d. The problem will get worse if it is ignored.

d.

A nurse-manager works at a unionized health care facility and is preparing for a disciplinary conference for an employee with a history of unexcused absences. What activity should the manager prioritize in this conference?

a. Promoting rapport with the employee in order to protect their future working

relationship

b. Requiring the employee to present compelling evidence to prove that he or she is innocent of rule breaking

c. Presenting a grievance that summarizes the way that the employee has failed to

meet organizational standards

d. Presenting objective evidence that demonstrates the employee's deficient

performance

d.

A nurse-manager has been managing a medical unit for several weeks and has just learned that a nurse has a reputation among colleagues for avoiding work responsibilities. What is the manager's best initial action?

a. Canvas the employees on the unit to identify any history of violence.

b. Review the employee's available personnel records and files.

c. Contact the client and family and apologize for the nurse's action.

d. Inform the client's health care provider about this incident.

b.

A nurse-manager has had difficulty improving the performance of a registered nurse who is a marginal employee on the hospital medical unit. The manager no longer wishes to work with the employee and has arranged a transfer to the postsurgical unit of the hospital. What type of transfer has the manager arranged?

a. Lateral

b. Downward

c. Inappropriate

d. Accommodating

c.

After the first few months on the job, a nurse-manager has recognized that an experienced practical nurse at the clinic is a marginal employee. What strategy by the manager is most likely to be effective?

a. Create a personalized improvement plan with the nurse and work with the nurse to promote improvement.

b. Place the nurse on probation and set firm requirements for reinstatement.

c. Arrange for the nurse to receive an education leave and complete remedial courses in basic nursing knowledge.

d. Apply disciplinary measures that have the potential to motivate the employee.

a.

A nurse-manager discovered that a nurse was retrieving narcotics from sharps containers and has been abusing these medications for several months. When addressing this behavior and assisting the nurse, what factor should the manager prioritize?

a. The safety of clients and families

b. The integrity of the unit

c. The nurse's well-being

d. The nurse's personal growth

a.