The nurse leader plays an integral role in the disciplinary process in a home health agency. Managing employee performance can be challenging, but it is necessary. Failure to address employees’ negative behaviors and actions can destroy morale among the staff. Knowing when and how to discipline is key. However, the proverbial “write-up” need not be the first action. Read this article to understand the different nuances of the disciplinary process and when to use which tactic.
Mentoring for Success
A proactive approach can help to prevent negative behavior before it begins. Often part of an orientation process for a new employee, a mentor is an individual who partners with a less experienced staff member to provide guidance. The mentor models company expectations for the job role to position the staff member for success. Mentor guidance might include improving skills needed for the job, reviewing policies and procedures, and providing support to the mentee. Mentors not only understand the organization and how processes run, but also typically have knowledge of home care in general. By sharing their own experiences, mentors help less experienced staff members to avoid mistakes and make better decisions in similar situations. Mentors also provide feedback to both the mentee and the nurse leader regarding the mentee’s progress or lack thereof.
It is important to select mentors based on their skill level and ability to mentor others. A good mentor should have the following qualifications:
- Knowledge of the job
- Good communication skills
- An active listener
- Enthusiasm for sharing their experience
- Respectful attitude
- Ability to provide honest feedback
- Eagerness to invest in others (Kalish, 2020)
Both the mentor and the mentee must have clear guidelines and expectations of the program. Additionally, both individuals should be able to give feedback during the process. Establish program goals early on and conduct regular check-ins to ensure progress is on target. Ensure there is a transition from the mentor process to the employee working independently. The nurse leader will need to determine core competencies the mentee must meet before completing the mentoring period.
Coaching
While an employee’s poor performance often prompts a disciplinary action, nurse leaders should also utilize coaching prior to a disciplinary action. Coaching should be a part of the nurse leader’s repertoire because it can enable them to resolve issues before launching the disciplinary process. By engaging in discussion with the employee, either formally or informally, the nurse leader can clarify and educate when poor performance first arises. Still, it can be difficult to determine when coaching is the most appropriate choice. According to Mary Dunlap from Mary Dunlap Consulting, the nurse leader should consider these questions:
- Does the employee need specific information to complete tasks or contribute more fully?
- Does the employee need to expand a specific skill?
- Are performance expectations unclear or not defined?
- Is the usually dependable employee suddenly showing behavioral problems (coming in late or appearing stressed, overwhelmed or distracted)? (Dunlap, n.d.)
If the answer to any of these questions is yes, then coaching may be the correct step to take to remedy the situation.
When coaching, the nurse leader should address employee behaviors, not personality traits. For example, an employee who has an abrasive personality may often come across as being rude. Rather than discussing personality traits, address the behaviors, such as inappropriate comments or eye rolling (Employer Services Corporation, n.d.).
Whether coaching occurs formally or impromtu, it is important to follow the same process. This should include:
- Identifying the performance gap – This is the difference between what is observed versus what is expected of the employee. For instance, the expectation may be that the employee engages with the patient and family in a friendly manner, but a family member complains that an employee has been abrasive.
- Identifying the reason for the performance gap – It is critical that the coach identify the reason the performance issue is occurring in order to assist the employee to correct it.
- Developing a plan – Identify a course of action that will close this gap. Set expectations and address what will occur if the identified behavior does not improve. Establish deadlines and a specific date for follow-up with the employee.
Although it is not part of the disciplinary process, the nurse leader should document the coaching conversation so that he or she can refer to it in the future, if needed.
Taking efforts to coach staff before engaging in the formal disciplinary process will promote respect from staff and may also improve morale.
Counseling and the Disciplinary Process
When the nurse leader does not see improvement in an employee’s behavior through mentoring or coaching, it is time to move to the formal process of progressive discipline. Progressive discipline is designed to provide a structured corrective action process to improve and prevent the recurrence of negative employee behaviors and performance issues. It is a multi-level process, with each step having increasingly severe penalties. The first step in this process is counseling, or what some may call a “verbal warning.” Like coaching, counseling enables the immediate supervisor to bring the issue to the employee’s attention and verbally discuss the steps he or she can take to improve or resolve the situation. However, this time, it is part of the disciplinary process and part of the employee’s record. Failure to improve will result in further disciplinary actions. Counseling should occur in private. Refer to the organization’s policy regarding counseling, as it may require giving prior notice to the employee or that an employee representative be present. Using a consistent process for counseling helps the nurse leader to address issues in the same manner every time.
When holding the counseling meeting, it is important to discuss the reason for the meeting with the employee. Be upfront but calm when discussing the employee’s infraction. Allow the employee to explain their actions. If the employee gives information that contradicts the manager’s initial impression, ask for additional time to review and consider the new information. After reviewing the information, if the employee’s actions are still an issue, work with the employee to set a course of action for improvement.
Sometimes the above interventions do not work, or the employee’s wrongdoing requires stricter discipline. When that is the case, nurse leaders may need to take these additional steps.
Written warning – A written warning is a more formal documentation of the performance issue and consequences for the continued failure to meet expectations. There are usually a certain number of written warnings allotted before proceeding to the next step. Refer to the organization’s policy to determine this.
Suspension – Some performance or safety issues are so problematic that the nurse leader may need to temporarily remove the employee from duty. Suspension may also be necessary when leadership is conducting an investigation and the employee is a suspect. The nurse leader can restore an employee on suspension to active duty or proceed to termination, depending on the outcome of the investigation.
Termination – Termination is the last and most serious step of the disciplinary process. Generally, an employee will proceed through the entire process of progressive discipline before reaching this step. However, if the infraction is egregious enough, such as a case of abuse, leadership may proceed straight to termination.
Conclusion
Holding staff accountable for their actions improves safety and working conditions for everyone. However, it is also key to use the right disciplinary action for the right situation. The nurse leader should work with his or her director or human resources person to determine how best to use the methods described in this article to maintain a consistent disciplinary process. This helps staff to know what is expected of them and emphasizes that all staff are held to the same standards, which helps boost staff morale.
References
Dunlap, M. (n.d.). When do i coach, discipline (counsel) or fire? Mary Dunlap Consulting. https://www.marydunlapconsulting.com/articles/when-do-i-coach-discipline-counsel-or-fire/
Employer Services Corporation. (n.d.). The five steps of coaching & progressive discipline. https://myesc.com/the-five-steps-of-coaching-progressive-discipline/
Kalish, A. (2020). 7 qualities that make a good mentor (and how to find someone who has them all). The Muse. https://www.themuse.com/advice/how-to-find-qualities-good-mentor
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