Essentials of Nursing Leadership and Management, 5th Edition

88 unit 2 | Working Within the Organization

Communication skills are also part of evalua-
tion. A comprehensive evaluation system can be an
effective mechanism for improving staff skills and
morale and for reducing costs by increasing staff
productivity. Constructive feedback demands
objectivity and fairness in dealing with each other

and leadership of both staff members and manage-

ment. Done well, feedback can provide many

opportunities for increased professionalism and

learning as well as ensure appropriate rewards for

high performance levels and professionalism on

the job.

Study Questions

1.This is your first position as an RN, and you are working with an LPN who has been on the unit

for 20 years. On your first day she says to you, “The only difference between you and me is the

size of the paycheck.” Demonstrate how you would respond to this statement, using assertive

communication techniques.

2.A physician orders “Vit K 10 mg IV.” You realize that this is a dangerous order. How would you

approach the physician?

3.A patient is admitted to the same-day surgical center for a breast biopsy. She is accompanied by

her significant other, who has just had an altercation with an admissions secretary about their

insurance. The patient then has to wait 30 minutes after her designated arrival time. When the

nurse comes to call the patient, her significant other turns and says loudly, “What is wrong with

you people? Can’t you ever get anything straight? If you can’t get the insurance right, and you can’t

get the time right, how can we expect you to get the surgery right?” How would you defuse the

situation?

4.Why is feedback important? Who needs to receive feedback? Who should give feedback to

health-care providers?

5.Describe the difference between constructive (helpful) and destructive (unhelpful) feedback.

6.Describe an ideal version of a 3-month performance appraisal of a new staff nurse. Why do nurse

managers sometimes fail to meet this ideal when providing formal evaluative feedback? Can new

staff nurses do anything to improve these procedures in their place of employment?

7.What is peer review? How is it different from other types of evaluation? Why is it important?

Case Study to Promote Critical Reasoning

Tyrell Jones is a new unlicensed assistant who has been assigned to your acute rehabilitation unit.

Tyrell is a hard worker; he comes in early and often stays late to finish his work. But Tyrell is gruff

with the patients, especially with the male patients. If a patient is reluctant to get out of bed, Tyrell

often challenges him, saying, “C’mon, man. Don’t be such a wimp. Move your big butt.” Today, you

overheard Tyrell telling a female patient who said she did not feel well, “You’re just a phony. You

like being waited on, but that’s not why you’re here.” The woman started to cry.

1. You are the newest staff nurse on this unit. How would you handle this situation? What would
   happen if you ignored it?
   2.If you decided that you should not ignore it, with whom should you speak? Why? What would you
   say?
   3.Why do you think Tyrell speaks to patients this way?