Leadership Budgeting

This week we learned about budgeting and healthcare expenses and expenditures. When I first learned of the topic being discussed I didn’t think it would apply to me in nursing but I was pleasantly surprised to learn how much it actually did apply to me and my current job. I really actually enjoyed learning about all the different types of expenses and how healthcare budgets. It was very eye opening to have this insight and explained a lot about why healthcare puts the emphasis on what they do such as supply usage, incremental overtime, waste, and correct charting for charges. I learned that even though one person may think that they do not make a difference within a company, everything they use and do truly adds up overtime and if every employee contributed to increased costs then it would cost an organization a fortune. I also learned that because hospital organizations are typically very large, it becomes even more important for them to watch budget and strive to stay within that budget. I think that healthcare is costly enough without the hospital causing more debt so moving forward I will take what I have learned and apply it to my own nursing practice such as clocking out on time and not to early as to decrease incremental overtime, only use supplies I absolutely need to complete my job and don’t over use what it available. Also decrease my waste by recycling when possible and again not using supplies and other things I do not need.  I want to do my part so I am not a reason for more debt and struggle in our country. 

For the group project this week, I feel grateful to have more minds in thinking about budgeting interview questions because I found budgeting questions to be a bit more tricky than some of the other interview questions. There are times when group work can be challenging but for the most part I really appreciate the team work and help received when it comes to the interview questions. I also enjoy the discussions and seeing other points of view. It allows me to think in ways I probably wouldn’t and provides new insights and opportunities. 

In summary, this was a great week. It was very eyeopening to learn about healthcare budgeting and I was able to understand on a personal level why my work organization stresses the things they do. 

Firing/Disciplining Interview

Firing/Discipline Interview 

The person I interviewed was Mathew Higginson whom works for a sale company called SolarWinds. He does not hire but is in charge of regularly meeting, training, disciplining, and firing sales executives on his team when they do not meet company expectations. 

  1. How do you prepare for a firing/disciplining interview?
    1. Matt said that how he prepares is by gathering all the necessary documentation needed to be filed and reported for proper legalities. He also gathers necessary information or proof  of actions against employee being fired. He then, with a few other managers in the company schedule a meeting time to fire face to face and talk about the issues at hand. 
  2. What is the most difficult part about disciplining or firing employees?
    1. Matt said that the most difficult part about disciplining or firing employees is that he personally knows and works with the employee and he knows how much being fired will affect them and their family. 
  3. What members of the team do you include during firing/disciplining? 
    1. Matt said he typically has the secretary from HR and one or two other managers from other teams present during firing/disciplining. 
  4. How do you begin your firing/discipline interview?
    1. Matt said that almost every employee who is being fired already has met with him about an issue so it isn’t a huge surprise but he gets right into it and start the interview by discussing what actions have caused for this meeting and reminding the employee of previous actions made. He said he tries to keep the meetings short and to the point so he just jumps right in from the very beginning. 
  5. What do you think is essential to include in a firing/discipline interview?
    1. Matt said that providing the necessary documentation is essential so the employee doesn’t have any excuses and all the evidence is at hand. He said it is also important to be organized and not to beat around the bush. He also explains the actions and course as to why the employee is being let go. Matt said that at the end of the meeting he also finds it helpful to provide the employee with an opportunity to speak and clear the air if needed. 
  6. What process do you have to go through before firing someone? Such as verbal/written warnings etc.
    1. Matt said, typically the employee receives a verbal warning and if it continues it become one written warning. After that a meeting among company owners and managers is held to determine if termination is the next necessary course of action.  
  7. Do you know of any offenses that could result in immediate firing?
    1. Matt said proven theft from the company could result in an immediate firing as well as multiple no-shows. 
  8. How many chances will you give a person before you decide that the employee should be fired?
    1. Matt said that typically it’s three strikes your out and after the first two warnings then the third is termination but there isn’t a set of rules and so it depends on the severity of actions and is ultimately based on  manager decision. 
  9. What tactics do you use to make sure the employee does not become angry when they are being fired?
    1. Matt said, he openly explains the reason for termination and states company standards. He ensures clear explanations and reasons so the employee knows its not personal. 
  10. When firing employees, do you call them in for a meeting to deliver the news or do you communicate it through other means such as email?
    1. Matt said he always fires in a face to face meeting unless the employee has stopped coming into the office such as in a no-show situation, then it’s conveyed over an email but otherwise a meeting is the proper method used for discipline/firing. 

After conveying this interview I realized that most companies are extremely fair in that they give employees multiple or more than one warnings and chances for redeemed opportunity. Most companies wont fire over one mistake unless it is a major situation otherwise most companies are somewhat forgiving and expect learning. I also realized that it is important not to drag out the disciplining process and when an employee is not meeting expectations it is better to give them a warning sooner than later so they can have faster opportunity to change actions and do better. 

Summary: Most of all I hope I am never in a situation of discipline or firing and I think most employees who try their best and work their hardest should never have this encounter unless the company is simply downsizing then laying off is appropriate. Unfortunately not all employees will do their best and work their hardest because we are all human and we all have flaws but in life there are consequences for our actions so disciplining and firing is necessary in the workplace. 

Ethical Responsibilities of the Nurse Leader

This week I learned a lot about Ethical dilemmas and the nurse leaders responsibilities during those dilemmas as well as what an Ethical Committee is and what it consists of. Before beginning this unit I wasn’t completely sure what an Ethical committee was or what the reasons were to have such committees. I learned that Ethical committees are there to help determine and make decisions on what the best course of action would be in an ethical dilemma. They are there to study each situation, research to see all points of view, and then come to a conclusion about what actions an employee, group of employees, company, or organization should take based off of morals and values. I learned that an Ethical committee consists of  usually 5 or more individuals such as healthcare workers like doctors, nurses, pharmacists, therapist, etc., religious leaders, someone not involved in healthcare who is involved in the community and can act as a third party, administrators, etc.  

Through this unit and the team work, my mind was opened to just how many ethical dilemmas or issues a nurse faces throughout her career. I also realized how many dilemmas I have already faced in just the short time of being a nurse such as contributing to the opioid crisis, vaccination compliance, and prolonging life through end of life care. These are just a few examples of the ethical dilemmas I have faced and I am sure that I will continue to face more.   Because of these dilemmas, it makes me feel truly blessing to have the support of an ethical committee and to work for an organization who provides one readily. I feel grateful because I realize that they are there to support the patient and employees and are there as backup during tough situations. 

Through the team work I also realized that most healthcare workers feel similar to being involved in ethical dilemmas. Nobody wants to encounter nor participate in them but I realized that everyone in healthcare just wants what is best for ourselves and our patients and there is a lot of support that comes from this. Remembering you are not alone in your job when facing dilemmas and you have a team to back you up is very reassuring. 

Taking what I learned from this unit, I will be more of a support to others facing/involved in ethical dilemmas and if I personally am involved in an ethical dilemma, I will not hesitate or procrastinate in getting others involved such as management and available committees. I will also continually remember the patient and make it a focus not to leave them out of the situation by basing my decisions off of them, their feelings, and their point of view throughout the entire process. 


Performance Appraisal Interview

This week for my Performance Appraisal Interview I interviewed Jake with Spark Inc. Spark Inc. promotes products by digital and social marketing as well as distributing them in retail. Jake is a part owner of the company as well as in charge of training new hires and reporting their performance to the head owners of the company.  He has been a part of this company for 7 years and knows all the ins and outs. 

  1. How often do you schedule performance appraisals?
    1. Jake said he schedules performance appraisals annually only because it is a small company and he works personally alongside with each employee. He feels through personally working with each employee he is able to see their contributions and know their work ethic so performance appraisals are not needed as often as in other companies with more employees. 
  2. How do you prepare for performance appraisals? 
    1. Jake said, “I have a list of questions that is the same for each employee such as how they feel about their job and the company and how they feel they are doing or what they need to improve on”. He sets up personal meeting times and he said he can usually meet with every employee in one day. He said he also likes to look back on each employees accomplishments throughout the past year and bring it up in the meeting. 
  3. Do you agree that peer reviews are helpful and do you use peer reviews for each employee?
    1. He said yes, “peer reviews can be helpful but he does not use peer reviews again because he personally works with each employee and it is a small company he feels he know each of them, is aware of their contributions and work ethic”. 
  4. When performing these appraisals, how do you communicate to your employee that this process is to help them improve rather than tearing them down by pointing out their flaws?
    1. Jake said “I like to go over their accomplishments throughout the past year first and let them know they are doing a good job before recommending changes. I believe all my employees are hard workers so rarely do these performance reviews a negative thing and everyone in the office views them as positive to being with”. 
  5. What are the main performances you focus on while doing these appraisals?
    1. Some of the main performances he focuses on are their ability to communicate effectively with others especially clients, their attitude towards helping the company succeed, motivation, and ability to be personal and professional with clients. 
  6. Do you have your employees set goals for themselves during appraisals and if so do you have them try to meet them in a certain time frame?
    1. Jake said “I do like to ask them where they think they can improve and strongly encourage them to make those areas goals to work on during the year then we will reevaluate the next annual scheduled meeting.  
  7. What are the main questions you ask your employees during the performance appraisal process? 
    1. Jake said he asks them questions about how they feel about the company, how they feel they best contribute to the company, what are their strongest attributes, where do they feel they need to improve, what are they going to change this next year to be more successful, if they have any concerns with their performance, the company, or job description, and is there anything he or the company can do to help or change to make it a better place to work. 
  8. Do you have your staff meet with you for a performance appraisal or is their performance evaluation based solely off of observations from managers?
    1. Jake said he likes to meet with each employee one on one in his office once a year and go over the questions because even though he is a manager and has been evaluating and working with each employee throughput the year, he likes to meet with them because this gives them an opportunity to speak their mind, ask questions, and clarify any unresolved issues. 
  9. How much feedback do you provide during a performance appraisal, is it just a quick update saying here is how you’re doing or do you go into more detail?
    1. Jake said he mostly likes to keep the interviews simple and just use them to clarify any non-understanding, provide a safe opportunity to ask questions or elaborate on issues, and provide some information about company and individual successes. 
  10. Do you tend to score employees highly or do you tend to score them lower so they will see they still have room to improve? 
    1. Jake said he does like to score highly because he knows his business couldn’t thrive without each of his employees and he is very grateful for all they do for the company. He feels that scoring highly is a great way to continue to keep his employees motivated and happy but he won’t score highly if he feels they do not deserve it. He said he is not afraid to confront others when they are in the wrong but he is also comfortable to congratulate them  and appraise their success. 

After doing this interview I learned that performance appraisals are a great opportunity to ask non-urgent questions about the company, your position, or any concerns. I realize that it is rare that you have a managers or team leads full attention during work so appraisals are a great time to utilize their full attention. I think that having performance appraisals more frequently would be beneficial for this reason alone along with many other reasons. I realized through this experience/interview, that most managers or leaders want you to succeed and want to help you be the best you can be because they understand that your attributes have a rippling effect. Even the worst bosses still want their employees to do well so I realized that this is one of the greatest reasons for performance appraisals and they should be viewed as a positive thing for further growth and opportunity rather than a negative or intimidating experience to focus on failure. 

Performance Appraisals & Problem Employees


So far in this semester, it has been very interesting as we are learning from the point of view of the employer or management which is something I am unfamiliar with. This week we discussed performance review and problem employees. I learned that the reason performance reviews/appraisals are used is to see how an employee is doing and its used as a report card, checkup, or measuring stick. It’s also a way to help employees improve their performance and get them to succeed. I also learned that the major key to employee appraisals is consistency. Consistency in frequency, performance measuring, and reviewing. Two things that I didn’t know before were that charge nurses are capable of doing performance reviews also that peer evaluations are for the reviewer to truly see who you are in the workplace because your peers know you best. One of the last parts of the employee appraisal section that we talked about was pay for performance which many companies and hospitals are moving towards. I think that this would be a great motivator to get employees to do more in the hospital I work at and is something I wouldn’t mind them pursuing.

Somethings that I learned about problem employees that I didn’t know before and found interesting was that discipline is not always a bad thing and can be a great motivator for change and to help employees succeed. Also that managers should not be the ones to do exit interviews. I thought this was particularly interesting as every exit interview I have ever had was performed by a manager.

Some things that I learned this week from the team activities is that it can be hard to come to a consensus or agreement on one thing when you have multiple opinions, ideas, and involved people. I experienced that when you have someone in your team who is not willing to hear other people’s remarks or points of view and is set on one idea than it can be hard to come to an agreement. I also noticed that the more passive people like myself will give in and agree with the more stubborn team members just to be done or because they do not want conflict. It can be frustrating and hurt the team as a whole.

Moving forward I will take what I learned and apply it to my own nursing practice in that I will make sure that in a team, every member is heard and has an opportunity to voice their opinions. I also think it is important as a nurse working in a team to see others points of view. This will allow me to broaden my own views and takes on things and I will be better able to adapt and learn. Learning about problem employees and talking about performance appraisals has been motivating in that I want to be the best employee possible and strive for higher achievements. I also hope to never be terminated so I will do what I can to make sure I don’t ever qualify for it.

Team Building & Organization

Some things that I learned this week was about team work and the importance that a team has in accomplishing goals and tasks. I learned that even if one member of the group is not cooperating that it can affect the entire group and make teamwork unsuccessful. I learned about the importance of leadership in teamwork, clear roles and team dynamics as well as the importance of effective communication skills. I also learned about job interviewing and gained perspective on the interviewers point of view. 

Some things I experienced from the team activities was that a team can only be successful if everyone is contributing and holding a role and responsibility. If someone is not following through or doing their part then it is no longer a team and success is hard. My opinion did not change because I know that everyone is different and has different strengths and weaknesses and unless everyone puts in 100% then success is difficult. It isn’t impossible but it is hard to be completely successful. 

Some of my personal feelings is that about team work is that communication is key. Our team struggled to get organized and find a meeting time because there was a complete lack of communication from some of the team members. This was frustrating and difficult. I also feel that it is important to be confident in your role and self when it comes to teamwork so that you can carry your part and work well with others. I did learn that if teamwork is positive and successful then it actually can be a way to build your confident and increase self-esteem. I also feel that trust is extremely important because if you do not trust the people in your team than having success in building each other and accomplishing goals is more difficult and it brings on tension. 

I will take what I learned and apply it to my nursing practice by trying to become of better communicator. I realized that communication is key to success in team work and whether it is a team of a nurse and patient or employee with employer, communication needs to be a focus so everyone is on the same page in achieving goals and expectations. I learned that great growth can come from effective teamwork so I will try to not always take the lead but let others. I will try to give my patients and coworkers a chance to show their leadership skills and find their dynamic within the team. I will also try to establish my own role early on. I will also try to be better at problem solving and trusting the help of others to do so. Nursing isn’t just a sole job but takes help from others to be successful. I will try to allow others to help me more as I like to do things on my own but I realize that that is not being part of a team. 


Hiring Interview

The person in which I chose to interview about Hiring is Nathan Dredge who works in a lead management position for Response Marketing and does most of the interviewing and hiring for the company. 

  1. What past experience makes you qualified for interviewing?
    1. Nathan started a few years before as a main employee working in their calling center. He got to know the company really well during that time and was able to work his way up into a management position. He runs a team of agents and knows what it takes from those employees to make the company succeed. He also had been in prior sales positions and is really comfortable with other people. 
  2. What is the most difficult thing about the interview process? 
    1. Nathan said that one of the most difficult things about the interviewing process is when he gets backlash for not hiring someone. Turning them down for the position is already difficult enough but then when they do not respond professionally makes it that more difficult. 
  3. How many candidates do you typically interview for a job?
    1. Nathan says he typically interviews 5-6 candidates per one or two open positions. 
  4. Do you have a standard set of questions that you ask the candidates?
    1. Nathan says that he does have a standard set of questions for each candidate. He typically keeps the interview professional but likes to throw in a fun question at the end so he can see some personality. 
  5. How do you prepare for interviews?
    1. Nathan said at first when he started interviewing it didn’t go as smoothly but now he feels very comfortable, has the questions already prepared a head of time, and reviews each candidates application thoroughly prior to the interview. He likes to ask them about questions on their application as well. 
  6. Do you interview in a group or one on one, and why?
    1. Nathan says that he almost always interviews one on one because he is the main management person they will be working with and so he is typically interviewing his own coworkers/team members. 
  7. What major qualities are you looking for in candidates?
    1. Nathan says the major qualities he is looking for in candidates is professionalism and also communication skills. The candidates he hires are working with the public and they need to be able to carry on a conversation as well as stay professional and take the job and company seriously. 
  8. When you ask questions are you looking for specific answers or are you just trying to see how the candidate responds under pressure?
    1. Nathan says when he asks questions he does take their answers into account but most of the questions are not right or wrong answers so he mostly looks to see their personality, how they present themselves, and their response under pressure. 
  9. What do you value more, problem solving skills or memorized knowledge?
    1. Nathan says he values problem solving skills more than memorized knowledge because anyone can list or spout out memorized knowledge but when things don’t go as planned or you are wanting improvement its the ones who can think outside the box, provide extra skills, and see things from another perspective that makes a company succeed. 
  10. Do you try to give off an intimidating aura or do you try to make the candidate feel comfortable during the interview process?
    1. Nathan says he tries to make the candidate feel comfortable and relaxed during the interview but at the same time insuring that professionalism is still constantly present. 

After interviewing I learned that a lot of people who do interview are just looking for candidates that are the right fit and depending on the job have the right amount of experience. I also learned that management or the person interviewing should be prepared to answer questions about the job and company from the candidates themselves so knowing the company well and going into an interview prepared is extremely important for an interview to go smoothly and be fair. I also learned that interviewers like when candidates ask questions and share concerns during an interview because it shows the interviewer how much the candidate is prepared themselves. I also learned that during an interview, it is normal to be nervous but just know that the person interviewing is human themselves and showing some personality is a good thing. 

Overall it was really interesting to see the perspective and side of an interview from the interviewers point of view.  It is interesting to see what they are thinking and looking for. Not all interviewers will be a like and depending on the company some of them will be focused on different aspects. I realize that there is a lot of autonomy that an interviewer has in an interview that I didn’t realize before so it is important for both the interviewer and the candidate to be as prepared as possible beforehand. 

Hiring- Nursing Leadership

This week in Nursing Leadership, we focused on hiring from the leadership or employer point of view. This was very eye opening as I typically have only ever focused on the interviewee side of things. I learned a lot about what leadership looks for in an application and what makes an application stand out. I also learned about the interviewing process and the interviewers  responsibilities.

I learned about what is and is not allowed to be discussed or asked by the interviewer and some of the legal aspects of things.  This can be tricky because I think that the more that stands out in a positive way and the more you know about the interviewer, the better and more confident your decision will be in hiring that individual. This is why I learned it is so important to do your research about the interviewee, take your time, and don’t rush to hire because it is the best thing to hire smart. I also learned that leadership doesn’t have to hire if they don’t like any of the candidates because it’s better to wait for the right fit rather than to fill the position for need. This makes me ask the question if there are time frames and certain stipulation as too how picky leadership truly can be and I’m sure it varies from company to company. 

As a group this week we had to come up with interview questions and debate on a possible candidate to hire. It was educational to see others ideas of interview questions and their arguments and reasoning for which candidate to hire. 

Overall, it was very interesting and I learned a lot about what goes on behind the scenes of an interview and hiring process and what the expectations and responsibilities of leadership is in that situation. 

Characteristics of Leaders

  1. Leadership requires personal mastery– Nurses demonstrate leadership when they show competence and mastery in the tasks they perform. Nurses are deemed competent by means of a license to practice nursing (NLN 2010).
  2. Leadership is about values– Nurses demonstrate leadership when they embody and live by five core values which include integrity, autonomy, altruism, human dignity, and social justice. Nurses should integrate these values into their clinical practice.
  3. Leadership is about service– Nurses demonstrate leadership when they serve by creating uplifting and positive moments and experiences for their patients by providing compassionate care by putting health, dignity, comfort, and the well-being of their patient first.
  4. Leadership is about people and relationships– Nurses demonstrate leadership when they provide care that enables the building of relationships with their patients through spending more quality time with them and interacting with them. Meaningful relationships assist nurses in establishing perspective about patient’s preferences.
  5. Leadership is contextual– Nurses demonstrate leadership when they understand how certain interventions will influence a situation at hand both positively and negatively.
  6. Leadership is about the management of meaning– Nurses demonstrate leadership when they are able to resolve conflict by understanding and synchronizing contrasting points of view.
  7. Leadership is about balance– Nurses demonstrate leadership when they are able to provide equal attention and focus between their work and home life.
  8. Leadership is about continuous learning and improvement– Nurses demonstrate leadership when they strive to acquire knowledge, skills, values, behaviors and understanding through experience, study, and teaching.
  9. Leadership is about effective decision making– Nurses demonstrate leadership when they can identify a problem, gather necessary information, evaluate alternatives, weight the evidence, implement a solution, then evaluate actions.
  10. Leadership is a political process– Nurses demonstrate leadership when they can identify where change is needed and how to achieve change through the existing political structure and processes within a system.
  11. Leadership is about modeling– Nurses demonstrate leadership when they demonstrate positive behaviors and values through example and others follow.
  12. Leadership is about integrity– Nurses demonstrate leadership when they live and demonstrate moral and ethical principles such as honestly and trust in every interaction.   


Leadership Theories and Reflective Journal

This week in Leadership I learned about the beginning roles of a leader. To me leadership is someone that others follow and they have a big influence. Leaders should set a positive example and affect others from that example.  One thing I learned was that Leadership and Management, although two different things go hand and hand. I am on maternity leave so I didn’t get the chance to ask someone else but I currently am a charge nurse and so from personal experience some of the expectations that were assumed when I took a charge nurse leadership role was that I was the go to or lead nurse on each shift. With that I needed to be confident in rules, processes, and flow of the floor. I also needed to be available to answer questions and assist with anything at all times during the shift. I also needed to know how to keep the unit safe by knowing processes. I really took it upon me as the charge nurse to make sure we all worked in a safe, happy, uplifting, and healthy environment each shift I work in that role. At first I was very nervous and felt that I needed to know everything but I learned that I have a lot of backup such as doctors and management. I also learned that other departments were there to help or back me up as needed.  

Some other things I learned this week about leadership were that there are three different kinds of leadership styles. First is Autocratic: my way or the high way. Second is Democratic which is vote, group, majority rules . Third is Lassiez-Faire which is doesn’t care as long as it is done. I think that each style has their positive aspects and all three need to come into play together. A good leader has all three. 

The DISC Personality Test: After doing the test I had a tie between being I(influential) and C(Conscientious). This was not totally surprising or new knowledge about myself as Influential people care about others and try to make everyone feel welcome and belonging. They get along with everyone as they can find relation. Conscientious people do not like confrontation. Both of these are common traits of mine as I have always put other peoples needs and feelings before my own and have always struggled with confrontation. The one part that surprised me was that Influential people are said to struggle with tasks and getting things done. I would have to disagree as I feel I am a very task oriented person. Moving forward as a leader knowing this information I will take the positive traits and try to focus on utilizing the more. I also will remember the negative traits and try to work on changing them to become a better leader.   

After participating in the group project, I realized that a leader can really be another who influences others affecting actions. A leader can influence both negatively or positively. There were many leaders in history and looking at the provided list of individuals, one could argue that all of the individuals were leaders at one point in time. I like to think that leaders can only have a positive effect but in reality a lot of leaders in history had negative effects such as Hitler. I really believe that anyone who motivates others and their actions is a leader. 

After reviewing all the material this week, I was able to learn and reflect on qualities of a leader and in what ways leaders can influence others. Moving forward in my nursing practice, I hope to be a positive leader instead of a negative leader because I learned that if you are not careful you could be either. I hope to achieve this by understanding what my positive and negative qualities are and then take my positive qualities and utilize them more and instead of suppressing the negative qualities try to change them. I also learned that balance is important with leadership in that you cannot be too strong in some types of leadership styles. This is important to understand in becoming a good leader. I don’t think that becoming a leader will happen overnight and it will be accomplished through continuous example but I hope that the information learned this week will help me become a better positive leader.