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Constructive vs. Destructive
ã _   can be defined as a training or molding of the
mind or character to bring about desired behaviors.
º comes from the Latin term
    and growing

㠄    is defined as an undesirable event that follows

an instance of unacceptable behavior and is intended to
decrease the frequency of that behavior (Guffey & Helms,
_  _

ã  ses threats and fear to control behavior.
ã This ͞big stick͛͛ approach to management focused on
eliminating all behaviors that could be considered to
conflict with organizational goals.
ã May succeed on a short-term basis, it is usually
demotivating and reduces long-term productivity,
because people will achieve only at the level they
believe is necessary to avoid punishment.
4  _

ã 4    
  uses discipline as a means of
helping the employee grow, not as a punitive
㠄unishment is frequently included when defining
discipline,but it also can be defined as training,
educating, or molding.
ã In constructive discipline, punishment may be
applied for improper behavior, but it is carried out in
a supportive, corrective manner.
„rogressive Discipline Model


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„rogressive Discipline Model

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1. Investigate thoroughly the situation.
2. To consult with either a supervisor
or the personnel department before
dismissing an employee.
„erformance Deficiency Couching

requires planning than 
Disciplinary Conference
Reason for Disciplinary action
Employee͛s Response to Action
Rationale for Disciplinary Action
Clarification of Expectations for Change
Agreement and Acceptance of Action
Termination Conference
1. Calmly state the reason of
2. Explain to the employee the
termination process.
3. Ask for employee input.
4. End the meeting on a positive not
if possible.
£hen employees and managers
perceive ͞fair͟ and ͞just͟ differently,
the discrepancy can usually be
resolved by a more formal means.
Common „ersonnel „roblems
I. Marginal employee
- Often make tremendous efforts to meet competencies, yet
usually manage to meet only minimal standards at best.
Marginal employees usually do not warrant dismissal, but they
contribute very little to overall organizational efficiency.

A. £ays in dealing with marginal employees

a. Ignore and attempt to ͞work around͟ the
employee (low-level managers)
b. Transferring the employee to other unit or
c. terminating or suggesting him/her for early
d. Active coaching and counseling
II. Chemically impaired
- nurses whose practice is impaired by
substance abuse or psychological dysfunction.

A. £ays in dealing with chemically

impaired employee
a. Dismissal
b. Suggestion of rehabilitation
=. Recognizing chemically impaired employees (three primary
a. „ersonality/behavior changes
ͻ Increased irritability with patients and colleagues, often
followed by extreme calm
ͻ Social isolation; eats alone, avoids unit social functions
ͻ Extreme and rapid mood strings
ͻ Euphoric recall of events or elaborate excuses for behaviors
ͻ  nusually strong interest in narcotics or the narcotic cabinet
ͻ Sudden dramatic change in personal grooming or any other
ͻ Forgetfulness ranging from simple short-term memory loss
to blackouts
ͻ Change in physical appearance, which may include weight
loss, flushed face, red or bleary eyes, unsteady gait, slurred
speech, tremors, restlessness, diaphoresis, bruises and cigarette
burns, jaundice, and ascites
ͻ Extreme defensiveness regarding medication errors
b. Job performance changes
ͻ Difficulty meeting schedules and deadlines
ͻ Illogical or sloppy charting
ͻ High frequency of medication errors or errors in
judgment affecting patient care
ͻ Frequently volunteers to be medication nurse
ͻ Has a high number of assigned patients who complain
that their pain medication is ineffective in relieving their
ͻ Consistently meeting work performance requirements
at minimal levels or doing the minimum amount of
work necessary
ͻ Judgment errors
ͻ Sleeping or dozing on duty
ͻ Complaints from other staff members about the quality
and quantity of the employee͛s work
c. Time and attendance changes
ͻ Increasingly absent from work without adequate
explanation or notification; most frequent absence on
a Monday or Friday
ͻ Long lunch hours
ͻ Excessive use of sick leave or requests for sick leave
after days off
ͻ Frequent calling in to request compensatory time
ͻ Arriving at work early or staying late for no apparent
ͻ Consistent lateness
ͻ Frequent disappearances from the unit without
C. Confronting the chemically impaired employee
a. 1st phase - the data- or evidence-gathering
phase, the manager collects as much hard
evidence as possible to document suspicions of
chemical impairment in the employee. All
behavior, work performance, and time and
attendance changes presented in the displays in
this chapter should be noted objectively and
recorded in writing. If possible, a second person
should be asked to validate the manager͛s

b. 2nd phase ʹ direct confrontation

D. The manager͛s role in assisting chemically
impaired employee

E. recovery process
a. 1st phase - the impaired employee continues to
deny the significance or severity of the chemical
impairment but does reduce or suspend chemical
use to appease family peers, or managers.

b. 2nd phase - as denial subsides, the impaired

employee begins to see that the chemical
addiction is having a negative impact on his or her
life and begins to want to change.
c. 3rd phase - the person examines his or her values and
coping skills and works to develop more effective coping
skills. Frequently, this is done by aligning himself or herself
with support groups that reinforce a chemical-free
lifestyle. In this stage, the person realizes how sick he or
she was in the active stage of the disease and is often
fraught with feelings of humiliation and shame.

d. 4th phase - people gain self-awareness regarding why

they becam chemically addicted, and they develop coping
skills that will help them deal more effectively with
stressors. As a result of this, self-awareness, self-esteem,
and self-respect increase.£hen this happens, the person is
able to decide consciously whether he or she wishes to
and should return to the workplace.
F. Reentry of the chemically impaired
employee into the workplace
The following are generally accepted reentry guidelines for the recovering
ͻ No psychoactive drug use will be tolerated.
ͻ The employee should be assigned to day shift for the first year.
ͻ The employee should be paired with a successful recovering nurse
ͻ The employee should be willing to consent to random urine screening with
toxicology or alcohol screens.
ͻ The employee must give evidence of continuing involvement with support
groups, such as Alcoholics Anonymous or Narcotics Anonymous.
should be encouraged to attend meetings several times each week.
ͻ The employee should be encouraged to participate in a structured
ͻ The employee should be encouraged to seek individual counseling or
as needed.
ã Voluntary absenteeism ʹ absenteeism under
employee͛s control
ã Involuntary absenteeism- absenteeism that is
not under employee͛s control
ã Total time lost- number of scheduled days an
employee misses
ã Absence frequency-total number of distinct
absence periods, regardless of their duration

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Attendance Model
ã Factors affecting an employee͛s motivation:
º Job itself
º Organizational practices
º Absence culture
º Supervision
º Labor market
º Employee͛s personal characteristics
Managing Employee Absenteeism
ã Actions the organization can take:
º Sponsor childcare center
º „rovide shuttle buses or coordinate car pools
º Health fairs, exercise programs, & stress
reduction classes
º Employee assistance plan
ã As a nurse manager:

º Coaching
º Motivating
º Enriching staff nurse͛s job
º Reducing job stress
º Creating a norm of excellent attendance
º Enhancing advancement opportunities
º Improving co-worker relations
º Trying to select employees who will be
satisfied with and committed to their jobs
º =eing a good role model
º Discussing employee͛s attendance during
performance appraisal interview
º Rewarding good attendance
º Enforcing absenteeism control policies







Employees who are always complaining,

behavior that affects the morale unit.