Deck 20: Feedback and Coaching, Disciplining, and Terminating Staff

Question 1

An employee has consistently violated policy and has not responded to coaching. The manager has decided that discipline is required. What should the manager do first?

A) Plan a private meeting for the disciplining.
B) Wait for one more infraction to occur and discipline immediately afterward.
C) Make certain that the information regarding policy violations is correct.
D) Keep the human resources department informed.

Answer 1

Make certain that the information regarding policy violations is correct.

Question 2

A nursing assistant has taken long lunch breaks for the last 2 days and today is 15 minutes late returning from the cafeteria. What should the manager do? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Go to the cafeteria and confront the assistant.
B) Send a message with a nurse going to lunch for the assistant to return to the unit immediately.
C) Call the cafeteria and ask that they send the assistant back to the unit.
D) Meet with the assistant and calmly say, "You have been late back from lunch for 3 days this week."
E) Anticipate that the assistant will give an explanation for the lateness.

Answer 2

Meet with the assistant and calmly say, "You have been late back from lunch for 3 days this week."
Anticipate that the assistant will give an explanation for the lateness.

Question 3

The nurse manager identifies a minor problem with the way a staff nurse documents client care. The manager meets with the nurse and discusses the issue, but does not issue a warning. What is the manager's next action?

A) Report the meeting to the human resources department.
B) Enlist the aid of a more experienced nurse to help monitor the documentation.
C) Record the specific behavioral steps discussed for future reference.
D) Tell the nurse that failure to comply with steps discussed will result in a written warning.

Answer 3

Record the specific behavioral steps discussed for future reference.

Question 4

A certified nurse's aide (CNA) has been reported to the nurse manager for refusing to perform hand hygiene between clients when providing morning care. Which statement by the nurse manager would be the most effective?

A) "Do you need a class on hand hygiene?"
B) "Forgetting to perform hand hygiene between clients can spread infection."
C) "Why do you refuse to perform hand hygiene?"
D) "If I hear of any more instances of you not performing hand hygiene, I will write you up."

Question 5

An OB nurse has violated a unit policy. The OB manager is discussing the incident with the nurse. During the discussion, the nurse informs the OB manager of the actions of other staff and the physician's attitude leading up to the event. How should the manager address these issues?

A) Tell the nurse that physician's attitude is none of the nurse's business.
B) Inform the nurse of the policy violation.
C) Inquire about the physician's attitude and the staff actions during the incident.
D) Redirect the nurse to focus on the issue.

Question 6

A nurse has frequent visitors while working. The manager has discussed with the nurse the negative effect of these visits on client care. What should the manager do next?

A) Ask staff if the visits have decreased.
B) Arrange a follow-up meeting with the nurse.
C) Counsel all nursing staff regarding the limitations of personal visitors.
D) Arrange to be visible on the nursing unit when this nurse is working.

Question 7

The staff has complained that a nurse receives frequent personal phone calls, which is a violation of policy. In what manner should the manager address this nurse?

A) Meet with the nurse privately and inquire as to the necessity of personal phone calls.
B) Meet with the nurse and give a verbal warning.
C) The manager should inform the nurse that the other nurses are complaining about the phone calls.
D) Tell the complaining nurses to handle the situation with peer pressure.

Question 8

A charge nurse on the night shift did not notify the anesthesiologist regarding an emergency case. The manager investigated the matter and learned the charge nurse thought the primary care nurse would call the anesthesiologist. Which response by the manager would be most appropriate?

A) "It is in your job description and your duty."
B) "It is your responsibility. In the future, call anesthesia and transfer the call to the primary nurse."
C) "It's not the surgery nurse's responsibility to call anesthesia!"
D) "Why was this considered an emergency case?"

Question 9

A terminated employee files a grievance against the nurse manager. Which situations would benefit the employee's claim? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The nurse manager wrote notes on the expectations discussed during disciplinary sessions.
B) The terminated employee's last evaluation discusses problems with performance, but no coaching is described.
C) When problems with the employee arose, the manager's average time of intervention was less than 1 day.
D) There are notes in the employee's record from human resources indicating the nurse manager had discussed issues with the HR director.
E) In one note, the manager describes the employee as "petulant, immature, and uncaring."

Question 10

Which statement by the nurse manager is the best example of day-to-day coaching?

A) "Can we meet this afternoon for about 30 minutes to discuss your progress?"
B) "I think you need to get different child care that would allow you to be on time."
C) "Over the past 6 months the narcotics count has been off on several days that you have worked."
D) "Let me show you a method I have found to be effective in making client assignments."

Question 11

The nurse was reported for not following unit policy in relaying a client's complaint regarding another staff member. During a meeting, the nurse insists he managed the situation appropriately. How should the manager respond?

A) "Let's schedule another meeting for later in the week after you have had time to reflect on the situation a little more."
B) "Let's explore some alternative solutions to what happened."
C) "I am going to request a meeting for both of us and the human resources director."
D) "As I see it, the problem is your inability to follow the simplest of unit policies and to take direction."

Question 12

An ICU nurse does not follow policy when administering a medication intravenously. Which would be the most appropriate action by the manager to assist the employee?

A) Provide written instructions for administering the medication.
B) Remediate the situation with the ICU staff.
C) Provide a copy of the policy and discuss the rationale for the policy as it relates to client care.
D) Reprimand the ICU nurse for giving the medication.

Question 13

A nurse who receives frequent phone calls informs the manager the phone calls are related to a health crisis concerning a family member. Other nurses also receive personal calls, but not as many as the first nurse. Which action by the manager is appropriate?

A) Tell the nurse to have family call the manager's office if there is a crisis.
B) Discuss with the nurse how personal phone calls may affect client care and should be limited.
C) Inform the nurse that the phone calls are causing morale issues among the staff.
D) Lift the policy against staff carrying personal cell phones for this nurse while the crisis continues.

Question 14

The nurse manager is coaching an employee who has been late for work three mornings this week. What statements and questions should the manager include in this coaching session? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "What is causing you to be late?"
B) "When you are late it throws the pace of the entire unit off and client care suffers."
C) "Does it not bother you that your lateness makes everyone else's job more difficult?"
D) "You have been late three times this week and that is not acceptable."
E) "What are you going to do to avoid being tardy again?"

Question 15

A newly hired certified nurse's aide (CNA) has been 15 minutes late returning from mealtime 4 days this week. The nurse manager coaches the employee and finds the CNA thought meal breaks were 45 minutes. What is the most appropriate response from the nurse manager?

A) Document the tardy behavior in the CNA's record.
B) Show the CNA the break hours in the employee handbook.
C) Warn the CNA tardiness is not tolerated and follow up in 2 weeks.
D) Warn the CNA that the charge nurse will be timing future meal breaks.

Question 16

A nurse has been pulled from the surgical unit to the ICU unit and is asked by an ICU nurse to administer a medication that requires monitoring the cardiac rhythm. When asked about the client's cardiac rhythm after the medication was administered, the surgical nurse states, "I don't know." What actions should be taken by the unit's nurse manager? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Meet with the ICU nurse to discuss the situation.
B) Meet with the surgical nurse to discuss the situation.
C) Give a written warning to the surgical nurse for not following policy.
D) Give a written warning to the ICU nurse for not following policy.
E) Meet with the nurses together and issue an informal verbal warning to both.

Question 17

It has been reported to the nurse manager that an employee is repeatedly parking in the client/visitor parking area. What action should the manager take?

A) Confront the employee.
B) Check the parking lot each morning.
C) Discuss the issue at the next employee appraisal.
D) Provide an education session for all staff regarding parking policy.

Question 18

A manager has been informed by a reliable RN that an assistant lied about bathing a client. The manager calls the assistant into the office with a written warning. Why is this action inappropriate?

A) The RN should issue the warning.
B) The first warning should be verbal.
C) The assistant should be allowed to discuss the matter.
D) This type of action should be conducted by the human resources department.

Question 19

Coaching and discipline have failed and the nurse manager is faced with no alternative but to terminate an employee. Which aspect of this situation requires the most careful planning?

A) When the termination will occur
B) How to keep the human resources department informed
C) Accurately documenting all stages of the situation
D) Whether the termination will adversely affect unit staffing

Question 20

What is the primary reason a nurse manager would confront a nurse who has been reported for violating infection control policy?

A) To punish the guilty
B) To protect the institution from liability
C) To set an example for other employees
D) To encourage the correct behavior

Question 21

________ is the day-to-day process of helping employees evaluate and improve their performance.

Question 22

In order for coaching to be effective, the nurse must be what?

A) Able to understand coaching
B) Psychologically able to accept coaching
C) Able to follow up
D) Open to the process
E) Capable of changing performance

Question 23

A nurse is being terminated due to continued violation of hospital policy. What statements by the manager are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Your actions have been degrading to the profession."
B) "You may wish to resign rather than being terminated."
C) "Human resources will answer any questions you may have about benefits."
D) "I'm sorry you could not be happy here."
E) "You are being terminated for the policy violations I have just outlined."

Question 24

An OB manager discusses a nurse's performance with the chief nurse officer (CNO). The CNO learns the nurse has had multiple client and physician complaints that the manager investigated and for which counseling was provided. The behavior continues even though the nurse has received verbal and written warnings. Which course of action would be most appropriate at this time?

A) Issue a written warning from the CNO.
B) Place the nurse on suspension pending a new investigation into the complaints.
C) Terminate the nurse.
D) Transfer the nurse to another department under another manager.

Question 25

The manager has disciplined a nurse with a written warning. At the end of the session, the manager asks the nurse to sign the warning and the nurse refuses. What should the manager do?

A) Tell the nurse that signing the form in mandatory.
B) Indicate on the form that the nurse declined to sign.
C) Sign the nurse's name to the form and include the manager's initials.
D) Complete a second warning for the nurse's failure to follow procedure.

Question 26

The manager has just terminated a nurse. What statement by the manager is appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "You may go back to the unit to say good-bye to your coworkers."
B) "We have cleaned out your locker and have your personal belongings ready for you."
C) "I have notified security to escort you as you leave the building."
D) "As of this time, you are no longer an employee of this institution."
E) "Please do not discuss your termination with any other nurses."

Question 27

A nurse has complained to the human resources (HR) director regarding unfair treatment by the nurse's manager. The nurse describes receiving a written warning, unlike other nursing staff who exhibit similar behaviors but are not reprimanded. Which concerns would the HR director discuss with the hospital chief nursing officer? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The unusual management styles within the department
B) Confronting the manager's direct supervisor about allowing this situation to occur
C) The apparent inconsistencies in discipline within the unit
D) The potential for litigation that arises from this complaint
E) The need to terminate this problem employee

Question 28

An ICU nurse manager has been struggling to correct client care issues on the unit and has asked the unit director for assistance. The director says, "Training and discipline on your unit is your responsibility. I have other things to do." Now, the manager is faced with disciplining a nurse regarding another client care issue. What is the most significant reason this manager is hesitant to administer this discipline?

A) The nurse may quit.
B) The nursing staff is a cohesive group and might retaliate.
C) The manager is not comfortable with confrontation.
D) The manager does not feel supported by the director.

Question 29

The manager is contemplating terminating a nurse. What should the manager consider regarding the expectations of the job prior to proceeding with termination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Did the nurse receive and sign for a copy of the appropriate job description when hired?
B) Was the nurse apprised of the criteria on which evaluation would be based?
C) Have any changes to policy and procedure been discussed with the nurse and made available in writing?
D) Was the nurse hired using the same documentation as others hired at the same time?
E) Have others hired during the same time period been successful?

Question 30

A director must discipline an ICU manager. The director and manager have become friends. When disciplining the manager, what is the best approach by the director?

A) Notify the human resources director that the meeting will occur.
B) Include the chief nurse officer (CNO) in the session.
C) Ask a manager from another department to sit in on the meeting.
D) Discuss the issue, concentrate on the issue, and do not make it personal.

Question 31

The hospital's new management company has assigned a "leadership coach" to groups of current nurse managers. Which statements made by a manager would the coach interpret as indicating the manager does not value this opportunity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Why do I need a coach?"
B) "I've been a manager longer than our coach has been a nurse."
C) "I'm getting burned out with the way we manage."
D) "Another new program to waste our time."
E) "Coaching has helped my nurses improve their practice."

Question 32

An emergency department (ED) manager is disciplining a nurse with a history of multiple client and staff complaints. The last disciplinary action was a verbal warning. If the institution follows the progressive method of addressing disciplinary issues, the manager would prepare for which action?

A) A written warning
B) A counseling session
C) Another verbal warning
D) Termination