Deck 25: Managing Personnel Challenges

Question 1

All of the following are grounds for immediate dismissal except:

A) Failing to pursue further medical help for a patient,after which the patient dies.
B) Selling narcotics obtained from the unit supply of narcotics.
C) Restraining a patient in bed for 7 hours,unsupervised,as punishment for hitting a staff member.
D) Grabbing the unit manager and threatening further physical harm after a poor performance appraisal.

Answer 1

Failing to pursue further medical help for a patient,after which the patient dies.

Question 2

The nurse manager notices that Tia,a staff nurse,has been absent 2 to 3 days per month for the past 3 months.What is the manager's best response?

A) "Why are you absent from shifts every month?"
B) "I am concerned that you have been absent 3 days this month."
C) "Your attendance record is not very good.Do you want to talk about it?"
D) "I am changing your shift rotation as it is obvious that you are not able to consistently implement your scheduled shifts."

Answer 2

"I am concerned that you have been absent 3 days this month."

Question 3

The nurse manager knows that the most serious effect that absenteeism has on the nursing unit is that:

A) Using replacement personnel with new ideas may be beneficial.
B) Salary costs are lower because personnel are fewer,and outcome is favourable.
C) Absence on the part of the rest of the staff is decreased.
D) Unacceptable patient care may result.

Answer 3

Unacceptable patient care may result.

Question 4

Nurses generally experience difficulty in identifying behaviours and actions that could signal chemical dependency in a coworker.Which of the following is not a behavioural change that occurs with chemical dependency?

A) Personality and behavioural changes.
B) Job performance changes.
C) Changes in educational involvement and pursuit.
D) Absenteeism.

Question 5

When progressive discipline is used,the steps are followed progressively only for repeated infractions of the same rule.On some occasions,the breaking of rules is so serious that the employee is:

A) Transferred to another unit.
B) Suspended indefinitely.
C) Asked to attend a union grievance meeting.
D) Terminated after the first infraction.

Question 6

You need to terminate Gregory,who has had a long-standing history of conflict with you and the staff and who recently was charged with theft of patient belongings.You consult the human resources department,and together you develop a plan,which includes:

A) A private meeting with Gregory,a human resources representative,and you to deliver the news and deliver the employment termination notice and all other documents that are related.
B) Planning an opportunity for Gregory to return and be recognized at a staff farewell.
C) Calling Gregory at home to tell him that he is fired and that his paperwork will be sent to him at a future date.
D) Calling him into a meeting in your office on the ward,where assistance is available,should he become upset or agitated.

Question 7

Aurora,RN,is a self-admitted drug addict and has abused codeine heavily.Aurora and the unit manager decide that changes have to occur.Aurora enrolls in an addiction program,and the manager has her transferred to a drug-free area.What other strategies might be appropriate?

A) The manager could refer Aurora to the human resources department.
B) The manager could assist in monitoring Aurora's progress.
C) The manager could counsel Aurora if Aurora has formed a trusting relationship with her.
D) Aurora needs to be asked not to involve her family in the recovery program because this is a work-related situation.

Question 8

A nurse manager must be familiar with the agency's policies regarding employment termination.Termination procedures include which of the following?

A) Following specific procedures at other organizations.
B) Having an attorney present at the termination meeting.
C) Having adequate written documentation to support the action.
D) Having a friend present during the termination meeting.

Question 9

The nurse manager places a staff member on probation because of reports of chemical dependency.The nurse manager should be aware that which of the following statements is true regarding chemical dependency?

A) The chemically dependent employee usually hides any changes in behaviour.
B) When confronted with the issue,the affected employee is usually relieved to have someone to talk to about the problem.
C) The chemically impaired nurse affects the entire health care organization.
D) Hospital policy,state laws,and nurse practice acts address procedures for the chemically dependent employee in the most general terms.

Question 10

Before terminating an employee,a nurse manger must:

A) Be an expert in all legal aspects of employment termination and discipline practices.
B) Know the organization's specific policies for addressing disciplinary problems and employment termination.
C) Function as a counsellor for problem employees.
D) Do everything to assist and protect the employee by adjusting standards and policies.

Question 11

The chief nursing officer understands that clinical incompetence is best prevented by which of the following?

A) A flexible protocol for evaluating competency skills.
B) A standardized clinical skills checklist.
C) A newly established peer review process.
D) A formalized competency program with established standards for practice.

Question 12

The chief nursing officer reviews the policy about "progressive discipline process." The progressive discipline process includes which of the following?

A) The manager is a counsellor and friend to the employee.
B) The manager should reprimand and suspend the employee as a last resort.
C) The manager should rehire the employee after a reasonable length of time.
D) The manager should terminate the employee if the problem persists.

Question 13

In keeping with guidelines of the organization,the nurse manager documents staff problems.Documentation of disciplinary problems should:

A) Include a plan to correct them and to prevent future occurrences.
B) State a detailed history of past problems that are related to the current one.
C) Be written at the convenience of the manager.
D) Accumulate until the evaluation period begins.

Question 14

The most important approach that a nurse manager can take with an emotionally troubled employee is to:

A) Act as a therapist for the employee.
B) Adjust the standard of care to assist the employee.
C) Assist the employee in obtaining professional help.
D) Adjust the employee's work schedule to decrease stress.

Question 15

Nathan has been on the cardiac unit for 6 months and has found it difficult to adjust to the expectations of his team.Which of the following behaviours are most likely to signal that Nathan is intending to resign from his position on the unit?

A) Increased absenteeism over the past month.
B) Increased attempts to discuss his concerns with his colleagues.
C) Testing of workplace guidelines.
D) Frequent defensiveness.

Question 16

Incivility is a disruptive behaviour or communication that creates negativity in the environment and interferes with quality of patient care and safety.The manager can implement steps that help to alleviate uncivil behaviour on a unit.Which of the following would not be an appropriate first step?

A) Suspending the staff member from work.
B) Providing written admonishment that is discussed and placed in the employee's file.
C) Providing verbal admonishment.
D) Terminating the staff member.

Question 17

A nurse manager understands that the second step in handling an employee with a disciplinary problem is to document the incident.Which of the following is best for documentation of personnel problems?

A) Use of the performance appraisal on an annual basis.
B) Notes made immediately after an incident that include a description of the incident,actions taken,plans,and follow-up.
C) A tally sheet of medication errors and other specific problems that will be used at annual review.
D) Copies of reports,placed in the employee's file,of all unusual occurrences involving the employee.

Question 18

A nurse manager understands that the typical first step in handling an employee with a disciplinary problem is to:

A) Provide a verbal reprimand.
B) Prepare a written reprimand.
C) Counsel the employee regarding the problem.
D) Give the employee the day off without pay.

Question 19

Susan,a new graduate,is upset that so many staff members have been absent lately from the unit.She declares to you that all absenteeism could be eliminated with proper management.Your response is based on understanding that:

A) Not all absenteeism is voluntary.
B) High personal control contributes to absenteeism.
C) Direct discussions with employees who have high levels of absenteeism are not recommended.
D) All absenteeism is related to personal issues and needs.

Question 20

The nursing director calls a meeting with one of the new unit managers.She is very concerned about a report of substance abuse on the manager's unit,and she reviews the procedures involved in dealing with chemically dependent staff.Which of the following statements would not be included in the discussion?

A) "As a manager,you need to be aware of professional regulatory reporting requirements."
B) "As a manager,you should check with the human resources department regarding chemically dependent employees and employment practices."
C) "As a manager,you check the nurse practice acts for the province in which the nurse resides."
D) "As a manager,you should realize that the nurse is a professional embarrassment and should be kept out of sight of other staff."

Question 21

Clinical incompetence is one of the more serious problems facing a nurse manager.Joyce,the nurse manager,is not aware of the problems of Sarah,a novice nurse.After she investigates,it is obvious that Sarah's peers are covering for her.Which of the following might Joyce include in her meeting with the nurses? (Select all that apply.)

A) "It is a nurse's professional responsibility to maintain quality control."
B) "All instances of clinical incompetence are to be reported."
C) "It is not considered being disloyal when one nurse reports another for poor care."
D) "Patient care is the number one concern.Meeting standards is mandatory and necessary."
E) "None of above"

Question 22

The unit manager discusses absenteeism with the unit clerk.She indicates that it is a serious problem on the unit.Which of the following points would they have probably discussed?

A) Employee morale is at a high level.
B) Care will suffer and standards will be lowered.
C) Existing staff have experienced little effect from the absenteeism.
D) Replacement staff usually needs little supervision.

Question 23

A nurse's emotional transference from past trauma may affect their ability to function within a clinical setting.A manager must be attuned to a nurse's level of emotional well-being.Which of the following could demonstrate a nurse who is exhibiting signs of past trauma? (Select all that apply.)

A) Hostility toward others.
B) Addictive tendencies.
C) Maladaptive perfectionism.
D) Testing of workplace guidelines.
E) None of above

Question 24

Role strain can result in which of the following manifestations? (Select all that apply.)

A) Withdrawal from interaction.
B) Feeling of belonging.
C) Job dissatisfaction.
D) Decreased commitment to the team.

Question 25

Although the Health Professions Acts and professional nursing standards and competencies vary across Canada,the underlying expectation is that members of any health care profession recognized in Canada have on overarching mandate to:

A) Maintain competence.
B) Uphold nursing practice standards.
C) Duty to report.
D) Protect the public.

Question 26

The education consultant for the hospital is presenting a workshop on "Documentation: A Manager's Responsibility." Which of the following points concerning documentation of personnel problems would she not include in her PowerPoint presentation?

A) "Documentation cannot be left to memory.A notation must be placed in the personnel file."
B) "Documentation should avoid discussion of the problem."
C) "Documentation should include what was done about the problem when it occurred."
D) "Documentation needs to include date,time,and place."

Question 27

Many employers have moved from a progressive discipline approach to a nonpunitive approach.The value of this approach is? (Select all that apply.)

A) Enables both parties to attain their dignity.
B) Takes longer to determine an actable outcome.
C) Minimizes ambiguity related role stress.
D) Shifts the responsibility to act from the manager to the employee.