Presented with the case of Cindy Jennings and how to best address it, it seems that the first step should be the nurse manager’s attention to Justin McDonald’s own failures as the charge nurse. If Justin is to continue on in this role, it is essential that he understand how vital it is that any problem in a nurse’s performance be addressed as immediately as possible. Remarkably, he failed to document any interaction with Cindy, as she has been lacking in performance in a range of ways. Before the need to address Cindy’s situation is dealt with, then, the manager must be confident that Justin understands how important it is to document transgressions and/or have third party witnesses present during verbal and written reprimands.

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Given Justin’s lack of any address of the issues with Cindy, then, the best means of dealing with her tardiness, etc., would be for the manager and Justin to meet with her and discuss the realities of poor performance. Management must acknowledge that it neglected to address the issues earlier, in any form, so this is in effect the first disciplinary action. All of Cindy’s performance problems should be covered, and Cindy should sign documentation affirming the process. She should as well be made to understand that, as this is an initial warning, any further performance issues will result in additional, written reprimands followed in turn by disciplinary measures. The forms of the latter are within the manager’s discretion but, and the failure to address the problems earlier notwithstanding, the measures should be strong, as in possible suspension or termination, because Cindy’s performance is consistently poor. It must be emphasized at the meeting that this action is a warning, and the first such that Cindy has received.

As to policy guiding actions from this point, it is repeated that any nurse with authority over others is obligated to address issues as they arise, and also document them. Then, this goes to communication in general. It seems that Justin failed to understand how performance expectations of nurses must be made clear, and in an ongoing process (Cherry, Jacob, 2013, p. 298). Communication is critical because both nurse and leader/manager must be “on the same page” regarding what each understands the responsibilities of the nurse to be. This in turn relates to the understanding that any issues in meeting these expectations will have repercussions. Consequently, with regard to Cindy and all nursing staff, a structure of discipline must be the policy, and supervisors failing to follow this will be subject to discipline themselves.

Justin’s failures regarding Cindy definitely impact on both patients and staff, and not in positive ways. Cindy was, importantly, a relatively new hire, and it is then all the more important that supervision be maintained consistently (Cherry, Jacob, 2013, p. 357); his lack here then suggests a similar irresponsibility with other nurses. This then endangers the nurses themselves. The level of competency of a nurse is crucial to his or her career, as any charge of poor performance may bring action against that nurse from patients, doctors, or administration itself. Also, and given the nature of health care in general, the nurse who, like Cindy, is repeatedly late or absent presents serious risks to patients, and also requires the nursing staff to make adjustments not serving the interests of the patients as they should be served. This reality is reinforced by how a single complaint against a nurse may lead to an investigation (Duclos-Miller, 2004, p. 44). In brief, then, Justin’s negligence affects patients receiving less than proper care, and nurses who are not given the opportunity to improve their performance because their issues are not addressed.

    References
  • Cherry, B., & Jacob, S. R. (2013). Contemporary Nursing: Issues, Trends, & Management, 6th Ed. St. Louis: Elsevier Health Services.
  • Duclos-Miller, P. A. (2004). Managing Documentation Risk: A Guide for Nurse Managers. Marblehead: HC Pro, Inc.