1. Describe a situation in your clinical practice (current or past) where management/leadership were required to address a problem employee (rule breaker, marginal employee, chemically, or psychologically impaired).
In my clinical practice, there was a colleague who had been assigned to a patient. The nurse failed to appropriately and time assess, monitor, and report the patient's condition on time. As a result, the patient acquired a permanent hearing disability, and the nurse had to face a process of absolving herself from the error. Such primary attention and responsibility always lies with the assigned nurse (Marquis & Huston, 2015). The patient had undergone surgery and was assigned to the said nurse. In the evening patient experienced hypertension and tachycardia. However, the nurse observed atypical behaviors such as the patient refusing nursing care and desiring isolation report these incidences to the physician. The leadership of the hospital had to decide on what should be done in response to the case.
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2. Describe how this employee was evaluated?
The nurse was evaluated based on what she had documented as her actions, the patient's condition compared to the initial and expected states, and how the nurse or whether the nurse carried out the physician's directives. The nurse was also evaluated based on the responsibilities documented in their contract and the nursing ethical codes.
3. What were the performance objectives?
The performance objectives were to achieve safety, patient care, efficacy, continuous learning and development, and accuracy (Harper & Maloney, 2017).
4. What performance strategies and tools were used?
The performance strategies used included checking the structures, processes, and outcomes of the incident. The nurse's tools and equipment during all that time, the kind of bed the patient was checked, and the nurse's credentials. The tools, such as the notes the nurses had made during the shift, were checked.
5. Plot out the quality control process by identifying each step as it played out.
The quality control process in the incident included incoming quality control where the case's initial facts were inspected, the nurse's raw entries, and the patient's condition checked. In-process quality control was done where the incidence was checked with a view of possible outcomes and repercussions both medically and legally. Outgoing quality control was done where the patient's next of kin were notified of the incident and fix it.
6. At the same time, describe how the American Nurses Association (ANA) scope and standards of practice played a role in the evaluation, quality control process, and outcome of this situation (discipline, coaching, referral, etc.).
The American Nurses Association (ANA) scope and practice played a role in the case. The nurse was found negligent in reporting the atypical changes in the patient. The physician explained that such symptoms were signs of the medication and would warrant a reassessment and likely medication change. The nurse, therefore, failed to communicate adequate information and did not play her role as the patient's advocate (Croke, 2016)
References
Croke, E. (2016). Nurses, Negligence, and Malpractice. AJN, American Journal of Nursing 103(9) , 54.
Harper, M., & Maloney, P. (2017). The updated nursing professional development scope and standards of practice. The Journal of Continuing Education in Nursing, 48(1) , 5-7.
Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application. Wolters Kluwer Health| Lippincott Williams & Wilkins.
