Question

Imagine yourself as night-shift charge nurse on a medical-surgical unit. For several months you have had a problem with a staff nurse whose performance you consider unsatisfactory. She seems to continually take advantage of quiet times during her shift to doze off at the nursing station. You have orally reprimanded her several times for sleeping on the job, and you have reached the point where you believe you can no longer simply scold her for her conduct. Her position, however, is “it’s no big deal,” that she's always certain to hear any call signals as long as she's at the nursing station. (Your hospital has a clear policy concerning written warnings, the policy is relatively loose concerning all oral warnings; these can be unlimited and issued at your discretion, so you can deliver as many as you believe necessary.)

For written warning to become official and the entered into an employee's personal file, it must be agreed to and countersigned by the unit nurse manager and the director of nursing. You issued the offending nurse two written warnings, both cleared only through the unit manager. However, you believe you can go no further without backing from the director of nursing, and there has been no follow-up from that direction. Meanwhile, the employee continues to be a problem.

1. If no follow-up from the director of nursing is forthcoming, what might you eventually consider doing to protect yourself?

Answer 1

Every organisation has some hierarchy within the organisation for the decisions to be taken. As mentioned in the question, the warning to become official, it is must that written warning to be approve by both the Unit Manager and the Director of nursing. Therefore, to do so, every written warning must be first approved by unit manager and then to be send to director for his signatures.

Here instead of giving the letter to be signed by the Director in hard copy to him, better would be to give the same via email explaining the reasons of such warning and count of oral warnings that already given to such nurse and her repeated behavior that forced you to take such step in written. Then, ask him his convenient time of availability to take his signatures in hard copy. This will make the matter more serious as now you have written prove of delegating the task to him over which he has the responsibility to do so and he delayed it for whatever reason he has for justifying at later stage.

Now, it is easy to follow up in such email by sending the reminder to such director twice. Even if he doesn’t reply afterwards, send this email to his supervisor and ask him that this action is required urgently. He will get this done though that Director.

Meanwhile, when this action is delayed. Delegate the duties of such nurse to some other nurse and don’t assigned any duty to her specifically. This will push her to think what is she doing with her job and may be she take it seriously.