Conflict in the Workplace

1. What did you actually learn from the unit?

This week we discussed conflict and various forms of communication in the workplace. We also discussed the conflicts involved in the move The Guardian with Kevin Costner and Ashton Kutcher.

Conflict – When two independent parties have a disagreement on a topic, direction, or goals to be achieved.

Assertive Communication – Being firm in your stance, message is delivered clearly and calmly, setting appropriate boundaries, express your point clearly and confidently, recognizing your needs matter as much as everyone else, compromise is possible.

Aggressive Communication – Being hostile in stance, refusing to see any other side of a conflict, can lead to shouting or aggression, talking over others.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

As a group, we came to a general consensus of what we felt the best definitions for each of the words was by combining our definitions together. It helped us to collaborate and effectively work together on communication the appropriate way. I don’t feel like it really changed my opinion because we were on the same page from the beginning.

3. How you will utilize the information learned in your nursing practice?

In regards to the movie, you never know what other people are struggling with/through in their lives. Communication is key, and you never know what you might learn in return. I also learned I would like to become better with assertive communication. I have a tendency to avoid confrontations, and I’m not very assertive when I do communicate. There are times when assertive communication is appropriate, and I will strive to be better with this.

4. Your personal feelings about the material covered.

This is an important topic to discuss because it does happen. There are various types of conflict, and how you handle this in the work environment can influence the people around you.

Strategic Planning

1. What did you actually learn from the unit.

This week we discussed strategic planning in the work place and for the future programs offered at Utah Valley University. We agreed it would be beneficial to have a MSN program that focused on Nurse Practitioner specialty. I learned plans can fail due to false assumptions, not knowing the overall goal, not having enough alternatives, inadequate time or resources, and inadequate delegation of authority. I also learned to avoid the “group hug.” Trying to please everyone or take into consideration all ideas can delay the project and cause bigger issues.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

Our activity this week was definitely outside my comfort zone. As a group, we were in charge of a community with a 100 bed community hospital. Our goal was to maximize profit by strategic building medical facilities through out the city. We were also competing against another team. It was intimidating to say the least, but the once I got an idea it lead to other ideas. It helped to think of the project sort of like the monopoly game where I want to purchase property and place hotels where I can gain the most profit. In this case we are looking for profit and how to offer the best medical care necessary that is also easily accessible.

3. How you will utilize the information learned in your nursing practice.

I learned I need to be willing to be the bad guy in a work environment, but this can be difficult for me. I’m more likely to place myself where I’m in a “group hug” trying to make everyone happy.

4. Your personal feelings about the material covered.

I thought the strategic planning activity was creative and difficult as a group. Although there are five people in my group, two people have stopped participating in assignments the last few weeks. It’s frustrating, and this week was even more so when we have a big assignment like this to work on combined with a group exam.

Managing Change

What did you actually learn from the unit.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

This week we discussed managing change, and I feel I do this fairly well thanks to my dad and my experience in sports. When I first started playing softball and opportunities began to present themselves, my dad taught me to always be open to change. It didn’t matter that I was already the number catcher for my age in the nation, we’re always looking to get better, and the only way to do that is to be open to change. He also taught me to give change time to work. It wasn’t something you try for a day, you have to really put effort and a positive attitude into it so you can say you really tried.
Another phrase I learned in college while playing softball for Sue Enquist at UCLA, was to try and avoid and try not to be an “energy sucker.” These are the people who are so negative that they affect your feelings and attitude.

3. How you will utilize the information learned in your nursing practice.

In five years I’ve moved to three different units out of the desire to learn various skills. For this reason, I feel I adjust well to change, and this is why I love nursing. There are so many opportunities in the nursing field. I will continue to strive to be positive, continue to learn, and try to avoid being an “energy sucker.” The lectures did mention people adjust to change better if it’s done slowly, and if they are given an explanation. As a floor nurse who has been through system changes along with unit changes, I do feel this is true. It’s easier for me to adjust if I understand why we are moving in this particular direction.

4. Your personal feelings about the material covered.

I particular enjoyed watching the video “Wo Moved My Cheese.” I can’t believe I have never heard of this before, but I enjoyed it. I found that although I see myself mostly in a combination of scurry and Haw, I can look back at my life and find moments where I have been one of the 4 characters at least for a moment. I feel I mostly resembled these two characters, because I’m ready to learn and move forward like scurry, but sometimes I may over analyze and have a tendency to be slow to move. I have also been like Haw where I have let friends or family affect my decision to move forward quicker because of their negativity.

Career Development and Staffing

1. What did you actually learn from the unit.

This week’s topic focused on career development and staffing a unit with all of the different needs that must be met to meet protocol for patient ratios and floor needs.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

In the team activity this week we were assigned to staff a floor by making a two week schedule. There weren’t a lot of rules besides to staff it, but three nurses were on vacation and 2 cnas were in training. We started the assignment on a google doc and filled in the chart for nurses. I think most of us found this assignment one of the most difficult to do based on the limited information. Some people in my group have yet to work as a nurse so they felt they didn’t know where to go with this assignment. I’ve always found staffing to be complicated when watching my charge nurses work hard to put the puzzle together on the most complicated nights with limited staffing. It’s one of the reasons I have turned down the opportunity to be a charge nurse. I’m mostly just glad we got through that assignment. Some felt the nurses should have to pick up extra shifts to accommodate those on vacation. I didn’t think this was fair or appropriate. As a manger, the three nurses shouldn’t have been approved for the vacation time if we didn’t have the staffing to cover them. I decided to make sure we had enough staff to cover them since we weren’t told exactly how many RNs and LPNs were on the unit to start.

3. How you will utilize the information learned in your nursing practice.

I realize you can’t make everyone happy, but I feel being straight forward and honest is the best approach. If the staff on the unit understands the position we are in as a team and where we stand, they may be more willing to help out. They won’t be happy, but they may have less questions. I have learned from experience, that if the staff understands it’s a temporary situation because management is working on a solution or new hires are on their way, then they are more resilient. Staff also responds well to incentives.

4. Your personal feelings about the material covered.

I found it extremely interesting and inspirational to learn what my colleagues have planned as far as career development. For example, I’ve heard of Doctors Without Borders, but I never understood what it entails to be quality to work with Doctors Without Borders. There’s a certain level of expertise that is required but can only be obtained through experience. I also found some people in my group are like me where our lives at the moment are centered around our family, and at this time we do not want to sacrifice time with our kids. I would some day like to participate in a humanitarian project or maybe become a travel nurse, but while my children are young and active in sports, I do not want to miss out on a minute of where they are at now. Just another reason why nursing is an amazing field to be a part of. We have opportunities to be a part of patient’s lives during some of the most important times in their lives. We have the privilege to care for special patients and their families. It’s a field that is constantly evolving, and there are various places to be as a nurse both in the U.S, abroad, bedside or behind a desk.

Budgeting Interview

This interview was conducted with a Financial Analysist at an Aerospace company.

What steps do you take in the budgetary process in terms of developing, implementing, and evaluating your plan?
I look at the previous year’s budget and then compare the budget numbers to the actual numbers for the past fiscal year. I look and see what the variances are (the difference between the actual and the budget for each line item). Then I prepare account numbers for each department and list the actuals by account number. Then I ask them to put in a budget number for each account. When all department budgets are complete, I look at all the expense items and review the revenue accounts, and also review the revenue accounts. Then I determine what the revenues minus the expenses would be (profit or loss). Upper-management will determine what the return percentage ought to be and then we start whittling down expenses by account numbers, reviewing revenues to make sure the percentage profit is what upper-management wants to have.

Can you tell me more about the costs of your organization: fixed, variable, direct, indirect, controllable, and non-controllable?
Fixed – fixed costs are usually contracted amounts that do not vary from year to year. An example in our company is lease payments.
Variable – the variable cost would rise or lower depending on how many pieces of equipment are produced in a fiscal year. An example in our company is communication equipment (i.e., radios that go in airplanes).
Direct – direct costs are the costs of the parts and labor that go into each piece of equipment. An example in our company is the parts required to build radios.
Indirect – indirect costs would be machinery used to build the product, utilities, and other overhead expenses.
Controllable – controllable costs are expenses that a business has power to change. Some of these in our company would include payroll and materials to build the product.
Uncontrollable – uncontrollable costs are expenses that the business has no control over. An example of uncontrollable costs in our company are State and Federal taxes and benefits legislated by the Government.

What do you do when there is inconsistency between the approved budget and the actual expenditure of a department?
Quarterly, you compare the budget to the actuals. If there was an inconsistency, you can push to generate more revenue or more likely, you would have to start cutting expenses from labor to overhead type costs.

Do you have to oversee several different department budgets? If so, how do you prioritize your time between each department?
Yes. Depending on how many accounts each department has, you will spend a percentage of your time on each department. Monthly I prepare a variance budget report which compares the budget to actuals and explains what the variances are.

Have you been a part of a large budget cut? How did you implement that?
Yes. Generally your largest expense is labor. Once we had to lay off a number of employees. Businesses cannot lose money for very long and stay in business. Cutting labor and other expenses was necessary.

What is the most challenging part of budgeting?
The most challenging part is projecting what the actual expenses and revenues will be. It is best to underestimate revenues and overestimate the expenses.

When you have a big expense once a year, do you allocate it across twelve months? Or do you add it to that month’s budget only?
If the expense is going to transpire over the 12-month period, you would allocate 1/12th of it each month (i.e., if you are leasing a facility).

When you have a variable amount for an item in your budget, how do you handle it? Do you take the mean, or just the highest possible amount for the item?
Most businesses will come up with a variable percentage based on past years’ history. They will add up all the variable expenses and multiple the percentage assigned to each department on a monthly or quarterly basis. An example of this might be upper-management salaries.

Do you use a zero-based budget or do you use last years’ numbers as a basis so you can increase or decrease the numbers from there?
We use a zero-based budget. This means we start with zero and need to justify every expensed dollar requested.

Do you give budgeted salary increases based on a percentage for everyone? Or do you give performance raises, and do you budget for those raises?
We give performance raises based on yearly evaluations. There will be a calculated amount of funds for raises. This will be divided up based on performance.

Who is involved in evaluating/implementing changes to the budget?
The CEO, the Finance VP, the CFO, the Controller, and the Budget Director all work together to develop an annual budget including evaluation and implantation of changes to that budget.

Do employees have access to the budget? Is the budget transparent to everyone in the department?
No, the Director of each department oversees the budget. Not every employee is involved in the budget planning or development.

What I learned from this interview:
Budgeting is a very complicated process to oversee in a company. It takes a specialist with training and an eye for seeing the overall picture. Good budgeting takes time to check and double check the numbers. One small mistake can play a huge part in a financial mishap. I also didn’t know how many people were involved in a financial budget plan. Everyone from the CEO, the Finance VP, The Controller, etc. all play a part in evaluating where money should be spent and where it can be shaved off. I have gained an enormous amount of respect for those who deal with finances in a business. It is a complicated matter that I don’t foresee myself being very involved in anywhere in the near future.

Week 8: Leaders As Educators

1. What did you actually learn from the unit.

This week’s topic was on Leaders as educators/future of nursing. We discussed the direction that we see the medical world heading, specifically in nursing.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

Each of us felt there is so much potential for nurses in the future that it’s actually a pretty exciting time to be in this field.  Patient needs are so much more complex. Nurses are having to make more critical decisions associated with care for patients that are sicker and more frail. There’s a huge need for nurses in various capacities and roles so the push for more education is important. As nurses are expected to help patients manage chronic illnesses, prevent acute care episodes and disease progression, we have the ability to contribute so much if we can get the proper education and are able to practice to our full potential.

3. How you will utilize the information learned in your nursing practice.

I think it is important that we speak up for what we believe to be important in the field of medicine. The nursing profession is the largest segment of the nation’s health care workforce, and the potential for nurses is incredible. The best thing I can do for myself is to continue in my education to achieve higher levels of nursing, and look for opportunities to improve my skillset, and practice to the best of my education. My overall goal is to become a nurse educator so that I can influence other students to become caring and compassionate nurses.

4. Your personal feelings about the material covered.

I do agree that nurses should play a larger part in the changes that are occurring and need to occur in healthcare. I found many of the statistics in lecture quite astounding. I had no idea that nurses made up that large of the total population of health care workers. With such a large number of us, and growing, we have opportunities to help change healthcare if we speak up and take a more active role.

Reflective Journal Week 7

This week included a budgeting assignment and discussion. We were to find a way to cut out about 10% of the budget doing our best to avoid laying off employees.  We each found that this was not a possible thing to do unless all of the employees took a pay cut or decreased the number of hours they worked each month. This week’s assignment was more challenging for me, because it was difficult for me to consider cutting employees’ hours. Budgeting might be one of my bigger challenges if I were to become a manager of a unit.

I think our team is working really well together. We’re getting in a groove of things, and we usually find it easy to get along or come to a consensus. We’re all pretty good at caring our own weight. We also interviewed someone in regards to discipline or firing an employee. I interviewed a regional closing manager for a mortgage company. Their employees usually did really well in regards to correcting their mistakes or any issue with work, but their biggest issue was in regards to attendance, specifically tardiness. I learned most companies will give a verbal warning the first time, but the second time they are usually written up. In the case for this company, the would give them 15 days to straighten up their act, but sometimes, if it was at month end when it’s their busiest, they may give the employee 30 days to do better. However, if the employee is given 30 days to clean up their act, then there aren’t any additional chances after that. They could be fired after those 30 days if they are still tardy or have too many unexcused absences.

Any time an employee needs to be written up or fired, there are always two managers in attendance. This really protects them from any conflicts or “he  said/she said” issues. They’ve never had anyone react in an aggressive manner during a firing, because the steps have been layed out very clearly. The employee was well aware of the situation. However, they did have a time where the person they “let go” was negative in her PTO. Human resource contacted them to notify them the employee that was “let go” needed to pay back the PTO. This of course came out of her last paycheck.

Ironically, from what I learned, I found the budgeting was more daunting than disciplinary meetings.

 

Reflective Journal Week 6: Ethics & Performance Appraisals

This week we discussed ethical responsibilities of the nurse leader.  Things such as the major ethical and legal challenges the nurse leaders face, distinguish between legal and ethical reasoning, the responsibility of advocating for patients/profession/self.  We also discussed what an ethics committee is and what their responsibilities are. What’s interesting is that an ethics committee has no authority in that they are there solely to give advice which can be followed or not. However, going against the ethics committee isn’t a very good idea.

What are ethics?  They are values that we adhere to.  They’re the intrinsic part of our culture, but they can change from culture to culture (religious, home, work, etc).  What do we do when an ethical decision arises? We usually fall back on our moral values.  When I have a personal ethical dilemma I can talk to a friend or religious leader, for guidance.  At work, I can take the situation to my charge nurse or manager, but there are also ethics committees for those special circumstances.  I learned organizations are only averaging the use of a committee 3x/year!

Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

A positive to working in a group, is that everyone brings valuable information that another person didn’t know or hadn’t come across in their research. It helps when we all agree on the same topic, because it allows us to complete assignments much quicker. It’s always nice when you feel validated in your opinion as well.

How you will utilize the information learned in your nursing practice.

An ethical dilemma that medical professionals may face can be difficult.  We must find a compatible way to work out conflicting situations between our practice and personal values/opinions.  Educating our patients along with knowing who my resources are and where to find them are tremendously important. I hope I never have to bring an issue to an ethics committee, but if something was to come up, I’m really glad I have that resource available to me.  As a nurse I work with a team at all times.  If I need help, there is always going to be someone there to give me assistance.  If I feel that the help I am receiving is not enough I can go up the chain of command.  

What I learned from conducting this Performance Appraisal Interview:

I had the pleasure of interviewing Rob Gleason who is the Chief Operating Officer at Fusion Healthcare. Based on this interview and the lectures from this week, I learned there are many ways to conduct a performance appraisal interview, and sometimes it’s based on the size of the company/how many employees they have. The bigger the company, the more likely they are to delegate these meetings to a manager, supervisor, or mentor role. Although it can be in their best interest to have another person included in these meetings, they’re often between the employee and someone from the leadership team. In the case of Fusion Healthcare, communication is tremendously important, along with weekly and monthly goals. Their goals are very numbers oriented, and Rob feels this can sometimes take away from the fact that they do care more about their employee in the long run than they do about the numbers. He’s found constructive criticism combined with positive feedback usually has the best outcome during these meetings. However, should someone perform less than average, they are placed on a “plan,” and when that plan is not followed during the specified time frame, then unfortunately they must let someone go. According to Rob, that is a discussion that never gets easier with time.

I learned that there is a lot of work and effort that goes into decision making when it comes to being a manager.  They might make more money, but I’d argue that they earn it.  The sleepless nights warrant better pay in my opinion.  Being a manger in charge of critiquing an employee, especially when their worth to the company is not beneficial, is extremely difficult.  I admire people in these types of positions as they have to put up with a lot of complaining, balancing fairness among employees, making sure they keep their employees happy, paying them enough to keep their employees working for them, and ensuring that they feel respected and worthwhile to the company.  I’m not sure this is a role I’m ready for just yet, but I hope over time I will be.

 

Reflective Journal Week 5

1. What did you actually learned from the unit.

This weeks discussions focused on grading criteria for employees, how to deal with problem employees, and who we believe to be the greatest leader of all time.  I was pleasantly surprised to find that my group and I agree on many points regarding these topics.

We were given a scenario regarding disciplinary action for a single mother, charge nurse, who is great at her job, over 15 years experience in her position, but does not pick up extra shifts on the unit.  As a group, we felt this person wouldn’t need any disciplinary action at this time, but we all agreed a conversation would help so that leadership of the unit and this nurse are all on the same page with expectations. We agreed nurses in leadership roles should lead by example, and once the conversation was had, if the manager is still insistent on the extra shifts, then maybe stepping out of the role of charge nurse might be in the best interest of the nurse and her family.

When it comes to grading criteria for employees, we came to the following conclusions:

Poor – I feel that people in this category consistently fail to meet required outcomes and perform significantly below performance standards. Unable to provide good quality and safe care. Employee never meets employer expectations. Behavior does not exhibit a desire for improvement. Consistently fails to meet expectations and job requirement. Constant need of supervision.

Below Average- Employee rarely meets employer expectations. Behavior rarely exhibits a desire for improvement. There is obviously a lack of knowledge and understanding in their job and they need improvement to meet expectations. Still requires supervision or constant assistance from coworkers.

Average- Average staff is effective and consistent in their level of job performance. Consistently meets all relevant job requirements and job standards.  Seldom exceeds beyond what is expected however knows what is expected and has knowledge of job responsibilities.

Above Average- Their performance exceeds jobs requirements and team members often turn to them for answers to clinical problems. Significantly exceeds all relevant job requirements and job standards. Show initiative, works well with others, shows strong interpersonal skills. Goes above and beyond what is expected.

Exceptional- Goes far above requirements and is committed to organization. They have an amicable disposition and are team players.  Consistently exceeds expectations and performance standards. Provides leadership and promotes teamwork, highly productive, generates high quality work.

We all struggled to narrow down who we felt would be the greatest leader of all time. When doing this assignment we all agreed to have thought about the same people for our top choices. It was so difficult to settle on just one person, but we all agreed Jesus Christ, Florence Nightingale, and Martin Luther King Jr. are among our top in leaders of all time.  I didn’t think it was fair to narrow it down to just one person.

  1. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

I appreciate the input from my team on grading criteria for employees.  I think we came together to make a fantastic scale upon which to judge employee work ethic by. My experiences with my team is that we usually have the same view points, and we all generally try to avoid conflict. I learned some great things about some of the leaders we discussed, but it never really changed my view point.

  1. How you will utilize the information learned in your nursing practice.

My take away from this week is that I need to look at how hard it is to be the leader sometimes.  When my manager is having to deal with all of our complaints, I need to recognize her position is a hard one, and she must remain fair.  I will also try my best to make myself measure up to what I believe an exceptional employee should be.

  1. You personal feelings about the material covered.

I found the material covered this week to be enlightening and inspiring. It’s inspired me to live up to my definition of an exceptional coworker/employee. It’s helped me to see things from all view points, and that it’s always important to have good communication whether it’s between coworkers or with leadership. I’ve never liked appraisal interviews, and I don’t think I ever will, regardless of whether I’m the employee or in the leadership role. I am grateful for the way my past managers have conducted the performance appraisal interviews as I found them to be positive and less painful than is always anticipated.

Week 4 Team Building Assignment

This week I learned there needs to be a good balance between leadership and followers. If there are too many leaders, then nothing will ever get done. We will spend too much time debating and not enough time taking action. Many of us chose to do online classes as a result of our hectic schedules and lives. Particularly nurses who work in a hospital atmosphere may not have regular working schedules. We don’t often work the same days every week. Our work schedules combined with personal lives made it particular difficult for my team to find an opportune time to do our team activity. At some point, I wondered if I should have chosen to work with a group on campus. This was a day and time given at the beginning of the semester thus giving me time to work out a babysitter and to move my shifts around so I could be at that physical meeting.

Once we were able to get together via Zoom app, the activities proved to be fun. I was able to get to know my group much better, and once the meeting was over, I noticed our messages were more personal now that we new a little more about one another. We had more of a feel for each other’s personalities. Sometimes my role changed in the group activity from leader to follower, but that was ok as long as it moved our team in the right direction. Through the activities we did, it was interesting to see how each of us handle pressure, competition, and process of elimination. Some of us were more competitive than others when it came to playing the app Fruit Ninja. Some of us really wanted the title of “Ninja of the Week.” None of us were crafty. We all chose to make simple objects from paper. We had the “no fuss” mentality. Some of us chose to make a hat out of paper, a plane, a game, or a fan. This simple activity brought humor to our group and helped us to become more comfortable with one another. In our activity where we had a life boat and we could only save nine people around us, it was interesting how many of my group members decided to go by age when we were faced with genuinely good people. It was easy to not allow people that are difficult to work with, or would be a “cancer” to the group, and had nothing to help benefit the group, allowed in the make-believe life boat. However, we struggled with the really good people that we just couldn’t fit in our boat. So when there wasn’t anything obvious, my group would go by age. If someone was younger, than they were worth saving because they have more life to live. I don’t think I shared their viewpoint since I’m almost in my 40s, and I feel like I have a lot more to live for.