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.

Hiring Interview with WECYBER

I learned the hiring process can be different dependent upon what the company does and what position they are hiring for. I had the privilege to interview the Chief Operating Officer and managing partner for WECYBER. Since they specialize in cyber security, researching a prospective’s digital footprint is just as important as how unique the person’s resume is. They look at a person’s skill set and how well they match the job description, but how their resume is unique will surely get their attention. If someone has something slightly different and creative in their opening description or has a different format to their resume, they will have a much better chance of securing an interview. They are a smaller company; therefore, she’ll interview anywhere from 5-10 candidates. Also, depending on the position they are hiring will determine whether it’s a group interview or one-on-one interview.

            One detail that is extremely important to them in an interview is how well the applicant can regurgitate the information they are asking of them. Natalie Unga, chief Operating officer, has worked over 12 years with her managing partner, and they are used to working in a fast paced environment. So they need someone that can “take it, get it, and go with it” mentality. So during an interview, it’s important to test the applicant’s ability to process information, tempo, and ability to tell them what they are looking for at that point. WECYBER wants to know how much entrepreneurism the applicant has in them.

            I’ve been on enough interviews, both group and one-on-one, that I didn’t think I could really learn much from this assignment. In the end, I’m glad it was part of our semester criteria, because I gained a tremendous amount of valuable information from Natalie Unga’s interview. I will try to instill in my children the importance of understanding how detrimental the internet can be to their future if the wrong thing is uploaded. I also learned Natalie Unga is part of the 100 Women in 100 Days cybersecurtiy certification program. They encourage more women to seek a career in cyber security to make our world more secure! I admire this women, and I’m grateful for the opportunity to get to know her.

Leadership Week 3

This week we focused a lot on management, leadership, and the hiring process.  The lectures this week taught us how leaders are cheerleaders and motivators, while managers focus on the day to day things by allocating and running the unit in order to get things done.  Management works with the team, leaders lead the team.

I’ve always thought I worked well in a team environment whether it be sports, work, or family, but I recently learned I am not a fan of teamwork when it comes to my online classes. On my own, I would complete assignments in a shorter amount of time. It takes us a while as we wait for everyone to find time to comment on the assignment, and then we have to wait and everyone’s opinions before we can come to an agreement on the final piece we will submit for grading. I do not like having to rely on strangers when it comes to my grades for school.

One such activity included a list of people from Buddha to Oprah Winfrey to Hitler. We were asked to pick out the leaders. The assignment did not tell us to pick out who we through were good leaders, just pick out the leaders. As expected we all had varying opinions, but once again for the sake of getting assignment done asap, and to because I do not like confrontations, I did not give voice to all my thoughts. Interesting enough, as a group, it was much easier and quicker for us to agree on behavioral based questions to ask an applicant during an interview than it was for us to unanimously agree on the leaders in a list.

I found the lecture on hiring an applicant more interesting than I thought I would. As an applicant I hate group interviews, but I understand the benefits to the ones doing the hiring. It’s great to get different view points, especially if they will all work together, but it also protects the person doing the hiring. If it’s a one-on-one interview, there’s room for “he said, she said” type of situation. It really helps to involve the employees who will be working with the prospective applicant as you can find out if they will get along or if their personalities will clash. I think the information I learned will help me with any future interviews I will participate in whether it be as the applicant or part of a group who is doing the hiring.



Reflective Journal Week 2: Successful Leadership

I learned some valuable information from this week’s unit. I learned specifically how leadership and management go hand in hand. Where management is a process of coordinating actions and allocating resources to achieve organizational goals, leadership can be a trait one is born with as well as an acquired or learned trait. We also defined the difference between an autocratic leadership vs democratic and laissez-faire. 

Based on my DISC personality test, I can see where a laissez-faire approach could be so easy to fall on, its not quite as affective unless you have a team full of self motivated people you can rely on to accomplish their task at hand. I tend to prefer a more democratic approach, but as with our team activity this week, my tendency to avoid conflict did not get productive results. I might have done my team an injustice by not fully committing to an answer. If you don’t have someone to take the lead, then the project is left at a standstill as is the case with this week. Our team waiting a little too long to submit our assignment since many of us were avoiding conflict and nobody wanted to take the plunge to be the main leader/opinion for the group. I think this would have been easier had we all known each other better. 

I’ll use the information I learned this week to be more confident in my contribution as a team member, and be more willing to have that “difficult conversation,” even if it results in a conflict/mild disagreement. For this reason, I found the material this past week to be extremely helpful. 

Characteristics of Leaders


  1. Leadership requires personal mastery – Nurses demonstrate leadership when they show competence and mastery in the tasks they perform. Nurses are deemed competent by means of a license to practice nursing (NLN 2010).
  2. Leadership is about values – The core of any nursing organization is based on its values. These values guide the priorities and ideals and affect what is done as an organization. Leaders must have a strong set of values to set vision, and tie people together (Schaefer, 2015).
  3. Leadership is about service – The healthcare leader of the future will be passionate about serving the needs of the customer. This is accomplished by spending more time talking and listening ot the customers, rounding in patient rooms and waiting areas every day, staying close to the medical staff, and providing a unique solution to a hospital’s competitive challenges through proven service improvement (Becker’s Hospital Review, 2012).
  4. Leadership is about people and relationships – Leaders can’t lead if they do not understand the people they are leading. The function of a leader is to lead and guide people who will follow with the same values. An effective leader must be able to build relationships and create communities inspiring people and planning for the future (Shaefer, 2015).
  5. Leadership is contextual – Leadership is about creating a context in which others can succeed (Erickson, 2014).
  6. Leadership is about the management of meaning – To inspire commitment, leaders must communicate their vision and create a culture that sustains this vision. Nursing leaders transform the social architecture of culture of healthcare organizations by using group discussion, agreement and consensus building and they support individual creativity and innovation. To do this, nurse leaders provide meaning and share experience so people know the expectations of how they are to act (Roussel, 2016).
  7. Leadership is about balance – A balanced leader recognizes value, develops and uses both his/her qualities and competences. We need balanced leadership in order to respond to challenges. Balanced leaders are able to create truly inclusive cultures that build sustainable solutions (Centre for Balanced Leadership, n.d.).
  8. Leadership is about continuous learning and improvement – Continuous investment into leadership development will inevitably lead to improvement. It is the capacity to develop and improve your skill that distinguishes you as a leader. Taking the journey of continuous improvement through learning, self-discipline and perseverance will help leaders become more successful (Borner, 2012).
  9. Leadership is about effective decision making – a leader must have self confidence in order to gather and process information and solve problems. If a leader doubts his decisions, followers will become less committed to the team. Decision making is a commitment to action (Ejimabo, 2015).
  10. Leadership is a political process – It is vitally important to build coalitions and networks in order to correctly lead a group of people. Often times the leadership process is very political. But, leading through the political process is usually only successful when people have the freedom not to follow. The key here is to be a significant influence that people want to follow and support (Sayles, 2015).
  11. Leadership is about modeling – Leaders need to model the way by doing what he or she expects the followers to do (, n.d.)
  12. Leadership is about integrity – Integrity is one of the top attributes of a great leader. This is established by always telling the truth, being honest with those you come in contact with, and having great character. When a leader lives by his integrity being incorruptible and incapable of breaking the trust of those who have confided in him he is the hallmark of integrity (Hopkin, 2012).


Becker’s Hospital Review. (2012). Tomorrow’s top healthcare leaders: 5 qualities of the healthcare leader of the future. Retrieved from

Borner, P. (2012). Leadership is a journey of continuous improvement. Retrieved from (n.d.). Leadership behavior: Model the way. Retrieved from

Centre for Balanced Leadership. (n.d.). Why balanced leadership. Retrieved from

Ejimabo, N. O. (2015). The influence of decision making in organizational leadership and management activities. Journal of Entrepreneurship & Organization Management, 4, 138. Doi 10.4172/2169-026X.1000138

Erickson, T. (2014). Developing contextual leaders. London Business School Review. Retrieved from

Hopkin, M. R. (2012). Leadership and integrity. Lead on Purpose. Retrieved from

National League for Nursing. (2010).

Roussel, L. (2016). Conceptualization of nursing administration: Theory and concepts.

Sayles, G. (2015). Lessons in leadership from the political process. Retrieved from

Schaefer, B. (2015). On becoming a leader: Building relationships and creating communities. Retrieved from

DISC Personality Test

The DISC personality test is used to measure behavioral preferences and styles based on two questions. After completing the test, I fell in the CONSCIENTIOUS category which didn’t really surprise me. The test defines a conscientious person as  “someone who is precise and given to detail. They are very systematic people and they need a lot of information when performing a project. They are like the steady people and they would choose to void conflict and tend to be more accommodating to others.” 

I’ve always known I prefer to avoid conflict and lean more on the accommodating side because of it. It’s one of the problems I also have when in a leadership role. However, I do feel many of these qualities are what makes me a good nurse. I’ve always been particularly attentive to detail and precision, it’s what helped me to become a great athlete at a young age. These qualities made me a good catcher in softball when I was young. My attention to the batter’s swing, strengths and weaknesses, helped my pitcher as we worked on a sequence of pitches to work the batter. As a catcher, I had the best view on the field and was expected to lead my defense. In order to direct my defenders, I had to be able to make quick decisions on the best play to make for my defense. In order to do this effectively, through practice, I studied and learned the strengths and weaknesses of my fellow teammates. It helps to know who has a strong arm or quick feet enable them to execute the out. 

It sometimes takes me a while to complete an assignment, because I want to gather all the details possible. I feel like I can do better or make a better decision if I have all the information. More importantly, if I have all the information, then I’m less likely to make a mistake. Unfortunately, I don’t always have the time I would like to gather this amount of information or it’s not always necessary. 

As far as my leadership style goes, this test is just another reminder that I need to get more comfortable with situations where conflict is necessary. There have been times where my patient care assistant isn’t as helpful as others, and instead of having that difficult conversation with them, I decide it’s quicker and easier if I do the task instead. Unfortunately, this isn’t always ideal as it makes things much harder on me as the nurse and for the patient. My patients must sometimes wait longer or they don’t get as much attention from me, because I’m now doing the tasks that is normally done by two people. I don’t believe in saying “my job” and “their job.” Sports have taught me we all work together as a team; however, there are certain tasks I must do for a patient that my PCT is not able to do. When I am taking on tasks for two roles, because I’m avoiding conflict, this does not result in the best care for my patients. 

Talofa Lava!!

My name is Toria, and I was born and raised in Garden Grove, CA. I used to watch the Disneyland fireworks from my bedroom window in the summer. I absolutely love everything Disney! My husband and I were married in the Los Angeles LDS temple 15 years ago. We have three children and a baby Siberian husky. I also enjoy sports, Polynesian dancing/music, movies, traveling, reading, and just in general hanging out with my family. Once upon a time I was athletic, and it was through softball that I had some amazing experiences, met wonderful life long friends, and learned valuable life lessons. In my youth I had a winning career that includes a handful of travelball/club national championships, a couple of CIF State championships, including a National Title (31-1-1 record), and an NCAA title with UCLA softball. I was even fortunate to wear the red, white, and blue uniform for many years.  

Currently I work in a level 2 nicu, and my only regret is that I didn’t start there sooner. I did not have any health care experience before becoming a nurse, so I had my sights set on med/surg in American Fork, because I knew I would get an all around experience. I quickly moved to progressive care & telemetry patients, but I found scheduling worked a little better for my family at Riverton Hospital on the mom/baby unit. I highly recommend that unit and hospital! 

As I continue on this path toward my BSN, I plan to utilize this blog to reflect upon anything I have found interesting, thoughtful, or maybe even confusing in my studies. I will share what has impressed me and why I find it helpful. If I do this, it should help me track my progress throughout the year or maybe bring to light some misunderstandings I may have.