One of the hardest jobs a manager has to do is discipline a worker for poor performance.

This is especially difficult if the erring nurse is ‘quite a nice person, really’, and you believe you have tried your hardest to remedy areas of concern. But the crunch has come and it all boils down to two main things:

Firstly, the nurse has a contract of employment that states what they must do to earn their wage, and secondly, one of your tasks as a manager is to manage poor performance.

So, I believe the following question-checks have the purpose of ensuring you have done everything possible to ensure the nurse has been afforded every opportunity to grow and improve.

1. Orientation to the Facility / Unit / Department

• Is your orientation process up to date?
• Have you discussed the role description and made sure the nurse knows their responsibilities and accountabilities and what is expected of them?
• Have they been ‘buddied’ for a couple of days with a colleague who has done a mentoring course, especially one who is supportive and coaching?
• Have they been given enough time to pick up the essentials? Remember, at an interview, a verbalised ability to perform the job is good, but ‘mastery’ takes time. Some people may take a little longer or less time than average to find their feet.
• Have you evaluated the ‘orientation program’ with the nurse before launching them solo (so to speak) with their patient/resident load? Some areas may still be a little confusing.
• Do they need re-training/skill updating? It needs to be provided.

2. The Job Itself

• Are there clear policies and procedures? Are hard copies accessible? Not all staff can quickly jump onto a PC.
• Does the nurse know who to go to for relevant advice and information?
• Do they understand all aspects of the job? Listen to their issues, acknowledge them and assist them to remedy.
• Do they need re-training/skill updating for a newly or recently implemented procedure? It needs to be provided.
• If they are doing a good job, provide positive reinforcement.
• If they are underperforming, provide feedback in the form of a 'critique', not a 'criticism'. You want to instil enthusiasm, not dampen or quash it altogether.
• Does your facility have a simple, understandable performance appraisal process that is utilised regularly?
• Do they have personal limitations? Have you noticed a slow decline in their performance? Are they unwell? Are there family problems? There are employee assistance schemes and HR departments to access. You need to broach the topic and offer assistance where appropriate.

3. The Workplace Itself

• Is it nurturing and supportive?
• Is it free from ‘cliques’?
• Is conflict dealt with quickly, discreetly and fairly, long before that conflict turns into crisis?
• Are the leaders/managers fair and consistent in their approach and honest to all staff? Remember that once trust has gone, it is very difficult to get back.
• Are ideas encouraged ‘from the floor’ for workplace improvement, letting the staff you know you need them and appreciate them?
• Is teamwork promoted?
• Is information provided anytime, all the time?
• Is your workplace free from bullying and discrimination? Or, at the very least, is it identified and addressed quickly?
• Do all staff demonstrate courtesy and respect to team members?

By answering as many of the above questions in the positive, you have ensured that the staff member (and all staff for that matter) has indeed had good opportunities to grow and develop in your facility/ward/unit.

This has been written from experience (not necessarily mine) and there is one final comment that needs to be made.

In any disciplinary investigation, the leader/manager is often seen as the one with the power, and the erring staff member as the vulnerable party, so don’t let yourself be seen as abusing that power.