Coaching Model
The nurse manager as a coach inspires, guides, and supports new nurses and addresses performance issues. A coaching session focuses on finding a solution to an identified clinical situation. Dressler (2015) writes that planning for a solution should be the focus of a coaching session from the outset. Actual coaching is preceded by a plan that prescribes the “steps to take, measures of success, and date to complete” (Dressler, 2015, p. 282). Based on this framework, a coaching session has four elements, namely, assessment, challenge, and support.
Assessment through a performance appraisal could identify an area in the nurse’s work that needs to be improved. Engaging the clinician over this issue would reveal her perspective. The engagement should be objective and impersonal to avoid defensiveness and encourage the nurse to talk (Dressler, 2015). The aim of challenging the nurse is to engage her in a dialogue over the issue. It also encourages her to challenge herself to perform better in an area of practice. A support plan is an action plan for achieving growth, resolving barriers, and meeting specific learning needs in the context of the performance issue.
Job Analysis
A job analysis identifies the position-specific roles and required competencies (Weber, Ward & Walsh, 2015). It is not an appraisal because it does not measure the performance of the jobholder. In this case, the person’s (the struggling nurse) tasks would fall into five domains, namely, assessment, planning, advocacy, intervention, and evaluation. She assesses patient data to determine a patient’s physical and psychosocial state in the context of holistic care (Rosenfeld, Pyc, Rosati & Marren, 2012).
She also develops patient treatment plans to support education and care continuity. Another core task would be evaluating the care delivered to ensure the expected post-intervention outcomes are met. The position holder should also advocate for patient-centered care in the health care system.
The required competencies for this role include a nursing school graduate, a licensed nurse (certified RN), good language/communication skills, reasoning ability/reflective practice, computer skills, and great interpersonal skills. These competencies represent the key knowledge, skills, and abilities (KSAs) essential for this role based on job tasks (Osman, Berbary, Sidani, Al-Ayoubi & Emrouznejad, 2011).
The Employee’s Current and Desired Performance
Current Performance
Employee performance is measured against professional standards. The evaluation of the nurse’s performance is based on five factors, namely, job knowledge, communication, teamwork, problem-solving, and employee responsiveness (Kvas & Seljak, 2013). Her current job knowledge, problem-solving skills, and responsiveness could be rated as being below expectations (2 out of 5). Her score on communication and teamwork is above average, i.e., meets expectations (3 out of 5).
Expected Performance
Nurse practitioners are expected to exhibit knowledge-based practice, teamwork and professional collaboration, and reflective practice. Therefore, the performance domains that need improvement include the nurse’s professional knowledge, critical thinking/reflective practice, and responsiveness, i.e., the ability to finish tasks on time.
Change Strategies
According to Fennimore and Wolf (2011), performance deficiencies identified through an appraisal can be corrected through employee training or job rotation. The change strategies for this case could include on-the-job training to impart new practical skills to the nurse and coaching to encourage new attitudes, e.g., the use of self-reflection and problem-solving in practice.
Follow-up Plans
The follow-up plan will involve a monthly performance evaluation using the critical incidence method to measure progress and setbacks based on the learning needs identified, utilization of resources, and practice goals.
Action Plan
The nurse will participate in a quality training program. The organization’s vision is to offer quality medical care founded on the principles of holistic care. Its mission is to improve community wellbeing through patient-centered care while its goals include reducing medical errors and providing quality care. The training will involve the quality assurance unit. It will entail a review of professional nursing procedures pertinent to the employee’s role to achieve a low medication error rate and achieve high-quality standards.
The supervisor will do impromptu quality checks of the employee’s performance over a period of two months. The monthly reports must indicate that the nurse performs as per the quality and quantity expectations, i.e., 2% quality errors and over 120 hours per month. Patient satisfaction rates will be used to measure the quality of care in line with the organization’s mission, vision, and goals. The nurse will be required to report any impediments or work constraints to the quality unit for action. The rationale for quality training is to improve the nurse’s hands-on skills and attitudes for better performance.
Mentoring and Coaching Plan
The mentoring and coaching of the nurse will involve four sessions. Each one-hour session will have three parts, namely, assess, challenge, and support.
Assess
The nurse will be assessed to determine her perspectives on her low performance. The assessment will also determine the motivation, strengths, and interests of the nurse. Socratic questioning and active listening will be employed.
Challenge
Open-ended questions will be posted to the nurse to elicit a discussion aimed at identifying the constraints and learning needs relevant to her current practice. The dialogue will also focus on aspects of a supervisory role to determine the nurse’s career interests.
Support
Useful resources and training will be provided to prepare the nurse for greater responsibilities. A follow-up on training will ensure the goals and timelines are met.
References
Dressler, G. (2015). Human Resource Management. New York: Pearson Education Inc.
Fennimore, L. & Wolf, G. (2011). Nurse Manager Leadership Development: Leveraging the Evidence and System-level Support. Journal of Nursing Administration, 41(5), 204–210.
Kvas, A. & Seljak, J. (2013). Continuing Education and Self-assessment of Knowledge of Nurse Leaders. Journal of Continuing Education in Nursing, 44(8), 342–349.
Osman, I.H., Berbary, L.N., Sidani, Y., Al-Ayoubi, B. & Emrouznejad, A. (2011). Data Envelopment Analysis Model for the Appraisal and Relative Performance Evaluation of Nurses at an Intensive Care Unit. Journal of Medical Systems, 35(5), 1039–1062.
Rosenfeld, P., Pyc, L.S., Rosati, R.J. & Marren, J.M. (2012). Developing a Competency Tool for Home Health Care Nurse Managers. Home Health Care Management and Practice, 24(1), 5–12.
Weber, E., Ward, J. & Walsh, T. (2015). Nurse Leader Competencies: a Toolkit for Success. Nursing Management, 46(12), 4-13.