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Community Health Nursing↗

An unsafe environment: the reflection of a clinical manager.

This reflection considers of the actions of the author, a junior ward sister working on a cardiology ward. The reflection is triggered by the unsafe environment found when arriving on the ward unexpectedly, and the report from a staff member. It explores the actions taken in relation to the staff involved, considers the implications of being an advocate for both patients and staff in practice, and focuses on creating an environment where staff feel they can speak out.

Employee Discipline↗

Work-related outcomes of the constructive-confrontation strategy in a job-based alcoholism program.

Most job-based alcoholism policies and programs incorporate a strategy of constructive confrontation. Data from two national samples of over 600 managers in a large corporation were collected to assess the effectiveness of this strategy with both problem drinkers and other problem employees. Results showed that supervisors of problem drinkers took more actions than did supervisors of employees with other problems. Work performance of problem-drinking employees improved more than that of other problem employees. Oral discussions containing both constructive and confrontational topics were positively associated with employees accepting help and with better work performance following intervention for both samples of employees. However, more severe forms of discipline--written warnings, suspensions or discharges--were negatively associated with work performance following intervention in both samples. The results suggest that (1) the strategy is most effective when repeated discussions balance both constructive and confrontational elements, and (2) the presence of the alcoholism policy encouraged supervisors to take more actions with problem drinkers, legitimated those actions and made the threat of discipline more credible.

Adaptation, Psychological↗

An alternative approach to discipline.

A role of the nurse manager is to promote a sense of personal responsibility, self-discipline, and personal commitment in each employee to achieve the objectives and goals of the organization. Positive, nonpunitive discipline creates a climate wherein the staff member willingly conforms to rules, regulations, and standards of conduct and works toward the organizational goals.

Employee Discipline↗

Progressive discipline in nursing. Arbitrators' decisions.

Nursing administrators occasionally must appear before an arbitrator during a hearing to present evidence about the disciplining or discharge of a nursing staff member. Labor arbitrators will examine the record for evidence of appropriate discipline, including progressive discipline, which gradually increases the severity of penalties. This gives the employee adequate warning about improper behavior and an opportunity to respond. The author describes progressive discipline, identifies its elements, and shows cases in which arbitrators have either upheld or overturned hospitals' disciplinary measures. Nursing administrators will discover guidelines for progressive discipline that will help them in either avoiding a demand for arbitration or convincing the arbitrator that disciplinary measures were appropriate.

Administrative Personnel↗

Specific strategies to refocus unproductive behaviors.

In summary, unproductive behaviors of employees have long been thought of as necessitating discipline; however, successful managers use a positive approach to discipline rather than a negative approach. A key feature of positive discipline views the final responsibility for behavior change as resting on the employee rather than on the manager.

Counseling↗

Improving supervisory skills in the management of unionized technicians.

The development and implementation of a labor-relations program that was designed to improve staff pharmacist supervisory skills and work relations with unionized technician is described.. This program of a large hospital pharmacy department was created at a time when the technician staff was being expanded substantially and the staff pharmacists lacked supervisory skills. The objective was to give both pharmacists and technicians an understanding of how job duties and responsibilities are integrated with the policies and procedures of the pharmacy and the hospital and with the requirements of the union contract. The program also provided the staff pharmacist with training in supervisory skills. A five-session course covered 20 labor-relations topics, including employee and management rights and responsibilities, employee relations, and discipline and grievance procedures. The program took a positive approach to improving interrelationships between the professional and technical staffs ot the department.

Labor Unions↗

A comparison of job performance and disciplinary records of smokers and nonsmokers.

The authors compared job performance and receipt of disciplinary action among smoking and nonsmoking hotel employees using organizational records and observation. Although smokers and nonsmokers did not differ on 3 measures of discipline, there were significant differences on a guest relations performance dimension and a summated overall job performance measure. Smokers received higher ratings than did nonsmokers. Implications of these findings for the management of smoking behavior in the workplace are discussed.

Absenteeism↗

Lost in cyberspace: the web @ work.

Most U.S. businesses provide Internet access for their employees. The current study surveyed representatives from 224 organizations on issues related to Internet abuse. Nearly 70% of companies surveyed had more than half of their employees online. Almost all companies had Internet access policies (IAP) in place (82.6%), outlining appropriate and inappropriate use of the Internet in the workplace. Despite IAPs, U.S. businesses are facing a severe problem. More than 60% of companies had disciplined-and more than 30% had terminated--employees for inappropriate use of the Internet. Accessing pornography, online chatting, gaming, investing, or shopping at work were the leading causes for disciplinary action or termination. Many companies were not concerned about the severity of the problem (49.6%) and/or had done very little to enforce their IAPs (59.4% use self or managerial oversight, and only 37.5% use filtering software).

Behavior, Addictive↗

The efficacy of preemployment drug screening for marijuana and cocaine in predicting employment outcome.

We present a prospective, controlled study of the association between preemployment drug screening results and employment outcomes in 2537 postal employees. For identified marijuana users, relative risk for turnover was 1.56 (95% confidence interval [Cl], 1.17 to 2.08); accidents, 1.55 (95% Cl, 1.16 to 2.08); injuries, 1.85 (95% Cl, 1.30 to 2.64); and discipline, 1.55 (95% Cl, 1.03 to 2.32). Their mean absence rate was 7.1% compared with 4.0% for nonusers. For identified cocaine users, relative risk for turnover was 1.15 (95% Cl, 0.65 to 2.05); accidents, 1.59 (95% Cl, 0.95 to 2.67); injuries, 1.85 (95% Cl, 1.01 to 3.39); and discipline, 1.40 (95% Cl, 0.62 to 3.17). Their mean absence rate was 9.8%. Our study shows that a preemployment drug screen positive for marijuana or cocaine is associated with adverse employment outcomes. The level of risk, however, is much less than previously estimated. This finding has important implications for the social, legal, and economic arguments for and against drug testing.

Absenteeism↗