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There have been rumors for some time that Mrs. Clark, one of the night nurses on the unit you supervise, has been coming to work under the influence of alcohol. Fellow staff have reported the odor of alcohol on her breath, and one staff member stated that her speech is often slurred. The night supervisor states that she believes “this is not my problem,” and your night charge nurse has never been on duty when Mrs. Clark has shown this behavior. This morning, one of the patients whispered to you that he thought Mrs. Clark had been drinking when she came to work last night. When you question the patient further, he states, “Mrs. Clark seemed to perform her nursing duties okay, but she made me nervous.” You have decided that you must talk with Mrs. Clark. You call her at her home and ask her to come to your office at 3 PM. ASSIGNMENT:  Determine how you are going to approach Mrs. Clark. Outline your plan, and provide rationale for your choices. What flexibility have you built into your plan? How much of your documentation will be shared with Mrs. Clark?

 

 
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You are the supervisor of a pediatric acute-care unit. One of your patients, Joey, is a 5-year-old boy who sustained 30% third-degree burns, which have been grafted and are now healing. He has been a patient in the unit for approximately 2 months. His mother stays with him nearly all the waking hours and generally is supportive of both him and the staff. In the last few weeks, Joey has begun expressing increasing frustration with basic nursing tasks, has frequently been uncooperative, and in your staff’s, opinion has become very manipulative. His mother is frustrated with Joey’s behavior but believes that it is understandable given the trauma he has experienced. She has begun working with the staff on a mutually acceptable behavior modification program. Although you have attempted to assign the same nurses to care for Joey as often as possible, it is not possible today. This lack of continuity is especially frustrating because the night shift has reported frequent tantrums and uncooperative behavior. The nurse who you have assigned to Joey is Monica. She is a good nurse but has lacked patience in the past with uncooperative patients. During the morning, you are aware that Joey is continuing to act out. Although Monica begins to look more and more harried, she states that she is handling the situation appropriately. When you return from lunch, Joey’s mother is waiting at your office. She furiously reports that Joey told her that Monica hit him and told him he was “a very bad boy” after his mother had gone to lunch. His mother believes that physical punishment was totally inappropriate, and she wants this nurse to be fi red. She also states that she has contacted Joey’s physician and that he is on his way over. You call Monica to your office where she emphatically denies all the allegations. Monica states that during the lunch hour, Joey refused to allow her to check his dressings and that she followed the behavior modification plan and discontinued his television privileges. She believes that his accusations further reflect his manipulative behavior. You then approach Joey, who tearfully and emphatically repeats the story that he told to his mother. He is consistent about the details and swears to his mother that he is telling the truth. None of your staff was within hearing range of Joey’s room at the time of the alleged incident. When Joey’s doctor arrives, he demands that Monica be fi red. ASSIGNMENT:  Determine your action. You do not have proof to substantiate either Monica or Joey’s story. You believe that Monica is capable of the charges but are reluctant to implement any type of discipline without proof. What factors contribute the most to your decision?

 

 
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Create a 6-8 page paper discussing “Managing by Metrics”. This paper shall consider what metrics (or KPIs) a well-rounded performance dashboard would look like at your organization or an organization with which you are familiar. Although managing by metrics is not reviewed within our textbook, this is an essential part of operations and supply chain management. Independent research on this subject will provide additional insight into this topic. Our textbook defines KPIs or Key Performance Indicators as “Quantifiable measurements that reflect a company’s critical success factors”. The terms “KPI and Metrics” are similar in definition and can be utilized as the same within this assignment. Within this paper you will define the metrics from key functional impact areas such as Operations, Finance, Customer Satisfaction, and People along with other areas that may impact the operation. Ideally one KPI from each of these functional areas would compose a performance dashboard of 4 to 6 metrics that easily reports the status of each area. After selecting your KPIs or metrics for your organizational performance dashboard, discuss how you would effectively manage the performance of the organization utilizing a PDCA (Plan, Do, Check, Act) methodology. Finally, include an example of what the metric package (or dashboard) might look like. This may include charts, graphs or a visual dashboard.

 
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You are the coordinator of a small, specialized respiratory rehabilitation unit. Two other nurses work with you. Because all of the staff are professionals, you have used a very democratic approach to management and leadership. This approach has worked well, and productivity has always been high. The nurses work out schedules so that there are always two nurses on duty during the week, and they take turns covering the weekends, at which time there is only one RN on duty. With this arrangement, it is possible for three nurses to be on duty 1 day during the week, if there is no holiday or other time off scheduled by either of the other two RNs. Several months ago, you told the other RNs that the state licensing board was arriving on Wednesday, October 16, to review the unit. It would, therefore, be necessary for both of them to be on duty because you would be staying with the inspectors all day. You have reminded them several times since that time. Today is Monday, October 14, and you are staying late preparing fi les for the impending inspection. Suddenly, you notice that only one of the RNs is scheduled to work on Wednesday. Alarmed, you phone Mike, the RN who is scheduled to be off. You remind him about the inspection and state that it will be necessary for him to come to work. He says that he is sorry that he forgot about the inspection but that he has scheduled a 3-day cruise and has paid a large, nonrefundable deposit. After a long talk, it becomes obvious to you that Mike is unwilling to change his plans. You say to him, “Mike, I feel this borders on insubordination. I really need you on the 16th, and I am requesting that you come in. If you do not come to work, I will need to take appropriate action.” Mike replies, “I’m sorry to let you down. Do what you have to do. I need to take this trip, and I will not cancel my plans.” ASSIGNMENT: What action could you take? What action should you take? Outline some alternatives. Assume that it is not possible to fl oat in additional staff because of the specialty expertise required to work in this department. Decide what you should do. Give rationale for your decision. Did ego play a part in your decision?

 

 
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