Reflective Journal Week 12

This week we learned/discussed conflict in the workplace. Many in our group discussions came to the same conclusion when creating steps to address the issue in the workplace. The first step should always be to recognize that there is conflict in the workplace between individuals or groups within. The next step is to if necessary intervene by separating individuals, mediating, or get security involved, and knowing when to get management involved. We also did a bargaining assignment that helped us realize when bargaining pay raises for employees may cause conflict and have financial repercussions to the employer and employees if not done with care as strikes/layoffs, and loss of production could occur.

The movie The Guardian helped us recognize conflict and the use of effective conflict management can create a better environment for both parties involved. It also portrayed poor conflict management skills that not only didn’t resolve issues but made them worse as the film progressed. The take away from for me was that when in a leadership position it behooves us to be respectful, do not public shame, and provide an environment where both parties are safe to discuss problems, concerns, or conflict in the workplace. My hope is that I can recognize when I recognize conflict within myself or others that I will be able to effectively use conflict management that can create a positive outcome.

Week 11 Journal

This week I learned that strategic planning has changed as healthcare leadership changes as well with a focus to look at a large goal and set benchmarks or time frames that are shorter to be more achievable with 6/12/18/24 month time frames that make goals more realistic to reach as CEO’s are able to create the change in this time frame. As a group we discussed strategic planning for what programs could be offered at UVU and how they may be implemented focusing on MSN/FNP programs that could be offered to help alleviate the disparity in Utah as the research has shown that there is a growing need for NP’s in the state of Utah. To implement a strategy as a University it would be quite time consuming to get all the pieces together to implement a new program. From obtaining the staff, budget, physical resources (building, office supplies, technology or programs), clinical sites, accreditation and creating a process to accept applicants into the program that share the same values to support the communities they will likely serve.

Utilizing this information will help me understand that when implementing goals for a large corporation such as many healthcare corporations it takes much more thought and planning to implement the change as it can be much more costly and should take proper steps to minimize negative effects of ideas that may be implemented poorly.

Reflective Journal Week 10

This unit I learned more about myself and how I deal with change by watching Who moved my cheese. This short clip had me connect with each character in different ways. At times I’m like sniff and scurry where I utilize my intuition and instincts to act promptly. In ways I’m like Hem and resist any change and will think of the worst-case scenario, and like Haw I learn to adapt to the change and learn that at times change is necessary to better myself and those I am around. Ultimately, I would say I am like Haw and I’ve been working on looking inward of what I can do to better myself through self-reflection.

The discussion for this week I found that many people were similar in that they felt as if they connected with the character Haw with Hem being a close second in that change can be hard to accept but are capable of recognizing change is necessary to better yourself.

To utilize this information in my nursing practice I will need to be open to the idea of change being a positive movement in my career even though it may be nerve wrecking at times. Another way I can be proactive in knowing that change is inevitable is to be on the forefront of seeking positive change within my career and work environment. It is also beneficial to help others understand the change and help provide guidance so that the change can be more readily accepted and implemented in their career.

Budget Interview

  1. How do you create a monthly budget and how do you decide how much to allot for something?

I create a budget on previous sales within that month to predict the current month expenses for any given product or service provided. Any excess revenue is placed into a saving fund for unpredicted expenses or short comings within the company.


  1. When you create a budget how do you stick to it?

Making specific budget allotments for each category within the business such as payroll, products, maintenance (building, cleaning supplies, office supplies ect.). When there is a need for going over budget such as employees going in overtime, increased expenses in general excess expenses are pulled from the savings fund for such expenses.


  1. When you overspend on your monthly budget how do you go about fixing this?

            In terms of staffing, utilizing previous years staffing needs we staff to prevent overtime by ensuring that there is no need for specific employees to go into overtime. Some times overspending is required but this is taken into account for next years or month budget and budgeting in the future may require cuts in certain areas.


  1. What different categories are included in your budget.

Staffing, maintenance/supplies, products


  1. Do you do monthly budgets, yearly budgets, budgets that extend beyond those time lines, or all the above?

A little of each, the company goes year to year to get a trend of sales throughout the year and what we may expect. Then we go from month to month based off of sales, holidays, and any other events that may require additional staffing or expenses.


  1. Do you utilize software to make and customize your budget? If so, what software do you use?

For the software that I utilize we use excel to help customize our budgeting needs.


  1. When creating a budget what your process of approval?

Our process of approval depends on the extent of the needs, for example if we need more staffing a few people will be involved. Outer department managers make the call if extra staff is needed however they are given an allotment of hours for each week which needs to be maintained. If they need to go over the hours allotted then there needs to be higher management such as my self.


  1. Budgeting helps a company track where a company is investing to increase profits or cut unnecessary spending. When creating a budget are you looking for expected or projected returns from the allocated budget?


Projected returns from an allotted budget is what is expected. We provide a service and that service doesn’t guarantee a profit. We can however track trends within the company to predict a projected profit for the given month.





  1. At what point will you not fund a project/employee due to loss in profits? (specific percentage or trending loss?)


The point we stop funding a project or employee due to loss in profits is more along the lines of a trending loss. There are bad days/months/years but doesn’t necessarily mean the project or employee is not effective but may be other outlying factors that affect the loss. However each scenario is different and needs to be looked at individually to make the call.


  1. What are your priorities when creating your budget? 

When creating my budget is to be profitable as a business so that we can keep our doors open to the services we provide. We try and create a realistic goal to maintain our budget to profit ratio. The goal is to build the business up and expand to communities in need of our services as a corporation.


  1. When creating a projected budget, are you utilizing last years budget to income as a reference? And if you do what other factors do you consider that would influence budget to income? (ie holidays or events)

Yes, we utilize last years budget as stated before, and holidays are always considered as the line of business we provide caters toward holidays or events. And each of these holidays/events are taken into consideration utilizing last years holidays/events budget.


  1. If you have budgeted appropriately, and there is a surplus at the end of a year, what do you do with the extra income? 

The extra income is saved into a high yield business savings account which will help fund future budgeting needs, projects, or expansion within the business.


  1. How do you help your employees work through potential challenges that may arise from budgeting cuts?

We try to keep our employees in the loop of our budgeting cuts or needs. This is done through transparency throughout our team by providing profitable or nonprofitable weeks/months/year. This helps the employees understand the company needs.


  1. Who all has an input into the allocation of the budget?

This depends on level of which the needs are. If it is simple supplies then we have a designated employee that maintains the budget for supplies. Each department manager makes the call when extra staff is needed within a given percentage over allotted budget, then upper management is consulted.

Retail Store Manager

During my interview I learned that there are many different factors that go into account when creating a budget and as a business grows, they create their own data to give reference to future budgeting needs. This is important  to track as it can be easy to let the cost of the business make it non-profitable. It is also important to look at other outliers that may affect a given project/employee from being profitable and not jump to conclusions by not funding a project/employee. Each budgeting cost needs to be considered as it will add up quickly by the end of the week/month/year to ensure the projected income will be greater than the projected budget.

Week 9 Reflection

This week we discussed career development, staffing, and reviewed a modern healthcare article. Career development was a reminder that there are different stages when developing our career. Education, experience, leadership opportunities, goals for further development (higher education/ administration), and work with people who will help you grow in your career. Staffing is important as we progress in our career as we may have to help create a staffing schedule for a unit/clinic/hospital. The most important aspect to staffing is to ensure that the unit is taken care of, experienced to new healthcare provider ratio’s to provide a safe environment for the staff/patients.

Our group discussed our goals in our personal career development, and the way our unit staffs. This helped provide perspective of what others long term goals are within the nursing profession, and realistic time frames to achieve them. This makes me think that many others have put some time and effort into planning their career choices to meet their goals. We also discussed the differences in our units staffing needs and realized that many not every unit will staff the same way which makes sense as every unit adapts and changes over time to meet the needs of the specific unit.

This information helps provide a path of knowledge that can be taken into consideration when making long term goals for my nursing career and the insight to what may be required to staff the unit.

Reflective Journal Week 8

This unit I really began to understand where the future of nursing is leading and requires us nurses and future nurses to rely invest into our education because the government body that oversees the funding that is offered for providing services and medicare and Medicaid funding would be withheld from the hospital if the RN who is taking care of the patient does not have their bachelors. Which makes sense why hospitals/corporations are shying away from hiring ADN’s forcing students to pay more for an education that has no increase in pay. APRN’s are also pushing to become sole providers without having to consult or work under a medical doctor as they are advocating that APRN’s provide equitable high quality care with no increase in medical errors/discrepancies.

The team activities provide an opportunity to see another classmates perspective which help me reflect on the different dynamics of the information ultimately playing a role in how I shape or reshape my opinions/beliefs/thoughts. I would say that it didn’t necessarily change my opinion on the subject but that it helped me see different perspectives which I may or may not agree with.

The information will help me understand where nursing is going in the future. The potential for growth in the future of nursing will help me rethink and shape my future goals of education and specializations that are available.

I believe that the current push that is happening for APRN’s is going to effect how healthcare is provided to communities and will over time shape the interactions and co-operations between healthcare providers mainly between medical doctors and APRN’s.

Reflective Journal Week 7

This week I learned much more of the nitty gritty of the financial realm of what it may take to run a unit/hospital. Every penny spent toward a unit is money taken away from profits, or the ability for a hospital to stay open to provide care to patients/community. It would be interesting to see more people go through a budget of a hospital unit to really understand what it cost, and what types of things can not be billed for in the medical profession such as a failed attempt of placing a catheter. I’m interested in performing my interview questions next week for a company that deals with outdoor retail. My brother works for the company and they have really made it a focus to treat their employees well. The Interview for this week was interesting as I talked with my mother in law who helps manage a team at Cadence. I found that some companies are very lenient toward their employees. In a state such as Utah I thought you would see more companies that would be quick to fire when they deal with poor performing employees.

This week I’ve learned that there is much more to running a hospital unit than meets the eye. There is a lot of moving parts within the financial realm. This aspect has opened my eyes to the materials we utilize at work, the work codes we use to show where the funding is going such as continuing education, and orientation. It’s important to get these right as it may take away from potential hours going to the unit for floor nurses/techs.

Firing/Discipline of Employee Interview Q’s and A’s

  1. What is the first action you take when an issue is brought up about an employee who needs discipline?

A conversation is started with the employee who is in question of discipline to further investigate what the true issue may be.

  1. Are there several steps that are taken to discipline an employee before termination?

Yes, a discussion with HR, write up agreement, basic performance plan after 3 months if there is no change then they are terminated.

  1. When do you usually fire an employee or discipline them? Do you do it before the weekend?

Depends on the situation for each employee but it is usually done at the beginning of the day. Performance improvement plan, Layoff (1%), lowest performers let go first, consulting with HR for termination packet or on phone. Ultimately it is done when convenient and when it feels right.

  1. Are you required to give severance pay if you fire an employee? If so, does this impact your decision on whether or not to fire them?

Not required, but typically give 2 weeks’ pay and some form of severance, or negotiation so that they can collect other benefits depending on situation, every employee has a special situation. The company also tries not to sever ties with employees especially if layoffs are to occur because when rehiring some employees come back to the company for work.

  1. Do you have the final say in whether or not an employee needs to be fired? Or is there a committee/someone over you that makes the final decision and you execute those decisions?

Usually hierarchy of management knows situation, HR is more involved and pulls trigger.

  1. Who all is involved in the firing process and discussion with the employee when they are fired?

HR and first line manager are the ones to start and finish the discussion with the employee who is to be terminated.

  1. How long is the discussion with an employee about them being let go?

As short as possible, employee checklist (badge, computer, turn off access, until security measures are taken care of) IT/security, HR, first line manager are some of the things that need to be taken care of before the employee is fully let go.

  1. Do you utilize verbal/written corrective discipline and education? If so how many times do you do this before proceeding to the termination of the employee?

Review process (rating), one on one every other week to talk about getting better, peer reviews, verbal, written, performance plan. There are many steps in the corrective action process.

  1. Does the process of termination for the company you work for ever hinder you from terminating an employee?

No, HR/management is very supportive, the process is just a lot of work and can be awkward when having to break news because of the security measures that have to be taken for the company (deny access to company computers, buildings, and finances)

  1. What is done to prevent gossip and retain the trust of employees in the workplace when terminating an employee?

Usually done secretive/out of public view to reduce gossip, people keep heads down to put oneself out there (limelight) of increasing chances of being let go. Performance problem employees are hard to disguise because most people are aware of the situation.

11. What types of issues/offences do you fire/ terminate over? What constitutes termination and what is discipline worthy?

A few examples of what some employees have been fired over are, pornography on work computer, working a second job while at work, blatant lies of whereabouts, misusing company credit card for personal use, causing tension at work (causing problems at work), using work time to engage in personal/intimate relationships, poor performance and layoffs.

  1. How many warnings/ offences do you allow before considering termination?

Cadence is very generous to their employees and gives them the benefit of the doubt and is apparent with the steps in the termination process.

Tami Wood

Cadence Design Systems Inc

After the interview with Tami I realized how lenient the company is with their employees. This helps foster the idea that education, training, and proper steps to avoid rash decisions when terminating an employee. Once the decision to fire a troubled employee has been made there is no doubt that the right decision was made as long as the policy in place was followed. It also helps mitigate any legal repercussions against the company as they are covering their bases with sufficient evidence that termination was necessary.

Reflective Journal Week 6

This week we talked about ethical issues in the workplace and what we may do when placed in a situation that may require an ethical committee to intervene or help the care team and family make a decision based on the specific situation. There are many different types of ethical or legal dilemmas in the workplace and all we need to be able to do is identify the need for an ethical committee to help the family and care team make the best decision for those involved.

During the team activities I found myself a bit more conservative when on the ethical committee for a patient that is in a vegetative state and the family wanting to go through with dialysis. From my experience of working in healthcare it is easy to have our own idea of what should happen to patients in specific situations, but it tends to be skewed or biased from what we know of healthcare and our cultural beliefs. I find it difficult to press my beliefs on someone especially when it comes to the care that is provided to a patient/family. I find it more beneficial to educate the family on the diagnosis/prognosis and give a recommendation but ultimately give the family a say in this specific situation.

I believe it is important to really understand why a family would want to pursue specific medical treatment especially in circumstances such dialysis for a patient in a vegetative state. Or in the movie My Sister’s Keeper, the daughter who was born solely to provide biomedical treatment by using her body as replacement parts for her older sister.

The information gained from this unit will help me understand that we need to look at these ethical dilemmas from a non-biased perspective to make a decision that is truly best for the patient/family that is involved. I need to be more aware of identifying ethical issues as well so that the proper team can be notified. It is not going to be easy when faced with an ethical dilemma and that is why these teams are available to healthcare.

Performance Appraisal Interview

  1. How long do your performance interviews last and do you feel it is an adequate amount of time?

There is some self-evaluation, but a lot of the data is subjective determined on how they meet the standards. Every 3 years it is a longer evaluation. Sitting down maybe 30 min. because the process has been going on for about year. Each employee has about 5 days to submit a statement about the performance evaluation.


  1. How often do you hold performance interviews with your employees.

Once a year for every employee and every 3 years for a more in depth process.


  1. Do you encourage or require your employees to set goals that they can work on throughout the year?

Yes, that is all part of the process, and at the beginning of the year they set goals that      are measurable utilizing the SMART goals acronym.


  1. Do you use a one on one method when doing a performance interview or do you have others in attendance? 

It is always a one on one, unless they are not meeting standards because there may be   disciplinary action and requires another administrator.


  1. What kind of setting do you hold performance reviews? A more formal time set aside outside of a shift? Or do you take people aside before during or after a shift in more of an informal setting?

It’s either in the office or in their workplace in private. Never liked the idea of summoning someone to the office as it may be intimidating or make the employee feel like they are in trouble. Likes to go to their office during a prep period. Tries not to do anything     before or after working hours.


  1. How do you determine the results of a performance review? Do you use some type of scale to grade employees?

Uses a standards or state standards and incorporate those in the performance review process. Rates every standard on highly effective, effective, minimally effective, partially effective, and ineffective. Partially effective for 2-3 years of employment is acceptable as long as there is a plan for improvement. If partially effective is met after the initial 3 years the employee requires reprimand, although those who change positions are given leeway.


  1. Are your employees pay/ raises affected by their performance review?

Yes, if you don’t meet standards then the raises for the year are not given.


  1. Do you have coworkers and employees evaluate each other? Is what they say taken into account when making decisions?

No, but there is a process to help one another by evaluating one another unofficially so that they can see where they might need improvement.


  1. Do you ever give employees a “perfect” score on a performance review? Why or why not?

That is called a straight-line evaluation and is discouraged and doesn’t say much about the person.


  1. What qualities are you evaluating? Attendance, ability to get along with coworkers, get projects done, etc..?

7-10 main Standards, evaluations on productivity, interaction with clients, client surveys, correction surveys, community surveys, performance in work force, attending and participating in meetings, do they support mission and values of the company, portfolio, and client engagement. These are all used when evaluating an employee and may be gathered throughout the year.

Marlisa Gerber, Varex Imaging

Some companies put more emphasis on an employee evaluation and it seems as though Varex is one of them. I believe that it is important to have a comprehensive employee evaluation but it seems to me that this may be overboard especially when it comes to the 3 year mark for evaluating the employees. The impression that I got was that during the more in depth evaluation it is very time consuming when the time/money could be spent mentoring those who really need the help within the company.