This is something that seems to be nearly impossible to consistently have in our lives. In healthcare, it’s essential to create environments that fuel motivation of employees so that they can perform to the best of their abilities. This week we looked into ways in which we can motivate staff and increase productivity. “Unfortunately, motivating people is far from an exact science. There’s no secret formula, no set calculation, no work sheet to fill out. In fact, motivation can be as individual as the employees who work for you. One employee may be motivated only by money. Another may appreciate personal recognition for a job well done. Still another may work harder if she has equity in the business.” As you can see, motivation completely depends on the individual. That’s why it’s essential to encourage and allow employees to voice their opinion and express what changes can be made to help them work to their best potential. As a group, we composed a list of ways or things that could help increase morale in a hospital setting. Some ideas we had included the following:

-Take a genuine interest in their work-life balance – To the extent that managers can offer some flexibility in schedules and be understanding about family commitments. This would be greatly appreciated. Small gestures often make a big difference!

-Provide sufficient paid time-off. Everyone needs to take a vacation every once in awhile. This honestly helps with well-being and increases work performance in my opinion.

-Provide many opportunity for advancement. People want chances for training and cross-training. If these opportunities are available to employees they would be more likely to stay.

-ENCOURAGE and spread positivity! It all starts with attitude- if people are genuinely happy and interact with others in a positive way it makes work much more enjoyable. 

-Ensure that you are not short-staffed. Stress can be created by an environment that is chaotic. If there are enough staff so that each person doesn’t have to run themselves thin, this will help create a less stressful environment.

I think it is ESSENTIAL that we first create a safe, positive, encouraging environment if we want to motivate employees. By communicating effectively and listening intently, we will begin to understand each individual’s needs and ways that they themselves are motivated. I hope that I will be able to use this week’s lesson in my personal life as well as my work life. I have always found it to be hard to keep myself motivated for long periods of time. Especially with working out and eating healthy. I use excuses such as “I’m too busy! I don’t have time today! I’ll do it tomorrow!” which doesn’t get me ANYWHERE. I love that we studied this topic, and will I strive to be POSITIVE, WRITE DOWN GOALS, and MOTIVATE MYSELF. 



This week we learned and discussed different types of communication. Communication is the key that opens the door to success. In healthcare, effective communication is essential for providing quality care to patients. As nurses, we are the “middle man” between doctors, patients, patient’s families, and a number of other healthcare providers. We are often the strongest link that keeps the chain strong. We learned about the differences between aggressive and assertive communication. I have seen examples of both of these types of communication in my career so far. Conflict cannot be resolved if people are communicating in a violent or aggressive way. It creates more destructive disagreements and disputes. We need to remember that empathy is the best policy. It doesn’t matter if the other party is at fault- we still need to respect others and try to understand where they are coming from. 


We learned more about a subject I don’t have a lot of practice in this week- and that is the topic of STRATEGIC PLANNING IN HEALTHCARE. In our reading for this week, I read an interesting article that states, “Creating a strategic plan gives everyone in your organization a working roadmap for the future. The pieces of the plan help guide daily actions—everything ranging from how to allocate company resources, to how to engage stakeholders. Even small companies need a strategic plan to formalize their values and vision, which guides goal setting while also allowing them to measure their impact beyond the bottom line.
Most strategic plans define the organization’s Mission, Vision, and Goals, and establish short-and long-term Objectives. Creating the plan might seem daunting, but referring to the plan keeps team members connected to guiding principles and actually makes daily operations easier.” This made me think about the fact that we need to create a mission and vision for ourselves in our personal lives. If we do not have a roadmap for success then we will become lost. What is our purpose? We need to figure that out and then plan accordingly. In nursing, we need to align our short and long-term objectives with our goals and really focus on moving in a positive direction. 


This week we discussed change and how this effects nurses and how to be a positive role model to others. It was interesting to watch the video “Who Moved My Cheese” about change and then discuss with our teams how we felt we reacted to change. I feel like I am apprehensive to change (when it makes me uncomfortable) and do have fears, but I face them and try to have a positive attitude as I walk through the “fire” so to speak. I think ways that a nurse leader can handle resistance to planned change is by being very open with communication and listening to and asking for people to voice their opinion. By having a positive attitude and being a good role model by implementing the change yourself, you can affect others attempt to change. I chose an article about diversity and being aware of equality in the workplace. There was an incident that happened at my work where a charge nurse ended up losing his position because he made a racial comment that ended up turning into a fight. It made me realize that it’s very important that we watch how we talk to others and treat people with respect.



Budget Interview

  1. What is the most common budget constraint you frequently run into and how can it be fixed?

The most common budget constraint is restrictions on how many people you can hire. How can it be fixed? Have infinite money of course! (haha I wish). No but in all seriousness, you can make a proposal about hiring someone and explain why it will help to accomplish projects that need to get done. For example, at one point, I knew that we were going to need more software testers to get this big project done. It took a lot of work and convincing to get more testers hired. You have to anticipate, plan, propose, and then convince those who are above you for approval. It’s hard work.. you have to prove and help others understand why the budget restraint is hurting the company.

What is your favorite thing about budgeting at your company? What I like about budgeting is that I am able to help the company improve by budgeting efficiently. 

What is your least favorite thing about budgeting? One thing I don’t like about budgeting, is that it’s usually only reviewed annually, and therefore budget planning gets misaligned with actual priorities. If there are changes in the middle of the year it usually is hard to fix right away.

What do you find to be the most difficult about planning your budget? What I find most difficult is that it’s really hard to know and anticipate the needs and resources we will have to have to complete projects. You usually don’t exactly know until you start the project (and then the budget might be too low or too high).

How does budgeting affect your employees & customers? Budgeting affects employees because it allows you to hire people, and it affects the whole team if you don’t hire the right people or enough people. In some cases, it might mean letting some employees go, which could affect the company (for worse or for better). Budgeting affects costumers indirectly because it can change the quality of service they receive.

What is the main cause for being over budget? The main cause of being over budget is probably underestimation.. For example, if you underestimate how much a project will cost and then it ends up taking 6 more months to finish, this means the company will have to spend money they didn’t anticipate using. This is often how companies end up going over budget. 

What is the main cause for being under budget? The main cause for being under budget would be employees quitting. Another common reason would be deciding not to hire more people.

Who helps oversee the budget for the company? The boss or manager of the company, along with other financial advisors and other employees who know what resources the company needs.

How often do you make changes to your budget? In my company, we make the biggest changes annually. However, if there is a need for a change in the budget throughout the year then we will look at it more often and implement 

How often do you fire employees as a way of decreasing your budget? In my company we honestly don’t fire employees to decrease the budget that often. We need employees to keep up with our work load!


This interview was interesting because I learned that budgeting really takes a lot more effort than I expected it would. You have to learn to anticipate needs of the company so that the whole team will benefit. This takes practice and skill of paying close attention to detail! In my own personal life, I need to take time to go over my budget so that I can save more money. I also agree with the person I interviewed that having infinite money would solve all budgeting needs ;). 

Reflective Journal

This week we had two discussions that brought up some interesting topics. The first discussion was about staffing in the workplace and how it affects patient care. In the Operating room where I work, it seems like we are always short-staffed. The reasoning behind this is that it takes more than half a year to train someone in the OR. Because it takes so long to train, if we have multiple nurses or scrub techs quit all at once we are short-handed until people come off orientation. We actually had a conversation in our meeting the other day, where the OR management said our budget was already tight so we needed to be careful about the number of FTE. It’s crazy to me that the hospital doesn’t see our needs to accommodate the increase in OR suites that came with the new building. You would think that patient safety would be their first concern but it seems like money takes priority in their eyes. We also discussed our five-year plans as nurses and how we were going to accomplish our goals. It was good for me to actually write-out my plans for the future because I need to start working towards my next steps in life. In one of the assignments for this week, I read an article about dangers in the workplace such as hazardous fumes. Working in the OR there are risks for accidents by (lifting heavy patients, radiation, needle-sticks, getting hit by a patient waking up, fumes, etc.) We need to be more aware of the risks for each of our specific jobs. The future of my nursing career is in my own hands! I have realized that I need to prioritize my time in working towards my goals that I have set for myself. “SUCCESS IS NEVER OWNED, IT’S RENTED. AND THE RENT IS DUE EVERYDAY”


This week we learned more about the future of nursing, based on the Institution of Medicine. It was interesting to read the articles for this lesson and learn what is significant moving foreword in the field of nursing. “The campaign is working to improve our collaborative work with the physicians, consumers and others who understand that nursing practice and care will only be enhanced if all providers are allowed to practice to the top of their education and training. And, in fact, we do have physician champions, who are extremely supportive of our work around modernizing scope of practice laws, but won’t speak out publicly.” The IOM also stated they were working on achieving a goal of having nurses receive their bachelors degree and even better, go on to obtain a higher education. The hospital where I work at assists in paying for nurses to receive their bachelors degree as incentive which I think is smart. The higher the level of education, the more competent the nurse will be in their job. I think it’s important that we utilize hands-on practice and collaboration with physicians and other healthcare providers while in nursing school to more prepared for real-life scenarios. Throughout this week, I have began to understand more the importance of my voice in changing policies related to nursing and I have a goal to become more involved. 

Reflective Journal- WEEK 7

1. What did you actually learned from the unit. This week, we talked a lot about budgeting and the basic concepts of being cost effective while providing quality care and patient safety. It was interesting to listen to the lecture videos and watch the breakdown of how nurses get paid for their services. You have to determine if the services the nurse is providing is minimal, moderate, or extensive (and that determines their pay). Everything has a cost- and you can control expenses. You have to look closely at your staffing (the experience determines wages and you can control that). We also discussed time management. In the OR where I currently work, timing is everything. We try to go as fast as we can without compromising patient care. Sometimes this can lead to problems– for example, sometimes surgeons don’t initiate time-outs because they want to hurry. This is an essential part in preventing wrong-site surgeries so it’s frustrating when surgeons don’t take it seriously. Along with time-management, it’s also essential to learn how to appropriately delegate. I feel as if I’ve learned this skill as I am the middle man between SO many different groups of healthcare providers in the Operating Room. As I delegate efficiently, my cases go a lot smoother. As a group, we looked over a spreadsheet of expenses from a unit at the hospital. We had to figure out how to cut 10% from the current budget. This was a good team building experience and we were going back and forth whether we should cut more from the supplies or the nurses wages. I actually learned a good deal from this lecture just because I am not so good with budgeting yet. I will be able to ability to analyze costs and budgeting not only in my life at work but also my personal life. We also interviewed a person outside of healthcare regarding discipling and firing employees. I discovered that I don’t really want to be in the position of firing people.. haha. Mostly because I am such a people person and I absolutely hate making people feel bad. I give people countless chances, even when they let me down. 

Firing-Discipline Interview

I interviewed Chase Hanssen who works as a manager at a French Bakery up in Northern Utah for this assignment.

What are automatic grounds for termination at your workplace? Insubordination, dishonesty, frequent absences or chronic tardiness, theft or other criminal behavior, sexual harassment, physical violence or threats against other employees are all automatic grounds for termination.

What is the process you use to discipline an employee who is constantly late? We have a policy in which an employee has five verbal warnings, followed by a written warning, followed by suspension. (If there is a sufficient excuse for the tardy we do not punish them for it) If an employee has repeated “no call/no show” offenses, they will be at a very high risk of termination. 

What is the hardest part of discipling an employee and firing an employee for you? I honestly just feel bad when having an intense conversation about discipline or while firing an employee. I especially feel bad when I have a good relationship with the employee. These conversations are never fun but they are needed. The most difficult situations, are when it’s an employee you know has been trying their best but they simply aren’t competent in the role. 

What tactics have you found be effective when disciplining/firing an employee? If you approach a situation in a positive light instead of negative, the response is always more receptive. When an employee is terminated, the final meeting should be in person and the employee should be given documentation and an explanation as to the exact reasons for the termination. If every issue has been documented every step of the way, the employee won’t be able to argue with a wrongful termination lawsuit.

What are good indicators which help you know if your disciplinary actions have been effective or not?

Indicators are measures that demonstrate whether a goal has been achieved. For example, if an employee’s tardiness and absence’s have not decreased the disciplinary actions would not be considered effective.

When you need to discipline an employee, do you have someone else there to help be a mediator? It depends on the situation.. sometimes I have other managers help mediate a disciplinary meeting and other times it’s one-on-one. If the issue is more serious, most times I have another person in the room with me to discuss disciplinary action.

How many “chances” do you give an employee before they are terminated? This totally depends on the offenses the employee commits and how serious it is. For example, if an employee sexually harasses or physically harms another person they are not given any more chances.

What is the main reason why you need to fire an employee? This is a hard question, but I would say it’s a combination of unethical conduct, poor performance, and dishonesty.

After firing an employee how does the workplace change/react to the firing? Depending on the employee, other employees in the workplace could be upset or relieved. There have been times when I have fired an employee who had positive relationships with those they work with and people have come up to me and argued specifically why it wasn’t fair or necessary. You have to use your best judgement and do what’s best for the company instead of giving into peer pressure. 

When a termination needs to happen due to budget issues, how do you choose which employee it will be? I usually approach this situation while budgeting by making a list of employees who have repeated offenses. I make a pro and cons list for each individual. With help from other managers I then narrow the list down to one person. 

This interview was interesting because I was able to learn the reasons why an employee could be fired, how to approach a disciplinary situation, and what areas of concern to look for in employees. I have seen so many examples of people who don’t act appropriately at work (in both managers and fellow employees.) Just last week I had a manager who was suspended because he got into a huge yelling argument with an employee after he made a racial comment. I think it’s important when not in a management position to not be afraid to stand up and voice concerns about disruptive behavior in the workplace- it’s for the benefit of everyone. 


I interviewed a manager of a local restaurant in Utah County for this assignment.

1.What is your least favorite thing about performance appraisals? I don’t particularly enjoy making an employee feel bad about themselves while we are discussing ways that they need to improve. (Even though they need to hear it, this can be awkward at times.)

2.How do you approach an interview with an employee who struggles performing their job duties adequately? I usually go into a performance review by asking them specifically what areas they feel they need to improve in. Instead of just telling them every little thing they are doing bad, I find that asking them for their thoughts first is a better approach. I also ask them why they feel they are struggling. Is something going on outside of work that is interfering with their ability to perform their job duties adequately? How can I help them succeed?

3. What behavior do you look for in an employee AFTER their performance review? I try to see areas of improvement in specific things we’ve talked about. If they are making a sincere effort to improve that shows they care. 

4. What things do you focus on in a performance appraisal interview? I focus on what the employee is doing well, and what they need to improve on. We can start by setting specific goals about certain things such as attentiveness to costumers, time-management etc. 

5.How do you help your employees improve after a performance appraisal? I usually help them set goals and ask in what specific ways I can help (more training, one-on-one personal education or training, a different schedule, etc.)

6. How often do you hold performance appraisals for full-time vs part-time employees? I hold performance appraisals as needed with certain employees, but other-wise I would say I hold more for full-time employees compared to part-time employees.

7. How long do your performance appraisals last? I try to make my performance appraisals last about 30 minutes to an hour depending on what we’re discussing and how much improvement they need. 

8.What does your performance appraisal criteria look like and how is it implemented? I go through categories and discuss each area with the employee. (Tardiness, time-management, customer interaction, competency, personal attitude, goals, concerns, etc.)

9. How do you prepare for a performance appraisal interview with an employee? I usually sit down and go over notes I’ve taken while observing their behaviors, and especially look at any concerns other employees or costumers have brought to my attention. 

10.What is the most common issue that comes up with employees during a review? The most common issue is tardiness. This is a common problem, and seems to take a while to fix if they are in the habit of being late consistently. 

It was interesting to learn about performance interviews and what employers expect of their employees. I want to exceed expectations in my job and career so it’s good to learn about the main areas of concern in the workplace. I like how this manager pointed out that using good communication and asking them to voice concerns first is a good way to approach a conversation about improvement! I hope to be able to work on things such as time-management, and competency in my current job in the OR.