Chapter 25 Flashcards
What is the primary difference between constructive and destructive discipline?
A) The manager is friendlier to the employee in constructive discipline than in
destructive discipline, so that the employee likes the manager as a person
B) Constructive discipline includes verbal and written reprimands, whereas
destructive discipline includes suspension without pay and termination
C) The person who has received constructive discipline always appreciates and
believes the feedback given, whereas it is resented and disbelieved in destructive
discipline
D) Constructive discipline helps the person to grow and to behave in a manner that
allows him or her to be self-directive in meeting organizational goals. Destructive
discipline focuses more on punishment
D) Constructive discipline helps the person to grow and to behave in a manner that
allows him or her to be self-directive in meeting organizational goals. Destructive
discipline focuses more on punishment
Constructive discipline uses discipline as a means of helping the employee grow. It is
not used as a punitive measure. Destructive discipline focuses more on punishment. The
remaining options are not necessarily true statements
Which statement concerning self-discipline is true?
A) It is one of the least effective forms of discipline
B) It decreases as an awareness of the rules and regulations that govern behavior
increases
C) It increases when employees identify with the goals of the organization
D) It is internalized, and thus the leader can do little to create an environment that
promotes self-discipline in employees
C) It increases when employees identify with the goals of the organization
The highest level and most effective form of discipline is self-discipline. When
employees feel secure, validated, and affirmed in their essential worth, identity, and
integrity, self-discipline is enhanced.
Which statement about rules is correct?
A) If a rule or regulation is worth having, it should be enforced
B) Most rule breaking is a result of the actions of a few employees
C) Organizations should have as many rules and regulations as possible so
employees are clear about what they are to do
D) Managers should increase monitoring efforts if a particular rule is constantly
broken by many staff members
A) If a rule or regulation is worth having, it should be enforced
If a rule or regulation is worth having, it should be enforced. When rule breaking is
allowed to go unpunished, other people tend to replicate the behavior of the rule
breaker. An organization can have too many rules making enforcement very difficult.
Evaluation of a rule that is being constantly broken is more effective than simple
increased monitoring.
What is the process involved in progressive discipline?
A) A written warning precedes verbal warnings
B) Formal warnings are followed up with informal warnings
C) Written warnings are advocated only in the most serious of offenses
D) The initial step is the delivery of a verbal warning by the manager
D) The initial step is the delivery of a verbal warning by the manager
The first step of the progressive disciplinary process is an informal reprimand or verbal
warning. This reprimand is followed by a formal reprimand or written warning when the
behavior has not been changed.
What would be the most appropriate level of employee discipline for a first infraction of gross mistreatment of a patient? A) Suspension with pay B) Suspension without pay C) Termination D) Written admonishment
C) Termination
For a first infraction of gross mistreatment of a patient, the most appropriate level of
employee discipline would probably be termination. The organization’s first
responsibility is in the protection of patients.
Which statement accurately describes a disciplinary conference?
A) It is generally a highly charged emotional event, so the manager should try to
soften criticisms to reduce the employee’s defensiveness
B) It should be scheduled in advance at a time agreeable to both the employee and
the manager
C) When it is held in front of peers it can be used as a teaching tool
D) It requires the manager to adopt nurturing and counseling roles
B) It should be scheduled in advance at a time agreeable to both the employee and
the manager
All formal disciplinary conferences should be scheduled in advance at a time agreeable
to both the employee and the manager. Both will want time to reflect on the situation
that has occurred. Allowing time for reflection should reduce the situation’s
emotionalism and promote employee self-discipline, because employees often identify
their own plan for keeping the behavior from recurring. None of the other options
accurately describe this process.
What should an employee expect when a manager terminates his/her employment for
continuous rule breaking?
A) The employee will be escorted from the building by security staff
B) The employee will be allowed to work out a 2-week termination period
C) The manager will describe what, if any, references will be supplied to future
employers
D) The manager will arrange for a meeting between the employee and senior
administration
C) The manager will describe what, if any, references will be supplied to future
employers
When a manager terminates an employee for continuous rule breaking, the manager
should tell the employee what, if any, references will be supplied to future employers.
The remaining options are not generally associated with such a termination.
Which statement is accurate when describing performance deficiency coaching?
A) It is less spontaneous and requires more planning than ongoing coaching
B) It is a one-time way of solving problems
C) It requires the manager to assume the role of enforcer rather than supporter or
enabler
D) It occurs as a component of an employee’s annual performance appraisal
A) It is less spontaneous and requires more planning than ongoing coaching
This form of coaching is less spontaneous and requires more managerial planning than
ongoing coaching. In performance deficiency coaching, the manager actively brings
areas of unacceptable behavior or performance to the attention of the employee and
works with him or her to establish a plan to correct deficiencies.
Which statement most accurately describes how discipline in a unionized organization
may vary from one that is nonunionized?
A) Nonunionized organizations require a demonstration of just cause, whereas
unionized organizations do not
B) Discipline in nonunionized organizations tends to entail more procedural,
legalistic safeguards than unionized organizations
C) Only unionized organizations have grievance procedures
D) Unionized employees must generally be disciplined according to specific steps
and penalties within an established time frame
D) Unionized employees must generally be disciplined according to specific steps
and penalties within an established time frame
Unionized employees must generally be disciplined according to specific, preestablished
steps and penalties within an established time frame. The remaining options
do not accurately describe unionized organizational discipline procedures.
What does the filing of a grievance by an employee do?
A) It serves as evidence that a manager’s actions have been unfair or arbitrary
B) It means that the conflict will have to be resolved in arbitration
C) It negates the need for the manager to attempt to solve the conflict through
communication, negotiation, compromise, or collaboration
D) It requires a great deal of time and energy from both the employee and the
manager
D) It requires a great deal of time and energy from both the employee and the
manager
Although grievance procedures extract a great deal of time and energy from both
employees and managers, they serve several valuable purposes. However, most
grievances or conflicts between employees and management can be resolved informally
through communication, negotiation, compromise, and collaboration before grievance
procedures need to be undertaken. The remaining options are not the result of a
grievance filing.
What action will the manager take when implementing the second step in the
progressive disciplinary process?
A) Suspend the employee from work for a specified period of time
B) Explain in detail the nature of the inappropriate behavior
C) Complete a formal written reprimand
D) Verbally instruct the employee not to repeat the infraction
C) Complete a formal written reprimand
The second step in the progressive disciplinary process is for the manager to complete a
formal written reprimand signed by the employee and the manager. The second step in
the progressive disciplinary process does not involve any of the other options.
A nursing aide has been given a formal written warning regarding arguing repeatedly
with the team leader about the given assignment. Today the nursing aide has taken four
lengthy personal phone calls during work time. This is the first offense of this nature.
How will the manager deal with this disciplinary situation?
A) Provide a verbal warning that includes the rules related to personal telephone calls
B) Determining whether there is a legitimate personal problem that justifies the
telephone calls
C) Presenting the nursing aide with a formal written reprimand
D) Suspending the nursing aide for a week
A) Provide a verbal warning that includes the rules related to personal telephone calls
The best choice of action in this case would be to provide an explanation for the rule
and proceed to give a verbal admonishment. Since this is a new infraction, the
progressive discipline starts with a verbal warning again and none of the other options.
How do managers view their responsibility to discipline staff?
A) It is a necessary means for controlling an unmotivated and self-centered
workforce
B) It is a ìBig stickî that management can use to eliminate behavior that conflicts
with organizational goals
C) It is a means to assist in the development of self-discipline in an employee
D) It is necessary to the organization if established rules are to be enforced
D) It is necessary to the organization if established rules are to be enforced
Managers use discipline to enforce established rules, policies, and procedures. The other
options are very limited views regarding discipline.
What is the manager’s role when dealing with employees who break the rules?
A) To terminate their employment
B) To be a good listener
C) To act as counselor
D) To ensure organizational goals are met
D) To ensure organizational goals are met
To act as coach and supporter, counselor, or good listener could be enabling to the
employee who breaks the rules. The manager should be humanistic, however, and not
scold or blame. Not all situations would result in employment termination.
Which statement is true regarding chemical addiction among nursing professionals?
A) Most chemically impaired nurses obtain drugs by stealing them from work
B) Morphine is the most commonly abused drug by nurses
C) Most nurses obtain their drugs on the street and avoid taking drugs from work
D) Most chemically impaired nurses cannot be diverted from drug use
A) Most chemically impaired nurses obtain drugs by stealing them from work
Most chemically impaired nurses abuse drugs they were taking for legitimate health
reasons, or they steal drugs from work. The remaining options are not statements
supported by research.
Which statement concerning the recognition of chemical impairment in an employee is
correct?
A) It is relatively easy to identify employees who are chemically impaired
B) It is easier to recognize if the employee is impaired by alcohol than by drugs
C) Impairment should result in an immediate intervention by the manager
D) Impairment must be supported by data gathering before intervention occurs
C) Impairment should result in an immediate intervention by the manager
For safety reasons and to protect clients, employees should be confronted as soon as
possible after chemical impairment is recognized. None of the remaining options are
true statements regarding the recognition of a chemically impaired employee.
What is the most common initial response of an employee to a manager’s confrontation
regarding suspected chemical impairment?
A) Emphatic denial and defensiveness
B) Reluctant acceptance
C) Gratefulness for finally being discovered
D) Silence
A) Emphatic denial and defensiveness
Employee denial and defensiveness are common behaviors in those who are confronted
with their impairment. Often, these individuals are in self-denial.
Which statement identifies a truth regarding the generally accepted plan for the reentry
of the chemically impaired employee into the workplace?
A) It is successful in only a small number of cases despite active treatment programs
B) It is discouraged by the board of registered nursing
C) It should not occur until 3 years after the employee has completed the treatment
program
D) It often includes an employer requirement that the employee agree to random
urine screening on request by the employer
D) It often includes an employer requirement that the employee agree to random
urine screening on request by the employer
Most nurses successfully return to work following a treatment program, and this
generally takes 1 year. Often, the conditions that the employee has successfully changed
his or her lifestyle and will submit to random drug tests must be met before the
employee can be allowed to return to work.
Which statement represents a correct statement regarding the identification and assisting
interventions provided employees with substance abuse problems?
A) It is done as an altruistic and benevolent action by the organization
B) It should not be undertaken by management or the personnel department
C) It should include screening that focuses on early detection
D) Is best handled through disciplinary action of the personnel department
C) It should include screening that focuses on early detection
The personal and professional cost of chemical impairment demands that nursing
leaders and managers recognize the chemically impaired employee as early as possible
and provide intervention since such behavior is a serious safety issue associated with
patient care. The remaining options are not correct.
Which statement is true concerning the management of an employee who performs at
the marginal level?
A) Marginal performance is generally a result of employee burnout
B) Poor motivation is the most common reason for marginal performance
C) Improving skill should be the focus when assisting the marginal employee
D) Some marginally performing employees will never improve their function levels
D) Some marginally performing employees will never improve their function levels
It is important for the manager to remember that each person and situation is different
and that the most appropriate strategy depends on many variables. Looking at past
performance will help to determine if the employee is merely burnt out, needs
educational or training opportunities, is unmotivated, or just has very little energy and
only marginal skills for the job. If the latter is true, then the employee may never
become more than a marginal employee, no matter what management functions and
leadership skills are brought into play.
What is the manager’s initial progressive initial response when a staff member is caught
stealing $3.00 from a patient’s bedside stand?
A) Dismissal
B) Suspension
C) Written notice
D) Verbal notice
C) Written notice
An employee caught stealing is initially presented with a written warning.
Which statement accurately describes the initial deterrent against breaking a rule
according to McGregor’s Hot Stove Rules?
A) All discipline should be administered immediately after rules are broken
B) Each time the rule is broken; there are immediate and consistent consequences
C) All employees must know the rule beforehand and be aware of the punishment
D) Everyone must be treated in the same manner when the rule is broken
C) All employees must know the rule beforehand and be aware of the punishment
All employees must be forewarned that if they break a rule, they will be punished or
disciplined. They must know the rule beforehand and be aware of the punishment.
What is the principle that guides constructive discipline?
A) Constructive discipline is punitive in its nature
B) The focus of constructive discipline is employee growth
C) Constructive discipline employs the manager as a resource not a helper
D) Behavior modification is the desired outcome of constructive discipline
B) The focus of constructive discipline is employee growth
Constructive discipline uses discipline as a means of helping the employee grow, not as
a punitive measure.
Which is a management function associated with dealing with a problem employee?
A) Forewarns the employee of the consequences of breaking a rule
B) Encourages employees to be self-disciplined in conforming to rules
C) Serves in the role of coach in performance deficiency coaching
D) Recognizes and reinforces the intrinsic self-worth of each employee
A) Forewarns the employee of the consequences of breaking a rule
Clearly identifies performance expectations for all employees and confronts employees
when those expectations are not met. The other options are leadership roles.
What is the fundamental rational for conducting a disciplinary conference for a staff
member who has failed to significantly modify the practice of arriving late for assigned
shifts?
A) This behavior disrupts the efficiency of the nursing team
B) The tardiness is costing the facility money
C) This behavior encourages other staff to disregard rules
D) The problem will get worse if it is ignored
D) The problem will get worse if it is ignored
Disciplinary problems, if unrecognized or ignored, generally do not go away; they only
get worse. The other options are likely outcomes of the staff member’s unacceptable
behavior but not the fundamental rational for the disciplinary action.
A hospital administrator is investigating why the turnover rate is so high and why it is difficult to attract new nursing employees. Which situation is most likely to have resulted in this problem?
- The hospital is in a poorer part of town and offers a great deal of charity care.
- The hospital pays about $.25 per hour less than other hospitals as a starting wage for nurses.
- The hospital has a reputation for allowing bullying behavior to occur.
- The other hospital in town has a more modern building and campus.
- The hospital has a reputation for allowing bullying behavior to occur.
Rationale 3: People do not like to be bullied. If the hospital has this reputation it is unlikely to attract new employees and older employees are likely to leave.
The nurse executive works hard to create a civil workplace that does not tolerate harassing behaviors. How would this nurse best explain the reason for this emphasis on civility?
- “Bullying behaviors make nurses uncomfortable.”
- “Physicians do not want to admit clients to hospitals with an uncivil atmosphere.”
- “Bullying and incivility are just not proper work practices.”
- “Bullying and incivility are dangerous to client care.”
- “Bullying and incivility are dangerous to client care.”
These behaviors can be dangerous to clients.
A hospital administrator has attended a conference on bullying and wishes to address the most likely bullies in the organization. Whom would the administrator invite to the first meeting about bullying behaviors?
Select all that apply.
- Nursing assistants
- Physicians
- Managers
- Office personnel
- Senior nurses
- Physicians
- Managers
- Senior nurses
Rationale 2: Physicians are among those reported as being the worst bullies.
Rationale 3: Managers are among those reported as being the worst bullies.
Rationale 5: Senior nurses are among those listed as being the worst bullies.
A nurse writes some scathing remarks about another nurse’s professionalism on a social media site. A complaint of bullying is lodged with the nurse manager. Which statement by the manager is appropriate?
- “I have no control over what the nurses do on their time away from work.”
- “This does not meet the standards for bullying because it was not a face-to-face encounter.”
- “You two are acting like a couple of high school kids.”
- “I will follow up on this complaint and take action as needed.”
- “I will follow up on this complaint and take action as needed.”
The manager must do an assessment of the complaint before acting.
A group of nursing students have just arrived on the unit. Which actions by staff would be considered uncivil to these students?
Select all that apply.
- The unit clerk groans when the instructor enters the nursing station with the students.
- A nurse quietly says, “Please do not assign a student to me today. I have two very sick clients who are going to require my full attention.”
- A nurse whispers, “Not students again today.”
- A nursing assistant asks the students how long they have been in school.
- A transport worker says, “Just great, more students to get in the way today.”
- The unit clerk groans when the instructor enters the nursing station with the students.
- A nurse whispers, “Not students again today.”
- A transport worker says, “Just great, more students to get in the way today.”
Rationale 1: Any action that indicates the students are unwelcome is not civil.
Rationale 3: This whisper is not civil, despite the level at which it is spoken.
Rationale 5: The intent of this remark is probably not civil.
A nurse says, “I don’t see what all the fuss is about bullying. Every new nurse has to go through it. It’s just a part of the history of nursing.” How should the manager respond?
Select all that apply.
- “I know. It’s a shame that all the old ways are changing.”
- “Why would you want to bully a new nurse? They are all so naïve and cute.”
- “The Joint Commission does not tolerate disruptive or abusive behavior.”
- “The American Nurses Association does not approve of bullying behaviors.”
- “New nurses bring new ideas. Why would you bully them?”
- “The Joint Commission does not tolerate disruptive or abusive behavior.”
- “The American Nurses Association does not approve of bullying behaviors.”
- “New nurses bring new ideas. Why would you bully them?”
Rationale 3: The Joint Commission recommends a zero tolerance policy regarding disruptive or abusive behavior.
Rationale 4: The ANA recommends several strategies to combat these behaviors.
Rationale 5: New ideas are brought by new nurses. Bullying of any segment of the profession is wrong.
A nurse makes a medication error and notifies the client’s physician. The physician berates the nurse over the phone and states, “You are an idiot.” How should the manager deal with this situation?
Select all that apply.
- Tell the nurse to go home for the rest of the day.
- Have the nurse call the physician back and demand an apology.
- Document the facts of the encounter.
- Privately tell the physician that the behavior was bullying.
- Confront the physician during rounds and demand an explanation.
- Document the facts of the encounter.
- Privately tell the physician that the behavior was bullying.
- Confront the physician during rounds and demand an explanation.
Rationale 3: The facts of the encounter must be documented.
Rationale 4: The manager should name the behavior.
Rationale 5: The manager should speak to the physician in a civil manner.
A nurse manager does not like conflict and would like to allow instances of bullying to “go away on their own.” What rationale by the manager’s supervisor is the most important?
- “The Joint Commission requires that we address instances of bullying.”
- “We don’t want to run off good nurses.”
- “If you let bullying go, it just gets worse and more frequent.”
- “A bully makes the work environment unpleasant for everyone.”
- “If you let bullying go, it just gets worse and more frequent.”
Bullying behavior tends to escalate if ignored.
The nurse manager becomes aware of frequent incorrect narcotics counts on the night shift. This is verified by the pharmacy. What should be the first action taken by the manager?
- Call a meeting of all night shift employees.
- Review the staffing pattern and absentee list for the night shift.
- Ask employees for their perceptions on missing narcotics.
- Request that security search employee lockers and personal items.
- Review the staffing pattern and absentee list for the night shift.
The first step is to assess the problem. By checking the staffing pattern on the nights in question, the manager can rule out some employees.
