Budgeting Questions for Approval

1. How often do you review your budget? Monthly, weekly, or yearly basis?
2. Who is involved in the process of reviewing the company budget?
3. If you are over budget, where are adjustments made first?
4. How do you determine how much of your budget will be allotted to employee pay, products, or other expenses?
5. Do you have a particular area that consistently causes your business to go over budget? Or do you consistently come in under or at budget?
6. If you have no problem areas of your budget, what would you say contributes most to being able to stay within your budget?
7. Are changes in the budget communicated to your employees and staff?

Career Development and Staffing Reflective Journal

I anticipated discussing one of the aspects of possible career development that we had talked about having a guest speaker discuss. As for staffing, I expected to discuss how staffing changes are made and who makes those decisions.  In class we actually talked about master's and NP degrees and what that entails.  We also covered travel nursing and some of the specifics that go along with that, such as how long of an orientation travel nurses get, that they have to apply for RN license in each state, and that most agencies require 2 years of experience.  I also learned that there is an MSN and there is an NP, although they are bother master's degrees.  The NP degree is better when anticipating that you would like to do more clinical work.  Our staffing discussion was also interesting.  The dilemma was brought up that a day position opened up for application and usually the nurse manager offers the more desirable position to the most senior RN on night shift first; however, they need those senior nurses on night shift or else they would all be new nurses.  We also did a scheduling exercise.  I enjoyed these discussions since they were real-life examples and it gave me a greater appreciation for staffing.  I also was interested in learning more about NP programs and about being an NP, so this was a great way to find all that out.

Budgeting Reflective Journal Entry

Reflect on the unit topic. Type the following in your Reflective Journal/Blog.
1. Share what you had expected to learn about the topic before the class.
2. What you actually learned from the unit.
3. How you will utilize the information learned in your nursing practice.
4. Your personal feelings about the material covered.
When finished with your entry, place one sentence in this assignment stating your Reflective Journal/Blog entry has been made.

Before class, I expected to cover budgeting in percentages, for example, 2% going to office supplies.  We learned about budgeting and how some aspects of budgeting cannot be changed, while others can flow from one part to another more flexibly.  Hospitals have about 175 items for which they budget.  The budget is divided by revenue and expenses and the monthly budget is compared to the year-to-date budget and actual figures.  Acuities are an important aspect of budgeting for healthcare and can mean the difference between $500 and $2,000 per shift.  During our budgeting exercise, I learned that, unfortunately, the best and easiest way to cut the budget is to cut nursing staff or just nursing hours.  I will keep this information in mind if I am ever in a management position, but even as an RN without a higher position.  If budget cuts were necessary, I would hope that I have worked impressively enough that management would consider me too valuable to cut.  It was an interesting exercise and I hope I don't have to make those tough budgeting and possibly firing decisions.

Hiring/Firing/Discipline Interview

I interviewed James at Thrive Life:

1. Does your company utilize “at will” employment policies?

Yes 

2. Are there any issues for which an employee would be fired immediately?

Yes, there are "out of bounds" immediate terminations for reasons like positive drug and alcohol tests, theft, etc.

3. How much of your hiring decision is based off of personal appearance of the candidate?

Technically, none of it should be, but personal appearance definitely makes a first impression in an interview.

4. When initially looking over applications, what are some reasons for which you would immediately throw out an application?

Vast grammatical errors, under-qualified for the position.

5. How would you deal with an issue between two employees that is purely based off of “he said, she said”, such as sexual harassment?

Take written statements from each employee to see if there are any disagreements, verbally discuss what happened and if they have disputes on the other employee's statement, talk about the severity and desired consequences from each employee, take necessary action (warning notices, termination, discussion in both personnel files), notify Manager if necessary.

6. Do you ask the same questions for every hiring interview?

No, it depends on the position.

7. Do you get references?  If so, do you call references?  How important are they in the hiring process?

We usually only request references for certain higher-level positions, and yes, we do call them once we've narrowed it down to a couple of candidates.  They play a major role in deciding between final candidates. 

8. Have you ever had to fire an employee?  If so, what was the process, if any, that you used?

Yes.  Explain why, provide proper documentation for their records, explain what happens next (final pay, etc.), return all company equipment (including credit cards, office keys, computer, etc.), remove all company access (logins, email, phone, etc.), escort out of the building, notify payroll and benefits of termination.  Mark reason for termination in personnel file and whether or not they are re-hirable.

9. Have you ever been involved in a lawsuit because of firing an individual?

No. 

10. Have you ever had a conflict while firing an employee and how did you handle it?

Yes, usually with proper communication (fully explaining the situation and why it happened), listening and resolving concerns, and sensitivity to their feelings.

11. Do you typically offer severance when firing an employee?

Generally only for salaried employees who are on good terms with the company.

       From this interview, I learned that health care businesses and hospitals are run much like other businesses, except for maybe a few small issues that are different from business to business.  I didn't realize how important references are, but I'm sure they are just as important when applying for a health care position as they are at other businesses.

Ethics Reflective Journal

Reflect on the unit topic. Type the following in your Reflective Journal/Blog.
1. Share what you had expected to learn about the topic before the class.
2. What you actually learned from the unit.
3. How you will utilize the information learned in your nursing practice.
4. Your personal feelings about the material covered.
When finished with your entry, place one sentence in this assignment stating your Reflective Journal/Blog entry has been made.

I expected to cover controversial, ethical issues we face in the health care world today and how hospitals deal with them.  In class, we had a panel that discussed a few cases, such as surrogacy, cultural differences, blood transfusions, possibly unnecessary procedures, and eugenics.  It was amazing to me the different opinions about each and how there really is no right answer.  When we were discussing eugenics, a guy on the panel said that the ethics committees decide on policy that they will allow for EVERYONE, not just the one case.  With that, there is a big discussion about, "where do we draw the line?" If this one couple wants the ensure their child won't have Huntington's Disease, then what about the couple that doesn't want their child to have Autism, or the couple that wants their child to be a boy?  I was also torn about the cultural case since there is a fine line between some cultural practices and abuse, even, possibly, in our culture from the eyes of another culture.  In my practice, I will be sure to communicate often with my coworkers and my supervisors if I even slightly suspect abuse since there are legal ramifications and it's my duty to take care of my patients.  I also am now aware that the nurse has the power to call an ethics committee.

Hiring/Firing/Discipline Interview Questions for Approval

1. Does your company utilize “at will” employment policies?

2. Are there any issues for which an employee would be fired immediately?

3. How much of your hiring decision is based off of personal appearance of the candidate?

4. When initially looking over applications, what are some reasons for which you would immediately throw out an application?

5. How would you deal with an issue between two employees that is purely based off of “he said, she said”, such as sexual harassment?

6. Do you ask the same questions for every hiring interview?

7. Do you get references?  If so, do you call references?  How important are they in the hiring process?

8. Have you ever had to fire an employee?  If so, what was the process, if any, that you used?

9. Have you ever been involved in a lawsuit because of firing an individual?

10. Have you ever had a conflict while firing an employee and how did you handle it?

11. Do you typically offer severance when firing an employee?

Performance Appraisal Interview

I interviewed Jaclyn Price, the HR Manager at VitalSmarts.  

1. How often do you perform employee evaluations?
These are done twice a year.

2.  What categories do you rate your employees on?
The overall categories for which VitalSmarts employee are evaluated are goals, budget management, and attitude.
 
3. How important do you feel an employee evaluation is?
These are important for the employees because they determine pay increase or punishments for not meeting goals.
 

4. How long do your evaluations take you to prepare?  
Not very long, since the HR manager does not meet with the employees. The employees do a peer review and then meet with their direct manager. 

5. How long is each meeting with your employees?
The employees don't meet with the HR manager, but after they do the peer evaluation, they meet for 1 hour with their direct manager.


In conducting this interview, I learned more about what we learned in class concerning the different forms performance evaluations can take.  I like the idea of a peer evaluation since they work directly with you and managers may not see how you work, just when you work and your attitude when they happen to see you working.  That gives a more realistic view into how you work with others and how that influences the workplace.  That being said, if you don't have that many people that work with you, then you will know where the feedback is coming from and, if it's a poor evaluation, then some people could get offended. A meeting with the direct manager is how most companies complete evaluations, I believe, since HR representatives don't work with the employees.  It's important to know what form your company does evaluations so that you as the employee or as the manager can properly prepare.