NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Name

Capella university

NURS-FPX 5007 Leadership for Nursing Practice

Prof. Name

Date

Performance Improvement Plan Development

Effective leadership and performance management are essential for ensuring quality patient care and maintaining a positive organizational environment (Huang et al., 2024). This paper presents a performance improvement plan (PIP) for Sarah Miller, a Licensed Practical Nurse (LPN) at Serenity Senior Care, an assisted living facility committed to empowering its residents through compassionate and dignified care. Several concerns about Sarah’s performance have recently been raised; as the newly appointed manager, I will evaluate these issues about Serenity’s approach to create a targeted improvement plan that addresses these concerns and promotes Sarah’s professional development. 

Evaluating Leadership Practices to Address the Scenario

An effective leadership approach combines supportive coaching with accountability to address Sarah Miller’s performance concerns. Applicable leadership practices for the scenario above would be transformational and servant leadership practices. Her personal growth and team cooperation are valued in harmony with Serenity Senior Care’s vision and aim of addressing concerns and empowering compassionate treatment. 

Transformational leadership seeks to work on change with subordinates to make them better individuals by providing a working environment that supports integrity, caring, and support among other subordinates (Gebreheat et al., 2023). With this approach in mind, I, as the nurse manager, would get an opportunity to sit down with Sarah and discuss with her the expectations of the managers, her responsibilities within the facility, as well as the impact that role she plays on the residents and the rest of the team.

With the help of transformational leadership, I can demand more from Sarah, giving her all the instruments she requires to succeed, which means that she has the only route for development. Besides, servant leadership focuses on the leader’s support of the employees or his fellows (Demeke et al., 2024). If I try to meet her needs in the line of work for professional development, I will get a better chance of her listening to constructive criticism that I would give her. This approach also teaches Sarah to put residents and colleagues first, which could help her change her practices to align with the mission of Serenity, which is to place the residents at the heart of care.

Standards of Professional Performance Violated

Two specific standards of professional performance are being violated in Sarah’s case: 

• Collaboration: American Nurses Association (ANA) standards require collaboration in practice so that quality and safety can be achieved in the practicing arena (ANA, 2020). Moreover, the opinions and behaviors of the colleagues mentioned in the scenario affect collaboration. Sarah’s refusal to work in groups and negative attitude toward her peers disrupt group work and harm collaboration, ultimately harming residents and teamwork. 
• Quality of Practice: Another ANA standard is thoughtful and complete documentation and adherence to standardized safety measures that reflect practice quality (ANA, 2020). Problems with Sarah include inadequate documentation, failure to follow the measures required to prevent falls, and the exposure of gaps in resident care delivery. These are indicators of the quality of care and contribute to the organization’s possible harms and legal responsibilities.

It is crucial to document the specific areas where Sarah’s practices are misaligned with Serenity’s standards and expectations to guide her performance improvement: 

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

• Resident Care: As residents complained, while Sarah is efficient in managing the tasks that have to be done for residents’ care, she lacks the warm and personal touch that Serenity promises to its residents. This has a negative effect on the residents’ emotional health and also detracts from their experience. 

• Documentation: She often gives incomplete documents or documents her accounts incorrectly. This practice is offensive to other team members’ follow-ups of required resident care for continuity and safety reasons. 

• Teamwork: Many colleagues who have worked with Sarah say she is reluctant to cooperate and speaks to them rudely when giving her verdict. It also affects the cohesiveness of the teams and hampers the working environment and its general climate. 

 

• Resident Safety: Under Sarah’s supervision, several near falls have occurred in the facility, a serious concern that demonstrates that the risk of falling has not received adequate consideration. The lack of injury to residents still implies that these risks are concerning to their lives.

Employee Behavior

Serenity Senior Care intends to offer elders end-of-life care that promotes independence and dignity. The vision is to maintain and support an environment for residents and staff free from abuse, fostering an atmosphere of safety for the residents. Serenity’s objectives revolve around resident protection, quality improvement in implementing client care, and encouraging stakeholder collaboration and professionalism.

Every one of Sarah Miller’s performance challenges, non-communication, failure to document, task-centric care, and safety violations go directly against Serenity’s mission, vision, and objectives. Brushing her conflict management skills makes Serenity realize that inconsistent collaboration with her peers weakens the team and demoralizes it since she relies on such an ideal environment in treating her personnel.

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Her attitude towards resident care, which many people consider impersonal, also goes against the assured, empowering, and compassionate care that is cardinal to the mission of this organization. A study shows compassion is a critical element in healthcare that significantly impacts patient well-being, satisfaction, and outcomes. The study emphasizes that fostering compassion improves both patient experiences and the work environment for providers, contributing to better quality care and reduced burnout (Malenfant et al., 2022).

Regarding the safety and quality aspects, we notice that due to Sarah’s lack of detailed documentation and supervision of fall preventive measures, Serenity needs to have the necessary safety standards, and the client’s care is not continuous. Another is documentation, for it is fundamental that all care planning is communicated accurately. With documentation, other staff members can assess the resident well-being and make appropriate care determinations (Demsash et al., 2023).

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Due to the above lapses, Sarah threatens the residents’ safety and the organization’s image, which claims to provide resident-centric safe care. To help Serenity fulfill its mission and vision, employee performance expectations for all nursing staff must align with compassionate, collaborative, and safety-focused care. Staff are expected to engage in teamwork actively, communicate respectfully, prioritize resident safety through established protocols, and complete thorough documentation to ensure continuity of care. Sarah’s behavior, in contrast, disrupts this standard, impacting resident experiences and the collective functioning of the care team.

While Sarah’s behavior has raised multiple concerns, it is important to consider possible underlying issues contributing to these performance gaps. Sarah’s five years of experience at Serenity indicate that she has succeeded in the role to some degree. She may simply be experiencing temporary challenges related to workload, burnout, or personal factors impacting her behavior. By approaching the situation from multiple perspectives and considering potential external influences on her performance, we can create a performance improvement plan that is fair, supportive, and aligned with Serenity’s commitment to resident-centered care.

Action Plan for Improving Employee Performance

This action plan focuses on clear expectations, targeted skill development, and measurable outcomes to address Sarah Miller’s performance issues at Serenity Senior Care. The objective is to align Sarah’s performance with the organization’s mission to provide compassionate, collaborative, and safe care, improving resident outcomes and team dynamics.

Professional Performance Expectations

Firstly, Sarah is expected to prioritize meaningful resident interactions, demonstrating a compassionate approach that aligns with Serenity’s mission. She should engage with each resident individually, showing respect and empathy rather than prioritizing task completion alone. Secondly, accurate documentation must be maintained for each shift, ensuring resident progress and care continuity to reduce errors or omissions. Further, Sarah must participate actively in team discussions, respect others’ contributions, and adopt a constructive communication style. Lastly, she is expected to focus on proactive strategies to reduce fall risks by implementing at least two safety measures, such as clearing pathways and assessing residents for fall risks at regular intervals.

She will participate in a few key training programs to support Sarah’s growth. First, she will be exposed to a documentation exercise to enhance the documentation process and review (Demsash et al., 2023). After the workshop, her documentation will be examined for one month, with one-week intervals for her progress to be checked. Also, the following interventions will be conducted by Sarah: TeamSTEPPS, which will address issues concerning communication, one of the effective communication techniques that promote teamwork (Hassan et al., 2024).

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

She will be honored during this training as she learns to be professional with her fellow employees and respect everyone regardless of gender, race, or sexual orientation. Lastly, Sarah will join a fall prevention program during the first two weeks of the improvement plan. The strategies to control fall risk she will learn in this course will enable her to avert possible falls by performing safety checks each time she is on duty. Research shows that this practice would help avoid complications and save costs massively (Ojo & Thiamwong, 2022). In addition to informing Sarah, she will have a senior nurse as a role model with whom she will meet weekly.

This mentor will assist Sarah in responding to challenges and effectively implementing what she learns in the training. Sarah will consult the nurse manager’s weekly feedback session to enhance the organization’s functionality. These meetings will be centered on her performance and general welfare, provide suggestions on remedial action where necessary, and motivate her to develop positive behaviors.

Timeline and Performance Review Milestones

• Week 1: The first discussion session will establish goals, including conducting proper documentation and fall prevention training.
• Weeks 2-4: Sarah attends and completes fall prevention training and TeamSTEPPS. Feedback from the nurse manager starts at least once a week, along with mentoring.
• Weeks 5-8: Documentation skill assessment, with weekly error—and omission checks, will be conducted. According to the results of the weekly evaluation, further collaboration training will be conducted. 
• End of Week 8: The organizational practice of conducting a review to determine changes in Sarah’s efficiency, interactions with the residents, documentation efficiency, and cooperation. 

With a more compassionate approach, Sarah is expected to improve residents’ experiences, aligning her actions with Serenity’s mission. Enhanced teamwork will boost morale and create a more supportive, efficient environment. Improved documentation accuracy will support continuity of care and reduce risks. Consistent safety practices should help reduce falls, directly enhancing resident safety (Ojo & Thiamwong, 2022). This action plan assumes that Sarah has a change readiness and is ready to do training, and the organizational resources are available to meet the job performance requirement.

Suppose any of the assumptions are found invalid. In that case, particular changes to the plan will be made, and this may also include seeking more assistance or looking at other intervention strategies to facilitate a change for the betterment of Sarah’s performance. Such a structured plan allows Sarah to change and outlines the steps to achieve professional norms that may serve Serenity’s mission and vision. Serenity’s growth in those areas can contribute to the improvement of patients’ outcomes and the organization of work relations in the healthcare institution.

Conclusion

In conclusion, this PIP provides Sarah with clear expectations, training, and mentorship to align her actions with Serenity Senior Care’s compassionate and safe care mission. She can enhance her documentation accuracy, teamwork, and resident interactions through structured guidance and support, fostering a positive environment for staff and residents. This plan encourages professional growth, aiming to improve individual and organizational outcomes at Serenity.

References

ANA. (2020). ANA principles. ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/ana-principles/ 

Demeke, G. K., Engen, M. van, & Markos, S. (2024). Servant leadership in the healthcare literature: A systematic review. Journal of Healthcare Leadership, 16(16), 1–14. https://doi.org/10.2147/jhl.s440160 

Demsash, A. W., Kassie, S. Y., Dubale, A. T., Chereka, A. A., Ngusie, H. S., Hunde, M. K., Emanu, M. D., Shibabaw, A. A., & Walle, A. D. (2023). Health professionals’ routine practice documentation and its associated factors in a resource-limited setting: A cross-sectional study. BMJ Health & Care Informatics, 30(1), e100699. https://doi.org/10.1136/bmjhci-2022-100699 

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Gebreheat, G., Teame, H., & Costa, E. (2023). The impact of transformational leadership style on nurses’ job satisfaction: An integrative review. SAGE Open Nursing, 9(2). https://journals.sagepub.com/doi/full/10.1177/23779608231197428 

Hassan, A. E., Mohammed, F. A., Zakaria, A. M., & Ibrahim, I. A. (2024). Evaluating the effect of TeamSTEPPS on teamwork perceptions and patient safety culture among newly graduated nurses. BMC Nursing, 23(1), 170. https://doi.org/10.1186/s12912-024-01850-y 

Huang, C.-H., Wu, H.-H., Lee, Y.-C., & Li, X. (2024). The critical role of leadership in patient safety culture: A mediation analysis of management influence on safety factors. Risk Management and Healthcare Policy, 17(17), 513–523. https://doi.org/10.2147/rmhp.s446651 

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Malenfant, S., Jaggi, P., Hayden, K. A., & Sinclair, S. (2022). Compassion in healthcare: An updated scoping review of the literature. BMC Palliative Care, 21(1), 1–28. https://doi.org/10.1186/s12904-022-00942-3 

Ojo, E. O., & Thiamwong, L. (2022). Effects of nurse-led fall prevention programs for older adults: A systematic review. Pacific Rim International Journal of Nursing Research, 26(3), 417. https://pmc.ncbi.nlm.nih.gov/articles/PMC9432804/