NURS FPX 5007 Assessment 2 Managing Toxic Leadership

NURS FPX 5007 Assessment 2 Managing Toxic Leadership

Addressing and Mitigating the Impact of Destructive Leadership

A nurse manager plays multiple critical roles, including leading the nursing team, advocating for team needs, ensuring safe patient care, and promoting high-quality patient outcomes. However, failing to meet the demands of this role can lead to significant negative outcomes. These may include increased staff turnover, higher rates of patient injuries, diminished quality of care, and a rise in staff grievances (Warshawsky et al., 2022). In this evaluation, the performance of the employee depicted in the “Managing the Toxic Leader” scenario will be examined. This analysis will focus on their current performance level, the repercussions of this performance, and a proposed plan for performance improvement to address these concerns.

Employee Performance Evaluation

The case study “Managing the Toxic Leader” presents the problematic behaviors of a nurse manager named Jackie. Jackie has failed to effectively oversee care conferences as required by the organization and the Joint Commission. Numerous meetings under her charge have been either canceled or poorly attended by the necessary service providers. As the person responsible for these meetings, it was expected of Jackie to conduct them regularly with the required staff members in attendance.

Jackie’s behavior has also raised concerns about her professionalism. She has been reported to engage in unprofessional interactions with staff, including inappropriate physical contact and showing favoritism towards certain employees (Hampton, 2019). Furthermore, Jackie’s conduct includes excessive use of her cell phone, insufficient presence on the floor, and dressing inappropriately, contrary to the organization’s dress policy.

Additionally, the unit under Jackie’s management has seen an escalating series of dangerous incidents involving a patient identified as K. This patient has exhibited aggressive behavior towards both staff and other patients, signaling a deterioration in their condition. Despite efforts by the floor staff to manage the situation, there has been no significant improvement. Jackie has not taken adequate steps to address these issues with the staff, the patient, or the patient’s conservator.

Implications of Employee Behavior

Care conferences are an essential tool for holistically treating each patient. Care
conferences bring together multiple disciplines to formulate care plans to address patient issues.
Jackie is the chair of these meetings and reportedly does not attend or attend late. The attendance
of other disciplines has likely declined due to the sporadic nature of leadership attendance. This
situation violates Joint Commission regulations, and patients are also in imminent harm by not
having updated care plans or addressing imminent harm potential (Dempsey, 2022). In this case,
a patient’s behavior has escalated into dangerous territory and needs to be addressed immediately.
Her lack of involvement with unit issues can lead to safety issues for patients and staff, be
considered negligent, and decrease the staff’s sense of support (Warshawsky et al., 2022).
Jackie’s lack of boundaries with her employees can create additional stress for the staff
and decrease the morale of staff. The boundary violations contribute to the more significant
issues of grossly unprofessional behavior. Employees may interpret her behavior as favorable to
some but not all (Hampton, 2019). Patients may be able to participate in staff-splitting if they
become aware of unequal treatment, which results in additional unit chaos. Additionally, the
employees’ morale will be noted by patients and result in more complications (Pavithra et al.,
2022). Excessive use of cell phone use while interacting with unit staff may imply that issues on
the unit do not take priority leading to employees feeling dismissed or undermined (Warshawsky
et al., 2022). Jackie’s lack of appropriate attire in the workplace can send the message that
professionalism is not required or that the rules do not apply to her, further sending a
compromised unit into further dysfunction.
 
The last concern identified is the patient’s condition change (K). The situation with this
patient involves staff and patient safety, violating the ethical code of quality patient care. While
Kyle is making a solid effort to manage the patient, he is not the only caregiver to this patient,
and comprehensive intervention is required to restore the safety of the unit and the patient
(Dempsey, 2022). Jackie’s actions disrupt the ability of staff to care for the patients, deny the unit
needed leadership, and contribute to unsafe working conditions.

 Performance Improvement Plan

The Performance Improvement Plan (PIP) will be reviewed with Jackie by the Director
of Nursing, quality improvement representative, human resources, and a representative of
Jackie’s choosing. The goals were developed using a SMART methodology: Specific,
measurable, achievable, relevant, and time-specific (Weintraub et al., 2021). The first goal will
address Jackie’s attire. Jackie will review the corporate policy regarding appropriate attire for the
professional environment. Effective immediately, Jackie will be required to comply with the
dress code while on hospital grounds. Violations of the dress code will result in Jackie being sent
home (Falcone, 2017).
Care conferences are a vital part of the unit’s function. Jackie will attend 90% of the care
conferences for the next 90 days. The Director must approve approval for missed meetings of
Nursing. Over the next 30 days, Jackie will reach out to all interdisciplinary team members and
update the expectations of the meetings and attendance of all staff members. Jackie will turn in
notes of the meetings once per week to the Director of Nursing for review. The Director of
Nurses can be contacted to assist with the attendance concerns of other department members
(Falcone, 2017). The goal will be re-assessed at 90 days to determine the plan moving forward. More about NURS FPX 5007 Assessment 2.
 
 
Jackie will complete LeaderWise training in the next 30 days concerning employee
boundary violations. LeaderWise holds a two-day, evidence-based, online training about
boundaries for managers. The company will pay for the training, and a certificate of completion
must be filed with human resources (LeaderWise, 2021). Jackie will be expected to maintain
professional boundaries for the next 90 days with all employees on or off her unit.
Jackie will be asked to assess and review the care plan for patient (K) within the next two
business days. She will be required to update the patient’s conservator within 48 hours. She must
implement an updated care plan in the next 48 hours. The updated care plan and interventions
will be reviewed with the Director of Nursing within 72 hours. The interdisciplinary team will
review the patient’s (K) case at the next scheduled care conference. Over the next 30 days, Jackie
will conduct a chart review and audit with nursing staff, update care plans as needed, and discuss
each patient at least once in the team’s care conference in the next 30 days. As the reviews begin,
the highest priority patients will be those with a change in condition, patients transitioning off of
the unit, and patients exhibiting imminent harm to self or others (Pavithra et al., 2022).
Jackie will refrain from frivolous use of her personal cell phone during business hours.
 
Jackie will review the corporate policy regarding personal cell phone use within one week.
Jackie will sign an acknowledgment that she has read and understands the policy. Jackie will not
take her cell phone into care conferences during meetings with patients or staff (Falcone, 2017).
At 90 days, the goals will be reviewed with all attendees of the original meeting. At that
time, the team will decide if any goals need to be extended. This PIP will be considered
progressive. If Jackie fails to meet the goals, she will receive a written warning and a new goal.
The team will discuss the need for a PIP if Jackie meets or exceeds the goals (Falcone, 2017).

Conclusion NURS FPX 5007 Assessment 2 Managing Toxic Leadership

Jackie is a Nurse Manager in an inpatient psychiatric unit. As presented in the scenario
“Managing the Toxic Leader,” Jackie has displayed concerning behavior on her unit, including
lack of engagement with staff and patients, boundary violations, dress code violations, excessive
cell phone use, and lack of attendance at care conference for which she is the chair. These
behaviors cause a hostile environment for the staff and patients. Additionally, the patients are not
receiving the care needed due to the lack of engagement in the unit. A performance improvement
plan offered some immediate goals for Jackie to address with the hope that she can retain her
employment and improve the safety of her unit.

References

Here’s the rewritten reference list:

Dempsey, C. (2022). Nursing leadership across the continuum. Nursing Administration Quarterly, 46(4), 283-290. Available at: [https://doi.org/10.1097/naq.0000000000000544](https://doi.org/10.1097/naq.0000000000000544)

Falcone, P. (2017). 101 sample write-ups for documenting employee performance problems: A guide to progressive discipline & termination (3rd ed.). AMACOM. Accessible at: [Capella University Skillport](https://capella.skillport.com/skillportfe/main.action?assetid=RW$123015:_ss_book:135636#summary/BOOKS/RW$123015:_ss_book:135636)

Hampton, D. (2019). The importance of boundary management. Nursing Management, 50(8), 51-54. Available at: [https://doi.org/10.1097/01.numa.0000575308.00185.00](https://doi.org/10.1097/01.numa.0000575308.00185.00)

LeaderWise. (2021). Boundaries training. Retrieved from [https://www.leaderwise.org/boundaries-training](https://www.leaderwise.org/boundaries-training)

Pavithra, A., Sunderland, N., Callen, J., & Westbrook, J. (2022). Unprofessional behaviours experienced by hospital staff: Qualitative analysis of narrative comments in a longitudinal survey across seven hospitals in Australia. BMC Health Services Research, 22(1). Available at: [https://doi.org/10.1186/s12913-022-07763-3](https://doi.org/10.1186/s12913-022-07763-3)

Warshawsky, N. E., Cramer, E., Grandfield, E. M., & Schlotzhauer, A. E. (2022). The influence of nurse manager competency on practice environment, missed nursing care, and patient care quality: A cross-sectional study of nurse managers in U.S. hospitals. Journal of Nursing Management, 30(6), 1981-1989. Available at: [https://doi.org/10.1111/jonm.13649](https://doi.org/10.1111/jonm.13649)

Weintraub, J., Cassell, D., & DePatie, T. P. (2021). Nudging flow through ‘smart’ goal setting to decrease stress, increase engagement, and increase performance at work. Journal of Occupational and Organizational Psychology, 94(2), 230-258. Available at: [https://doi.org/10.1111/joop.12347](https://doi.org/10.1111/joop.12347)

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