Eliminating Bullying & Incivility Through Deliberate Documentation

iStock-1072675574.jpgErik had had enough of his charge nurse, Taylor, who is a known bully.

For years, everyone put up with her because she was “so good.” However, Erik just lost another new nurse because of her and decided enough is enough. He can no longer afford to lose nurses and support staff because of Taylor’s nasty behavior.

Erik makes an appointment with his HR business partner, Emily. He tells her about Taylor and that he’s had enough with her behavior and wants to terminate her. Emily immediately asks for documentation.

When Erik shares a few documents, Emily reads them and says, “You’ve got nothing here that we can use. How about a verbal warning?”

Erik leaves Emily’s office frustrated and angry.

Has this ever happened to you?

The Leader-HR-Documentation Disconnect

I’ve talked with many leaders who’ve shared a similar story as Erik’s.

They finally decide to DO something about their toxic employee but when they get to HR, are typically told they don’t have enough documentation. While the leaders complain about hitting a brick wall when asking HR for help, I’ve seen things from HR’s side too.

Many HR representatives may believe the leader, want to support their decision to therapeutically extract the employee, but without the proper documentation, they would be putting the organization at risk.

Keep in mind that leaders and their HR business partners are on the same team and want the same things – for employees to show up, ready for practice, and work collaboratively as a team to deliver the best, safest, and highest quality of care to the patients they serve.

In order for both to achieve this utopia work environment, it requires that from time to time, you therapeutically extract those employees who are unwilling or incapable of showing up ready for practice. This is where documentation is essential. For it is the documentation that helps you and your HR business partner arrive at the same conclusion – the employee is not worthy of continued employment.

Deliberate Documentation

Holding employees accountable requires a dedicated commitment to setting clear expectations regarding conduct AND…deliberate documentation. Here are 3 tips to help you document in a way that increases your chances that HR will support you.

1. Start documenting as soon as you sense a problem

Just like a bedside nurse, we tend to pay more attention to our documentation when we sense there is a problem.

When I was working as a neuro nurse, my colleague and I walked my heavy set, short recent stroke patient (with mild left-sided weakness), to the bathroom. I wanted to put her on the bedside commode but she INSISTED on walking to the bathroom.

We barely got her to the toilet. Seriously, it took every ounce of strength to keep her from falling until we got her to the toilet.  Getting her back to bed required 6 of us. 30 minutes later, the patient’s daughter called me to her room and accused me of allowing her mother to fall. Even though I assured her that her mother DID NOT fall, she kept insisting that she did.

You better believe I took extra time to document every detail of what happened that day and sure enough, 6 months later she tried to sue us for “the fall”. It was my and my colleague’s documentation that saved us.

Do the same thing with your employees. Once you sense an issue, start an ongoing documentation trail.

2. Include these items in every documented incident

Believe it or not, I’ve seen many documented incidents of disruptive behaviors that don’t include the basics. Always, always include the following items:

Dates, times, and location – When, what time, and where did the incident take place?

Incident – Describe the incident as objectively as possible. Keep all opinions out!

Any witnesses – Who was present when the incident occurred? Note – it doesn’t matter if the witness also documents. Including witnesses in your documentation lends credibility.

Verbatim comments – Let’s say your nurse said to your newest nurses, “Listen here, bitches. You just took away our overtime”, include these exact words (Yes. True example).

Any action is already is taken – If you’ve had a conversation or did any counseling, including the details, especially if you’ve already addressed the behavior in the past. Make sure you include any action items or expectations you’ve included.

3. Include the “so what” factor

Before you go down the documentation path, make sure you can answer the “so what” question. So, your nurse says to your newest nurses, “Listen here…” How does that behavior impact one of the following: Patient safety, quality of care, patient satisfaction, or the way the team communicates with each other. What if this nurse said this in a patient care area? Not only does the behavior have a negative impact on the way the team communicates with each other but also it may impact patient satisfaction if a patient or their family member hears that interaction. Would you really want to be a patient in that department?

Or what if one of your experienced nurses refuses to take a report from another nurse, refuses to help, or walks off the unit when a crisis hits? Always, always think about the impact, or the “so what?” factor. If you can’t identify a clear connection to patient safety, quality, satisfaction, or team communication concern, I’m not sure it’s worth your time.

I certainly wouldn’t waste my precious time documenting every incident of eye rolling!

How does the behavior impact patients or the team? Answer that and you’ll exponentially increase your chances of your HR business partner supporting your decision to go down the disciplinary path!

In a professional workplace, it’s disturbing to think we have to address unprofessional behavior!! Instead, leaders should be spending their time helping their employees become the very best version of themselves, building and strengthening relationships, and doing everything they can to provide the very best possible care. That’s what leaders WANT to spend time doing! However, if leaders HAVE to spend time walking employees down the disciplinary path, they have a responsibility to do so. Following the guide I’ve provided will help leaders increase their chances that their HR business partner will support their decision – time well spent.

Employees, like Taylor, no matter how “good” they are, should not be allowed to continue disrupting the workplace, especially because I’s weren’t dotted and T’s weren’t crossed.

If you’re going to document, do it right!

Leave me a comment below if this resonated with you.

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About Renee Thompson

Dr. Renee Thompson is a keynote speaker, author and professional development/anti-bullying thought leader. Renee spends the majority of her time helping healthcare and academic organizations address and eliminate bullying behavior. To find out how you can bring Renee to YOUR organization or nursing event, visit www.healthyworkforceinstitute.com

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