1. Campbell, Gladys MSN, RN

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QI'm finding that more of my staff members are having a significant amount of personal issues, which are affecting their work performance. I think they need to leave their personal problems at the door. Is this the right approach?


In today's work world, employees are demanding attention to the creation of healthy work environments. Standards for a healthy work environment have been published by both the American Association of Critical-Care Nurses and the American Organization of Nurse Executives. The explosion of interest in our work environments mirrors a strong sense that employees want their human needs recognized and supported in the workplace, from safety to respect. The question for managers is: Where's the boundary between being a supportive humanistic leader and letting the individual and sometimes excessive needs of a few team members create an unhealthy work environment for the rest of the team? It's important for all managers to rely on organizational or department standards and employment policies as the foundation for decision making in the areas of staffing, scheduling, and fitness for duty.


All employees in the workplace must be either fully fit for duty or on a formal and defined accommodation plan. This type of structure protects the manager from employees who may use health and wellness issues to manipulate their shift assignments. For employees who have personal priorities that impact the shift and schedule they work, policies and procedures for making schedule requests-as well as compliance with organizational, state, and federal law related to rest periods, breaks, sick leave, vacation time, family medical leave, and disability-should guide the manager's decisions. No manager should be put in the position to prioritize the needs of one employee to have her school schedule accommodated against another's need to care for his sick grandmother or to choose between the child-care challenges of one staff member and the church mission trip of another.

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In the rare situation where there's no policy to guide decision making and a staff member's need for accommodation will impact negatively the schedules of the other members of the team, I've had the staff member make her request to the full team, describing not only the need, but also how long it must be accommodated and what she's willing to do for the team in return. This approach often works well, and it most definitely forces an individual to acknowledge how her needs may impact others.


QI've been a nurse manager for 3 years and I believe I'm ready to take the next step in my career. Is 3 years of experience enough to be considered for a promotion?


There's no single right time to ask for a promotion. Moving your career forward requires not only an assessment of your time in your current role, but also an evaluation of the scope of the roles you've held, the specialty areas that you've worked in, your educational credentials, your personal confidence and competence, the size of the organization in which you work, and the various parts of the country where you have experience. You also need to define your picture of what a promotion looks like and what it means to you.


If you feel you've fully mastered your current role and are anxious for a new challenge, those are indicators that you're ready to move on. At this point, it might be wise to have an honest conversation with your boss, seeking out her opinion of your talents, areas for improvement, and an assessment of your ability to move to the next level. It's always good to let a supervisor know that you're thinking of promotion, so that you come to mind when potential positions become available. Another suggestion might be to consult a professional coach. A perfect time to seek out coaching is when you're considering or engaging in role transition. Many feel you should only consult a job coach when you've unexpectedly lost your job, but the best time to seek coaching is actually when you're intentionally moving your career to the next level. Best of luck to you and congratulations on your choice to make your optimal contribution to your profession!!