Nursing Management Ch 23 Managing Absenteeism

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Absenteeism in health care organizations is both pervasive and expensive.It has detrimental effects on the work lives of other staff nurses. For the nurse manager, the question is what she or he can do to lesson the unit's recurrent absenteeism problem. The nursing manager must first understand the causes.

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Absenteeism

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TOTAL TIME LOST the number of scheduled days an employee misses

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TOTAL TIME LOST

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Voluntary versus involuntary absenteeism – voluntary absentteism is absenteesm under the employees control (e.g. not coming to work in order to finish one’s income taxes) whereas involuntary absenteeism is abseentteism thant is not under the employees control (e.g. taking a sick day due to food poisoning).

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A Model of Employee Attendance

Voluntary versus involuntary absenteeism

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Absence frequency – the total number of distinct absence periods, regardless of their duration; used as an indirect estimate of volunatry absenteeism.

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Absence frequency

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Job itself – employees holding more enriched jobs are less likely to be absent than those with more mundane jobs; and nature of job

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Attendance barriers

Job itself

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Organizational practices-increase attendance motivation by carefully recruiting and selecting employees; organizational activities such as offering wellness programs, employee assistance programs, van pools, on site child care or coordinating car pools could influence an employees ability to attend work.

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Attendance barriers

Organizational practices

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Absence culture –some work units reflects tolerance for excessive absenteeism. Example, people in a cohesive work group may develop an understanding that missing work, except for ER or serious illness is unacceptable.

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Attendance barriers

Absence Culture

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Supervision –a nurse manager can influence the nature of a staff nurse’s job by stressing the importance of good attendance (such as degree of responsibility given and participation in decision making, decisions about personnel, whether sanctions are enforced for abuse of sick leave)

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Attendance barriers

Supervision

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Labor market – during nursing shortage, nurses perceives it would be easy to find an equivalent job if he or she disliked the current one.

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Attendance barriers

Labor market

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Personal characteristics – employees attitude, values or goals. A staff nurse with a high personal work ethic or who has a goal of getting promoted should be more highly motivated to attend to work than a nurse who lacks such a work ethic.

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Attendance barriers

Personal characteristics

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To diagnose the key factors leading to absenteeism, the manager needs information from several sources, including staff, the human resource department, other nurse managers, and administration. Absence patterns can answer such questions as:
1. Is absenteeism equally distributed across staff nurses?
2. In comparison to other units, does your area of responsibility have high absenteeism rate?
3. Are most absences of short or long duration?
4. Does the absenteeism have a consistent pattern (e.g., occur predominantly on weekends or shortly before a person quits)?

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Managing Employee Absenteeism

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The best way for nurse managers to control absenteeism is by encouraging their staff's motivation to attend.

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Managers control absenteeism

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1. Enrich the staff nurse job by increasing its responsibilities, variety, or challenge
2. Reduce job stress
3. Create a norm of excellent attendendence
4. Enhancing advancement oppurtunities
5. Improve co-worker relations
6. Try to select employees who will be satisfied with and commited to their jobs
7. being a good role model by rarely taking sick days
8. Discussing the employees attendence during the performance appraisal interview
9. Rewarding good attendence with salary increases and other rewards
10. Enforcing absenteeism control policies

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Management Strategies to Control Absenteeism5t

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Most organizational policies allow employees to accrue paid sick days--typically, 1 sick day for every month employeed. An innovative approach for managing absenteeism is substituting personal days for unused sick days. The employee does not have to lie and the manager may have time to find a replacement.

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Absenteeism Policies

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The federal Family and Medical Leave Act took effect in 1993 and has a significant impact on employers. 12 weeks during any 12 month period, maintaining health insurance covering, allowing them to return to the same or equivalent position at the end of the leave period.

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Family and Medical Leave Act

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Even though they are exceptionally productive, are technically proficient, and account for a large part of the organization's output, they can present management problems that equal or exceed their productivity.

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Overachievers or Superachievers

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Bulls and A-bombs, the most common type, Bulls believe that their ideas, ways of doing things, and beliefs are the only way. Their main weapon is abusive, intimidating, and overwhekming behavior. The
A-Bomb displays tantrum like behaviors as a substitute fot the direct attack. These tantrums can be physically dangerous.

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Bulls and A-Bombs

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-Let them run their course if no physical danger is involved, Give them time to cool off.
-Present your position, ehich will require standing up to them. You may need to raise your voice to get their attention.
-Do not argue, but continue to state your view firmly.
-Outside of these confrontations, ask them for advice.
-You will not change their behavior yourself; professional help may be needed.

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Strategies for dealing with Bulls and A-Bombs

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They achieve their goals by digs and cutting remarks. They feel they need to be right at the expense of others and take deliberate efforts to make other employees look less competent. They have a need to feel superior to all around them.

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Killer Angels

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-confront the employee directly with the behavior, confrontation lets the person know you know what they are doing.
-Provide Killer Angels with a forum in which they can air their views, such as problem solving meetings. Always set ground rules in these meetings, and do not let the Killer Angel dominate.
-Seek the Killer Angels advice.

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Strategies for dealing with Killer Angels

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Is an expert and wants everyone to know this. They are the least dangerous overachiever. They want to be admired and thus gives advice on anything and everything. The best strategy is to filter out the expert advice. If the behavior causes problems with co-workers, confront the behavior in private. Coaching techniques often work with these individuals.

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Know-It-All