I am a manager for a Medicare HMO. I have 20 Nurses that are direct reports and they perform daily onsite reviews at hospitals and Skilled Nursing Facilities. They gather clinical and psychosocial information on the member's, and then give a brief telephonic report daily to a medical director. They have all been trained to give the basics of what brought the member in, symptoms, treatment and discharge plan. They all do well, except for one.
Although "Suzy" is very competent and knowledgeable, her reports are painful. She will go on and on about the most inconsequential discussion she had with the member's daughter about her poodle, but fails to mention that the member is on a vent, with 3 drips, NG tube, and + MI. You want to bang your head against a hard object when listening. She has only been with us 5 months, but has been an RN for 15 years, and has extensive UR and CM experience. I have had her precept with a seasoned Field Case Manager, I have worked with her one on one. I have had her listen to everyone else give report. I have had her highlight the most pertinent part of her review so that she can focus on what to deliver, all to no avail.
She does amazing documentation, and can tell you everything clinically, etc regarding her member, but cannot regurgitate it during report. I can't blame the medical director as he is extremely kind and gentle during his interactions with all of the Nurses, and will even try to redirect her during her stories by saying "OK, now in reference to the respiratory status" to which yesterday he got a response of "well I guess he was breathing OK, but you know he doesn't speak english like I said, and the wife does, but she wasn't there, so I had to find an interpreter, but if the wife had been there it would have been easier... for 5 minutes" Our reports are recorded, so I listened to the playback.
All of our staff work at home through out a large geographical area, and this nurse is located 2 hours from me. I try to make regular visits to work with all of my direct reports, but typically manage only once a month working 1 on 1 with them after they have completed their 6 week training.
I am at a loss and am open to any suggestions that anyone has to help redirect and focus "Suzy".