doctors participating in nurse performance evaluations

[rockymtrn]

I need your help guys. Recently in the Er I work in, the MDs have decided that they want to be involved in our annual evaluations. Without notifying us of the policy change, our nurse manager had them write up a page long anonomous letter regarding the quality of my "performance" in their opinion, for my annual review.

This is the first time I've run across this situation in my long ER career, and I would like some feedback on what is going on in other hospitals. I feel that if they can evaluate us, we should be able to evaluate them back. If your hospital does allow this, what policies, procedures, criteria and accountablity do you go by? Any input would help. I am now working in a small private hospital, in the past I have always been in large teaching facilities. Thanks!!

[purplemania, BSN, RN]

Are these MD's employed by the hospital, or just have privileges there? If they are employed, I would consider their comments like any other co-worker. However, NURSES should be able to evaluate them as well, for the same reason. Otherwise, you are going to draw a line between the disciplines and I see all kinds of problems in the future.

[fergus51]

I have never been evaluated by a doctor, as performance appraisals are done by supervisors and peers, not coworkers. I don't think a doctor has the qualifications to evaluate nursing. If everyone is evaluating everyone else, that's one thing, if it's just the docs doing evaluations on other team members, that's another. The fact that it was never discussed in the open and that they want to do it anonymously makes it seem like a power thing to me.

[ceecel.dee, MSN, RN]

I don't think it is the physician's place to "evaluate" you.

However, feedback (pat-on-the-back or constructive criticism) from anyone contributing to the care of patients is acceptable. I, actually, would like the opportunity to be invited to give feedback to the housekeeping dept, certian Xray and lab techs, and the docs. Otherwise, the only feedback they may recieve could be in the form of a complaint or incident report.

[sevans]

I would be a little concerned about the "anonymous letter" - if they have legitimate feedback, and it is going to go into a person's permanent file, they should be required to idenitfy themselves. A supervisor or manager that is responsible for evaluations or reviews is rarely "anonymous". In addition, it allows a person with an agenda or a personality conflict to alter or twist facts in a way that would be difficult to respond to if you have no way of knowing which doctor had a problem with you. It often seems that the very best nurses who are true advocates for their patients are the ones most likely to upset a doctor with a "God complex".

[Gardengal]

I don't really have a problem with selected MDs having input into certain portions of a performance appraisal, but would want to delineate those up front ahead of time. I do not find an anonymous letter acceptable. Inareas of clinical decision making, collegial relations, being supportive of the team I believe that MDs have a unique viewpoint which can be helpful. The opposite is true as well, and these same issues regarding MDs can be evaluated by RNs.

As a nursing manager I use many pieces of information throughout the year in my performance appraisals, and I do use some observations from key attendings for my department (not an ED though)in the appraisal, but only as an adjunct to my own appraisal. Example: any compliment or positive comment is immediately recognized, shared with the staff and added to my file for end of the year appraisal. Any incidental or ongoing complaints by anyone against one of my staff is investigated, and if validated will be used as an educational topic, counselling session or if repeated or severe a possible discipline area. I do not however allow an MD to think that he is causing any discipline. I only say that I will look into any allegation. I inform the MD of generalities of my findings and they are satisfied with that.

The topics validated will be added to my files in addition to random audits, observations, attendance at meetings, education, documentation, patient compliments and complaints, interpersonal issues, attendance, clinical issues, etc....

By the way, recently I worked with the director of our residency program and nurses are now contributing to the evaluations of the residents. We developed criteria which coud be scored on a scale and I seek information from my staff, average their scores and paraphrase their comments to make an evaluative tool by th enursing staff for each resident each month. I am keeping the individual scoring and comments of RNs, but the RN staff was hesitant to have the evaluative tool be attributed to any individuals as they don't want to have any repercussions from the residents. (Do you think this is why the letter by MD in your case was anonymous? It shouldn't be anonymous if it is only from 1 person. It could be biased.

[sjoe]

sevans writes: "I would be a little concerned about the "anonymous letter" - if they have legitimate feedback, and it is going to go into a person's permanent file, they should be required to idenitfy themselves."

I would be VERY concerned, whether or not is going into any kind of file, permanent or not. This is most unprofessional, as well as risky to your career. What and why are they hiding? Why would they not be willing to stand behind any comments they might have--positive AND negative.

"doctors participating in nurse performance evaluations "

What does your union have to say about this? No union? Here's an issue around which to organize one.

Remember:

[mattsmom81]

Originally posted by sevans

I would be a little concerned about the "anonymous letter" - if they have legitimate feedback, and it is going to go into a person's permanent file, they should be required to idenitfy themselves. A supervisor or manager that is responsible for evaluations or reviews is rarely "anonymous". In addition, it allows a person with an agenda or a personality conflict to alter or twist facts in a way that would be difficult to respond to if you have no way of knowing which doctor had a problem with you. It often seems that the very best nurses who are true advocates for their patients are the ones most likely to upset a doctor with a "God complex".

ITA Sevans!

Doc evals can easily turn into a vindictive game. Too many doctors would get off on judging us by how much we cater to THEM. Administration gets complaints all the time about stuff like this...from docs with God complexes.

We are two different professions. They have no business evaluating us in such a way as described, IMHO. They have no idea of the realities of my job other than how it effects THEM, in my experience.

[live4today, RN]

A doctor evaluate me?????????

HELLLLLLLLLLLLLLLL NO!!!

What is nursing coming to nurses? Do some of you actually ENJOY being crucified or what????????

I would NOT work where I was evaluated by someone not my equal. Doctors often times do NOT work for the hospital. They are NOT employees of the hospital like nurses are, so why should they be given MORE autonomy over nurses than they already seem to have by the "big ball of self-importance" they already carry around their necks!

Nurses.......we truly ARE going backwards! No, it's NOT the "white uniform and cap" that makes us "dark-age material", it's stuff like this that keeps sliding us backwards!

[Tweety, BSN, RN]

I wouldn't want that to happen. Our ER docs are staff members, true, but do they truly understand the nurse's role. Why not let the paramedics evaluate us, then the housekeepers, phlebs, and social workers.

Let nurses eval nurses I say.

[CougRN]

I wouldn't have a problem with it if it was done how our performace evals are done now and my hospital. We are given 5 "peer" evals and pick the 5 people we want to have eval us. They can be aids, RRT's, SLP's or anyone else we come into contact with. If I got to pick an MD whom I respected then I would like to get their feedback. I think it is important to know how other professions percieve my work. It doesn't scare me.

[Chiaramonte]

At my facility, our nursing manager asks the ER Medical Director in a general manner if our ER Docs have any particular issues that need to be included in our evaluation. I do have a problem with this for 2 reasons...first, there should be no surprises at your evaluation time...problems should be addressed when they crop up. Secondly, we have no input into their evaluations nor does our MD Medical Director deal with our issues concerning some of the ER Doc's antics.

[Tweety, BSN, RN]

Originally posted by CougRN

I wouldn't have a problem with it if it was done how our performace evals are done now and my hospital. We are given 5 "peer" evals and pick the 5 people we want to have eval us. They can be aids, RRT's, SLP's or anyone else we come into contact with. If I got to pick an MD whom I respected then I would like to get their feedback. I think it is important to know how other professions percieve my work. It doesn't scare me.

It doesn't scare me either. But look at the CNA/RN battles that happen and how we don't perceive each others roles. That a nurse can be charting but is percieved as lazy.

We do peer evals too. We get to pick three of them and our manager picks the other two. I've never been afraid of getting feedback from others within my department.