Employee Eval Help

Hi, I have a great one that I use. It's fairly thorough and leaves room for responses. If you want it, I can e-mail it to you.

Hey vital nurse Mom,

Glad to have you come back to Virginia! We need lots of good nurses. You can PM me and send your e-mail address and I will send the form to you. It's on my computer so I can send it as an attachment. Sorry to be so late to reply, I didn't get back on the computer until now.

This is a rather simple one. I have a couple of others that I would have to look for. If I find them I will repost. Note this is not typed in the format of the actual form. The classification is for Licensed Practical/Vocational Nurse.

Performance Appraisal

Employee:
Classification:
Date of Hire: Date of Appraisal:

(Column) (Column) Col Col Col
Performance Standard Data Base Appraisal DNME ME EE

1. Provides skilled nrsg
in the home as ordered on
the plan of care & nrsg care
plan.

2. Ea shift reflects the pro-
vision of skilled nrsg care
IAW the physician order.

3. Problems, changes, and/or
resolution are ident and comm
to the RN.

4. Adheres to policies and
procedures.

5. Functions as team mbr
under the dir of the RN.

6. Clin notes are completed
& submitted as per respective
pol & proc.

7. Participates in other man-
dated act as req by RN or
agency Director.

8. Dem willingness to contrib
to agency growth, as well as,
personal growth is evident
through participation in educ
and committee work r/t pt care.

DNME=Does Not Meet Expectations ME=Meets Expectations EE=Exceeds Expectations

Page Two

Large Open area titled Overall Performance-room for handwritten comments w/
DNME ME and EE at bottom of paragraph

Large Open area titled Goals for Next Performance Period
Third Open area titled Employee Comments

Signatures and Dates for Employee and Director of Clinical Services at bottom

HTH