Need advice on staff motivation

[KateRN1]

I am a clinical manager in a large mom-and-pop agency (read: no corporate influences, just the owners). I have only been in my position about a month and have discovered that there are some issues that need to be addressed. I'll spare you the details of those issues, unless someone expresses a desire to read the laundry list, but basically, nurses and therapists are doing the bare minimum to get by and don't seem to care about anything other than getting paid.

Can anyone recommend an action plan for me to outline and take to the owners as a way to address the issues? I can identify the problems and possible outcomes but am having a hard time thinking of solutions.

[tablefor9, RN]

What's the root cause of the problem? They aren't engaged. There's no sense of ownership if they are doing the minimum daily requirement.

Without knowing details, my best suggestion would be to bring everybody in for a round-table. What do they perceive are the problems? What would they do if it was their "baby" to fix?

For them to get on the bus with whatever happens, they are going to have to see a benefit to them (ex. No one stocks, they don't see the value until they are the one who is holding the bag with no equipment!) and believe that they can make a difference.

Low morale often has a bunch of different causes, and there really is no bandaid. You have to get it at the source, and that's what this smells like to me.

[KateRN1]

Your assessment is spot on. There is no ownership for problems and no one cares that patients aren't receiving their services. I had a long discussion with the DON today which turned into a Manager's meeting. I also suggested a round table, but they don't it's possible to get everyone together at the same time. I'm willing to stay late, come in early, come in on Saturday, whatever it takes to get a solid team.

The only good thing that came out of the meeting is that I got the go-ahead to implement a kudos system for rewarding those who consistently go above and beyond the bare minimum. We'll have a bulletin board that will hold public kudos messages whenever a staff member receives a compliment from someone. We'll also reward those who have no missed visits in a week, perfect attendance, or turn in charts that are error-free. At the end of the month, all kudos go in a "hat" and draw for a prize. The only problem that I anticipate is having meaningful rewards (like gas cards, gift cards) rather than crappy promotional items. I want this to be a place where people feel appreciated and understand that their work impacts lives. I really don't think that negative attention is the way to achieve this, but what do I know? ;-)

Any other suggestions would also be greatly appreciated.

[caliotter3]

I would bet that job evaluations have not been done in the past. Start quarterly (at first) or yearly job evaluations with positive and negative reinforcements that have a tie in with company performance goals. If the owners can be convinced that it would be in their best interest, I would have very modest pay increases as a positive incentive. Even ten cents an hour adds up. Or fifty cents an hour at the five year anniversary mark. But the person would have to earn this by meeting minimums and more. How much more is the question. You would need clear cut goals and bench marks for attainment that would be explained to the employees so they know what their goals are. Likewise, negative consequences should be in place. Poor performers (very poor) can always be replaced, and those who don't put forth effort won't get the modest pay raises. Or any other positive reinforcements. The poor performers can also have their work hours decreased or they can be put at the bottom of the list for available work or they can be demoted to "on call" status. Try to give them the idea that they can be phased out if they don't want to cooperate.

[classicdame, MSN, EdD]

someone in the past has 1) either not written a clear job description or 2) not enforced it at eval time. If you do not have the support of your supervisor your hands may be tied.

[tewdles, RN]

You are the clinical manager, part of your job is to inspire the clinical staff to the level of team work and excellence that you desire. I would recommend identifying what you believe to be the top 3 problems, discuss them with your boss, develop action plans, begin to meet regularly with the staff to implement plan(s).

Clin sups are in the position to inspire the clinical staff to levels of performance which make them proud.