Week 5: Human Resource Management

A difficult situation can result when personal and working relationships are combined. You have been assigned to a new area as the nurse leader, where a good friend of the family has worked for many years. You are made aware of multiple issues of tardiness by your friend over the last few months. Discuss how you would handle the situation.


Question 2

A nurse gives the wrong dose of medication to a patient. Discuss the components of professional negligence related to this incident.

Scholarly references to support your response are required.


Week 5: Introduction

Table of Contents

Welcome to Week 5!

This week, we will focus on human resource management and legal and ethical issues in our role as a nurse leader. Let’s get started!



Appraise the effects of strategies to reduce costs and improve the quality and safety of healthcare. (PO1 & PO4)

Weekly Objectives

  • Integrate human resource management.


Organize legal and regulatory components of healthcare strategies to promote safety and quality care. (PO1 & PO4)

Weekly Objectives

  • Examine legal and ethical issues.


Synthesize and communicate research findings to promote quality improvement and safety in healthcare. (PO1 & PO4)

Weekly Objectives

  • Summarize human resource management.

Week 5: Reading

  • Due Aug 12 by 11:59pm
  • Points None

Marquis, B.L. & Huston, C.J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). China: Wolters Kluwer Health.

  • Chapter 5: Legal and Legislative Issues
    • Introduction
    • Sources of Law
    • Types of Laws and Courts
    • Legal Doctrines and the Practice of Nursing
    • Professional Negligence
    • Avoiding Malpractice Claims
    • Extending the Liability
    • Incident Reports and Adverse Event Forms
    • Other Legal Responsibilities of the Manager
  • Chapter 15: Employee Recruitment, Selection, Placement, and Indoctrination (Recommended)
  • Chapter 22: Understanding Collective Bargaining, Unionization, and Employment Laws (Recommended)
  • Chapter 24: Performance Appraisal (Recommended)
  • Chapter 25: Problem Employees: Rule Breakers, Marginal Employees, and the Chemically or Psychologically Impaired
    • Constructive Versus Destructive Discipline
    • Self-Discipline and Group Norms
    • Fair and Effective Rules
    • Discipline a Process
    • Discipline Strategies for the Manager
    • Disciplining the Unionized Employee
    • The Disciplinary Conference (all sections)
    • The Termination Conference
    • The Chemically Impaired Employee (all sections)
    • Recognizing the Chemically Impaired Employee (all sections)

Roussel, L., Thomas, P., & Harris, J. (2016). Management and leadership for nurse administrators (7th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 8: Procuring and Sustaining Resources
  • Chapter 10: Managing Performance

Recommended Article

Mazzocato, P., Holden, R.J., Brommels, M.,  Aronsson, H.,  Bäckman, U.,  Elg, M., & Thor, J. (2012, February). How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children’s hospital, Stockholm, Sweden. BMC Health Services Research, 12, 28.

Week 5: Lesson

Table of Contents

Human Resource Issues in Healthcare



As we begin this week’s lesson, it is important to understand how human-resource issues can affect an organization. As the nurse leader of an organization, you have the ability to influence many of the human-resource issues that may be present at the facility.

Human Resource Management

Human-resource management is the utilization of human resources effectively through various activities (Roussel, Thomas, & Harris, 2016). Human-resource management by the nurse leader encompasses a wide range of activities, such as recruitment, retention, orientation, training, performance evaluations, and employee compensation. One human-resource challenge for some organizations or some specialized units is the recruitment of needed trained nurses to safety staff an area. Creative approaches to attempt recruitment of nursing students may be utilized, such as paid internships. Most organizations have one or more designated nurse recruiters.

Marketing of an area or overall organization marketing can have an influence on who may wish to work in a facility. Targeted marketing for a certain nursing skill set may be beneficial. For example, some Magnet-designated facilities will only hire baccalaureate-prepared nurses, and some specialty areas require a year or more of experience in a certain area. In addition, it is imperative that the potential new hire has the needed professional licensure to meet state and organization criteria. Meeting these criteria in certain geographical areas may pose a challenge for some facilities. Some organizations may appoint a specific search committee for a specific position with select criteria, such as a dean, director, or chief nursing officer.

After the applicants are screened for the selected position, an interview is scheduled with the hiring manager. Some organizations may require another nurse leader to also meet with the candidate to determine if the candidate would be a good fit for the mission, vision, philosophy, and culture of an area or organization. Some leaders find it beneficial to use the same set of interview questions in order to compare the responses of several candidates to aid in the final-candidate selection. The human-resource department is a great resource to educate leaders on what questions should not be asked during an interview. You may refer to your textbook for a list of some illegal questions.

Turnover rates and retention rates are outcome data generally monitored by the nurse leader. Ensuring that clear job expectations are communicated during the initial interview, during orientation, and ongoing prevents job dissatisfaction. An unhappy employee will typically leave an area or the organization; therefore, it is beneficial to the organization to retain employees when feasible. Many organizations and nurse leaders have become proactive in reducing turnover or resignations by developing various retention strategies, such as career-ladder programs, job sharing, career-development programs, coaching programs, self-scheduling, and tuition reimbursement.

As a nurse leader, you may find you work for an organization that is unionized, or there may be an organization in which the nurses are moving in the direction of becoming unionized. To stay current on employee concerns, it is helpful to review the current literature on various human resource and other employee-related topics. When developing work schedules, certain criteria may need to be followed based upon union, state, and/or organizational guidelines and standards. For example, some states have a mandated staffing ratio regarding the number of registered nurses in relation to other staff persons for a particular area.

Legal and Ethical Issues

Many legal and ethical issues can occur within an organization. Adequate training and preparation for employees can be helpful to educate them on expectations and appropriate procedures if an incident should occur. For example, if a medication error is made, what is the policy and procedure for a team member to follow and report the incident? An incident report is typically for the organization’s internal use. Therefore, it is beneficial not to leave a copy in a patient’s chart; however, proper procedure for the organization must be followed. Many organizations forward a copy to a quality-assurance office for review and filing.

Malpractice coverage is a benefit that many organizations offer to their employees. Malpractice is when a person with professional training fails to act in a prudent and reasonable manner (Marquis & Huston, 2017). It is often recommended that individuals obtain individual malpractice coverage as well. A nurse is accountable, responsible, and liable for his or her own nursing practice. Staying up to date on specific skills, continuing education, policies and procedures, and practicing within the scope of practice can greatly reduce the incidence of malpractice claims against a nurse.

It is recommended that nurse leaders become familiar with various state laws and various policies within the organization related to this topic and nurse-leader roles regarding legal and ethical issues. As a nurse leader within an organization, you have some legal responsibility for quality control of nursing practice within your area of oversight. Some quality-control topics that may pose concern include ensuring that informed consent is obtained only after the patient has received full disclosure of the risks and benefits of a procedure and ensuring that medical records are stored properly and only accessed by authorized personnel.

If a legal or ethical issue arises with an employee, not following up and acting on a situation can put the organization at risk and also potentially affect the morale of a particular nursing area. If you are unsure of how to respond to a situation or unclear on the proper steps to follow in a situation, human-resource personnel can provide information and support. Typically, nursing areas have policies and procedures in place regarding the disciplinary process. In addition, deficient performance may result in a coaching plan to help an employee get back on track with some additional support.

If a termination is most likely forthcoming, consulting with your human-resource representative is a great way to ensure that you are following all necessary steps in the process. In addition, if layoffs must occur within your organization, the human-resource department can provide consultation on the best approach to a difficult and challenging issue.

In the nursing profession, there are many positions whereby a nurse has access to medications such as narcotics, or a nurse may engage in the use of illegal substances outside of work any may come to work still in an impaired state. Being able to identify such behaviors that can cause legal and ethical concerns is helpful to the nurse leader.

Review Display 25.4

Please review Display 25.4—Characteristic Changes in Chemically Impaired Employees (Marquis & Huston, 2017).

Changes in Personality of Behaviors

  • Increased irritability with patients and colleagues, often followed by extreme calm
  • Social isolation; eats alone, avoids people until social functions
  • Extreme and rapid mood swings
  • Euphoric recall of events or elaborate excuses for behaviors
  • Unusually strong interest in narcotics or the narcotic cabinet
  • Sudden dramatic change in personal grooming or any other area
  • Forgetfulness ranging from simple short-term memory loss to blackouts
  • Change in physical appearance, which may include weight loss, flushed face, red or bleary eyes, unsteady gait, slurred speech, tremors, restlessness, diaphoresis, bruises and cigarette burns, jaundice, and ascites
  • Extreme defensiveness regarding medication errors

Changes in Job Performance

  • Difficulty meeting schedules and deadlines
  • Illogical or sloppy charting
  • High frequency of medication errors or errors in judgment affecting patient care
  • Frequently volunteers to be medication nurse
  • Has a high number of assigned patients who complain that their pain medication is ineffective in relieving their pain
  • Consistently meeting work performance requirements at minimal levels or doing the minimum amount of work necessary
  • Judgment errors
  • Sleeping or dozing on duty
  • Complaints from other staff members about the quality and quantity of the employee’s work

Changes in Attendance and Use of Time

  • Increasingly absent from work without adequate explanation or notification; most frequent absence on a Monday or a Friday
  • Long lunch hours
  • Excessive use of sick leave or requests for sick leave after days off
  • Frequent calling in to request compensatory time
  • Arriving at work early or staying late for no apparent reason
  • Consistent lateness
  • Frequent disappearances from the unit without explanation

Proving an employee is chemically impaired can be challenging. The manager can play a proactive role in helping an employee receive any needed treatment. Often, an employee may return to work after completing a rehabilitation program. Generally there is a limitation on drug access for this employee for a designated period. Many state boards also have resources to help nurses recover and return to work.


This week, we discussed human-resource issues in healthcare, specifically how the nurse leader influences these within the healthcare organization. Next week, we will explore management information systems.


Marquis, B.L. & Huston, C.J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia: Lippincott Williams & Wilkins.

Roussel, L., Thomas, P., & Harris, J. (2016). Management and leadership for nurse administrators (7th ed.). Burlington, MA: Jones & Bartlett Learning.

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