Budget Interview

This week I interviewed Ray Weber, CFO of First American Title. I learned that budgeting can be very difficult and it was interesting talking with someone not in the healthcare field. I also realized how complex some budgets can be, especially the one we worked with from a unit in the hospital. A title company definitely has different expenses and actually a lot less things to budget for. Going over budget can sometimes mean good things, in this case specifically.

1. In what areas does your department/company overspend when looking at your budget?

Our office specifically usually overspends on office supplies each month.

2. Which expenses do you most often adjust if you are over budget?

We generally don’t cut expenses back. Our profit margin that month is just decreased. We have a budget for a few things and cutting back on client lunches will lose business, cutting back on office supplies generally isn’t an option, and rent and phone bills are set. If we are having to spend more on office supplies, generally it means we are doing more business to in the long run we are making more money.

3. Are there certain months during the year the company overspends? Is there a pattern?     

Spring, Summer, and Fall are our busiest seasons so we try to anticipate the expenses but we can’t always predict the market.

4. If you don’t meet budget a certain amount of times, what kind of consequences are there?

Generally it isn’t a big deal because it is seasonal and we will make up for it. If it gets really bad an employee may be furlowed.

5. Do you have a range for a budget? Or is it a set number that you work with?

Some are set (rent, bills) others we are given a range and try to stay within that.

6. What about a range for certain areas in your budget?

Office supplies ranges from $1,000-$1,500 per month.

7. If you are over budget, what do you do? And how do you decide what gets cut?

Employees may get furlowed, we analyze what areas were over budget and see if we can change that. However, like I mentioned before, if we are over budget, it generally means we are actually having more business.

8. What do you find to be the most difficult thing associated with making/adjusting the budget?

The most difficult thing is deciding what areas to make cuts in and how much to cut. It is difficult to know what effect that will have sometimes. I try to make the necessary cuts so we don’t have to furlow someone; people are more important.

9. Are you generally able to keep within your monthly/yearly proposed budget?

Yes.

10. What process do you need to go through to increase the budget for the department?

All expenses are approved along the way. We generally don’t need approval from anyone else to make some changes to our monthly/yearly budget.

Career Development and Staffing

1. What did you actually learned from the unit.

Staffing a unit can be very difficult. There are multiple ways to staff and schedule employees each having their pros and cons. I think I realized that the best way to staff a unit is one that a obviously meets the needs of the unit but also keep the employees mostly happy and satisfied with their schedule otherwise you might have high turnover and staffing calling in sick more often. I also was reminded about the importance of career development and that it pays of to sit down and ponder what it is I want to do in my nursing career and what that is going to take not only on my part but what education/training I need, how I am going to pay for it, where I need to live, etc.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

I enjoyed learning about my fellow classmates and how their current nursing positions are scheduled and how their schedules rotate as well as how they word the holidays. Because this is my first nursing position, the schedule we use is really the only one I knew. I realize that I love how my schedule is put together and the expectations we have. I feel that I can plan vacations and events well in advance and know pretty much exactly when I will work. I loved reading about the career plan of my fellow peers as well. It makes me realize how broad the nursing field is and also be comfortable with where I am at and how I feel about continuing on. I feel that we really validated and motivated each others' desires and I think it is great that I can work with these people.

3. How you will utilize the information learned in your nursing practice.

I can definitely take this experience I had with trying to staff a unit and understand more of how to do it so I can eventually do this for my own unit wherever I might be. I think it takes a special skill set to be able to organize in that way and that is something I can work on and use to my advantage. I also realize that while I may not be working in the area I want to specialize in, I am gaining valuable experience and am in no rush to hurry and figure it out. I have my entire career ahead of me and want to take full advantage of any learning I can receive wherever I am at.

4. You personal feelings about the material covered.

I thought this week was interesting and challenging to try and staff a unit. I felt it was important for me to take the time to focus on my career development as well as discuss with other nurses their future career plans as well as understand how their units are scheduled and staffed.

Leaders as Educators/Future of Nursing

1. What did you actually learned from the unit.

I really enjoyed the lecture about the future of nursing this week. It helped me to realize what a big influence nurses have on the entire population and also the challenges and struggles this profession is facing. I learned that the future of nursing is heading toward a leadership centered, goal driven, and higher education requirements. I learned that these goals are attainable and that there is a plan set out to achieve these. It was interesting to hear statistics regarding the nursing profession around the world and more specifically the United States. I didn't realize there was such a high percentage of nurses who were not practicing to their fullest potential or using the skills and abilities nurses are set out to have. I realized how important it is that I am receiving my bachelor's degree and feel very lucky that I have had this opportunity.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

The discussion this week helped us all realize where the future of nursing is headed. Each of the team members brought a different but similar perspective regarding the focus of the future of nursing and what the lecture was getting at. My perceptions were not changed but were definitely enhanced from participating in the discussion this week.

3. How you will utilize the information learned in your nursing practice.

I can be a huge part in the achievement of the goals for the nursing profession. I can utilize these concepts I have learned and become a better nurse leader. I can continue to obtain higher degrees and receive more education to better myself and my practices which will in turn better my community. The healthcare system is continually changing and the more positive changes we can make and the better practice we use can help influence all people.

4. You personal feelings about the material covered.

I thought this week was very interesting and really opened my eyes to this profession I have just entered into. I feel inspired and motivated to make a difference and hope to see these goals attained by 2020.

Managing Healthcare Resources

1. What did you actually learned from the unit.
I learned a lot this week and had a very difficult time with the budget cut assignment. I probably was over thinking it but it made me realize how important a budget is and how costly it can be if a few things are over budget. It was difficult to really decide what could be cut in the budget but with problem solving and critical thinking I was able to find a solution. I learned that developing a budget goes through a process similar to the nursing process (Assess what needs to be included in the budget, develop a plan, implement the plan, and evaluate the plan).

Regarding time management I learned that the three basic steps are: to allow time for planning to establish priorities, complete the highest priority task first and finish a task before starting another one, and reprioritizing based on the remaining tasks and on new information that may be received. It is important to know myself and understand how I waste time or tasks I do not like to do. Things that waste time are the inability to say no and inability to delegate.

Delegation has been a difficult skill for me to develop over this first year of my nursing career. However, I do realize it takes practice and I am getting better and more comfortable with delegation. I learned this week about things to focus on when delegating. It's important to give credit for those who deserve it, make sure it is the right person, right time, and for the right reason.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

The discussion this week was HARD! It was interesting to see all the different areas we thought could use a budget cut. However, we all focused on the staffing issue and it was interesting to discuss with team members about the different solutions to the staffing problems. We also were able to come up with very interesting interview questions regarding budgeting for next week.

3. How you will utilize the information learned in your nursing practice.

First of all, these skills about budgeting and budget cuts are valuable. I really thought it was great that we were able to look at a budget and try to interpret it. I know that being a manager is something I should strive toward but having to go over this this week made me realize that there are certain things I do not look forward to. Time management is something every nurse has to learn to be good at. As I have had students work with me as well as train new nurses I realize that I have developed some great time management techniques for myself. I have found what works for me. However, there are days I need to give myself more time to plan everything out and prioritize to help the morning med pass run smoother. I also know the things I dislike doing and things that I procrastinate. I am trying to get those things done quicker and sooner so it doesn't effect my mood while at work every shift. I also am going to actively try and be a better delegator to my charge nurse as well as the CNAs I work with.

4. You personal feelings about the material covered.

I felt this week was extremely useful in my nursing practice. I really thought the information was valuable and very relevant to my career.

Firing-Discipline Interview

This week I interviewed Jeff. He head of operations for Elite Mentoring Group.

I really enjoyed this interview and found it to be interesting. It is good to know that firing people never gets easy, as I don't feel that it should. I like that he mentioned he realizes that he is causing a huge change in someone's life and that isn't easy. I think this part of any job is one of the most difficult things to do but it's life and that's what happens. I try and make it my goal each day that I will never do anything that would cause termination of my employment with any employer.

1. When it comes to firing someone, do you first follow the process of Verbal Warning, Written Warning, Final Written Warning, and then Termination? Or do you have another set of steps? Verbal, Verbal, Terminate.

2. Do you make the final decision in terminating an employee or do you consult with other people/team first?  Consult with others before terminating. The hope is to find another way the employee way be utilized by the company, but if not, they are terminated.

3. What, if anything, would cause an employee to be immediately terminated? (without verbal warning) dishonesty or mistreatment of another employee

4. What are some reasons/examples of why you’ve fired someone? Embezzling money, excessive absence, not staying focused on the job and Not following company procedure.

5. Is there any specific kind of paperwork you need to fill out prior to firing and afterwards?  “Reason for Termination form” and a police report if needed.

6. How easy is it for you to discipline an employee? Not very easy because they usually feel picked on.

7.  Does the firing process get easier the more you do it? Not really because you know that you have
created a big change in their life that is sometimes unexpected by them. Always difficult.

8. On average how do your employees handle being fired? Usually they feel like their behavior was justified so it is difficult for them to accept.

9. If termination is needed, do you typically do it in person or via telephone?  Always in person unless they have stopped coming to work.

10. Have you ever had any crazy or out of the ordinary things happen during the termination process? Not really. It has always worked out OK

11. Is termination effective immediately or do you give them a few days to finish up their work and pack up? Most of the time its immediate. However there have been times they have been allowed to finish certain things.

Organizational Structure and Power

What did you actually learned from the unit.
 This week was interesting...I guess I learned or was reminded of the different ways of thinking that men and women have. I realized that from the readings and surveys done about leadership qualities and their relationship to men and women, that women seem to possess more leadership specific qualities and they may make a better leader in the workplace. I learned that both men and women have skills and traits of a leader and it really comes down to just that, traits and characteristics not skills alone that make a great leader. I also learned how important it is to use power appropriately and not like a golf club and just swing it at coworkers. Currently I am a staff nurse and have leadership over CNAs. I am always striving to successfully lead them and delegate to them. I hope I never come across as the nurse that says my way or the high way.

2. Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

The discussion this week was interesting. It was difficult for all of us to have a specific answer about whether men or women would be better leaders. I feel that I am sticking to my original post and feel that women would be the better leader. It was interesting to hear from everybody's perspective and I think we were split on our decision. But ultimately, it comes down to preference and environment I think.


3. How you will utilize the information learned in your nursing practice.

I can learn to cultivate those leadership traits and qualities that were identified in the survey as being ones that create and effective leader (honesty, integrity, intelligence, hard work, compassion, outgoing, and creativity to name a few). I can utilize power in the correct way and use democratic leadership styles.

4. You personal feelings about the material covered.

I felt the discussion this week was difficult and it definitely wasn't my favorite. The videos were interesting and the lecture was helpful in understanding leadership and command in the nursing field. I was able to see what was beyond a charge RN position or house supervisor and the benefits to each of those higher management positions.

Performance Appraisal Interview

This week I interviewed Tamra from First American Title-Branch Manager, Escrow Officer.

1. How often do you do performance appraisals? Are the employees notified in advance or is it a surprise?

 Anually. Yes the employee knows – The employee fills out their own evaluation online first then we review and discuss their performance

2.     Do you use the same set of questions for every employee?

The online questions are the same – the personal review is different based on the employee evaluation comments

3. What scale do you prefer to use for performance appraisals? (unsatisfactory-satisfactory-outstanding, poor-below average-average-above average-excellent)

Needs improvement / Meets expectations / Exceeds Expectations

4. Do you offer pay for performance incentives?

No – raises are given but not necessarily based on the review.

5. How long does each evaluation take? Is there a certain time frame you like to keep it within?

The face to face evaluation is approximately ½ hour.  Can differ based on the individual.

6. Do you use a third party to evaluate performance or does your company do it internally?

The online evaluation is done by a third party company. Face to face review is done in person.

7. In your time doing performance appraisals, have you noticed that incentives tend to yield better results with your employees?

Not necessarily

8. What are your main objectives that you like to achieve when holding performance appraisals?

Acknowledge what the employee is doing well and see where they can make improvements.

To let them know they are appreciated and valued.

9. Do you set goals with employee during interview?

Yes - goals are an important part of the interview.

10. What do you do to create an environment that allows open and honest communication?

Ask for their ideas as to what process and procedures could be changed to make things better.

I really enjoyed conducting this interview and learned that it is important to set goals with employees and help them feel valued and appreciated as well as comfortable. I also like that she asks the employees what they feel could be changed for a better workplace. I think this helps build the relationship. Overall, I would feel very comfortable having a performance interview done at this company and feel they value their employees and it shows.

Ethical Responsibilites of the Nurse Leader

1.   What did you actually learn from the unit.

This week I learned what ethics committees are and how they can be beneficial in certain situations. I also realized that I can call upon an ethics committee if I feel a need for it. I have also been reminded of how difficult ethical dilemmas are, especially in healthcare. We are dealing with life and death situations almost every day making these dilemmas perhaps some of the most difficult that exist. There are so many ways to go about making the “right” decision. A dilemma is actually created when both decisions are good…it becomes good decision vs. good decision sometimes. The views of the patient and family are so important to take into consideration but medical expertise, evidence, and perspectives are also important. I realized that it all comes down to a patient’s quality of life.

2.   Discuss your feelings/experiences from the team activities? Did it change your opinion on the subject? If so, how? If not, why?

The discussions this week provided some new insight for me. I learned of some methods and steps to follow when trying to make a decision about an ethical dilemma and all the aspects that should be considered. It was interesting and kind of fun actually to attempt to act as the ethics committee and make a decision regarding dialysis for a patient. I think discussing other ethical dilemmas and seeing others’ points of view has helped me have a better, more well-rounded perspective and understanding of ethics and all things that should be taken into consideration.

3.   How you will utilize the information learned in your nursing practice.

I can utilize the ethics committee if I am ever in a situation where I feel it to be necessary. I realize how difficult these situations are and don’t take them lightly. I need to always remember to validate the family’s and the patient’s feelings and wishes but also educate from a medical perspective to provide understanding. Documentation is also very, very important and I want to continue to be thorough with documentation so if an ethical dilemma arises, there won’t be any questions as to why we made a decision or not.

4.   Your personal feelings about the material covered.

Ethics are so hard and ethical dilemmas are even more difficult. I don’t want to be faced with decisions like we have discussed this week but the fact is, I am going to be because of my profession. I feel this week has really helped me to see proper steps to take and things to consider to make an appropriate decision. I felt this week was very helpful and had deep meaning.