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The philosophy of nursing is to provide comprehensive quality nursing care to the family,

group, community or individual. It is essential for both the nurse educators and nurse
administrators to participate in teaching as well as supervising the students and staff since
the primary focus is same, that is better nursing care.
Need of Dual Role
Nursing E.ducation and Nursing supervision have their own area of service. But blending of
the two making liaison between two services will always improve the quality or standard of
nursing care and raise the standard of skill of students who are the future nurses.
Teachers are not directly posted in the clinical field. But as they are involved in teaching,
they usually update their theoretical knowledge regularly for better quality of teaching than
the nurse administrators do. If they abide by the rule to supervise nursing staff posted in
the clinical field along with teaching nursing students, the quality of care will definitely
improve. However, to succeed, this has to be agreed upon and accepted by the concerned
parties.
In the same way, nursing adminis trators like nursing superintendents and ward sisters can
supervise nursing students besides supervi sion of nursing staff, because they get the
student nurses in the clinical field and get the opportunity to I observe, teach supervise and
correct. Since they are posted in the clinical field, they are more skillful in clinical practice
since student nurses will develop more skill by their supervision. Moreover, students will
learn to provide quality care with less articles as most of the time insufficient supply of
articles is a hindrance for providing quality care. Students can get anopportunity for thinking
alternative arrangement while being supervised by ward sister or nursing superintendent.
Quality of care depends upon knowledge and skill. Educational preparation, supervision and
guidance affect it :tnd both, the educator and the administrator are needed by one another.
There is a need to prepare the nursing personnel for both teaching and service. Nursing
personnel may have different attitudes towards faculty supervisor's dual role. They should
understand and accept each other's role and this can be facilitated by in-service education
programmes i.e. workshops, group discussions etc.
These are two separate departments and many a time do not realize that both the
department's goal is to provide quality nursing care. They should accept each other and
cooperate and coordinate between both teaching and service for improvement of standard
of care. They should also liaison and not undermine each other.
Since such type of dual role is not usually present in nursing service or education, there is
an urgent need to make the nurse leaders (educator and administrator) aware and motivate
them for dual role for improving standard of nursing care First and foremost sensitization is
needed to develop an attitude. Policy making is important to implement such responsibilities
to nurse administrators and nurse teachers.

PERFORMANCE APPRAISAL SYSTEM


INTRODUCTION
A desired result of any employees behavior is effective job
performance. An important part of behavior managers job is to define
performance in advanced and to state desired results. Performance
related behaviors are directly associated with job tasks and need to
be accomplished to achieve a jobs objectives.
An hospital administrator has to have
information regarding the performance of all the personal working in
the hospital. Except for the few top administrative
officers(managers). The administrator will not have direct information
of those working in a medium sized or large sized hospital. There is a
need for a system of performance appraisals.
DEFINITION
1. Performance appraisals is the evaluation of work done (quality,
quantity, and the manner it is carried out) during a specified time
period against the background of the total work situation.
2. Performance appraisals is the planning and record of certain
personality and behavioral characteristics of the individual,
effectiveness at the job and contribution to the achievement of
organizational goal.
3. Performance appraisal is the process of interaction written
documentation, formal interview and follow-up that occurs between
managers and their employee to give feedback, make decision and cover
for employment practice law.
4. It is a systematic evaluation of a individual of respect his or
her performance on the job his or her potential for development
PURPOSE OF PERFORMANCE APPRAISAL
1. Employee performance
2. Employed development
3. Supervisory understanding
4. Guide to job change
5. Salary and wage administration
6. Coaching and counseling
7. Remaining dissatisfaction
8. Validating personnel programmer.
APPRAISAL PROCESS
1. To set standard based on job analysis.
2. Communicate standard of job performance.
3. Measure performance
4. Compare performance to standard
5. Rate the employee performance
6. Communicate the rating to the employee
7. Use the appraisal for decision making and developmental process.

PRINCIPLES OF PERFORMANCE APPRAISAL


The nurses evaluation should be based on
1. Behaviorally, Oriented performance standards for the position that
she occupies.
2. Adequate and representative sample of the individuals behavior
should be observed in evaluating her performance.
3. The individuals should be given a copy of job description format
standard and evaluation form
4. In documentary employees performance appraisal the supervisor
should indicate this area. In which performance is satisfactory and
these in which improvement are needed.
5. If we want the improvement in several area then specify which area
are to be given priority.
6. Evaluation conference should be scheduled at a time convenient for both
.
. COMPONENTS TO BE EVALUATED
Nurses engage in a variety of job related activities. To reflect the
multidimensional nature of the job, the performance appraisal form
usually requires a nurse manager to rate several different performance
dimensional such as use of the nursing process, professionalism,
safety, continuing education and initiative.
In developing an appraisal device, an organization can focus on
employee trails, results, behaviors, and or same combination thereof
(Bernardin and Beatly 1984). The specific focus of the form affects
the whole appraisal process.

1. TRAITS AND PERSONAL CHARACTERISTICSMany appraisal system focus on personal traits and characteristics
such as ability or stability to handle stress because trait oriented
instruments are in expensive to develop and can be used for a wide
variety of position.

2. RESULTS ORIENTED SYSTEMAll organization, even non-profit health care organizations, needs to
be concerned with the bottom line. If the hospital has a 35% occupancy
rate or 20% employee absenteeism rate its future is in jeopardy.
In recent years therefore top management has turned to
appraising same employees at least partly on results. There are pros
and cons to evaluating health care personnel on such a basis.
3. BEHAVIORAL CRITERIABehavior-oriented system focus on what the employee actually does.
Such as system gives new employee specific information on how they are
expected to behave and is less likely to lead to legal problems. The
behavioral focus facilitates employee development. The major drawbacks

of a behavior-oriented appraisal system are that it is relatively time


consuming and tied to only job or narrow range job.
4. COMBINING DIFFERENT OF CRITERIAIn such a system each employee may have a few major objectives, he or
she is expected to accomplish. In addition to being evaluated on
whether these results were attained, individuals are also evaluated in
terms of both general personal characteristics and behaviorally
specific criteria.
FORMATS FOR APPRAISAL
Several techniques exist for appraisal of employees in an
organization. Each has its own combination of strengths and weakness.
No one technique by it self is able to achieve all the purpose for
which management institutes the appraisal program. The choice of a
particular technology depends on three major factors1. UTILIZATION CRITERIAWhy is performance evaluation being done?
The objective may be for disciplinary action, feedback for employee
development, promotion, selection or training.
2. QUALITATIVE CRITERIAConsideration of organizational constraints assumptions of the method
relevance of evaluation criteria, data availability, practicality,
potential for equilence and interpretability.
3. QUANTITATIVE CRITERIAPsychometric property of the evaluation-reliability, discriminability
accuracy, inherent rating occurs. A technique which is potentially
less subjective and more objectives than another is to preferred.
Objective is the ability of the format to bring out impartial,
reliable and valid information about the individual.

METHOD OF APPRAISAL
1. SELF APPRAISALSEmployees are increasingly being asked to submit written summaries or
portfolios of their work related accomplishments and productivity as
part of the self appraisal process.
Portfolios often provide examples of how the employee has implemented
clinical guidelines; patient outcomes achieved, and sample patient
care documentation (Tailor, 2000). The portfolio also generally
includes the employees goals and an action plan for accomplishing
these goals.

2. APPRAISAL BY OTHERS
RATING ON APPRAISAL BY SUPERVISORGraphic rating scale
Rating
Forced distribution system
o Free writer
o Essay
o Forced choice appraisal
Critical incidence method
Field review techniques
Rating by self and by groups
Feedback of appraisal information
Appraisal using performance statistics
Other method
o MBO
TECHNOLOGY OF APPRAISAL
Since the 1920s, many appraisals tools have been developed. Certain
types of tools or renew techniques have been popular at different
times. Since the early 1990s, the Joint commission an Accreditation of
healthcare organization (JCAHO) has been advocating the use of an
employees job description as the standard for performance appraisals.
The following is an over view of some of the appraisal tools commonly
used in health care organization.
1. TRADITIONAL RATING SCALE
Many organization use a TRS for all employees in a class (example
staff nurse, clinical nurse specialist) regardless of their specific
job setting (example outpatient surgery, ambulatory clinic)
A traditional rating scale includesGeneral performance
Equally weighted dimensions
Absolute judgment standard
Judgment based on supervisors idea.
In filling out a traditional rating scale, the appraiser is required
to reflect on the appraisee performance over the entire evaluation
period (12months) and rate the individuals against the raters internal
standard of performance.

2. FORCED DISTRIBUTION EVALUATION


This is similar to grading on a curve. The manager is required to rate
employees in a fixed manner. If the rating scale has five categories
Advantages- In that all employees cant be given average or good
ratings, some rated better than others.
Disadvantagesi) It is too gross doesnt discriminate better individuals in a group.

ii) Problem occurs borderline cases.


iii) The scale doesnt explain the reason for certain performance
gradation and employee doesnt know what specifically he must do to
improve his performance.
The manager may be required to spread employees rating equally over
the five
categories.
Because this technique is constraining restrict severely
Because of general dislike of forced distribution system, they are not
commonly used.
3. TRAIT RATING SCALE
A rating scale is a method of rating a person against a set standard,
which may be the job description, desired behavior, or personal
traits. The rating scale is probably the most widely used of may
available appraisal method.
Rating personal traits and behavior is the oldest type of rating scale.
There are two types of rating scales mainly used in many organization
a) Job Dimension Scale
b) Behavior Anchored Rating Scale
JOB DIMENSION SCALEThis technique requires that a rating scale be constructed for each
job classification. The rating factors are taken from the context of
the written job description.
Weakness- It focuses on job requirements rather than ambiguous terms
such as quantity of work.
BEHAVIORALLY ANCHORED RATING SCALEFirst developed by Smith and Kendall for staff nurse in 1963, the BARS
assumes the followingA persons effectiveness on the job can be best inferred from the
behavior on the job rather than on personality traits. Evaluation of
behavior is more objectives than judging personality traits.
The employees performance is complex results from several
dimension. The amount or degree of each dimension can be effectively
recorded through statement rather than by mere numerical gradation.
During the evaluation process, BARS forces appraisal to focus on an
employees actual behavior.
LIMITATION
1. The process of BARS construction is time consuming.
2. BARS developed for one situation cant be easily used in another
situation as the job requirements may be different in another
situation.
4. CHECKLIST
There are several types of checklist appraisal toolsa). Weighted scale
b). Forced checklist
c). simple checklist

a). WEIGHTED SCALE


It is most frequently used checklist, is composed of many behavioral
statements that represent desirable job behaviors. Each of these
behavior statements has a weighted score attach to it. Employee
receives an overall performance appraisal score based on behavior or
attributes.
b). FORCED CHECKLIST
It requires that the supervisor select an undesirable and a desirable
behavior for each employee. Both desirable and undesirable behavior
have quantitative values, and the employee again ends up with a total
score on which certain employment decisions are made.
c). SIMPLE CHECKLIST
It is composed of numerous words or phrases describing various
employee behavior or traits. These descriptors are often clustered to
represent different aspects of one dimension of behavior, such as
assertiveness or interpersonal skill.
LIMITATION
1). There is no set performance standard.
2). Specific components of behavior are not addressed.
5. ESSAYS
The essay appraisal method is often referred to as the free from
review. The appraiser describes in narrative form an employees
strength and areas where improvement or growth is needed.
Although this method can be unstructured it usually call for certain
items to be addressed. This technique has some strength because it
forces the appraisal to focus on positive aspects of the employees
performance. How ever, a greater opportunity for personal has
undoubtedly exists.
6. PEER REVIEW
When monitoring and assessing work performance are carried out by
peers rather than by supervisors. It is referred to as peer review.
Most likely, the managers review of the employee is not complete
unless some type of peer review. When implemented property, provides
the employee with valuable feed back that can promote growth.
ADVANTAGEIt also can provide learning opportunity for the peer reviews.
Taylor(2000) suggests that peers who work together have a level of
insight in to each others clinical practice and that peer review
provide them an opportunity to receive better feed back about self
improvement.
DISADVANTAGEAs evidence by some university teacher receiving by justified tenure
or the failure of physicians to maintain adequate quality control
among some individuals in the profession. It involves much risk
taking. Time consuming. Requires a great deal of energy.

7. PERFORMANCE APPRAISAL INTERVIEW


In performance appraisal interview the nurse manager need to establish
that performance has been carefully assessed that, when merited,
rewards will be forthcoming.
Developmental activities also need to be derived from an accurate
evaluation. If an employee is rated on needs immediate improvement
on delegation skills, for example-Any effort to remedy this deficiency
must stem from the employees acceptance of the need for improvement
in delegation.
The appraisal interview is most likely to go well if the nurse manager
has written and shared critical incidents throughout the evaluation
period. If such feedback has occurred, staff members go in to the
interview with a good idea of how they are likely to be rated, as well
as what behavior led to the rating.
If nurse manager has not kept notes throughout the year, It is
important to recall numerous, specific examples of behavior, both
positive and negative to support the rating given.

LEADERSHIP ROLES ASSOCIATED WITH PERFORMANCE APPRAISAL1). Uses the appraisal process to motivate employees and promote growth.
2). Uses techniques to reduce the anxiety inherent in the appraisal process.
3). Uses coaching techniques that promote employee growth in work performance.
4)Involves employees in all aspects of performance appraisals.
MANAGEMENT FUNCTION ASSOCIATED WITH PERFORMANCE APPRAISAL1). Use a formalized system of performance appraisal.
2). Gathers data for performance appraisals that are fair and objective.
3). Uses the appraisal process to determine staff education and training needs.
4). Maintain appropriate documentation of appraisal process.
FOLLOWING ARE RECOMMENDATION FOR CONDUCTING AN APPRAISAL INTERVIEW1). Put the employee at ease.
2). Cleary state the purpose of the appraisal interview.
3). Go through the rating one by one with the employee.
4). Draw out the employees reactions to the rating.
5). Decide on specific ways in which performance areas can be strengthened.
6). Set a follow-up data.
7). Express confidence in the employee.
APPRAISAL INTERVIEW DIFFICULTIESa). BEFOREi). Make sure that the conditions mentioned previously have been met.
ii). Select the appropriate time.
iii) Care the employee 2-3 days advance notice of scheduled appraisal.
iv) Personally prepare, mentally and emotionally.
v). Plan a seating arrangement.
b). DURINGI). Greet the employee warmly.
ii) Begin the conference on a pleasant informal notes.

iii) Avoid surprises.


iv) Use caching technique.
v). Conduct the conference in a nondirective manner.
vi) Focus on employee performance.
vii)Use term language which are easily understood.
c). AFTERi). Both the manager and employee need to sign the appraisal form.
ii). End the conference in a pleasant notes.
iii) Documents the goals.
iv) The manager should develop a method of follow-up to ensure such
coaching task place.
DESCISION TREE FOR EVALUATING PERFORMANCE
ASSESS PERFORMANCE
IS THERE IS PROBLEM GIVE FEEDBACK AS
NO

APPROPRIATE
YES
IF THE PROBLEM IS

SKILL RELATED

MOTIVATED RELATED

EXPECTATIONS
CLARIFY EXPECTATION
.COACH
. DETERMINE OBSTACLES
AND REMOVE THEM
SIMPLY TASK
DETERMINE IF DESIRED
PERFORMANCE IS BEING
REASSIGN
PUNISHED, REMOVE PUNISHMENT
REPLACE IF TIME
DETERMINE EMPLOYEE VALUES
REGARDING DOESNT WARRANT OTHER
REWARD, ENSURE EQUITABLE
TREATMENTS
TECHNIQUES
POTENTIAL APPRAISAL PROBLEMS
There are 3 types of potential appraisal problemi) Leniency error
ii) Regency error
iii)Halo error
LENIENCY ERROR
The tendency of a manager to overrate staff performance.
REGENCY ERROR
The tendency of a manager to rate an employee based an recent events,
rather than over the entries evaluation period.
HALO ERROR
The failure to differentiate among the various performance dimension
when evaluating.
CONFLICTS IN APPRAISALS (General problem)

i. BIAS
a). Opportunity biasSome employee have better working conditions, supportive supervisors
more experienced co-workers.

b).Group characteristics biasGroup cohesiveness morale, group interpretation of fair days work.
c). Predictor biasAppraisers knowledge of parts record of an individual.
d). Individuals prejudicesRegarding age, sea, religion behavior.
Ii .EQUIVALANCE
A major aim of appraisal is to compare the performance of an
individual with that of his peer. These assumptions enter that all
individual being compared were subject to similar work environments to
similar inhibitory and facilitator falters assumptions that are rarely
true. Consequently employees subject to less competition or to lenient
appraisers revive higher appraisal higher appraisal than equally
competent or superior associates.
iii. PRESSURE
From power group unions and superiors to rate the subject favorable.
THE APPRAISERWho knows best about an individuals performance is an important
issue in appraisal. Equally important is the question whether the
person who knows, best about the individuals performance is the best
person to record this performance in the light of the organization
objectives.
PERIODICITY OF APPRAISALPerformance appraisal is most often conducted as an annual activity,
though for trainees and new recruits, quarterly frequency is usually
the norm. Thus employees may be rated at the same time during the year
or an anniversary date of employment of the respective individuals.

POINTS ARE TO BE KEPT IN MIND FOR APPRAISING FAIRER AND MORE ACCURATE
ASSESSMENT
1. The appraiser should develop an awareness of his own bias and prejudices.
2. Consultation should be sought frequently.
3. Information should be gathered appropriately

4. Information should be written down and not trusted to memory.


5. Collected assessment should contain positive example of growth and
development achievement areas where development is needed.
6. The appraiser needs to guard against the three common pitfalls of
assessment halo, horn and central tendency.
7. Some efforts must be made to include the employees own appraisal
of his other work.
A SOUND APPRAISAL PROGRAM MUST SATISFY THE FOLLOWING
1. The system must be consistent with the management style and
philosophy, work technology and socio-cultural characteristics of the
individuals concerned.
2. It should be in tuned with other personnel programs, such as the
system of rewards, compensation scheme training programs etc.
3. The technology in use should have the co-operation of the
appraisals. It should have the ability to assess, in as objective
manner as possible, the performance and effectiveness of an
individuals as related to his job.

BASIC REQUIREMENT-

CONCLUSIONDespite from numerous problems associated with appraisal, most


organization continue to have the formal appraisal program. It is
hence clear that the alternative to a bad appraisal program at all,
but it can and ought to be a batter appraisal program.

BIBLIOGRAPHY

1. BESSIE L. MARQUIS, CAROL J. HUSTON- Leadership Role And Management


Function In Nursing Theory And Application . 4rth Edition . Lippincott
William and Wilkins Philadelphia. PP 467-492.
2. B.T BASAVANTHAPPA- Nursing Administration. 1st Edition, Jaypee
brothers medical publishers (P) LTD. New Delhi PP 425-429.

3. C. M. FRANCIS MARIO C DESOUZA- Hospital Administration . 3rd


Edition . Jaypee brothers medical publishers (P) LTD. New Delhi PP
221-223.

4. ELEANOR J. SULLIVAN , PHILIP J. DECKER- Effective Leadership


Management Nursing . 6th Edition . Pearson Prentice hall upper saddle
river New Jercy . PP 281-288

5. P. V. SAMUEL , A . P SATHE- Epidemiology And Management For Health


Care For All . 2nd Edition . Popular prakashan Mumbai PP 189-197

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