Assignment

on

Accountability & Discipline

Submitted to Submitted by
Miss. Maloti Devi,MSc Nursing Mrs. [Link] Devi
Principal 2nd year [Link]
Noor College of Nursing Noor college of nursing
Bangalore. Bangalore
Accountability

Meaning

Accountability is a concept that has been present in nursing for a very long time, although
the use of word itself is relatively recent. In its simplest sense, accountability is
synonymous with responsibility; in this regard; it permeates the writing of Florence
Nightingale; “I have often seen really good nurses distressed, because they could not
impress the doctor with the real danger of the patients”.

Accountability deals with the other dimension also, of answerability, the necessity
of offering answers and explanations to others. This answerability can be to public, the
other members of a profession and allied professionals.

Some related terms to accountability are, autonomy which refers to independent

functioning, the ability and recognized right to perform one’s total professional function
on the basis of one’s own knowledge and judgment. Authority, another synonymous
term can be defined as being in a position to make decisions and to influence others to act
in a manner determined by those decisions.

Relations of accountability to:

1. Client & Public

Client: nursing is a profession dealing with persons. Therefore, almost by

definition, a profession must be accountable to that public. The consumer has the rights to
receive best quality of care, grounded with firm knowledge, sound judgment and
appropriate value system.

Nurse is ultimately accountable for all the care she is giving and to health care delivery
system also. Nursing is also accountable to the public in guarding against ill prepared
coworkers being certified to give nursing care under the guise of a new category of health
care worker.

2. Profession
Nursing is a profession and that makes it to be more accountable for everything as it is
hallmark of any organization. A profession should have its own policy and
procedures. A profession should know for what it is accountable for and should
develop their own standards and attempt to enforce them. It is also a means through
which the accountability of profession can be evaluated. Policies to control duties,
punishments should be there in nursing profession
3. Self

Professional life is one aspect of her life. It includes refusing to work in situations that
she considers unsafe either because of her own lack of knowledge or experience in an
area or because of insufficient staffing or some other problems inherent in the situation.
It also involves acknowledging personal limitations and recognizing the need of further
education to more fully and safely perform the nursing role.

4. Employing Agency

The agency is accountable to the public for the care under its auspices. In turn it has
the right to expect the nurse to be accountable to agency. The quality of the nurse’s
work is one aspect in which she must be accountable for the agency. This includes a
preparation for the job. The nurse is also accountable for her peer’s performance also,
she must be aware of what they are doing and how they are doing it.

DISCIPLINE

Conduct is three quarters of our life and its largest concern.

- Matthew
Arnold

Introduction:

One method by which a nurse manager can control subordinates’ behavior is to invoke
official disciplinary procedure. Discipline can be self- control by which an employee
brings her or his behavior into agreement with the agency’s official behavior code, or it
can be a managerial action to enforce employee compliance with agency rules and
regulations.

Meaning:

It allows one individual to have some control over another. It is a necessary and positive
tool in promoting subordinate growth. It refers to working in accordance with certain
rules, regulations and customs, whether they are written or implicit in character. Human
performance is greatly influenced by the state of discipline in any organization.

Definition:
A training or molding of the mind and character to bring about desired behaviors.

Principles of effective discipline

As a nurse manager, purpose for imposing disciplinary action should be to correct, rather
than t punish, a wayward employee. Certain psychological principals should be employed
in correcting unacceptable behavior

1. Following rule infarction by an employee, discipline should be administered

promptly, privately, thoughtfully, and consistently.

Ex. Suppose a nurse speaks disrespectfully or threateningly to a patient , she or he

should be taken aside by the manager for a friendly, informal talk that includes
review of the official code of conduct, identification of the manner in which the
nurse has violated the code , and advice about improving communication with
patient.

2. For all but the most sever offences, discipline should be progressive and preceded
by counseling.

Ex. Suppose the nurse berates the patient, the nurse manager should give the nurse
an oral reprimand, which is a firm reminder that the nurse’s behavior departs from
expected standard and that repetition o the undesirable behavior will lead to steps
of progressive discipline, upto and including discharge.

If the nurse persists in verbally mistreating patients, the manager should

administer a written reprimand, which is a formal written warning with patients
and that failure to improve communications with patients and that failure to
improve will culminate in steps of progressive discipline up to and including
discharge. Finally, if efforts to correct, mold, and perfect the nurse’s behavior
prove unsuccessful, she or he should be discharged.

3. Disciplinary action may have long term and serious consequences for employee,
such as loss of income and damage to professional reputation. Therefore a
manager should use caution in implementing disciplinary problems. Before a
written or verbal reprimand is given, and especially before suspension or
discharge is imposed, the manager should investigate the episode of undesirable
behavior to ensure that an agency rule has been broken, the nurse was informed of
the rule, and that there were no extenuating circumstances to justify violation.
 4. To be effective discipline, should be administered, not as a punishment, but as a
aversive conditioning.

Ex. People refrain from touching a hot stove to avoid sure and unpleasant
consequences. Likewise , most employees comply with an agency’s official
behavior code , when for an agency’s official behavior code, when forbidden
behavior are clearly described and unpleasant consequences(loss of privilege, pay ,
or position) are provided quickly , equitably and unemotionally to all offenders

5. Have a prompt attitude

Ex. If staff nurses are treated as suspect, they are more likely to provide the
trouble that the manager anticipates. People generally tend to do what is expected
of them; therefore it is manager’s duty to maintain a positive attitude by expecting
the best from the staff.

6. Protect privacy

Ex. Disciplinary action affects the ego of the staff nurse. Thus it is better to discuss
the situation in private. By helping the nurse save face, there is less possibility of
future resentment and a greater chance for future cooperation. However, .a public
reprimand is necessary for the nurse who does not take private criticism seriously

7. Focus on the act

Ex. When disciplining a staff nurse, the manager should emphasize that it was the
ct that was unacceptable, not the employee. If the employee is not acceptable, the
person should be fired.

Approaches of discipline:

There are two main approaches in discipline:

1. Traditional approach:
It emphasizes punishment for undesirable behaviors; Odiorne (1984), explained
the purposes of traditional discipline , punishment for sin, enforce conformity to
custom, and strengthen authority of the old over the young . Here discipline is
always applied by superiors to subordinates; the severity of punishment is
 designed to be proportional to the severity of the offense, and when no single
individual admits to the violation, the whole group is punished to motivate group
members to identify the violator or punish him or her themselves.

2. Developmental approach:

The purpose of developmental discipline is to shape behavior by providing

favorable consequences for the right behavior and unfavorable consequences for
the wrong behavior. This approach is characterized by avoidance of physical
punishment, protection f the rights of the accused and replacement of arbitrary
individual judgments of guilt. Often the traditional approach is used in
bureaucratic organizations, under an authoritarian style of leadership, and the
developmental approach to discipline is used in innovative, matrix type
organizations under a democratic or participative style of leadership.

3. Positive discipline approach:

 Managers in industry and health care have stimulated employees to aim for
the “higher ideal” of organizational mission by employing what is known
as “positive discipline” or discipline without punishment. It differs from
traditional discipline in that the former is motivational, the latter is
punitive..
 Positive discipline is based on the assumption that an employee with self –
respect, respect for authority, and interest in the job will adhere to high
quality work standards.
 It is further assumed that when an interested, respectful, and self- respecting
worker temporarily strays from his or her usually high standards, a friendly
reminder is enough to redirect his or her efforts in the desired direction
 Organizations that have employed a positive discipline have noted a
subsequent decrease in absences, dismissals, disciplinary actions,
grievances, and arbitration, along with improvement of employee morale.

4. Self controlled discipline approach:

Here the employees bring her or his behavior into agreement with the organizations’
behavioral official code, i.e. the employees regulate their own activities for the
common good of the organization. As a result human beings are induced to work for a
peak performance under self controlled discipline.
 5. Enforced discipline approach:

A managerial action enforces employee compliance with organizations’ rules and

regulations [Link] is a common discipline imposed from the top. Here the manager
exercises his authority to compel the employees to behave in a particular way

Penalties

 Oral Reprimand: for minor violations that may have occurred for the first time,
managers may opt give an oral warning in private. When oral warning is given the
nurse manager is advised to make an anecdotal record of the time, place, occasion,
and the gist of the reprimand.
 Written Reprimand: if the offense is more severe or repeated, the
reprimand may be written. It is suggested that the manger and staff associate
develop a written pal for improvement that defines what the staff associate will do
to make the performances acceptable and what manager will do to change the
environmental situation if appropriate. Sign should be taken by the person as
witness and a copy of it should be given to worker. If again the terms are not met,
other penalties will probably be necessary.
 Other penalties: fines may be charged for offenses such as tardiness. Loss of
privileges might include transfer to a less desirable shift and loss of preference of
assignment. Layoff, demotion, and discharge are the most serious penalties and
need approval beyond the manager.
 Demotion is a questionable solution. It creates hard feelings, which may be
contagious, and more than likely places offenders in a position for which
they are overqualified.
 Suspension
 Withholding increment
 Termination becomes necessary, as a last resort.

Employee Code of Conduct

The basic prerequisite for effective discipline is employee awareness of agency rules and
regulations governing employee behavior. Behavior rules should be written in clear and
concise language, incorporated in a handbook given to new employees during induction,
posted in each work unit, and discussed with employees by the manager of each work
unit. Following are typical behavioral rules for a health agency. Infraction of these rules
should precipitate disciplinary actions for the employee, employee shall not;

1. Absent herself from a scheduled assignment without the manager’s approval.

 2. Physically or verbally abuse a patient, visitor, or agency employee
3. Transmit confidential information about patients or agency affairs to unauthorized
persons.
4. Appropriate patients’ belongings or agency property for personal use.
5. Refuse to follow the directions of a duly authorized superior.
6. Intentionally falsify organizational records.
7. Sleep during duty hours.
8. Be under the influence of alcohol or unprescribed drugs while an agency premises.
9. Carry a weapon while on agency premises.

A nurse manger should inform subordinates of behavior rules and explain the rationale
for each rule. The manager should encourage employees to discuss the application of
each behavior rule with members of the primary work group predisposes an employee to
identify with agency goals and accept the necessity for behavioral restrictions.
conduct should be fair and transparent. The employees should show truthfulness in
actions throughout their tenure in the organization.

2. Disclosure of information: The employees should not disclose the

company information to third parties and other outside organizations.
However the employers should reveal the various policies of the
organization to their employees and make them aware about the code of
 conduct and other policies.

3. Harassment: The work environment should be free from all kinds of

harassments, especially sexual harassments and verbal harassments. No
physical harassments like hitting or pushing are acceptable on part of
employees.
4. Outside employment: Employees should not indulge in to any kind of
concurrent employment without the prior knowledge of employer.
5. Conflict of interest: An employee should not indulge into other
professions or services or other interests which might conflict with the
interest of the company. This means personal interests should not
overshadow organizational interests.
6. Confidentiality: Employees should protect company’s confidential
information. The financial records and unpublished data should be kept
within the organizations and should not be spread outside the organization.
7. Equal opportunity employer: This factor expects the employer to be an
equal opportunity, that is, no discrimination should be done on the basis of
caste, color, race, gender, religion or physical disabilities.
8. Misusing company resources: Employees should not misuse company
resources, intellectual property, time and other facilities. They are provided
to them for business purposes and thus, should be used in a cost effective
way.
9. Health and safety: An employer should provide a safe and healthy work
environment to its employees. Proper cleanliness and lightening should be
provided. A health and safety committee can be set up by the employer
consisting of representatives of workers as well.
10. Payment and gifts: The employees should neither accept nor offer any
kind of illegal payments, donations, remuneration and gifts from outsiders.

The maintenance of harmonious industrial relations within an industry depends on

the extent of promotion and maintenance of discipline in the organizations. No
organizations can grow and prosper without effective disciplinary system.
Discipline on account of employees means complying with the predefined rules
and regulations of the organization. It is a form of training that enforces
organizational rules. Conduct problems arise from the employees who fail to
follow the code of conduct of the organization. These employees are most often
affected by the disciplinary system of the organization. Such employees are often
called problem employees. The problem employees comprise a small number of
employees, but they are the ones who cause the most disciplinary situations.
If employers fail to deal with problem employees, negative effects
on other employees and work groups may result. Some common disciplinary issues
caused by problem employees include absenteeism, tardiness, productivity
deficiencies, pilfering, alcoholism, insubordination, misuse of equipments and
other company resources, and negligence. The goal of discipline is behavior
modification, that is, to modify unacceptable behavior and misconduct.

Components of a Discipline Action Programme:

 Code of conduct
 Authorized penalties
 Records of offenses and corrective measures
 Right of appeal

Theories and models in nursing:

1. Canter’s Model of Assertive Discipline:

Focus: The primary focus of Lee Canter's theory is on the concept of teacher's
rights in the classroom. His methods attempt to show teachers, how to responsibly
take charge of their classroom by observing the rights of the students as well as
those of the teacher.

Concept: Canter's model intends to promote a supportive classroom that allows

teachers to teach and students to learn. Students are taught how to behave and
teachers are taught to be less punitive in their disciplining. However, this model
uses extensive praise and other rewards that inhibit more intrinsic motivation. This
model must be carefully considered prior to implementation. Canters’ rely heavily
upon external rewards and control, rather than internal motivation. Assertive
teachers care about students to the point that they won't let them do harmful things.
These teachers also care about themselves enough not to let children walk all over
them. Canter gives various steps to become an assertive teacher. He also gives
ideas on what to do when consequences need to be used. These must be unpleasant
but not harmful to the children. Some of his ideas are to be consistent, give
consequences calmly, and provide students with escape mechanisms in case they
wisely choose to avoid a conflict.

2. The Neo-Skinnerian Mod

Focus: Shaping Desired Behavior. B.F. Skinner is the father of the behavioral
school of psychology. A recently popular outgrowth of Skinnerian behaviorism is
Behavior Modification.

Concept: Behavior is conditioned by its consequences. Behavior is strengthened

if followed immediately by reinforcement. Behavior is weakened if it is not
reinforced. ["Extinction."] Behavior is also weakened if it is followed by
punishment.

 In the beginning stages of learning, reinforcement provided every time the

behavior occurs produces the best results.
 Behavior can be maintained by irregular reinforcement. Reinforcers include
verbal approval, smiles, "thumbs up," high grades, free reading time,
goodies, prizes and awards.

3. The Kounin Model:

Focus: Withitness, Alerting, and Group Management.

  The ripple effect: when you correct one pupil's behavior, it tends to change
the behavior of others.
 The teacher needs to be with it to know what is going on everywhere in the
room at all times.
 Smooth transitions between activities and maintaining momentum are key
to effective group management.
 Optimal learning takes place when teachers keep pupils alert and held
accountable for learning.
 Boredom [satiation] can be avoided by providing variety to lessons, the
classroom environment and by pupil awareness of progress.

4. The Ginott Model:

Focus: Addressing the Situation with Sane Messages.

 Discipline is little-by-little, step-by-step. The teacher's self-discipline is key.
Model the behavior you want in students.
 Use sane messages when correcting misbehavior. Address what the student
is doing, don't attack the student's character [personal traits]. Labeling
disables.
 Use communication that is congruent with student's own feelings about the
situation and themselves.
 Invite cooperation rather than demanding it.
 Teachers should express their feelings--anger--but in sane ways. "What you
are doing makes me very angry. I need you to ...."
 Sarcasm is hazardous.
 Praise can be dangerous; praise the act, not the student and in a situation
that will not turn peers against the pupil.
 Apologies are meaningless unless it is clear that the person intends to
improve.
 Teachers are at their best when they help pupils develop their self-esteem
and to trust their own experience.

4. The Glasser Model:

Focus: Good Behavior Comes from Good Choices. Glasser's recent work
focuses on the class meeting as a means of developing class-wide discipline.
 Students are rational beings capable of controlling their own behavior.

Concept:
 Help pupils learn to make good choices, since good choices produce good
behavior.
 Do not accept excuses for bad behavior. Ask, "What choices did you have?
Why did you make that choice? Did you like the result? What have you
learned?"
 Reasonable consequences should always follow good or bad student
behavior.
o [Usually developed in classroom meetings,] class rules are essential
to a good learning climate, they must be enforced.
o Classroom meetings are a good way to develop and maintain class
behavior. [The group diagnoses the problem and seeks solutions.]

6. The Dreikurs Model:

Focus: Confronting Mistaken Goals.

 Discipline is not punishment. It means self-control.
 The teacher's role is helping pupils to impose limits on themselves.

 Teachers can model democratic behavior by providing guidance and

leadership and involving pupils in setting rules and consequences.
 Misbehavior is the result of their mistaken belief that it will gain them peer
recognition. [It is usually a mistake to assume that misbehavior is an attack
directed at the teacher.]
 Misbehavior is directed at mistaken goals: attention-getting, power-seeking,
revenge, and displaying inadequacy. The trick is to identify the goal and act
in ways that do not reinforce mistaken goals.
 Teachers should encourage students' efforts, but avoid praising their work
[?] or character. [Others disagree.]
 Support the idea that negative consequences follow inappropriate behavior
by your actions.

Dealing with disciplinary problems:

When dealing with disciplinary problems, it is better to conduct disciplinary

conference. While conducting disciplinary conference both directive and non-
directive interview techniques can be used. To guide the discussion in the
 conference, the manager:

 Should begin with clear statement of the broken behavior rule, i.e. gives
description of the specific rule by the employee.
 Should describe corrective action expected by the employees, i.e. action
that employees should take to correct the problem.
 Should specify the time to allowed to employee to remedy his
shortcomings;
 Further discipline to result if specified behavior change is not made.
 See that disciplinary conference documented and included in
employment record.

To ensure that there are no failures in disciplinary procedures and no unfair is

occurring resulting in an ineffectual disciplinary action manager should ensure
that:

 There is an agency rule or standard that governs the behavior under

consideration
 The employee was aware of the rule or standard governing her or his
problem behavior
 The employee did, in fact, violate the agency rule or standard.
 The penalty imposed is appropriate to the rule or standard violated.

Ways of dealing with disciplinary problems:

1. Disciplinary conference:

Meaning: It means a group discussion using both directive and nondirective

interview techniques. It is difficult and unpleasant to employee’s self esteem to
give criticism to one another that generally occurs in conference. Thus this
conference is anxiety provoking situation for both employee and the manager

Task: In a disciplinary conference then manager should check the

cordiality of environment and minimize any kind of stress. The session should
be planned to be short, focused, positive, and simple. Conversation should be
controlled focused on employees actions rather than motives, and maintain
objectivity when discussing the rule violation and the proposed disciplinary
action.

Introduction should be with a clear statement , should describe, clearly the

broken rule by the nurse, corrective actions expected by the employee, time
prescribed to correct the behavior by nurse and remedy to shortcomings and
 further discipline to be administered if changes are not taking place.

2. Disciplinary Letter

Meaning: it’s a letter send to the nurse/employee immediately after the

conference, documenting the interview content from the manager’s view point.
It is needed as sometimes employee’s anxiety may block perception of the
painful feedback offered by the manager.

Task: the letter should parallel the outline followed by the manager in
conducting the interview, explaining the employee’s rule violation , reason for
the manager’s concern, behavioral change(s) expected of the employee, plan of
action for effecting desired behavior change, employee’s comments about the
problem and promised behavior change, and consequences if undesirable
behavior persists. A copy of letter documenting the disciplinary interview
should be retained in the employee’s subsequent behavior change, to determine
the need for later discipline, or to provide evidence during subsequent
grievance or arbitration.

3. Model standing orders

Meaning: it specifies the terms and conditions which govern day to day
employer- employee relationship, infringement of which could result in a
charge of misconduct.

Task: it contain various provisions in relation to following area:

1. Classification of workmen into permanent, probationer, temporary,

causal, apprentice and the explanation of meaning of each.
2. Rules for publication of working time, holidays and pay days, wage
rates, shift working, etc.
3. Notices of shift changing
4. Provisions regarding attendance and late coming.
5. Provisions for various types of leave
6. Provisions for stoppage of work, termination of employment
7. Provision of certificate on termination of service.
8. Disciplinary action for misconduct

Misconduct :

It is willful insubordination, disobedience any lawful and reasonable order of the

superior, theft, fraud, dishonesty in connection with the employers business or
property. An action or behavior can be defined as misconduct if it is prejudicial to
the interest of the employer and the other employees, inconsistent and
incompatible with the norms set for discharging duties, unsafe , undesirable or
unfaithful, amounting to a degree of insubordination to such a degree that it
becomes incompatible to continue the employee and employer relationships.

Standing orders specify acts of misconduct in a wide perspective; they are only
indicative and as such does not follow, what is not scripted in standing order, is not
misconduct.

Types:

Minor:

1. Entering or leaving the premises or departments of the hospital except by

the gates provided.
2. Late attendance or absence of duty
3. Leaving the place of work without the permission
4. Failure to carry ID card
5. Smoking, drinking or eating prohibited things.
6. Failure to wear uniforms / wearing unclean uniforms
7. Unproductivity or laziness , not maintaining office decorum
8. Refusal to receive , accept , notice letters of any communication form
management
9. Bribe
10. Wandering or malingering during working hours
11. Improper or disrespectful behavior towards patients, other colleagues,
public and shouting, loud talking making noises
12. Failure to report any disease one may have that can endanger others also

2. Major:

1. Entering other’s depart. with unassigned purposes.

2. Failure to observe safety instructions.
3. Unauthorized handling of safety machines.
4. Misusing any machine, apparatus or equipment.
5. Failure to report any loss of any tools or materials entrusted to him in the
performance of his duties or failure to account for the same.
6. Withholding any relevant information / furnishing any false information at
any time.
7. Using hospital facilities for unauthorized purposes.
8. Sleeping while on duty.
 9. Refusal to accept transfer order.
10. Using indecent language
11. Organizing, holding, attending or taking part in any meeting, exhibiting,
sticking, or distributing any learning materials without prior written
permission of the management.
12. Commission of any offence punishable under the Indian Penal Code.
13. Committing any minor misconduct three times.

Errors Encountered In Disciplining The Employees

Perhaps the most pleasant task for supervisors and managers is the task of
disciplining an employee. While some staff seems to think that managers take
some perverse pleasure in the process, the truth is that it is usually dreaded, and
often done in an ineffective way. Part of the reason why this is so is that there are
some psychological factors in play that militate against constructive discipline
processes.

Error #1: Discipline As Punishment

Perhaps one of the most prevalent errors is based on the idea that discipline is
punishment. The manager that perceives discipline as a punishment process tends
to apply negative sanctions, expecting that those negative sanctions will have some
sort of positive effect; for example, to eliminate the unwanted behavior simply
through the "threat" of additional sanctions. Unfortunately, the use of negative
sanctions on their own, bring about unpredictable results. In rare cases, they may
work, through the fear factor. In other cases, they have an effect opposite to the
one intended, and can contribute to escalation in the manager-employee
relationship. Why? Because negative sanctions will only succeed when:

 the employee values what is taken away or fears what is threatened.

 the employee sees the sanction as fair, and consistent with the "offense".

 the employee acknowledges and respects the right of the manager to impose
 the sanction.

 Unless these three elements are in place, employees respond to punishment

with resentment, and counter-attacking, either covertly or overtly.

Error #2: Discipline As An I-You Confrontation

A second error is that some managers see discipline as something done to an

employee, not something done with an employee. Perhaps we must consider a hard
reality in the government workplace; it's pretty difficult to do anything TO an
employee without getting wound in trails of paper, documentation, and investment
of time. Even then it can be to no avail. We suggest that you consider discipline as
requiring you and the staff member to work together to solve a problem. The
fundamental task, when possible, is to create a situation which encourages the staff
member to work with you to identify causes of problematic behavior, and to take
action to correct those problems. Discipline needs to be a "we process".

Error #3: Too Late, Too Late

It's probably safe to say that managers do not go hunting for disciplinary problems.
Lord knows, you have enough other things to do to look for trouble. Sometimes,
though managers are too slow to respond to an emerging issue or problem.

The reason why delay is problematic is that it sends a message that undesirable
behavior will be accepted or even not noticed. Second, delay can have an adverse
effect on the manager later, if the problem increases in frequency and intensity so it
cannot be ignored. When a problem is allowed to grow, the manager often will
develop an emotional set towards the employee that makes constructive interaction
difficult. To be blunt...managers get pissed off, at repeated "offenses" even if the
manager has done nothing to stop them.

It is very important that inappropriate behavior or actions in the workplace be, at

minimum, noted, and the fact communicated with the staff member, right at the
first occurrence. This need not be a lengthy difficult discussion, particularly if the
event is relatively minor.

Error #4: A Non-Progressive Approach

Related to the previous point (Error #3) is the issue of progressiveness, or lack of
it. Progressive discipline starts with the least possible use of power and disciplinary
action, and over time, will involve stronger actions, if the situation continues.

Error #5: Missing Root Causes

It is understandable when beleaguered and frustrated managers/supervisors "lay

down the law" to a problem employee. In some cases, a problem employee may
require this kind of approach particularly if they have the skills to do what is
desired, but have not been applying the skills for one reason or another, related to
motivation. But in many situations, exhortation, threats, or an offer of positive
rewards may have little effect on behavior, simply because they do not address the
root causes of the [Link] an employee is not succeeding because they
lack the skills (even if they are not aware of the skill deficit). Sometimes an
employee is not succeeding because they have underlying personal or
psychological problems. And, sometimes an employee is not succeeding because
the system in which s/he works is not set up to engineer success. Without knowing
the root causes underlying a performance problem it will be difficult to work with
an employee to improve that performance.
Procedure for disciplinary action

Give employee an opportunity to explain against the charges alleged to him

Employee can explain either in a written manner or oral recorded inquiry

In case of any major misconduct, employee shall be issued a charge

sheet, show cause notice explaining clearly everything
In case the employee is not admitting the charge against him, recorded enquiry
has to be conducted; a enquiry officer has to be appointed from the staff of
hospital or management, or any presenting officer from among the staff may be
appointed.
 Employee should be present in the required time otherwise enquiry shall be
preceded with ex-parte in his absence.

Employee has the freedom to choose any co-employee with him; he can cross
examine the witness, deposing in support of charges and also to produce witness in
his defense. Whole conversation and enquiry has to be recorded.

On conclusion of the enquiry, the enquiry officer shall record his findings whether all or
any of the charges leveled against are established.

If charges are proved then, management will look over the previous records or any
extenuating events that assist in awarding punishment to the employees. Nature and
amount of punishment will be decided by the management and will be passed to
employee later.

Administrators role in Discipline management

1. Encouraging employees to abide the rules

2. Helping employees to identify the goals of organization and standards of
conduct.
3. Using discipline humanistic ally as a means of promoting employee growth.
4. Periodical assessment of existing rules and regulations.
5. Demonstrating the severity of environment in which discipline is to be
given.
6. Uses authority formally to take serious actions against the employees
committing mistakes repeatedly.
 Conclusion:

Accountability and discipline are two intimate terms which is the need of all
organizations. Management should also know the issues and challenges
commonly occurring and the ways to resolve and bring discipline and harmony
in the organizations.

Bibliography:

1. BT Basvanthapa. Nursing Administration. Jaypee Publication. Delhi.

2nd Edition-2008. [Link].590-610.
2.

MASTER PLAN

DISCIPLINE IN NURSING

1. Introduction
2. Terminologies
3. Definition
 4. Principle
5. Penalties
6. Approaches
7. Employee code of conduct
8. Components of a Disciplinary Action Program
9. Models and theories in discipline
10. Dealing with disciplinary problems
11. Procedure of disciplinary action
12. Administrator’s role in discipline management

ACCOUNTABILITY

1. Introduction
2. Terminologies
3. Accountability and its relation to
 Client and public
 Profession
 Self
 Employing Agency
 Conclusion
 Bibliography
 Journal Abstract

Assignment
On.

Accountability & Discipline.

Submitted to:

Miss. Maloti Devi,Msc Nursing

Principal ,

Noor College of Nursing.

Submitted By:

Mrs. [Link] Devi

[Link] Nursing IInd Year

Medical Surgical Nursing Departt.

Noor College of Nursing, Banglore.