Staff Performance in Nursing Setting


Achieving optimum staff performance takes effort, practice, and time. These skills must be acquired in a process that utilizes resources. All organizations require their employees to give their best to achieve maximum production. Moreover, their efficacy is essential in determining employee performance. Employees from a healthcare setting are very important as they work to among others, save lives. Therefore, their overall performance is very important as it improves their quality of life. It is important to note that there are various groups of employees. However, regardless of this, each category of workers must perform their tasks effectively.

This is a rare occurrence in most healthcare settings as the different categories overlap their chores. Such activities have led to disorganization in healthcare settings as workers scramble to perform their duties. It is quite important to note that each organization requires planning, division of labour and specialization to coordinate their duties. Moreover, channels of communication should be organized in an orderly manner to improve employee coordination. It is in this respect that each category of employees is assigned a supervisor/mentor with experience in the area to achieve acceptable results. This paper will explore issues that affect staff performance in a nursing context. Moreover, it will explore the theoretical approaches to staff performance as well as recommend strategies for its improvement (Hart & Rotem, 1995, p. 3-10).

Staff performance

Staff performance is a very significant aspect of efficiency. In fact, optimal performance is governed by many factors. These include work environment, support, reward and encouragement, among others. This ensures that staff are empowered, happy, contributing and productive. Moreover, staffs need adequate space and information as well as tools to carry out their duties. This should be accorded to them to achieve acceptable results. Maximizing output in a healthcare setting is quite difficult and requires managers with the right strategies of ensuring tasks are done as required. Healthcare settings have different categories of workers.

These depend on departments as well as the kind of services offered. Among these, include Clinical resource nurses, clinical nurse specialists, clinical laboratory nurses, accountants, administrators and doctors. Due to the number of responsibilities to be handled, as well as the ever-changing roles of nurse specialists, their duties must be organized in an orderly manner. In addition, a qualified, as well as motivated human resource department, is required to monitor adequately health provisions and personnel management. These are essential requirements that must be enhanced to achieve health service provision (Burda, 2006, p. 23).

Staff performance and related issues usually arise from lack of adequate coordination; the desire to learn as well as a breakdown in communication. Moreover, several activities that overlap other nurses’ functions are likely to compound issues in a nursing context. It is therefore very important that this be monitored to ensure that the right channel for service provision is followed. Staff performance is influenced by numerous factors. These include the number of staff members, poor working conditions, conflict (ethical or otherwise), overlapping of tasks due to the numerous changes in professional development and motivation, among others.

Staff performance is very important to the development of a better working relationship between management and workers. This is mainly because it provides a positive response to the injection of resources and employee management by the human resource department. Of great concern is the fact that healthcare centres in rural areas find it difficult to provide human resource management as those in urban centres.

This is also due to the scarcity of human resource personnel in a rural healthcare setting. This factor contributes greatly to poor health provision as well as lowered staff performance. It is therefore very important that hospital management explore all aspects of human employee management to improve their performance. This encompasses conducting detailed research on employee motivation factors as well as the theories and approaches that improve employee performance (Almost, 2006, p. 444-453).

Staff organization in a nursing context

The nursing setting is composed of various types of nurses among other workers. In this regard, there are various nursing responsibilities in healthcare centers. These range from in-home nurses to high traffic hospital nurses, among others. In essence, healthcare centers have numerous categories of nurses who perform a range of functions. Moreover, some of their roles overlap as they try not to overlook other areas of work.

This has led to numerous organizational issues, which range from conflict to professional development, among others. Furthermore, nurses have found themselves overlapping in responsibilities since very few organizations have specific details of roles and responsibilities for each category of nurses. Healthcare settings contain various categories of nurses who are trained to perform different chores. For instance, certified nurse assistants (CNA) acts as nurse aids and usually perform their duties under a registered nurse. On the other hand, registered nurses (RNs) have a wide range of activities at their helm.

Others include licensed practical nurses (LPN) who work in between the RNs and the CNAs. Still, others include nurse practitioner (NP) that works as a doctor after completing some specialized courses that elevate him/her. Clearly, it can be noticed that there are various categories of nurses with varying responsibilities and skills. This ensures that healthcare services are provided as warranted. However, this also calls for an exemplary organization, which would ensure that duties are coordinated without causing unnecessary inconveniences. To do this, clarity should be emphasized.

This is required to ensure that each staff member recognizes his job responsibilities, which are well documented. In addition, the organization requires a human resource department that motivates staff and communicates their expectations to them. Further to this, the management is expected to enforce parameters that determine acceptable and unacceptable performance. This would enable staff members to work within their jurisdiction. This should be enforced, in addition to other strategies that can optimize staff performance (CGSST, 2012, p. 1).

Theoretical approaches to staff performance

Staff performance is very instrumental in any organization. In this regard, several theoretical approaches have been explored to understand employee performance. These range from an ethical perspective to the psychodynamics of work, among others. These approaches try to give a view or perspective of staff performance. For instance, the ethical perspective views humans as equal and dignified. In this sense, close attention is paid to employees actions and outcomes as well as repercussions.

This allows staff to be viewed ethically concerning their performance. Moreover, each staff member is entitled to his/her actions and their consequences. Therefore, employees are valued according to their actions and not the performance of the organization. This perspective plays a small role in improving employee performance. Another approach used in staff performance is the humanistic approach. This approach views human beings as unique individuals (CGSST, 2012, p. 1).

In this regard, each individual is allowed to explore his/her strengths as well as make their own decisions. This approach depends on an individual’s ability and effort to improve performance. It involves consulting of staff on establishing organizational strategies and objectives. The other theoretical approach used in staff performance is the psychodynamics of work. This can be utilized to come up with utility judgments of workers. For instance, it involves consideration of the work process and its related constraints in a regular performance evaluation period. This may be in terms of an annual performance evaluation or monthly evaluations.

Moreover, this approach utilizes evaluations from peers. This enables judgment to be made by those who are qualified to undertake such responsibilities. Similarly, the behavioral approach can also be utilized in employee performance. This approach focused mainly on the individual behavior of employees to control them and achieve optimal performance. It bases its fundamentals on the fact that behavior can be stimulated and directed by resulting consequences. This involves activities such as rewarding of highly performing employees. This boosts employee motivation even though it may discriminate against some employees who feel that they are not recognized (Swihart, 2009, p. 1).

Issues that affect staff and organizational performance

Staff performance relies heavily on cooperation with other members. A collaboration between staff members is very important for the coordination of chores. This is very important in the nursing context where collaboration between nurses provides avenues for efficacy in service delivery. Moreover, a collaboration between nurses and patients as well as management provides good ground for healthy working conditions.

In this respect, organizational performance is a factor in the relationship between workers and management, among others. However, it is important to note that several issues arise in healthcare settings. These include conflict between staff, staff and management, staff and patients, among others. In addition, issues such as resource allocation create problems in healthcare centers. Further to this, it is important to note that varying interests and differential in ideas for professional development tend to cause tensions in nursing environments. This paper will deal primarily with conflict in nursing environment as well as professional development as issues that affect staff organizational performance.

Staff performance is known to be blended in an institution’s organizational behavior. Moreover, healthcare centers have various mission statements and objectives that drive them. This cannot be achieved in an environment of conflict. Conflict is a common subject in organizations where people have differing interests. Nursing is a profession that bases its success on collaboration. In this regard, conflict is likely to damage performance of staff in health care organizations. This is mainly because the chief driving factor in nursing is broken (collaboration). As stated below, there are numerous causes of conflict in nursing settings.

These range from ethical to physical conflict, among others. Another issue of profound nature in the healthcare setting is professional development. The Healthcare system is increasingly changing and complex. This is mainly because several advances have been made over the years to make the practice simple and up to date. However, some staff members are usually slow to changes while others make quick development. This is a big issue because when nurses are employed they are all expected to be ready to embrace new techniques. This makes training, employment and retaining of nurses quite challenging. In essence, it requires good management to obtain optimum staff performance (Heimer, 2012, p. 1).


As has been stated above, nurses rely heavily on collaboration to perform their duties effectively. This involves colleagues, management as well as patients. In addition, since it brings people from diverse cultures together, their working relationship is very important to dispel any damaging conflict. According to Marshal, politics cannot be considered as good or bad. This is mainly because there are constructive and destructive conflicts.

Moreover, destructive conflicts can at times, lead to changes that are desired in an organization. However, in terms of performance, conflict serves to destroy working relationships, which are the basis for collaboration. Conflict can occur anywhere at any moment. This is because people have different interests, values and needs. Moreover, those from diverse cultures serve to harbor good grounds for conflict. Nurse patient relationship is very important in any healthcare organization. as it helps in promoting the patient’s well being as well as satisfaction in nursing work. When this is upset, conflict can arise, which may result in decreased performance (Yoder-Wise, 2007, p. 125).

Another cause of conflict in the nursing environment is the ever-changing roles of nurses. In ancient times, nurses used to work independently. However, this has changed as healthcare centers embrace new managerial skills aimed at improving the quality of work as well as teamwork. This brings people from diverse background and hence the possibility of conflict due to varying values and social backgrounds, among others. Diversity is also a huge cause of conflict in nursing settings. This is mainly because varying cultures harbors unresolved conflicts as workers interact. This is highly likely to break teams into smaller groups, which seek different interests.

In the end, this can cause conflict that negates performance and organizational objectives. In addition, due to the wide roles of some nursing units such as RNs, interests can clash when a nurse overlaps another’s work. These situations have the capability of negating the achievement of optimum performance. In essence, conflict is very destructive to the achievement of high staff performance.

Professional development

Nursing is an ever-changing profession due to constant research work and advancement that come with its practice. Moreover, some nurses work towards being doctors in their profession to specialize in various areas of health. This has made the achievement of maximum performance difficult as their effort and attention is divided on various issues. In addition, some nurses are slow to these developments.

Such cases make it difficult for nurses to work in collaboration for a common purpose. In the process, this affects the provision of services, which is hinged on performance. It has also been noted that current managerial skills have transformed into business models where group ethics is nurtured. Moreover, nurses are nowadays required to be multi-equipped for various healthcare issues. These requirements have brought about the need to develop the profession along with the requirement to acquire more skills in new areas. These have ensured that nurses are constantly unsettled about their professional development prospects (Winslade & Monk, 2000, p. 15-120).

These are likely to affect their overall performance in the provision of healthcare services. Professional development also offers nurses challenging tasks as they are prepared to manage the organization at different levels. These are aimed at improving their levels of competencies as well as attaining the best patient care results. Moreover, they are also taught how to minimize resources but maximize their exploitation. In addition, they have to cope with the ever-changing technological advances aimed at improving service delivery. Nurses also face the need to respond to new health issues, which mean that they have to consider professional development.

To make matters worse, this is a requirement to provide useful service to the patient. They are therefore in a constant learning mode in which every advancement is responded to as necessary. This complicates their profession and deters their performance as they work to achieve many requirements. These, therefore, negatively influence optimal performance as requirements overwhelm nurses (Tappen, Weiss & Whitehead, 2004, p. 9-58).

Effect on organizational performance

Organizational performance is very essential as it determines the quality of service delivered. Therefore, issues that affect staff performance are very crucial as they effectively influence the quality of service. Issues such as resource allocation, professional development and conflict, among others are very destructive to staff performance. In fact, ways are always established to help curb such issues. For, instance, conflict is a very common obstacle to organizational performance.

This is mainly because people have different values, interests and expectations. Once an individual’s expectations are not met, a clash is always brewed and this affects relationships. Having stated earlier that nurses depend heavily on collaboration, affected relationships cannot work as close as required in any given organization. This, therefore, ensures that collaboration is sparingly achieved leading to decreased performance and reduced efficacy in service delivery. In the process, quality of service may also be affected, thereby resulting in a total failure of the organization (Patronis-Jones, 2007, p. 111).

From the example above, it is quite evident that conflict can ground activities in a healthcare organization, let alone affect staff performance. Professional development is also another issue that should be taken seriously in healthcare systems. Given the high rate of employee mobility, its effects on employee performance must be considered. Professional development in the nursing context is a dynamic term that refers to the constant acquisition of new ideas to respond to new healthcare issues. These activities need resources, time and adequate personnel to conduct the training. On the other hand, hospitals are always full of demands in working places.

This makes the overall process difficult, as the same nurses who are scarce in some cases need to work on these tasks at the same time. This, therefore, results in a tasking occupation for nurses wherein other psychological aspects take shape to increase fatigue, among other problems. These together with other tasks reduce their performance and quality of services provided to a patient. In this regard, it is evident that professional development can sometimes hinder staff performance (Nilakant & Ramnarayan, 2006, p. 33-109).

Strategies for addressing conflict issues

To achieve success in any organization, conflict should be brought to a manageable level. This ensures that working relationships are warm and conducive for occupation activities. However, achieving a collaborating work ethic is not easy as modern healthcare settings derive people from different backgrounds. It involves a series of strategic planning aimed at emphasizing on objectives of the organization. In the first place, employees are required to accept the fact that they come from different backgrounds and therefore have differing interests, expectations and behaviors, among others. Moreover, the organization should develop a working culture or an organizational culture that nurtures organizational objectives. These are key elements that can ensure people go about their businesses without affecting their counterparts. This is very crucial for the achievement of goals set to be realized (Moss, 2005, p. 77).

Another strategy that should be nurtured in health organizations is the fact that conflict is common in any place and can occur anywhere. Once they have accepted this fact, then they should create ways of solving conflicts. In this regard, conflict resolution should be given priority over other methods of control. This is mainly because it ensures that the conflicting parties agree to disagree, thereby borrowing the hatchet.

Moreover, given that healthcare centers are globalized, it is imperative that nurses learn about other cultures or at least how to handle various people. This is important in helping them accept one another irrespective of their backgrounds. Virtues such as respect for self and others should be enforced in the organization. Furthermore, the objectives of the organization should be clearly stated and documented to help employees focus on them rather than concentrate on conflict. These considerations, among others, would be important in developing an organizational culture to spur staff performance (Ministry of Health, 2005, p. 1).

Strategies for addressing professional development issues

Professional development comes with several issues that require attention. In fact, if they are ignored, performance levels can be affected greatly. For instance, a registered nurse (RN) who shoulders other responsibilities as a leader nurse and mentor/supervisor to CNS nurses have other responsibilities which may include classes to further his/her specialty, family issues, executive duties as a leader nurse, among others.

These responsibilities are likely to weigh on this individual to an extent that optimum performance cannot be achieved, as he/she has to concentrate explicitly on one aspect as opposed to others. These are likely to cause more problems to other associated nurses who may feel that they are not recognized. In essence, the management should consider carefully when delegating duties, conducting professional development courses as well as when giving study leaves, among others. Moreover, this should be carried out in an orderly manner to achieve organization performance (Marriner, 2004, p. 22-78).

Professional development affects various performance indicators in healthcare settings. These include productivity, competence, responsiveness and availability. Therefore, as much as it tries to improve competence, responsiveness is affected since the nurse is overwhelmed. Moreover, availability may also be affected if professional development involves missing from work. Ultimately, productivity will also be low since attention is divided.

In this regard, stakeholders and policymakers must monitor the four elements of performance to ensure that professional development does not hinder them. Other strategies that are necessary for the improvement of staff performance include ensuring that the fundamentals of managing staff performance are incorporated, planning effective strategies for enabling professional development as well as staff performance, implementing working strategies and revising dysfunctional ones. In addition, the management should recognize as well as reward employee improvement (Kouzes & Posner, 2007, p. 55).


Staff performance is a very important element of determining the quality of service delivery. This is mainly because it is the total of all elements of a performance. These elements include competence, responsiveness, productivity and availability. When the elements are positive then performance is also positive. On the other hand, when the elements are negative, then performance becomes negative. It is also important to note that the elements are closely linked to an extent that changes in one can result in a proportional change on the other. For instance, when an employee misses work, then availability is affected. This affects productivity and hence questions are asked on competency as well as responsiveness. In this regard, employees are expected to be positive about all these elements to register a positive performance (Hyde & Cook, 2004, p. 112).

Several approaches have come up to explain employee performance; these include behavioral, psychodynamics of work and humanistic, among others. At the same time, it has been discussed that several issues affect employee performance. These include resource allocations, conflict and professional development, among others. The paper emphasizes conflict and professional development. Conflict is very destructive to staff performance as stated above and this can be controlled through conflict resolution. In addition, proper management of employees is necessary to reduce the effects of professional development on staff performance.

These are issues of great concern to the numerous healthcare facilities around the globe as they face new obstacles in the form of diversity and new threats to life. Effective management strategies are therefore required to optimize employee performance (Daly, Speedy & Jackson, 2004, p. 56).


Employee performance is crucial to the provision of quality healthcare services. In this regard, employees are required to maintain high levels of performance to achieve organizational objectives. This involves improving each element of performance as stated above. These elements are productivity, availability, responsiveness and competence. To maintain high levels of competence, nurses are required to maintain an effective level of collaboration (Currie, Morrell & Scrivener, 2003, p. 1).

However, this cannot be achieved when issues such as conflict and professional development, among others are left unattended to, as this will lower staff performance. In this regard, issues such as conflict should be resolved amicably and solutions to problems found to enforce close collaboration between nurses. In addition, management of employees should be done in such a manner as to enable professional development without hindering any of the elements of performance (performance indicators). This will ensure that working conditions in healthcare centers are improved to promote job satisfaction, employee recognition and staff performance, among others (Baine, 2006, p. 56-65).


To achieve maximized performance, several strategies should be employed to improve performance indicators. These include incorporating effective conflict resolution strategies to improve collaboration between employees as well as employees and their patients. The next strategy should involve nurturing organizational culture to promote the achievement of organizational objectives (DuBrin, 2007, p. 22). Moreover, professional development should be managed to ensure that positive working attributes are gained to improve staff performance. In addition, management should ensure that basic components utilized in managing staff performance are incorporated.

These components include documentation and clarification of job responsibilities to minimize overlapping of duties. Managers should communicate their expectations to employees. In addition, they should establish both acceptable and unacceptable parameters as well as their consequences. Prospects of improvement in staff performance should also be pursued. Moreover, strategies should be planned to work with employees. Furthermore, strategies should be implemented and revised whenever necessary. This should be done on time. Finally, the organization should reward and recognize improving staff members as this will increase motivation (Braithwaite & Travaglra, 2008, p. 12-44).

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