Examining the disciplinary process in nursing: a case study approach

Abstract

This article examines the disciplinary process in nursing using data drawn from qualitative cases studies carried out in three healthcare Trusts in the north of England.The main method of data collection employed in the cases studies was in depth interviews with managers, nurses and trade union representatives.The study considers the models of discipline employed by managers when making the decision to discipline, the conduct of disciplinary cases and their outcomes.The study pays particular attention to ‘quasi-formal’ discipline in which investigative processes may be used as punishments.The study also considers the poor outcomes of disciplinary action and their relationship to the ways in which disciplinary processes are conducted.

Integrative review of studies about nurses who have been disciplined by their professional regulatory bodies

“…The nursing profession carries this out at individual, organizational and national professional regulatory levels. The individual level refers to self‐regulation of nurses' own responsibility for their professional knowledge and practical skills (Balestra, ; Cooke, ; Cronquist, ). On the organisational level, professional regulation refers to health care managers monitoring, controlling and advising employees (Cooke, ).…”

“…The individual level refers to self‐regulation of nurses' own responsibility for their professional knowledge and practical skills (Balestra, ; Cooke, ; Cronquist, ). On the organisational level, professional regulation refers to health care managers monitoring, controlling and advising employees (Cooke, ). Professional regulation is exercised at an authority level by national nursing boards, regulatory bodies or other supervisory authorities, and they are responsible for investigating whether the actions of nurses have violated patient safety or legislation (Cooke, ; Raper & Hudspeth, ).…”

The challenge of managing informally

“…Traditionally, it has been argued line managers prefer to handle workplace disputes informally (Earnshaw et al, 2000), whilst HR practitioners prefer a more procedural approach to resolution (Cooke, 2006). However, this paper suggests that as conflict management has devolved to the line, front-line managers appear to have become more rigid in their adherence to procedure.…”

“…In this way, more formal processes could provide a degree of cover for managers (Cooke, 2006) and also the appearance of fairness and consistency (Cole, 2008). Moreover, the promotion of consistency in conflict handling had also resulted in the formalising of informal process.…”

“…I think one our biggest faults of performance management is that it comes to the end of year review and then people are then just told that they're not good enough but there's been nothing through the year, there's been no sort of coaching (HR practitioner -Organisation D) This also reflects a concern, particular expressed by HR respondents that front-line managers sometimes saw more formal processes as a means of justifying or legitimising arbitrary action rather than encouraging them to seek to resolve the issue at an early stage (see Cooke, 2006;Earnshaw et al 2000). An HR practitioner explained this as follows:…”