Nursing team opinion concerning the performance evaluation process

Abstracts

OBJETIVO: O estudo teve o propósito de analisar o processo de avaliação de desempenho segundo a opinião da equipe de enfermagem. MÉTODOS: Trata-se de um estudo survey de caráter quantitativo. Participaram 119 auxiliares de enfermagem e 45 enfermeiros de unidades de internação clínica e cirúrgica do Hospital de Clínicas de Porto Alegre, totalizando 164 profissionais. Utilizou-se um instrumento não identificado contendo questões fechadas, que foram analisadas com base estatística descritiva, freqüências absolutas e relativas e teste quiquadrado para estabelecer significância. RESULTADOS: Os dados apontam, de forma geral, predomínio de satisfação e aspectos positivos, porém essa satisfação não abrange toda equipe, indicando falhas e necessidades de melhorias em algumas etapas do processo. CONCLUSÃO: A insatisfação com o processo é maior entre os funcionários mais antigos. O instrumento avaliativo, a periodicidade das avaliações e a possibilidade de avaliações mais participativas necessitam ser discutidos visando a construção de novas alternativas para o processo avaliativo.

Avaliação de desempenho; Enfermagem; Recursos humanos de enfermagem no hospital; Pesquisa em avaliação de enfermagem

ORIGINAL ARTICLE

Nursing team opinion concerning the performance evaluation process^*

Opinión del equipo de enfermería sobre el proceso de evaluación del desempeño

Marise Márcia These Brahm^I; Ana Maria Muller de Magalhães^II

^INurse. Student of the Oncological Nursing Graduate Program of the São Camilo Educational Center - São Paulo (SP) - Brazil

^IIAdjunct Professor of the Department of Occupational Assistance and Guidance at EENF – Federal University of Rio Grande do Sul – UFRGS - Porto Alegre (RS)- Brazil; Master of Education – Pontifícia Universidade Católica – PUCRS - Porto Alegre (RS)- Brazil; Coordinator of the Nursing Group of the Porto Alegre Clinics Hospital – HCPA Porto Alegre (RS)- Brazil

^{Corresponding Author}

ABSTRACT

OBJECTIVE: This study proposes to analyze the performance evaluation process based on the opinion of the nursing team.

METHODS: In this quantitative survey, 164 professionals (119 nursing assistants and 45 nurses) working in the medical and surgical inpatient units at Hospital de Clínicas de Porto Alegre answered an anonymous multiple choice questionnaire. Descriptive statistics was used to analyze the data, with calculation of absolute and relative frequencies. The chi-square test was used to establish significance (p = x).

RESULTS: The results suggest overall predominance of satisfaction and positive aspects. However some team members are not satisfied with the process, indicating gaps and the need to improve some steps.

CONCLUSION: The insatisfaction with the evaluation process is bigger among the oldest employees. The evaluation instrument, the periodicy, and the possibility of more participative evaluations, should be argued for the construction of new alternatives for the evaluation process.

Keywords: Employee performance appraisal; Nursing; Nursing staff, hospital; Nursing evaluation, research.

RESUMEN

OBJETIVO: En este estudio se tuvo como propósito analizar el proceso de evaluación del desempeño según la opinión del equipo de enfermería.

MÉTODOS: Se trata de un estudio de survey de carácter cuantitativo. Participaron 119 auxiliares de enfermería y 45 enfermeros de unidades de internamiento clínico y quirúrgico del Hospital de Clínicas de Porto Alegre, con un total de 164 profesionales. Se utilizó un instrumento no identificado que contenía preguntas cerradas, que fueron analizadas con base estadística descriptiva, frecuencias absolutas y relativas y test del chi cuadrado para establecer significancia.

RESULTADOS: Los datos apuntan, de forma general, predominio de satisfacción y aspectos positivos, no obstante esa satisfacción no abarca a todo el equipo, indicando fallas y necesidades de mejorías en algunas etapas del proceso.

CONCLUSIÓN: La insatisfacción con el proceso es mayor entre los funcionarios más antiguos. El instrumento de evaluación, la periodicidad de las evaluaciones y la posibilidad de que éstas sean más participativas necesitan ser discutidos visando la construcción de nuevas alternativas para el proceso evaluativo.

Descriptores: Evaluación del desempeño; Enfermería; Recursos humanos de enfermería en el hospital; Investigación en evaluación de enfermería.

INTRODUCTION

When searching for higher productivity and trying to develop quality, companies focus on their employees, who are fundamental elements in terms of productivity and effectiveness towards organizational goals.

The way the companies see their employees has changed because of the modifications in the work market and in organizational culture. The term "human resources" is now referred to as "human capital", and personal administrative processes are now called "people management", which main focus is on organizational development.

Therefore, professional performance has evolved from a traditional hierarchical pattern, centered on productivity measurement to a more flexible and participative pattern, which enables workers to develop their skills, foster their personal and professional growth, and thus recognize their potential and invest in their creativity and commitment to work.

For the employee it is relevant to know how he/she has performed and managed his/her professional development according to the company's expectations.

For the companies it is a challenge to develop their contributors' qualifications and potential in order to achieve optimal performances⁽¹⁾. An evaluating process can be used for that aim, and it is an important tool to provide workers with feedback, as well as to develop new potentials, and motivate group qualification.

Performance evaluations monitors group and individual work, the results obtained compared to the expected ones. In addition, it enables a continuous, constant, and broad follow up of group actions⁽²⁾. When used correctly, it is one of the best tools a company can rely on to develop and motivate workers⁽³⁾.

At hospitals, the nursing staff has an important position in the human resources group because of the high number of professionals. The performance evaluation technique is a useful tool to fit the team's approach to production and personal achievement.

The quality of health services is strongly linked to the nursing staff's personal performance. Being aware of that performance develops human resources and assures the quality regarding the care they provide⁽⁴⁾.

Evaluating workers' performance in the team that he/she coordinates is one of the nurse's administrative assignments. The nurse who evaluates must be the worker's direct supervisor, and must observe his/her work and take notice of biases and prejudice, avoiding subjective influences and values⁽³⁾. Moreover, he/she is responsible for the performance of his/her group and should be able to arouse critical views in relation to the process and results⁽⁵⁾.

The evaluation process is an important tool both for work development and for gaining benefits for all those involved in the process.

Evaluators often observe and collect data about the employee who is going to be evaluated when the assessment time is close, which results in an unclear representation that values recent issues⁽³⁾ .

In some cases, nursing professionals state that the evaluation "scares, hurts, oppresses, causes fear" and as a consequence they "suffer in anticipation"⁽⁶⁾, thus it is often characterized as an emotionally strong event⁽³⁾ .

Those feelings can be related to certain concepts that have been fastened upon the evaluation process and that characterize it as "centered on mistakes, failures and negative feelings that are consequences of such practice, which leaves deep wounds"⁽⁷⁾, or relating it to "a kind of compensation and punishment, taking the evaluations as resources to identify workers' problems". However, anxiety is overcome as a more participative process between evaluator and evaluated is developed⁽⁵⁾.

Performance evaluation is considered a continuous process and each member of a work team uses and understands it in a different way. Understanding how all of that reflects on the group, and consequently on the institution, and analyzing its real meaning in the work context are significant aspects in outlining and conducting that process in the real world.

OBJECTIVE

To analyze performance evaluation according to the nursing team's opinion at units for adult hospitalization.

METHODS

This is a quantitative survey. The institution under study conducts a performance evaluation of the nursing group that starts in the probationary period, with two evaluation interviews (at days 45 and 90), which is performed annually. There is an instrument divided into three groups: identification and education; behavior areas (personal presentation, assiduity and punctuality, know-how, cooperation and relationship, organization and attitudes at work); and subjective comments. The topics in the behavior area are rated in a decreasing classifying scale.

That process is being studied and the idea is to develop it into a computerized model, centered on the professionals' profile and on the responsibilities involving each position, developed from knowledge, skills, and attitudes needed to occupy certain positions.

The study population comprised nursing assistants and nurses who worked in the morning, afternoon, and night shifts (1, 2, and 3) at units of clinical and surgical hospitalization at Hospital das Clínicas in Porto Alegre.

The sample consisted of 164 professionals, that is, approximately 40% of all the employees working at the units participating in the study.

One hundred nineteen nursing assistants and 45 nurses participated, that is, 37% of all nursing assistants and 51% of all nurses. There were 73 (44.5%) workers from clinical units and 91 (55.5%) workers from surgical units.

An unidentified tool created by the researchers was used to collect data. The tool had 10 closed-end questions (^{Attachment A}). It was provided with a sealed "ballot box" in every unit that was participating in the study. The tool was in the units for three days and the employees were invited to participate and instructed about how to proceed. Those who participated freely filled in the tool and put it in the sealed box, which was collected when those three days were over.

As there was no identification of the respondents in the questionnaire, the data was exclusively used for research purposes, posing no harm for the participants' job or any other implications. Returning the completed questionnaire meant that the workers had agreed to participate in the research.

The Hospital das Clínicas in Porto Alegre Ethics and Research in Health Commission approved the study.

The analysis was performed based on descriptive statistics and absolute and relative frequencies were used. The Chi-squared test (X²) was used to compare professional categories in relation the information. Unanswered questions were not included in the statistical numbers because they are not significant for the results. Therefore, the number of answers in each question was different.

RESULTS

The sample consisted of 43 (36.1%) nursing assistants who have been working in the institution for 1 to 5 years, and 21 (46.7%) nurses who have been working there for over 10 years.

Regarding the time since the previous evaluation, 39 (33.6%) nursing assistants and 9 (20%) nurses had their last evaluation up to 6 months ago; 50 (43.1%) nursing assistants and 18 (40%) nurses were evaluated from 6 to 12 months agor; 16 (13.8%) nursing assistants and 10 (22.2%) nurses were evaluated from 12 to 24 months ago; and 11 (9.5%) nursing assistants and 8 (17.8%) nurses had their last evaluation over 24 months ago. Considering the percentages of professionals that had their last evaluation over 24 months ago (17.8%) and from 12 to 24 months ago (22.2%), it is clear that 40% of the professionals have not been evaluated for at least 1 year.

By associating the evaluation periods and the number of years worked in the institution, as shown in Table 1, it is possible to notice that all employees who have been working there up to 1 year (100%) are evaluated within 12 months.

According to Table 1, the evaluation periods are different for the number of years worked in the institution. The longer the employee has worked in the company, the longer is the evaluation break, as observed by analyzing the evaluations performed with a break of more than 24 months. The data are significantly related if the X² test is performed for linear tendency (p< 0.001).

Among the employees who have been working in the company from 1 to 5 years, 2 (3.9%) were evaluated with an interval over 24 months, whereas 20% of the employees who have been working there for over 10 years were evaluated in the same time break.

Ninety-two (78%) nursing assistants and 38 (84.4%) nurses described their performance during the evaluation as very participative and participative; 26 nursing assistants (22%) and 7 nurses (15.5%) described their performance as somewhat participative and not participative.

Nine (7.7%) nursing assistants and 2 (4.5%) nurses said that they were completely satisfied with the evaluation tool; 61 (52.1%) nursing assistants and 23 (51.1%) nurses were satisfied with it; 31 (26.5%) nursing assistants and 14 (31.1%) nurses were somewhat satisfied with it, and 16 (13.7%) nursing assistants and 6 (13.3%) nurses were dissatisfied with it.

If the satisfaction with the evaluation tool and the period working in the institution are related, it is possible to notice that the longer the work time in the institution, the lower the satisfaction with the tool, as shown in Table 2.

Employees who have been working in the institution for up to 1 year (94.1%) are satisfied and completely satisfied, and 5.9% are somewhat satisfied and dissatisfied; Considering the employees who have been working there for more than 10 years, the rate drops to 49% satisfied and completely satisfied, and 51% are somewhat satisfied and dissatisfied. Applying X ² test for linear tendency, it is possible to notice that there is a linear data relation (p = 0.006).

Sixty-eight (57.1%) nursing assistants and 25 (56.8%) nurses were satisfied with the evaluation interview, and 13 (20.2%) nursing assistants and 8 (18.2%) nurses were somewhat satisfied with it. Fourteen (11.8%) nursing assistants and 8 (18.2%) nurses were completely satisfied with it and 13 (10.9%) nursing assistants and 3 (6.8%) nurses were dissatisfied with it.

Eighty (69%) nursing assistants and 30 (68.2%) nurses considered dialogue as the main perceived attitude during the evaluation, followed by intimidation, mentioned by 16 (13.8%) nursing assistants, and feedback reported by 11 (25%) nurses (Table 3).

During the evaluation process, the most strongly stressed points were: 44 (37.9%) nursing assistants mentioned improving aspects and 19 (42.2%) nurses mentioned positive aspects. (Table 4).

The X² test was used to compare nursing assistants' and nurses' different choices; feedback (in perceived attitudes) and fostering potentials (in strongly stressed aspects) were higher in the nurses' opinion (p= 0.03 and p = 0.01 respectively).

The feelings that came up during the evaluation in the answers of both nurses and nursing assistants showed up in similar frequency order. They were respectively: tranquility 57 (47.9%) and 20 (45.5%); tension 35 (29.4%) and 15 (34.1%); insecurity 20 (16.8%) and 8 (18.8%); satisfaction 13 (10.9%) and 8 (18.8%); others 8 (6.7%) and 3 (6.8%); fear 8 (6.7%) and 1 (2.3%). Only the nursing assistants felt hardship 3 (2.5%) and apathy 2 (1.7%).

Regarding their motivation after the performance evaluation, 17 (14.8%) nursing assistants and 6 (13.6%) nurses were very motivated; 55 (44.7%) nursing assistants and 29 (65.9%) nurses were motivated; 18 (15.7%) nursing assistants and 4 (9.1%) nurses were somewhat motivated, 13 (11.3%) nursing assistants and 2 (4.5%) nurses were unmotivated and 12 (10.4%) nursing assistants and 3 (6.8%) nurses were apathetic.

The goals of the evaluation process in nurse assistants' and nurses' opinion, respectively, are: professional development 71 (50.71%) and 30 (52.63%); corrective proposal 36 (25.72%) and 11 (19.3%); punishment 14 (11.8%) and 4 (8.9%); others 11 (9.2%) and 8 (17.8%); department relocation 4 (3.4%) and 4 (8.9%). Only nursing assistants mentioned promotion 1 (0.8%); dismissal 2 (1.7%) and financial incentives 1 (0.8%) as objectives too.

DISCUSSION

Results showed that an evaluation process takes place every year, however there are employees who have not been evaluated for longer than that. Thus, the periodicity and the reason why some of them are evaluated more often than others is questioned. The evaluations should be performed annually in order to obtain and to follow a professional's development⁽⁸⁾ . The data analysis suggests that the institution needs to develop strategies to improve the evaluation periodicity.

The employees have a probationary period in the company and during that period they are evaluated; so employees who have worked in the company for one year are evaluated within 12 months. It is a formal evaluation periodicity, according to legal aspects involving a newly hired worker's trial period. Since the personnel department is in charge of that, each employee is included in the process⁽⁹⁾ .

The evaluation periodicity is related to the work time in the institution. The longer the employee has worked in the institution, the fewer are the evaluations and the longer is the interval between them.

It is clear that the evaluation tool needs to be improved because nearly 40% of nursing assistants and 44% of nurses were somewhat satisfied or dissatisfied with it. The longer the work time in the institution, the lower the satisfaction, and the higher the dissatisfaction rate for the evaluation tool. This indicates that it is necessary to review the evaluation process and the way the tool is used. Using the same tool for every employee, no matter how long they have been working at the institution, results in evaluations that do not show the worker's development, which leads to questioning whether the object of the evaluation is the same for all employees⁽¹⁰⁾ .

The meaning that professional assigned to dialogue in the evaluation process is questionable because dialogue is the main perceived attitude. The participants can be indifferent or intimidated subconsciously, which prevents them from being more spontaneous⁽¹⁰⁾ and makes them afraid of speaking up. Dialogue is assumed to be positive or negative depending on the way the participants have it.

The data clearly shows that evaluators have a stronger tendency to provide feedback to nurses and motivate them over nursing assistants, which shows that such behavior needs to be rethought and redirected. More participative and challenging evaluations are offered to nurses compared to nursing assistants.

We can understand that, even in small number, there are professionals who, after the evaluation, seemed to be apathetic and unmotivated. That can suggest some failures in one of the steps or lack of consciousness about the importance of that process for some professionals.

Mentioning professional development as a goal of the evaluation reinforces that worker improvement and development are the goals in the evaluation process^(4-6). The nursing team is aware that professional development is one of the main foundations for the success of the evaluation process.

They are satisfied with the interview and because they considered themselves participants, and they believed that dialogue and tranquility are perceived attitudes and feelings. Positive evaluations prevail, which shows that the institution has been planning and making the participants aware of having an effective model of evaluation process.

CONCLUSION

The studied nursing team is satisfied with the performance evaluation process, although there are failures, some dissatisfaction and a need for some improvement to make the evaluation process effective at developing the nursing team's work, indicating that some of its aspects need to be redirected.

The professional and the group must be aware of the importance of their evaluation focusing their performance and, whether the evaluation process is successful or not depends on that awareness. Searching for capacities in a participative evaluation process will contribute to professional growth and development and it will provide a better attention to the client, and that makes a difference for the institution and in the work market.

This study offered a broad view of the evaluation process in a specific institution. The findings show several positive aspects but they also indicate the need of raising awareness of points that need improvement.

Nurses that are managers and supervisors must improve performance management processes and search for mechanisms to identify areas where implementing a participative and open-to-change model is difficult.

REFERENCES

Received article 22/02/2007 and accepted 21/06/2007

Attachment A - Data collection tool

^{Click to enlarge}

• 1. Lucena MDS. Avaliação de desempenho. São Paulo: Atlas; 1992.
• 2. Chiavenato I. Gerenciando pessoas: o passo decisivo para a administração participativa. São Paulo: Makron Books; 1994.
• 3. Marquis BL, Huston CJ. Administração e liderança em enfermagem: teoria e prática. Porto Alegre: Artmed; 2005.
• 4. Balbueno EA, Nozawa MR. Levantamento dos tipos de repercussões resultantes da avaliação de desempenho em enfermagem hospitalar. Rev Lat Am Enferm. 2004;12(1):58-64.
• 5. Chaves EB, Magalhães AMM. Avaliando a avaliação de desempenho na prática de enfermeiros. Rev Gaúch Enferm. 1996;17(2):115-23.
• 6. Dall'agnol CM. Avaliação de desempenho na enfermagem e o ser(a) crítico[tese]. São Paulo: Escola de Enfermagem, Universidade de São Paulo; 1999.
• 7. Dall'agnol CM, Ciampone MHT. Avaliação de Desempenho: diálogos e representações de um grupo na enfermagem. Rev Bras Enferm. 2002; 55(4): 363-9.
• 8. Peres HHS, Leite MMJ, Gonçalves VLM. Educação continuada: recrutamento e seleção, treinamento e desenvolvimento, e avaliação de desempenho. In: Kurgant P, organizadora. Gerenciamento em enfermagem. Rio de Janeiro: Guanabara Koogan; 2005. p.139-56.
• 9. Bezerra ALQ, Silva MB. Avaliação de desempenho em enfermagem. Rev Paul Enferm. 1993;12(2): 62-4.
• 10. Gonçalves VLM, Leite MMJ. Diagnóstico situacional de um processo de avaliação de desempenho profissional. Rev Bras Enferm. 2004;57(4):430-3.

*

Monograph presented in the Nursing Undergraduate Course at the Federal University of Rio Grande do Sul (UFRGS) at College of Nursing, performed at the Porto Alegre Clinics Hospital - Porto Alegre (RS), Brazil.

Publication Dates

• Publication in this collection
  18 Jan 2008
• Date of issue
  Dec 2007

History

• Accepted
  21 June 2007
• Received
  22 Feb 2007