Performance Management and Crucial Conversations

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In this section, we will explore communication strategies to assist the nursing leader with crucial conversations and coaching and how to navigate the process of remediation and performance management.  We will also explore strategies to aid in professional development and continuing competence at the individual level.


Crucial Conversations and Coaching

Crucial conversations tend to be about tough issues.  They are conversations between two or more persons when one of the following is at play: stakes are high, opinions differ, or emotions are strong.  Most of us try to avoid these conversations or handle them poorly.  As a leader, it is important to know how to engage in them as the repercussions of not doing so may be problematic. Waldrop and Derouin, (2019) defined coaching “as supporting another person in achieving specific performance goals by providing guidance and ongoing support”.  Nurse leaders may receive coaching in their roles as leaders especially when they are new to them or provide coaching and support to staff.


Activity #1

Read the following two articles:

  1. Angelo, E. (2019). Managing interpersonal conflict: Steps for success. Nursing management, 50(6), 22–28.
  2. Sherman, R. (n.d.). Crucial Conversations. EmergingRNleader. 


Activity #2

In this video, LeeAnne shares a very practical application to giving and receiving feedback during crucial conversations.

Video: The secret to giving great feedback | The Way We Work, a TED series (5:01)


Professional Development in Nursing Practice Part Two – The Individual

All nurses are required to engage in professional development to maintain and continually improve their practice.


Activity #3

Read the following documents:

  1. College of Nurses of Ontario. (2019). Entry to practice competencies.
  2. College of Nurses of Ontario. (2021). Quality assurance self-assessment guide.


Activity #4

The following videos from the College of Nurses of Ontario (CNO) have been included to emphasize the value and importance of reflection in our daily practice and as part of the CNO’s yearly quality assurance requirements.

Also included, is a short video explaining the Gibb’s reflective Cycles as a possible reflective practice framework.

Video: How to become a reflective practitioner (2:08)


Video: The Value of Practice Reflection (1:13)

Video: Gibbs’ Reflective Cycle Explained (8:46)



Activity #5

Reflection Exercise

How to complete this activity and save your work: Type your responses to the questions in the box below. When you are done answering the question navigate to the ‘Export’ page to download and save your response. If you prefer to work in a Word document offline you can skip right to the Export section and download a Word document of this exercise there.


Performance Management and Remediation

It can be challenging to motivate staff to be their best.  Performance management is more than annual performance appraisals.  It is a continuous process that includes planning, coaching and reviewing the performance of the persons who report to you.


Activity #6

Read the following document on the performance management process.

State of Oklahoma Training and Development. (N.D). Performance management process. It’s not merely evaluation. Office of Management and Enterprise Services.


Activity #7

Please read at least four (4) additional articles from the list below.

  1. Braithwaite, J., Herkes, J., Ludlow, K., Testa, L., & Lamprell, G. (2017). Association between organisational and workplace cultures, and patient outcomes: Systematic reviewBMJ Open7(11), e017708.
  2. Effken, J. A., Verran, J. A., Logue, M. D., & Hsu, Y.-C. (2010). Nurse managers’ decisions: Fast and favouring remediationJONA: The Journal of Nursing Administration40(4), 188–195.
  3. Harding, A. D., & Batista, C. S. (2016). Nursing practice remediationNursing Management47(10), 10–11.
  4. Madlabana, C., Mashamba-Thompson, T., & Petersen, I. (2020). Performance management methods and practices among nurses in primary health care settings: A systematic scoping review protocolSystematic Reviews9(1).
  5. Raso, R., & Gulinello, C. (2010). Creating cultures of safetyNursing Management41(12), 26–33.
  6. Seljak, J., & Kvas, A. (2015). Three-stage data envelopment analysis as a tool for nurse leader performance appraisalsSAGE Open5(1), 215824401557766.
  7. College of Nurses of Ontario. What to report. (2020, February 7).


Reflection Exercise

Consider the last time you received feedback from a co-worker or your direct report in your organization.


Check Your Understanding


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Leadership for Nurses in Clinical Settings Copyright © 2022 by Dr. Kirsten Woodend, Dr. Catherine Thibeault, Dr. Manon Lemonde, Dr. Janet McCabe is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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