PERFORMANCE CORRECTION NOTICE

DISCIPLINARY LEVEL

Verbal Correction—(To memorialize the conversation.)

Written Warning—(State nature of offense, method of correction, and action to be taken if offense is repeated.)

Investigatory Leave—(Include length of time and nature of review.)

Final Written Warning

Without decision-making leave

With decision-making leave (Attach memo of instructions.)

With unpaid suspension

SUBJECT:Refusal to follow legitimate and proper working instructions; unsatisfactory work performance regarding safety

Policy/Procedure Violation

Performance Transgression

Behavior/Conduct Infraction

Absenteeism/Tardiness

PRIOR NOTIFICATIONS

Incident Description and Supporting Details: Include the following information: Time, Place, Date of Occurrence, and Persons Present as well as Organizational Impact.

Dan,

On August 10, 2017, at 3:45 P.M., the hospital campus experienced a loss of electrical power. Power was out for approximately two and one-half hours, and this was technically designated a brownout. At that time, the emergency generators came on to supply power to the patient care areas, but the majority of the electrical power remained out of service throughout the campus. This was considered an emergency situation.

Paul Mahoney, your coworker, arrived at approximately 3:45 P.M. when the power went out. Paul could not find you in your office, so he looked for you in the generator building. He located you at 4:00, the end of your regularly assigned shift. Paul updated you on the status of power around campus and asked you to work with him to restore power throughout the campus. You stated, however, that you could not stay because that would result in overtime. Paul asked if you understood that the entire campus had lost power. You stated that you realized this, but you still insisted that you could not stay at work since your overtime had not been preapproved. You consequently left work. Such poor judgment compromised patient care and employee safety and violated Victory Hospital’s standards of performance and conduct.

PERFORMANCE IMPROVEMENT PLAN

Measurable/Tangible Improvement Goals: Dan, I expect you, as a maintenance mechanic, to use judgment based on your knowledge and experience in situations such as this one. Although you were notified in writing the week before that there would be no approved overtime because of budgeting constraints, it is an understood rule that no employee is to leave the hospital during an emergency condition when that employee is capable of helping. The “statement” that you made by leaving was an obvious protest of the rule prohibiting overtime. I expect you, however, to safeguard patient care and employee safety at all times, whether an emergency exists or not.

Training or Special Direction to Be Provided: I am enclosing a copy of the hospital’s policy on employees’ responsibilities during emergencies. Please read this policy immediately and see me with any questions. In any future emergency that requires your assistance, you will be paid overtime for work performed above and beyond your shift.

Interim Performance Evaluation Necessary? No

Our Employee Assistance Program (EAP) provider, Prime Behavioral Health Group, can be confidentially reached to assist you at (800) 555-5555. This is strictly voluntary. A booklet regarding the EAP’s services is available from Human Resources.

In addition, I recognize that you may have certain ideas to improve your performance. Therefore, I encourage you to provide your own Personal Improvement Plan Input and Suggestions:

(Attach additional sheets if needed.)

OUTCOMES AND CONSEQUENCES

Positive: I will remain available to help you and discuss areas where you require additional support. If you meet your performance goals, no further disciplinary action will be taken regarding this issue.

Negative: You are now being placed on written notice for lack of judgment and failure to perform your essential job functions. If you ever again fail to follow emergency instructions or compromise patient care or employee safety, you may be immediately dismissed. A copy of this document will be placed in your personnel file.

Scheduled Review Date: None

EMPLOYEE COMMENTS AND/OR REBUTTAL

EMPLOYEE ACKNOWLEDGMENT GOES HERE