NURS 522 Week 1 Reflection Paper on Current Impressions of Performance Management Example

Reflection Paper: From a Once-a-Year Form to an Ongoing Conversation, My Changing Impressions of Performance Management in Nursing

Where I Started

For most of my eleven years as a medical-surgical nurse, performance management meant one meeting a year. My manager would complete a form rating me on twelve competencies, I would add a self-evaluation, and we would sign it in a fifteen-minute meeting, usually weeks after the due date. The ratings rarely surprised me, and they rarely changed what I did. When I became a charge nurse, I began to sit on the other side of the form for the staff I precepted, and I noticed something uncomfortable: the form asked whether a nurse completed documentation on time and attended required education, but it said almost nothing about how the nurse cared for patients. My impression entering this course was that performance management was a human resources requirement, useful for documenting problems but not for improving care.

What the Reading Changed

The first chapters of Poister et al. (2015) challenged that impression by separating performance measurement from performance management. Measurement is the collection of data on how well a program or person is doing. Management is the use of that information, together with goals, feedback and support, to steer the organization toward its mission. By that definition, what I had experienced was measurement without management: a score was recorded, but nothing was done with it. The problem I saw was not that performance management failed but that my unit had never really practiced it. The text also describes performance management as continuous rather than annual, which matched what I already did informally as a charge nurse when I gave a new graduate feedback after a difficult shift. I had not thought of that as performance management, but it was closer to the real thing than the annual form.

What the Research Adds

Recent research supports my early discomfort about what appraisals measure. In a cross-sectional study of 228 nurses at a public hospital, Kuntarti and Rahmayanto (2026) compared nurses' caring behavior, measured with a validated inventory, with their official performance index scores and found no significant association between them. Both measures were high, yet they did not move together, and the authors concluded that current appraisal systems may not capture caring competencies and recommended adding explicit caring indicators. If the instrument that decides a nurse's rating cannot see the qualities patients value most, it cannot guide improvement in those qualities.

Research also raises questions about who does the rating. Khaleghparast et al. (2026) evaluated 137 nurses in cardiac care units using both a conventional head nurse rating and a 360-degree evaluation that included head nurses, colleagues, the nurses themselves, and patients and families. Average scores across every dimension were lower when rated by the head nurse alone than when drawn from the 360-degree questionnaires. That finding does not prove which rating is correct, but it suggests that a single rater sees only part of a nurse's work, which fits my experience of managers who rarely saw night shift.

Finally, research suggests that how performance information is shared shapes how nurses receive it. In a meta-analysis of 19 studies including 8,360 nurses, Oweidat et al. (2026) found a significant negative association between leadership transparency and workplace cynicism, with transparency linked to greater trust, less emotional exhaustion and better team alignment. An annual rating delivered without explanation is the opposite of transparency, and I now think the cynicism my colleagues expressed about reviews was a predictable response to how the process was run.

What My Unit Should Measure

If performance management is meant to steer work toward a mission, the first question is what the unit is trying to achieve. My unit's stated goals are safe care, patient experience and a stable staff, yet the annual form measures none of them directly. Poister et al. (2015) distinguish outputs, the work a program produces, from outcomes, the results it achieves for the people it serves, and they argue that outcome measures are what tell leaders whether a program is succeeding. On a medical-surgical unit, outputs include completed hourly rounds and documented education; outcomes include falls with injury, pressure injuries, patients' ratings of nurse communication, and first-year turnover. Individual goals for nurses could then be drawn from those outcomes. A nurse who leads the unit's mobility work, for example, could be evaluated partly on progress toward the unit's fall and pressure injury goals and partly on peer feedback about how the nurse supports colleagues. I am not sure how to make that fair to a nurse whose patients are sicker than average, and I expect later chapters on measurement to help me answer that question. Even so, connecting individual goals to unit outcomes would give the annual conversation something real to discuss, which it now lacks.

A Biblical Perspective

Peter urged church elders to "shepherd the flock of God that is among you, exercising oversight, not under compulsion, but willingly" (English Standard Version Bible, 2001/2016, 1 Peter 5:2). The picture is of attentive, ongoing care by a leader who knows each member of the flock, offered willingly rather than as a duty to be discharged once a year. Applied to nursing leadership, it suggests that performance management is part of stewardship: knowing the people entrusted to a leader well enough to see how they are doing, what they need, and how they can grow. A leader who meets staff once a year to sign a form, under the compulsion of a deadline, is exercising oversight in the narrowest sense. That principle also carries an obligation of fairness, since a shepherd who judged the flock from a distance would misjudge it, which is the concern the 360-degree research raises.

What I Will Do Differently

My impressions have shifted from seeing performance management as a form to seeing it as a system that should connect each nurse's work to the unit's goals through regular, transparent conversation. As a charge nurse now and a nurse leader later, I plan to test three changes. First, I will hold brief monthly check-ins with the nurses I precept, using two or three goals we agree on rather than the full competency list. Second, I will propose to my manager that our unit pilot peer and patient input for the annual review, following the 360-degree approach, so ratings reflect more than one view. Third, I will advocate for adding at least one caring indicator, such as patient comments on being listened to, to our unit's evaluation. I expect this course to show me how to build measures that are fair and useful, and I hope to finish it able to design a performance system my staff would trust rather than tolerate.

Conclusion

I began this course seeing performance management as an annual obligation that changed little. The reading and recent research suggest that what I knew was measurement without management, conducted by a single rater, focused on tasks rather than caring, and delivered without transparency. Scripture's picture of a shepherd who knows the flock offers a better model, and the commitments above are my first steps toward practicing it.

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Khaleghparast, S., Kamali, M., Chaibakhsh, S., Sari, L., Khosrobeigi Bozchaloei, F., Mazloomzadeh, S., & Karimian, S. (2026). Comparing the impact of 360-degree evaluation and conventional methods on the performance evaluation of Iranian nurses. Journal of Education and Health Promotion, 15, Article 257. https://doi.org/10.4103/jehp.jehp_110_25

Kuntarti, K., & Rahmayanto, I. (2026). Do nurse performance appraisals reflect caring behaviors? Evidence from an Indonesian hospital. Frontiers in Health Services, 6, Article 1773688. https://doi.org/10.3389/frhs.2026.1773688

Oweidat, L., Ayyad, A., Alosta, M., Al Mugheed, K., ALBashtawy, M., & Alkhawaldeh, A. (2026). Relationship between leadership transparency and workplace cynicism among nurses: A systematic review and meta-analysis. Nursing Management, 33(5), 34-41. https://doi.org/10.7748/nm.2026.e2209

Poister, T. H., Aristigueta, M. P., & Hall, J. L. (2015). Managing and measuring performance in public and nonprofit organizations: An integrated approach (2nd ed.). Jossey-Bass.