MMHA 6220 Week 9 EAP Referral Case Example

A Formal Referral, Not a Kind Suggestion: Using the Employee Assistance Program With a Home Health Nurse Whose Documentation and Arrival Times Have Slipped

Student Name

Walden University

MMHA 6220: Human Resource Management in Healthcare

Instructor Name

Month Day, Year

A Formal Referral, Not a Kind Suggestion: Using the Employee Assistance Program With a Home Health Nurse Whose Documentation and Arrival Times Have Slipped

Documented Behavior

The case begins with what the clinical manager at Bellwood Valley Home Health, a fictional rural agency, has documented. Only observed facts are listed here.

Table 1

Documented Performance Concerns, Past Six Weeks

The nurse had no documentation or attendance concerns in her four previous years at the agency.

The manager has heard from other staff that the nurse is caring for a spouse with a serious illness. That information is not part of the documentation and does not shape the referral; the manager does not know it to be true and has no right to inquire.

Two Paths

The first path is a kind suggestion. The manager mentions the employee assistance program informally, perhaps in passing after a meeting: the agency has a confidential counseling benefit, and the nurse might find it helpful. Nothing else changes. The second path is a formal supervisory referral. The manager meets with the nurse, reviews the documented performance concerns and the expected standard, and refers her to the program as a resource for whatever may be affecting her work, with a follow-up meeting on performance.

The second path is chosen. The performance problem is real, and patients are affected: late wound care documentation can delay changes in treatment, and late arrivals leave patients and families waiting. A kind suggestion treats the problem as private and leaves performance unaddressed, which is unfair to patients and, eventually, to the nurse, who may later face discipline without ever having been told clearly that her work was falling short. A formal referral is not harsher; it is clearer.

The Meeting

The manager meets the nurse privately, in person, and follows this order.

First, the documented concerns: the manager reviews the dates and facts in the table, without characterizing them or speculating about causes.

Second, the expected standard: visit notes completed within 24 hours, first visits begun no more than 15 minutes after the time scheduled, unless the office is notified, and attendance at case conferences.

Third, the program: the manager explains that the agency offers a confidential employee assistance program, available at no cost to her and her household, by phone or in person, for personal, family, health, financial or work concerns. Participation is voluntary. Using it does not protect her from performance expectations, and declining it does not count against her.

Fourth, follow-up: the manager sets a meeting in three weeks to review documentation timeliness and arrival times. If the nurse needs time off or a schedule change, the manager tells her how to ask HR, including about leave protections.

The Supervisor's Limited Role

Employee assistance programs have become a common part of employers' approaches to workplace mental health, offering short-term counseling and referral to employees and their families (Attridge, 2019).

The Employee Assistance Professionals Association describes the program's core technology as including consultation with and training of supervisors to manage employees with performance problems, confidential and timely problem identification and assessment for employees, referral for treatment, and follow-up (Employee Assistance Professionals Association [EAPA], 2011). The supervisor's part is consultation, referral and follow-up on performance. Assessment belongs to the program's professionals. The manager does not diagnose, counsel or ask about the nurse's personal life. Before the meeting, the manager may call the program for consultation on how to make the referral, which the program provides without needing the nurse's name.

What the Manager Should Avoid

Three mistakes undo a referral. The first is mentioning what others have said about the nurse's spouse. It invites the nurse to discuss her family's medical situation, which the manager has no need to know, and it tells her that colleagues have been talking about her. The second is naming a cause: saying "you seem depressed" or "you must be exhausted" turns the manager into a diagnostician and may later be described as treating the nurse as disabled. The third is making the program sound mandatory or punitive, which discourages use. The manager should also write a short, factual note of the meeting, listing the concerns reviewed, the standard explained, the resources offered and the follow-up date, and give the nurse a copy.

Confidentiality

The manager will not learn whether the nurse contacted the program, what she discussed or any diagnosis. If the nurse signs a release, the program may confirm to HR that she attended and, if relevant, recommend a temporary schedule adjustment. The manager will learn only what the nurse chooses to share and what performance shows.

Outcomes

If performance recovers, as the manager hopes, the follow-up meeting records the improvement and the matter closes. The manager should say so plainly, since an employee who has been through a hard period benefits from hearing that her work is back where it was. Many employees who use these programs report improvement in their wellbeing and work functioning, though the research is uneven in quality (Joseph et al., 2018).

If performance does not recover, the manager proceeds with the agency's progressive discipline policy on the documented concerns, as with any employee. The referral does not change the standards. If the nurse discloses a medical condition or a need to care for a family member, HR reviews whether leave or an accommodation applies.

Either way, the referral serves the nurse and her patients. It tells her clearly what is expected and offers help without demanding that she explain herself.

References

Attridge, M. (2019). A global perspective on promoting workplace mental health and the role of employee assistance programs. American Journal of Health Promotion, 33(4), 622-629. https://doi.org/10.1177/0890117119838101c

Employee Assistance Professionals Association. (2011). Definitions of an employee assistance program (EAP) and EAP core technology.

Joseph, B., Walker, A., & Fuller-Tyszkiewicz, M. (2018). Evaluating the effectiveness of employee assistance programmes: A systematic review. European Journal of Work and Organizational Psychology, 27(1), 1-15. https://doi.org/10.1080/1359432X.2017.1374245