Please help Carol Greely had been a registered nurse for 25 years and a nurse ma
ID: 383639 • Letter: P
Question
Please help
Carol Greely had been a registered nurse for 25 years and a nurse manager for more than 10 years when she was asked to take over as nurse manager of a particular medical/surgical unit known throughout the hospital, none too affectionately, as the “hot seat.” Although she had heard a few things about this floor, because of the size of the hospital and her recent assignment in a relatively removed area, Carol had little information about why the hot seat was so designated. After three months on the job, however, Carol had formed some strong opinions regarding the bases of many of the unit’s problems. To her, the majority of staff on the unit exhibited a complete lack of professionalism. Carol became convinced of this for a number of reasons, including the following:
There were many appearance problems and many violations of the department’s none-too-often-enforced dress code. If there were a worst-dressed list maintained, Carol concluded, surely her nurses would be on it.
The unit’s rate of absenteeism was the worst of any unit within the nursing department.
Two (thankfully unsuccessful) attempts by unions to organize the hospital’s nurses had apparently originated with the nurses in Carol’s unit.
Carol had never before seen a unit with such a high level of schedule juggling—shift trades, requests for specific days off, and especially changes to the schedule at the last minute.
It was not long before Carol found herself becoming highly cynical about the unit and its future. It seemed to her that nursing meant no more to many of these people than the paycheck and that they constantly put their social lives and personal preferences before the needs of the patients.
When she had been on the job six months, Carol received a startling piece of secondhand information from a friend in the nursing department who swore her to secrecy as to the source. It was apparently a closely guarded secret in nursing administration that her particular unit was deliberately maintained as a concentration of marginal employees. It was, in the words of Carol’s friend, “to keep the butterflies and malcontents all in one place as much as possible, so they wouldn’t disrupt other units.” Carol was further led to believe that she could expect to be reassigned after about 18 months on the job, when it would then be someone else’s turn to sit in the hot seat.
Carol’s initial reaction to what she had learned was anger; however, the more she thought about the position in which she found herself, the more she became determined to do something with the time left to her in the unit. She decided she was going to do everything in her power to turn the hot seat into a real nursing unit.
Instructions:
1-Make a list of three critical steps that Carol should consider to help her accomplish her admittedly difficult objective or to go as far toward accomplishing it as possible.
2-Include at least one step that the human resource department can probably provide positive advice or assistance, and describe the likely nature of the human resource involvement.
Explanation / Answer
Since Carol is designated as the Manager for the specific nursing unit, she has all right to make changes to her department to maintain the discipline in the unit. Three critical steps that Carol should consider to help her accomplish her admittedly difficult objective or to go as far toward accomplishing it as possible are as follow:
Make sure that the proper dress code is followed in the unit. If someone is violating the dress code and Carol will have a full right to send the nurse back from the hospital and let her come back with the proper appearance. In this situation make sure that the nurse is not taking privilege of the situation and in such cases if the nurse does not return to the hospital, deduct the pay for the day so that the nurses will become responsible and aware of the situation.
Make a limit on the absence/ leave for nurses. By the help of HR and its policies make changes to the current leave system to make sure nurses will take care of the leave that they are taking. Put a threshold on the leave, like if a nurse is taking more than 2 leaves in a month than for every extra leave there will be a deduction on the pay.
One of the biggest concerns for Carol was the nurses missing there shift or changes in the shift. To overcome this problem, give different time shift for the nurses, say for example if one person is working on morning shift for a week, allow them to change their shift with proper pre notification. If this doesn’t happen do not allow the nurse to mark the presence in case of shift change without prior notification.
As suggested in point 2, human resource can help Carol in making an upper limit on the leaves taken by nurse in a month. Since leave is something that will be same for all hospital staff, this is something Carol will not be able to take decision with HR involvement. In here HR manager can take Carol through the leave policies and accordingly suggest possible outcome of the situation.