ULTIMATUM
The "Case in Health Care Management" is a regular feature of The Health Care Manager. Readers are invited to analyze the problem presented in the case and develop a reasonable response to the situation.
In analyzing a case:
* Look for the principles that appear to be involved, and look for the applicability of rules of reason, common sense, and fairness.
* Seek help from published sources. Associate the concerns of the case with key words that describe principles, concepts, theories, or techniques, and look these up in texts on supervision and basic management.
* Make whatever reasonable assumptions you need to fill in the blanks in the information given.
* Keep your assumptions reasonable, and state your key assumptions in your conclusions.
* Recognize that there are few solutions to a case problem that are entirely right or wrong. You are dealing primarily with human behavior, and all people will not necessarily behave the same way in similar situations.
ULTIMATUM
You are the administrative director of the hospital's department of radiology. One of your more troublesome areas of late has been special procedures; you have chronically had difficulty recruiting and retaining special procedures technologists. You presently have your allotted full staff of 3 special procedures technologists, but these people are fully utilized, and at least 2 of them have recently made comments about the staffing level being inadequate for the workload.
Your senior technologist, Arthur Morris, has been especially vocal in his comments claiming understaffing in the department. Several times, and as recently as Monday of this week, Morris spoke with you concerning his perception of the need for another special procedures technologist. Today, Wednesday, September 9, you received the following note from Morris:
As I suggested I would do in our conversation of Monday this week, I am going on record notifying you that additional technologist help for special procedures must be available by Monday, September 21. If you are unable or unwilling to provide another special procedures technologist, I will be unable to continue in my present position beyond Friday, September 18.
Questions:
1. What should you do about the ultimatum delivered by Arthur Morris? Why?
2. Identify the key issue in the case and describe why it presents a significant problem.
LET US HEAR FROM YOU
Readers are invited to submit their written analysis of this issue's case for possible publication in HCM 35:3(July-September 2016). This is not a contest. Because a solution to a case may be neither completely right nor completely wrong, there will be no winners or losers. We will select 1 solution that appears particularly appropriate or relevant, or we may elect to publish excerpts from several proposed solutions.
Responses to this issue's "Ultimatum" should be submitted under the following conditions:
* Your response, not exceeding 300 words, should be e-mailed no later than May 15, 2016, to Charles R. McConnell, Editor, HCM, at [email protected].
* Your response should include your full name, title, organization, and e-mail address.
* The editor will notify anyone whose response is selected for publication. Selected responses will be subject to normal editing for language and style.
SYLVIA'S CHOICE (FROM ISSUE 34:3, JULY-SEPTEMBER 2015)
When head nurse Sylvia Miller was faced with the opportunity to promote one of her staff members to a charge nurse position, she found that she was not lacking apparently qualified employees. In fact, after sorting through several possibilities, Sylvia was left with 2 equally appealing candidates. Jane Wilson and Hilda Ross, in Sylvia's opinion the 2 best nurses on the floor, appeared equal in qualifications and experience in just about every respect.
It was evident to Sylvia that Jane and Hilda both wanted the position; each had made her desires known to Sylvia upon first learning that the position would be available. Both Jane and Hilda were energetic, willing, and apparently career oriented.
Sylvia eventually made her choice and promoted Jane Wilson to charge nurse. Although she did not discuss the ultimate basis of her decision with anyone, Sylvia admitted to herself that her decision was based largely on personality-Jane seemed friendlier than Hilda and more able to relate to other people on a one-to-one basis.
Jane Wilson eagerly accepted the promotion and plunged into her new role with enthusiasm. Hilda Ross expressed some initial disappointment, which seemed, at least to Sylvia, to dissipate rapidly.
However, 6 weeks after Jane's promotion, it was plain to Sylvia that Hilda Ross had changed both her outlook and her behavior. Where previously Hilda had always seemed willing to do more than her share of work, she now seemed content doing just enough to get by. Although never overly talkative or socially outgoing, Hilda now seemed all the more silent and withdrawn. Worst of all, at least to Sylvia, was Hilda's apparent practice of resisting instructions from the new head nurse and creating obstacles for Jane.
Sylvia realized that she had a problem requiring her active involvement when she overheard Hilda Ross grumbling about how "a person has to be the head nurse's buddy to get anywhere around here."
Questions:
1. How might unintended personal bias here have intruded in Sylvia's selection of Jane over Hilda?
2. What do events subsequent to Jane's promotion have to say about Sylvia's choice of a charge nurse?
3. How should Sylvia go about dealing with Hilda Ross?
RESPONSE TO "SYLVIA'S CHOICE" (FROM HCM ISSUE 34:3)
No reader responses to the case in HCM 34:3, "Sylvia's Choice"' were received. Following are a few possibilities, some of which might figure in a reasonable response.
It is possible that unintended personal bias may have had some effect on Sylvia's selection of Jane over Hilda largely because Sylvia simply liked Jane better than she liked Hilda.
Events subsequent to Jane's promotion seem to suggest that Jane may well have been the right choice. If both Jane and Hilda were equally qualified, either could probably have done the job satisfactorily. But Hilda's reaction to losing out on the position was rather unprofessional, suggesting that even if she someday entered management she may perhaps react unprofessionally in some instances when things did not go her way.
Sylvia is now faced with an employee who exhibits poor work performance and whose behavior at times borders on insubordination. Even with the best of management and counseling skills, it may be too late to reverse Hilda Ross's resentment. In addition, if others in the unit also perceive Jane's selection as a result of personal bias, the morale of the entire unit could be affected.