TO MOTIVATE THE UNMOVABLE
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.
TO MOTIVATE THE UNMOVABLE
"My hands are tied," said laboratory supervisor Melissa Wilson. "Because of the way this place is organized there's absolutely nothing I can do to motivate the employees in the laboratory. I should have listened when I was told 2 years ago that I wouldn't be free to supervise normally in this environment."
"What's wrong with this environment?" asked Melissa's manager, assistant administrator June Allen.
Melissa spread her hands and lifted her shoulders. "You know as well as I do, June. Goodness knows you've worked under it long enough. Government. We're a municipal hospital, an arm of local government."
"But we're still a not-for-profit general hospital," said June. "What makes motivating employees any different here than it would be almost anywhere else?"
"Almost everything," said Melissa. "Look what our governmental status and the civil service system do to us."
Melissa bent down the little finger of her left hand and said, "First, I can't give an employee a pay raise or a bonus for good performance because that's not allowed." She gathered the next finger with the small one and continued, "Second, I can't promote a good performer because there's no career ladder structure, and I can't advance anyone unless something opens up, and third," she said as she drew the middle finger into a bundle with the other two, "creating a new position falls somewhere between impossible and taking forever, and finally if an opening occurs or I manage to get another position approved I'm usually required to go by the results of some examination in filling the job."
June Allen shrugged and said, "Civil service has its drawbacks, that's true, but I think maybe you're looking in the wrong places for most of the motivators."
"I don't know, June," Melissa responded. "Oh, I've heard all this stuff about how money supposedly doesn't really motivate. If that's so, why do our employees talk about money so much? As far as I'm concerned, I've about decided that 'thank you' goes only so far and that's not far enough."
Instructions:
Putting yourself in the position of assistant administrator June Allen, prepare a response for your subordinate supervisor Melissa Wilson. Be sure to include some clear direction for Melissa to follow in seeking more effective ways of motivating her staff.
LET US HEAR FROM YOU
Readers are invited to submit their written analysis of this issue's case for possible publication in HCM 35:4 (October-December 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 one solution that appears particularly appropriate or relevant, or we may elect to publish excerpts from several proposed solutions.
Responses to this issue's "To Motivate the Unmovable" should be submitted under the following conditions:
* Your response, not exceeding 300 words, should be e-mailed no later than August 15, 2016, to Charles R. McConnell, Editor, HCM, atmailto:[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 34:4, OCTOBER-DECEMBER 2015)
[Note: In error this case, "Sylvia's Choice," appeared in issue 34:4 and also in issue 34:3. A suggested solution appeared in issue 35:1 (January-March 2016)].
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 34:4)
No additional responses to the case in HCM 34:4, "Sylvia's Choice," were received (as noted, this case appeared in 34:3 and was repeated in 34:4, and no new responses have been received). The following are a few possibilities some of which might figure in a reasonable response.
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. (If bias was deliberate, a different sort of problem is created when a manager places personal preferences ahead of individual qualifications.)
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 border 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.
Also, Sylvia needs to be well aware that one cannot legitimately be disciplined for "attitude." Rather, in all instances, it is not a person's attitude or approach that matters, but rather the results of the person's behavior.