Barbara Norris: Leading Change in the General Surgery Unit Fall 2010
1. What are the key issues that Barbara Norris faces at the GSU? Why are they important to the organization?
Barbara faces a bewildering array of obstacles to success in the General Surgery Unit (GSU) at Eastern Massachusetts University Hospital. Based on reputation alone, it was clear that her new unit had serious issues long before she took her position as Nurse Manager of its 33 member nursing staff. Having held an informal, off site meeting with her nurses, she has identified 9 of their chief complaints. These complaints can be mostly categorized under three of the most common stressors: incivility, work overload, and lack of task control. Incivility is manifested in complaints of a lack of collaboration, contribution acknowledgement, and advocation on the staff’s behalf. Occasionally, staff interactions are punctuated with bursts of frustration and anger. Work overload is evident in that older nurses tend to overlook their responsibilities as mentor in favor of getting their own work done as fast as possible, resulting in feelings of stagnation and isolation among the younger staff members. Lack of task control is apparent in the belief that assignments are random and unearned, the perception of favoritism, the secretive performance review process, and the inescapable shift from traditional nursing duties to perceived excessive administrative responsibilities. With her team having gone from the more beneficial form of stress known as eustress to outright and long-term distress, it is no longer capable of functioning at peak efficiency. Symptoms of this include job-dissatisfaction, angry and negative emotions, impatience with younger co-workers, and lowered organizational commitment resulting in excessive staff loss during a hiring freeze. Barbara must get a handle on this situation before GSU suffers from even lower levels of job performance, decision-making, and potentially higher levels of workplace accidents.
2. Does diversity play a role in the issues at hand? If so, how will workforce composition affect issues you noted in Question 1? If not, why not?
There is little question that age is a real surface-level diversity issue causing problems in the GSU. With respect to deep-level diversity, the conflicts seem to center upon personality and attitude differences that range from unrealized expectations to closed-mindedness and include faultlines of separation based on pay level. From the information provided, the general makeup of the staff seems to range in age from young, recent nursing school graduates to employees who have spent as much as 30 years performing patient care. The younger nurses feel their skill sets are deemed insufficient by those who are longer tenured in the nursing staff. The problem is exacerbated by the unwillingness of the established staff to serve as mentors to the newer hires. In contrast, younger nurses feel the older staff are reluctant to adopt newer techniques and technology in providing patient care. Whether this is a result of stereotypical grouping by age, attitude, or both is difficult to determine based on the few comments that were made. However, these are clearly points of separation among the employees, making teamwork more difficult to achieve. A central problem affecting the attitude and emotion of all attendees at the off-site meeting was a lack of fair treatment by both superiors and colleagues. The nursing staff complained of being under-appreciated by the hospital administration in terms of hiring freezes and lack of financial reward for jobs well done, a key component of the high performance workplace. Additionally, they felt physicians questioned their skill level and treated them with some measure of disregard. At the same time, however, the nurses had similar complaints about the skill level of the patient care assistants; these...