Table of Contents


Choose a case study with the primary topic of either COMMUNICATION  or CRITICISM AND DISCIPLINE. (See list of cases on table 3-1 in chapter 3 of your text).

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Step one:  Briefly summarize the case.

Step two:  Answer the questions and or instructions at the end of the case.   (Consider the following self assessment questions in reviewing your answer:   Do my recommendations show that I fully understand the issues involved in the case?  Could my recommendations realisticaly solve the problem?  Do my recommendations appear to be as fair as possible to al parties involved?  Do my recommendations support the goals of the organization?  If this were a real world problem, could I live with my recommendations?)

Step three: Review the author’s responses for your case in the responses section of your materials.  Briefly discuss whether or not your recommendations were similar to the author’s.  Would you adjust your recommendations after seeing the author’s proposed recommendations, or would you defend your own recommendation?  Why?


& P a r t II

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C a s e 1

More Help Needed—Now!

Primary Topic—Decision Making

Additional Topics—Criticism and Discipline; Employee Problems and Problem Employees; Methods Improvement

You are manager of the health information management department of Memorial Hos- pital. You have 20 people in your group. Three of your employees have the title super- visor, but all are usually more involved in doing the work of the department than in supervising others. One of these, your transcription supervisor, is expected to devote 60 percent of her time to transcription duties and the other 40 percent to supervision.

Several times in recent months the transcription supervisor has mentioned that the backlog of work was growing and that she needed more help. She has never been more specific than simply saying that “more help” was needed, and her complaints seemed to be no more than passing remarks offered without preparation or forethought. Since you have been under pressure from a number of directions and your transcription supervisor’s complaints seemed to represent no more than chronic grumbling, you have not felt compelled to add the transcription backlog to your currently active worries.

However, today, Monday, the transcription supervisor sought you out and con- fronted you with: “I need one more full-time transcriptionist and I need her now. I’m tired of waiting and tired of being ignored, and I’m sick of being overworked and taken for granted. If something isn’t done about it by Friday, you can find yourself a new transcription supervisor.”



Propose at least three possible solutions to this problem and describe the potential advantages and disadvantages of each.

The case places you in a trap. Describe this trap, explain why it is a trap, and explain how you believe you should proceed toward a solution in view of the hazards you face.

Explain what you believe is the general condition that caused the specific prob- lem described in the case. Who is responsible for the matter, and what can be done to address the cause?

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C a s e 2

Up froM tHe raNks

Primary Topic—Leadership

Additional Topics—Authority; General Management Practice; Time Management and Personal Effectiveness

After 8 years as a staff nurse in a medical/surgical unit, Julie was appointed head nurse of that unit. After a meeting at which her promotion was announced, Julie found herself surrounded by three coworkers offering their congratulations and other comments.

“I’m really happy for you,” said Sarah, “but I suppose this means our car pool is affected. Your hours are bound to be less predictable now.”

Elaine said, “And the lunch bunch, too. Management commitments, you know.” The emphasis on management was undeniable. Julie was not at all sure she was happy with what she was hearing.

Jane offered, “Well, maybe now we can get some action on a few age-old prob- lems. Remember, Julie, you used to gripe as much as we did.”

“We’ve all griped a lot,” Sarah agreed. “That’s been a way of life around here.” Her tone changed and her customary smile faded as she added, “Now Julie’s going to be in a position where she can do something, so let’s hope she doesn’t forget who her friends are.”

Elaine and Jane looked quickly from Sarah to Julie. For an awkward 10 seconds or so, nobody spoke. At last, someone passing by spoke to Julie, and as Julie turned to respond, Elaine, Jane, and Sarah silently went their separate ways.


1. What possible advantages does Julie have in becoming supervisor of the group of which she has long been a member?

2. What are the possible disadvantages that may present themselves to Julie? 3. If you were Julie, how do you believe your promotion would affect your

relationships with your former coworkers?

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C a s e 3

tHe sileNt GroUp

Primary Topic—Meeting Leadership

Additional Topics—Change Management; Communication; Motivation


As the admitting manager recently hired from outside, it took you very little time to discover that morale in the department had been poor for some time. As you worked to become acquainted with your employees by meeting with each of them alone, you soon became inundated with complaints and other evidences of discontent. Most of the complaints involved problems with administration and the business office and the loose admitting practices of physicians, but there were also complaints from the admitting staff about other members of the department and a couple of thinly veiled charges concerning admitting personnel who “carry tales to administration.”

In listening to the problems, you detected a number of common themes. You decided that much misunderstanding could be cleared up if the gripes were aired openly with the entire group. You then planned a staff meeting and asked all employ- ees to be prepared to air their complaints—except those involving specific staff members—at the meeting. Most of your employees seemed to think such a meeting was a good idea, and several assured you they would be ready to speak up. However, your first staff meeting was brief. When offered the opportunity to air their gripes, nobody spoke.

The results were the same at your next staff meeting 4 weeks later, although in the intervening period you were again bombarded with complaints from individuals. This experience left you frustrated because many of the complaints you heard were problems of the group rather than problems of individuals.


1. What can you do to get this group of employees to open up about what is bothering them?

2. How might you approach the specific problem of one or more of your employees carrying complaints beyond the department; that is, “carrying tales to administration?”

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C a s e 4

tHe repeat offeNder

Primary Topic—Criticism and Discipline

Additional Topics—Communication; Delegation; Employee Problems and Problem Employees

“So I slipped up and made a mistake,” said chemistry technician Arnold Adams. “All that proves is that I’m human, that maybe I’m a little careless once in a while, like everybody else.”

“I can’t call your behavior carelessness,” said laboratory manager Elsie Clark. She slid a piece of paper across her desk to Arnold and continued, “I have to call it negligence, and that’s what this warning notice says.”

Arnold scowled and said, “I don’t deserve a warning and certainly not for negli- gence.” He spread his hands and added, “What am I supposed to be—perfect? I can’t make an honest mistake once in a while?”

“You can’t make mistakes like this one. The test request was clearly marked stat but you logged it in as routine and it sat for several hours.”

Arnold shrugged and said, “Nothing happened to the patient, did it?” “No,” Elsie answered, “but Dr. Baker ordered it stat because of this particular

patient’s history. Something could have happened—we’re just lucky it didn’t.” “So nothing happened,” Arnold repeated, “but I get a warning in my file? If a

warning’s supposed to be a form of punishment, how come I’m punished for some- thing that didn’t cause any harm?”

Elsie said, “Arnold, you’re all by yourself every night at the satellite. We must be able to depend on you to process all requests according to procedure and to perform all stat work as it’s received.”

Arnold simply scowled at the warning notice as Elsie added, “And this sort of thing has got to stop. This is the fourth conversation we’ve had like this, and the most serious yet.”

“Fourth?” Arnold’s eyebrows rose. Elsie nodded. “In 3 years,” she said. “I can’t believe you’d hold some thing against me that happened 3 years ago. A

warning that old ought to be wiped out. You’ve got no business using that against me.” “I’m using it only to point out a pattern. You seem to go along fine for 8 or 9

months or so, then up comes a major problem again.”

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“Just bears out what I said before,” Arnold said. “I’m human. I make mistakes. And 8 or 9 months since the last mistake entitles me to a clean slate.”

“I can’t agree,” Elsie said. She handed Arnold a pen and added, “Please sign the form to show that we’ve discussed this. You can write out any objections or com- ments in the space at the bottom. And should we have such a conversation again, you may find that more than a written warning is involved.”


1. Consider Elsie’s statement, “You can’t make mistakes like this one.” Is this a valid statement? If yes, why?

2. What is wrong with Arnold’s description of a warning as “a form of punishment?”

3. How would you deal with the repeat offender if you were in Elsie’s position?

Case 4: The Repeat Offender 37

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C a s e 5

a Good eMployee?

Primary Topic—Criticism and Discipline

Additional Topics—Communication; Employee Problems and Problem Employees; Rules and Policies

Housekeeping supervisor Ellie Richards was faced with a situation that left her feel- ing uncomfortable about the action she would have to consider taking. In discussing the matter with Stan Miller, the other housekeeping supervisor, she began: “I have no idea how I should deal with Judy Lawrence. I just don’t recall ever facing one like this before. Her attendance has deteriorated and this once truly good employee is causing problems for the department as a whole.”

Stan asked, “What’s the problem?” “Excessive absenteeism,” Ellie answered. “Judy has rapidly used up all of her

sick time, and most of her sick days have been before or after scheduled days off.” “What’s unusual about that? Unfortunately, we have several people who use

their sick time as fast as it’s accrued. And most get ‘sick’ on very convenient days. I have a couple I can count on to do it regularly.”

“What’s unusual is the fact that it’s Judy Lawrence. She’s been here 7 years, but this apparent sick time abuse has all been within the past few months. She’s used up her whole sick-time bank in 7 months. And most recently, she was out for 3 days without even calling in.”

Stan said, “You can terminate her for that.” “I know,” said Ellie. “Especially when you take her other absences into account. You’ve warned her

about them?” After a moment’s silence Ellie said, “No, not in writing. Just once, face to face.

I really didn’t want to put pressure on her.” “Any record of it? Fill out a disciplinary dialogue form for her to sign? Some-

thing you’ve filed—even in your own office?” “No,” said Ellie. “I really hated to. I know I should have taken some kind of

action by now, but I can’t seem to make myself do it.” Stan asked, “Why not?” “Because she’s always been such a good employee. She’s always been pleasant,

she’s always done what she’s been told to do, and she’s always done quality work.

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She’s still that way, except for her attendance problems of the past 7 months. I’m really afraid there’s something wrong that she’s not telling anyone.”

Ellie shrugged and continued, “I guess what I’m really hung up on is: How do I discipline someone who is usually a good employee, and do it in such a way that it doesn’t destroy any of what is good about her?”

Stan shook his head and said, “Good performer or not, I’d say you ought to be going by the policy book. That’s all I can suggest.”


1. How would you advise Ellie to proceed in the matter of Judy Lawrence? 2. Do you feel that Ellie’s failure to take action thus far affects her ability to take

action now? Why or why not?

Case 5: A Good Employee? 39

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C a s e 6

tHe CliNGiNG ViNe

Primary Topic—Delegation

Additional Topics—Communication; Criticism and Discipline; Employee Problems and Problem Employees; Leadership; Motivation

“I feel like I have an open line of communication with Brenda,” said building services supervisor, May Carey, “and maybe that’s part of the problem. She never hesitates to come to me about even the smallest matter that she ought to know she can take care of without me. She checks in with me so often that I feel I might as well be doing her work in addition to my own.”

Jane Scott, a head nurse and May’s carpool companion, said, “Maybe you ought to be glad that she keeps you informed. I wish some of my nurses were better about bringing things to my attention. I don’t know if there’s such a thing as too much communication.”

“In this case there is too much,” said May. “Half of what Brenda brings to me is simple stuff, regular parts of her job that she’s expected to take care of. And she’s always asking me what to do next—and if she can’t find me right away, she doesn’t do anything until I show up and give her new instructions.”

Jane asked, “How did Brenda get along with your predecessor? Same problem?” “I don’t know. The last supervisor’s style was a lot different from mine. She

seemed very authoritarian in the way she ran the department.” “Do you suppose Brenda ever got in trouble for not checking in? That may be

why she thinks she’s expected to do what she’s doing.” “I don’t know that either,” May answered. “There’s been so much to do that I

haven’t really begun to uncover all of the major problems in the department. I’ve been stalled for 6 months just trying to get at our antiquated job descriptions.”

“Well,” said Jane, “I should think you’d be glad to have the open communication that you have with Brenda.”

“I am,” said May, “and I’d like to keep it. But how can I go about getting her to work more independently without damaging that open line of communication?”


Develop a recommended approach for May to follow in instilling more independence in Brenda while attempting to maintain open communication with her.

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C a s e 7

tHe iNHerited probleM

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; Criticism and Discipline; Delegation; Leadership

Shortly after she moved into the position of kitchen supervisor, Donna Wayne decided that a food service aide named Sandra Cleary was emerging as a problem employee. Sandra, nearing the end of her 6-month probationary period, was frequently idle. She would apparently do what she was told to do and then do nothing until specifically assigned to another task. Donna grew especially sensitive to the situation when she began to pick up grumblings from several other workers about Sandra not doing her fair share of the work.

Because she did not want to be unduly influenced by what others might have said, Donna did not look at Sandra’s record when she drafted Sandra’s 6-month review. She tried to avoid focusing on the employee’s attitude, which at best seemed to be distant and disinterested, and instead attempted to focus strictly on Sandra’s performance. Even this approach yielded a highly uncomplimentary review; Donna had already decided that Sandra was probably the department’s worst performer.

Donna set up an appointment for Sandra. In opening her conversation with Sandra, Donna said, “I’ve deliberately avoided looking at your 3-month review, but I’ll be surprised if it’s much better than the one I have to give you now.”

Sandra responded with, “What 3-month review? I didn’t know I was supposed to have one.”

Astonished at this response, Donna dropped her plans to discuss the 6-month evaluation. Instead, she turned the conversation to Sandra’s experience over the pre- ceding 6 months. In her discussion with Sandra, and through personal investigation and a review of Sandra’s record, Donna learned that:

• Sandra indeed had never been given a 3-month review, and in all probability had never been told there was such a review.

• Sandra had never been told that she was performing unsatisfactorily. • Sandra felt that she was expected to wait for instructions before beginning any

new task. • There were no warnings or other indications of trouble in Sandra’s personnel


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It was with dismay that Donna reviewed the problem: The employee’s perfor- mance was below standard, apparently through no fault of her own, and yet the pro- bation period had expired and the employee was expected to be fully functioning.


1. What probably caused the problem with Sandra to develop? 2. What should Donna do to try to correct the problem? 3. What should Donna tell Sandra about the apparent happenings of the past

6 months?

42 Case 7: The Inherited Problem

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C a s e 8

tHe well-eNtreNCHed eMployee

Primary Topic—Change Management

Additional Topics—Delegation; Employee Problems and Problem Employees; Leadership; Motivation

When Dave Farren was hired from outside to be manager of communications for University Hospital, he gave little initial thought to the one-person mail room opera- tion that was part of his department. However, he was soon forced to focus on the mail room because of an alarming number of complaints he received about mail room service. Other departments and elements of his own department complained of slow service on outgoing mail, late and erratic service on incoming mail, and frequent losses of interdepartmental mail.

The mail room operator, Mary West, was a long-time employee who had been in the same job more than 20 years. Her title was actually mail room supervisor, although she had never directly supervised any other employees. However, she had always been left to function very much on her own.

Before Dave could begin to make sense of the complaints about the mail room, Mary West launched something of a complaint campaign of her own. She insisted that she needed a full-time helper in the mail room, claiming that “There’s far too much work here for one person and there’s nobody to help me.” However, Dave quickly learned from others that Mary’s “I need help” campaign was an approach that she had used on all of his predecessors over the years.

Dave’s first visit to the cramped, out-of-the-way mail room left him appalled. The area was cluttered, with battered interoffice mailers piled everywhere and just plain junk accumulated in every available space. Although Dave was ready to con- cede that some physical improvements could aid the situation, he was also forced to conclude that the biggest problem area was Mary West’s complete lack of an efficient approach to the job.

Dave offered some suggestions aimed at improving the operation of the mail room. However, for the most part his suggestions were met with icy silence and he later picked up secondhand complaints to the effect that Mary wanted “real help, not some new boss nosing around and trying to tell me how to do my job.”

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Dave proceeded to authorize a few hours of regular overtime apparently bud- geted for that purpose to see if that would help Mary get caught up and become more organized. The overtime had no noticeable effect; rather, it seemed to Dave that Mary spent most of her time wandering about the hospital visiting with people. It also seemed that everyone Mary visited heard all about how “overworked” poor Mary was.

After several weeks of casually observing Mary and pondering the mail room situation, Dave concluded that Mary was the major problem. She was apparently still working the way she had worked when she started on the job back when the hospital was less than half its present size.


Putting yourself in Dave Farren’s position, develop an approach to the problem that includes:

• Development of a rationale with which to try “selling” the need for change • An honest effort to win the employee’s cooperation • Identification of alternative approaches to consider should “selling” fail

44 Case 8: The Well-Entrenched Employee

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C a s e 9

tHe seNsitiVe eMployee

Primary Topic—Criticism and Discipline

Additional Topics—Communication; Employee Problems and Problem Employees; Rules and Policies

May as well get it over with, thought business office manager Theresa Fallon as she summoned billing clerk Barbara Goodman to her office. It was with dread that Theresa arranged the papers on her desk and waited for Barbara to be seated. Theresa felt that she knew exactly what was coming and she was determined that this time she would address the continuing problem as well as the specific problem.

Theresa handed a warning form to Barbara and said, “Barb, we have to talk about your excessive absenteeism. This is your second warning. I’m sure you knew it was coming.”

Barbara barely glanced at the warning and dropped it on Theresa’s desk. “I knew nothing of the kind,” she snapped. “There’s nothing excessive or unusual about my few days off because I was sick. I’m not signing any warning.”

Theresa sighed. “Barb,” she said, “you can count the days yourself. Ten sick days in the last 6 months, and 7 of them on Mondays.”

“I can’t help it if I’m sick a lot.” “Even if you’re legitimately ill on those days, and honestly, Barb, it’s tough to

accept all those Mondays as legitimate sick days, you make it difficult to staff the department reliably.”

“Why me? Why don’t you lean on Judy for a change? She’s been out as much as I have.”

Theresa said, “No, she hasn’t. Not nearly as much. At any rate, that’s strictly between Judy and me. Just like this is strictly between you and me.”

Theresa continued, “You know that you’ve used up all of your sick time.” “I know. This place made me use vacation the last two times.” There was accusa-

tion in Barbara’s voice. “You wanted to get a full paycheck, didn’t you?” Barbara glared at her supervisor. “I think it stinks to make me use vacation when

I’m sick.” Theresa looked at Barbara. Barbara’s face was stony, her eyes cold, and her

mouth a thin line. Theresa thought, Any time now—the next thing I say will do it.

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Theresa, fighting against the knot in her throat, said, “Barbara, you haven’t been reliable. I just can’t count on you to be here when I need you. Your first warning was deserved, and this one is deserved. You can appeal, if you want, through proper chan- nels, but the warning stands.”

Theresa watched Barbara’s face. Barbara’s eyes grew round and quickly filled with tears. Her mouth turned down and she began to sob.

If any other employee had been involved, Theresa might have felt sympathy. However, she had been through this a number of times, in fact every time she had occasion to reprimand Barbara. The pattern was always the same: anger and defen- siveness, even belligerence, followed by tears and charges of persecution and injus- tice. And as always, Theresa wondered what to do next.


1. Although Theresa was well prepared with the facts concerning Barbara’s absenteeism, she might have considered a different opening for the disciplin- ary dialogue. What opening would you consider suggesting? Why?

2. How did knowing “exactly what was coming” bias Theresa in her approach to Barbara?

3. What would you suggest as a possible way of dealing with this apparently resentful and emotional employee?

46 Case 9: The Sensitive Employee

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C a s e 10

tHe eNeMy CaMps

Primary Topic—Criticism and Discipline

Additional Topics—Authority; Employee Problems and Problem Employees; General Management Practice; Meeting Leadership; Motivation

Helen Williams was hired from outside of the hospital to fill the position of business office manager. She accepted the job suspecting that it was something of a “hot seat”; she was to be the fifth person in that position in just 3 years.

Although Helen did not know the specific reasons behind the short stays of her predecessors, after a month she decided that the atmosphere in the department was definitely unhealthy. Her staff appeared to be divided into two distinct rival camps. There was so much animosity between these groups that Helen began to think of them as “Enemy Camp A” and “Enemy Camp B.” (Helen kept the “enemy” designa- tion to herself, but she often referred in conversations with her superior to “Camp A and Camp B.”)

From her first day on the job, it was apparent to Helen that many of the problems in the department stemmed from poor intradepartmental communications. She was surprised to learn, for instance, that her immediate predecessor never held department staff meetings. Instead, the previous supervisor met sporadically with groups of two or three people to deal with specific problems.

Helen instituted the practice of holding a weekly 30-minute staff meeting for all of her employees. She made it plain that everyone was expected to attend.

After 4 months of staff meetings it seemed to Helen that the atmosphere of rivalry between the “camps” had diminished substantially. However, it was still evident that the group was divided on many matters. It also seemed to Helen that “Camp A” was becoming her group in the sense that these people were steadily becoming more supportive of her and her approach to managing the department. Unfortunately, this condition seemed to ensure that “Camp B” would often be opposed to Helen herself on matters in which full staff cooperation was vital.

Early in Helen’s seventh month on the job she received a quiet visit from Jeanette Woods, a longstanding member of “Camp A.” Jeanette informed Helen that she had heard Sandy Davis, an acknowledged informal leader within “Camp B,” admit to snooping in Helen’s office and reading a number of confidential documents. When

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Helen reminded Jeanette that most if not all of her confidential records were kept in a locked drawer, Jeanette responded with some reluctance, “I think Sandy has a key to your desk.”

Helen’s first reaction to Jeanette’s revelation was to consider how she could suc- cessfully discipline Sandy without compromising Jeanette.


Consider the problem in terms of the following questions:

1. What hazards is Helen likely to face in taking direct action against Sandy based on what she heard from Jeanette? Why should she—or why should she not—take such action?

2. What would you do if you were in Helen’s position?

48 Case 10: The Enemy Camps

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C a s e 11

tHe tUrNaroUNd CHalleNGe

Primary Topic—Change Management

Additional Topics—Delegation; Employee Problems and Problem Employees; General Management Practice; Leadership; Methods Improvement

In February, Fred Jarvis took over as manager of laundry operations. He came from outside the hospital, but he brought with him several years of experience in insti- tutional laundry operations. He was told bluntly that he was following a weak (or perhaps unmotivated) manager who had allowed the department to become quite lax over a period of several years. Fred quickly recognized that his employees’ apparent practice of doing just enough to get by fell far short of his own standards of accept- able performance.

Fred inherited an assistant supervisor who was, in that employee’s own words, “Just a gopher with a title—the old boss never really gave me any responsibility.”

For his first few weeks on the job, most of Fred’s crew struck him as being friendly, reasonable people. However, in March, when Fred announced some new and carefully determined productivity targets, many of the smiles turned to scowls, and the crew’s friendly chatter dropped off markedly. He was seeking improvement in output per personnel hour of 18 percent over a year, to be achieved at a rate of 3 percent for each 2-month period.

In spite of the turn in attitude, Fred’s crew easily boosted productivity by 3 per- cent during March and April. However, during the May–June period output rose by only 2 percent, and over July and August productivity dropped by 1 percent.

Fred did his best to maintain a friendly but businesslike attitude. However, by the end of August none of his employees would initiate conversation with him, except for his assistant supervisor, who by then seemed to be getting the same treatment Fred was receiving.

Most of the laundry employees would respond when spoken to, accept Fred’s instructions without question, and then go about their business at a pace that Fred could only describe as foot-dragging. Although few were openly resistant, Fred felt that most of his employees were passively but stubbornly fighting all of his efforts to improve output.

At the end of August, Fred was told by his manager, the vice president for gen- eral services: “I don’t see much happening in the laundry. You know that you were

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put there to correct the problems that your predecessor allowed to develop, especially the intolerably poor level of output. For a while you seemed to be making progress, but now things seem to be sagging again. Tell me—just how long is it going to take you to turn the department around?”


1. How long should it take Fred to turn the department around? Should the 7 months he has already been there have been enough?

2. Describe a tentative approach and timetable for Fred to consider in correcting the productivity problem, and explain how Fred should go about selling this approach to the assistant administrator.

3. Consider the kind of department—a laundry—and identify one or more seemingly drastic options that would probably take care of the productivity problem.

4. Would it assist your analysis to know about the age and condition of the equipment in the laundry? How?

50 Case 11: The Turnaround Challenge

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C a s e 12

oNe persoN’s word aGaiNst aNotHer’s

Primary Topic—Criticism and Discipline

Additional Topics—Delegation; Employee Problems and Problem Employees; General Management Practice

You are second-shift supervisor in the food preparation area of the dietary depart- ment. Your normal hours are from 3:30 pm to midnight. However, about half of the people who report to you are finished for the day at 7:30 pm; for the sake of having maximum help available over the lunch and dinner hours, a number of food prepa- ration workers are assigned to a shift that begins at 11:00 am and ends at 7:30 pm. Because of these differences in work schedules, the persons who report to you from 3:30 to 7:30 have a different supervisor—the day shift supervisor—before 3:30.

You have felt that a problem was developing with Janet Mills, a kitchen helper assigned to the 11:00 am to 7:30 pm shift. Janet frequently asked to leave early, as much as an hour or more before 7:30. It seemed to you that the more readily you accommodated her requests—you usually let her go unless you were short of help for the work remaining to be done—the more frequent her requests became. When you finally realized that Janet managed to punch out early at least twice a week, and when some grumbling about special treatment came to you from other employees, you decided it was time to start discouraging Janet’s early departures.

After you had refused permission twice in the same week, Janet did not ask again to leave early for several days. You thought that perhaps the problem had been easily corrected. However, on Monday of this week the problem resurfaced in a somewhat different manner.

At about 6:00 pm Janet came to you and said, “Mrs. Carter said I could leave at 6:30 today. I’m supposed to tell you.”

You could not imagine why Mrs. Carter, the day supervisor, would grant such permission on a day like this when all shifts were short of help. However, you did not want to contradict another supervisor so you simply let Janet leave at 6:30.

The next day you asked Mrs. Carter about Janet’s early departure. When you told her what Janet had said, Mrs. Carter responded, “That isn’t everything that was said. I did say, ‘You can leave at 6:30,’ but I also said, ‘if the work is under control

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and the evening supervisor agrees.’ I also told her that we were short of help and it was a bad day to leave early, but she said there was something very important that she had to take care of.”

That day you spoke twice with Mrs. Carter and twice with Janet Mills. Their stories remained the same: Janet claimed that she had clear, unmistakable permission to leave early; Mrs. Carter claimed that Janet had distorted what was said to her and had in effect left without permission.

One day later, Mrs. Carter advised you that she was issuing a written warning to Janet Mills for her “distortion or misrepresentation” of what she had been told. She asked you to cosign the warning with her.


Consider the problem in terms of the following questions:

1. What is your immediate reaction to Mrs. Carter’s request for you to partici- pate in the warning?

2. What course of action would you follow if you are convinced that the employee is actively playing one supervisor off against the other?

3. How would you suggest attempting to minimize the communications prob- lems that are bound to develop when an employee reports to more than one supervisor at different times?

52 Case 12: One Person’s Word Against Another’s

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C a s e 13

tHe GroUCHy reCeptioNist

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; Criticism and Discipline

“As your assistant, I’m certainly not trying to tell you what to do,” said Marie Stark. “You’re the boss and I’m only pointing out—again—a problem that’s leading us into lots of grief.”

“I know,” laboratory administrator Morris Craig said with more than a trace of annoyance. “I’m trying to take it the way you mean it. I’ve heard it from several people and I know we’ve got a problem with Jennifer. I just don’t know how to deal with it, that’s all.”

“It has to be dealt with,” Marie said. “As lab receptionist Jennifer is in a posi- tion to leave a first and lasting impression on a lot of people, and she’s generat- ing an endless trail of complaints. I’ve heard from patients, staff, and physicians alike—just about anyone you care to name—about her curt, rude treatment of them. It’s been going on for months, and it’s getting worse. And now she’s starting to mix up appointment times as well.”

Morris said, “I know. I had hoped that whatever was bugging her would pass. But it hasn’t. She’s gone from bad to worse. And it’s too bad—she’s been here a long time, and this is only relatively recent.”

“One of us needs to talk with her. Or at least make some attempt to find out what’s wrong.”

Morris spread his hands, palms up, and said, “I’ve tried to talk with her. Just a week ago I gave her a chance to talk in private. I even asked if I could help out in any way, but. . . .” He shrugged helplessly.

“But what?” “She told me nothing was wrong, or something like that. I got the impression

that she was telling me—kind of roundabout—to mind my own business.” “Well, something’s wrong,” Marie said, “and we need to do something about

it. Our receptionist is coming across as a first-class grouch and the department is suffering.”

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Develop a tentative approach for dealing with the apparent attitude problem presented by the laboratory receptionist. Make certain you provide for reasonable opportunity for correction of behavior and that you account for:

• Possible ways of assisting the employee with “the problem” • The necessarily progressive nature of any disciplinary action considered • The needs of the department

54 Case 13: The Grouchy Receptionist

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C a s e 14

wHat’s tHe trUtH?

Primary Topic—Communication

Additional Topics—Criticism and Discipline; Delegation; Employee Problems and Problem Employees

“I’ve really had it with that Stan Thomas,” said maintenance supervisor Tom Davis to his boss, Harry Willis, director of building services.

“What’s wrong?” Willis asked. “You mean what’s wrong this time,” said Davis. “It’s been one thing after another

longer than I care to think about. This time I’d call it insubordination. He refused to clean up the scraps and leftover construction material behind the new business office when I told him to.”

“A direct refusal of your direct order?” “Not right away,” said Davis. “First I put it in the form of a request, but he started

making excuses about how much he had to do. I told him it had to be cleaned up today and he simply told me he had so much important work that he didn’t know if he could get at it today. When I told him he had to do it today he simply glared at me for a moment and said, ‘No way.’”

“No way?” Willis asked. “Those were his exact words?” “Yes. His exact words.” “We’ll see about that,” said Willis. Some time later, just before the end of the shift, Tom Davis located Stan Thomas.

Thomas was performing the task that had been the focus of the earlier difficulty. When he saw Davis, Thomas stopped working, glared at him, and said, “I would have gotten this done as soon as I got a few things caught up. You didn’t have to sic your boss on me. And you especially didn’t have to tell him what you told him.”

“What are you talking about?” Thomas said coolly, “You lied to Willis about what I said to you. I don’t forget

things like that.” Davis tried to get Thomas to explain further what he meant by that remark. How-

ever, Thomas would say nothing else. Tom Davis went looking for Harry Willis.

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Assess the foregoing incident and its possible causes, implications, and ramifications, from: (a) Tom Davis’s point of view; (b) Harry Willis’s point of view.

1. Considering the present state of affairs, what—if anything—would you rec- ommend doing?

56 Case 14: What’s the Truth?

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C a s e 15

iN a rUt

Primary Topic—Change Management

Additional Topics—Delegation; Employee Problems and Problem Employees; Methods Improvement

“Sometimes I’m not sure you did me a favor by promoting me,” said Sue Allen, the human resource department’s newest employee and the newly appointed employ- ment manager. “Maybe it’s because I’m so new—to the rest of the folks in the office I’m still an outsider—that I don’t seem to have any effect on the people in my little group.”

“What do you mean?” asked human resource director Andy Miller. “Well, I was under the impression that you put me in charge of the employment

office so I could streamline things and bring a lot of our practices up to date.” “That’s right.” “It doesn’t seem to be working at all,” said Sue. “I have all sorts of ideas about

what we ought to be doing, and you seem to agree with everything I suggest. But I can’t get this bunch to go along with anything. I took a great deal of time—my own time, I might add—to work out a plan of short-range and long-range goals and objec- tives for them, but I can’t get them to do anything differently.”

“Remember,” said Miller, “most of them have been here lots longer than you and I. You’ve been here just a few months, and I came here barely a year ago.”

“They act like they’ve been here forever,” said Sue. “And I guess they have. They range from 7 to 15 years of service, with the average just over 10 years.” She shook her head sharply and said, “Talk about people being set in their ways!”

Miller asked, “What do they seem to think about the changes you’ve wanted to make?”

“I don’t know,” said Sue. “They just listen quietly and then go about their busi- ness in the same old way as though I weren’t here. It’s really a frustrating situation, and I guess what I really want you to tell me is: How can I possibly go about setting new goals for a bunch of disinterested and inflexible people who’ve been doing the same thing in the same old way for years?”

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1. Identify an apparent major error in Sue Allen’s approach to the situation in her group and suggest how she might have proceeded differently.

2. Outline the kind of approach you believe human resource director Andy Miller should be advising the employment manager to follow.

58 Case 15: In a Rut

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C a s e 16

tHe Up-aNd-dowN perforMer

Primary Topic—Criticism and Discipline

Additional Topics—Delegation; Employee Problems and Problem Employees; Leadership

“I’ve come to the end of my patience with Roberta Weston,” said accounting manager Sam Best. “The position she’s in is so important to us that we simply can’t afford any more of her omissions or mistakes. For the sake of the hospital and the department, I believe she’s got to go.”

“What’s the problem?” asked human resource director Charlene Harrison. “Problems, plural,” Best answered. “She’s so late in posting the receipts on rent-

als in the medical arts center that we wind up double billing a number of physicians every month. Actually, it’s the same with just about all miscellaneous income—since she’s responsible for all receipts except third-party reimbursement. We’re losing con- trol of income, and I get three or four complaints a week from people who claim they’ve been billed again for charges they’ve already paid.”

Best shook his head and added, “I’ve really tried to give her every chance to turn around, but nothing seems to work. At least not for very long.”

Harrison said, “I’ve reviewed Roberta’s file. The only evidence of a problem I found was your rather detailed performance improvement review of 2 months ago. In that process, you’re supposed to give the employee detailed direction aimed at cor- recting the problem—which you did—along with a warning that task performance will be monitored closely for 30 days and that she could be let go by the end of that period if her work hasn’t come up to satisfactory levels. You did the review, but I didn’t see anything about any follow-up.”

Best said, “That’s because she had shaped up by the end of the 30 days.” “But now she isn’t working up to the requirements of the job?” “Right. Her work was just marginally okay at the end of the 30 days, but within

2 weeks of that the bottom dropped out again, and the mistakes started rolling in.” Harrison asked, “What do you mean by ‘again’?” “This is the third time I’ve been through this with her. I go over the areas in

which she’s not working up to standard, she puts on a burst of effort and does better, and a month or so later she falls back into her old ways.” Best frowned and added, “I can’t put up with it any longer. Three strikes—she’s out.”

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Harrison said, “According to her file it’s just one strike. The only documentation is your single performance improvement review. What about the other two times?”

“Strictly verbal.” “You didn’t write anything? You’re supposed to cover oral warnings with a dis-

ciplinary dialogue form for the record.” Best said, “If I wrote up one of those every time I had to warn an employee, I’d

never get done writing. It’s a lot of work.” “I know it is,” responded Harrison, “but you’ve got to have your documentation.

As it stands right now, if you terminate her she could probably give us a real hard time with the state.”

“So what should I do?” Best asked.


1. Why could the employee give the institution “a real hard time” if she is ter- minated now?

2. What plan of action would you recommend to Sam Best for dealing with the up-and-down performer?

60 Case 16: The Up-and-Down Performer

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C a s e 17

i’ll Get aroUNd to it

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Change Management; Communication; Delegation

Housekeeping supervisor Mabel Wilson felt she had little control over the activities of housekeeper Ellie Masters. It seemed Ellie was generally nonresponsive to spe- cial requests and instructions to perform unexpected tasks. Regarding her routine, regularly assigned work, Ellie usually did what was expected of her in a reasonable amount of time and with acceptable results; however, Mabel could count on Ellie’s resistance to unanticipated assignments. Also, it seemed to Mabel that Ellie was unable to adjust her activities to account for anything that occurred unexpectedly.

For instance, this morning Mabel received a call regarding the sorry state of the hospital’s emergency room entrance. It seemed that prolonged bad weather had cre- ated widespread mud and much had been tracked in. Because that was Ellie’s area, Mabel sought her out and said, “The ER entrance is muddy and needs going over again. Please take care of it; it’s bound to be slippery, and we don’t want anyone to fall.”

Ellie simply nodded and said, “When I get around to it.” She continued with what she had been doing when Mabel found her. It was

not the first time Mabel had gotten that response from Ellie. One pace, one order of activities, one level of concern whether or not something was urgent, that was Ellie.


Develop a recommended approach for Mabel to apply in dealing with Ellie. Make certain your approach deals with the overall problem as well as with the immediate need expressed in Mabel’s recent instruction to Ellie.

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C a s e 18

tHe alterNate day off

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Criticism and Discipline; Rules and Policies

Early in June licensed practical nurse Susan Butler approached her supervisor, nurse manager Mabel Wesley, and volunteered to work on the upcoming Fourth of July holiday. Although Mabel was well aware that Susan was volunteering to work a day for which she would be paid time-and-a-half, she accepted Susan’s offer because a number of people had asked to have the holiday off and staffing would be tight, as it usually was on holidays.

Thus scheduled to work the holiday, Susan was entitled, by staffing policy, to take off an alternate day as her holiday. The policy simply said that the alternate day must be taken within 2 weeks of the legal holiday.

Susan Butler took her alternate day off 1 full week before the actual Fourth of July holiday. She said that she especially needed this day; getting this particular day off was the reason she volunteered to work on the Fourth of July. She pointed out that the policy that said the alternate day must be taken “within 2 weeks” of the holiday could be interpreted as meaning before or after the holiday. Mabel, however, could not recall a case in which the employee had not taken the alternate day within 2 weeks after the holiday.

Susan Butler, having already taken her alternate day off, came to work on the Fourth of July. However, she stayed less than half of the shift; shortly before 11:00 am she said she did not feel well and punched out and went home. Mabel’s unit had to function for the balance of the shift with less than its required staff.


1. Do you believe Mabel Wesley should take any action regarding Susan? If so, what action might she consider taking?

2. What—if anything—could Mabel do regarding the alternate-day-off policy?

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C a s e 19

if yoU waNt tHiNGs doNe well . . .

Primary Topic—Delegation

Additional Topics—Communication; Motivation; Time Management and Personal Effectiveness

John Miller, manager of laundry and linen for City Medical Center, dreaded the one day each month he had to spend doing the statistical report for his department. Miller was responsible for all laundry and linen activities in the 800-bed hospital, two smaller satellite facilities, and several municipal agencies whose linen needs were filled by the hospital. At one time the report had been relatively simple, but as Miller’s scope of responsibility grew and administration requested increasingly more detailed information each month, the report had become more complicated. Miller had simply modified his method of preparing the report each time a new requirement was placed upon him, so there was no written procedure for the report’s preparation.

Faced once again with the time-consuming report—and confronted, as usual, with several problems demanding his immediate attention—John Miller decided it was time to delegate the preparation of the report to his assistant, Bill Curtis. He called Curtis to his office, gave him a copy of the previous month’s report and a set of forms, and said, “I’m sure you’ve seen this. I want you to take care of it from now on. I’ve been doing it for a long time, but it’s getting to be a real pain and I’ve got more important things to do than to allow myself to be tied up with routine clerical work.”

Curtis spent perhaps a half minute skimming the report before he said, “I’m sure I can do it if I start on the right foot. How about walking me through it—doing just this one with me so I can get the hang of it?”

Miller said, “Look, my objective in giving you this is to save me some time. If I have to hold your hand, I may as well do it myself.” He grinned as he added, “Besides, if I can do it, then anyone with half a brain ought to be able to do it.”

Without further comment Curtis left the office with the report and the forms. Miller went to work on other matters.

Later that day Curtis stopped Miller in the corridor—they met while going in opposite directions—and said, “John, I’m glad I caught you. I’ve got three or four questions about the activity report, mostly concerning how you come up with the count and percentages for the satellites.” He started to pull a folded sheet of paper from his back pocket.

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Miller barely slowed. “Sorry, Bill, but I can’t take the time. I’m late for a meet- ing.” As he hurried past Curtis, he called back over his shoulder, “You’ll just have to puzzle it out for yourself. After all, I had to do the same thing.”

The following day when the report was due, Miller found Curtis’s work on his desk when he returned from lunch. He flipped through it to assure himself that all the blanks had been filled in, then scrawled his signature in the usual place. However, something caught his eye—a number that appeared to be far out of line with anything he had encountered in previous reports. He took out two earlier reports and began a line-by-line comparison. He quickly discovered that Curtis had made a crucial error near the beginning and carried it through successive calculations.

Miller was angry with Curtis. The day was more than half gone and he would have to drop everything else and spend the rest of the afternoon reworking the figures so the report could be submitted on time.

Miller was still working at 4:30 pm when Pete Anderson, the engineering man- ager, appeared in the door way and said, “I thought we were going to rework your preventive schedule this afternoon. What are you up to, anyway?”

Miller threw down his pencil and snapped, “I’m proving an old saying.” “Meaning what?” “Meaning, if you want something done right, do it yourself.”


• Miller committed several significant errors in “delegating” the activity report to Curtis. Identify at least three such errors in the case description.

• Using as many steps as you believe necessary, describe how this instance of delegation might have been properly accomplished.

64 Case 19: If You Want Things Done Well…

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C a s e 20

sixty MiNUtes or less

Primary Topic—Time Management and Personal Effectiveness

Additional Topics—Communication; Methods Improvement

When business office manager Judy Morrison returned from a 2-day seminar, she found her desk half covered with telephone message slips and her in basket overflow- ing with other work. As she glumly surveyed the pile of work before her, department secretary Ann Rose reminded Judy that she was due at a major meeting in barely an hour and would probably be tied up for the rest of the day.

“Just look at this mess,” said Judy. “I knew I shouldn’t have gone away. Now I’ll take forever getting back to normal.”

Ann suggested, “You don’t have anything at all on your calendar for tomorrow. And you have almost an hour available right now.”

Judy sighed and said, “An hour doesn’t seem like much time in the face of this pile of work. I don’t know what I could possibly accomplish in only an hour.”

Ann indicated the array of telephone messages and said, “Maybe some phone calls. You could probably return most of the important calls within an hour.”

“But how do I know that the calls are what I should really be working on? It might make more sense for me to use the time to go through everything and sort it all according to priority and plan how I’m going to attack this backlog.”

“Okay, you could do that,” Ann said. “You could also check quickly through everything and pick out a couple of important items that you can resolve within the hour. That way you would be trimming the pile down at least a little bit.”

“Well, I’d better do something,” said Judy. “I’ve already used up 5 minutes of my hour just wondering where to begin.”


In the conversation between Judy and Ann, three approaches to the use of the avail- able hour were suggested:

1. Return the telephone calls, concentrating first on the more important calls. 2. Sort everything according to priorities and develop a work plan. 3. Select one or two important items for immediate resolution.

Which of these three approaches would you recommend? Why?

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C a s e 21

is it iNsUbordiNatioN?

Primary Topic—Authority

Additional Topics—Criticism and Discipline; Decision Making; Leadership; Motivation; Rules and Policies

Peter Hamilton, the hospital’s maintenance department supervisor, was sure that the announcement he had to make would not be well received by many of his employees. He did not like the idea of having to place limits on when his employees could take their vacations, but after several meetings with his boss, the director of environmental services, Pete was convinced that he would need his full staff plus outside help for a particular 6-week period.

At a November staff meeting, Pete Hamilton announced, “Those of you who figure on vacations during the first half of the year, we’re going to have to ask you to leave May 15 to June 30 out of your planning. The new admitting offices will open May 15. Demolition of the old west wing will start July 1, timed with some work on the adjoining property. That means we’ve got just 6 weeks to gut and remodel the old admitting area so we can get accounting out of the west wing by the end of June. We’ll need all the hands we can find for those 6 weeks. So, if you have vacation in mind, either schedule it so you’re back by May 15, or wait and go some time after July 1.”

There was some muttering in the group, but no voices were raised in immedi- ate protest. However, just as Pete thought that perhaps there would be no trouble, a single hand went up. The person was Ed Mason, a long-time employee and one of the hospital’s two electricians.

Mason said, “I’ve always taken the same 2 weeks in June, every year almost as long as I’ve been here. You trying to tell me I can’t go then?”

Hamilton repeated his explanation and added a general appeal covering the need for all of them to pull together to get a difficult job done in a limited amount of time. Ed Mason uttered a one-word obscenity that was clearly audible to all in the room. Mason’s expression was one of anger and his manner might have struck some as threatening.

Pete dismissed the group, but ordered Ed Mason to remain. When the others had left, Mason said, “I’ve been here 17 years, and for the last 12 years I’ve taken vacation the same 2 weeks in June. There shouldn’t be any reason why I can’t do the

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same next June. I always have my request in first. The others in the department know that, and they’re all used to doing without me during that period.”

Pete responded, “This applies to all of us in maintenance, myself included—I usually go the last part of May, around Memorial Day.”

“You can’t change that on me,” Ed said stubbornly. “That vacation is my right, considering my seniority here.”

“Ed, maybe we all need reminding that vacation is scheduled at management’s discretion. Sure, we try to give you exactly the time you want if we can, providing— like the policy says—that it’s convenient to the functioning of the department and the hospital. This is one time when it isn’t convenient. You don’t seem to appreciate all the work that needs to be done and how limited we are with present staff.”

“Nuts to that,” said Mason as he headed for the door. He added, “My seniority ought to be good for something. I’m not changing my plans for you or anybody.”


Put yourself in Peter Hamilton’s position and decide how you would deal with the problem presented by Ed Mason’s reaction to the vacation restriction.

Case 21: Is It Insubordination? 67

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C a s e 22

Get baCk to yoU iN a MiNUte

Primary Topic—Communication

Additional Topics—Authority; Leadership; Time Management and Personal Effectiveness

You are the laundry manager at Community Hospital and you report to the director of support services. You have just been through a particularly trying week, and you have concluded that your relationship with the director of support services is not in the best of shape. You review the contacts you had with your boss during the week.

Monday morning a personnel problem arose that you felt could require severe disciplinary action. You thought you had better clear the action with your boss. How- ever, you could not reach him. You called his office three times; each time you spoke with his secretary who said she would have him return your call. Monday ended without a response from the boss.

Tuesday you encountered your boss in a basement corridor when he was going in the opposite direction. As you moved directly toward him so as to nearly block his passage, you told him you needed to see him on a matter of some importance. With- out slowing, he detoured around you and called back over his shoulder, “Something’s up—can’t stop. Get back to you in a minute.” You didn’t see him again that day. When you called his office you were told he was in a meeting.

Wednesday morning you decided to visit the boss’s office. However, you found he had two visitors. He saw you at the door and shrugged, smiled faintly, and waved you away. That afternoon you telephoned the boss’s office. His secretary was away from her desk and he answered his own phone and immediately told you he was tied up with someone and added, “Buzz you back as soon as I’m free.” You remained nearly an hour after quitting time but he did not “buzz you back.” When you left you noticed that his office was dark.

Thursday you made no effort to contact the boss. Rather, because the item you had been holding open since Monday was still plaguing you and someone needed an answer, you went ahead and used your best judgment and took care of it. You felt you were perhaps overstepping your authority a bit, but you knew that further delay would only cause harm.

Friday you encountered the boss twice while you were moving about the lower level of the building. The first time you told him you needed to get a few minutes of

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his time. He told you he was on his way to the president’s office but he would get back to you shortly. Nothing. On the second occasion he saw you before you saw him, and he called out, “Hey, we need to get together. I’m on the way to a meet- ing, but catch me in my office at about 4 o’clock.” The boss was not in his office at 4:00 pm. Neither was he there at 4:30 pm, the normal quitting time, nor was he there at 5:00 pm when you left for the weekend. You learned on the way out of the building that the boss’s meeting had ended at 3:30 pm.

Upon review you felt that the week, taken in its entirety, looked pretty grim. Unfortunately, you had experienced too many such weeks.


There are two general approaches you can adopt to handle the problem of working with this particular boss. You can:

• Mount an all-out effort to get his attention, focusing on getting him into situ- ations in which he cannot avoid dealing with you for at least a few minutes.

• Decide to do your own thing, doing your job as you see fit and handling all decisions that arise regardless of where they fall relative to your scope of authority.

Determine how you might develop these approaches, including what specific steps you might consider in either or both cases, and identify all possible pitfalls and hazards present in both.

Case 22: Get Back to You in a Minute 69

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C a s e 23

tHe deleGated diGGiNG

Primary Topic—Delegation

Additional Topics—Leadership; Motivation

John Kaye, director of biomedical engineering, was discussing an information need with his boss, Peter Gideon. Both agreed that their equipment maintenance and repair records were not providing them with the kind of information they needed—nature of breakdown and failures, maintenance problems, and unique situations encountered— to design an effective preventive maintenance program.

Asked Gideon, “Since we started your department 18 months ago, haven’t we kept records of all the work done by you and your technicians?”

“Sure we have,” answered Kaye, “but they won’t tell us anything useful without lots of digging. We have 18 months worth of completed work orders filed in chrono- logical order.”

“Could someone sort through all of the work orders and separate them by kinds of problems? Perhaps see if there are any patterns to the various kinds of work required?” asked Gideon.

“I suppose so,” Kaye said, “but I certainly don’t have the time to do it myself, and both of my techs are swamped with open work orders. I guess I could always delegate it to my secretary, Sharon—just tell her what I want and let her go about collecting it in her own way.”

Gideon asked, “Does Sharon know the language? Know all of the work order codes? Perhaps you might want to provide her with some detailed instructions and maybe even give her a deadline for completion or a schedule for finishing various steps of the project.”

“I don’t see much point in delegating the job if I’m going to have to do all that work just to get ready,” said Kaye. “It ought to be enough for me to give her my objectives, suggest an approach, let her add her own ideas to it, and turn her loose.”

Gideon asked, “Could this become a regular part of her job?” “It should. Hers or somebody’s. Then we could monitor the kinds of information

we need rather than having to dig for it like we are now,” Kaye answered.

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“Between us, we seem to have thrown out three ways of using Sharon on this project,” said Gideon. He outlined the three possibilities:

1. Tell her what is wanted and let her do it in her own way. 2. Provide her with expected results, a procedure or other instructions, and a

schedule or a deadline. 3. Tell her what is wanted, recommend an approach, and turn her loose.


• Assuming Sharon is qualified for the project, what should determine whether John Kaye does indeed assign the task to her (as opposed to doing it himself or looking for another way)?

• Identify the advantages and disadvantages of the three possibilities outlined by Peter Gideon.

• Which of the three approaches would you recommend in this instance? Why?

Case 23: The Delegated Digging 71

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C a s e 24

tHe seCoNd CHaNCe

Primary Topic—Delegation

Additional Topics—Leadership; Motivation; Time Management and Personal Effectiveness

John Kaye, director of biomedical engineering, felt the pressure of having too much to do. He knew he was not giving a number of matters the attention they deserved, including a special work-order analysis project he had hastily assigned to his sec- retary, Sharon. Sharon had already interrupted him with questions five times this week—and today was only Tuesday. He fully expected another such interruption at any time, and he had decided that when it occurred he could react in one of three ways. He could:

1. Review what Sharon had accomplished so far, show her where she might be going wrong, and help her plan out the rest of the task.

2. Assume active responsibility for the project and finish it himself. 3. Thoroughly and patiently answer her current question and hope that this

would be sufficient to keep her going without having to interrupt him again.


1. To which of the three foregoing questions should John Kaye give the most serious consideration?

2. Why?

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C a s e 25

tHe bUNGled assiGNMeNt

Primary Topic—Delegation

Additional Topics—Communication; Criticism and Discipline; Leadership; Motivation

“I’m afraid that this report of yours is practically useless,” said John Kaye, director of biomedical engineering, to his secretary, Sharon. “You used some wrong numbers in several critical places, and I’ve found enough errors in arithmetic to make me doubt the value of any of the percentages you came up with. Frankly, Sharon, I’m surprised. This isn’t your kind of output at all.”

“I know it isn’t,” Sharon said. “I didn’t feel good about it while I was doing it, but I did the best I could do with what I had. Remember, this isn’t my normal kind of work at all.”

Kaye said, “You might have asked a few more questions if you had doubts about where you were going. When I didn’t hear from you these last several days I felt that everything must have been going okay.”

“That wasn’t so,” said Sharon. “I was snowed, and I knew it. I asked you four or five questions during the first 2 days, remember? But you seemed annoyed with the interruptions. You made me feel like I shouldn’t be bothering you. So I decided to tough it out and do the best I could by myself.”

“That was the wrong decision,” Kaye said. “You may have done no more than remind me that I should never delegate an assignment unless I know for certain that the person is qualified to handle it.”

“It seems to me that if you need that kind of certainty you’ll never delegate any- thing. Or at least anything that’s new and different.”

Kaye shrugged and asked, “What do you think went wrong here? Didn’t I com- municate my needs clearly when I assigned the job?”

“Yes, you did,” Sharon answered. “At least I felt that I knew what you wanted of me. But once I got into the job the questions began to pop up—all sorts of things that I didn’t expect and didn’t know about—and before I knew it I was really in the woods. And you seemed so busy that I quickly came to feel uneasy about bothering you.”

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“We seem to be left with two open questions,” said Kaye. “First, what do we do to salvage this particular assignment? Second—and probably more important—what can we do to keep this sort of thing from happening again?”


Offer your detailed suggestions for dealing with the two questions posed by John Kaye in the final paragraph of the case.

74 Case 25: The Bungled Assignment

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C a s e 26

it isN’t iN tHe Job desCriptioN

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Delegation; Leadership; Motivation

George Morton, the hospital’s maintenance supervisor, felt growing frustration with the behavior of mechanic Jeff Thompson. Morton considered Thompson a good mechanic, and this opinion was regularly reinforced by the consistently high quality of Thompson’s preventive maintenance work and by his success at difficult repair jobs. The problem stemmed from Thompson’s apparent lack of motivation; he seemed always to need to be told what to do next. If not directly instructed, when he finished a job he would take a prolonged break until Morton sought him out and gave him a specific assignment.

Morton’s frustration peaked one day when a small plumbing problem got out of hand and became a large problem. He knew that Thompson must have seen the leak- ing valve, because it was beside the pump on which Thompson had been working. However, when Morton asked why he had done nothing about the valve, Thompson said, “Plumbing isn’t part of my job.”

“You could have at least reported the problem,” Morton said. Thompson shrugged. “There’s nothing in my job description about reporting

anything. I do what I’m paid to do, and I stick to my job description.” “You certainly do,” said Morton. “Jeff, you’re a good mechanic. But you never

extend yourself in anyway, never reach out and take care of something without being told.”

“I’m not paid to reach out and extend myself. You’re the boss, and I do what I’m told. And I do it right.”

“I know you do it right,” Morton agreed, “but I also know that you usually take longer than you need to. I know you’re capable of giving a lot more to the job, but for some reason or other you’re not willing to work up to your capabilities.”

Again Thompson shrugged. “I stick to my job description and do what I’m told.”


Putting yourself in George Morton’s position, consider some possible ways of deal- ing with employee Thompson. Provide a number of steps or guidelines that you might recommend in an attempt to get Thompson to perform more in line with his capabilities.

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C a s e 27

delayed CHaNGe of CoMMaNd

Primary Topic—Change Management

Additional Topics—Communication; Decision Making; Delegation; Motivation

With full notice to administration and with the knowledge of his staff, the manager of information services left the hospital to take a more responsible position else- where. Within the department it was assumed that Mr. Smith—“Smitty” to almost everyone—would move up from senior systems analyst and become manager. How- ever, a week passed and no appointment had been made.

The week became several weeks. The finance director, to whom the information services manager normally reported, began to make the administrative decisions for the department. Smitty was left with the growing task of overseeing the functions of the group in addition to performing his regular work.

Department personnel became aware that the hospital was advertising for an information services manager and that the finance director was conducting inter- views. However, nobody was hired. Finally, after the group had been without a manager for 6 months, Smitty was elevated to data processing manager and was immediately authorized to hire a replacement systems analyst.


1. For the period during which there was no manager, how would you assess Smitty’s position from the department’s viewpoint? The finance director’s viewpoint? Smitty’s own viewpoint?

2. How would you assess Smitty’s position after he was finally made manager?

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C a s e 28

tHe tiGHt deadliNe

Primary Topic—Time Management and Personal Effectiveness

Additional Topics—Decision Making; General Management Practice

“Just one day out with the bug and the work comes pouring in,” said nursing office manager Susan Wagner. “You won’t believe everything I’ve got to do. It took half an hour to sort this stuff and decide what my priorities are.”

“What’s first?” asked secretary Betsy Adams. “The hottest item of real importance is the monthly overtime report. It’s due the

day after tomorrow. Trouble is, it takes 3 to 4 hours and right now I’ve got just”— Susan looked at her watch—“three-quarters of an hour before I jump into a series of interviews that will last the rest of the day.”

“I know that report is a bear,” Betsy said. “Remember, I’m the one who types it. When are you going to have it ready?”

“I was thinking of getting it started right now and finishing it tomorrow morning, though it’s a pain to try to pick up the calculations again once they’ve been started and dropped.”

Betsy said, “Our next 2 days are fairly open.” She grinned as she added, “Maybe wait and do it on the day it’s due? There’s nothing like a little deadline pressure to make us work efficiently.”

“More pressure I can do without,” Susan responded. “I’m half thinking that I should jump into it tomorrow and save the final day as a buffer in case I get inter- rupted or something goes wrong.”

Betsy shrugged and said, “Well, I’ll be ready when you’re ready for me. When can I probably expect it?”

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In their conversation, Susan and Betsy identified three choices for approaching the overtime report:

1. Start now and finish tomorrow. 2. Do it entirely tomorrow. 3. Do the report on the day it is due.

Put yourself in Susan’s position and select the approach you would take. Justify the approach by describing its advantages and by noting the disadvantages of the other alternatives.

78 Case 28: The Tight Deadline

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C a s e 29

teN MiNUtes to spare?

Primary Topic—Time Management and Personal Effectiveness

Additional Topics—Decision Making; General Management Practice

You are the hospital’s manager of supply, processing, and dispatch (SPD), and you report to the director of material management.

This morning you returned to work following a 3-day absence to find your in basket overloaded and your desk littered with telephone message slips. You were greeted by your secretary, Ellen, who informed you that you were expected to sub- stitute for your boss at an outside meeting today. You will have to leave no later than 9:30 am to get to the meeting on time, and you know you can plan on being gone for the remainder of the day.

You are left with 1 hour during which you can start making order of the chaos on your desk before leaving for the meeting. True to your usual pattern, you set about reviewing the items on your desk, message slips as well as the contents of the in basket, and creating separate stacks according to apparent importance or likely priority. You feel that you can perhaps get sufficiently organized to begin work the following day with emphasis on your most important tasks.

Halfway through your hour of organizing, Ellen enters to say, “The finance director, Mr. Wade, is here. He says he wants 10 minutes of your time to discuss a minor question having to do with last month’s operating expense report. Shall I tell him you’ll call him? Or that he should give you a memo about it?”

You cannot help feeling that the last thing you need at this moment is an inter- ruption, especially for something that is not urgent. It occurs to you that Ellen has described two possible choices for you, to which you have quickly added another, so that you have the following three options:

1. Say that you cannot get involved at the moment, but that you will call Mr. Wade the following morning.

2. Ask for a memo detailing the problem so that you can take care of it when time is available.

3. Grant the request for a meeting then and there, and try to limit the discussion to 5 to 10 minutes.

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• Identify the advantages and disadvantages of each of the three choices. • Indicate your most likely choice, and give your reasons for making this


80 Case 29: Ten Minutes to Spare?

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C a s e 30

assiGNMeNt aNd reassiGNMeNt

Primary Topic—Delegation

Additional Topics—Communication; Leadership; Motivation

Carol Ames was director of inservice education at James Memorial Hospital. She reported to Ann Baker, assistant director of nursing, who in turn reported to Helen Carey, director of nursing.

One morning, as Carol sat working in her office, Ms. Carey entered and said, “Come and have a cup of coffee, Carol. There’s something I’d like to talk with you about.”

When they had gotten their coffee and found seats in a quiet corner of the caf- eteria, Ms. Carey said, “How busy are you these days, Carol? There’s something I’d like you to do for me.”

Carol answered, “I’m almost overloaded right now. I don’t have much time to spare.”

“I didn’t think your teaching schedule was too full just now, at least not since you finished the nursing leadership program,” Ms. Carey said. “What’s taking up your time?”

“It’s true that my class schedule is only moderate right now. That’s probably why Ann just gave me a couple of new assignments.”

Ms. Carey asked, “What assignments?” “For one thing, she’s given me just 2 weeks to compile an inventory of instruc-

tional materials and training aids throughout the hospital. Also, she’s having me do a report about the costs of supplying employee education. It’s long and com- plicated, and it has to be submitted to the State Hospital Association by the first of the month.”

Ms. Carey said, “Well, it has suddenly become very important that we get moving on the development of our new nursing audit criteria. I think you suspected this was coming. We’re under pressure from administration to do something about nursing audits, and we don’t have much time to do it.”

Carol asked, “Where do I fit in?” Ms. Carey answered, “You’re in the best position to take charge of the nursing

audit committee. It will be up to you to convene the committee as necessary and get the criteria developed on time.”

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“But what do I do about the inventory and the cost report? Surely I’m not going to have time for everything.”

“Of course you won’t have time for everything,” said Ms. Carey. “Ann will have to find some other way to get the cost report done, and the inventory will just have to wait.”

“Is Ann aware of this?” Carol asked. “No,” responded Ms. Carey. “I want you to bring her up to date. And please

stress the importance of the audit activity.” At this point Ms. Carey excused herself. Carol got a second cup of coffee and sat

by herself to ponder the situation. She felt that her immediate supervisor, Ann, had been quite clear about what she expected over the coming weeks. However, Carol now found herself wondering how to tell her boss that her commitments had been changed by higher authority.


1. What fundamental management error was committed? 2. What would you recommend that Carol Ames do about the situation in which

she finds herself at present?

82 Case 30: Assignment and Reassignment

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C a s e 31

tHe UNreqUested iNforMatioN

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Leadership

One morning more than a half hour before the start of your department’s normal working hours you were enjoying a cup of coffee in a quiet corner of the cafeteria, sorting through some low-priority reading material, when you were approached by one of your employees. The employee, Nellie Morris, one of your most senior staff in years of service, seated herself across from you without invitation and said, “There’s something I have to talk to you about—I’ve simply waited far too long.”

Nellie Morris proceeded to tell you—“In strictest confidence, please, I know you’ll understand”—that another long-term employee, Marge Greely, has been making a great many derogatory comments throughout the department about you and your management style and generally calling your competence into question.

You heard a considerable number of “she saids” and “she dids” and a smattering of apparently second-hand or twice-told tales, but no specific incidents that you could identify jumped out at you and initially you were too surprised to ask for clarification.

For the greater part of 10 minutes Nellie showered you with criticism of you, your management style, and your approach to individual employees, all attributed to Marge Greely. On exhausting her litany Nellie proclaimed that she did not ordi- narily “carry tales,” but that she felt you “had a right to know, for the good of the department—but please don’t tell her I said anything.”


Should you:

• Thank Nellie for her concern and ask her to report anything else she might hear? • Acknowledge her concern for the good of the department, but ask her to bring

you no further stories? • Thank her, ask her to say nothing to anyone else, and decide for yourself to

keep an eye on Marge Greely?

What would you do instead of or perhaps in addition to taking one of the preceding three approaches?

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C a s e 32

did He HaVe it CoMiNG?

Primary Topic—Criticism and Discipline

Additional Topics—General Management Practice; Leadership; Motivation;

“That was an absolutely idiotic thing to do,” said Peter Jackson, the hospital’s chief operating officer.

“In what way?” asked recently hired purchasing manager Dan Smither, redden- ing noticeably at his boss’s words.

“You fiddled around with your price break calculations so long that you stalled us right into a significant price increase. Thanks to this one move of yours, we’ll go about $10,000 over budget on paper products for the year.”

“So I made a mistake,” Smither retorted. “Mistake? More like a major blunder. Ten thousand bucks out the window. I

don’t know what ever convinced you that you know the paper market. The way prices have been going, you know you’ve got to get in and cut a contract fast once the sup- pliers know what you need.”

Jackson shook his head and repeated, “Ten thousand!” Smither glared down at Jackson. “So I slipped—and I know it, although the

way we jump around among group contracts and our own deals, I can hardly blame myself. But I do know that in the 2 months I’ve been here I’ve saved twice $10,000 in other areas. How come I don’t hear about those?”

“Because that’s your job,” Jackson snapped. “Well, maybe I need a new one,” Smither said, and stormed out of the office.


• Respond to the title question: Did he have it coming? • Assuming that Jackson was right and that Smither’s error did constitute a

major blunder, how should Jackson have proceeded with the discussion?

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C a s e 33

it’s His Job, Not MiNe

Primary Topic—Delegation

Additional Topics—Leadership; Motivation

As administrative manager of the hospital’s diagnostic imaging department, you have found your workload increasing to the extent that you now definitely need assistance, especially with some of your nonmanagerial duties. One of the first tasks that comes to mind as available for delegation is your monthly statistical report. The report itself is fairly easy to create, but gathering the data is a time-consuming activity.

You select an employee to do the report, and you provide the necessary instruc- tions. In doing so, you are certain to choose an employee who you believe is capable of doing a decent job and who has sufficient time available. The individual you select expresses no opinions or feelings for or against taking on the report.

Two days after assigning the task, you find that the report has not yet been started. You remind the employee; the employee tells you that completion of other work has delayed the data gathering. You emphasize the need to get the report done on time, but the assigned person seems in no particular hurry to get into the task.

One day later you accidentally overhear a portion of a conversation in which the employee to whom you have assigned the report says to another employee, “. . . his lousy statistics, and I think he ought to do it himself. It’s in his job description, not mine.”


• Describe what you might have done incorrectly in delegating the statistical report to this particular employee.

• Decide what, if anything, you can do to try to correct the employee’s attitude as revealed by his comments to the other employee.

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C a s e 34

i Used to rUN tHis UNit

Primary Topic—Change Management

Additional Topics—Decision Making; Delegation; Leadership

For several years Community Hospital, a small, rural institution, had difficulty find- ing enough registered nurses to fill all of the positions ordinarily held by RNs. As a result of this shortage, for nearly 2 years Unit 2-A had a licensed practical nurse, Ms. Adams, serving as head nurse. She had been appointed as “acting” head nurse, but she was in place for so long that the “acting” designation had fallen out of use.

Recently a registered nurse, Ms. Williams, was hired as head nurse of 2-A. Ms. Adams was left within the unit as one of the staff. Although the change was clearly a demotion for Ms. Adams in terms of leaving supervision, her pay was left unchanged. In fact, she had recently received an increase after a favorable performance evalua- tion. However, these changes left her “red circled,” carrying more than the maximum rate for an LPN with no room left for further financial advancement.

Ms. Adams said little about the change for some weeks, but neither was she particularly friendly or communicative. When finally Ms. Williams was able to get Ms. Adams to speak about the change in her assignment, Ms. Adams said, “I can see why the hospital prefers a registered nurse in charge of the unit. But I ran this unit for 2 years. My evaluations have been good; I’ve gotten regular raises and there’s never been any real criticism of my work. Sure, I was called “acting” head nurse at first; but that got dropped after a while, and since then I’ve been given no reason to believe that the job was anything but permanent.”


1. How should Ms. Williams go about managing Ms. Adams so as to minimize hard feelings and gain her cooperation?

2. If Ms. Adams becomes resentful to the point of being uncooperative, what alternatives can Ms. Williams pursue?

3. How could this problem possibly have been avoided in the first place?

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C a s e 35

yoUr word aGaiNst tHe boss’s

Primary Topic—Communication

Additional Topics—Authority; General Management Practice; Leadership

In many ways it is a typical day. You find yourself at a meeting chaired by your department head. Also present are another department head and four first-line manag- ers other than yourself. The subject of the meeting is the manner in which the organi- zation’s supervisors are to conduct themselves during the expected union organizing campaign. Your department head seems not in the best of moods, possibly because this important meeting started late and most parties feel pressured to hurry so as to make subsequent commitments.

Your boss makes a statement about management’s behavior during organizing. You are surprised to hear what he said. Earlier that same day you had read a legal opinion that was exactly opposite to the boss’s statement and made his intended direction illegal. In other words, were he allowed to proceed along the lines of his statement he would be actively advocating illegal management activity.

You interrupt with, “Excuse me, but I don’t believe it can be done quite that way. That might leave us vulnerable to an unfair labor practice charge.”

Obviously annoyed with the interruption your department head snaps, “This isn’t open to discussion. You’re wrong.”

You open your mouth to speak again but think better of doing so on seeing the boss’s expression.

You are certain the boss had inadvertently reversed a couple of critical words and described a “cannot-do” action as a “can-do” action. Unfortunately, you have been abruptly silenced, and you are in a conference room full of people while the docu- ment that could prove your position is in your office.


1. What do you believe you can do to set the matter straight without incurring further disfavor with your boss?

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C a s e 36

yoU’re tHe boss

Primary Topic—Delegation

Additional Topics—Communication; Employee Problems and Problem Employees; Leadership; Motivation

“I don’t think this is the approach to take at all,” said accountant Harold Winslow to his manager, finance director James Ross.

This response had not been unanticipated; Ross, in his second month on the job, had already come to expect Winslow to oppose almost every assignment he handed out or every course of action he recommended. Ross was especially frustrated with his less-than-satisfactory relationship with Winslow because he recognized this long- time employee of the hospital as a capable accountant who was highly knowledge- able of healthcare finance and reimbursement.

Ross asked, “And why do you think it isn’t right?” “It just isn’t, that’s all,” said Winslow, who then added, “It’s unlike anything

we’ve ever done. If this sort of thing really worked we’d have done it long ago.” “Was this plan ever considered? Or one like it?” Winslow shrugged. “Don’t know.” Ross took a deep breath. “Look Harold,” he began, “I’ve got my orders—and

there are orders involved—and I believe this is probably the best way of doing what we’ve got to do. And since you have more knowledge of this area than anyone else in the organization, I’ll need you to take the lead on this project.”

“Of course I’ll do it, if that’s what you’re telling me to do,” said Winslow. “More than that,” said Ross. “I need you to own the project, to innovate, to look at

it in ways that never occurred to me. I need you to do the best job you can do on this.” Again Winslow shrugged, his mask of skepticism unchanged, and he said, “You

tell me to do it, I do it. You’re the boss.” After they parted Ross could not help feel uneasy about the assignment, even

though Winslow was technically the best person available.


1. What can Ross do to try to get Winslow to willingly apply his full knowledge and experience to the assignment?

2. What might be behind Winslow’s apparent lack of motivation, and how should Ross address this problem overall?

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C a s e 37

The New Broom

Primary Topic—Change Management

Additional Topics—Communication; Delegation; Employee Problems and Problem Employees; Leadership; Rules and Policies

Shari Daniels, the new nurse manager for the emergency department, was not feeling particularly happy with her lot in organizational life. She was just 1 month into her new role and already she felt like walking away from the job.

The problem, she decided, was staff resistance to change. She knew that a cer- tain amount of resistance to a new manager and her ways of doing certain things was inevitable, but it seemed to Shari that everything she said or did was resisted simply because it came from her. There was so much she needed to do—the department had coasted literally for years under an apathetic manager, and the emergency depart- ment customarily received little attention from top management—that she had hardly known where to begin. And with so much to be done, she had jumped in and begun fixing everything that needed fixing as rapidly as possible.

As Shari related to her friend Sue Ross, also a nurse manager at the hospital, “I resurrected the dress code and brought it up to date; you have no idea what was being tolerated in the way of appearance. And I put a fast stop to personal telephone calls and the use of food and drink and reading matter within view of the public. In addition, I’ve started to enforce the hospital’s policies on attendance and tardiness; I can’t tell you how long those people have been allowed to wander in and out almost whenever they felt like it.

“And what do I get? A nearly complete lack of support except, fortunately, for some ‘It’s about times’ from a couple of the older staff. I’ve held a staff meet- ing every week since I started, and I’ve tried hard to sell them all on the need to improve the general appearance and level of professionalism of the department. But all I get is a lack of support, lots of apparent bitterness, and resistance to everything I say.”

Sue asked, “It sounds like you inherited a terrible mess. But are you sure you’re not trying to do too much too quickly?”

“But it’s such a mess that I’ve got to move quickly,” Shari answered. “Besides, we’re less than a year away from our next Joint Commission survey. What am I going to do about that?”

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1. Based on just the preceding information, what do you believe is probably causing most of the resistance Shari is encountering?

2. How would you recommend that Shari proceed in addressing the situation she faces?

90      Case 37: The New Broom

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C a s e 38

No BeTTer ThaN I Used To Be?

Primary Topic—Communication

Additional Topics—Change Management; Employee Problems and Problem Employees; Leadership; Motivation

Supervisor Carrie Johnson was not at all comfortable with the way the performance appraisal interview with Helen West was going. Helen seemed uncommunicative; she would speak only when asked something, and then only briefly, and Carrie’s two or three attempts to warm the atmosphere with some light remarks had no vis- ible effect.

Except for a brief probationary review of sorts 3 months after Helen’s transfer to Carrie’s unit, this was the only real opportunity made available for a thorough review of Helen’s performance. Helen had initially seemed eager to have this meeting with Carrie, but upon sitting down together and laying out the completed appraisal forms Helen fell largely silent and seemed to withdraw.

Growing increasingly frustrated with Helen’s apparent unwillingness to partici- pate, Carrie finally stopped in the middle of trying to make a point and said, “Helen, something about this discussion is bothering you. Out with it.”

“Nothing’s bothering me,” answered Helen. “I know you well enough to know that you’re upset about something. Out with

it, so we don’t simply wind up wasting our time here.” For a moment Helen said nothing. Then she rapped a fingertip against the

appraisal form and said, “It’s this—my rating.” “There’s nothing wrong with it,” Carrie said. “It’s comfortably above stan-

dard performance and very close to the average of a very good group of people on this unit.”

“It’s lower than any score I ever got from Sue Collins,” Helen said, mentioning her previous supervisor. “I know I’ve done at least as well here as I ever did there, but you’ve given me my lowest score in nearly 5 years.”

“Helen, this is a good evaluation score,” Carrie insisted. “I can’t agree,” Helen said. “All of you who do these use the same forms and

the same job descriptions, and the evaluations ought to be consistent. Compared with Sue, are you telling me that after all my hard work I’m still no better than I

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used to be? Or even that my performance is slipping because I had a higher score last year?”


1. If you found yourself in Carrie’s position, how would you try to explain the differences in evaluation scores to this employee?

2. What, if anything, do you believe the organization should be doing about its performance appraisal system?

92      Case 38: No Better Than I Used to Be?

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C a s e 39

The INcompaTIBle employees

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Criticism and Discipline; Leadership

“I’m so frustrated by the situation in my department that I’m ready to get rid of two fairly good employees just for the sake of tranquillity,” said supervisor Annette Johnson.

“I don’t see why you’d want to get rid of good employees at all,” commented fellow supervisor Barbara Wilson. “Sometimes the good ones are pretty hard to come by.”

Annette said, “I said fairly good; the two of them would be practically ideal if I could keep them out of each other’s way. But they work in the same office—like we all do, 12 or 13 people in one large area—and they just don’t get along.”

Barbara asked, “Personality conflict?” “Don’t know, but it’s a possibility. If one of them says something’s black the

other says it’s white, seemingly just for spite. If anything’s at all wrong with one’s work input or anything’s out of place at one station, the other is always blamed. They seem always to be competing, and if one sees the other as gaining favor in any way the jealous behavior becomes intolerable.”

“Maybe they deserve each other,” Barbara said. “Why not just stick the two of them in the farthest corner of the department and leave them be?”

“I can’t,” Annette said. “They both have to relate to about half of the rest of the staff on any given day, and when they’re not getting along the tension affects others in the work environment. It gets so bad that sometimes these two people—who are supposed to be communicating regularly during the day—will speak to each other only through a third party.”

“Childish,” said Barbara. “Childish, yes,” said Annette, “but the effects of their behavior are serious. And

they’ve been talked to about it, a couple of times in fact, but even though things simmer down a little when they’re spoken to they’re back at each other’s throats in a week.”


Putting yourself in the position of supervisor Annette Johnson, describe how you would go about addressing the problem presented by the incompatible employees.

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C a s e 40

where does The TIme Go?

Primary Topic—Time Management and Personal Effectiveness

Additional Topics—Communication; General Management Practice

Kay Thatcher, director of staff education, decided she had to get organized once and for all. Recently her work days had been running well beyond quitting time, cutting noticeably into the time required by her family responsibilities, but instead of going down, her backlog of work was growing.

Inspired by an article she read about planning and setting priorities, Kay decided to try planning each day’s activities at the end of the preceding day. This past Mon- day Kay came to the office with her day planned out to the last minute. During the morning she had to complete a report on a recent learning needs analysis, write the performance appraisals of two part-time instructors, and assemble the balance of the materials for a 2-hour class she was scheduled to conduct that afternoon. After lunch she had to conduct the class, complete a schedule of the next 3 months’ train- ing activities (now 10 days overdue), and prepare notices—which should have been posted this very day—for two upcoming classes.

Kay got off to a good start; she finished the report before 10:00 am and turned her attention to the performance evaluations. However, at that time the interruptions began. In the next 2 hours she was interrupted six times—there were three telephone calls and three visitors. The calls were all business calls. Two of the visitors had legitimate prob- lems, one of them taking perhaps 30 minutes to resolve. The other visitor was a fellow manager simply passing the time of day. Neither performance appraisal was com- pleted, and the training materials were assembled in time for the class only because Kay threw them together during lunch while juggling a sandwich at her desk.

Kay’s afternoon class ran 20 minutes overtime because of legitimate discus- sion and questions. When she returned to her office she discovered she had a visitor, a good-humored, talkative sales representative from whom Kay sometimes bought materials, who “happened to be in the area and just dropped in.” The sales representa- tive stayed for more than an hour and a half.

Once again alone, Kay spent several minutes simply wondering what to do next. The performance appraisals, the 3-month schedule, the class notices—all were overdue. Deciding on the class notices because they were the briefest task facing her, she dashed off both notices in longhand and asked the nursing department secretary

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to type them, run them off, and post them immediately. Then she set about to tackle the training schedule.

When Kay next looked up from her work it was nearly an hour past quitting time. She still had a long way to go on the schedule and had not yet started the two performance appraisals. As she swept her work aside for the day she sadly reflected that she had not accomplished two thirds of what she intended to accomplish that day in spite of all her planning. She decided, however, to try again; when she could get a few minutes of quiet time late in the evening, she would plan out her next day’s activities.

On her way out of the hospital she paused at the main bulletin board to assure herself that the class notices had been posted. The small satisfaction she felt when she saw the notices vanished instantly when she discovered that both were incorrect—the dates and time of the two classes had been interchanged.


1. What errors did Kay commit in her approach to planning and the establish- ment of priorities?

2. In what respects could Kay have improved her use of time on the Monday described in the case?

Case 40: Where Does the Time Go?      95

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C a s e 41

sylvIa’s choIce

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; Hiring and Placement; Motivation

When head nurse Sylvia Miller was faced with the opportunity to promote one of her staff members to a charge nurse capacity, she found that she was not lacking apparently qualified employees. In fact, after sorting through several possibilities Sylvia was left with two equally appealing candidates. Jane Wilson and Hilda Ross, in Sylvia’s opinion the two 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 avail- able. 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 creat- ing 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.”

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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?

Case 41: Sylvia’s Choice      97

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C a s e 42


Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; Leadership

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 chroni- cally had difficulty recruiting and retaining special procedures technologists. You presently have your allotted full staff of three special procedures technologists, but these people are fully utilized and at least two 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 com- ments 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.”


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


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C a s e 43

To moTIvaTe The UNmovaBle

Primary Topic—Motivation

Additional Topics—Communication; Delegation; Leadership; Rules and Policies

“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 moti- vating 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 does 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 pro- mote 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 examina- tion 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.”

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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.

100      Case 43: To Motivate the Unmovable

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C a s e 44

who’s The Boss?

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; General Management Practice; Leadership

“Since we began our total quality program I’ve gotten genuinely confused about who’s really running the department,” said supervisor Carrie Block. “I certainly don’t feel like it’s me these days.”

“Why is that?” asked her friend, Janet Mason. “We’ve got all these employee project groups working on a lot of things that

used to tie me up so much, and maybe that’s good. But it seems like I’m just not doing some of the things I’ve always been paid to do.”

Janet asked, “Like what?” “Like making some of the really hard decisions, like scheduling—who’s going

to work when has always been touchy—and like deciding on capital equipment pur- chases. These have always been tough, but I accept that. After all, it’s what they pay me for. But I seem to have lost control.”

Carrie continued, “It isn’t bad enough that I’ve got a dozen people going off in their own directions talking about this ‘empowerment’ stuff. There’s also the problem of Freddie the Expert.”

“Who’s that? I haven’t heard you mention a Freddie before.” “Just hired him a couple of months ago,” Carrie explained. “He seemed bright

and willing to work, maybe too much so. Willing—to take over, apparently. He’s never managed anything in his young life, but he’s taken a couple of management courses and he has all the answers.”

“Thus the ‘expert?’” Carrie nodded. “All the answers,” she repeated, adding, “and always absolutely

right—just ask him.” Carrie sighed wearily and said, “Between Freddie always challenging what I

say and telling everyone how to do their jobs, and these quality project groups who seem bound and determined to make all the decisions, I’m left feeling like I’ve been deposed. Who’s the boss, anyway? And if it isn’t me, what am I here for?”

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1. What would appear to be the major problems Carrie is experiencing with her organization’s total quality process, and what should be her true role in the organization?

2. What should Carrie be doing about “Freddie the Expert?”

102      Case 44: Who’s the Boss?

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C a s e 45

BUT I’m really sIck!

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Criticism and Discipline; Rules and Policies

“I’m really up a tree as to what to do with Kelly,” said nurse manager Jane Babson. “I know she’s genuinely ill quite often, or at least I know she’s asthmatic and some of her absences seem to relate to that. She’s out often enough that her sick time is always used as fast as it’s earned, and she’s chipped away a lot of her vacation bank to cover illness. Yet she’s never out long enough to go on disability so I could get some reliable temporary coverage for a while.”

Personnel representative Diane Jones asked, “What happened with the other absence problem you mentioned some time ago? Wilson? Or was it Williams?”

“Wilson,” Jane said. “That one’s pretty clear cut. Sick time taken as fast as accrued, patterned absences—always before or after scheduled days off. Good health, at least by all appearances. She’s even been seen at the mall a couple of times when she was supposedly sick.”

“No problem dealing with Wilson,” she added. “A file full of warnings—next time she’s out.”

“What about Kelly?” Diane asked. “I’ve tried to work with Kelly about the time she’s missing. After all, I’ve got a unit

to staff and whether somebody is truly ill or just faking it, the work still isn’t getting done. And Kelly’s pretty quick to claim that she’s really sick—not like those others and their so-called mental health days, as she puts it—and she’s come pretty close to threatening me with some kind of legal action if she gets disciplined for absenteeism.”

Jane sighed heavily and asked, “Diane, what can I do about Kelly? And can I do something different about Wilson?”

Diane leaned forward in her chair and began, “Let’s consider what we’ve got here, and then we’ll look at options. First, . . . .”


Put yourself in the position of personnel representative Diane Jones and summarize the advice you would present to Jane Babson.

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C a s e 46

all ThaT empowermeNT Jazz

Primary Topic—Delegation

Additional Topics—Authority; Communication; Leadership; Motivation

“As a middle manager, I’ve got five supervisors to deal with on a daily basis,” said business office manager Susan Benton to Craig Williams, the hospital’s training manager. “Over the past several years, I’ve tried as hard as I could to use true par- ticipative management techniques in dealing with them, but this effort seems to be backfiring on me.”

“How so?” asked Craig. “Well, I’ve tried to delegate to them faithfully and completely—or I guess I

should say I’ve tried to empower them, using today’s more acceptable terminology— and I’ve encouraged them to do the same with the people who report directly to them.”

Craig asked, “What’s wrong with that? As long as you’re clear and up-front in dealing with the supervisors, they should be able to do the same with their employees.”

“The problem is that most of the five supervisors act like all I’m doing is trying to shift my duties and responsibilities to them. The one who’s been toughest to deal with, Ellie Patrick in the billing section, told me she wouldn’t dream of backing away from her responsibilities by sticking someone else with them.”

Craig nodded. “Kind of a ‘the buck stops here’ reaction?” “Exactly,” said Susan. “Ellie used that precise phrase in describing her attitude

toward her responsibilities. And her attitude toward my responsibilities as well, I guess, when she told me directly, ‘Don’t try to hand me all that empowerment jazz, either.’”


1. What is the difference between true delegation or empowerment and simply shifting duties and responsibilities?

2. How should Craig Williams advise Susan Benton to proceed in dealing with her five supervisors?

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C a s e 47

why doesN’T aNyoNe Tell me?

Primary Topic—Communication

Additional Topic—General Management Practice

On Monday of this week, business office manager Carrie Owens learned that one of her key staff members had decided not to return to work after her maternity leave. Carrie learned this first from one of her employees, but it was confirmed later that day by the hospital’s employee health service.

That same day, she was asked by two employees whether the hospital’s new policy on vacation accruals would affect their vacation banks. Since she had heard nothing on this subject, she asked them where their concern had come from. One employee said she saw it in writing in the accounting office; the other said, “Barry told me.” (Barry was the director of patient services and, not incidentally, Carrie’s immediate superior.) It was Wednesday before Carrie received a copy of the policy change.

The two foregoing occurrences left Carrie feeling that she was a step behind most of her employees in receiving information of importance to her department. This feeling was intensified on Thursday. That day she received a call from a fellow manager asking why she was not at an important meeting that was already starting. Hastily saying that she knew nothing about the meeting, Carrie dropped everything to attend. When she returned to her department after the meeting, she found an announcement for the meeting in her mail tray. It had not been there that morning when she emptied the tray as she did each day, but it was dated 5 days earlier.

By the end of the week, Carrie was feeling considerable frustration with com- munication practices within the hospital organization. As she said to a good friend over breakfast on Saturday, “I feel totally out of the mainstream of information, espe- cially when my employees hear about things before I do. Why doesn’t anyone tell me what’s going on?”


Unlike previous cases, this is not asking the reader to describe what is wrong in the situation. We can safely conclude that, for whatever reasons, communication within

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Carrie’s hospital organization leaves much to be desired. Rather, you are asked to suggest what Carrie can do—what actions she can take and how—to improve her overall communication posture in the organization and generally increase her chances of receiving the information she needs to do her job. In other words, what can she do to improve organizational communication for herself?

106      Case 47: Why Doesn’t Anyone Tell Me?

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C a s e 48

The dedIcaTed hIp-shooTer

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; Delegation; Motivation

“We’re not a really large organization as maintenance departments go,” said plant engineering manager Dan Stevens, “and because of our size I don’t have real full- time supervisors in the different sections. Rather, we use working leaders, people who do lots of the work themselves and supervise maybe two to five others. My problem is Bob Wade, the lead electrician, who has to manage two other electricians and a helper in addition to looking after his own workload.”

Assistant administrator Elias Woods asked, “What makes Wade a problem? The guy has spent most of this life here and he lives and breathes for this place. He treats every last circuit and device around here like it was his child.”

Woods shrugged and added, “If a person with Wade’s dedication is a problem, I can say only that we need a few more problems around here.”

“I’m not questioning Bob’s intentions at all,” said Stevens. “I know he’s incred- ibly dedicated to this place.”

“So?” “So he’s still a problem, even though he’s an outstanding electrician,” Stevens

answered. “He’s a working boss—emphasis on working. He pays most attention to what he—personally—is doing at the moment, and there’s no apparent rhyme or reason to how his task of the moment is chosen. There’s no visible organization in the group. Anything that comes up—well, Wade just shoots from the hip. Jobs get done well, but all the group’s efforts seem haphazardly applied, there are always problems and complaints—especially complaints about things that need attention—and except for Bob himself, nobody seems to know what to work on at any given time.

“I’d truly like to know,” Stevens added, “how to get this guy and his group focused on the job they’re supposed to be doing.”


Put yourself in the position of the assistant administrator and suggest how Dan Stevens might begin to turn around Bob Wade and the electrical group and make them more efficient and productive.

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C a s e 49

The paperwork sImply IsN’T ImporTaNT

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Criticism and Discipline; Motivation

“I’ve got this absolutely brilliant employee—probably the best patient-contact person out of the two dozen in the department, and clearly the most successful in terms of results—who drives me nuts by not keeping up with her documentation.” Manager Sharon Ward slapped the file folder on the desk in front of her and added, “Truly, Julia gets more positive results than anyone else, yet she consumes more of my time than any other two put together, even the ones who bend the attendance rules.”

Employee relations manager Jean Howell asked, “How can this person be so good—so ‘absolutely brilliant,’ as you put it—if she doesn’t document what she’s doing?”

“Because everything else is great,” said Sharon. “Her productivity is high, maybe the highest in the group, so that means she’s a revenue producer. Quite simply, she sees more patients on a consistent basis than just about anybody else, and her results are generally better, at least based on the number of personal referrals she’s received and the minimum number of complaints I’ve ever had about her work.”

“Isn’t documentation part of the job description?” Jean asked. “We generally require that anything done with, for, or on behalf of a patient be documented, and usually there are payment implications as well. That is, if certain documentation isn’t provided, we don’t get paid.”

Sharon said, “Hmmpf! Minimum documentation for billing purposes is just about all we get, and we have to drag that out of her. Our therapists are all on a pro- ductivity arrangement, so they know—even Julia knows—that their own income as well as the division’s depends on timely and accurate billing.”

“Then what’s the real problem?” “A chronic lack of complete visit reports. Almost never any real progress notes.”

Sharon spread her palms in a gesture of helplessness and continued, “Julia’s charts are a time bomb waiting for a state inspection or external audit, not to mention a profes- sional standards review. Yet every time I try to address the issue she brushes me off. I even caught her at a quiet time the other day and tried to bring up the problem, but

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she just gave me one of her standard little flip responses, something like, ‘You worry too much, Sharon. The paperwork just isn’t that important!’”


Put yourself in the position of employee relations manager Jean Howell and recom- mend a course of action for supervisor Sharon Ward to pursue in dealing with the professional with the delinquent documentation problem.

Case 49: The Paperwork Simply Isn’t Important      109

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C a s e 50

why shoUld I always Go The exTra mIle?

Primary Topic—Communication

Additional Topics—Authority: Leadership; Motivation

“I practically have to set a trap for my boss to get him to stand still and listen to me for 2 minutes,” complained maintenance supervisor Harry Jones.

“I could almost say that you’re lucky,” said Millie Phillips. “I wish I could get my boss off my back. All she’s ever doing is communicating.” Millie spoke the word “communicating” with considerable scorn.

Harry shrugged. “I wouldn’t have thought there was such a thing as too much communication. Half the time I’m in the dark as to what’s expected of me and my crew. Outside of scheduled preventive maintenance, that is.”

“There is such a thing as too much communication. I know my job, but I’m always being reminded how to do it. And if I’m being given a simple assignment I don’t have to have it explained three times and then asked five times along the way if I’ve got any questions. It’s a big, big pain.”

“I think I could use a little of that pain,” said Harry. “To get a few words in side- ways with that guy I’ve got to follow him down the hall at top speed, trying to talk while I’m nearly running.”

“How about department staff meetings?” asked Millie. “Or your regular meet- ing? You do have a regularly scheduled meeting with your manager? Every supervi- sor I know has one.”

“If so it’s everybody but me. And staff meetings are as rare as major natural disasters. Lots of staff meetings regularly scheduled, but always canceled for one reason or another.”

Millie inquired, “Have you ever asked about a staff meeting? Or requested a regular time for you to meet with him?”

“No.” “Or put any of your concerns in writing to him? Tried to nail him down to

answering on paper?” “I don’t think that’s my place,” said Harry. “He’s responsible for the operation

of the whole department, not me. He ought to have a real interest in communicating,

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and communicating well. I don’t see why I should have to reach out because he’s not doing what he should. Why should I always go the extra mile?”


Develop some individualized advice for both Harry and Millie to apply in dealing with their separate communication problems with higher management.

Case 50: Why Should I Always Go the Extra Mile?      111

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C a s e 51

doN’T Tell Them I saId so

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Leadership

Admitting supervisor Rita Malloy occasionally stayed an hour or so after normal business hours in search of some quiet time to catch up on mail and project work. The majority of the department’s staff went home at 4:30 pm, leaving two admitting representatives to cover later hours. However, one admitting representative had been making it almost a habit to seek out Rita on her late days and talk about other mem- bers of the department. This tale-carrying employee, Molly Nelson, worked a differ- ent shift from all others, starting at noon and ending at 8:30 pm, straddling two regular shifts to provide needed additional help during the afternoon and early evening.

Last Thursday, Rita had barely gotten organized and into her planned after-hours activity when Molly showed up at her door. Molly began as she usually did, with a pained expression and urgency in her voice, “Rita, there’s something I have to talk with you about for the good of the department.”

Molly proceeded to relate what went on when Rita was away at an all-day conference 2 days earlier, how three specific people—Molly named them without hesitation—had overstayed their lunch break by fully a half hour and how they could be counted on to do this every time Rita was absent.

Rita noted that Molly made regular reference to “the group,” an apparent clique of employees that centered about the three alleged lunchtime abusers. Rita had to agree that her staff seemed divided between the “ins” and the “outs,” with Molly, perhaps at least partly because of her unique schedule, definitely one of the “outs” as far as “the group” was concerned.

Although the lunchtime-abuse story was quite specific, complete with names, Molly’s comments became more general as she continued, “And I swear I don’t know how some of them have time for any real work, what with coupon clipping and all those personal telephone calls!”

Close to 10 minutes of reporting included, in addition to the foregoing, a strong suggestion that someone in the department was an active substance abuser while at work and a direct accusation that members of “the group” had been actively and openly criticizing Rita’s management of the department. When she had apparently exhausted her supply of information for this particular visit, Molly concluded with, “Really, Rita,

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some of these people have really got it in for you. They’re hurting this department, and something ought to be done about them. But don’t tell them I said so!”


How should Rita deal with Molly Nelson and the information she furnishes? Specifi- cally, should Rita:

• Take any action concerning the abuse of scheduled lunch breaks? • Do anything—if indeed there is anything she can do—about the effects of

“the group?” • Encourage Molly’s reports, but ask her to be more specific? • Discourage Molly’s reports altogether? • Initiate any follow-up concerning the alleged substance abuser?

Case 51: Don’t Tell Them I Said So      113

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C a s e 52

The oIl-aNd-waTer employees

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Criticism and Discipline; Leadership

Feeling nearly at the end of her rope in dealing with two constantly bickering employ- ees, supervisor Carrie Wilson sought counsel with personnel specialist Janet Baker.

“Janet,” Carrie began, “I truly don’t know what to do about Ellie and Nellie.” Janet responded, “Ellie and Nellie? Sounds like twins.” “Hah! More like bitter enemies. But maybe you’re onto something,” said Carrie.

“They’re about as much alike as some twins I’ve known—they’re both stubborn, uncompromising, and short-tempered.”

Carrie continued, “You know I’ve got a fairly small group. We’re stuck in an extra-small office where we’re always bumping into each other, and anyway we’re really required to work together closely most of the time.”

“So what’s the problem?” asked Janet. “Ellie and Nellie are the problem. Almost totally incompatible. Almost any con-

versation between them quickly degenerates into arguments and name-calling. They essentially do the same job and are forced by circumstances to work side by side most of the day.”

“How good are they at what they do? Any performance problems, either of them?”

Carrie answered, “Both are fairly highly productive, in fact the two best in the group as far as output is concerned. If I had to choose, though, I’d say Nellie is just a bit better. Nearly perfect work records, both of them, at least until I had to start talk- ing to them about their disruptive feuding.”

Janet asked, “How disruptive?” “The tension in the group is becoming unbearable. And although Ellie and Nellie

appear to be keeping up with the work very well, other staff’s productivity is begin- ning to suffer.”

“Where do things stand right now? Today?” Carrie said, “Big blowup this morning.” She released a long sigh and continued,

“I thought someone was going to get her eyes scratched out. Worst of it, though, was the effect on others. One of them, young Lorraine, finally screamed at both of them to shut up and ran bawling from the office. It’s really a mess, Janet, and unless

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you’ve got a better suggestion I’m going back to the department and give them both a strong written warning for misconduct, for actions disruptive to the department’s functioning.”


Putting yourself in the position of personnel specialist Janet Baker and develop an approach for Carrie to follow in dealing with the apparently incompatible employees.

Case 52: The Oil-and-Water Employees      115

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C a s e 53

GeTTING off The feNce: JUmp, fall, or pUshed?

Primary Topic—General Management Practice

Additional Topics—Decision Making; Leadership; Motivation

Without being aware she was doing so, Myrna Wallace was actually summing up the concerns of a number of her fellow supervisors in the Supervisor Skills Development Program when she said, “As a first-line manager I always find myself ‘straddling the fence.’ I came up out of this same group that I’m supervising. Because I have to work so closely with all these hourly employees—most of whom were my peers for a long time, not to mention my friends as well—I’m considered by many to be one of them, to be treated as they’re treated.”

Encouraged by several nods of assent within the group of 15 mostly new supervi- sors, Myrna continued, “On the other hand, my boss expects me to act like a member of management and certainly to perform as a manager.”

“On the fence is a lonely and thankless place to be,” came a mutter from the rear of the room.

Myrna smiled and added, “I wouldn’t put it quite that dramatically, but it can be an uncomfortable position. I really don’t like this on-the-fence feeling. I want to know how to handle my situation, given that I’d like to continue getting along with these people I’ve known for so long, but I’d also like to do what my boss expects me to do.”

The voice from the rear of the room said, “First thing, you’re going to have to get off the fence.”

Myrna turned and asked, “How?” Myrna turned again as the group’s instructor said, “You can jump off the fence as

you choose, fall off if you’re not careful, or get pushed off from one side or the other. Only partly your choice, but if you don’t jump down on your own you’ll eventually fall or be pushed. How do you want to do it?”


Advise Myrna how she could best approach getting “off the fence,” balancing her concerns for relations with the work group with the needs of her manager.

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C a s e 54

The vocally UNhappy camper

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; Criticism and Discipline; Motivation

“I have a problem with one employee that’s affecting the whole department’s per- formance,” said business office manager Carol Jamison, “and I’m wondering if I can refer that person to you to help find out what’s going on.”

“What does seem to be going on?” asked employee health nurse Agnes Wilson. “Who’s the employee?”

“It’s Jean Todd,” Carol answered. “A really longtime employee, one of the most senior in the group.”

Agnes nodded and said, “I’ve known her for years. What seems to be the problem?”

“I don’t know. As long as I’ve been there—you’re aware that I came in as manager from the outside, just 4 years ago—Jean’s projected an extremely negative attitude. She’s been here lots longer than I have, but I don’t know if she’s always been like that.”

“She’s been here over 20 years, and no, she hasn’t always been that way.” Carol said, “Jean turns out good work. In fact, it seems that a tall pile of work

or a minor workload disaster is made to order for her capability. She’s really very productive most of the time, but to listen to her constant griping you’d think she was the most unhappy person you ever met.”

Agnes asked, “What does she usually complain about?” “Just about everything. Me and my style. The hospital’s policies. Her coworkers.

Her pay and benefits. The work itself.” “What about her life outside of work?” “I think something’s going on but I don’t know what. She complains about life

in general just about as much as she gripes about work. And don’t ever get her on the subject of her oldest child!”

“If her work is so good, what’s the real problem? Outside of having her attitude in the middle of the department?”

Carol said, “I’m worried mostly about the other employees. Jean has alienated almost everyone. About once a week she has one of the others in tears, and two

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people have asked me to move their work stations farther from hers. One of my best billers has threatened to quit if I don’t do something about Jean.”

“That bad?” “Truly that bad. How can I turn her around before the other employees start



Respond to Carol’s question. How would you advise her to proceed in dealing with this employee whose attitude seems so disruptive?

118      Case 54: The Vocally Unhappy Camper

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C a s e 55

To maNaGe The maNaGer

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Leadership; Motivation

From the look on the face across the desk from her, human resources representative Margie Olson thought she had better pay special attention to what supervisor Nancy Wright was saying. Not ordinarily given to emotional displays, Nancy was clearly on the verge of tears as she spoke of increasing frustration and pressure that she appar- ently felt was to the result of the behavior of another supervisor.

“Please understand,” Nancy was saying, “that my job and the jobs of Linda Williams and Mark Allen are extremely interrelated. The three of us work at the same level and report to the same boss. Mark does just fine, and I don’t have any problems because of him. But Linda is making my life miserable and I don’t know how to change things.”

Margie asked, “Miserable how?” “Linda simply will not address any real problems that arise and she continually

puts off any decisions that have to be made.” “How does that affect you?” “It means I do her work, and so does Mark. At least the more difficult stuff. She

schedules disciplinary conferences to happen when she’s conveniently not going to be here. In the same way she procrastinates on decisions until someone else—usually Mark or myself—is forced to make them.”

Margie asked, “Why are you and Mark always so conveniently available to bail her out?”

“The way we’re organized, the three of us are set up to cross-cover each other’s areas on virtually a minute’s notice. Jane Worth set it up that way.”

At the mention of the three supervisors’ mutual boss, Margie asked, “What about Jane? Isn’t she aware of what’s going on with Linda?”

“I don’t know how aware she really is. Anyway, it seems like any time Jane calls Linda on the carpet for anything, Linda manages to shift the blame to someone else. Usually Mark or me. Remember, Linda was on the scene before I came here and before Mark was promoted. Linda and Jane go a long way back, and anyway I’ve never felt I could go to my boss with a complaint about a peer supervisor.”

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Nancy was silent a moment, strain evident in her expression. At last she said, “I don’t know how to fix this. I only know I can’t remain on this job forever picking up the slack for a supervisor who refuses to be accountable.”


Put yourself in Margie’s position and advise Nancy how to proceed in the matter of the apparent responsibility dodging by a fellow supervisor.

120      Case 55: To Manage the Manager

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C a s e 56

The weekly sTaff meeTING

Primary Topic—Meeting Leadership

Additional Topics—Communication; Leadership; Time Management and Personal Effectiveness

There are 15 people in your department. It has been your longstanding practice to hold a weekly staff meeting at 3:00 each Wednesday afternoon. Rather, we should say you attempt to hold it at 3:00 pm because about half of your employees are more than 5 minutes late, and two or three of them are usually late by 15 minutes or more.

You have made repeated announcements about being there on time, but to no avail. Come Wednesday at 3:00 pm, you usually find yourself and the same six or seven punctual attendees present and waiting for the latecomers.


Without immediately turning to disciplinary action (which you should always regard as the last resort), what can you do to encourage punctuality in attending your staff meetings?

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C a s e 57

where are They wheN I Need Them?

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Delegation; General Management Practice

Jenny Lee is nurse manager of 3-West, a 40-bed geriatric unit that is nearly always fully occupied. Many of the patients spend several hours each day in wheelchairs, but most return to their beds for 2 or 3 hours in the afternoon.

Jenny has been concerned that her limited staff is only marginally able to fulfill all the needs of the elderly patients. She has spoken with many patients concerning needs that volunteers could possibly fill for them, and she has developed a list of volunteers who indicated they could make themselves available to help. Jenny devel- oped a 30-day schedule for volunteer support.

On the first day of the schedule three of the five volunteers did not show up. On the second day, two did not appear. Only one showed up on each of the third and fourth days, and on the fifth day there were no volunteers present in the unit. Jenny abandoned her schedule.

Jenny was thoroughly discouraged by what she perceived as the volunteers’ lack of dependability. Further, since Jenny had made no secret of her volunteer program, a number of patients were similarly discouraged and several complained.


1. What has Jenny been doing wrong? 2. What might she consider doing to correct the situation that she has gotten

herself into?

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C a s e 58

The UNNecessary Task

Primary Topic—Delegation

Additional Topics—Authority; Communication; Criticism and Discipline; Motivation

The health information management (HIM) department of Memorial Hospital was considered able to function for a day or two at a time without a manager when neces- sary. However, when Mrs. James, the director of HIM, was hospitalized for several weeks, administration asked Guy Smith, the director of admissions, to look in on HIM on a regular basis. In his previous position with another, smaller hospital, Smith had supervised both HIM and admitting.

About noon one day Smith noticed a completed form entitled “Daily Census Report” on the corner of a clerk’s desk in the medical records department. It caught his eye because in his months at the hospital the only census report he had seen was the computer-generated report he received each morning. He became even more curi- ous when he noticed that the hand-generated report was dated for that day. He asked the clerk who created the report and why.

“I do it,” she said, “but I don’t really know why.” She proceeded to describe the process: Each morning she took the previous day’s record department count of admissions and discharges and merged it with the information obtained from copies of the midnight census report generated by the head nurse in each nursing unit. This took her about an hour and a half each day.

Smith asked, “Who uses this report?” “I don’t think anybody uses it.” “Then let me put it this way,” said Smith, his frustration beginning to show,

“Who receives the report?” “Nobody,” the clerk answered. She went on to explain that some time earlier the

hospital experienced problems with its computer system and certain census informa- tion was being lost. Mrs. Victor, who was her supervisor then, showed her how to do the report and told her where to leave it. For about 4 weeks the report was picked up faithfully at noon every day.

“Why hasn’t it been discontinued?” asked Smith. “It was discontinued, once,” the clerk answered. “By me. And I got into plenty

of trouble over it. It got picked up regularly only for about 4 weeks. After that, before I knew it I had eight or nine on my desk. I tried to ask Mrs. Victor about it but I still

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couldn’t get an answer—you couldn’t get her to stand still for 10 seconds—so I just stopped doing it on my own because I couldn’t see any sense in it. When Mrs. Victor found out I dropped it, she gave me the chewing out of my life and said that I’d better never do anything like that again without a direct order.”

Smith said, “But Mrs. Victor has been gone more than a year. Did you mention this to Mrs. James?”

“Yes, but I’m not sure it ever sank in. She’s just as busy as Mrs. Victor ever was, and the only people who seem able to get her attention for more than a minute at a time are administration and the physicians. She said she’d look into it, but I haven’t heard anything. And I’m not sticking my neck out again.”

Guy Smith spent a few more minutes with the clerk looking over some of the reports. In that time he discovered that the clerk had done neat, accurate work, taking as long as 90 minutes a day, for nearly 25 months. And 23 months’ worth of this work was never seen by anyone other than the clerk herself.


1. Who do you see as responsible for the duration of this task? Why? 2. What fundamental errors do you believe caused this to happen? 3. What should Smith do with his newly acquired information?

124      Case 58: The Unnecessary Task

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C a s e 59

yoUr wasTefUl frIeNd

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; General Management Practice

You are one of two supervisors in the central supply department. You take your job seriously, and in light of a current economic pinch, you are keenly aware of the necessity to economize wherever possible.

You are also aware that your fellow supervisor does not share your attitude and outlook and is costing the institution unnecessary expense through failure to exercise what you consider to be common sense cost control. You have attempted to control costs closely because you see this as part of your job and because you believe cost control to be necessary. However, the other supervisor makes no effort to control costs and openly resists any economy-oriented changes you attempt to make.

Higher management, from the central supply manager on up, seems to be paying no attention to what is going on in the department. The other supervisor whose atti- tudes and actions seem constantly to frustrate your own is supposedly a close friend of yours, so you are reluctant to “blow the whistle.”


1. What approaches could you take, considering that you are in a bind between the dictates of your conscience and a personal relationship?

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C a s e 60

oNe Boss Too maNy

Primary Topic—Leadership

Additional Topics—Authority; Communication; Decision Making; General Management Practice; Motivation

The engineering and maintenance groups of Memorial Hospital are headed by three first-line supervisors. These supervisors and a department secretary report directly to a manager of engineering and maintenance, who in turn reports to the director of environmental services.

The institution is in the midst of a prolonged period of growth and expansion owing mostly to merger and acquisition. Almost weekly some organizational unit or other is being located to new quarters or drastically rearranged within its original area. The institution promises to be in a chronic state of change for some time to come, with much extra effort required by engineering and maintenance as numerous areas are opened, renovated, or rearranged.

The position of director of environmental services was created at the start of this period of major change. The incumbent was hired specifically for his apparent abil- ity to get a new operation up and running through active involvement of personnel at all levels.

The director was quick to discover that his immediate subordinate, the manager of engineering and maintenance, came across as a man of considerable inertia who moved slowly, was reluctant to change, and usually defended “the way we’ve always done things.”

Although the manager had longstanding relationships with the three supervisors, the director began avoiding the manager and dealing directly with the first-line super- visors. Most matters, however, found their way back to the manager, who would then take action or give instructions contrary to what the director had done.

After several weeks in this mode of operation, one of the first-line supervisors summed up the circumstances as follows: “We now have two bosses, and they’re opposed to each other on everything. What one decides, the other reverses; what one puts together, the other tears apart. They can’t even agree on anything as basic as an obvious need for disciplinary action. How do we go about maintaining effectiveness in dealing with our employees, and how do we prevent morale and inefficiency from going straight down the drain?”

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Deal with the question posed by the supervisors in the final paragraph of the case. Based on what you believe to be sound management practice, develop an approach the three supervisors might take. State any assumptions you may have to make, and fully explain the reasons for your recommended approach.

Case 60: One Boss Too Many      127

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C a s e 61

how TIme flIes

Primary Topic—Time Management and Personal Effectiveness

Additional Topics—Authority; General Management Practice; Leadership

You are the business office manager at Community Hospital. At 9:00 am your boss, the controller, called you into his office for, as he put it—“a little chit-chat, 10 minutes or so, on where we stand on getting the new procedure manuals done.” You scooped up the proper papers and went into his office, bracing yourself because you knew how frustrating these sessions could be.

After you entered and sat down, the controller shuffled through the clutter on his desk looking for a particular document. At the same time he found the document he also found a pink telephone message slip apparently left over from the previous day. He said, “Oh-oh, should have done this yesterday. Excuse me just a minute. Sit tight.”

The “minute” turned out to be a quarter of an hour as he transacted a bit of busi- ness and engaged in some social conversation. You fidgeted, wondering as you did at such times whether you should get up and leave and return when he was free.

You were perhaps 5 minutes underway with the true subject of your meeting when the telephone rang. Your boss answered it himself, although his secretary was in her usual place. This time it was fully 10 minutes before you could return to the subject of the meeting. Before you concluded your business, your boss had taken two more calls and made a brief additional call for something that he had “just remembered.”

When at last you were finished to the boss’s satisfaction, you rose to leave. He rose also, reaching for his empty coffee mug. On the way out of his office he glanced at his watch and said, “Wow, 10:00 already. Time sure flies.”

You made no comment. You were well aware that the pile of work on your desk had gotten no smaller while you were tied up for a full hour trying to accomplish about 10 minutes’ worth of true work.


1. What assumptions about the value of your time and his time are implicit in the boss’s behavior?

2. What can you possibly do or attempt to do to encourage your boss to show more respect for your working time?

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C a s e 62

yoUr UNhappy dUTy

Primary Topic—Authority

Additional Topics—Communication; Criticism and Discipline; Leadership; Motivation; Rules and Policies

You are the manager of purchasing and general stores for Ajax Memorial Hospital. In the 1 year you have been there you have come to know your four employees quite well. They are generally a happy, cohesive, and cooperative group, usually joking among themselves, but getting the work done more than satisfactorily. All of them seem to give a great deal to the hospital, and it is obvious to you that they care about what they are doing. A couple of them usually come in a bit early, going over their plans for the day’s work over coffee before starting time, and although quitting time is 4:30 pm, all of them generally stay a few minutes later to finish what they happen to be working on at quitting time. You have felt all along that you could not ask for a better group of employees.

This afternoon, however, things changed. You returned at about 3:00 pm from an outside meeting to be met by four grim faces reflecting varying degrees of gloom and anger. The department secretary, Carol, said, “The CEO is looking for you. In fact, three calls in the last hour—although I said you weren’t due back until 3:00.”

The telephone rang. Carol answered it and after a few seconds said, “Yes, he just walked in. He’ll be right there.”

Without an inkling of the problem you hurried to the CEO’s office, where you were greeted with a stern look and a firm instruction to close the door before seating yourself.

“I want to know whether you think you’re running a hospital department or a social club,” the CEO snapped.

“What do you mean?” “I was walking along the corridor near your office when I heard an awful racket

coming from the stockroom. Laughing, practically shrieking, so loud I could hear it two hundred feet up the hall. I went in and found all four of your staff eating lunch in the stockroom. Actually eating lunch in the department. Were you aware that they did so?”

“Certainly. They’ve always done that. I wondered about it when I was new here, but I did enough digging to convince myself there was no rule against it.”

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“There are common sense rules of behavior I insist on. These should be suffi- ciently plain that they need not be written. And eating in the department is an obvious case. Why do you suppose we provide a cafeteria?”

You said that you agreed as far as certain areas were concerned. For instance, you said that it would not look good for someone to be eating lunch at the admissions desk. You believe it does not really matter in the case of the stockroom because this is a closed area never entered by patients or visitors.

“What’s good for one department is good for all departments,” the CEO responded. “And that goes for the coffee pot. I don’t permit coffee pots in the depart- ments. Your people can get their coffee in the cafeteria at specified break times just like everyone else.”

Not quite biting your tongue you said, “There’s a coffee pot in the dictating room health information management. Of course that’s used by doctors as well.”

Your remark triggered a few choice comments about your attitude, and you found yourself on the receiving end of a spontaneous and rather critical “performance evaluation” until a few minutes before quitting time. Although you tried your best to defend your employees, citing their good-humored cooperation and flexibility, you nevertheless departed with a clear message to take back to your employees: We are running a healthcare organization in businesslike fashion, and that means no boister- ous laughter, no eating in the department, and no coffee pot.

You arrived back in your department at exactly 4:30. Your four employees, grim faces and all, were the first persons in line at the time clock in the corridor. It was the first time you ever knew any of them to leave at 4:30 on the dot.


1. Assuming you disagree with the CEO’s directive, but recognizing that you are under orders to see that it is followed, how are you going to get the word across to your staff?

2. Because staff morale has already been adversely affected and you have yet to reaffirm the order they received during the CEO’s surprise visit, what can you do to blunt the demotivating effects of this turn of events?

130      Case 62: Your Unhappy Duty

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C a s e 63

The INdepeNdeNT employee

Primary Topic—Delegation

Additional Topics—Authority; Leadership, Motivation

Maintenance supervisor Jim Wood often felt that he has his hands full getting elec- trical repairman Bob Trent to follow his instructions. A case in point: On Monday of this week Wood realized that the laboratory air conditioning unit was due for its semiannual servicing and inspection, a task that either Bob Trent or the one other mechanic usually accomplished. He further realized that if this job was not done by the end of Wednesday it was not likely to get done for some time; some new equip- ment was scheduled to arrive on Thursday, and Trent’s fellow mechanic would be gone on vacation the following week.

Wood customarily tried to assign Trent 2 or 3 days’ work at a time, because once he was underway Trent could usually be found (or not found, as often was the case) just about any place in the building tackling his assigned tasks—and often a number of unassigned tasks—in seemingly random order.

Wood gave Trent the file on the laboratory air conditioner and said, “You don’t necessarily have to do this first, but I’d like you to take care of it today or tomorrow. In any case, it has to be finished by noon Wednesday.”

Trent simply shrugged and took the file. Wood did not see Bob Trent again until Thursday morning coffee break. The laboratory air conditioner had not crossed Wood’s mind until the sight of Trent reminded him of it. He approached Trent and asked, “Any trouble with the lab air conditioner?”

“Haven’t done it yet,” said Trent. “Why not? I specifically told you it had to be finished by noon Wednesday.” “I almost got started on it,” said Trent, “but the assistant administrator collared

me and told me he wanted the fan coil unit in his office fixed right away. I had to tear the whole thing down to do it, but I figured that was more important than the air conditioner in the lab.”

Wood felt a sense of frustration. he said, “Bob, this is the fourth time at least that I can think of when I told you specifically to do something and you went and decided something else was more important. Just what do you think I mean when I delegate something to you, anyway?”

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Trent shrugged and said, somewhat defensively, “I don’t know, Mr. Wood, but I figure when I see something that’s more important than what I’m doing at the moment I better take care of it. Anyway, if the lab air conditioner was so all-fired important, how come you didn’t say anything about it until now?”


Analyze the foregoing occurrence of incomplete delegation, criticizing the conduct of both employee and supervisor as necessary. Spell out those steps you believe Jim Wood should take in the future to assure that Bob Trent does not decide that other tasks are “more important” than duties specifically assigned by Wood.

132      Case 63: The Independent Employee

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C a s e 64

here we Go aGaIN

Primary Topic—Change Management

Additional Topics—Communication; Leadership; Motivation

The position of business office manager at Memorial Hospital has been a “hot seat,” changing incumbents frequently. When the position was vacated last May the four senior employees in the department were interviewed. All were told that because they were at the top of grade and the compensation structure for new supervisors had “not yet caught up with that of other jobs,” the position would not involve an increase in pay. All four declined to pursue the position, and all were given the impression that they were not considered fully qualified anyway, but that they might be considered for supervision again at a later date.

That same month a new business office manager was hired from the outside, and the four senior employees were instructed to “show the new boss all you know.” Over the following several months the finance director told all four employees that they had “come along very well” and would be considered for the manager’s position should it come open again.

In October of that same year the manager resigned. However, none of the four senior employees got the job; the process described in the preceding was repeated, and again a new manager was hired from the outside.


1. How do you believe the four senior employees would feel, having gone through the foregoing process twice?

2. What do you believe would be the attitude of the business office staff toward the organization?

3. What do you believe would be the attitudes of the four senior employees toward the finance director?

4. Is the apparent inequity in the organization’s wage and salary structure at all justifiable? Why, or why not?

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C a s e 65

The forcefUl orGaNIzer

Primary Topic—Labor Relations

Additional Topics—Communication; Decision Making; Leadership

Your are the hospital’s admitting manager. This morning you were called to attend a meeting concerned with possible union organizing activity.

On your way to the meeting you observe a man backing one of the housekeep- ers into a corner. The man’s back is turned to you, and you do not recognize him. The man appears to be trying to get the housekeeper to take a card and a pen he is holding.

You cannot hear what is being said, but the housekeeper appears to be close to tears, and she is effectively trapped in a corner. Your first thought is of active solicita- tion of interest in a union election.

You move closer in an attempt to see the man’s face.


1. What will you do if you recognize the man as an employee? 2. What will you do if you are certain the man is not a hospital employee? 3. Whether or not you recognize the man as an employee, what should be your

first action?

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C a s e 66

The reqUesTed favor

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Rules and Policies

You are head nurse of a 40-bed medical/surgical unit. This morning one of your nurses, Mrs. Allen, came to you with a request for a “small change” in her hours of work. She asked to be permitted to start and end her shift 30 minutes earlier than scheduled. She explained that this was necessary because her husband’s hours had changed (he works evenings), and she has to be home before he leaves so the children will not be unattended.

You told her that you would have to think about the request and get back to her. Your thoughts seemed to resolve into three alternatives:

1. Deny the request. 2. Grant the request. 3. Grant the request on a temporary basis, giving her some time to work out a

permanent arrangement.


1. What are the advantages and disadvantages of all three options? 2. Which option do you believe you should choose? Why?

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C a s e 67

Boss? who Needs oNe?

Primary Topic—Change Management

Additional Topics—Authority; Communication; Leadership

Kay Morgan is assigned to the reception desk at Community Hospital. Her job also includes sorting mail for distribution, and metering and bundling all outgoing mail. She has been doing this same job since the hospital opened nearly 15 years ago. She has always worked independently and has never been assigned to any particular supervisor. She never appears on an organization chart, and she considers the admin- istrator, whom she rarely saw, to be her only “boss.”

During a period of internal growth it was considered necessary to establish the position of business manager. You are hired from the outside to fill this new posi- tion. One of the activities placed under your direct supervision is Morgan’s mail and reception area.

You cannot tell from your initial visit with Morgan if her seemingly quiet and stern manner is natural to her or perhaps indicates resentment. Your visit was not preceded by any announcement concerning your arrival as her supervisor.


Develop an approach that will help you “start out on the right foot” with Kay Morgan. Do not assume at the outset that she will resist your authority. You actually have no idea how she will react, although showing up without notice does create some basis for concern on her part.

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C a s e 68


Primary Topic—Hiring and Placement

Additional Topics—Communication; Employee Problems and Problem Employees; Rules and Policies

You have a position open in your department, and you have been presented with three candidates for consideration. All are equally qualified. They are:

1. A young woman, 19 years old, who has one child and is separated from her husband.

2. A woman, 31 years old, who had been unsuccessfully seeking work for several months and whose husband is disabled.

3. The daughter of a fellow employee. This young lady actually desires to get into a different department, but would like to have this job until there is an opening in the department of her choice.

Much of the little you know about the first two candidates (as noted) is “forbid- den information” in that you are not allowed to ask for it on an application or an interview. However, the candidates themselves volunteered this information. What you know about the third person came to you from the fellow employee who wants you to hire her daughter.


1. What are the points of “forbidden information?” Why are you not allowed to solicit this information?

2. What are some of the potential problems coming with the hiring of any of the three?

3. Under what circumstances would you be likely to rule out all three candidates?

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C a s e 69

shorTaGe of help

Primary Topic—Hiring and Placement

Additional Topics—Authority; Communication; Rules and Policies

You are director of nursing in a hospital that recently completed an expansion pro- gram and opened a new 36-bed medical/surgical unit. Recently you have not done too badly in keeping your nursing staff up to required levels in spite of a general shortage of nurses in your geographic region, but the opening of the new unit has strained your resources to the extent where you are short several registered nurses. This shortage is particularly evident on the evening shift (3:00 pm to 11:00 pm). You have more than enough people willing to work days, and you have long had a thoroughly stable crew who prefer to work nights.

In response to your long-running recruiting efforts, a well-qualified registered nurse has applied for employment. You are impressed with her; she seems energetic and personable, and she is immediately available. Also, she is quite willing to take a position on the evening shift.

Unfortunately, although she is willing to work 3:00 pm to 11:00 pm, she has also stated during her initial interview that she cannot work any weekends. She will say only that weekend work causes severe inconvenience in her family life, and she repeats her willingness to work evenings, but only Monday through Friday.

You have not yet explained to her that scheduling practices in your hospital require everyone below the level of day, evening, or night supervisor to work every other weekend.


1. Conscious of your critical need for nursing help on weekends, what are you going to tell this applicant?

2. If you adhere to your scheduling policy and the nurse refuses the job, what problems will you be facing?

3. If you alter your scheduling policy and offer the applicant a Monday-through- Friday position that she accepts, what problems are you likely to face?

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C a s e 70

who aNswers To whom?

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Criticism and Discipline

As a recently hired housekeeping supervisor at County General Hospital, Will Ross has put a great deal of effort into trying to tighten up housekeeping operations and improve staff productivity. Every day he provides each member of his crew of house- keeping aides with a work plan to follow, and he stresses that his employees are not to deviate from this plan. He has arranged his employees’ work so that the workload is not unreasonable or overly demanding, but the employees have to work steadily to stay on schedule.

One afternoon housekeeping aide Tom Mooney was buffing a corridor in a medical/ surgical unit when the unit’s head nurse hurried up to him and said, “Shut that thing off and come with me. We need to clean up a mess in room 211.” Without shutting off the buffer Mooney responded, “Sorry, but I’ve got a schedule of things to do and only so much time to do them. Mr. Ross says I’m not to take on any extra jobs unless he tells me to.”

The nurse replied, “I don’t care what Mr. Ross says. Right now you’re in my nursing unit, and when you’re in my unit you’ll do what I tell you to do. Now come with me.”

Mooney shut off the buffer but did not move. Rather, he said, “I think we need to call Mr. Ross.”

The nurse snapped, “We don’t need to call anyone. Now, if you’re interested in keeping your job you’d better do as I say.”


Decide how this incident should be handled and by whom it should be handled. In developing your tentative solution, consider the question of authority: To whose authority must Mooney ultimately respond? Why?

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C a s e 71

wheN do yoU sTop BeING GeNeral?

Primary Topic—Criticism and Discipline

Additional Topics—Communication; Employee Problems and Problem Employees; Meeting Leadership

You are supervisor of transcription at City General Hospital. Your group includes several transcriptionists who handle all the dictation from the laboratory and x-ray, and the typing for several department managers, as well as all transcription of physi- cians’ dictation.

You are in the habit of holding a brief informational meeting with your staff early each month. At your June meeting you felt obligated to point out that quality was slipping and word processing errors were on the increase, and that more care had to be taken with keyboarding. At your July meeting you made the following state- ment: “The overall quality of transcription has not improved at all in the last month; in fact, it has gotten worse. I expect all of you to begin improving your typing quality immediately.”

It is now almost time for your August meeting. In your estimation, and backed up with error-rate statistics and complaints, quality has not improved in the least.


1. Do you continue to deal with the group at large? Why, or why not? 2. How do you believe you might approach the problem of making your criti-

cism increasingly more specific?

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C a s e 72

aN acT of NeGlIGeNce

Primary Topic—Criticism and Discipline

Additional Topics—Communication; Employee Problems and Problem Employees; Leadership

This morning you entered the work room of your nursing unit just in time to see Jenny Walters, an aide whom you considered a usually careful worker, commit an act of negligence. There was little room for doubt, and Jenny’s behavior resulted in several pieces of costly glassware being broken before your eyes. In addition to Jenny, three more of your employees were present when you entered and witnessed the incident.


1. Should you reprimand Jenny on the spot, while the incident is fresh and the other employees can take your criticism as a warning; or, should you separate Jenny from the group and deliver the reprimand in private?

2. Which of the foregoing options did you choose? Why? 3. How can you improve upon your chosen option?

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C a s e 73

IT wasN’T my decIsIoN

Primary Topic—Change Management

Additional Topics—Authority; Communication; Meeting Leadership

Within the finance division of City Hospital, a problem developed in the process- ing of receiving reports from the receipt of incoming material to the completion of payment. The purchasing manager, Mr. Sampson, first recognized the problem and pointed it out to the assistant administrator. Sampson said he believed he understood the situation and knew how it should be corrected. However, five different depart- ments were involved.

Sampson was directed to “get together with the other four supervisors and work out a solution.”

On extremely short notice Sampson called a meeting of the affected supervisors. Only two of the four were able to attend; the others were out of the building when Sampson decided to get together. Nevertheless the three persons who were present went to work on the problem.

The three supervisors developed a solution that required no implementation on their part but called upon the other two supervisors to take all of the required action. Sampson put the results of their decision in a memo to the two supervisors who were expected to translate the decision into action.


1. Assuming the solution Sampson and his companions arrived at was the most reasonable answer available, could there be any legitimate reasons for resist- ance from the two supervisors who were expected to carry it out.

2. If you were one of the two supervisors left out of the decision process, how would you react to the “directive” from Sampson? What would you do about it?

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C a s e 74

The dodGer

Primary Topic—Criticism and Discipline

Additional Topics—Communication; Employee Problems and Problem Employees; Motivation

Jane Wilson had considerable difficulty developing the schedule for her nursing unit for the coming 2 weeks. The nursing department was in marginal position overall as far as available nurses were concerned, so her flexibility was limited. To make matters worse, within hours after Jane developed the new schedule, Alice Johnson, a part-time licensed practical nurse, submitted a request for a personal day on one of the days she was scheduled to work.

The request caused Jane to realize she had been seeing Alice’s name in con- nection with scheduling difficulties often in recent months. Looking back over the preceding 6 months’ schedules she discovered that the current request was the fifth time in 6 months that Alice had requested time off on a scheduled weekend day. Even more significant was the pattern of Alice’s use of sick time. She had called in sick four times, all of these on Saturdays or Sundays. All in all Alice had worked only about half of the weekend days she was scheduled to work over a period of 6 months.

Jane was displeased with Alice’s attendance and unhappy with herself for not discovering the problem sooner. She felt she had to talk with Alice about it, but she also felt that her unit could ill afford to lose a nurse. Nevertheless she believed that she could not allow Alice’s attendance pattern to continue uncorrected.


1. What are the hazards Jane faces in (a) dealing firmly with Alice’s behavior? or (b) ignoring Alice’s absences and saying nothing?

2. Assuming Jane is seriously considering talking with Alice, how might she approach the subject of the attendance problem?

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C a s e 75

yoUrs, mINe, aNd hoUrs

Primary Topic—Rules and Policies

Additional Topics—Communication; Employee Problems and Problem Employees

You were recently hired as director of health information management (HIM). Among your first official acts was the hiring of an assistant director and an additional medical transcriptionist.

On the first morning of your fourth week on the job, and the second week for your two new employees, your new employees came to you with a complaint. They said they just discovered they were working 40 hours per week, but the other employ- ees in the department—five in all—were working only 37.5 hours. This was the first you had heard of anything less than a 40-hour week.

You questioned the other employees one by one. You learned that the former director of HIM, who had been there many years, hired all of these people, one by one, with promises of a 37.5 hour week. You told each employee, as you felt you must, that the basic work week throughout the hospital is 40 hours, and there is no policy that states this department is entitled to operate on the basis of a shorter work week.

Your employees agree that nothing was ever written down about a 37.5 hour week, but each claimed that this was promised orally as a condition of employment. All of them insisted that the hospital is honor-bound to observe what is apparently an unwritten policy established by the former director of medical records. As one employee put it, “This place has always had a pretty good reputation as an employer; I didn’t think we had to have everything in writing.”


1. What are you going to do about the predicament in which you find yourself? 2. Who else may you have to involve in the solution to your problem? Why?

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C a s e 76

An ExpEnsivE GAmE

Primary Topic—Hiring and Placement

Additional Topics—Authority; Decision Making; Motivation

Dr. Gable, chief of anesthesiology, said to vice president Arthur Phillips and human resource director Charlie Miller, “There are no two ways about it—we’re going to have to raise the pay of our nurse anesthetists by at least 10 percent. With Don Williams leaving—he’s going to Midstate University Hospital for a lot more money—we’re going to have to pay more than we’re now paying to fill that spot. Of the ten hospitals in this city, our nurse anesthetists are by far the lowest paid.”

Charlie Miller said, “Since we talked about this same matter a week ago, I’ve obtained an up-to-date survey of the community. We’re not the lowest paying of the ten. In fact, we’re the third highest paying.”

Dr. Gable shook his head. “That doesn’t wash,” he said. “Some of our people moonlight at the other hospitals and they’ve told me the hourly rates they’re getting for part-time work. They said they can bring in pay stubs to prove it.”

Arthur said, “A week ago you said they were going to bring you pay stubs from other places. You didn’t get them yet?”

“No, they forgot.” Miller said, “Moonlighting rates aren’t relevant. Most of these places pay their

per diem nurse anesthetists a rate that amounts to more per hour than their full-time employees get. That’s because the per diems work only when called and they don’t receive vacation, sick time, or other benefits, and they don’t get retirement credit.”

Arthur asked, “How about Midstate University Hospital? I understand that it has more than one pay scale for nurse anesthetists, with a second scale that might not be readily shared with the agencies who do our salary surveys.”

Miller nodded and said, “That’s right. Midstate is the highest paying hospital in the area, based on this sort of hidden scale that they apply to some of their people. They pay up to 15 percent more to this one small group, all of whom have agreed to an extra-long work week and a certain amount of weekend call. But it’s not really comparable to our situation.”

Arthur said, “In all the years I’ve been here, it seems I can depend on this same exercise coming up every time one of our nurse anesthetists leaves. I’ve also come to

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count on it happening with radiologists and pathologists every few years—they go to work on one hospital to get their compensation increased, then they use this new pay leader as a wedge to get the other hospitals to pay more.”

Charlie Miller said, “I’m sure that all of the nurse anesthetists in town know what the others earn. All it takes is a few people in one hospital to get a strong advocate to go to bat for them, and the pressure to bump pay rates is felt throughout the region.”

Dr. Gable said, “I take it that you’re seeing me in that strong advocate role.” Miller did not respond.

Arthur said, “Anyway, Dr. Gable, you obviously see the nurse anesthetist pay rates as a problem and we’re willing to listen to any potential solutions you may have to offer. However, the budget year is barely one-third over and there is no more money to play with until the first of next year. As a first pass at the problem, we’ll be happy to take a close look at any creative solutions you can come up with that lie within the limits of this year’s budget.”


1. What does this case suggest about the supply of nurse anesthetists in the area? And what might come of Dr. Gable’s arguments if the realities of sup- ply were different?

2. Do you believe that the interorganizational “bumping” of pay rates, if indeed a fact, is appropriate professional behavior? Why, or why not?

3. Because it might be reasonably suggested that the nurse anesthetists in the area are acting together, at least in a loosely organized way, one might be tempted to suggest that the area’s ten hospitals get together and establish fair and consistent pay rates for nurse anesthetists. Comment on this as a potential approach.

4. How do you suggest Phillips and Miller proceed in their consideration of Dr. Gable’s request?

146      Case 76: An Expensive Game

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C a s e 77

ThE REclAssificATion REquEsT

Primary Topic—Communication

Additional Topics—Authority; Decision Making; Hiring and Placement; Motivation

“All of the justification for upgrading the position of hematology supervisor is right here,” said Dr. Smithers, indicating the two-page memorandum that lay in front of human resource director Carl Miller. Laboratory administrator Lori Brandon, seated alongside Dr. Smithers, added, “I know that you folks need to do your magic by cranking it through some kind of job evaluation process, and for that you need a new job description. Just tell me what I need to write to get this job moved from Grade 6 to Grade 7 and I’ll take care of it.”

Carl said, “The hematology supervisor—Pat Forrest, I believe you said—where does he stand in Grade 6 in terms of pay?”

Apparently ignoring the question, Dr. Smithers said, “I don’t see where a job evaluation system has anything to do with it. I’m director of laboratories, and I want the position of hematology supervisor upgraded.”

Lori responded to Carl’s question with, “He’s at the top of the grade. We won’t be able to give him an increase the next time around, and the only chance he’ll have to get more money is when the range for Grade 6 moves with the whole structure.”

“I must insist on the continued ability to reward people financially for work well done,” said Dr. Smithers. “I don’t want to lose Pat the way we’ve lost so many other good people, taken away by local industry for more money.”

Lori Brandon said, “As I understand it, job evaluations are comparative in nature. How can we really evaluate a job like hematology supervisor when there’s only one in the house?”

Carl said, “We can come pretty close by assessing the various elements of the position such as educational requirements, level of decision-making authority, number of employees supervised, and the like. We also can and frequently do make comparisons using surveys of the other hospitals in our region.”

Lori asked, “Can you do that for hematology supervisor? Survey the other hospitals?”

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“It’s already been done, through the Regional Hospital Association,” Carl answered. “By a narrow margin, Pat Forrest appears to be the highest paid hematol- ogy supervisor in the region. But in terms of job responsibility he commands only the third largest of seven hematology sections in the region.”

With a flip of his hand Dr. Smithers said, “Comparisons with other laboratories are simply not valid. This hospital is different, this laboratory is different, and our hematology supervisor position is different from all the others. Frankly, I’m tired of a personnel department that uses a so-called system simply to prevent deserving people from getting more money.”

Carl said, “The system calls for re-analysis of a job at the request of the depart- ment manager. If Ms. Brandon will provide an updated job description, I’ll see that it’s analyzed thoroughly in every respect. Believe me, I’ll give it a fair shake. I can’t tell you that the possibility of an upgrade is strong because it isn’t. But I’ll look into it and make a recommendation for the chief operating officer to consider—because he must approve all individual upgrades.”

As Carl’s visitors rose to leave, Dr. Smithers grumbled, “Bah! And I’ll be going directly to the chief executive officer if necessary.”


1. What is the major problem in the request to upgrade the position of hematol- ogy supervisor?

2. Is an upgrade a valid reaction to the threat of the loss of a valued employee to local industry? Why or why not?

3. If Carl’s analysis simply reaffirms that the position should not be upgraded, how far may he realistically be able to go in enforcing his recommendation?

148      Case 77: The Reclassification Request

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C a s e 78

sEEkinG ThE limiTs

Primary Topic—Authority

Additional Topics—Criticism and Discipline; Decision Making; Leadership

When you accepted the position of manager of engineering and maintenance, your boss, assistant administrator Peter Jackson, told you that you would not find a great deal of decision-making guidance written out in policy and procedure form. As Jackson put it, “Common sense is the overriding policy.” However, Jackson cau- tioned you about the necessity to see him about matters involving employee disci- pline because the hospital was especially sensitive to union overtures in the service and maintenance areas.

Early during your third week on the job, a matter arose that seemed to you to call for disciplinary action of a routine nature. Remembering Jackson’s precau- tion, you tried to see the assistant administrator several times over a period of 3 days. Being unable to get Jackson and receiving no response to your messages specifically describing the situation, you went ahead and took action rather than risk losing credibility through procrastination. When you were finally able to obtain a meeting with Jackson some several days later you described both the situation and the action you had taken. Jackson agreed with you, and of your apparent concern for getting to him quickly he said, “What’s the big deal? As I said, common sense is the best policy and yours was a sound, common-sense decision.”

When a similar situation arose some weeks later and you could not get to Jackson although you tried to reach him several times, once again you took action. However, this time the disciplinary action involved an employee whom you later learned was a vocal informal leader of a sizeable group of discontented employees. Your disciplin- ary action blew up in your face and provided the active union organizers with an issue that they instantly took up as a rallying point.

Jackson was furious with you, accusing you of deliberately overstepping your authority by refusing to bring such problems to his attention as he had directed.

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1. Develop a tentative approach to the determination of the limits of your decision- making authority.

2. Since the limits of your authority are ultimately those limits set by your boss—and your boss here is the aforementioned Peter Jackson—develop a possible approach for getting Jackson to help you define the limits of your authority.

150      Case 78: Seeking the Limits

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C a s e 79

A pEER pRoblEm

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Leadership; Motivation

Sally Lowe and Carl Stratton were two of the seven physicians’ assistants (PAs) assigned to the emergency department of City Hospital. Scheduling was such that there was at least one PA on duty at all times and two PAs on duty during the busiest periods.

Sally was experiencing some difficulty in her working relationship with Stratton. She felt that her work was being made more difficult and more demanding by Carl’s conduct, specifically by his lackadaisical attitude and apparent unwillingness to do more than absolutely necessary to get by. As Sally confided to her friend Jane, also a PA, but assigned to the department of medicine, “I really don’t know what to do about working with Carl Stratton. He’s never been a real ball of fire, but he was better when he first started here a year ago. Now it seems as though he’s either lazy or simply doesn’t care.”

Jane asked, “Doesn’t care in what way?” “About much of anything,” Sally answered. “As you know, sometimes there are

two PAs on together in the emergency department. Lots of times there’s just one, but often there’s about an hour’s worth of overlap because of our staggered shifts.

“About the only time I can count on Carl to even come close to what he’s sup- posed to do is when our boss, Dr. Markis, is around. He’s at his best—if I can call it that—when there’s a chance Dr. Markis might see him in action. Most of the time, though, he’s late getting started, takes more coffee breaks than any other two people together, and seems to take forever at lunch. I know he’s making life more difficult for the other PAs and for others on the staff, although the only one I’ve heard say anything about it is Helen Jones, one of the nurses.”

Jane asked, “Do you suppose that any of the other PAs feel the way you do?” “I don’t know. I know that I’m the one who has most of the working contact with

Carl, and I know—and I’m not being paranoid—that I’m doing a lot of the work he should be doing. And it isn’t just amount of work; it’s quality as well. I can think of a dozen times when I’ve taken over his cases at shift change and had to redo half or more of what he did.”

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Jane said, “It sounds like you have a real problem, but I can’t see how you can do much about it.”

Sally sighed wearily and said, “The trouble is that it’s two problems. One prob- lem is wondering how to address the real problem. Carl Stratton and I are peers, supposedly equals. We’re both supposedly professionals in the same field. Even though he and his performance are affecting me and my performance, I don’t know how to go about getting anything changed.”


List and briefly explain at least three alternative approaches that Sally might consider in addressing the problem with her peer. Fully identify all apparent advantages and disadvantages of each alternative, and on the basis of these advantages and disadvan- tages recommend which approach Sally should try first, which she should hold for second as necessary, and which to apply as a last resort.

152      Case 79: A Peer Problem

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C a s e 80

ThE oRphAn suppliEs

Primary Topic—General Management Practice

Additional Topics—Communication; Decision Making

When Jerry Bennett joined the John James Memorial Hospital staff as an administra- tive intern, he was assigned to study the organization’s structure and the apportion- ment of departmental responsibilities.

Early in his travels about the hospital to visit the supervisors of various depart- ments, Jerry encountered a condition that disturbed him. In the basement of the main building, just outside of central supply, several dozen large cartons of paper products were stored in the corridor. The large cartons were stacked three deep against the wall along nearly 200 feet of the corridor. Although the corridor was wider than most and the cartons did not impede normal traffic, materials stored there placed the hospital in violation of local fire codes.

Because examining departmental responsibilities was part of his basic charge, Jerry decided to see if he could determine who was responsible for this material and find out why it could not be stored elsewhere. Because the supplies were stored out- side of central supply, he made that department his first stop.

The manager of central supply explained, rather indignantly, that the boxes belonged to purchasing and stores; they had put them there because there was no room in their own storeroom. Because the boxes had been undisturbed for some months, it was probably a case of “purchasing fouling up and overordering again.”

Jerry next visited purchasing, where he asked the manager about the supplies. The answer was, “Those belong to central supply. They didn’t know what to do with them, so they just stuck them in the hall as usual.”

Jerry Bennett’s investigation hit a dead end when he could find no paperwork that could tell him to which department the supplies belonged. The purchase orders and accounting’s records of payment were all on file. However, the purchase requisi- tions had been only partially completed; there were no signatures, and the receiving copies of the purchase orders were nowhere to be found.

What Jerry found most disturbing was that of the four products that made up this cache of material, one of them represented a 10-year supply of the item.

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1. What are the systems problems Jerry has begun to uncover? 2. What can be said about the state of departmental authority versus responsibility

in the case of the supplies? 3. What do you recommend doing with the orphan supplies?

154      Case 80: The Orphan Supplies

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C a s e 81

ThE EmployEE Who is AlWAys RiGhT

Primary Topic—Communication

Additional Topics—Criticism and Discipline; Employee Problems and Problem Employees

“I know what I heard, and that’s all there is to it,” staff nurse Janice Wayne said curtly. The muscles of her face were tensed, and she spoke in the righteous tone that head nurse Wilma Paul had heard so many times.

“Dr. Gordon says otherwise, Janice,” said Wilma. “He told me in no uncertain terms that the instructions he gave you were just the opposite of what you actually did. And he really came on strong.”

“He’s wrong, period,” snapped Janice. “He says that you were wrong, and he seemed quite sure about his position.”

Wilma paused thoughtfully before adding, “He went to the trouble of explaining the whole situation to me, and I have to admit that I understood his instructions. At least I was able to repeat his directions in my own words so he was satisfied that I understood what he said.”

Janice scowled, then shrugged and said, “Then Dr. Gordon changed his story between the time we talked and the time he spoke with you.”

“Are you suggesting that he lied to me?” “I didn’t say that. I’m only saying that he told me one thing and then apparently

told you something different. Maybe he didn’t realize what he was saying to me. You know how he just kind of rattles off something quickly and runs away.”

Wilma sighed and said, “Janice, did you consider the possibility that you didn’t understand? It isn’t hard to misinterpret a message when things happen so fast and—”

“I know what I heard,” interrupted Janice. “When I know I’m wrong, I’ll say so. If I even think that I may be wrong, I’ll say so. But in this case I know I’m right. It’s not even remotely possible that I could have misinterpreted Dr. Gordon.”

Feeling that Janice had given her cause to speak up about something that had been nagging her for quite some time, Wilma said, “It seems to me that you’re never wrong, Janice.”

Janice Wayne glared at her supervisor. “What do you mean by that?”

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Wilma took a deep breath and offered her explanation. “I’ve been head nurse of this unit for 3 years, and in all that time I’ve never known you to admit being wrong about anything. This problem with Dr. Gordon is just one more example of how you always turn things around so that you look innocent or correct. Is it so necessary that you be right about everything?”

Janice’s tone, already cool, became colder. “As I said, I’ll admit that I’m wrong— but only when I am wrong. And I want to know the other times you’re talking about, the times when I supposedly ‘turned things around.’”

Wilma began, “Well, there was—” She stopped, shook her head, and said, “No, I was thinking about something else. In any case, you ought to know what I’m talking about. Think about it and you’ll know what I’m saying. You seem to have an answer for everything, and it’s always an answer that places you in the right.”

“You can’t think of any specific incidents because there haven’t been any,” said Janice. She rose from her chair and continued, “You may be my supervisor, but I don’t have to listen to this. Is there anything else you wanted to say about Dr. Gordon’s problem?” She glared down at Wilma.

Wilma rose to her feet. “Just that the incident is not to be considered closed. Dr. Gordon insists that it be written up for disciplinary dialogue—a verbal warning.”

“I’ll protest, of course,” said Janice. “I won’t accept a warning that I don’t deserve, and I won’t say that I’m wrong when I know I’m right.”

When Janice left the office, Wilma began to regret having spoken to Janice as she did. She was convinced, however, that she had to try to get through to Janice about her apparent need to be right whenever a disagreement or misunderstanding arose.


1. When Wilma left the specific incident to talk about Janice’s overall conduct, she made a mistake that is embodied in the words “You always turn things around so that you look innocent or correct.” What was Wilma’s mistake, and why was it a mistake?

2. How would you recommend attempting to determine the cause of the misun- derstanding involving Janice and Dr. Gordon?

3. Taking Janice’s departure from Wilma’s office at the end of the case as your starting point, how would you propose to deal with the employee who is always right?

156      Case 81: The Employee Who Is Always Right

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C a s e 82


Primary Topic—Authority

Additional Topics—Communication; Criticism and Discipline; Employee Prob- lems and Problem Employees; General Management Practice; Leadership

One day when nurse manager Diane Cowan was in the supermarket, she encountered Ruth Miller, a neighbor and acquaintance and also one of the nurses in Diane’s unit. After a bit of social conversation, Diane asked Ruth, “I know that since you went part-time you’ve been working every other weekend. Eve Bonner, our new weekend charge nurse, came in about the same time you changed. How do you like working with her?”

Ruth hesitated a moment, then said, “Quite honestly, Diane—and just between the two of us, outside the hospital—I don’t like working for her at all.”

“May I ask why?” “It’s her whole manner and approach,” said Ruth. “She’s curt and snappish, and

she doesn’t ask people to do things or even give instructions—she just barks orders. Most of the time she sounds more like an army sergeant than a charge nurse.”

Although she realized that it was only a single person’s view, Diane was never- theless disturbed by this informal report on a weekend charge nurse whom she had appointed. It was true that Eve Bonner appeared no more or less qualified than a number of other nurses on the unit, but Eve had no objections to working weekends and seemed to Diane even to welcome the opportunity. For 3 days each week Eve was simply one of the capable nurses on Diane’s unit. However, Diane had to admit that she knew nothing about how Eve was functioning as weekend charge nurse because she had never seen Eve in action in that capacity. Until her conversation with Ruth, Diane had received no reports about Eve’s performance.

Diane decided that although the need to evaluate Eve Bonner as a weekend charge nurse was months away, she had nevertheless better look into the matter of Eve’s per- formance. Over the course of 2 weeks Diane sought out most of her unit’s weekend workers for individual discussions. In each discussion she was no more pointed in her initial questioning than, “How are you getting along with our new weekend charge?” However, this approach was sufficient. Diane had known most of these people for several years, and, given that opening, the majority of them spoke freely.

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In the process of her one-on-one meetings Diane learned that several weekend employees were convinced that Eve’s conduct was directly responsible for the resig- nation of one nurse who cited “personal reasons” for her departure. From her discus- sions Diane was also able to glean the following comments:

• “During the week when she’s not in charge she’s fine to work with, but on the weekends she’s a terror.”

• “She dictates like a drill sergeant.” • “She doesn’t do much herself—just tells everybody else what to do.” • “I think being in charge has gone to her head. She really likes to lord it over


All in all, Diane was quite disheartened by all the secondhand information she had acquired about the style of her weekend charge nurse, Eve Bonner.


How should Diane proceed in addressing the problems of the weekend charge nurse? Outline your steps or options, and supply a complete rationale or justification for each.

158      Case 82: The Drill Sergeant

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C a s e 83


Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Communication; Criticism and Discipline; Leadership

Wende Carlson, office manager for the hospital’s ambulatory services division, was secretly happy that her half-day conference had been in the morning and not the afternoon. Mornings in the office were so hectic that it was a relief to get away once in a while. The afternoons were relatively quiet, and Wende had hopes of getting caught up on some delinquent paperwork. However, when Wende arrived at her office after lunch, she was greeted by four angry expressions and one empty desk.

Indicating the empty desk, Wende asked the others, “Where is Sue? And what’s going on around here?”

“Sue went home,” Eleanor said. “She had to go home after Dr. Greer got through with her,” said Kay. “I think

I would’ve spit in his eye and walked out for good.” Wende asked, “What in the world happened?” Eleanor explained, “Sue had the misfortune to make a simple booking mistake

when Dr. Greer was at his busiest. He’s a bear most of the time anyway, and we all know how he’s been lately with the group running one physician short.”

Wende said, “We obviously shouldn’t make booking errors, but as hectic as it gets around here, they’re bound to happen once in a while, and there’s usually noth- ing serious about them.”

Kay said, “You’d think they were life threatening the way he took off on her. He called her about ten different kinds of an idiot and said he was going to have her fired for incompetence. He literally screamed at her, in front of the four of us and Dr. Wilson and at least three or four patients in the waiting area.”

“No class, rotten style,” Eleanor muttered. The others nodded in agreement. “Why did Sue go home?” Wende asked. Eleanor answered, “Greer really leveled her and ordered her out of the office.

She cried in the ladies room for nearly half an hour, but even after she calmed down a bit she was afraid to come back in. She just signed out and went home.”

In further discussion with her four staff members, Wende learned that Sue had stated there was no way she could continue working where she was treated in that

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fashion and that Dr. Greer had announced for all to hear that she was forbidden ever to touch his schedules again.


1. How should Wende Carlson approach the discussion of the incident with Sue? 2. Recognizing that Dr. Greer is neither her employer nor her organizational superi-

or, how should Wende approach the discussion of the incident with Dr. Greer? 3. How should Wende proceed in general to deal with the situation outlined in the

case? List a number of possible steps or actions and provide reasons for each.

160      Case 83: The Tyrant

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C a s e 84

ThE busy boss DElEGATEs

Primary Topic—Delegation

Additional Topics—Authority; Communication; Leadership

Director of materials management Tom Netter was responsible for activities divided among five managers, some with subordinate supervisors. As someone responsible for a wide range of activities and many tasks, Tom had always espoused a belief in active delegation of authority and active participative management as far as his five direct-reporting managers were concerned.

It seemed to Tom as though a common response throughout the hospital to many problems and questions that arose was, “That’s Netter’s responsibility.” In a way it made him feel good to be identified so strongly with many important activities.

Among Tom’s many responsibilities was membership, on behalf of the hospital, on several product committees of the region’s group purchasing program. He also served on at least four hospital committees, including the product evaluation com- mittee and the safety committee.

As is often the case with a growing healthcare institution and with the expand- ing field of health care, Tom Netter’s job continued to grow until it reached a point at which he became painfully aware that he could no longer cover all of the bases as he had been doing for so long. He was missing committee meetings and failing to completely fulfill a number of his other responsibilities.

In an attempt to gain some relief, Tom delegated representation on several com- mittees to some of his subordinate managers and likewise delegated some other tasks that he had become too busy to handle. He thought that doing so would be wise for both him and his subordinate managers, so he was surprised to discover that his five managers were quite resentful of their newly delegated assignments. He inadvertently heard one manager say to another something about “Netter dumping off his responsi- bilities on us.” Another, purchasing manager Bill Marlowe, said to Tom directly, “Of all things, why did you have to stick me with the safety committee? Couldn’t you take it any more?”

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1. What in the brief description of Tom Netter’s role in the hospital suggests that the seeds for resistance to his delegation may have been long present?

2. What was Tom Netter’s primary failing in his working relationship with his subordinate managers?

3. Having met with resistance from his subordinate managers, how might Tom readdress the matter of proper delegation so they might better appreciate the value of the tasks being delegated?

162      Case 84: The Busy Boss Delegates

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C a s e 85


Primary Topic—General Management Practice

Additional Topics—Authority; Communication; Criticism and Discipline; Delegation; Employee Problems and Employee Problems

Several weeks ago physical therapist Walt Palmer said to his boss, director of physi- cal therapy George Jackson, “You know, George, the way that we develop the budget in this department doesn’t make much sense. All we do is take last year’s actual expenses and add on an inflation factor and make some other guesses. What we really ought to be doing is budgeting from a zero base, making every line item completely justify itself every year.”

George said something about simply following the budgeting instructions issued by the finance department and doing it the way he was told. He pursued the matter no further.

Within a few days of the budget question, Walt approached George with, “Don’t you think the way this place does performance evaluations ought to change? Certainly most smart managers know it’s better to evaluate employees on their anniversary dates than the way we do it.”

George again answered to the effect that as a manager he was simply doing what he had to do to comply with the policies and practices of the organization. They dis- cussed the matter for perhaps 5 minutes, and although George was not about to start working to stimulate change in the performance appraisal system, he nevertheless felt led to concede that Walt had brought up a number of good points. It struck George that his employee was idealizing an evaluation system in almost textbook terms; it seemed flawless in theory, but George had been through enough actual systems to be able to recognize a number of potential barriers to thorough practical application.

In the ensuing 2 to 3 weeks Walt had more and more to say to George about how the organization should be managed. And it took Walt only a matter of days to get beyond generalized management techniques—such as budgeting and appraisal—and begin to offer specific advice on the management of the physical therapy department.

Quickly George Jackson came to realize that he could virtually count on Walt to offer some criticism of most of his actions in running the department and most

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of administration’s actions in running the hospital. George did not appreciate this turn in his relationship with an otherwise good employee. George had always seen Walt as an excellent performer as a physical therapist, perhaps somewhat opinion- ated but not to any harmful extent. Recently, however, he had come to regard Walt as a sort of conscience, a critical presence who was monitoring his every move as a manager.

The worsening situation came to a head one day when Walt attempted to inter- cede in a squabble between two other physical therapy employees and, when George entered the situation, proceeded to criticize George’s handling of the matter in front of the other employees.

George immediately took Walt into his office for a private one-to-one discussion. He first told Walt that although he was free to offer his suggestions, opinions, and criticisms regarding management, he—Walt—was never again to do so in the pres- ence of others in the department. George then asked Walt, “It seems that lately you have a great deal to say about management and specifically about how I manage this department. Why this sudden active interest in management?”

Walt answered, “Last month I finished the first course in the management pro- gram at the community college, a course called Introduction to Management Theory. Now I’m in the second course, one called Supervisory Practice. I know what I’m hearing—and quite honestly, it’s pretty simple stuff—and when I see things that I know aren’t being handled right, I feel that I have an obligation to this hospital to speak up.”

George ended the discussion by again telling Walt that he expected all such criti- cism and advice to be offered in private and never again in front of other employees. Overall, the conversation did not go well; more than once George felt that Walt’s remarks were edging toward insubordination. Because of the uneasy feeling the dis- cussion left with him, George requested a meeting with Carl Miller, the hospital’s vice president for human resources.

After describing the state of the relationship between him and Walt in some detail, George spread his hands in a gesture of helplessness and said to Carl, “I’m looking for your advice. Apparently on the strength of a course or two of textbook management, this guy suddenly has all the answers. What can I do with him?”


1. If Walt does indeed act as though he has all the answers, what can George do to encourage modification of this attitude?

2. If you were Walt, how should you best proceed in applying your newly acquired knowledge of management? Explain and provide an example.

3. What are the possible reasons behind George Jackson’s growing aggravation with Walt Palmer? List a few possible reasons and comment on the validity of each.

164      Case 85: The Management Expert

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C a s e 86

no lonGER pullinG hER WEiGhT

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Criticism and Discipline; Decision Making; Leadership

Head nurse Mary Bennett felt that she had a problem of considerable dimensions involving staff nurse Eleanor Collins. As Mary explained to her manager, associate nursing director and day supervisor Ruth Wells, “I just don’t know what to do about Eleanor any more. She’s simply not pulling her weight, and I have to recognize that.”

Ruth asked, “Has she been having health problems? Or do you think she’s another burnout case?”

Mary responded, “She’s definitely not a burnout case. She still seems to care about nursing, and she’s a pretty cool head most of the time. She just seems com- pletely unable to keep up the pace on the job. Let me take a few minutes to fill you in on where she’s at and the things I’ve been thinking about.”

Mary talked to Ruth for 15 minutes or longer. The following list summarizes the major points of her presentation.

• Eleanor had experienced some apparently minor health problems within the recent 2 years, but she did not seem to be troubled by anything chronic and her recent attendance record was better than average.

• Eleanor was older than the hospital’s minimum retirement age as stated in the pension plan. However, she was still short of becoming completely vested in the plan and short of the minimum eligibility age for social security.

• Eleanor was always pleasant and always cooperative, but it invariably took her 8 hours to accomplish the same amount of work that others were doing in 5 or 6 hours. Her slowdown had been sufficiently gradual that Mary could not truthfully indicate a point in time at which her productivity began to drop.

Because staffing was marginally tight, a condition prevailing in all units, every- one in the unit had to put forth maximum effort at all times. Mary was getting com- plaints from other staff members about Eleanor’s inability to keep up with the pace. Most of these complaints were offered kindly and with some reluctance; however, Mary had received information—admittedly secondhand and unverified—that she,

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Mary, was being accused of “covering up for the dead wood” because she had done nothing about Eleanor’s obviously diminished productivity. Mary felt that most of the other staff members liked Eleanor and felt sympathy for her, but that these kindly feelings were in danger of being crowded out by growing resentment for having to work harder because of Eleanor.

Mary had considered urging Eleanor to seek transfer opportunity, but Mary did not know if Eleanor would be amenable to a transfer or even if there were any other positions in the department where Eleanor would not likely experience the same problems.

“In short,” said Mary, “Eleanor is a nice person but her inability to keep up is causing harm within the unit, and I have to do something about it.”


If you were in the position of day supervisor Ruth Wells, how would you advise Mary to proceed in the matter of staff nurse Eleanor Collins?

166      Case 86: No Longer Pulling Her Weight

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C a s e 87

shE’s hAvinG A RouGh TimE

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Authority; Criticism and Discipline; General Management Practice; Leadership

Janet Carling, manager of the business office for Wilson County Hospital, a small rural facility serving a geographically large but sparsely populated area, was having difficulty covering her office’s essential functions for five 8-hour days each week because of one particular staff member. In addition to Janet, the business office con- sisted of just two full-time and two part-time employees. Janet felt she could not count on Dale Hamlin, one of the full-time employees and second only to Janet her- self in hospital longevity, to be regularly available when needed.

“Most of the time it doesn’t seem to be Dale’s fault,” Janet said to her friend and fellow supervisor, Harriet Redding, over coffee one morning before work. “I know she has a chronic health problem that keeps her out on short, unpredictable absences and sends her off to medical appointments on short notice. It’s a day here, a half day there, once in a while 2 days, and never more than 3 days—I think it was 3 days just once—all without any real notice.”

Harriet asked, “How does Dale cover her time off? If she’s as bad as she sounds I can’t imagine she has any sick-time bank at all.”

“None. She has no bank, and she long ago passed the point where she was using up sick time as fast as she earned it. In fact she uses all of her vacation time to cover these bits and pieces of time off.”

“As I understand the policy, her supervisor—that’s you kiddo—is supposed to approve vacation requests in advance,” said Harriet. “You’re not obligated to approve all these little ‘vacations’ of hers, especially if you haven’t been given notice.”

Janet spread her hands in a gesture of helplessness. “What am I supposed to do? One way or another she’s going to be off, and if I don’t approve vacation she’ll have to take the time without pay. As it is it looks like she’ll go through all of her vacation well before year’s end and will get stuck with unpaid time anyway.”

Janet went on, “I feel sorry for her, I really do, but I can’t even plan 1 week’s worth of coverage of all activities given her unpredictability. And I have three other employees who are getting just as tired as I am of having the whole group’s schedule subject to her comings and goings.”

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“Have you spoken with Miller?” Harriet’s reference was to Scott Miller, the hospital’s chief financial officer and their mutual boss.

“Yes, for all the good it’s done.” Harriet smiled knowingly. “Nothing from Mister Indecision? My, my, imagine that.” “Less than nothing,” Janet said. “I told him I wanted to do something with Dale’s

status. You know, make her part-time, change her hours, something that will give me more flexibility. You know, I’m even way past the point where I should be taking action based on chronic absenteeism, so now I’m backed into a place where I’ll prob- ably have to cut the others some extra slack so I’m not accused of differential treat- ment of employees. But all I get from Miller when I try to talk about Dale is, ‘She’s having a rough time, so don’t pressure her.’”

Harriet glanced furtively to her right and left and lowered her voice. “You do know—or maybe you don’t know—that Dale is related to Miller’s wife? Cousin, I think.”

Janet rolled her eyes toward the ceiling. “Great. I’ve got a sweet lady for an employee but she’s turning into a liability, and I can’t deal with the situation because I get no backing from my boss. What am I supposed to do?”


Suggest one or two possible courses of action Janet Carling might consider in addressing the problem presented by Dale Hamlin’s circumstances and the absence of higher management support or assistance.

168      Case 87: She’s Having a Rough Time

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C a s e 88

DischARGE foR cAusE

Primary Topic—Criticism and Discipline

Additional Topics—Authority; Employee Problems and Problem Employees; General Management Practice; Leadership; Rules and Policies

William Short is chief executive officer of Benton Memorial Hospital, a 120-bed institution serving a fairly widespread semirural area. He has been in his position for 8 months. Before his arrival the hospital operated for 4 months without a CEO after the abrupt and unexplained departure of the former CEO.

The previous CEO appeared to have been extremely well liked by his manage- ment group but at the same time was at constant odds with the hospital’s board of trustees. This former CEO had been considered easygoing, low-key in style, and relatively slow to act in many matters. William Short stands in stark contrast to his predecessor; his pace is rapid, his manner is brusque and forceful, and many find his size and demeanor to be intimidating. It is generally believed he was brought into the organization to apply pressure to the management team and perhaps to weed out certain individuals. It is, then, no surprise that his arrival was greeted with some apprehension and resentment, and his personal style has only supported those initial impressions.

Among several members of management remaining cool toward Short was Clara Jackson, RN, an employee of some 9 years who for the most recent 5 years has been emergency department supervisor.

It took Short the better part of his initial 8 months to work his lengthy priority list down to one particular problem: overtime authorization and approval. One of the departments with consistent overtime use out of proportion to the rest of the hospital was the emergency department.

Short asked Clara Jackson to turn over her overtime logs. These included the names of persons authorized to work overtime, dates, hours, and authorizing initial of either the director or assistant director of nursing service. Clara’s cool response was that she had misplaced the logs, and anyway she “saw no good reason why he should need them.” All he had to do, she claimed, was check the time cards retained by the payroll department. Nevertheless, Short repeated his request several times and finally directed Clara to stop stalling and locate the logs.

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When Short received the overtime logs he was initially struck by the fact that all of the entries were in the same color ink and the same style of writing. He took this as an indication that all of the entries may have been made by the same person at the same time. This indication became a certainty when he noticed that the date on which the most recent log pages had been started was some 3 weeks before the date appearing in the lower left-hand corner as the reprinting date of the form. Further investigation revealed that the initials of the director and assistant director of nursing were not authentic.

When Clara was confronted, she first denied creating the logs and then reversed her story and admitted doing so. She claimed she did so because Short was apply- ing pressure and she was afraid to admit she had lost the originals. She resisted Short’s allegation that she had never maintained the logs in the first place but had simply authorized overtime herself, entered it on the time cards, and put it through without following policy, a practice already proved to have occurred in two other departments.

Short’s allegations were largely supported by the director and assistant direc- tor of nursing who claimed it had been a year or more since they were last asked to authorize overtime for the emergency department. When asked why this did not seem to concern them, their answers suggested that under the former management policies such as the one for overtime authorization were neither observed nor enforced.

One the basis of violation of policy and falsification of records, William Short discharged Clara Jackson. Clara strongly objected to the firing and appealed directly to several trustees. Her personal appeals were unsuccessful, so she filed a complaint with the State Employment Commission charging that her discharge was arbitrary and unjust.

William Short was called to a Commission hearing to show cause why Clara Jackson should not be reinstated.


Consider the information provided in the case description and prepare to offer a decision that either supports the firing of Clara Jackson, or orders Clara Jackson to be reinstated in her position. Explain why you decided as you did, enumerating the factors that prompted your decision, and describe what you believe to be the manage- ment errors that permitted the situation to occur.

170      Case 88: Discharge for Cause

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C a s e 89


Primary Topic—Change Management

Additional Topics—Authority; Communication; General Management Practice; Leadership

Alan Mack was recruited from out-of-state and brought into County Memorial Hos- pital as director of biomedical engineering. In addition to Alan, the department’s staff consisted of one senior biomedical engineer, two junior biomedical engineers, and three biomedical engineering technicians. The job of the department was to maintain, calibrate, and repair as necessary all of the hospital’s electrical and elec- tronic medical equipment except for those pieces in sizeable fixed installations, such as analyzers in the clinical laboratories that were under maintenance contracts with manufacturers.

Alan was introduced to his new group by his predecessor, the retiring Fred Richards, during Fred’s final few days on the job. Fred emphasized the difficult nature of much of the work, noting that in his opinion much of the equipment they had to maintain had outlived its true useful life; for financial reasons, the hospital had been stalling certain replacement purchases. Old equipment notwithstanding, Fred also noted that he felt the employee relations aspects were the most important dimensions of the job. He believed, said Fred, that what worked best with this group was letting them work independently at their own pace and learn from their own mistakes. This was, Fred boasted, a cohesive group of people with high morale and upbeat attitudes.

During his first few weeks Alan made no changes to existing departmental pro- cedures. Instead, he concentrated on getting to know the staff and sometimes actually working with an engineer or technician to get the feel of some of the more difficult tasks they faced. Alan soon concluded, however, that total amount of work turned out was quite low considering the size of the staff. It seemed there was always a consider- able backlog of repairs and calibration work, yet relations with the line departments they served were generally good.

Alan discovered that by personally working together with someone in the group on the more challenging repair jobs, the more quickly certain problems were isolated and the faster the equipment went back into service. He concluded that his employees were not working efficiently, nor were they putting forth their best efforts.

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Rather than expressing his observations to the staff, Alan decided to require indi- vidual productivity reports from each person on a weekly basis and use these to track individual productivity. Each report was to enumerate: the number of PMs (preven- tive maintenance jobs) performed; number of repairs, including time spent on each job and the problems encountered; and the amount of calibration activity.

With the introduction of the reports, Alan was pleased to see an immediate increase in the total amount of work accomplished and a corresponding reduction in the department’s backlog. However, it seemed there was now a more strained rela- tionship existing between Alan and the group.

About 6 weeks after the weekly reporting was started, one junior biomedical engineer and one technician, employees of 4 and 2 years, respectively, gave notice of their resignation. They both cited as their reason for resigning the pressure of work, specifically, as one expressed it, “the unrealistic demands of the department director.” This came as a complete surprise to Alan, who felt, compared with industry standards and other organizations with which he was familiar, that his staff, following recent improvement, was barely operating at average efficiency for a department its size.


1. What do you believe to be the character of the problem that Alan has encoun- tered, and how did it likely become a problem?

2. Because Alan cannot back up and start over with this group, what do you believe he will have to do to stand a chance of restoring good working rela- tionships with the employees?

172      Case 89: The “Demanding” Manager

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C a s e 90

ThE uncoopERATivE collEAGuE

Primary Topic—Communication

Additional Topics—Authority; General Management Practice

Irene West, day shift supervisor in Central Processing at County General Hospital, usually did not take her problems outside of the department. She rarely complained to anyone about the frustrations she experienced from time to time. However, what was heavy on her mind must have shown on her face when she joined her friend from Human Resources, Melinda Walters, for coffee in the employee cafeteria shortly before the start of the Tuesday’s work day. Melinda took one look at Irene and said, “Wow, why the storm clouds? What’s bugging you?”

Irene hesitated, waging a brief internal struggle over whether she should speak up to her friend. Frustration and anger won out, and Irene said, with con- siderable vehemence, “Tami Dean’s what’s bugging me. If I can’t do something about her, I’m going to walk off the job one of these days and put this place behind me forever.”

“Tami? The one who’s got your job on second shift?” “The very same,” Irene muttered sarcastically, “Tami the let’s-leave-most-of-

messes-for-the-day-shift, my evening counterpart who’s divided her work into two categories: the stuff she ignores, and the stuff she does wrong.”

“Like what?” “Like almost everything. Packs assembled incorrectly by her people, work left

half done or undone, inventories and stock reports done wrong or ignored, even normal housekeeping ignored—I can always tell what she had for lunch by looking at the top of our shared desk.”

Melinda asked, “What have you tried to do about it?” “I’ve talked to Tami until I’m sick of talking. She either brushes aside my

remarks as unfounded or she becomes so defensive that there’s no talking with her. Whenever I try talking with her about problems we’re having on days because of something the evening shift has done—or hasn’t done, as the case may be—she shuts down on me immediately.”

“What about her employees? Does she seem to get along with them?”

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“Oh, they all get along for the most part. It’s a small staff on evenings, no heavy demands. And the staff all love Tami, not surprisingly; she practically lets them come and go as they please and work at their own pace—whatever that pace may be.

“But much of what Tami does is affecting me and my shift,” Irene continued, “and I seem totally unable to get through to her. I’m getting really tired of trying hard to do my best while this person just coasts along while she makes more work for me and my people.”


Put yourself in the position of Melinda Walters—and remember, Melinda works in human resources—and outline some possible actions for Irene to consider in her ongoing conflict with the evening shift supervisor.

174      Case 90: The Uncooperative Colleague

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C a s e 91

ThE infoRmAnT

Primary Topic—Communication

Additional Topics—Criticism and Discipline; Employee Problems and Problem Employees

Admitting manager Estelle Porter felt she was in a quandary concerning a faithful volunteer who spent a great deal of time in the department. As Estelle described to her friend, Kathy Wilson, a manager in another department that frequently used vol- unteers, “You know that I rely fairly heavily on volunteers, especially when it comes to running the desk in the front lobby and the information center near the cashier’s office.”

“Sure do,” said Kathy, “even more than I do. And if your volunteers are anything like mine, you’re overjoyed to find an occasional one who can actually be depended upon to show up when needed.”

“That’s not a problem with the situation that’s bugging me. I’ve got this one particular volunteer, Edwina Marsh. I think you know her, or at least know who she is. She puts in lots of hours and I can always depend on her to show up. She’s small and soft-spoken, the kind of person who does her work and bothers no one. She’s so inconspicuous that it’s easy to forget she’s even there much of the time. And I think that’s a lot of the problem.”

Kathy asked, “How so?” “I have a few staff members who sometimes act out when I’m not around. And—“ “Join the club,” said Kathy. “—and since they don’t pay much attention to Edwina they’re not bashful about

goofing off when I’m not there.” “And the problem?” “Although Edwina does wonderful work, she seems to feel like she’s got to keep

me clued in on all of the errors and shortcomings and behavior problems of the regu- lar staff. She usually comes to me with a standard opening like, ‘There’s something I think you ought to know.’ But of course a lot of what I get from her I can’t realisti- cally use without getting Edwina into trouble with the others.”

“Why not just tell her to keep her observations and comments to herself?” asked Kathy.

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“Because—and this is the scary part—every time I’ve been able to check out something she’s told me, it turns out that she’s absolutely correct. How should I deal with her, and how can I constructively use what she’s bringing me?”


Put yourself in Kathy’s position and suggest how Estelle should deal with Edwina and how, if at all, she can constructively use the information Edwina brings.

176      Case 91: The Informant

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C a s e 92

mAnAGinG ThE DRAmA quEEn

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; Criticism and Discipline

Janice Jenkins, one of several supervisors within the business office structure at Mammoth Medical Center, had an ongoing problem with one particular employee, a biller named Helen Benjamin. As Janice attempted to explain to her immediate manager, Casey Sutton, “I’m at a loss as to how to deal with Helen Benjamin. She’s not the poorest performer in the group, but she’s far from the best and she makes her share of mistakes. But every time I criticize her or try to get her to change the way she’s doing something, I get a pretty wild reaction. It’s not always the same reaction from one time to the next, and we seem never to get anything accomplished.”

Casey asked, “Wild in what ways? What’s she doing?” Janice thought a moment before saying, “The mode I see her in most often is

defensiveness. I’ll try to correct something she’s been doing wrong. First, she’ll deny wrongdoing, sometimes quite vehemently. Almost always her first reaction to criti- cism of any kind is that she just doesn’t make mistakes. Then when we’ve reached a point where she really can’t successfully deny the mistake, she’ll demand to know whether this incident is going to appear on her next evaluation. And she lets me know that if it does appear as part of her evaluation, she’ll file a grievance.”

“What else?” “Her other significant approach is even tougher for me to deal with. I’ll take

her aside concerning something that’s been done improperly—and it’s always aside, always in private, and when it’s Helen I always try to approach the situation as gently as possible—and she’ll burst into tears and carry on about how unfair everything is, how she does her honest best all the time, and how the stress of the job and the way she’s treated are driving her crazy. Whether she’s in her defensive mode or her weep- ing mode, she carries on as though she’s trying to impress an audience.”

Casey asked, “Is she treated differently from the others at all?” “Only to the extent that she takes up more of my time than any other employee.

Believe me, I do my best to play no favorites. But I have 14 employees overall and I treat them all the same, and Helen is the only one who consistently gives me trou- ble. Seems to me she has no clue as to how to take criticism like an adult.”

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“How does she relate to the rest of the group?” “She seems to get along with coworkers just fine. In fact, I don’t think the others

know what I go through with Helen. Whether it’s been one of her defensive tirades or a weeping-and-whining session, she seems to be back to normal 30 seconds after leaving my office.”


1. Offer two or three possible reasons that might at least partially explain the behavior of “the Drama Queen.”

2. Recommend a course of action for Janice to consider in dealing with Helen. Be sure to provide justification for your recommendations.

178      Case 92: Managing the Drama Queen

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C a s e 93

ThE holiDAy sWiTch

Primary Topic—Rules and Policies

Additional Topics—Communication; Employee Problems and Problem Employees

Nurse manager Carrie Williams had a complaint about licensed practical nurse Sue Marvin. According to Carrie, Sue was unfairly working the hospital’s scheduling prac- tices to her own advantage. As Carrie explained to assistant director of nursing Dana Daniels, “I think I’ve gotten stung at least twice by Sue Marvin’s schedule switching. She came to me a couple of weeks ago and volunteered to work the upcoming holiday, for which she wasn’t scheduled. And you know how tough holiday scheduling is, so we’re usually overjoyed when someone offers to work the holiday.”

“For time and a half, of course,” offered Dana. “I think I know where this is going.” “And I think you’re probably right. Sue then had the option to choose another

day as her ‘holiday.’ Which she took several days before the actual holiday she was now scheduled to work.”

“Which our policy allows her to do. She can pick any replacement day before or after the holiday as long as it falls within the same 2-week pay period.”

“Correct,” said Carrie. “The problem? I bet I can guess.” “No bet. I’m sure you’ve seen this more than once. She took her replacement day

off for something that was apparently important to her. Then she reported to work on the actual holiday but worked barely half of the shift before pleading illness and leaving. Making us one person short for 4 critical hours.”

Dana asked, “She’s done this before?” Carrie nodded. “At least once that I can remember. That time she claimed an urgent

family situation as her reason for leaving early. It seems that Sue has been able to get cer- tain days off that she specifically wants without honoring her end of the agreement.”


Imagining yourself in the position of nursing assistant director Dana Daniels:

1. How would you advise Carrie in dealing with Sue Marvin?, and 2. What might you consider doing in an effort to curtail such occurrences in the


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C a s e 94

ThE ElusivE EmployEE

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; General Management Practice; Leadership

Laboratory supervisor Vera Simpson was expressing her frustrations with employee Daniel Brandon to her friend, human resources representative Ginny Flavin. Said Vera, “Most of the time I really have no idea what Dan’s doing, since I hardly ever see him. He works what I refer to as our crazy shift, and most of the time his hours overlap the other shifts. And he’s alone much of the time, completely on his own.”

Ginny asked, “Is he getting the work done?” “He seems to be, but at any given time it’s awfully hard for me to tell because

I just don’t see him. And a couple of times when I tried to call him from home—times he was covering nights in clinical chemistry—I couldn’t reach him. He claimed he was responding to a stat call, but I couldn’t verify that. And at least twice the night nursing supervisor said it took 10 or 15 minutes to track him down when she needed something.”

“So you’re concerned about whether he’s really working all the time? Or that his work is up to standard?”

“I’ve never found his work to be anything but acceptable. That is, at least when I’m aware of what he’s doing. My concerns are really twofold: How can I adequately supervise an individual who I’m able to see for only about 10 percent of an average shift, if that? And, how can I do an honest performance evaluation of someone work- ing in his circumstances?”


As noted in the preceding paragraph, how can Vera adequately supervise this employee given the small percentage of time he’s actually in her presence?

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C a s e 95

This plAcE oWEs mE

Primary Topic—Employee Problem and Problem Employees

Additional Topics—Communication; Criticism and Discipline; Leadership; Motivation

“I have a particular part-time employee who is giving me a great deal of grief,” said business office manager Darlene Swift, “and I’m looking for advice on how to deal with her.”

“What’s she doing?” asked human resources representative Ellen Francis who then added, “Are you going to tell me it’s Jennifer Wilson again? The one we spoke about maybe 6 months ago?”

“Yes, the same. I’d forgotten we talked about her briefly. I tried counseling like you suggested, but nothing changed. If anything, things have gotten worse.”

“How so? Fill me in; I don’t recall the particulars of our earlier discussion.” Darlene offered, “Jennie’s still part-time, 20 hours a week. But she takes more

sick time than any full-time employee. She’s out frequently, and whenever she returns she automatically expects that someone will have completed anything she left unfin- ished. She expects someone else to clear up her backlog any time she’s out, and unfortunately that’s what’s been happening.”

Darlene continued, “And whenever she’s asked to work extra time help cover for vacations or others’ illnesses, she always refuses. With what usually sound like good reasons.”

Ellen asked, “How long has she been employed here?” Darlene sighed. “Maybe that’s part of the problem. She’s been here forever—

close to 25 years. In fact, she told me recently that she’d given her share of extra effort to the hospital over the years and that it was about time the hospital gave back to her. As she puts it, ‘This place owes me.’”

“Have you talked about her behavior recently? Specifically, the absences?” A shrug. “I tried counseling. About absences. That’s when I got the speech about

expecting the hospital to give back to her.” “Still concerning the absences, any disciplinary actions?” “No,” Darlene answered. “I don’t believe she’s ever been disciplined for anything.” “Okay,” said Ellen. “Let’s take a look at her file, access her attendance records,

and see what we might be able to do about Jennifer.”

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1. Imagining yourself in the position of human resources representative Ellen Francis, what advice would you offer Darlene for dealing with her trouble- some employee, Jennifer?

2. How could Darlene have avoided—or at least minimized—the present problem? 3. What personnel policies are likely to be in place to assist Darlene in address-

ing difficulties such as those presented by Jennifer?

182      Case 95: This Place Owes Me

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C a s e 96

hE DiDn’T WoRk ouT

Primary Topic—Hiring and Placement

Additional Topics—Authority; Decision Making; General Management Practice; Leadership

Bill Young, an all-around mechanic and electrician, was hired by James Memorial Hospital as supervisor of engineering and maintenance. Although he had 15 years experience in the field, this was Young’s first supervisory position.

Shortly after Young’s arrival a maintenance helper job became available. This was an important job because of the numerous preventive maintenance tasks involved, and Bill Young recognized the need to fill this position as soon as possible. Imme- diately after receiving the departing helper’s resignation, Young asked the human resource department to locate several candidates for him to interview.

Young’s immediate supervisor, chief operating officer Peter Jackson, chose to sit in on the interviews, giving as his reason Young’s newness to management. Jack- son indicated that since Young had never interviewed or hired before he should be assisted in the process.

Young and Jackson jointly interviewed five candidates. Of the five, two appeared to be reasonably qualified for the job. One of these was a young man named Sim- mons who was employed in the hospital’s food service department. The other was a young man named Kelly who had not worked recently but had had several months of building-and-grounds experience at a school.

After the interviews Young expressed his desire to hire Simmons from food ser- vice because he appeared to have the aptitude and ability and exhibited a strong desire to better himself. Young also reasoned that selecting Simmons would show that the hospital was genuinely interested in developing employees within the orga- nization. However, Jackson disagreed with Young, told Young he could do the hiring “the next time a job opened.” Jackson himself made the decision to hire Kelly and personally communicated the offer to Kelly.

As the 30-day probationary period progressed, it became increasingly evident to Bill Young that Kelly was not shaping up as a satisfactory employee. Even with being sure to give Kelly all reasonable orientation and guidance, and extending every ben- efit of the doubt because he had been “the boss’s choice,” Young could conclude only that they would be making a mistake keeping Kelly on past the introductory period.

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On the 28th day of Kelly’s employment Bill Young went to see Jackson. He had kept Jackson advised of Kelly’s poor progress and lack of response to guidance, so it was no surprise to Jackson when Young said they should let Kelly go and start all over again.

“Okay,” was Jackson’s reply, “let Kelly go.” Young hesitated, wondering a moment if he should say anything, and finally said

to Jackson, “I don’t believe I should be the one to let him go. I’m not the one who hired him.”

“He’s your employee,” Jackson responded. “You get rid of him.”


1. Do you believe Jackson dodged responsibility by ordering Young to get rid of Kelly? Why, or why not?

2. In what other way could this situation have been more equitably handled? 3. What effect is the Kelly incident likely to have on the future relationship

between Young and Jackson?

184      Case 96: He Didn’t Work Out

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C a s e 97

TAkE youR choicE

Primary Topic—General Management Practice

Additional Topics—Authority; Change Management; Time Management and Personal Effectiveness

You are a registered nurse with 20 years of hospital experience, and you have spent 10 years as nursing director in a 60-bed rural hospital. You recently applied for the position of assistant director of nursing at a 375-bed city hospital. During your initial interview the nursing director posed four sets of “conditions” and asked you to state which of these best described the circumstances under which you believed such a position should be taken. The “conditions” are:

1. You step into the job with the full authority and responsibility of the position as experienced by your predecessor.

2. You assume the full authority of the position but have somewhat reduced responsibility because of your newness to the job.

3. You have equal responsibility and authority but at a lesser level than your predecessor, leaving you room to “grow” in the position.

4. You assume the full responsibility of the position but can exercise less author- ity than your predecessor (again, temporarily, because you are “new”).


Designate the set of “conditions” under which you would consider taking the job, and explain why. In doing so, consider the advantages and disadvantages of each set of “conditions.”

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C a s e 98

Why shoulD i?

Primary Topic—Employee Problems and Problem Employees

Additional Topics—Communication; Criticism and Discipline; Delegation

You are a unit manager in a hospital’s clinical laboratory, and you have 22 direct- reporting employees.

You believe that you have comfortable working relationships with all of your employees except one. The single employee in question, a laboratory technologist, continually gives you a hard time regarding assignments. Whenever you give this person a task that she considers not part of her daily routine and is not specifically designated in her job description, her response is, “Why should I? That’s not part of my job.”

In once recent, frustrating exchange you found yourself responding angrily, “Because I said so, that’s why!” This response not only failed to get results, it also generated increased hostility.


How are you going to deal with this employee?

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C a s e 99

ThE DRop-in visiToR

Primary Topic—Time Management and Personal Effectiveness

Additional Topics—Communication

As the door closed behind her departing visitor, central supply supervisor Janet Mills glumly reflected that she had just lost an hour that she could ill afford to lose. She would either have to forgo the schedule she was working on or be later for an upcom- ing meeting.

The hour had been lost because of a visit from a pleasant but marginally aggres- sive sales representative trying to acquaint her with “the greatest little thing ever to come along.” As was her practice, Janet consented to see the visitor, although she resented the intrusion.

This incident, occurring on a Friday, made Janet realize that she had lost time to four such drop-in visits this week alone. She did not like the idea of simply saying no or otherwise trying to avoid people who wanted to see her, but she was becom- ing more aware that her work was beginning to suffer because of such demands on her time.


Develop some guidelines that might help Janet and other supervisors deal with the problem of drop-in visitors.

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C a s e 100


Primary Topic—Leadership

Additional Topics—Change Management; Communication; Motivation

You have been employed in the hospital’s business office for 12 years. Starting in a clerical capacity, you have worked your way up through several jobs in the depart- ment. You consider yourself friends with all 14 other business office employees, and at least two of them you number among your closest friends.

Recently you were appointed business office manager. You willingly accepted the position. You believe that although one or two persons in the department may feel some slight resentment over your appointment, they are, for the most part, support- ive. However, you realize that as a supervisor it may sometimes be necessary for you to do things that are inconsistent with your feelings for this group of people, these people with whom you have worked for so long.


1. Should you find it necessary to “pull away” to any extent from those people with whom you have worked for so long?

2. How do believe you should go about reestablishing a long-term relationship with your former coworkers?

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. 8645

    • CASE 15 IN A RUT

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