Synthesis of Concepts: Organizational Behavior, Theory, and Design in Health Care

Case Study #1: We Only Wanted to “Scare” Management Into Making Changes! A small group of nurses, employed at a large community hospital, were unhappy about their work environment and would meet daily during lunch to discuss the situation. There had been a recent change in the hospital’s senior management, which caused a high level of uncertainty and anxiety among the nursing staff. The nurses felt overworked due in part to the industry’s current nursing shortage. Their wages and benefits had been stagnant with no salary market adjustments for the past two years. The nurses saw the situation as management requiring them to do more work with fewer resources, with no appreciation or recognition of their efforts. Whenever the nurses approached management with their concerns, they perceived them as falling on deaf ears since no changes were made. Feeling like they had no other choice, the nurses contacted a labor union. The labor union began an organizing effort in the hospital shortly thereafter, holding an aggressive campaign over a six-week period. There was tremendous peer pressure, as some of the well-respected nursing staff became active leaders for unionization, although they were not part of the initial group of nurses who had first contacted the union. The election was held and the union was voted in by two thirds of the nursing staff. In the weeks that followed, the original group of nurses remarked that they were surprised by the union’s victory; they had only wanted to “scare” management into making changes to their work environment.
Using Herzberg’s Two-Factor Theory, explain why the nurses were motivated to contact the labor union. Using Blake/Mouton’s Managerial Grid, explain the leadership style displayed by management to the nursing staff. Compare and contrast formal and informal groups. (Note: include in your answer (1) why management needs to be aware of informal groups within their organizations, and (2) why people join informal groups). Explain the French and Raven model of power. Who displayed power(s) in this case and why?

Case Study #2: Where Did Ms. Zamora Go Wrong? Ramila Zamora looked forward to her recent promotion to management and was looking forward to her transfer within the large county hospital to another nursing unit. She was enthusiastic and hopeful about working together with other nurses to improve patient care through effective teamwork. She felt that she was well prepared to lead and supervise and was grateful for the opportunity. Ms. Zamora was provided very little information about her predecessor and knew less about her subordinates. She was stymied and baffled about the behavior of the nursing staff during her first team meeting. Ms. Zamora introduced herself to the group and with what she thought was great enthusiasm, distributed her agenda and immediately began to delegate tasks to the team members. She noticed that three of the five members began to look at each other and roll their eyes. As she continued to read the list of responsibilities, designating team members to the various tasks, two members got up and began pouring coffee and speaking softly to each other. Ms. Zamora was exasperated. She told them that the meeting was over and that she did not want to take any more time away from their jobs then was necessary. She returned to her new office feeling deflated and discouraged. She asked herself several questions. What went wrong? Why did the nursing staff treat her so rudely? Had she made a grave career mistake? What should she do?

What stage of group development was the group in? What are the leader’s tasks in this stage? What are the members’ tasks in this stage? Reconstruct the group meeting and put yourself in the role of Ms. Zamorra. Using Hersey and Blanchard’s Situational Leadership Theory, explain what style of leadership Ramila Zamora should have used given the current situation. Why?

Case Study #3: What Can Joe Do About Betty? Just before quitting time, Joe, the hospital’s health information department manager, watched his three new trainees struggling with the complicated electronic medical records software they had to learn to use to do their jobs. Across the room, Betty, who was an expert with the software, was preparing to leave for the day, her tasks done ahead of time as usual. Also as usual, she gathered up her belongings and left without saying good-bye to any of her coworkers. “There goes the answer to my problem,” thought Joe, “if only I knew how to reach her.” With her expertise and experience in using the system, Betty would seem to be an ideal coach for the new employees. However, she had begged off from taking on training duties when Joe had asked her. Her reasons were that she wasn’t comfortable telling anyone else what to do, didn’t want the responsibility for someone else’s work, and preferred to work by herself at her own job. Joe was stunned by her refusal; he enjoyed helping his coworkers and felt it was why he had advanced to department manager last year instead of Betty, who had more seniority and experience with the company than he did. Since her work was excellent, Joe hesitated to make it an “either you do what I want or you’re in trouble” situation; he believed employees worked best at what they wanted to work at. But his problem still remained: There was no money in the training budget and no other employees as skilled with the system as Betty was. Was there an approach to convincing her to help that he hadn’t thought of?

As Betty walked to the hospital’s parking lot, she thought, “how could Joe think I would lift a finger to help him? I should have been the one promoted to department manager last year, not him. I’m the one with seniority and the necessary experience. In fact, I was the one who trained Joe when he first joined the hospital! Just because he has a Masters in Health Information Management and I don’t should not have been the determining factor, but obviously senior management thought so when they selected him over me! I could care less what happens from this point forward. I only have 5 more years until I can retire with my full pension. As long as my work continues to be excellent there is no way Joe can upset my plans. Not that he could since he hardly understands the complexity of the software we use since it requires a person with a lot of technology knowledge and experience.” Questions: Describe French and Raven’s five sources of power. In the above case, who has power(s) and why? Describe the four sources of conflict. In the above case, what conflict(s) do you observe and why? Using Vroom’s Expectancy Theory (VIE), explain Betty’s lack of motivation. Using Fiedler’s Contingency Theory, explain what style of leadership Joe would use given the current situation in his department.

Case Study #4: Conflicts Within Best Bio-Medical Research Firm Part One Jennifer Smith, a young scientist, is a single parent with two children. Although she finds social interactions with co-workers rewarding, she is concerned about the security of her position and pay. She is an excellent employee who enjoys her work. When a vacancy occurred for the project manager position in her department at Best Bio-Medical Research Firm, she considered the opportunities this presented for professional growth and development, as well as for a higher salary, and applied for the position. Smith looked forward to the challenges she would face when promoted. However, a more experienced co-worker was promoted. Smith’s disappointment showed and she became concerned about her future. Several co-workers noticed her reaction and made special efforts to ease her disappointment. They told her that other opportunities would come and that, with a little more experience, she would be promoted. After a few weeks, Smith returned to the level of enjoyment she obtained from her work before this episode. Part Two Kathy Harris, a scientist employed by the Best Bio-Medical Research Firm with over five years experience, recently received a promotion to acting project manager within her department. As acting project manager, Harris is responsible for scheduling of work assignments but also the hiring, promotion and, if necessary, the termination of employees within her department. A few days after Harris started in her new interim position she encountered problems. The previous project manager had retired unexpectedly and most of the other scientists within Harris’s department assumed that Jennifer Smith would be automatically promoted to the position. The CEO of Best Bio-Medical Research Firm related to Harris that although Smith had been considered she was thought too inexperienced for that much responsibility and that Harris was selected because she had five years experience as a scientist and during the period she has been employed by the Best Bio-Medical Research Firm, she had demonstrated her ability to consistently completed her project assignments on time and under budget with high client satisfaction. However, the CEO made it clear to Harris that she was appointed only as the acting project manager of the department and that the company planned to conduct a national search for the position and that she was most welcomed and encouraged to apply for. If she was the best candidate from the applicant pool, the position would be offered to her. The CEO also asked Harris that although she was responsible for the efficiency and effectiveness of the department during this period, that she not make any personnel changes and keep things status quo until the permanent project manager was appointed. It soon became evident that, although, Smith was cooperative, many employees were not. Employees who were unhappy with an assignment would tell Harris that, if Smith had been appointed, such problems would not occur. Many comments were made as Harris continued her duties. Some were very embarrassing. One person suggested that she had a “friend” in senior management who gave her the job due to their “relationship” rather than because she was competent. Questions: Using Herzberg’s Two Factor Theory (or Alderfer’s ERG Theory of frustration/regression) explain Jennifer Smith’s motivation needs. Using Fiedler’s Contingency Theory, explain what style of leadership Kathy Harris would use given the current situation in her department. Discuss why senior management of Best Bio-Medical Research Firm and the employees of Harris’ department perception about and attitudes towards Kathy differ so completely. Describe specific ways Kathy Harris can change her employees’ attitudes.

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