Seaside Convalescent Care Center-Case for Chapters 13 and 3 H. Wayne Nelson Mind
ID: 397711 • Letter: S
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Seaside Convalescent Care Center-Case for Chapters 13 and 3 H. Wayne Nelson Mindy Alternot has been the administrator of Seaside Convalescent Care Center (SCCC) for seven months. This was her first job after earning her Nursing Home Administrator's license, and despite her initial enthusiasm, she began having second thoughts about her career choice. Things weren't going well at SCCC. Actually, things hadn't gone well there for several years. Mindy had hoped to turn things around, but the facility's last survey was terrible. Th more than minimal harm to the residents. There were other significant problems relating to resident care, resident rights, and quality of life. Consequently, SCCC was denied pay- ment for new admissions and was being fined $3,000 a day for noncompliance e inspectors had found several deficiencies indicating a patten of "potential for Mindy blamed her nurse's aides (NAs). After all, they provided more than 90% of the hands-on patient care. She found it nearly impossible to find good ones, and even when she did, she couldn't keep them. Their turnover rate was well over 100% a year (not rare in troubled facilities). Even those who seemed to enjoy working with the elderly would inevi tably leave during the summer when it was easy to find more lucrative tourist-trade work. Mindy had tried to motivate her aides by improving their training and by making their job more meaningful. She tried to encourage their input in matters related to patient care-and primary care team (which didn't sit well with the nurses). She wanted the aides to assume more responsibility for solving everyday resident problems. Moreover, she tried to build good relationships with hem. She wanted to lead by being visible, available, engaged, and in tune with what was environment. After two months of "beating her brains out" trying to build relationships, Mindy finally conceded to her Director ofNursing Services Ann, that the task was hopeless. This was a bitter pill for Mindy, who had been warned by wanted to work with the licensed nurses to make the aides part of the total going on in the interactive caregiving Ann that "touchy-feely schoolbook approaches" just wouldn't work with this crowd. Ann was a top-notch nurse and a vete ran nursing manager. She found the nurse's aides to be a sullen lot, generally, and very hard to manage. Her experience showed them to 422Explanation / Answer
Mindy Alternot has a multitude of problems, as a new administrator at the Seaside Convalescent Care Center Mindy was trying to turn the center around and make major changes to their poor reputation. However, the center's last survey was terrible, inspectors found a number of deficiencies around the center that could cause "potential for more than minimal harm." This not only hurt the reputation of the hospital but was also costing them $3,000 a day for non compliance, a hefty fine. Mindy found this to be a problem with her nurse's aides because they provided most of the care around the center. One of the main issues that Mindy had with her aides was that they seemed to be unmotivated and did not want to work to the best of their abilities. Another problem she had was when the nurse's aides were doing a good job they would leave during the summer to find more lucrative work, giving the center a turnover rate of well over 100%. Mindy tried making bonds with them and motivating them but shortly after became frustrated and gave up, delegating this task to a veteran nurse and well versed nursing manager, freeing her to work the logistics of the care center.
Course of Action Chosen
Mindy worked to build better relationships with the staff at the center, motivating them, educating them and making their jobs more meaningful. She tried to encourage the nurses and nurses aides to give their input into matters related to patient care to get them involved in the overall process. Mindy also tried to work with the licensed nurses to make the nurses' aides part of the primary care team, something that the nurses did not take too kindly to. Most of all Mindy tried to lead by being a visible head of the organization, she worked to be involved, available, and engaged whenever she was in the office and working with her employees. After two months of working to be engaged and developing the competency of the nurses' aides Mindy had enough, she began to become reserved and ignore her staff all together. In her third month she delegated the task of oversight of the nursing staff to Ann. Ann had worked as a nursing manager before and knew what it would take to get the nursing staff whipped into shape. Ann stressed discipline, and saw employees as unmotivated. Her plan was to punish staff that were not fulfilling their duties and to use her employees while she had them, leading to a lot of overtime and double shifts. This delegation by Mindy allowed her to focus on the technical aspects of running the care center, something she enjoyed and had the skills to do.
Results of Actions or Potential Implications of Actions
The results of the actions taken by Mindy and Ann were not great ones. First and foremost it created a lot overtime for Ann and her nurses and nurses' aides. One of the main reasons found for nurses and aides leaving their positions in nursing homes was the issue of understaffing (Donoghue and Castle, 2007). This problem goes hand in hand with the current shortage of nurses, pharmacists, technicians and therapists in the health care industry (Colie, 2002). Because of this nursing shortage, the care center had to over work their employees which led them to quit when the more lucrative tourist season came along, creating an even larger shortage of nurses for the care center. Another result of the course of action was the lack of communication between Mindy and the nurses and aides. Gratto Liebler and McConnell recommend that managers remain in regular contact with each of their employees (Gratto Liebler and McConnell, 2008). At first Mindy did this, trying to be engaged in the staffs work day, but as time went on Mindy could no longer do this. By the third month Mindy was avoiding her employees, creating more disinterest from the employees and only perpetuating the problems she was having with the retention of nurses.
Recommendations
Mindy Alternot has a number of problems, that if not taken care of could cost her care center a lot of money. That being said I have a number of recommendations that if implemented should be able to fix her problems. First and foremost, Mindy needs to change her hiring process. By providing a job description when posting for an open position Mindy can make sure that only applicants who are serious about the job and have the right qualifications for the job are applying. This will also lead to employees with good organizational fit, they will work well in the organization and create a positive work environment leading to success. The second thing that Mindy needs to do is to have a formal evaluation process once every three months. By having this evaluation process Mindy will be able to sit down with her employees, go over their strengths and weaknesses, make recommendations to how they can change their bad habits and lead them to strive to improve their work. For this case specifically I would suggest the 360 evaluation listed previously. This assessment would allow an evaluation from all points of view, in this organization I think this would be a good idea because everyone needs to get on the same page so they can start to provide high quality health care.
Another recommendation I would make would be to give a survey to each employee who quits at the center. This survey would allow Mindy to see what is wrong with her center and why employees choose to work in other places. After getting the results she can then work to fix these problems. Tied in with this point, one of the main reasons for leaving a job is the issue of understaffing, Mindy needs to hire more employees so that her nurses do not get over worked and quit. Although this may require hiring some average nurses, I believe that this will keep the good nurses from leaving due to being over worked. Keeping these nurses around can help Mindy build a solid foundation on which to build her organization. I also believe that Mindy needs to make clear to her nurses that the nurses' aides will be a part of the health care delivery system whether they like it or not, this shift will only benefit the nurses and this is a way that Mindy can show them they are a valued part of this organization.
Finally I think that there does need to be some discipline issued in the care center. I think that employees believe that they can get away with too much and that needs to change. Ann does need to be an authoritative leader to keep the unmotivated staff working at a high level, if Ann is not there to discipline them they will continue to give minimal effort, and the care center's reputation will continue to slip and they will continue to lose money. Although I do agree with the switch in general every day management of nurses from Mindy to Ann, I do believe that Mindy still needs to be a well seen presence around the center. The switch will allow Ann to do what she does best, manage nurses, and Mindy to do what she does best, run the technical aspects of the care center. However, Mindy cannot leave all of the responsibility to Ann, this is her care center, she needs to manage her employees as well, even if it is from an overall management standpoint.
All of these recommendations need to be implemented if Mindy is to save her care center from becoming worse than it already is, if she decides to keep things the way they are and not serve an active role in managing her employees she will lose their respect and possibly her center.
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