Article Content

BUT SHE'S REALLY SICK

The "Case in Health Care Management" is a regular feature of The Health Care Manager. Readers are invited to analyze the problem presented in the case and develop a reasonable response to the situation.

 

In analyzing a case:

 

* Look for the principles that seem to be involved, and look for the applicability of rules of reason, common sense, and fairness.

 

* Seek help from published sources. Associate the concerns of the case with key words that describe principles, concepts, theories, or techniques, and look these up in texts on supervision and basic management.

 

* Make whatever reasonable assumptions you need to "fill in the blanks" in the information given.

 

* Keep your assumptions reasonable, and state your key assumptions in your conclusions.

 

* Recognize that there are few solutions to a case problem that are entirely right or wrong. You are dealing primarily with human behavior, and all people will not necessarily behave the same way in similar situations.

 

 

BUT SHE'S REALLY SICK

"I'm really up a tree about 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?"

 

Instructions:

 

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

 

LET US HEAR FROM YOU

Readers are invited to submit their written analysis of this issue's case for possible publication in HCM 36:2(April-June 2017). This is not a contest. Because a solution to a case may be neither completely right nor completely wrong, there will be no winners or losers. We will select 1 solution that seems particularly appropriate or relevant, or we may elect to publish excerpts from several proposed solutions.

 

Responses to this issue's "But She's Really Sick" should be submitted under the following conditions:

 

* Your response, not exceeding 300 words, should be emailed no later than February 15, 2017, to Charles R. McConnell, Editor, HCM, at[email protected].

 

* Your response should include your full name, title, organization, and email address.

 

* The editor will notify anyone whose response is selected for publication. Selected responses will be subject to normal editing for language and style.

 

 

TO MOTIVATE THE UNMOVABLE (FROM HCM ISSUE 35:2)

"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 two years ago that I wouldn't be free to supervise normally in this environment."

 

"What's wrong with this environment?", asked Melissa's manager, assistant administrator June Allen.

 

Melissa spread her hands and lifted her shoulders. "You know as well as I do, June. Goodness knows you've worked under it long enough. Government. We're a municipal hospital, an arm of local government."

 

"But we're still a not-for-profit general hospital," said June. "What makes motivating employees any different here than it would be almost anywhere else?"

 

"Almost everything," said Melissa. "Look what our governmental status and the civil service system 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 promote a good performer because there's no career ladder structure and I can't advance anyone unless something opens up, and third," she said as she drew the middle finger into a bundle with the other two, "creating a new position falls somewhere between impossible and taking forever, and finally if an opening occurs or I manage to get another position approved I'm usually required to go by the results of some examination in filling the job."

 

June Allen shrugged and said, "Civil service has its drawbacks, that's true, but I think maybe you're looking in the wrong places for most of the motivators."

 

"I don't know, June," Melissa responded. "Oh, I've heard all this stuff about how money supposedly doesn't really motivate. If that's so, why do our employees talk about money so much? As far as I'm concerned, I've about decided that "thank you" goes only so far and that's not far enough."

 

Instructions:

 

Putting yourself in the position of assistant administrator June Allen, prepare a response for your subordinate supervisor Melissa Wilson. Be sure to include some clear direction for Melissa to follow in seeking more effective ways of motivating her staff.

 

RESPONSE TO "TO MOTIVATE THE UNMOVABLE" (FROM HCM ISSUE 35:2)

No reader responses to the case in HCM 35:2, "To Motivate the Unmovable,"' were received. Following are a few possibilities, some of which might figure in a reasonable response.

 

Melissa might truthfully say that "Thank yous go only so far, and that's not far enough." Thank yous do have a certain positive effect in encouraging employees to perform acceptably; however, simple thanks usually do not provide sustained motivation.

 

On the other hand, Melissa cannot conclude that money always motivates because "employees talk about money so much." Although the mix of motivating forces can vary dramatically from person to person, money can indeed motivate if it is enough. (Consider whether you would step up the pace and turn out more and better work just as willingly for a 5% raise as you would for double your present salary.)

 

Admittedly, Melissa is working in a highly structured environment that limits the actions she can take on behalf of her employees. However, the restricted circumstances do not themselves prevent the supervisor from taking some positive steps with her employees.

 

In Melissa's circumstances, it would be best to recognize the difference between the true motivators and those other factors that Frederick Herzberg referred to in his classic motivation-maintenance theory as potential dissatisfiers. These potential dissatisfiers, also frequently referred to as environmental factors, represent conditions of employment that must be continually reinforced or maintained or they will become dissatisfiers. Most often, money is in this category; periodic raises do not necessarily motivate, but their absence can breed dissatisfaction and have an adverse effect on performance.

 

Looking beyond the environmental factors, the potential dissatisfiers, we are eventually led to conclude that the true, lasting motivators reside in the work itself. The true motivators include the opportunity to learn and achieve; the opportunity to do interesting, challenging, and interesting work; and the opportunity to assume responsibility and become involved in determining how the work is done.

 

To be able to identify the true motivators, Melissa needs to focus more on the work itself and less on the environment in which the work is performed.