Decision Making

& 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.”

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