Case Study on Leadership and Management

This case study focuses on the problems faced by a surgical ward due to employee dissatisfaction and the lack of effective leadership. It provides insights into the issues and offers recommendations to mitigate them. The document type is a case study and the assignment type is a study material. The subject is leadership and management, and the course code and college/university are not mentioned.

Running head: CASE STUDY ON LEADERSHIP AND MANAGEMENT
CASE STUDY ON LEADERSHIP AND MANAGEMENT
Name of the student:
Name of the university:
Author note:

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CASE STUDY ON LEADERSHIP AND MANAGEMENT
Introduction:
The problems mentioned in the case study arose due to employee dissatisfaction. The
surgical ward was a 33 person staffed ward with 25 registered nurses and eight care assistants.
Analysis of the problems occurring in the General surgery Unit at the Eastern Massachusetts
University hospital made Barbara develop the following insights. There has been a high turnover
rate but at the same time new hiring is freezed because of fund issues. Hence, the leader named
Barbara has to develop the present condition of the team to ensure uninterrupted service to
patients which are not only high in quality but immediate and prompt as well. The assignment
would first see the different concerns and problems that the team is facing and this should be
followed by providing recommendations that can help in mitigating the situations.
First problem:
Ineffective teamwork with poor teamwork skills among the nursing professionals was the
first problem. Complete lack of bonding was absent among the senior and the junior nurses and
this was reflected from the experiences of Meghan and Louise. The former nursing leaders might
not have contributed enough effort and time of developing an organizational climate in the ward
which would exhibit love; care and bonding among the team members, thereby making them
work as a team. The junior nurses were of the opinion that the seniors did not acknowledge their
contribution and often considered them inexperienced and burden on the healthcare unit. The
senior nurses on the other hand used to consider them that they do not have proper knowledge
and that they always ask for help that affects the flow of the work of the senior nurses. Hence,
complete lack of collaboration and coordination seems to be completely absent in the team
working in the GSU.

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Lack of elements of effective teamwork found:
A number of aspects had been found to be absent among the team-members that created a
barrier between the team-members and resulted in dissatisfaction and agitation among the
members. One of the most important aspects of teamwork that is absent is the trait of the
members of being straightforward and honest. Studies are of the opinion that it is important to
maintain transparency within teamwork as that helps in developing trust among the members and
prevent development of misconceptions about the others (Frich et al., 2015). Meghan, a junior
nurse found out that her senior nurses were talking behind her back regarding her skills in a
negative tone that affected her motivation and employee morale. If the seniors had been honest
and straightforward to her about the aspects they like or do not like about her in a constructive
manner, such negative emotions would not have developed within Meghan. However, lack of
effective constructive feedback exchange session between the members of the team could have
contributed to further development of negative feelings among the members.
Another important aspect that was lacking among the team is the trait of sharing loads of
the work. Barbara had noticed a complaint where members stated that they could never count on
others for helping them. Studies are of the opinion that team members should have the urge to
move forward and help other members in time of their crisis and increased work burden as that
ensure providing quality care to the patient and saving the patient from poor quality services
(Rosen et al., 2018). High work burden can result in emotional and physical fatigue of nurses
making them feel burned out (Hargett et al., 2017). The team-members should always come
forward in such scenarios to share their work burden to provide effective care that satisfies
patients. Development of good bond and rapport among the team-members can help members to
feel for each other emotionally and thereby share their work-burden to help the member to

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manage the work demands effectively. However, lack of bonds and rapports among the members
prevented them from developing friendly and emotional connection with the team members and
this resulted in the members not sharing their burdens with each other.
High rate of blame games and power struggles are also observed among the senior and
junior nurses and also among the doctors and the nurses. One of the incidents shows a nurse
complaining that doctors treat them as order takers but not as caregivers. Hence, power struggles
and blame games are found to be two of the most important aspects that have the capability of
affecting emotions of team-members and affecting the flow of work as a team. Organizational
climate that do not defend blame games have seen to have higher number of turnovers and higher
rates of employee dissatisfaction among the members (Husebo et al., 2016). Blame games
hampers employee morale and motivation to work beyond their potential making them develop
negative feelings about the organization. It damages the enthusiasm and zeal of the employees
thereby demotivating them. Moreover power struggles make victims feel disrespected and not
cared for in the organization. It makes them feel that other members of the team are not paying
the worth one deserves and these results in lower productivity at work, various forms of conflicts
and poor quality service (Poghosyan et al., 2016). In case of the present situation, power struggle
and blame game were observed within the teamwork and this had resulted in poor relationships
and bonds among members and lack of employee morale.
Second problem:
One of the problems that are also noticed is the lack of effective leadership in the general
surgical unit. Huge numbers of problems were discussed in the feedback session that Barbara
conducted for about one and half hours to know about the grudges and complaints about the

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issues faced by the team members. A number of points were objected that showed lack of proper
guidance to the members, lack of motivation among the members, excessive work pressures, lack
of feedback sessions, lack of acknowledgement and lack of career growths were the main criteria
of concerns. All of these aspects could have been handled effectively if the leaders guided and
supported the embers in their crisis periods making them develop trust over the nation.
Lack of elements of effective leadership found (before arrival of Barbara):
One of the most important aspects of effective leadership is to ensure motivation among
the members by promoting the positive skill sets of the members and guiding subordinates to
develop their weakness and turning them into their strengths (Lee et al., 2017). Studies are of the
opinion that one of the best ways to develop motivation among the employees is to acknowledge
for their contribution in front of the team and respecting their dedication and exhibiting them as
role models to be followed (Forsyth et al., 2017). This makes the individuals feel that the
organization had recognized their dedication and that they value their dedication. However, in
case of GSU in the healthcare centre, Barbara noticed that the previous nurses have not
conducted nay acknowledgment sessions to show respect and value the contributions of the
nursing professionals. Studies are of the opinion that employee acknowledgment and rewards
have positive impact on employee motivations (Fernandez et al., 2015). This aspect helps in
making happier employees where employees are found to become more productive and it also
increases employee trust (Rosenman et al., 2015). As the leaders have not put significance on
this aspect, the nursing professionals of the ward were found to be demotivated.
Another important element that the leaders have not incorporated in the organizational
climate is the transparent feedback sessions not only among the team members but also between

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leaders and subordinates. Most of the nursing professionals have complained to Barbara that they
are not provided the scope to put their impacts on the matters that impact them greatly. Studies
are of the opinion that lack of effective communication and feedback exchange sessions with the
employees can affect the morale of the employees making them feel withdrawn from the work
culture (Musinguzi et al., 2018). One of the studies have shown that healthcare organizations
which include employee feedbacks and suggestions in decision making or making better
workplace have 14.9% lower employee turnover rates who do not provide importance to
employee feedbacks (Eppich et al., 2016). Another study also showed that employees are two
times more disengaged in their work if their leaders or managers ignore their participations and
suggestions. Motivation and engagement increases by 30% when employees are provided scope
of communicating their concerns, suggestions and other feedbacks (Ryan, 2017). This would
make the subordinates feel cared by the organization making them feel that their suggestions and
feedbacks are valued. The leaders have not incorporated such aspects in the team atmosphere
before which had made the employees demotivated and increased the turnover rates
Another important aspect that the leader had also not put significance to is development
of career growth opportunities among the employees. The nursing professionals that they are
nor provided scopes of career growth and opportunities and even if they undertake personal CPD
sessions, such sessions are not provided importance during the appraisal systems. Studies are of
the opinion that by career development opportunities, leaders can help the employees to develop
the skills for the position he wants and also helps the organizations see a higher level of
commitment and better retention from employees (Regan et al., 2016). The nursing professionals
might also be demotivated as they have not got the scopes of developing the skills and even
Jennifer was of the opinion that developing skills and knowledge were also not paid importance

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during appraisal. All these affected the employee motivation and zeal of working in the
organization. This can be also contributed to higher turnover rates as well as in the healthcare
center.
Cost-benefit analysis:
The main priority of Barbara would be to ensure retaining more number of present nurses
and prevent any turnovers. This is because the allocation of funds to the healthcare organization
had reduced and hiring has been also freeze to prevent further allocation of salaries to newly
recruited nurses. In such a scenario, the nursing leaders should be mostly benefitted if the
individual focuses in increasing employee dissatisfaction and developing the motivation among
the nurses who are currently present rather than negotiating with higher authorities for recruiting
more nurses. In order to support the already present nurses and make them develop motivation, it
becomes important to introduce strategies that suffice their demands and also develop the
organizational climate which is healthier for the well-being and effective functioning of the
team-members (Logan, 2016). Hence, taking into consideration of this output of the cost-benefit
analysis, following recommendations need to be undertaken.
Recommendations:
 One of the most important strategies to develop transparency among the team
members to stop blame games and power struggles is to ensure building up of strong
rapport among the members. Therefore, the leader should be initiating a number of
informal programs like picnics and outings on specific days where members get to talk
with each other and develop informal bonding.

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Moreover, the leaders should also engage in fun activities twice a week where
members would be performing as min-teams with exchanged partners every week. Such
games would help in developing rapport and understand the working styles of each
members, their likings and disliking and similar others (Sadideen et al., 2017). Such form
of activities would not result in allocation of huge funds but might help employees to
develop informal bonds with members.
One of the innovative program that can be arranged is the allocation of half an
hour for constructive feedbacks among the 33 nursing members where they would reveal
the feelings they harbor for each other. These would be more informal and would
promote constructive feedbacks and not negative ones. This would help in maintaining
transparency among the members and would also help each member to understand about
what are liked and disliked by others about them. This would not only reduce blame
games and power struggles but would also help to ensure all members can connect with
each other’s feelings and thinking patterns (Schwartz et al., 2018).
 Another important strategy would be to apply transformational leadership skill by
Barbara to make sure that people gets highly motivated. One of the most important
aspects would be to develop opportunities for the nursing professionals where they can
train themselves with new approaches in healthcare and thereby engage in continuous
professional development. The leader should develop a supportive environment where
nurses can attend to such training sessions and do not face constrictions because of their
duties on the ward.
Moreover, it is highly important for the nursing leader to initiate a reward system
that would help to acknowledge the deserving candidates and value their contributions to

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the healthcare centre. It has been found that there had been already restrictions of funds
and hence financial incentives could not be included as a strategy for rewarding the
deserving professionals. The nurses can be acknowledging in front of the entire ward by
declaring the specific contributions they had made one by one by the leaders in front of
the entire unit. This would make them feel respected in front of the entire unit and this
can contribute to make them feel more motivated (Rosenman et al., 2015). They can be
also given additional benefits like extra-day offs, developing insurance policies for their
health or other assets, providing them discount coupons on different accessories, objects
and many others.
Effective feedback sessions need to be arranged for gaining feedback from the
employees both on one on one basis and also on a cumulative feedback exchange
sessions. Such sessions would help in providing important attributes that the leaders
should note down and consider them when taking decisions, or managing changes and
several other actions. Moreover, Barbara can also initiate a social media account of an
new mail account which should be only dedicated in handling feedbacks, suggestions and
concerns of the professionals and should attend to them completely or allocate a
personnel for it so that concerns and feedbacks of every people can be managed and
resolved (Logan, 2016).
Evaluation strategy:
 Barbara would allocate resources like employee satisfaction surveys about specific
aspects which she wants to change in the organization.

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 Apart from close ended surveys, she should also introduce open-ended employee
feedback form to understand the specific areas which employees feel need to be changed.
 Moreover, complaint cell of the unit should be scrutinized every month. Gradual
reduction of the complaint numbers can help in understanding that the interventions are
helping to address the changes or not (Eppich et al., 2016)
 The policies developed by the leaders for changing the organizational climate promoting
collaboration should be also evaluated to find whether teamwork is being effective or not
 Patient satisfaction surveys discussing the performance of health care teams in
perspective of patients can also give insights into development of team-bonding.
 Burn-out scales of professionals can also be assessed to develop an idea about well-being
of the nurses.
Conclusion:
The main issues are ineffective teamwork and lack of proper leadership skills in the GSU
wards that have resulted in employee dissatisfaction and higher turnover rates. Proper
recommendations should be planned, implemented and evaluated by Barbara to make sure that
team bonding and motivation are developed along with increase in employee retention.

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References:
Eppich, W. J., Mullan, P. C., Brett-Fleegler, M., & Cheng, A. (2016). “Let's Talk About It”:
Translating Lessons From Health Care Simulation to Clinical Event Debriefings and
Coaching Conversations. Clinical Pediatric Emergency Medicine, 17(3), 200-211.
Fernandez, R., & Grand, J. A. (2015). Leveraging social science-healthcare collaborations to
improve teamwork and patient safety. Current problems in pediatric and adolescent
health care, 45(12), 370-377.
Forsyth, C., & Mason, B. (2017). Shared leadership and group identification in healthcare: The
leadership beliefs of clinicians working in interprofessional teams. Journal of
interprofessional care, 31(3), 291-299.
Frich, J. C., Brewster, A. L., Cherlin, E. J., & Bradley, E. H. (2015). Leadership development
programs for physicians: a systematic review. Journal of general internal
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Hargett, C. W., Doty, J. P., Hauck, J. N., Webb, A. M., Cook, S. H., Tsipis, N. E., ... & Taylor,
D. C. (2017). Developing a model for effective leadership in healthcare: a concept
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Lee, C. T. S., & Doran, D. M. (2017). The role of interpersonal relations in healthcare team
communication and patient safety: a proposed model of interpersonal process in
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Regan, S., Laschinger, H. K., & Wong, C. A. (2016). The influence of empowerment, authentic
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Ryan, S. (2017). Promoting effective teamwork in the healthcare setting. Nursing
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