Healthcare Case Study 2022

Running head: CASE STUDY
Case-Study
Name of the student
Name of the university
Author’s name

1CASE STUDY
Introduction
Healthcare professionals and the nursing members are responsible to save the lives of the
patients. The primary health care (PHC) is a major significant key for improving the access to
healthcare for the underserved societies and attainment of the Millennium Development Goals.
Though, due to the severe lack of the healthcare workers (HCWs) have hindered struggles of
various developing and underdeveloped nations in providing universal PHC (Nkomazana, Mash,
Shaibu & Phaladze, 2015).
The following case-study describes about the leading change in the General Surgical Unit
(GSU) of the Eastern Massachusetts University Hospital (EMU). Barbara Norris is the nurse
manager of the GSU. As a nurse manager it was her duty to manage the staff, their schedule and
budget for the unit. In the GSU, she had a staff of 33 people which included 25 Registered
Nurses and 8 patient care assistants. During her first month of being a nurse manager 2 RN’s
already left the job and in the next six months more 3 RN’s left. The EMU organization has been
facing a hiring freeze due to which Barbara Norris failed to refill some of those positions which
was still empty.
Description of Barbara Norris
Barbara was born in a small town in Western Massachusetts. Her mother and
grandmother were both nurses due to which she got the inspiration of being a nurse at an early
age. By the time she joined high school, she realized that she will become a nurse like her mother
and grandmother. She completed her nursing program from the EMU, and later joined it to work.
She worked in the ED for a long four years and later shifted to the trauma unit for a year before
giving birth to a child. She later joined back the trauma unit when her children were in the grade

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school. Later when Barbara’s two daughters were in high school, she took up a challenge to
pursue Masters in Nursing and Healthcare Administration. During the time, when Barbara
completed her Master’s program, at that similar time, the nurse manager of the EMU retired
from her position. Barbara took up the challenge of opting for the nursing manager role at EMU
even after knowing that the GSU had a high turnover and less retention rate. It was observed that
the revenue of EMU was constantly decreasing and costs were significantly increasing.
Problem
The main issue of the Eastern Massachusetts University Hospital (EMU) was that the
GSU was known for high turnover and low retention rate. Turnover rate refers to the percentage
of employees leaving an organization during a certain period of time. Retention rate refers to the
percentage of employees staying back in an organization for a longer period of time.
There are three major problems that have to be sought out by Barbara Norris – Lack of
motivation and teamwork, interpersonal and intergroup conflict and performance review
procedures.
According to a literature the nursing turnover is considered as a rapidly-growing problem
in the healthcare industry. The turnover rate worldwide is considered as 15 - 44%. The literature
conducted an online survey to assess the reason for the nurses to leave their jobs. The survey
found that there were four major reasons for the nurses to leave their jobs – 36% nurses quit their
job due to personal reasons, 33% nurses got another job offer from another organization, 10%
nurses were not satisfied from their job and the working conditions and 3% nurses had their other
reasons (Dewanto & Wardhani, 2018).

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According to another report, it is estimated that the turnover for the bedside RNs ranged
from 6.6 - 28.7%. It was seen that an average national turnover rate of the RN’s was 16.8%
which increased by 2.2% from 2016 (NSI Nursing Solutions, 2018).
According to the report of Dewanto and Wardhani (2018) the participants of the study
stated that the hospital revenue used to be indirectly disrupted due to the nursing turnover, which
led to the decrease in the work productivity of the fresh nursing members during the adaptation
stage. Contradictorily, the costs and expenses of the hospital keep on rising as a result of
recruiting to training the new nurses, which range from the recruitment process, adaptation and
training to the placement. Beside than the impact of the turnover on the hospitals, it has also
been observed that the patients, nurses, and healthcare professionals are also impacted.
In the same report of Dewanto and Wardhani, patient experiences were recorded. As per
the patients, due to the consistent nurse replacements it makes them feel like they are being
treated by a less competent nurse, which hampers the patient-nurse relations especially
decreasing the trust and this increases the complaints towards the nursing services. Furthermore,
the hospital nursing manager described that the senior nursing members felt unenthusiastic to
accept an augmented workload because of the shortage of the nursing members. Also, the
adaptation procedure of the new nursing members created various challenges, like problems in
maintain a trustworthy relationship, working relationships, and team work.
In the paper of Nkomazana, Mash, Shaibu and Phaladze (2015) it has been stated that due
to the shortage of the vital resources for care delivery to the patient, deprived career framework,
vague guidelines, lack of compassionate management and also deprived service conditions, were
recognized as ‘push factors’ for the resignation of the nursing staff members.

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Thus, it is highly necessary for the nurse manager like Barbara and other healthcare
senior staffs to develop effective strategies that can help up in coping with retention rate and also
help in reducing the wastage of the important resources.
Recommendation and solutions
In order to reduce the turnover rate of the nurses in the healthcare organizations it is
necessary for the healthcare organization sand the nurse mangers to follow the underline stated
recommendations -
 HR skills are needed to develop for the management of the healthcare organization, patient
health, systemic monitoring and evaluation. Healthcare organizations and the nurse mangers
should implement strategies to train and exercise additional healthcare members. The training
should comprise of all the necessary training models that focus on the needs of the healthcare
system and also instruct applicable proficiencies. Strategies to increase the retention rates
should involve inceptives structures involving the monetary, lodging, constant career
development opportunities, and development of rural infrastructure (Nkomazana, Mash,
Shaibu & Phaladze, 2015).
 By implementing effective engagement strategies, this can help the nurse managers to
increase the retention skills and the experience of the RN’s and eventually will decrease the
turnover rate. Retaining of the exceptional RN’s can be a vital strategy for the
accomplishment of the healthcare organization goals since they possess years of medical
practice and institutional knowledge. The role of the nurse managers is to study the findings
and to identify effective engagement approaches affiliated with the organization’s individual
management exercises, organizational objectives, and social citizenship guidelines.

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Healthcare organizations and the nurse mangers should enable engagement strategies which
will be reliable and attuned with the objectives of the organization.
 It is necessary for the healthcare organizations and the nurse mangers to develop an
autonomous organization that will empower the nursing members and develop a practice
setting where they will be effectively enact decision making approaches and their actions will
be assisted by prioritizing them. Autonomy is a very significant feature in a healthcare
organization as per the literature study and it has been highlighted as it provides job
satisfaction and high retention to the organization for several nurses and it is considerably
correlated to turnover. As per the literature autonomy and satisfied nurses always retain their
jobs. Furthermore, autonomy is described to be as the most significant aspect that enhances
production of the nurses’ and the quality of nursing care.
 Recognizing the importance and relevance of one's commitment to the functioning of an
organisation is a basic human need and necessary to personal and professional development.
Recognition is possible in many ways, whether physical and intangible (i.e., financial
bonuses or medals) and intangible (i.e., oral praises or recognition). Ensuring that well-
qualified staff are employed, actively involved in the enjoyment of customers, manage
available capital and enhance the organization's efficiency is necessary for successful
incentives and appreciation systems. Through acknowledging the positive work and
accomplishments of the staff, nursing leaders foster a supportive working atmosphere in
which their employees feel respected and supported. The positive results of lower turnover
and higher corporate participation will also be reached (Gess, Manojlovich & Warner, 2008).
 Positive feedback is another technique for workplace appreciation. Management insists on
what has been done right by providing positive input and recognizing such successful

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accomplishments. It relates to creating a culture that is not oppressive, but that acknowledges
the positive results (Gess, Manojlovich & Warner, 2008).
 In all organizations, communication and approachability to feedback are two key notions. It
is also important to use the appropriate tools and techniques with different types for
communication. Another technique for developing better interactions is to listen to what
nursing staff members think about patient care. Because nurses are the primary caretakers in
the healthcare organization, they are the most conscious of what takes place in this setting. If
nurse managers respond carefully to what their workers say about patient care, they show a
real dedication to their workforce. Hearing of staff also validates employee concerns and
gives hospital leaders a greater sense of commitment to staff (Gess, Manojlovich & Warner,
2008).

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References
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efficiency during pulmonary resection. The Journal of thoracic and cardiovascular
surgery, 151(5), 1391-1395.
Barry, G. (2018). Improving Nursing Knowledge, Satisfaction, and Retention in Long Term
Care.
Coleman, S. M. (2018). Developing a Nurse Retention Program Aimed at Reducing Nursing
Turnover.
Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a
preliminary study at private hospitals in Indonesia. BMC nursing, 17(2), 52.
Gess, E., Manojlovich, M., & Warner, S. (2008). An evidence-based protocol for nurse
retention. JONA: The Journal of Nursing Administration, 38(10), 441-447.
Hayward, D., Bungay, V., Wolff, A. C., & MacDonald, V. (2016). A qualitative study of
experienced nurses' voluntary turnover: Learning from their perspectives. Journal of
clinical nursing, 25(9-10), 1336-1345.
Murray, T. A., Pole, D. C., Ciarlo, E. M., & Holmes, S. (2016). A nursing workforce diversity
project: Strategies for recruitment, retention, graduation, and NCLEX-RN
success. Nursing Education Perspectives, 37(3), 138-143.

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Nkomazana, O., Mash, R., Shaibu, S., & Phaladze, N. (2015). Stakeholders’ perceptions on
shortage of healthcare workers in primary healthcare in Botswana: focus group
discussions. PloS one, 10(8), e0135846.
Ruiz, P. B. D. O., Perroca, M. G., & Jericó, M. D. C. (2016). Cost of nursing turnover in a
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Solutions, N. N. Inc. 2018 national health care retention & RN staffing report [Internet].
Petersburg (PA): NSI Nursing Solutions, Inc.; c2018 [cited 2018 Sep 10].