Leadership. in nursing discussion minimum 250 and.3 references for | Nursing
Confronting Sexual Harassment
You are a new female employee at Valley Medical Center’s intensive care unit and love your job. Although only 25 years old, you have been a nurse for 4 years, and the last 2 years were spent in a small critical care unit in a rural hospital. You work the 3:00 PM to 11:00 PM shift. Ever since you came to work there, one of the male physicians, Dr. Long, has been especially attentive to you. At first, you were flattered, but more recently, you have become uncomfortable around him. He sometimes touches you and seems to be flirting with you. You have no romantic interest in him and know that he is married. Last night, he asked you to meet him for an after-work drink and you refused. He is a very powerful man in the unit, and you do not want to alienate him, but you are becoming increasingly troubled by his behavior.
Today, you went to your shift charge nurse and explained how you felt. In response, the nurse said, “Oh, he likes to flirt with all the new staff, but he’s perfectly harmless.” These comments did not make you feel better. At approximately 7:00 PM, Dr. Long came to the unit and cornered you again in a comatose patient’s room and asked you out. You said no again, and you are feeling more anxious because of his behavior.
Outline an appropriate course of action. What options can you identify? What is your responsibility? What are the driving and restraining forces for action? What support systems for action can you identify? What responsibility does the organization have? Be creative and think beyond the obvious. Be able to support your decisions.
LEARNING EXERCISE 18.7
A Chief Nursing Officer’s Dilemma
You are the chief nursing officer of County Hospital. Dr. Martin Jones, a cardiologist, has approached you about having an intensive care unit/critical care unit (ICU/CCU) nurse make rounds with him each morning on all of the patients in the hospital with a cardiac-related diagnosis. He believes that this will probably represent a 90-minute commitment of nursing time daily. He is vague about the nurse’s exact role or purpose, but you believe that there is great potential for better and more consistent patient education and care planning.
Audrey, one of your finest ICU/CCU nurses, agrees to assist Dr. Jones. She has always wanted to have an expanded teaching role. However, for various reasons, she has been unable to relocate to a larger city where there are more opportunities for teaching. You warn Audrey that it might be some time before this role develops into an autonomous position, but she is eager to assist Dr. Jones. The other ICU/CCU staff agree to cover Audrey’s patients while she is gone, although it is obviously an extension of an already full patient load.
After 3 weeks of making rounds with Dr. Jones, Audrey comes to your office. She tearfully reports that rounds frequently take 2 to 3 hours and that making rounds with Dr. Jones amounts to little more than “picking up his pages and being a personal handmaiden.” She has assertively stated her feelings to him and has attempted to demonstrate to Dr. Jones how their allegiance could result in improved patient care. She states that she has not been allowed any input into patient decisions and is frequently reminded of “her position” and his ability to have her removed from her job if she does not like being told what to do. She is demoralized and demotivated. In addition, she believes that her peers resent having to cover her workload because it is obvious that her role is superficial at best.
You ask Audrey if she wants you to assign another nurse to work with Dr. Jones, and she says that she would really like to make it work but does not know what action to take that would improve the situation.
You call Dr. Jones, and he agrees to meet with you at your office when he completes rounds the following morning. At this visit, Dr. Jones confirms Audrey’s description of her role but justifies his desire for the role to continue by saying, “I bring $10 million of business to this hospital every year in cardiology procedures. The least you can do is provide the nursing assistance I am asking for. If you are unable to meet this small request, I will be forced to consider taking my practice to a competitive hospital.” However, after further discussion, he does agree that eventually he would consider a slightly more expanded role for the nurse after he learns to trust her.
Do you meet Dr. Jones’s request? Does it make any difference whether Audrey is the nurse, or can it be someone else? Is the amount of revenue that Dr. Jones generates relevant in your decision making? Should you try to talk Audrey into continuing the position for a while longer? While trying to reach a goal, people must sometimes endure a difficult path, but at what point does the means not justify the end? Be realistic about what you would do in this situation. What do you perceive to be the greatest obstacles in implementing your decision?
LEARNING EXERCISE 19.12
Memo to Chief Executive Officer Leads to Miscommunication
Carol White, the coordinator for the multidisciplinary mental health outpatient services of a 150-bed psychiatric hospital, feels frustrated because the hospital is very centralized. She believes that this keeps the hospital’s therapists and nurse-managers from being as effective as they could if they had more authority. Therefore, she has worked out a plan to decentralize her department, giving the therapists and nurse-managers more control and new titles. She sent her new plan to Chief Executive Officer Joe Short and has just received this memo in return.
Dear Ms. White:
The Board of Directors and I met to review your plan and think it is a good one. In fact, we have been thinking along the same lines for quite some time now. I’m sure you must have heard of our plans. Because we recently contracted with a physician’s group to cover our crisis center, we believe this would be a good time to decentralize in other ways. We suggest that your new substance abuse coordinator report directly to the new Chief of Mental Health. In addition, we believe your new director of the suicide prevention center should report directly to the Chief of Mental Health. He then will report to me.
I am pleased that we are both moving in the same direction and have the same goals. We will be setting up meetings in the future to iron out the small details.
Joe Short, CEO
How and why did Carol’s plan go astray? How did her mode of communication affect the outcome? Could the outcome have been prevented? What communication mode would have been most appropriate for Carol to use in sharing her plan with Joe? What should be her plan now? Explain your rationale.