Responsibility bodes well for seaside convalescent

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Mindy Alternot has been the administrator of Seaside Convalescent Care Center (SCCC) for seven months. This was her first job after earning her Nursing Home Administrator’s license, and despite her initial enthusiasm, she began having second thoughts about her career choice. Things weren’t going well at SCCC. Actually, things hadn’t gone well there for several years. Mindy had hoped to turn things around, but the facility’s last survey was terrible. The inspectors had found several deficiencies indicating a pattern of “potential for more than minimal harm” to the residents. There were other significant problems relating to resident care, resident rights, and quality of life. Consequently, SCCC was denied payment for new admissions and was being fined $3,000 a day for noncompliance.

Mindy blamed her nurse’s aides (NAs). After all, they provided more than 90% of the hands-on patient care. She found it nearly impossible to find good ones, and even when she did, she couldn’t keep them. Their turnover rate was well over 100% a year (not rare in troubled facilities). Even those who seemed to enjoy working with the elderly would inevitably leave during the summer when it was easy to find more lucrative tourist-trade work.

Mindy had tried to motivate her aides by improving their training and by making their job more meaningful. She tried to encourage their input in matters related to patient care—and wanted to work with the licensed nurses to make the aides part of the total primary care team (which didn’t sit well with the nurses). She wanted the aides to assume more responsibility for solving everyday resident problems. Moreover, she tried to build good relationships with them. She wanted to lead by being visible, available, engaged, and in tune with what was going on in the interactive caregiving environment. After two months of “beating her brains out” trying to build relationships, Mindy finally conceded to her Director of Nursing Services, Ann, that the task was hopeless. This was a bitter pill for Mindy, who had been warned by Ann that “touchy-feely schoolbook approaches” just wouldn’t work with this crowd.

Ann was a top-notch nurse and a veteran nursing manager. She found the nurse’s aides to be a sullen lot, generally, and very hard to manage. Her experience showed them to be young, immature, poorly educated, untrustworthy, undependable, and condescending (to residents), with very poor work habits and almost no motivation. “Besides,” she complained “most of them barely speak English, and even those that can don’t really like working here—they do it only because they can’t get work elsewhere.”

Mindy didn’t buy this at first, but quickly became frustrated by the aides’ lack of commitment. Soon, she resigned herself to the fact that she couldn’t develop the aides’ competence, especially when they left before they really got to know their jobs or the patients’ individual needs. Moreover, because she had to maintain the minimum required staff-to-patient ratios, she couldn’t be too choosy and was compelled to hire warm bodies just to avoid fines.

Stressed, exhausted, and feeling defeated, Mindy began to resent her ignorant and “uncaring” nursing assistants and began to avoid them. By her third month at SCCC, she had delegated their direct oversight to Ann. Mindy felt this was feasible because Ann had worked in nursing homes for years and had a clear vision and the strength of character to whip a poorly motivated workforce into shape. Ann was a strict disciplinarian who understood how to deal with workers who only wanted a paycheck.

“You set clear rules and guidelines, you punish infractions, and you ride them all the time,” she explained. “It sounds tough, but unskilled and reluctant workers need clear direction and they only respect strong, determined leadership. You know, there is such a thing as being too supportive—and this type of workforce see that type of boss as a sucker.”

Ann set about to “clean up the place.” But due to high turnover and staff shortages, Ann required a good deal of overtime. Double-shifting was not uncommon. Ann knew this would take a toll on the aides’ resilience, but she reasoned that it’s “better to use’em while you got’em, as they’ll quit for better bait during the tourist season anyway.”

This delegation of responsibility to Ann allowed Mindy to focus on managing the budget—where Mindy had excellent skills. In fact, she was highly adept at all the technical aspects of managing a nursing home.

After reading the case study, please answer the questions below in a 2-3 page report. Be sure to include at least one, well-developed paragraph, to answer each question.

Do you think this change in management responsibility bodes well for Seaside Convalescent?

Which theory of motivation does Mindy represent in this case?

Which theory of motivation does Ann represent in this case?

Reread the case carefully. What is the underlying reason for the aides not staying on the job?

Should Mindy have handed over the reins to Ann? Explain your rationale.

Minimum 2 pages with APA format

Reference no: EM132159376

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