The following “2” questions need to be answered using the case study attached and the
MAX
word count is “125” that’s combined for question 1 & 2. The question response answer can’t go over 125.
1.At the 12 month review for Dr. Ratchet:
- Does Dr. Ratchet meet any of the criteria for being a toxic leader? If so, which ones?
-If so, what will you tell her now?
- What will be your performance improvement plan for Dr. Ratchet? Whatexpectations will you set for Dr. Ratchet? How will you measure progress/improvement?
-What resources or support might Dr. Ratchet need to assist her?
-What happens if improvement doesn’t occur: What will be your “trigger points” totake definitive action regarding Dr. Ratchet’s continued employment as your Directorfor Nursing Services?
2.After the events of the following three months:
-As a leader, what are you going to do about Dr. Ratchet when she returns and why?
Microsoft Word - Toxic Leader Case Study.docx HCL 712: Case Study – Toxic Leadership 1 Case study: You may have hired a toxic leader…. now what? (Real case: some minor details, names changed) You are the CEO of a mid-size community hospital located in a suburb of a medium midwestern city. Your hospital has 100 beds, a 20 bed ICU, a 5 bed NICU, 10 operating rooms, and a small stroke rehabilitation unit. Your offer most primary care and specialty services and the majority of physicians within a 20-mile radius of your hospital hold privileges there and use your hospital for admissions, surgeries, and procedures. You have two main competitors: (1) a private community hospital offering similar services about 25 miles away in the next town; and (2) a large academic medical center downtown (about a 45 min drive) which is part of the local university and is the regional trauma and subspecialty referral center. Your board just purchased a tract of land next to your current campus with plans of expanding inpatient capacity to accommodate local population growth and also grow/offer more specialty surgical services. As part of the growth plan, you conducted a national search for a new Director of Nursing Services to replace your current director who is retiring. You were interested in hiring someone with leadership experience who could develop and execute an effective strategy to attract, recruit, and retain nursing professionals to both support current services and planned service expansion. Although your nursing staff turnover rate is low (five nurses/month on average), you would like to either sustain or reduce that rate. The major reasons nurses leave right now are seeking better work-life balance or retirement. Pay seems to be comparable to your competition and has not been cited as a reason for nurses leaving. Right now, 35% of your nursing workforce is temporary contract labor. You feel you are overly reliant on temporary contract nursing labor and would like to grow more permanent staffing to reduce labor costs and provide better continuity and staff efficiency. Thinking ahead, there is a new nursing school downtown and there is an opportunity to establish a relationship to provide clinical training rotations to students and, hopefully, hire them after graduation. You retained a national search firm and your search netted over 50 candidates which, after screening by the search firm, was narrowed down to the top five. All five were invited to your hospital for a tour and to meet/interview with members of the senior leadership team. Consideration was given to also including interviews with select nurses from some of the wards and other clinical areas, but this was not done because of scheduling issues. All five submitted references as part of their application package. Ultimately, you selected Dr. Karen Ratchet to be your next Director of Nursing Services. Dr. Ratchet completed her education at a top HCL 712: Case Study – Toxic Leadership 2 university/nursing school and her clinical rotations at some of the best medical centers in the country. She holds a doctorate in nursing research and, in addition to writing a textbook on nursing research practices, also has several publications on nursing workforce development. She has spoken at several national nursing conferences on nursing workforce challenges. Her most recent position was as the Director of Nursing Services at an Ivy League academic medical center. Her reason for leaving was that she wanted a new challenge and to be closer to her parents who live about an hour away. Of the five references she submitted, you spoke with two. Both commented on how intelligent she is and her work ethic to get things done. The CEO of the academic medical center made a curious comment that “she works her people hard but she gets things done and is a good role model for the other nurses on commitment to the job.” There were no overt red flags noted in either interview. During the visit to your hospital, she was well-groomed, poised, and articulate. She spoke extensively about her education, her research, and her accomplishments. Your Chief Operating Officer asked her what other nurses under her charge would say about her and her response was “They know I have high expectations, but we go into nursing to work hard and make a difference. There are those who can’t cut it and I help them find a better fit in other organizations or professions if needed.” Your current Director of Nursing Services asked her what her primary areas of weakness/opportunities for future personal growth might be and her response was “none. I’m pretty happy with myself and the many, many things I bring to an organization.” During the tour, she was introduced to several nurses in different areas of the hospital and was cordial, making a point to tell them about herself and her accomplishments. It was curious that she didn’t really ask too much about them or their perspectives about working here. But you chalked it up to her trying to make a good impression. After discussion with your senior leadership team and informing your board chairman, you extended an offer to Dr. Ratchet, which she accepted. Besides a generous salary, the terms of the offer include a one-year probationary period and specific performance measures linked to your nurse staffing goals to reduce turnover and support organizational growth. Although you offered her a three-month period to close out her affairs at the academic medical center and move herself to the area, she informed you she would be here in a month, ready to go. As a professional courtesy, you called her current boss, the CEO of the academic medical center, to ensure he was OK with her leaving on such short notice. He told you that was not a problem, which you found curious since he also admitted that they had not yet started a replacement search but was sure he could find an interim Director of Nursing Services to cover. Dr. Ratchet’s reporting sooner offered the opportunity for your current Director of Nursing Services to do a full turnover and retire a little early. Dr. Ratchet reported for work, as promised, after a month and completed a full turnover with your current Director of Nursing Services. On her exit interview, your outgoing Director of Nursing Services remarked that the turnover had gone well, although she did find it curious that Dr. Ratchet frequently commented that “the way things are done here is different than from where I came from.” That said, she was cordial, asked many questions, and appeared to interact well with her office staff and her direct reports. HCL 712: Case Study – Toxic Leadership 3 The first three months were fairly uneventful as Dr. Ratchet settled into her new role. She did issue several new policies within her first week about documentation required to take sick leave and a new requirement to seek permission from her before taking vacation. She also implemented a new patient safety program that she had brought with her from her previous job which was designed to reduce nursing errors on the inpatient units. There was some grumbling because the program required all nurses and nursing aids to take a two-hour training and begin to document their actions. This course was taught by a contractor which Dr. Ratchet hired using her Director of Nursing budget but was not discussed with the leadership team before doing so. But, if it will help improve patient safety, then that slight omission was forgivable. That said, you were somewhat surprised when she submitted a request to replace and upgrade all the furniture in her office and conference room and also hire an additional secretary to manage her schedule and engagements. Since the current furniture in her office was less than five years old and had been purchased as part of a general C-suite upgrade, you informed her that you could not approve her furniture request, especially since the nursing lounges had not been upgraded in almost 10 years. You were worried about the optic of a second Director of Nursing office upgrade in five years. She said she understood but she was clearly not happy. To appease her and despite the fact that she would now have more support staff than you as the CEO, you did approve the new hire for which she thanked you. She also had requested that Security identify and mark a dedicated parking spot for her near the front entrance. You told her that you had disapproved this request since the hospital took pride in not having special parking places for senior leaders. You mentioned that this helped support your commitment to servant leadership and was well-received by the staff. She nodded but didn’t say anything. By the end of the second week, Dr. Ratchet had produced a document which she called her “Top Priorities for Nursing.” She then had a meeting with her direct reports to review the priorities, get their inputs, and set expectations before more widely distributing the document. One of her direct reports attends your church and, after Sunday services, remarked that Dr. Ratchet sure seemed to hit the ground running