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Assume that you are the project director of a small family planning clinic. You have just received word that your federal and state funds have been slashed and that the clinic will probably close in 3 months. Although an additional funding source may be found, it is improbable that it will occur within that time period. The board of directors informed you that this knowledge is not to be made public at this time. You have five full-time employees at the clinic. Because two of these employees are your close friends, you feel some conflict about withholding this information from them. You are aware that another clinic in town currently has job openings and that the positions are generally filled quickly. ASSIGNMENT: It is important that you staff the clinic for the next 3 months. When will you notify the staff of the clinic’s intent to close? Will you communicate the closing to all staff at the same time? Will you use downward communication? Should the grapevine be used to leak news to employees? When might the grapevine be appropriate to pass on information?

 

 
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You are an RN employed by an insurance company that provides workers’ compensation coverage for large companies. Your job requires that you do routine health screening on new employees to identify personal and job-related behaviors that may place these clients at risk for injury or illness and then to counsel them appropriately regarding risk reduction. One of the areas that you assess during your patient history is high-risk sexual behavior. One of the clients you saw today expressed concern that he might be positive for HIV because a former girlfriend, with whom he had unprotected sex, recently tested positive for HIV. He tells you that he is afraid to be tested “because I don’t want to know if I have it.” He seems fi rm on his refusal to be tested. You go ahead and provide him information about HIV testing and what he can do in the future to prevent transmission of the virus to himself and others. Later that evening, you are having dinner with your 26-year-old sister, and she reveals that she has a “new love” in her life. When she tells you his name and where he works, you immediately recognize him as the client you counseled in the office today. ASSIGNMENT: What will you do with the information you have about this client’s possible HIV exposure? Will you share it with your sister? What are the legal and ethical ramifications inherent in violating this patient’s confidentiality? What are the conflicting personal and professional obligations? Would your action be the same if a casual acquaintance revealed to you that this client was her new boyfriend? Be as honest as possible in your analysis.

 

 
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You are the evening charge nurse of a medical unit. The staff on your unit has voiced displeasure in how requests for days off are handled. Your manager has given you the task of forming a committee and reviewing the present policy regarding requests for days off on the unit. On your committee are four LVNs, three CNAs, and five RNs. All shifts are represented. There are three men among the group members, and there is a fairly broad range of ethnic and cultural groups. Tomorrow will be your fourth meeting, and you are becoming a bit frustrated because the meetings do not seem to be accomplishing much to reach the objectives that the group was charged to meet. The objective was to develop a fair method to handle special requested days off that were not part of the normal rotation. On your first meeting, you spent time getting to know the members and identified the objective. Various committee members contacted other hospitals, and others did a literature search to determine how other institutions handled this matter. During the second meeting, this material was reviewed by all members. At the last meeting, the group was very contentious. In fact, several raised their voices. Others sat quietly, and some seemed to pout. Only the three men could agree upon anything. One LVN thought that the RNs were overly represented. One RN thought that the policy for day-off requests should be separated into three different policies—one for each classification. You are not sure how to bring this committee together or what, if any, action you should take. ASSIGNMENT: Review the section in this chapter about how groups work. Write a one-page essay on what is happening in the group, and answer the following questions. Should you add members to the committee? Does your group have too many task members and not enough team-building members? What should be your role in getting the group to perform its task? What could be some strategies you could use that would perhaps bring the group together?

 

 
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You are the supervisor of the oncology unit. One of your closest friends and colleagues is Paula, the supervisor of the medical unit. Frequently, you cover for each other in the event of absence or emergency. Today, Paula stops at your office to let you know that she will be gone for 7 days to attend a management workshop on the East Coast. She asks that you check on the unit during her absence. She also asks that you pay particularly close attention to Mary Jones, an employee on her unit. She states that Mary, who has worked at the hospital for 4 years, has been counseled repeatedly about her unexcused absences from work and has recently received a written reprimand specifying that she will be terminated if there is another unexcused absence. Paula anticipates that Mary may attempt to break the rules during her absence. She asks that you follow through on this disciplinary plan in the event that Mary again takes an unexcused absence. Her instructions to you are to terminate Mary if she fails to show up for work this week for any reason. When you arrive at work the next day, you find that Mary called in sick 20 minutes after the shift was to begin. The hospital’s policy is that employees are to notify the staffing office of illness no less than 2 hours before the beginning of their shift. When you attempt to contact Mary by telephone at home, there is no answer. Later in the day, you finally reach Mary and ask that she come in to your office early the next morning to speak about her inadequate notice of sick time. Mary arrives 45 minutes late the next morning. You are already agitated and angry with her. You inform her that she is to be terminated for any rule broken during Paula’s absence and that this action is being taken in accord with the disciplinary contract that had been established earlier. Mary is furious. She states that you have no right to fi re her because you are not her “real boss” and that Paula should face her herself. She goes on to say that “Paula told me that the disciplinary contract was just a way of formalizing that we had talked and that I shouldn’t take it too seriously.” Mary also says, “Besides, I didn’t get sick until I was getting ready for work. The hospital rules state that I have 12 sick days each year.” Although you feel certain that Paula was very clear about her position in reviewing the disciplinary contract with Mary, you begin to feel uncomfortable with being placed in the position of having to take such serious corrective action without having been involved in prior disciplinary review sessions. You are, however, also aware that this employee has been breaking rules for some time and that this is just one in a succession of absences. You also know that Paula is counting on you to provide consistency of leadership in her absence. ASSIGNMENT: Discuss how you will handle the situation. Was it appropriate for Paula to delegate this responsibility to you? Is it appropriate for one manager to carry out another manager’s disciplinary plan? Does it matter that a written disciplinary contract had already been established?

 

 
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