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Case in Health Care Management

doi: 10.1097/HCM.0000000000000255
Case in Health Care Management
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The “Case in Health Care Management” is a regular feature of The Health Care Manager. Readers are invited to analyze the problem presented in the case and develop a reasonable response to the situation.

In analyzing a case:

  • Look for the principles that appear to be involved, and look for the applicability of rules of reason, common sense, and fairness.
  • Seek help from published sources. Associate the concerns of the case with key words that describe principles, concepts, theories, or techniques, and look these up in texts on supervision and basic management.
  • Make whatever reasonable assumptions you need to “fill in the blanks” in the information given.
  • Keep your assumptions reasonable, and state your key assumptions in your conclusions.
  • Recognize that there are few solutions to a case problem that are entirely right or wrong. You are dealing primarily with human behavior, and all people will not necessarily behave the same way in similar situations.
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CASE: TO MANAGE THE MANAGER

From the look on the face across the desk from her, human resources representative Margie Olson thought she had better pay special attention to what supervisor Nancy Wright was saying. Not ordinarily given to emotional displays, Nancy was clearly on the verge of tears as she spoke of increasing frustration and pressure that she apparently felt was to the result of the behavior of another supervisor.

“Please understand,” Nancy was saying, “that my job and the jobs of Linda Williams and Mark Allen are extremely interrelated. The 3 of us work at the same level and report to the same boss. Mark does just fine, and I don't have any problems because of him. But Linda is making my life miserable, and I don't know how to change things.”

Margie asked, “Miserable how?”

“Linda simply will not address any real problems that arise, and she continually puts off any decisions that have to be made.”

“How does that affect you?”

“It means I do her work, and so does Mark, at least the more difficult stuff. She schedules disciplinary conferences to happen when she's conveniently not going to be here. In the same way she procrastinates on decisions until someone else—usually Mark or myself—is forced to make them.”

Margie asked, “Why are you and Mark always so conveniently available to bail her out?”

“The way we're organized, the 3 of us are set up to cross-cover each other's areas on virtually a minute's notice. Jane Worth set it up that way.”

At the mention of the 3 supervisors' mutual boss, Margie asked, “What about Jane? Isn't she aware of what's going on with Linda?”

“I don't know how aware she really is. Anyway, it seems like any time Jane calls Linda on the carpet for anything, Linda manages to shift the blame to someone else, usually Mark or me. Linda was on the scene before I came here and before Mark was promoted. Linda and Jane go a long way back, and anyway I've never felt I could go to my boss with a complaint about a peer supervisor.”

Nancy was silent a moment, strain evident in her expression. At last she said, “I don't know how to fix this. I only know I can't remain on this job forever picking up the slack for a supervisor who refuses to be accountable.”

Instructions:

Put yourself in Margie's position and advise Nancy how to proceed in the matter of the apparent responsibility dodging by a fellow supervisor.

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LET US HEAR FROM YOU

Readers are invited to submit their written analysis of this issue's case for possible publication in HCM 38:4(October–December 2019). This is not a contest. Because a solution to a case may be neither completely right nor completely wrong, there will be no winners or losers. We will select one solution that appears particularly appropriate or relevant, or we may elect to publish excerpts from several proposed solutions.

Responses to this issue's “To Manage the Manager” must be submitted under the following conditions:

Your response, not exceeding 300 words, should be emailed no later than August 15, 2019, to Charles R. McConnell, Editor, HCM, atmclighthouse@juno.com.

  • Your response should include your full name, title, organization, and email address.
  • The editor will notify anyone whose response is selected for publication. Selected responses will be subject to normal editing for language and style.
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(FROM HCM ISSUE 37:4, OCTOBER–DECEMBER 2018) CASE: GETTING OFF THE FENCE: JUMP, FALL, OR PUSHED?

Without being aware she was doing so, Myrna Wallace was actually summing up the concerns of a number of her fellow supervisors in the Supervisor Skills Development Program when she said, “As a first-line manager I always find myself ‘straddling the fence.’ I came up out of this same group I'm supervising. Because I have to work so closely with all these hourly employees—most of whom were my peers for a long time, not to mention my friends as well—I'm considered by many to be one of them, to be treated as they're treated.”

Encouraged by several nods of assent within the group of 15 mostly new supervisors, Myrna continued, “On the other hand, my boss expects me to act like a member of management and certainly to perform as a manager.”

“On the fence is a lonely and thankless place to be,” came a mutter from the rear of the room.

Myrna smiled and added, “I wouldn't put it quite that dramatically, but it can be an uncomfortable position. I really don't like this on-the-fence feeling. I want to know how to handle my situation, given that I'd like to continue getting along with these people I've known for so long, but I'd also like to do what my boss expects me to do.”

The voice from the rear of the room said, “First thing, you're going to have to get off the fence.”

Myrna turned and asked, “How?”

Myrna turned again as the group's instructor said, “You can jump off the fence as you choose, fall off if you're not careful, or get pushed off from one side or the other. Only partly your choice, but if you don't jump down on your own, you'll eventually fall or be pushed. How do you want to do it?”

Instructions:

Advise Myrna how she could best approach getting “off the fence,” balancing her concerns for relations with the work group with the needs of her manager.

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