CASE STUDY 2-2 Managing ConflictHuman Computer Interaction

                Sergül Duygulu

Sevda has worked for 6 years at a private hospital with a capacity of 20 beds. She recently earned her bachelor’s degree in nursing and is now working as a clinic nurse in orthopedics and traumatology at the hospital. As a student, Sevda wanted to change several unfavorable conditions in patient care after she graduated. Her belief that nothing could be done about system failures had solidified after spending so many years working at the hospital. Sevda is also experiencing family burdens, including caring for her husband, who is unemployed, and her 3-year-old daughter, and these burdens led Sevda to continue working at the same hospital. She goes to work every day with the hope that she can at least make a difference in the lives of her patients. There are eight nurses and a unit charge nurse in the orthopedics and traumatology department where Sevda works. Four of them have bachelor’s degrees in nursing, and four of them are graduates of vocational schools. The hospital management is forced to hire vocational graduates because of a high turnover rate. Three nurses work the day shift, two nurses work the evening shift, and one nurse works the night shift. Although there is an effort to provide service in accordance with predefined standards, it is known that there are often patient care mistakes. However, the measures taken to reduce the mistakes have been limited. People have been held responsible, and the necessary warnings have been made. Sevda is working with another nurse on the evening shift. She is more senior than the other nurse, who is a vocational school graduate and has recently completed her first year in the profession. After they take over from the day-shift nurses, Sevda and her colleague divide the patients and start to provide care. Two of the patients under Sevda’s care require careful attention because they have recently come out of surgery. Midway through the shift, one patient’s fever has gone up, and the other has started to bleed. Sevda asks the other nurse to help her by checking the vital signs of her other patients, but the nurse says she is too busy with her own patients. Sevda was barely able to finish her work as her shift drew to a close. She remembered that the daughter of one of the other nurse’s patients asked Sevda to give pain medication to her mother. Because Sevda was busy with her postsurgical patients, she told the daughter that the other nurse was assigned to her mother and that she should be available soon. At the end of the shift, Sevda and her colleague handed off their patients to the night nurse and went home. The next morning, when the unit charge nurse visited patient rooms, the daughter who asked Sevda for her mother’s pain medication complained, saying that neither of the evening nurses stopped by her mother’s room, and her mother did not get her pain medication until the night nurse gave it to her. The unit charge nurse, who believes that patient satisfaction is essential, apologized and said that she would take care of the situation. She reviewed the records from the evening shift and found a note saying that the evening nurse visited the patient three times to take her vital signs and twice to give medication. The unit charge nurse called Sevda and the other evening nurse and asked them to come to a meeting that afternoon. In the meeting, the unit charge nurse asked Sevda and her colleague to explain what happened. Sevda said the woman was not her patient; she cared for 10 patients, two of whom were in critical condition. She explained that the daughter who complained had asked her for pain medication, and she told the daughter that the other nurse should come by. Sevda said she did not know anything else about the situation. Sevda’s colleague said the patient and her daughter were lying. She said she went to the patient’s room at least five times, as noted in the hospital record. The unit charge nurse did not know what to do, so she referred the issue to the nursing services director, who requested the videotape from the camera that records patient room entrances. The tape showed that no nurse had entered the patient’s room except when the patient was handed off between shifts. The nursing services director called Sevda to her office. She told Sevda that, as an experienced nurse, she should manage the evening shift better. She told Sevda that if another such mistake is made, her employment would be terminated. Sevda loses her motivation and begins to think that she should take the necessary steps to find a job in another hospital. The nursing services director told the other nurse that her employment was terminated. The nurse responded by saying that many nurses make the same mistake, but the director said her conduct is unacceptable. She stands by her decision to terminate the nurse so the other nurses will see the results of such behavior. Now that one evening nurse has been terminated, only one nurse will work that shift.

Case Study Questions

1. Describe the issues that complicate the case. How are these issues interrelated? 2. What possible system problems occurred in this situation? 3. If you were Sevda, how would you have handled the situation? 4. How do you assess the leadership behaviors of Sevda, the unit charge nurse, and the nursing services director in handling this situation? 5. Who are the power holders in this case, what power sources did they use, and how did they use that power to manage the situation? 6. How did the players’ actions affect the resolution of the problem? 7. Do you think the problem was solved? 8. How do you assess this case in terms of effective leadership? 9. If you were the unit charge nurse or the nursing services director, how would you have handled the situation?