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HSC0003 Intro To Health Care Questions  The Case   Denise Gogetter, RN, MSN, has been at City Medical Center (CMC) for two years as the Assistant Vice President of Nursing (AVP). She is a hard working, bright, articulate nurse who has contributed many creative ideas for providing excellent quality of care at CMC. Recently, however, she has gone from a pleasant, easy-to-work-with coworker to a cranky one. She used to bubble with enthusiasm about her job and the opportunities it afforded her. Denise made no secret of the fact that she wanted to advance within the organization.   Today she comes up to you in the cafeteria and says, If I have to work for Rose Durham one more week, I’ll scream. You’re more than a coworker, you’re Denise’s friend, and you are the AVP to the CFO. You are alarmed by her tone of voice and suggest you go out after work to discuss the matter. Over coffee and dessert, Denise confides that when she was hired, she was promised a promotion at the end of 2 years. As soon as Rose retired, she was supposed to be the VP of Nursing. However, today HR informed Denise the promotion was not a promise, merely a possibility mentioned to her during recruitment. Rose, like many others, had been hard-hit by the recession and was not in a financial position to retire. She decided to put off her retirement to age 70, instead of 65. And Rose wasn’t interested in taking a cut in pay and stepping down from her role. Denise has no interest in remaining as an AVP. She’s ready to be promoted NOW.   While you understand Denise’s frustration, you wonder to yourself how such a major misunderstanding could have occurred. Denise took copious notes at every meeting. The recruiter, who was an independent headhunter, put nothing in writing except for e-mails setting up interview days and times. Denise shows you the letter from HR. It is a standard letter with salary, start date, and benefits package. The letter includes nothing about opportunities for advancement, nothing about promotions, and nothing about older nurses retiring to make way for younger nurses.   Essay Instructions   1. What are the facts of this case?   2. What are three factors contributing to this dilemma?   3. What are the top three management issues in this case?   4. Who should be responsible for addressing these organizational issues?   5. Headhunters earn commissions on finding candidates for jobs. If the employee stays for a year or more, the headhunter often gets to keep a large amount of money. Do you think the headhunter made promises she couldn’t keep? Or, do you think Denise heard what she wanted to hear?   6. Do you think Denise should have wondered if the headhunter’s promises were too good to be true? Should she have insisted on getting those statements in writing? Your Recommendation(s) 7. At this point in time, what, if anything, can Denise do? What choices does she have? Provide your reflections and personal opinions as well as your recommendations and rationale for addressing this problem. Answers 1. As per the given case, Denise is acting as the AVP for nursing at CMC (City Medical Centre). Even though she was exceptionally efficient at her job but recently, her motivation levels have dipped since she wants to be promoted. At the time of hiring, she was promised that she would be promoted at the end of the two year period when her senior was due to retire. However, due to recession, she has postponed her retirement and hence continues to occupy the post. It is noteworthy that the salary contract contains standard clauses and mentions no written commitment in this regard. 2. The three factors that have contributed to the dilemma is lack of coordination and communication between the HR and independent headhunter, lack of proactive communication between HR and Denise at the time of recruitment and reliance on oral communication with regards to commitments (Borkowski, 2011). 3. Three management issues that are relevant to the given case are recruitment, promotion policy and employee motivation. With regards to recruitment, it is imperative that the independent recruiter must not make unsubstantiated commitments to the potential recruit. Further, the promotion policy should be discussed and made clear to the employees at the time of joining. Also, employee motivation is a key issue especially in the wake of limited opportunities for growth (Patterson et. al., 2004). 4. The responsibility of resolving the  issues that have been outlined in the given case should be the job of the concerned HR (Human Resource) manager as the various aspects of the problem such as recruitment, promotion policy in place and ensuring that employee motivation remains high fall within the sphere of work of the human resource department (Borkowski, 2011). 5. Under the given situation, it seems highly likely that headhunters made false promise rather than Denise being mistaken. This is because there is enough incentive present for the headhunters to lie to Denise in order to lure her into this job.  Headhunters tend to get commission for carrying out recruitments  of candidates that need to stay within the company for one year. As a result, the commitment for promotion after 2 years would have been made (Feldman, 2010). 6. Yes, it is always advisable to rely on written commitments and not oral commitments, This becomes especially true when the hiring process is being carried out by an independent recruiting agency which would have incentive in hiring a talented employee. It is quite naïve on Denise’s part not to insist on the inclusion of the promotional clause in the written agreement. Further, even more surprising, Denise did not even have a conversation about the same with the HR ever. 7. Well, Denise cannot force the company to promote her and get her senior retired. As she does not have this understanding in written, hence no legal options are available. The only way forward is for Denise to persuade that on account of her performance she merits a raise and a promotion. Persuasion with the concerned personnel made lead to the company creating a new post for Denise which could potentially delegate part of the work from her senior to her. Additionally, a higher designation may also be allocated (Patterson et. al., 2004).. But, getting a pay raise is next to impossible especially considering the current macroeconomic climate. References Borkowski, N. (2011). Organizational behavior in health care (2nd ed.). Sudbury, MA: Jones and Bartlett.  Feldman, L. (2010). Report: New workforce models needed to adapt to changing environment. H&HN: Hospitals & Health Networks, 84(3), 12.  Patterson, K., Grenny, J., McMillan, R. & Switzler, A. (2004). Crucial confrontations. New York, NY: McGraw-Hill.

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