Case Study Forty-Five: Nurse Bullying: Unprofessional Conduct Raymond was one of the two male nurses working in an ICU in an inner-city hospital. The nurse manager always put him in charge of the ICU whenever he worked his twelve-hour shift. When Raymond was in charge, problems were handled quickly and without drama. His efficient demeanor during a code comforted families, staff nurses, and even the medical interns and residents. Attending physicians requested that Raymond care for their sickest patients as well as their family members. In addition, letters were often written to the hospital about his outstanding care and his attention to details. His exceptional customer service and outstanding patient care made Nordstrom’s customer service department look bad!

 Instructions
Supporting Lectures:
Review the following lecture:

Healthcare Turnover (Lecture bottom of page)
Introduction:
Case Study Forty-Five: Nurse Bullying: Unprofessional Conduct
Raymond was one of the two male nurses working in an ICU in an inner-city hospital. The nurse manager always put him in charge of the ICU whenever he worked his twelve-hour shift. When Raymond was in charge, problems were handled quickly and without drama. His efficient demeanor during a code comforted families, staff nurses, and even the medical interns and residents. Attending physicians requested that Raymond care for their sickest patients as well as their family members. In addition, letters were often written to the hospital about his outstanding care and his attention to details. His exceptional customer service and outstanding patient care made Nordstrom’s customer service department look bad!

However, if there was a question that needed an answer, Raymond knew it and wasn’t shy about letting everyone else around him know it too. His self-assured behavior came across as overconfident and conceited. It didn’t help him win any popularity contests as he was the only master’s-prepared nurse on the unit; most of the nurses didn’t even have their bachelor’s degree. He tried to fit in with the other nurses by joking with them or giving the best assignments to the most popular nurses. Raymond didn’t realize it, but the nurses in the most popular group were always putting him down and criticizing him behind his back. During morning rounds with physicians, the other nurses would challenge Raymond and try to embarrass him or roll their eyes whenever he spoke.

Raymond wanted to join the “in gang” and so started to share some personal information with the other nurses about his deteriorating relationship with his wife. She was unable to work due to a chronic medical condition and was becoming increasingly needy with repeated hospitalizations. The other nurses rallied around him pretending to offer support when they were actually scheming to teach him a lesson since he was a “know it all.” One nurse got his personal e-mail, while the other nurse planned the prank.

A few weeks later, Raymond started receiving e-mails from a secret admirer named Terry. Their e-mail relationship lasted several months before he told his coworkers about it. He shared stories with his interested coworkers about the admirer and told them that he was actually thinking about leaving his wife for her. Later, Raymond found out that not only did the entire staff in the ICU know about this prank but his e-mail conversations were distributed to the unit’s nursing and support staff.

Tasks:
Discussion Questions
What are the facts of this case?
What is the nature of the organizational behavior problem?
Which theory or theories do you believe best explain the behavior of Raymond’s coworkers?
As the nurse leader, what interventions would be useful in dealing with workplace bullying?
What types of workplace behaviors define bullying?
Have you ever experienced or observed workplace bullying? Describe what happened and how it was managed.
How does bullying impact the workplace morale? Productivity? Patient care? Can you think of the other effects of bullying in the workplace?
How does the leadership or management team contribute to bullying?
What types of ethical issues are identified in this case study?
What kind of financial impact do you think the behavior of the nurses and their supervisor may have on the hospital?
Provide your reflections and personal opinions as well as your recommendations for addressing this problem.
Submission Details:
To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Your initial posting should be addressed at 500–1000 words as noted in the attached PDF. Submit your document to this Discussion Area by the due date assigned. Be sure to cite your sources using APA format.

Healthcare Turnover
Turnover is inevitable in all health organizations. However, when there is high turnover over a longer period of time, an HR manager tries to determine the issues within an organization that may be affecting the turnover rate. These issues may include:
• Benefits (pay rate, medical/dental insurance)
• Engagement in their job (not feeling challenged)
• Poor management
Turnover has a significant impact on patient satisfaction, treatment outcomes, and staff productivity. There are also financial implications to turnover. The cost of replacing a single nurse can range anywhere from $22,000 to more than $64,000 (Barajas, 2014).
Healthcare employees are especially prone to work-related threats to their physical health. Their work environment is often stressful and filled with potential risks of exposure to biohazards, diseases, and other physically demanding tasks that can lead to health problems (Kramer & Son, 2016). Above all, situations like fluctuating work schedules make the most experienced employees leave healthcare organizations. Effectively, a wealth of human capital leaves prematurely, increasing instability in the workplace.
Retaining key employees constitutes a salient human resource management (HRM) issue. In response, a growing number of companies are upgrading their reward strategy by complementing their traditional benefits package with perquisites, a tangible form of organizational rewards (Renaud, Morin, & Béchard, 2017). There are two types of rewards, identified as tangible and intangible. Tangible rewards focuses on the basic needs ex. (financial), whereas intangible rewards focuses on the psychological needs ex, (nonfinancial). Healthcare employees operate in a highly demanding work environment that affects outcomes for both organizations and their employees. Many of the work characteristics in healthcare organizations are beyond the direct control of the individual organization (Kramer & Son, 2016). Particular occupational positions like that of nurses have been found to have increased numbers of turnover/burnout. The goal here is to find work-life balance and match the rewards to what matters most to employees to help increase job satisfaction.
Nurse Turnover Rates
Review each tab to know more.
• Relationships
• Staffing
• Personal Reasons

Example
If the relationships among nurses in a unit or between nurses and their managers or physicians are strained, the nurses are more likely to leave that hospital.
Potential Solution
There are several reasons these relationships might turn sour. For instance, some nurse managers are promoted without actually being qualified for the position.
Frequent employee satisfaction surveys can help reveal if nurses in individual units are satisfied or not.
Reference
3 biggest causes of nurse turnover. (2013). Retrieved from https://www.beckershospitalreview.com/human-capital-and-risk/3-biggest-causes-of-nurse-turnover.html
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References:
Barajas, B. (2014). How to reduce staff turnover in hospitals and healthcare facilities. Retrieved from https://www.precheck.com/blog/how-reduce-staff-turnover-hospitals-and-healthcare-facilities
Kramer, A., & Son, J. (2016). Who cares about the health of health care professionals? An 18-year longitudinal study of working time, health, and occupational turnover. ILR Review, 69(4), 939–960. doi: 10.1177/0019793916640492
Renaud, S., Morin, L., & Béchard, A. (2017). Traditional benefits versus perquisites: A longitudinal test of their differential impact on employee turnover. Journal of Personnel Psychology, 16(2), 91–103. doi: 10.1027/1866-5888/a000180
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Additional Materials
From your course textbook, Cases in Health Care Management, review the following cases:
• Case 50: An Affair at Work
• Case 51: Another California Wildfire
• Case 52: Back to School
• Case 54: Super Natural Medical Center’s Staffing Crisis
• Case 55: The Lesser of Evils

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