As you are aware, Barbara Norris has recently been promoted as nurse manager in the General Surgery Unit (GSU) here at Eastern Massachusetts University Hospital (EMU). She has inherited a unit with the lowest employee satisfaction scores and highest employee turnover rate among all the departments at the hospital. GSU is known for its culture of confrontation, blaming, and favoritism. Additionally, the staff that has remained is dissatisfied, unmotivated and does not function as a team to deliver care. As a result of the lack of unity, GSU’s patient satisfaction scores, although average, have been declining steadily over the past few years.

One of Barbara’s main objectives for accepting the position was the challenge to try to turn the unit around. While Barbara has a tough job ahead of her, she is off to a good start in showing the staff that she is genuinely interested in hearing their problems and concerns. The purpose of this memo is to analyze the main issues in the unit and offer recommendations to solve them.

The Off-site
In an off-site workshop that Barbara conducted earlier this week, the GSU staff revealed to her several problems in the unit. Megan Mahoney, who had only been on the unit for one year, expressed her disappointment with some of the senior nurses. She said, “You make me feel like I am doing everything wrong but won’t address me directly or in a straightforward manner” and “you said you were tired of me and all of my questions and called me a pest!”

Louise Scribner, who worked in GSU for 23 years, complained about the support asked for by the younger nurses and patient care assistants. Her response was, “I barely have time to do my own job…we have too few nurses in the ward and because some of that staff is inexperienced to boot, I am put in the position to pick and choose the care I can give.”

Jennifer Goodwin’s main issue was