People Organisations and Society

Los Ros del Sol Medical Centre is a hospital and surgery centre located in Florida. Its main facility has 500 beds and several outpatient centres, it employees 2,600 people, and has recently partnered with the Mayo Clinic. Despite this seeming success, Los Rayos is experiencing high turnover amidst its nursing staff. The nurse average turnover rate is 14% for hospitals, while Los Rayos has a turnover rate of 21%. New graduate nurses turn over at a rate of 27% within the first year, with an additional 37% of those new nurses wanting to leave, according to a survey conducted nationwide. At Los Rayos, new nurse turnover is 40%. The hospital spends an average of 13% weeks to fill a vacant position and thousands of dollars per hire. Turnover often leaves units understaffed, which creates poor patient experiences, nurse burnout, and lower quality of care. It also cuts into the firm’s bottom line. Why are the nurses leaving? Los Rayos strives to provide the highest quality in patient care, but it also has to manage costs and comply with the new government regulations from the Affordable Care Act. Thus, over the last 10 years, Los Rayos has made a number of changes. Ten years ago, Los Rayos changed the staffing model. All units had two licensed nurses and a housekeeper. Housekeepers were minimum-wage staff that helped the nurses do things like wash linens and stock the nurses’ station with basics. These tasks can take a lot of time away from normal nurses’ job duties of doing rounds, required charting, administering doctors’ orders, and helping patients. Los Rayos promoted the housekeepers to health techs, which were supposed to do more patient care tasks, but most were not equipped with the skills needed to do these advanced tasks and were not given training by the hospital. At the same time, Los Rayos reduced the number of nurses per unit by one. This raised staffing ratios from 12 patients to one nurse to 24 patients to one nurse.

 Eight years ago, Los Rayos cut the annual employee picnic and Christmas party in order to save money.

 Five years ago, Los Rayos expanded nurses’ jobs to engage in activities like cost cutting and quality control. It required nurses to provide three to five cost saving ideas per year or they would be negatively evaluated on their performance appraisals. The next year, the firm put a cap on each position’s wage brackets, which resulted in nurses with greater than 12 years of service not receiving raises.

 A year ago, Los Rayos began requiring all its nurses to take turns developing, planning, and presenting continuing education courses to reduce training costs. Nurses are required to complete 60 hours of continuing education annually for license renewal. The nurses did not receive any additional compensation for the training they developed, nor were they given any nonmonetary rewards.

 Six months ago, Los Rayos changed from 8- to 12-hour shifts to reduce costs and to allow patients to be closer to their caretakers. However, patients from the maternity and geriatrics wards have complained about only seeing nurses at the start and end of shifts and negatively rated the hospital experience on surveys. Most employees agree that the 12-hour shifts are exhausting, and the nurses often state they do not have the time and energy to “go the extra  mile” for colleagues and patients. Collaboration in solving unexpected issues and advice sharing between the staff members have decreased significantly.

Drawing on theories on job satisfaction, motivations, communication, leadership and organisational culture, write a report which analyses the decisions that hospital managers and administrators have made and discusses the consequences for the staff members (the nurses in particular) and the
hospital itself. As a starting point for drafting your report, consider answering the following questions:1. How do you think the changes Los Rayos made affected nurses’ attitudes and behaviours?
2. What problems to the business may poor nurse attitudes and motivations cause in addition to turnover?
3. What do the changes made suggest about the leadership and organisational culture at Los Rayos?

Please, note there is no need to follow the order, just be sure that all questions/issues are addressed
coherently and comprehensively.