One thing that is very urgent is to clarify what the role of each person is, because there seems to be confusion over who is responsible for what. There seems to be also a gap between what the team aspires to do, and what is achievable within the time and resources available. The nurses should perhaps spend some of their group consultation time agreeing what an acceptable service is, and setting boundaries for that so that people do not feel stressed out reaching for the impossible. A focus on doing fewer things well may in fact bring an improvement in results and less stress, but the team must help managers define what these few things are. It has been noted that increased collaboration between health professionals and managers outside the health system is likely in the coming years and that “some health professionals may resist this inevitable oversight as an intrusion on their professionalism.” (Kovner and Knickman, 2005, p. 457) A willingness to re-draw the boundaries of the nurse role with families may well result in nurses being responsible for less, and this may take some getting used to for some nurses who find this the most rewarding part of the job.Betsy Cline is committed, hardworking, and respected by her team. These are all good points. She is also competent and aware of her own pressure points, such as a tension between communication roles and hands on nursing roles. One significant weakness is taking on too much herself, and lacking systems which could ease her burden. The issue of sickness reporting, for example, should be set down as an automatic process which is embedded in the team’s work, rather than something that has to be checked on and followed up by Betsy. Because of the multiple stresses that Betsy has, she is at risk of seeing herself as indispensible, a scenario known as “the savior complex” which could mean she is suffering from burnout, (Wicks, 2006, p. 20). Betsy must learn to look after herself first, so that in turn she can be there for her team. There is evidence that as nurses get older they are tempted to leave hands on nursing care (Kovner and Knickman, 2005, p. 430 and this could happen to Betsy if she is not willing to take steps to look out for herself.
5. The hospital administrator needs to look at some of the communications breakdowns and unacceptable delays that are occurring in this unit. Many of these problems, such as late delivery of medication or lack or fore-warning about new equipment originate in other parts of the hospital, and so the administrator nee