The City Main Hospital Cochin

The City Main Hospital Cochin, was incurring losses inspite of its rising popularity and increasing number of outdoor patients. The management had been thinking of doing something to solve the problem. As the major burden of the heavy cost was due to the surplus manpower, the simplest solution, according to the Hospital’s Executive Director, was to reduce staff, especially, from the nursing department. The hospital had five floors. The fifth floor was meant for keeping chronic and old age patients under observation”.

Like all other floors, this unit had 80 beds with all the excellent facilities and round the clock services of 50 nurses reporting to Lily Joe, the Senior Nurse Manager. The Executive Director knew that over the years the fifth floor as “observation” unit had been only partially utilized. For the last 20 months the floor had never served more than 6 patients at any given time. Naturally the floor with its huge staff was considered under-utilized and to a large extent a unit that could be dispensed with. The Executive Director, Dr.

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Pandey discussed the matter with the hospital management and suggested that the patients of the fifth floor could be kept in other wards and dosing the fifth floor could avoid recurring losses. The management agreed to close the fifth floor and decided to terminate the services of its senior manager Lily Joe as her services would be no more required. The management asked Dr. Pandey to remove also those nurses, who were specially appointed for the “observation” unit because of their experience and training in looking after the chronic and elderly patients.

A number of meetings with the senior executives were held to plan the closing of the fifth floor. However, discussions brought out a few complicating factors in this regard. Firstly, it was pointed out that no permanent employee of the hospital could, as per the hospital’s practice and service rules, be laid off. The hospital followed the policy of “reassignment” and not “removal”. The management could close the fifth floor, but it could not remove the long-standing employees working in the observation unit on fifth floor.

Hence, the management was committed to shift the fifth floor staff to other units having positions for them, according to their suitability across the hospital; it was believed that most of the affected staff could be suitably absorbed. But, the senior managers from other units expressed reservations about the possibility of moving the fifth floor employees to other units. According to them the fifth floor staff over the years had developed their own set and habitual ways different from the ways of employees of other units.

The fifth floor nurses, for example, refused to accept to do anything more than what was assigned to them. The staff had been idling since long. Therefore, they lacked participative and cooperative attitude. Their senior manager Lily Joe was generally considered least effective as a manager. Because of all these reasons, the senior managers of all other units were most unwilling to accept the proposal of reassigning the fifth floor workers to other units. Both these complicating factors were conveyed to the management.

To resolve the problem management decided to discuss the matter with all nurse managers of the hospital administration. A series of meetings was conducted by the Vice-President of nursing, and attended by all ten of the nurse managers, including Lily Joe as well as General Manager of Public Relations, Director of Personnel and a Labour Relations Officer. Initially, the management did not want Lily Joe to be included in these meetings as she was personally concerned with the matter. However, the management considered it would look proper if Lily was involved in the planning process of the lay-off.

In every meeting Lily created a scene by crying and making all other members present I can do this feel extremely embarrassed. It was resolved that nothing discussed in the meetings would be revealed to anyone until the final decision with regard to the closing of the fifth floor was taken. Every member of the meeting was placed under the oath of secrecy. But soon, the entire hospital was full of rumours that the management had decided to throw out long standing workers and that the fifth floor was its special target. Anxiety, nervousness, whisperings spread across all the floors of the City Main Hospital.

Hysteria gripped the fifth floor. Finally to meet the situation a plan was developed. On the following Friday morning, the Vice-President of nursing and the Director Personnel would go to the fifth floor and meet the entire staff of the “observation unit” to inform them about the plan of either shifting them to other units if so desired, for whom positions in other units had been worked out, or the scheme of Golden Handshake of parting with generous provisions of retirement benefits specially created for the fifth floor employees who would be laid-off.

Immediately after this meeting, the same information would be announced at a general meeting of all the hospital workers; increasing simultaneously the hospital’s Chief Medical Officer (CMO) would hold a meeting of medical staff and brief problem them about the plan of closing the fifth floor. On Wednesday, individual letters signed by the Director General cording to would be sent to all employees so that most would reach by Thursday morning and departmental meeting would be held on Thursday afternoon.

On Friday, the whole staff, in a general meeting, would be informed about the scheme. On Thursday morning a press release on the generous golden handshake scheme of the City Main Hospital would be organized with the media. Thus, by Friday news about the hospital’s generous action regarding the fifth floor employees would appear in the newspapers and be known to all. Two days before the action on the fifth floor was to take place the Vice-President of nursing met the hospital’s CMO, Dr.

Manoj Mehta and the Chief Administrative Officer (CAO), General Khurana to review the plan formulated in the meetings. The Vice-President nursing was astonished to find both Dr Mehta and General Khurana react to the plan negatively. Both, insisted on knowing exactly how many persons would be suggested removed and who all would be reassigned to different positions. But the Vice-President could not beforehand give exact number of reassignments, as the nursing positions always kept fluctuating everyday, depending on the number of resignations and new appointments.

Dr. Mehta shouted, “Nursing never gets its numbers right”. Besides, General Khurana violently reacted to getting the letters to individual employees signed by the manager Director General. “We should stop putting blame on the higher-ups”, he exclaimed. Infact, both made it clear that they would not allow the things to move forward until the specific numbers were worked out and the letter to the employees was redrafted. Meanwhile, the hospital’s grapewine was spreading like wildfire. Everyone was talking about the fifth floor going to be closed in two days.

Perhaps, the fifth floor employees themselves had come to know about the closing of the fifth floor. One of the fifth floor employees put an announcement on the hospital’s computer ‘s network saying, “Through a most reliable source it is learnt that we the loyal and longest serving staff of the fifth floor are soon going to be thrown out onto the street by the hospital. If you wish to help support hurt persons, you could contribute to the charity fund, we are raising for this purpose. Please send your donations to other toy fifth floor employee’s home address. On Thursday, the fifth floor employees wore black armbands. They hung black curtains in the patient’s rooms. The patients too were distressed to know that they were going to he removed from the observation unit. Next morning, confusion and tension overtook the fifth floor. While the management and senior executives kept debating the number of workers to be retained and the fine details of the effective communication plan, the fifth floor employees were restlessly awaiting the orders of their termination.

Every moment they felt that they were going to be asked by someone to go home for good. Gradually the tension mounted and the situation became unbearable. One nurse grew hysterical and started crying loudly. Some other nurses began sobbing and clinging to one another. The news of the fifth floor’s complete breakdown spread across the hospital. The Director Personnel came up. She saw what was happening. With the help of G. M.

Public Relations, she made the fifth floor employees go home, and organized the shifting of fifth floor patients to other wards on other floors. The following day (Saturday), The Executive Director announced that the City Main Hospital had closed the Fifth Floor. Questions 1. Analysis the reasons for spreading of rumours of the layoff of the observation ward staff. 2. Was it correct to include Lily in the initial discussion meeting? 3. Ideally, how should this situation have been handled?