CNO Lee is the Chief Nursing Officer

Case study scenario: CNO Lee is the Chief Nursing Officer of a 200-bed community hospital. The hospital has a 12 bed ICU and a 10 bed Emergency Department. The hospital is the only hospital within a 45 miles radius. The nursing staff prior to COVID was fairly stable with most nurses living near the hospital and no nearby competitors. The CNO is responsible for the nursing departments and her management team consists of the following direct reports: An Emergency Department manager, an ICU manager, three Med-Surg managers, a Surgery Director, a Women’s Health Director, an Employee Health Director, an Infection Control Director, Nursing Administration Supervisors and administrative staff, a Resource Management/Utilization Review Director, and a Risk Manager. Prior to COVID CNO Lee's management team was a tight knit group and worked together successfully on many improvement projects. The hospital has recently been experiencing the strain of the COVID pandemic and has lost 30% of the nursing staff who have either decided to try travel nursing or leave nursing all together. All areas in the hospital are short staffed but the three Med-Surg units have been especially hit hard. The ICU has been full with patients boarding in the Emergency Department and the post-anesthesia care unit. CNO Lee has been meeting regularly with the CEO, CFO and other members of the Administrative​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​ team about the nursing staff shortages. At this point the CFO and CEO are pressuring the CNO for an immediate action plan. CNO Lee has struggled with the decision and put off making a decision until the staffing crisis became dire. CNO Lee has been working independently on a plan and has considered multiple alternatives including the option to close one of the Med-Surg units and combine the staff to cover the other two Med-Surg units, the option to hire travel nurses to cover staffing shortages on the Med-Surg units as well as the ICU, or the option to request retention bonuses and increased pay for the nurses who have remained loyal. The cost of the travel nurses will be $125/hr. The average staff nurse is paid $30/hr. The CNO independent of any feedback from her team, made the decision to bring in travel nurses and to pair each travel nurse with a staff nurse to assist in orientation of the travel nurses. She had been working on the plan for several weeks but did not inform her managers until the day before the travel nurses were to arrive for a 12-week contract. The nurse managers were angry, frustrated, tired, and burned out. They voiced their concerns about fears of more nurse resignations due to the imbalance in pay rate. The managers were stunned at the change in CNO Lee's leadership style. Prior to COVID CNO Lee asked for their input and seemed to value their opinions. They now feel disconnected and left out of the loop. Silently they also consider leaving to take travel assignments for more pay and less responsibility. Answer the questions in this case study based on this scenario. Discussion question: Answer the discussion question using a minimum total of 150 words and cite at least one peer-reviewed journal article. Consider the case study scenario. 1. CNO Lee considered several alternatives and struggled with her decision. What might CNO Lee have done differently in her decision making process? Answer the discussion question using a minimum total of 150 words and cite at least one peer-reviewed journal article. 2. CNO Lee is implementing a major change in the staffing patterns in her organization. Describe what she could do moving forward to be a more effective change age​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​nt.