Question: Discipline and Insubordination You are the coordinator of a small, specialized respiratory rehabilitation unit. Two other nurses work with you. Because all of the staff are professionals, you have used a very democratic approach to management and leadership. This approach has worked well, and productivity has always been high. The nurses work out schedules so that there are always two nurses on duty during the week, and they take turns covering the weekends, at which time there is only one RN on duty. With this arrangement, it is possible for three nurses to be on duty 1 day during the week, if there is no holiday or other time off scheduled by either of the other two RNs. Several months ago, you told the other RNs that the state licensing board was arriving on Wednesday, October 16, to review the unit. It would, therefore, be necessary for both of them to be on duty because you would be staying with the inspectors all day. You have reminded them several times since that time. Today is Monday, October 14, and you are staying late preparing fi les for the impending inspection. Suddenly, you notice that only one of the RNs is scheduled to work on Wednesday. Alarmed, you phone Mike, the RN who is scheduled to be off. You remind him about the inspection and state that it will be necessary for him to come to work. He says that he is sorry that he forgot about the inspection but that he has scheduled a 3-day cruise and has paid a large, nonrefundable deposit. After a long talk, it becomes obvious to you that Mike is unwilling to change his plans. You say to him, "Mike, I feel this borders on insubordination. I really need you on the 16th, and I am requesting that you come in. If you do not come to work, I will need to take appropriate action." Mike replies, "I'm sorry to let you down. Do what you have to do. I need to take this trip, and I will not cancel my plans."

ASSIGNMENT: What action could you take? What action should you take? Outline some alternatives. Assume that it is not possible to float in additional staff because of the specialty expertise required to work in this department. Decide what you should do. Give rationale for your decision. Did ego play a part in your decision?