Question: Downsizing Panic and Anxiety As the result of rising costs and shrinking reimbursement, many hospitals downsized their staffs in an effort to shrink costs. Because the hospital where you are the chief nursing administrator is faced with mandatory staffing ratios, it is impossible to cut further staff nurse positions and meet requirements for state licensing. Therefore, the CEO of the hospital has mandated that management positions be reduced by 30% throughout the hospital. The CEO has decided that department heads can reduce management positions by any method they choose as long as it is done in 6 months. Job duties are to be reassigned among the remaining managers. This affects you significantly, as nursing has more managers than any other department.

It does not appear that attrition or turnover rates in the next months will be adequate to eliminate the need for some reassignments, demotions, or termination of your group of 17 managers. This includes both house supervisors and unit managers. The news travels rapidly through the hospital grapevine. Semi-hysteria prevails, with many managers consulting you regarding whether their position is in jeopardy and what they can do to increase the likelihood of their retention. Morale is rapidly plummeting, and relationships are becoming increasingly competitive rather than cooperative.

ASSIGNMENT: Determine how you will handle this situation. What strategies might you implement to reduce the immediate anxiety level? What advice can you give to staff who may face either a layoff or a demotion? Is it possible to preserve the morale of your managers in an uncertain situation such as this?