Question: Restructuring-In Depth

You are the supervisor at a home health agency. There are 22 RNs in your span of control. In a meeting today, John Dao, the CNO, tells you that your span of control needs adjustment to be effective. Therefore, the CNO has decided to flatten the organization and decentralize the department. To accomplish this, he plans to designate three of your staff as shift coordinators. These shift coordinators will "schedule patient visits for all the staff on their shift and be accountable for the staff that they supervise." The CNO believes that this restructuring will give you more time for implementing a continuous quality improvement (CQI) program and promoting staff development. Although you are glad to have the opportunity to begin these new projects, you are somewhat unclear about the role expectations of the new shift coordinators and how this will change your job description. In fact, you worry that this is just a precursor to the elimination of your position. Will these shift coordinators report to you? If so, will you have direct line authority or staff authority? Who should be responsible for evaluating the performance of the staff nurses now? Who will handle employee disciplinary problems? How involved should the shift coordinators be in strategic planning or determining next year's budget? What types of management training will be needed by the shift coordinators to prepare for their new role? Are you the most appropriate person to train them?

ASSIGNMENT: There is great potential for conflict here. In small groups, make a list of 10 questions (not including the ones listed in the learning exercise) that you would want to ask the CNO at your next meeting to clarify role expectations. Discuss tools and skills that you have learned in the preceding units that could make this role change less traumatic for all involved.