Mrs. Jackson’s Dilemma

The emergence of human resources management as its own department is a relatively new development in many organizations. While HR has not always existed as its own department, businesses and organizations—particularly those in the health care field—have always had a need for human resources management.

In this week’s Discussion, you will examine a case study that illustrates how HR responsibilities were handled before the existence of HR departments. Then, you will consider the related challenges in the health care field.

To prepare for this Discussion:

a. Read the article, “Strategic Human Resource Management as Ethical Stewardship,” and consider how the existence of an HR department benefits an organization and its employees.

b. Review the case study “Mrs. Jackson’s Dilemma”. Weigh the advantages and disadvantages—both personal and organizational—of Mrs. Jackson’s involvement in hiring new nurses.

c. Think about how the existence of an HR department in the hospital would help to aIDress some of the disadvantages you identified. Would the HR department’s involvement in hiring new nurses have the same advantages as Mrs. Jackson’s involvement?

Post a brief summary of the key differences and similarities between Mrs. Jackson‘s responsibilities and concerns and those of health care organizations today. Then, briefly describe what has changed since the time of the case study and what has brought about this change. Compare how Mrs. Jackson’s situation would be handled today, how HR would be involved, and how these changes have been impacted by an evolving legal framework. Finally, highlight the purpose of HR and reflect on its value.

Case Study: Mrs. Jackson’s Dilemma

In 1930, a hospital located in a prosperous town was growing along with its community. Mrs. Clara Jackson was effectively the administrator of the hospital, although it is doubtful that the title administrator was applied. Hospital administration had yet to emerge as a specialized field of study and a profession in its own right. This hospital had started as many others had begun, as a private clinic owned by physicians who eventually turned their operation over to a community board that would convert it to a not-for-profit institution.

In 1930, few professions were represented in a typical hospital. There were physicians, most of whom were in private practice and admitted some of their patients to the hospital. A pharmacist might have been in attendance at least part of the time, as well as a few others working in occupations that later developed into the health professions known today. The dominant occupation in a hospital of that time by far was nursing. Nurses originally provided nearly all of the services required by patients. Because nurses composed the majority of the staff and the persons who were in the hospital all the time, it was natural for a senior nurse, in this case Mrs. Clara Jackson, to oversee the operation of the facility.

Growth was accompanied by the emergence of people assigned to perform specialized tasks and activities such as housekeeping and food service. Despite their presence, Mrs. Jackson remained the principal manager in the hospital. Her administrative responsibilities, however, cut into the time she could spend where she felt she belonged, which was involved in the nursing issues of patient care. The task that especially consumed much of her time was hiring employees. Even though she was able to delegate the hiring of non-nursing personnel to other group supervisors, Mrs. Jackson was often swamped with activities related to hiring nurses. She felt trapped. If she concentrated on nursing, where she believed she belonged, jobs went unfilled and conditions worsened. If she gave her full attention to hiring nurses, however, she had inadequate time available for her professional nursing responsibilities. Her dilemma intensified when the hospital’s sole bookkeeper and paymaster began to complain of having too much work to perform for a single person in keeping up with staff aIDitions and departures. What options were open to Mrs. Jackson in 1930? What options would be available to her today? What other issues or requirements did Mrs. Jackson have to think about in 1930? With what other issues, requirements, or regulations would a contemporary hospital have to cope?

Resource:

Jr., L. Fleming F., Charles McConnell. Human Resource Management in Health Care, 2nd Edition. Jones & Bartlett Learning, 08/2013. VitalBook file.

Caldwell, C., Truong, D. X., Linh, P. T., & Tuan, A. (2011). Strategic human resource management as ethical stewardship. Journal of Business Ethics, 98(1), 171-182.