Solved by Expert Tutors
Read the case information below to prepare for this project: Human Resource Case Study.
Solved by Expert Tutors
Question

Read the case information below to prepare for this project: Human Resource Case Study.


Draft a memo of no more than eight hundred words for the CEO of the hospital to demonstrate at least five of the potential HR issues involving Nurse Cusack, Nurse Minor, Nurse Albert, and the HR department. The memo may be in a list format, identifying the issues and then providing a recommendation on any action to take against the employment of either Nurse Cusack or Nurse Minor.


In the memo, do not address any potential tort or criminal actions. The CEO at this point in the process is only interested in HR issues.



Human Resource Case Study


Mary is the risk manager for the facility. Mary's duties include interfacing with other departments in the facility when Mary have issues involving their staff. Mary regularly work with the HR staff when issues Mary uncover in the cases involve current staff. 


The facility is working diligently to improve its standing in the region. Mary and the fellow administrators are expanding the services that Mary provide. Mary have been providing neurosurgical services for quite some time and have a good reputation in the area for the neurosurgical team's performance. In order to retain the best neurosurgeons in the area, Mary are also enhancing the services provided in the intensive care unit (ICU). At their request, more equipment has been purchased and additional services have been provided since 2015. 


In June 2014, Sam Lawson was admitted to the hospital. He was an active 67-year-old husband, father, and grandfather. Despite his age, he still worked regularly as a consultant for the engineering firm he started years before. He enjoyed a fairly good income from his work. In April 2014 he began having headaches. Following an MRI, it was determined that he had a brain tumor. The morphology and other tests revealed that it was most likely benign. He was to undergo surgery for the removal of the benign brain tumor. His prognosis for full recovery was very good. 


Dr. Belmont was his neurosurgeon and is a cautious provider. Dr. Belmont was concerned about the possibility of Mr. Lawson's brain swelling following surgery. Therefore, Dr. Belmont placed an intracranial pressure (ICP) monitoring line into the ventricles of his brain. This line allowed the nursing staff to monitor the pressure in Mr. Lawson's brain. They were to alert Dr. Belmont if there were any increases in the ICP beyond acceptable parameters set in the postoperative orders written by Dr. Belmont. Mr. Lawson also had orders for IV morphine for pain or agitation. 


After Mr. Lawson's surgery he was sent to ICU. He had orders for monitoring of his vital signs and ICP every 15 minutes for the first hour then every half hour thereafter. In this facility, this intensive monitoring is the standard and followed policies for ICP monitoring. Mr. Lawson's initial postoperative hours were uneventful. He was cared for by a very conscientious nurse, Nurse Albert. At shift change from day shift to evening shift, Nurse Albert noted that she was to be followed by Nurse Cusack. Nurse Cusack would not have been Nurse Albert's initial choice, but she knew that the ICU was short-staffed and there were numerous temporary staffing agency nurses working that evening. Nurse Albert knew that Nurse Cusack had a history of being written up for tardiness, excessive break times and attitude issues. She also did not consider her the most attentive nurse in the ICU. 


As part of the patient hand-off, Nurse Albert reported Mr. Lawson's condition to Nurse Cusack. During this transfer discussion, Nurse Albert noted that Nurse Cusack appeared tired, which Nurse Cusack brushed off as a busy day before reporting for her evening shift. When pressed for more assurance by Nurse Albert that she was OK, Nurse Cusack became agitated and said that she was fine. Nurse Albert was concerned but this behavior was the norm that everyone had come to accept for Nurse Cusack, and she chalked up her behavior to Nurse Cusack's explanation that she had had a busy day. 

Nurse Cusack assumed Mr. Lawson's care. She did his initial vital signs and ICP reading and seemed to be attentive for the first few hours of the shift. Nurse Minor, the charge nurse, was making rounds that evening. When checking Mr. Lawson's charting, she noted that a set of vital signs and ICP reading had not been recorded for over 40 minutes. Nurse Cusack was not in the patient's room so she started looking for Nurse Cusack and found her as she was exiting the bathroom. She seemed a bit confused by Nurse Minor's concerns and went back to Mr. Lawson's room. The ICU got very busy and Nurse Minor spent most of the rest of the evening dealing with issues related to the agency nurses and their need for extra attention. 


Near the end of the shift, the ICU staff responded to a call for help coming from Mr. Lawson's room. He was unresponsive and one of his pupils was larger than the other, which is an indication of pressure building up in his brain. The ICP monitor had not alarmed. Nurse Cusack exclaimed that the alarm must not be working. When his ICP was checked, it was found to be far above the acceptable range established by Dr. Belmont in the postoperative orders. Dr. Belmont looked at the charting of the vital signs and ICP. All of the vital signs and ICP readings that were recorded appeared to be normal. He could not explain the sudden rise in Mr. Lawson's ICP. 


Mary are now performing a root cause analysis to help determine what happened with the ICP monitor and the events of that evening. During her participation in the meeting, Nurse Cusack breaks down and starts crying. That is when the real story comes out. She has been a morphine addict for years. She states that Nurse Minor is aware of her problem and has been helping her cope with her addiction. Nurse Minor used to work in a drug rehabilitation unit. The evening of Mr. Lawson's surgery, Nurse Cusack was personally using Mr. Lawson's morphine. She had inserted a heparin lock (sometimes called a saline lock) into her leg and hid it with her scrubs. She would sign out Mr. Lawson's morphine then go to the bathroom and inject it in her heparin lock. Nurse Cusack believes that Nurse Minor watched her patients more closely than those of the other nurses. She thinks that is why Nurse Minor found the missed set of vital signs and ICP reading and went looking for her. Once she realized that she was being watched that evening, she fabricated a set of vitals and an ICP reading for the set that had been missed. Because she was actively using morphine that evening, she was not monitoring or recording the vital signs and ICP as ordered. When she noted late that evening that Mr. Lawson was unresponsive, she fabricated the vital signs and ICP readings making it look as if she had been performing the required checks and that all of them had been normal. 

Mary contact HR in order to determine what is in Nurse Cusack's employment file. There is no reference to any disciplinary actions. It is immediately apparent that Nurse Cusack has never been caught using morphine at work. Her performance evaluations are average to poor with occasional reference to not returning from her breaks in a timely manner. She has never been on corrective action. Her license is in good standing. Nurse Minor is still the employee. Mary request her employment file too. Her file is unremarkable.

Step-by-step answer

facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. N

  1. et, consecte
  2. inia pulvinar tortor ne
  3. o. Donec aliquet.
  4. ng elit. Nam lacinia pulvinar tortor
  5. , ultrices ac mag

acinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a mo

acinia pulvi

amet, consectetur adipiscing el

ur laoreet. Nam

e vel laoreet

ur laoreet. Nam risus ante, dapibus a molestie

e vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adip

  1. amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia p
  2. dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pel
  3. ipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem
  4. sus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fu
  5. nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam

ce dui lectus, c

, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vi

  1. ce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam
  2. s a molestie consequat, ultrices ac magna. Fusce dui lectus, congue vel laoreet ac, dictum vitae odio. Donec aliquet. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nam lacinia pulvinar
  3. ia pulvinar tortor nec facilisis. Pellentesque dapibus efficitur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac mag
  4. itur laoreet. Nam risus ante, dapibus a molestie consequat, ultrices ac

ipsum do

ec alique

sum dolor sit

Subscribe to view the full answer

Why Join Course Hero?

Course Hero has all the homework and study help you need to succeed! We’ve got course-specific notes, study guides, and practice tests along with expert tutors.

  • -

    Study Documents

    Find the best study resources around, tagged to your specific courses. Share your own to gain free Course Hero access.

    Browse Documents
  • -

    Question & Answers

    Get one-on-one homework help from our expert tutors—available online 24/7. Ask your own questions or browse existing Q&A threads. Satisfaction guaranteed!

    Ask a Question