BLDR Assignment

Barbara Norris: Leading Change in the General Surgery Unit

Submitted by Group AB2 (Section 5)

15F526 Khushboo Langalia
15F529 Mayank Srivastava
15F540 Samarth Gattani
15F549 Siddhartha Varma
15F556 Vidit Jain
Barbara Norris Case Analysis BLDR Group Assignment

Question 1: How well has Barbara Norris done in her first month as nurse manager of
GSU? Was she a good choice for the position?
During her first month as nurse manager of GSU, Barbara tried to closely understand the
way the GSU unit functions. She observed operations of the unit, behaviour of the staff and
identified the loopholes. She also compared the GSU unit’s functioning with her old unit.

Reading the case, we think she was a good choice for the position of nurse manager in GSU
due to following reasons:-

1. To begin implementing the required changes in GSU, she used her past experience in
trauma unit and learnings from her earlier manager Ms Betty.
2.  To begin discussion among the members of the GSU, she implemented an open
communication channel by running an offsite.
3. Barbara asked each and every member to write their issues which she discussed in
an open forum. She persistently listened to the issues and gave a chance to staff
members to come out with solutions.
4. Barbara expressed the need of staff being involved in finding solutions to the
problems from her previous experience at trauma unit. She assured the GSU staff
that she is going to include them in the decision making process going ahead and
they will have more say in the working of the unit. 
5. Barbara collected all the issues anonymously which ensured that real sentiments of
the staff are expressed. She read the responses aloud in the open forum so everyone
knows all the issues the unit is facing. She also requested if anyone wanted to
comment or follow up on any of the issues.
6. Barbara was a great observer and listener. Whenever a staff member expressed their
issues verbally, she knew exactly the experience, skill sets, personality and their
contribution to the GSU unit. She has the right combination of analytical skills and
emotional intelligence.
7.  Barbara made a note of each and every one issues identified by the staff and started
to work on her action plan immediately.  
8. She observed that her ex-incumbent had not kept some of the vital management
tools like formal review records and informal check-ins. She decided to maintain it to
build cohesion and better resolution of problems going ahead. 

Question 2: What changes is she trying to make and why?

1. Increase the staff motivation and reduce the dissatisfaction among staff members
2. Increase team work, collaboration and interpersonal bonding between peers
3. Change of performance review procedures by making it more transparent. Ensure
only merit-based performance appraisal and eliminate favouritism
4. De-centralize the decision making by including the staff in arriving solutions to the
problems faced by the unit
5. Have well drafted performance-reward system to acknowledge the efforts of the
staff members
6. Have regular training and development workshops to upgrade the skills of the staff
7. Change the functioning of the unit from administration centred to patient centred

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Barbara Norris Case Analysis BLDR Group Assignment

GSU unit is lacking employee motivation factors. The staff opinions about the unit are full of
negativity since there is no link between effort, performance and reward. The staff focuses
on those functions which provide them desirable rewards. But once the staff achieves the
expected performance, there aren’t any rewards to motivate them to continue their efforts.
Thus GSU needs to realign its functioning following Victor Vroom’s expectancy theory.
Barbara must find a way to motivate her staff to put forth the effort that she wants to
see. The employees need to view the outcomes or rewards as something positive for them
and not a routine yearly process.  

Another obstacle that Barbara has identified is the lack of intellectual transfer and training

that goes on at GSU. Some staff members perform duties beyond their job descriptions
while others don’t even perform their routine tasks. The more experienced staff should
invest time in training the new staff. This should be included in their performance review.

As company is facing economic crisis and shortage of staff, Barbara may need to develop a
reward system that does not involve financial compensation or holidays/leaves. The staff
should rather be offered recognition and constructive feedback, which will help in building
an emotional connect among the staff members.

Question 3. What are the three obstacles that she should anticipate and how should she
address them?
The obstacles that Barbara should anticipate are:-

1. Establishing the determination to change inside the unit due lack of motivation in staff
members

During the first few days when Barbara become the nurse manager, 29 of the unit’s staff
members went to talk to her which made her sense the culture of conflict and blaming. This
shows a sense of urgency inside the unit. However, during the off-site meeting, when
Barbara was asking suggestions from staff, there was awkward silence. This shows that the
staff members are getting used to complaining instead of offering solutions.

The issues related to human resources such as the hiring freeze are one of the biggest
obstacles at EMU. To address this, Barbara should ask her director to put off from the hiring
freeze and get more staff for the unit by establishing the sense of urgency. If, on the other
hand, this does not work well, she can schedule the shifts of the existing nurses in a way
that they do not feel over worked. She should ensure that the ones who put good amount
of effort are not left unacknowledged.

2. Complaints for the existing performance review system

Nurses are frustrated that the performance review process is not fair and transparent.
Barbara should get in touch with HR department and try to devise a transparent and fair
review process and should communicate to all the nurses. Barbara can institute a
transparent review process which can link the compensation with performance. But at
present, she does not possess the authority to do so especially during the prevailing

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Barbara Norris Case Analysis BLDR Group Assignment

financial crisis. Thus, what she could do now is to incorporate a system that rewards the
good performers with non-monetary rewards, for example, some verbal acknowledgement
or certificates of merit or regular meetings where performers are identified and thanked for
their valuable contribution by their peers and bosses. By this she will regain the trust of all
the employees.

3. Lack of cooperation and team cohesion

Barbara needs to break the hostility among staff members and create a more cooperative
and collaborative environment. She can do this by holding regular meetings with staff
members to solve the problems together. She can also institute a team building system
wherein the nurses have to work as a team rather than working by themselves. This would
create a friendly environment and a sense of belonging among the staff members. Barbara
can also organise training programs for new recruits and specialised programs for
experienced nurses on how to work with advanced equipment.

Question 4. Please device an action plan for Norris based on the Kotter’s 8 steps for
change.

Kotter’s 8 steps for change are as follows:-

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Barbara Norris Case Analysis BLDR Group Assignment

The action plan recommended for Barbara based on Kotter’s 8 steps for change is as
follows:-

1. Create Urgency: Barbara should get in touch with HR department and try to devise a
transparent and fair performance review process to regain the trust of all the employees.
She should try to create transparent working environment and increase motivation and
interpersonal bonding among staff.

2. Form a powerful coalition: Identify change supporters and committed people from
juniors and experienced staff who would lead the cause of change in the system. Barbara
should motivate them to be face of change in the organization.

3. Create a vision for change: Find out how the new action plan which will help to achieve
the goals of hospital in a better way. Experienced staff has to lead from the front and
motivate junior staff to help in implementing new action plan.

4. Communicate the vision: After implementing all changes in the procedures, it should be
communicated to the staff during a meeting. Also, Barbara should make one of the
experienced nurses supervisor who can check whether the new action plan is being
implemented or not.

5. Remove Obstacles: Barbara has to make sure that the new plan is enforced strictly and
issue warning to those people who are not collaborating or who are resistant to work
according to new rules. If the employees still resist even after warning, she can take stricter
action like termination of the employee to set an example.

6. Create short term wins: Identify the staff who achieves the targets according to new
action plan and reward them. Publicly announce how their collaboration and teamwork
helped whole staff in achieving their goal. This will motivate others also to achieve the goal
and it will improve overall performances from the staff.

7. Consolidate improvements: Barbara should not be satisfied with the success of action
plan in initial stages and should not become complacent. She should try to maintain the
same level of enthusiasm in the employees for long term.

8. Anchor the changes in your department culture: Make teamwork and collaboration a
part of culture. Every member of staff be it experienced or new should be willing to sacrifice
his own goal for the team goal.

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