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Preface
I
have been teaching human resource man-
agement (HRM) for many years. Prior to
teaching, I was in management. I realized as
I managed employees how important the HRM
department is to the success of an organization.
I think any HRM course should be a core course
for all managers, regardless of industry. If you
cannot manage your employees, your organiza-
tion will not be successful. Plain and simple. Yet,
it continues to amaze me how often a human
resource (HR) department is located in the base-
ment of a building, far from senior management.
Although larger organizations have estab-
lished HRM departments that managers can
utilize, smaller organizations may not have
an HR department; therefore, general man-
agement should be comfortable with HRM
activities. This text will provide information
that both general managers and HR managers
can apply to the healthcare industry. The text
is organized into five sections.
▸▸ Part I: Introduction
This text provides a glimpse into the impor-
tance of HRM in all aspects of healthcare orga-
nizations. Each chapter discusses HRM and
its role in many different aspects of healthcare
management. The following is a summary of
each chapter in this text as it relates to HRM.
Chapter 1: What Is Human
Resource Management?
This introductory chapter emphasizes the
important role that HRM activities play in the
operations of a healthcare organization. It is
fascinating that HRM activities were observed
as early as 2000 bc. HR can be applied to any
activity in the operations of an organization,
regardless of the industry. The role of HRM is
briefly discussed in this chapter in the context
of the following organizational activities: legal
and safety issues, careers in health care and
HRM, labor unions in health care, job analysis
and design, recruiting and selecting employ-
ees, employee benefits, training and motivat-
ing employees, and terminating employees.
Strategic planning, including labor budgeting
and forecasting, is also addressed because of
the contribution of HRM to successful stra-
tegic planning. In addition, the impact of the
global economy, demographic trends, and
information technology on HRM is discussed
because these trends have impacted how
HRM is now implemented in the healthcare
industry.
Chapter 2: Human Resources-
Related Law
Employers have a legal mandate to provide a
safe and fair workplace. A healthcare manager
must be familiar with the different federal and
state laws that affect the healthcare industry.
The HRM department must provide training
for all employees to ensure they understand
the seriousness of violating the law and under-
stand the differences between civil and crimi-
nal law and the penalties that may be imposed
for breaking those laws. Both federal and state
laws have been enacted and policy has been
implemented to protect both the healthcare
vii
viii Preface
provider and the healthcare consumer. New
laws have been passed and older laws have
been amended to reflect needed changes that
allow health care to continue to protect its
participants. The healthcare industry is no
different. Because of continued legal changes,
training must be routinely offered by HRM.
The MeToo movement has increased the num-
ber of sexual harassment complaints across the
country, which highlights the need for contin-
ued training by HRM in sexual harassment
issues. Unfortunately, with the increase of
mass shootings across the country, workplace
violence training prevention has also become
necessary. There is a section on strategies for
dealing with an active shooter situation. Work-
place bullying continues to be a problem. Strat-
egies and training suggestions are highlighted
to address these major employment issues.
▸▸ Part II: Staffing the
Organization
Chapter 3: Designing Jobs
Evaluating the workflow of any organization
is the first step toward developing jobs for
individuals to perform that will ensure the
workflow produces the desired outputs of an
organization. Prior to creating jobs, a job anal-
ysis must be performed to determine which
type of activities will be performed within a
certain position in the organization. Job anal-
ysis is the foundation of HRM because the
analysis of a job is required before an organi-
zation recruits individuals for specific jobs. At
the conclusion of a job analysis, a written job
description and written job specifications are
developed; these outline the responsibilities,
skills, and experience needed to perform the
job successfully.
An important component of developing
jobs is how the jobs are designed to ensure
that the health and safety of the employees are
protected through ergonomics, that the work
is efficiently performed, and that the employ-
ees are motivated to perform at a high level.
Motivational job designs include flextime, job
sharing, job enlargement, enrichment, rota-
tion, and telework.
The same process must be performed
if the organization decides to alter the way a
service is being offered. For example, if elec-
tronic medical records will be implemented
in a healthcare facility, it is necessary to deter-
mine the current workflow patterns and then
redesign the projected workflow to accommo-
date the new technology. If an organization is
diligent in these job processes, the analysis and
design will help the organization perform at its
highest level.
Chapter 4: Recruiting, Selecting,
and Hiring a Healthcare Workforce
An organization should plan a systematic
recruitment process to ensure that the appro-
priate candidates will apply for positions.
Organizations can recruit both internally and
externally to the organization. Regardless of
the recruitment method, the organization
must assess the effectiveness of the types of
recruitment methods chosen. Characteris-
tics of good interviewers and recruiters are
emphasized because they represent the orga-
nization. Once the recruitment process has
been completed, the next step is to select the
appropriate candiates for the organization
using approaches such as interviews and, in
some instances, tests that assess aptitude, atti-
tude, honesty, and personality. These procesess
must be legally defensible, which means they
must be objective and fair to all applicants.
Hiring and retaining diverse employees is a
pirority for many organizations; so, a cultural
competence training is outlined to encour-
age the successful completion of this goal.
 Preface ix

HRM plays a considerable role in these pro- department in any healthcare organization
cesses to ensure that the most qualified appli- that may be used to provide career education
cants are hired. for employees.

▸▸ Part III: Training Chapter 6: Employee Benefits

and Developing the There are four legally mandated employee
benefits: social security, unemployment
Organization insurance, workers’ compensation, and fam-
ily and medical leave. However, there are
several employee benefits that employers
Chapter 5: Careers in the Health can offer to employees that can be used as
Industry recruitment and/or retention tools. Employ-
ees expect employers to provide medical
Healthcare personnel represent one of the
insurance, including dental and vision plans,
largest labor forces in the United States. This
vacation and sick leave, and retirement plans.
chapter provides an overview of the several
However, employers can offer other benefits,
types of employees in the healthcare indus-
such as education reimbursement, childcare
try, e.g., healthcare consumers and potential
or eldercare services, or flexible work sched-
employees. Some of these positions require
ules. Employers may consider a cafeteria plan,
many years of education but others can be
which enables employees to select which
achieved through 1- to 2-year programs. The
benefits are best suited for their lifestyles.
healthcare industry will continue to progress
Employers should survey their employees and
as U.S. trends in demographics, disease, and
their competition to determine the best type
public health patterns change and cost and
of benefits package that would motivate and
efficiency issues, insurance issues, technolog-
retain quality employees. Establishing a qual-
ical influences, and economic factors continue
ity benefits package would also be an excellent
to evolve. More occupations and professions
recruitment tool. The HR department plays a
will develop because of these trends. Because
key role in educating employees about their
of our aging population, the Bureau of Labor
different benefits. Although most organiza-
Statistics indicates that the health industry will
tions provide an orientation to new employees
generate nearly 2.5 million new jobs by 2026.
that explains benefits, as well as an employee
When one thinks of healthcare providers, one
benefit handbook, benefit education is ongo-
automatically thinks of physicians and nurses.
ing in an organization. Often, HR depart-
However, the healthcare industry comprises
ments will invite experts from disability and
many different health services professionals,
long-term care insurance to the organization
such as dentists, optometrists, psychologists,
to provide information to employees about
chiropractors, podiatrists, nonphysician prac-
their benefits choices.
titioners, administrators, and allied health
professionals. Allied health professionals,
who represent nearly 60% of the health- Chapter 7: Developing and
care workforce, provide a range of essential
healthcare services that complement the ser- Retaining Healthcare Employees
vices provided by physicians and nurses. This The goal of healthcare organizations is to pro-
chapter also contains information for the HR vide quality of care to their patients. Nurses,
x Preface
physicians, and other healthcare providers
have direct contact with patients. There are
also different types of healthcare employees
who provide indirect care to patients. Labo-
ratory technologists and technicians play a
major role in diagnosing disease, assessing the
impact of interventions, and applying highly
technical procedures, but they may never see
patients.
Regardless of the employees’ role, under-
performing employees could risk the lives of
their patients. Research on high-performing
organizations, including healthcare organi-
zations, reveals that employees are motivated
to perform well by the quality of their work
environment. A quality work environment
includes initiatives, such as employee empow-
erment, training and career development pro-
grams for employees, pay for performance,
management transparency and support, and
work–life balance.
Motivation of healthcare employees can
be achieved in different ways. Providing
extrinsic and intrinsic rewards is appropri­
ate. Employee training and development
programs can be motivational. Described in
this chapter are several different motivational
theories that can improve employee perfor-
mance. In health care, high productivity is
vital. If employees are not satisfied, their job
performance will suffer. Nurses suffer from
burnout because of high patient/nurse ratios.
A high patient/nurse ratio also causes lower
quality of care because nurses do not have
time to provide quality care, and if they are
dissatisfied in general, the quality of work suf-
fers. Burnout causes high employee turnover,
which results in high organizational operat-
ing costs. This chapter will discuss different
motivational theories and different organi-
zational strategies for motivating employee
performance.
▸▸ Part IV: Employee
Relations
Chapter 8: Labor Unions
and Health Care
Because of the economic revolution in the
United States, President William Howard Taft
established the U.S. Department of Labor in
1913. Its mission was and is to promote the
welfare of working people and the decency
of their working conditions. By the end of
World War I, the U.S. Department of Labor
had established policies to ensure fair wages
and decent working conditions so that human
resources—employees—were treated fairly
(Grossman, 1973). Early labor union organi-
zations were established from the late 1700s
to the early 1800s because employees believed
that management was not treating them fairly
with respect to wages and hours. Early mem-
bership labor organizations represented differ-
ent types of skilled employees, such as printers
or carpenters, to ensure the fair treatment of
the employees by management. Labor unions
focused on job security, fair wages, and shorter
working hours. Union membership reached its
peak in the 1950s but has declined over the last
20 years in many industries. Labor unions can
be regarded as the predecessors of HR depart-
ments. The goal of both is the equitable treat-
ment of employees by management.
Despite the decrease in union mem-
bership, healthcare unions are increasing in
strength, particularly in the nursing sector.
In 2007, the Service Employees International
Union (SEIU) created a national healthcare
union, which is the largest healthcare union in
the country. SEIU Healthcare represents one
million members, including hospitals, nurses,

physicians, long-term care, and many outpa-
tient facility workers. In 2009, the California
Nurses Association, the United American
Nurses, and the Massachusetts Nurses Asso-
ciation merged, creating the National Nurses
United, the largest nurses’ union in the United
States, representing more than 150,000 mem-
bers in every state. This chapter will describe
the history of U.S. union development, how
unions are formed, legislation that affects
unions, and the impact of healthcare unions
on the industry.
Chapter 9: Terminating
Healthcare Employees
Employment is a relationship between an
employee and an employer with expectations
by each that the responsibilities of the other
will be fulfilled. Both employers and employ-
ees have rights and should treat each other
respectfully. Employers must provide a safe
working environment for their employees.
Employees must perform to the best of their
ability in accordance with their job descrip-
tions, which is why they were hired. How-
ever, that does not always happen, which is
why there are rules and regulations in place
to ensure that both sides maintain their rights
when an employee is terminated. This entire
chapter focuses on employee termination
because it is often the most difficult action
taken by a manager and the organization.
Although this is the shortest chapter in the
text, it may be the most important. If an orga-
nization has a legally defensible hiring process
that provides an opportunity to hire the best
employees for the organization, there should
be minimal need to terminate employees. If
an employee is terminated for deficient per-
formance, it is possible that the person should
Preface xi
not have been hired. The organization must
emphasize to their employees that the hiring
process must be a quality process that will
select the best employees for an organization.
This chapter focuses on the types of employee
separation actions, employees’ legal and con-
tractual rights in the termination process, the
impact of the employment-at-will doctrine on
termination of employees, employee discipline
approaches, and the importance of a system-
atic termination process.
▸▸ Part V: Long-Term
Planning in HR
Chapter 10: Trends in Healthcare
Human Resource Management
The opioid epidemic is a public health emer-
gency. The U.S. Surgeon General has asked that
employers play a more active role in the opi-
oid epidemic. The opioid crisis has impacted
every socioeconomic class. Employers need to
think of their employees’ health outside their
business because employee health impacts the
productivity. HR departments need to work
with state and local resources that promote
best practices, such as pain management cen-
ters that identify nonopioid treatments, disease
management programs, and behavioral health
interventions.
U.S. healthcare organizations are expand-
ing their facilities overseas and U.S. patients
are seeking healthcare services internation-
ally because of the high costs of U.S. health
care. Technology continues to impact the
industry, and the industry is developing cre-
ative ways for health services to be delivered.
Recent mergers and acquisitions have changed
healthcare industry operations. Managing an
xii Preface
intergenerational workforce can also be a chal-
lenge. These initiatives require HRM training,
development, and support to their employees
to ensure that personnel or organizational
issues are managed.
Chapter 11: Strategic Human
Resource Management
Strategic thinking is the ability to assess the
organization’s operations with a long-term
perspective using creativity and intuition. It
is about what to modify or eliminate (Harris,
2018).1 HRM plays an integral role in strate-
gic management of any organization, includ-
ing healthcare organizations. For a healthcare
organization to be competitive, it must pro-
vide quality care to its consumers or patients.
Quality care comes from quality employees.
Quality employees come from quality HRM
procedures, which include a recruitment and
selection process that will find appropriate
1
Harris, J. (2018) (4th). Healthcare Strategic Planning: Health. Chicago, IL: Administration Press: pp. 16–21.
employees for an organization. The HR
department must provide appropriate train-
ing for employees as healthcare organiza-
tions evolve and change their strategic plans.
Long-term planning also requires employees
to remain up to date with the newest scientific
information regarding health care. Employee
turnover in a healthcare organization is very
costly. The HR department can play a role
in developing an organizational culture that
empowers employees and encourages their
productivity. Another integral role that the
HR department plays in strategic planning is
forecasting the supply of labor and the future
labor demands of the healthcare organization.
In addition to finding qualified employees for
the organization, budgeting for labor costs is
necessary because labor costs are the greatest
operating expense of a healthcare organiza-
tion. This chapter will focus on the five steps
of strategy development and implementation
and the role of HRM in the strategic manage-
ment process.
© roberuto/Getty Images
About the Author
Nancy J. Niles is an Associate Professor of Health
Care Administration at Rollins College, located
in Winter Park, Florida. She became interested
in health services because of her experience as
a rural development agent with the U.S. Peace
Corps in Senegal, West Africa. Her gradu-
ate education focused on health policy and
management. She received her PhD from the
University of Illinois at Urbana-Champaign,
Master of Public Health from Tulane University
School of Public Health and Tropical Medicine,
Master of Science with emphasis in healthcare
administration, and Master of Business Admin-
istration from the University of Maryland.
xiii
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Acknowledgments
As always, my mother, Joyce Robinson, who And, a huge thank you to Danielle Bes-
continues to inspire me as my role model. sette, Tess Sackmann, and Suganya Karuppas-
My husband, Donnie, who is my biggest amy for their support on this project.
supporter and best friend.
Thank you to Mike Brown, Publisher.
I will always be indebted to him because he
started me on the path as an author.

xv
 PART I
Introduction
CHAPTER 1 What Is Human Resource Management? . . . . . . . 3
CHAPTER 2 Human Resources-Related Law. . . . . . . . . . . . . . 29
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1
© roberuto/Getty Images

CHAPTER 1
What Is Human Resource
Management?
LEARNING OBJECTIVES
The student will be able to:
■■ Discuss the history of human resource management (HRM).
■■ Identify four applications of HRM to healthcare organizations.
■■ Discuss four ways the human resource (HR) department can collaborate with organizational
management.
■■ Assess the impact of Frederick W. Taylor on managing employees.

DID YOU KNOW THAT?

■■ The Chinese and Greeks used employee screening and apprenticeship programs in 2000 bc.
■■ It is the legal responsibility of the employer to provide a safe and healthy work environment.
■■ The healthcare industry employs more than nine percent of the U.S. workforce.
■■ Employee benefits are considered incentives to recruit and retain employees.

The level of productivity can vary depending

▸▸ Introduction on the skill levels the employees demonstrate

H
in their jobs and the satisfaction levels of the
RM is defined as a system of activities
employees with the organization and their jobs.
and strategies that focus on success-
To develop a high-performance and effective
fully managing employees at all levels
workforce, the organization should use HRM
of an organization to achieve organizational
input in the following organizational areas:
goals (Byars & Rue, 2006). Employees are the
HR of an organization and its most valuable 1. Job analysis and job design
asset. To be successful, an organization must 2. Recruitment and selection
make employee productivity a major goal. 3. Healthcare career opportunities
3
4 Chapter 1 What Is Human Resource Management?

4. Distribution of employee benefits
5. Employee motivation
6. Negotiations with organized labor
7. Employee terminations
8. Preparing for emerging and future
trends in health care
9. Strategic planning
▸▸ Major Milestones
of HRM
At what point in history did the concept of
HRM emerge (TABLE 1.1)? During prehistoric
times, there existed consistent methods for
selecting tribal leaders. The practice of safety
and health while hunting was passed on from
generation to generation. From 2000 bc to
1500 bc, the Chinese used employee-screening
techniques, and the Greeks used an apprentice
system (Kumar, 2015). These actions recog-
nized the need to select and train individuals
for jobs.
During the late 1700s and early 1800s,
because of the rapid industrialization of
Great Britain, the United States evolved from
an agricultural nation to an industrial nation.
British factories were being built, and inno-
vative manufacturing processes were being
developed. The United States benefited from
this progress as British immigrants brought
their new knowledge to the United States.
Because of the Industrial Revolution, there
developed a separate class of managers and
employees in the factories (The Emergence
of Modern Industrialism, 2010). Labor
unions were established from 1790 to 1820.
These membership labor organizations rep-
resented different types of skilled employ-
ees, such as printers or carpenters, to ensure
that these employees were treated fairly by
management. Labor unions focused on job
security, fair wages, and shorter working
hours for employees (Byars & Rue, 2006).
This dramatic change in the U.S. economy
emphasized the need for a system in the
workplace to manage both employees and
management—the HRs of these new types
of organizations. During this period, labor
unions became powerful advocates for
employee rights, although there were many

TABLE 1.1 Major Milestones of HRM Development in the United States

2000–1500 bc Chinese used employee-screening techniques.

Greeks used an apprentice system.

1700 to early United States evolved from an agricultural nation to an industrial nation.
1800

Great Britain experienced rapid industrialization.

British immigrants brought industrialization knowledge to the United States. A new

U.S. labor system established a division of labor: management and employees.

1790–1820 Labor unions were established to protect employees’ rights.

1900 B.F. Goodrich Company established the first HR department.

 Major Milestones of HRM 5

1902 National Cash Register established an HR department to handle employee issues.

1911 Frederick W. Taylor: Scientific management principles established a differential pay

system.

1913 U.S. Department of Labor was established to promote the welfare of employees.

1920–1930 Hawthorne studies increased productivity by changing the physical work

environment of the employees.

1935 Social Security Act was passed, which created “old age” insurance for those of
retirement age. Through payroll taxes, employees pay a portion of their wages to
contribute to the fund.

1938 Fair Labor Standards Act of 1938 established federal minimum wage laws.

1960–1980 Equal Pay Act of 1963, Civil Rights Act of 1964, Occupational Health and Safety
Act of 1970, and Pregnancy Discrimination Act of 1978 focused on employee
discrimination and safety.

1990–2000 Americans with Disabilities Act of 1990 (ADA) and Older Workers Benefit Protection
Act of 1990 prohibit discrimination against disabled workers and workers older than
age 40.
The Civil Rights Act of 1991 enables individuals to receive monetary damages.
The Family and Medical Leave Act of 1993 provides up to 12 weeks of unpaid
leave, during any 12-month period, to provide care for a family member or the
employee himself or herself or other family issues.
Health Insurance Portability and Accountability Act of 1996 was passed to
promote patient information and confidentiality in a secure environment.
The Mental Health Parity Act of 1996 requires the equality or parity of lifetime
and annual limits of health insurance reimbursements for mental health care.

2001–2010 The Genetic Information Nondiscrimination Act of 2008 prohibits U.S. insurance
companies and employers from discriminating based on the information derived
from genetic tests.
The Wellstone Act or the Mental Health Parity and Addiction Equity Act of 2008
amends the Mental Health Parity Act of 1996 to include substance abuse treatment
plans as part of group health plans.
The Lily Ledbetter Fair Pay Act of 2009 (FPA), an amendment to Title VII of the
Civil Rights Act of 1964, also applies to the Age Discrimination Act of 1967 and the
ADA, all which provides protection against unlawful employment practices related
to discrimination.
The Affordable Care Act of 2010 (ACA) was passed to increase the number of U.S.
citizens and permit them access to health insurance. An individual mandate required
the purchase of health insurance, and the establishment of a health insurance
marketplace provided health insurance options. Small businesses with more than
50 employees were required to provide health insurance coverage.
6 Chapter 1 What Is Human Resource Management?
court skirmishes attempting to mitigate the
power of unions over the decades.
From 1950 to 1970, union membership
represented more than 25% of the U.S. work-
force. From 1980 to 1999, as the U.S. economy
focused less on manufacturing and evolved
into a service economy, union membership
declined (Mathis & Jackson, 2006). Although
union membership has since continued to
decline, union membership has increased in
health services. Labor unions can be regarded
as the predecessors of HRM departments.
The goal of both is the equitable treatment of
employees by management.
In 1900, the B.F. Goodrich Company
pioneered the establishment of an employee
department to address labor concerns. In 1902,
National Cash Register also formed a separate
department to handle employee issues such as
wages and grievances (Kumar, 2015). More com-
panies eventually followed their lead in HRM.
A labor shortage existed in the early 20th
century increasing the need for managers
to focus on productivity of its employees. In
1911, Frederick W. Taylor promoted scien-
tific management based on the following four
principles:
1. Evaluate a task by dissecting its
components.
2. Select employees who had the
appropriate skills for a task.
3. Provide workers with incentives
and training to do a task.
4. Use science to plan how workers
perform their jobs (Kinicki & Wil-
liams, 2008).
Taylor developed a differential pay sys-
tem that rewarded workers who performed at a
higher level. This type of HRM is still used today.
Because of the economic revolution in
the United States, a federal agency, the U.S.
Department of Labor, was established in 1913
by President Taft. Its mission was and is to
promote the welfare of working people and
safety of their work conditions. By the end
of World War I, the Department of Labor
had established policies to ensure that fair
wages and work conditions existed so that the
employees, were treated fairly (U.S. Depart-
ment of Labor, 2018).
In the 1920s, a Harvard research group
implemented the “Hawthorne studies,” which
focused on changing the physical work envi-
ronments of employees to assess changes in
their work habits. The results indicated an
increase in productivity, as workers believed
that management was concerned about their
welfare, which improved their productivity.
Although these experiments were eventually
criticized for having a poor research design,
they illustrated the importance of manage-
ment treating employees well as an impetus
to improved worker performance (Kinicki &
Williams, 2008). The Fair Labor Standards
Act of 1938, enforced by the U.S. Department
of Labor, established federal minimum wage
standards, child labor laws, and increased
wages for overtime. Both laws and manage-
ment theory established the precedent for
HRM today.
Recent Milestones of HRM
During the 1960s and 1970s, legislation such
as the Equal Pay Act of 1963, the Civil Rights
Act of 1964, the Occupational Safety and
Health Act of 1970, and the Pregnancy Dis-
crimination Act of 1978 required employers to
recognize employee rights. During the 1980s
and 1990s, legislation such as the ADA of 1990
and the Older Workers Benefit Protection Act
of 1990 further supported employee rights.
Recently, legislation such as the Genetic Infor-
mation Nondiscrimination Act of 2008 and the
Lilly Ledbetter FPA of 2009 continued to focus
on employment discrimination. The goal of
the Patient Protection and Affordability Act or
ACA of 2010, although controversial, was to
increase the number of individuals who have
healthcare insurance through various man-
dates. However, with the change in adminis-
tration, the impact of the ACA’s mandates is
uncertain. Health care and the economy are
 Role of HR Departments in the Health Industry
the two key issues of Americans. The economy
continues to improve according to various
pundits, but the healthcare system is unstable.
There have been calls to repeal portions of the
legislation. There has also been reduced fund-
ing for some of the insurance mandates, which
has weakened its impact. It is impossible to
assess the future of this landmark piece of leg-
islation, and Americans are concerned about
access to and the rise of healthcare costs.
▸▸ Role of HR
Departments in the
Health Industry
HR departments have integrated the wide-
spread use of technology in their departments.
For years, HR technology was developed to
automate payroll, personnel record-keeping,
recruitment and hiring, performance apprais-
als, and employee portals to access their
personal information. In addition to these
process efficiencies, HR technology has also
moved toward automated employee engage-
ment surveys. These data can assist manage-
ment to determine if organizational changes
are needed to improve employee satisfaction
because satisfied employees are productive
employees (Bourque, 2015).
Typically, the HR department establishes
a partnership with organizational manage-
ment regardless of the organizational type.
Most HR departments have similar responsi-
bilities. The HR and management partnership
is unique in the healthcare industry because
many healthcare organizations have a dual
administrative structure of clinical managers
and health services managers who supervise
two distinct groups of employees with dif-
ferent responsibilities and different training
needs. For example, clinical managers have
training or experience in a specific clini-
cal area and, accordingly, have more specific
responsibilities than do generalists or health
7
services managers. Directors of physical ther-
apy are experienced physical therapists and
nurse managers have nursing degrees, but
most health services managers have a bach-
elor’s degree or master’s degree in health ser-
vices (Bureau of Labor Statistics, 2018).
According to Zingheim and Schuster
(2002), an organization can take the following
steps to foster a relationship between the HR
department and senior management:
1. Treat HR employees as internal con-
sultants to the organization who can
provide recommendations about
employee relations.
2. Ensure that management actively
collaborates with HR employees,
which includes inviting HR man-
agement to strategic planning
meetings.
3. Ensure that HR routine provides
extensive training to all employees.
4. Both HR and management should
participate in an HR audit to assess
the state of the organization. Turn-
over rates, incentive plans, diver-
sity rates, and strategic planning
activities should be continuously
reviewed to ensure that the organi-
zation is performing at a high level.
5. The following sections of this chap-
ter describe specific workplace issues
where the role of HR and manage-
ment is integrated to ensure that
these issues are addressed through-
out an organization.
Legal and Safety Issues
in Health Care
Employees at all levels should understand basic
legal principles that affect the work environ-
ment, particularly in the healthcare industry.
The legal relationship between the organiza-
tion and the consumer—the healthcare pro-
vider and the patient—is the foundational
relationship of all healthcare activities. Federal
8 Chapter 1 What Is Human Resource Management?
and state laws have been passed and policies
have been implemented to protect both the
healthcare provider and the healthcare con-
sumer. The passage of new laws and amend-
ments of older laws reflect needed changes to
protect healthcare participants.
A major employment issue is that of a safe
working environment. According to the fed-
eral Occupational Safety and Health Admin-
istration (OSHA), it is the responsibility of
the organization to monitor and ensure a safe
and healthy work environment for employ-
ees (OSHA, 2018). Healthcare employees are
exposed to toxic chemicals, contaminated
blood, bacteria, and radiation. Hospitals, lab-
oratories, physicians’ and other healthcare
providers’ offices, and skilled nursing facili-
ties require constant surveillance by OSHA to
monitor workplace standards. As part of health
and safety, the Joint Commission (formerly the
Joint Commission on Accreditation of Health-
care Organizations) also reviews health and
safety standards for both patients and employ-
ees. In collaboration with HR departments,
OSHA provides training and educational
materials to inform employees about the dan-
gers of the workplace.
With the increase in mass shooting
incidents across the country, the “me, too”
movement, and workplace bullying issues,
establishing a safe and fair workplace is a neces-
sity. In concert with federal government agen-
cies and management, it is the responsibility of
the HR department to inform employees about
the basic concepts of law, employment-related
legislation, and workplace safety.
Job Analysis and Design
When starting or expanding any organiza-
tion, the first goal is to determine its overall
mission. If the mission is long-term care, for
example, the first major decision is to decide
how the work or tasks will flow through the
organization to accomplish this goal. This pro-
cess also applies to existing healthcare organi-
zations if they decide to change their services.
For example, healthcare organizations have
integrated technology into their operations,
such as the implementation of electronic
patient health records. This type of major tran-
sition would require a review of the workflow
to ensure that this new activity would be suc-
cessful. Evaluating the workflow of any orga-
nization is the first step in job development
to produce the desired outputs of an organi-
zation. The second step in job development is
job analysis.
The HR department is responsible for
performing job analysis to assess the workflow
of the organization. Job analysis is a process of
determining the different tasks that are asso-
ciated with a specific job (Dessler, 2012). It is
the foundation of HR management. Job anal-
ysis is the tool for organizations to understand
what type of staffing and training is required to
ensure the high performance of employees. Job
analysis enables the organization to develop
job descriptions and specifications to recruit
individuals who have specific knowledge,
skills, and abilities for these jobs. The next step
in the process of job development is job design.
Job design defines how tasks are per-
formed and the types of tasks that are part of
a job (Mathis & Jackson, 2006). Job design can
be considered a retention strategy to encour-
age employee satisfaction. In health care, job
design is less flexible than in other industries
because many job responsibilities have legal
restrictions and standards. However, team-
work is commonly used in the healthcare
industry and can have some flexibility with
its structure. Team designs such as functional
teams, project teams, self-directed teams, task
forces, and virtual teams are used in healthcare
organizations. Job design in teams can be an
important tool to ensure that teams fulfill their
designated goals. In addition, job schedule
redesign, such as flextime or compressed work
schedules, may be an incentive for employee
satisfaction and motivation (Byars & Rue,
2006). Once job analysis and job design are
performed, the next step is to recruit the best
employees for these jobs.
Another random document with
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very little more effort than is required to paddle it. The use of the pole
necessitates a standing position, but this is neither risky nor difficult
for any canoeist who understands the knack of balancing a canoe,
and none but an experienced canoeist has any business in swift,
white water. The setting pole is gripped with the left hand near the
top, with the right hand held stationary about 2 ft. lower, and as the
canoe travels past the pole, firmly planted on the river bottom, the
poler leans forward and makes use of his weight and strength to give
a quick push. The pole is again shoved forward as quickly as
possible, that the craft may lose as little headway as possible, and a
new grip secured for the next push. After a little experience with the
pole, the canoeist will find it an easy matter to swing his craft across
the current and avoid rocks and other obstructions as easily as when
paddling. When contemplating a long trip up a stream where the
water is heavy and the current swift, the use of two poles will make
the work easier. Both persons should pole from the same side, the
man in the bow doing the steering while the stern man adds his
straight-ahead push to force the canoe upstream.
 Shifting the Paddle from One Side of the Canoe to The Other

The Track Line

The average wilderness stream of the North has enough “tight”

places which judgment tells the traveler to avoid by making a detour
by land rather than risk a capsize and a possible loss of the outfit. To
“tote” the outfit overland means more or less hard work, and as
every canoeist will avoid portaging if there is a fair chance of getting
the canoe through a bad stretch of water, the tracking line will come
in handy very often. The usual ring in the bow of the canoe is far too
flimsy for hauling the loaded craft, and sufficient length of stout rope
should be carried along to pass through the painter eye, and then
carried aft and half-hitched to the first and second thwarts. One man
can pull the canoe up a swift stream by walking along the bank while
his partner takes up the opposite side and steers the craft away from
rocks by using a stern line. With a heavily loaded canoe in very swift
and shallow water, both men must often wade, and a tump line
rigged up as a breast or shoulder strap will make it easier work for
the man at the bow line.

Paddling a Canoe Single-Handed

The open, or Canadian-model, canoe is, of course, handled more

easily and with better speed with two paddlers but there are
occasions when the canoe is used single-handed. When out for a
few hours’ paddle, the canoeist usually balances the craft by sitting
on the bow seat—or kneels on the bottom with his back against the
bow-seat brace—and using the stern for the bow. This brings the
paddler’s weight nearer the center and keeps the canoe better
balanced than when paddling from the stern with the bow high in the
air. However, when the canoe is loaded, many canoeists stow their
camp duffle forward and paddle from the stern, the weight of the
outfit keeping the craft on an even keel. This answers well enough
for smooth-water going, but when the water is rough, or a stretch of
rapids is run single-handed, the stern position is by no means a good
one since the craft is more difficult to control, and much more
strength is required to drive it forward. The Indian manner of
paddling a canoe alone is the only correct one, for he always sits
amidships—kneeling in the center—and if a load is carried, it is
placed in front and back of him so that the craft is balanced on an
even keel. Consequently the canoe draws less water and can be
paddled faster with the same effort, while the paddler has the craft
under perfect control. But the experienced line paddler does not
kneel in the center, he moves out until his body is close to the
gunwale. This makes the craft heel at a decided angle, it is true, but
this position makes for better speed because it enables the paddle to
be held almost vertical, and the more nearly perpendicular the
paddle is swung the more efficient will be the stroke.
 In using the double blade, the paddler dips first on one side, then
on the other, and to make the blades travel through the air with the
least resistance, it is customary to set them at right angles to each
other. The motion is really a push and pull, the shaft of the paddle
being rotated in the hands so that the blade will enter the water with
the full breadth facing the canoeist. Rubber cups, to catch the drip as
the paddle rises in the air when making the stroke, are sometimes
used by novices, but these are unnecessary if the paddles are set at
right angles, and the paddler will bend his wrist a trifle to throw the
drip ahead and to one side. At the beginning, the novice will very
likely throw a little water in the canoe, but a little practice will soon
master the knack.

Care and Repair of the Canoe

The canvas-covered cedar canoe will stand a vast amount of hard

service, but it should not be dragged over the ground or over the
boarding of the landing float, neither should it be so placed that any
strain will come amidships while the ends are well supported. When
storing for the winter, keep it under cover, resting bottom side down
on a floor, or turn it bottom side up and support it with boxes, or other
standards, at the center as well as at the ends. While unused at the
camp, turn it bottom side up on the bank. Birch bark must be kept
out of the sun, and the paint of canvas-covered canoes will last
longer if kept in the shade. When the paint becomes rough,
sandpaper it down smooth, and give it a couple of coats of canoe
paint. When the paint is worn off and exposes the canvas, give the
bare cloth a couple of coats of shellac before painting.
 Paddling should be Done on the Knees When Traveling Where High Winds
and Seas are Encountered

A repair kit should be taken along on all long trips, consisting of a

small can of white lead, a can of orange shellac, and a sheet of oiled
silk. For small cuts in the canvas, a coat or two of shellac will suffice,
but for bad gashes, cut off the loose threads of canvas and rub on a
little white lead under the raised portion near the hole and on the
surface, cut a patch of the oiled silk to cover it, and paste it in
position. When the lead is dry, give it a couple of coats of shellac.
For making quick repairs, a roll of electrician’s tape will come in
handy. The birch canoe is quickly repaired in the same manner as
suggested for the canvas-covered craft, and as the shellac is
waterproof and dries quickly, all ordinary repairs may be made by the
stream side with but little loss of time.
 Oiling Tool for Clocks
Jewelers use a little tool for oiling clocks and watches that could
be used profitably by others for the same and similar work. It
consists of a steel wire, bluntly pointed on the end and set into a
wood handle. Very often the only thing that is the matter with a clock
which does not keep good time, is that it is dirty and dry. If this is the
case, any person handy with tools can fix it at practically no cost.
Remove the works, which are usually held with four screws, from the
case, immerse them in kerosene and allow them to stand for a few
minutes, then remove and drain. This will clean out the dirt.

The Tool will Pick Up a Drop of Oil and Deposit It Where Wanted

The oiling tool is dipped in light oil and a drop applied to each
bearing. Replace the works in the case and the job is finished. A
reliable jeweler will charge very little for this work, but the more crafty
ones may ask a good price for this “mysterious” process. If the works
are not dirty, apply the oil with the tool. Anyone who has tried to oil a
clock with an ordinary spout oilcan knows the futility of the attempt.
The object of the tool is to pick up and carry a drop of oil and deposit
it where wanted. A can, a feather, or a match will do, but any one of
them is apt to carry dirt, flood the dry part, or smear up nonmoving
parts.
Easily Constructed Wall Shelves
 Shelves for Books Supported with Picture-Frame Wire to the Wall

All that is necessary to make and support the simple set of wall
shelves, shown in the illustration, is lumber for the shelves, four
screw eyes, four screw hooks, sufficient picture-frame wire to form
the braces and supports, and wood screws for attaching the wire. On
the top side of the upper shelf are fastened the four screw eyes, two
near the wall edge and the others near the outer edge. To support
the upper shelf four screw hooks are used; two placed in the wall
and spaced to match the set of screw eyes nearest the wall, the
others being placed above the first and connected to the outer set of
screw eyes with the wire, thereby forming strong inclined supports.
The remaining shelves can be hung to suit by the supporting wires,
which are fastened with screws to the end of each shelf.
 Showing the Strength of a Giant
This trick is not so well known as it might be, although for a while it
was quite a popular drawing attraction for circus side shows and
other amusement places. It is one of the favorite Hindu tricks. The
performer passes for examination two pieces of rope 10 ft. long. In
one end of each rope a large ring is fastened. Taking a ring in each
hand the performer commands three or four men at each end of the
rope to take hold of it and at a signal they pull as hard as possible.
They pull until they are exhausted as in a tug of war, but the
performer only appears a trifle exerted and finds no difficulty in
holding the men.

The Performer Seems to Hold the Ones Pulling on the Ropes without Any
Effort, Producing an Effect That cannot be Readily Understood, and Making
an Excellent Trick for the Lawn Party

The secret is in the use of a piece of flexible wire, which passes up

the right sleeve of the performer, across the back and down the left
sleeve, lying just inside of the coat sleeve. At the ends of the wire
are small hooks. When about to perform this trick the performer puts
on a pair of gloves. The gloves are slit in the palms to allow the
hooks to pass through. The hooks are covered with cloth, colored to
match the gloves. An essential point to remember in performing the
trick is to keep the fingers well around the rings to prevent the ropes
from dropping in case of a slack-up on the tension.
 The Tricks of Camping Out
By STILLMAN TAYLOR

PART I—The Camping Outfit

Toouter
enjoy a vacation in the woods thoroughly, it is essential that the
be provided with the right kind of an outfit. The
inexperienced are likely to carry too much rather than too little to the
woods; to include many unnecessary luxuries and overlook the more
practical necessities. However, camp life does not mean that one
must be uncomfortable, but rather implies plain and simple living
close to nature. An adequate shelter from the sun and rain, a
comfortable bed, a good cooking kit, and plenty of wholesome food,
are the important things to consider. No man or woman requires
more, and if unwilling to share the plain fare of the woodsman, the
pampered ones should be left at home, for the grouchy, complaining
individual makes, of all persons, the very worst of camping
companions.
The Old Hand at the Camping Game Prefers
to Cut Poles on the Camping Site and Set
Them Up on the Outside for the Camp-Fire
Tent

The Wall Tent may be erected with the

Regular Poles, or, When Ordered with Tapes
along the Ridge, It can be Set Up with Outside
Tripod or Shear Poles
 The Choice of a Tent

There are tents and tents, but for average outings in what may be
considered a permanent camp, the regulation wall, or army, tent is
generally used to make a comfortable shelter. It is a splendid utility
tent, with generous floor space and plenty of headroom. For the
permanent camp, the wall tent is often provided with a fly, which may
be set up as an extra covering for the roof, or extended over the front
to make a kind of porch. An extension may also be purchased to
serve the same purpose. The 7 by 9-ft. wall tent will shelter two
persons comfortably, but when the camp is seldom moved, the 9 by
12-ft. size, with a 3¹⁄₂-ft. wall, will afford more room. The regulation 8-
oz. duck is heavy enough, or the same tent may be obtained in tan
or dark green khaki, if preferred. In any case the tent should have a
sod cloth, from 6 to 12 in. wide, extending around the bottom and
sewed to the tent. An extra piece of canvas or floor cloth is desirable,
but this as well as the fly are extras, and while convenient, are by no
means necessary. The wall tent may be erected with the regular
poles, or it may be ordered with tapes along the ridge and erected by
suspending between two trees. The old hand at the camping game
rarely uses the shop poles supplied with most tents, but prefers to
cut them at the camping site and rig them up on the outside, one
slender pole fastened with tapes along the ridge and supported at
either end in the crotch formed by setting up two poles, tripod or
shear-fashion.
The “Baker” style is a popular tent, giving a large sleeping
capacity, yet folding compactly. The 7 by 7-ft. size, with a 2-ft. wall,
makes a good comfortable home for two, and will shelter three, or
even four, if required. The entire front may be opened to the fire by
extending it to form an awning, or it may be thrown back over the
ridge to form an open-front lean-to shelter.
The “Dan Beard,” or camp-fire, tent is a modification of the Baker
style, having a slightly steeper pitch, with a smaller front opening.
The dimensions are practically the same as the Baker, and it may be
pitched by suspending between two trees, by outside poles, or the
regular poles may be used.
 For traveling light by canoe or pack, a somewhat lighter and less
bulky form of tent than the above styles may be chosen, and the
woodsman is likely to select the forester’s or ranger types. The
ranger is a half tent with a 2-ft. wall and the entire front is open; in
fact, this is the same as the Baker tent without the flap. If desired,
two half ranger tents with tapes may be purchased and fastened
together to form an A, or wedge, tent. This makes a good tent for two
on a hike, as each man carries his own half, and is assured a good
shelter in case one becomes separated from his companion, and a
tight shelter when the two make camp together.
The forester’s tent is another good one, giving good floor space
and folding up very compactly, a 9 by 9-ft. tent weighing about 5¹⁄₂ lb.
when made of standard-weight fabric. It may be had either with or
without hood, and is quickly erected by using three small saplings,
one along the ridge, running from peak to ground, and one on each
side of the opening, to form a crotch to support the ridge pole, shear-
fashion. These tents are not provided with sod or floor cloths,
although these may be ordered as extras if wanted.
The canoe or “protean” tents are good styles for the camper who
travels light and is often on the move. The canoe tent has a circular
front, while the protean style is made with a square front, and the
wall is attached to the back and along the two sides. Both tents are
quickly set up, either with a single inside pole or with two poles set
shear-fashion on the outside. A 9 by 9-ft. canoe or protean tent with
a 3-ft. wall makes a comfortable home in the open.
Whatever style of tent is chosen, it is well to pay a fair price and
obtain a good quality of material and workmanship. The cheaper
tents are made of heavier material to render them waterproof, while
the better grades are fashioned from light-weight fabric of close
weave and treated with a waterproofing process. Many of the
cheaper tents will give fair service, but the workmanship is often
poor, the grommets are apt to pull out, and the seams rip after a little
hard use. All tents should be waterproofed, and each provided with a
bag in which to pack it. An ordinary tent may be waterproofed in the
following manner: Dissolve ¹⁄₂ lb. of ordinary powdered alum in 4 gal.
of hot rain water, and in a separate bucket dissolve ¹⁄₂ lb. of acetate
of lead—sugar of lead—in 4 gal. of hot rain water. The acetate of
lead is poisonous if taken internally. When thoroughly dissolved, let
the solution stand until clear, then pour the alum solution into a tub
and add the lead solution. Let the solution stand for an hour or two,
then pour off the clear water and thoroughly soak the fabric in the
waterproofing mixture by rubbing and working the material with the
hands. Hang the cloth up without wringing it out.
The Forester’s Tent is Quickly Erected by
Using Three Small Saplings, One along the
Ridge, and One on Each Side of the Opening
to Form a Crotch for the Ridge Pole
The Ranger’s or Hiker’s Tent Comes in The Canoe or Protean Tents
Halves. Each Half may be Used Are Good Styles for the
Independently as a Lean-To Shelter for One Camper Who Travels Light
Man, or Both Joined Together to Make Room and Is Often on the Move,
for Two Persons and They can be Quickly Set
Up with a Single Inside Pole

How to Pitch a Tent

It is, of course, possible to pitch a tent almost anywhere, but for

the sake of comfort, it is well to select a site with natural drainage.
Many campers dig a shallow trench around the tent to prevent water
from running in during a heavy rain. This is a good idea for the
permanent camp, but is not often necessary if the soil is sandy or
porous, or where a sod cloth is used.
It is rarely necessary to carry the regular poles to the camping
ground, and they may be omitted excepting when en route to a
treeless region. The wall and other large tents may be pitched in
several ways. In some places the woodsman cuts a straight ridge
pole, about 3 ft. longer than the tent, and two crotched uprights, 1 ft.
or more longer than the height of the tent. The ridge pole is passed
through the opening in the peak of the tent, or fastened to the
outside of the ridge with tapes sewed to the cloth. The two upright
stakes are then firmly planted in the ground, one at the back and the
other in front, and the ridge pole is lifted and dropped into these
crotched supports. Set up the four corner guys first to get the tent in
shape, then peg down the side guys and slide them taut so that all of
them will exert an even pull on the tent. Another good method for
setting up the side guys is to drive four crotched stakes, each about
4 ft. long, somewhere near 3 ft. from each corner of the tent, and
drop a fairly heavy pole in the rest so formed, then fasten the guy
ropes to this pole. When a sod cloth is provided it is turned under on
the inside, the floor cloth is spread over it and the camp duffel
distributed along the walls of the tent, to hold it down and prevent
insects and rain from entering.
To overcome the disadvantage of placing the poles in the center of
the entrance, the uprights may be formed by lashing two poles
together near the top to make a crotch and spreading the bottoms to
form a pair of shears. Poles may be dispensed with entirely,
providing the tent is ordered with tapes for attaching a rope to
suspend the ridge of the tent between two trees. In a wooded
country this manner of setting a tent is generally preferred.
Where a wall tent is used in a more permanent camp, it is a good
plan to order a fly, a couple of sizes larger than the tent. This should
be set up by using separate poles and rigged some 6 or 8 in. higher
than the ridge of the tent, thus affording an air space to temper the
heat of the sun and also serving to keep things dry during long,
heavy rains.

The Camping Kit

The camping kit, including the few handy articles needed in the
woods, as well as the bedding and cooking outfit, may be either
elaborate or simple, according to the personal experience and ideas
of the camper. In making up a list, it is a good plan to remember that
only comparatively few articles are really essential for a comfortable
vacation in the wilderness. A comfortable bed must be reckoned one
of the chief essentials, and one may choose the de-luxe couch—the
air mattress or sleeping pocket—use the ordinary sleeping bag, or
court slumber on one of the several other styles of camp beds. The
fold-over combination bed, the stretcher bed, or a common bag
made of ticking, 6¹⁄₂ ft. long by 2 ft. wide, which is stuffed with
browse or leaves, will suffice for the average person. Folding camp
cots, chairs, tables, and other so-called camp furniture, have their
places in the large, fixed camps, but the woodsman can manage to
live comfortably without them. A good pair of warm blankets should
be included for each person, providing the sleeping bag is not taken
along. The regulation army blankets are a good choice and
reasonable in price, or the blankets used at home may be pressed
into service.
A good ax is the woodsman’s everyday companion, and a good-
weight tool, weighing 3 or 4 lb., and a smaller one of 1¹⁄₂ lb. should
be carried. When going light, the belt ax will suffice.
The oil lantern is only suited for the fixed camp, since the fuel is
difficult to transport unless it is placed in screw-top cans. The
“Stonbridge” and other folding candle lanterns are the most
convenient for the woods and give sufficient light for camp life.
The aluminum cooking outfits are light in weight, nest compactly,
and will stand many years of hard usage, but like other good things,
they are somewhat expensive. A good substitute, at half the price,
may be obtained in tin and steel, having the good feature of nesting
within each other, but, of course, not being quite so light nor so
attractive in appearance as the higher-priced outfits. Both the
aluminum and steel outfits are put up in canvas carrying bags, and
an outfit for two includes a large and a small cooking pot coffee pot;
frying pan with folding or detachable handle; two plates; cups knives;
forks, and spoons. Outfits may be bought for any number of persons
and almost all sporting-goods stores carry them. The two-man outfit
in heavy aluminum will cost $9 or $10, while the same outfit
duplicated in steel is priced at $3.35.