Jane Couch is the director of nursing for a 400-bed nonprofit hospital in the Southwest. Susan Smith joined the hospital as a staff nurse 3 years ago after relocating from the Northeast. She is 30 years old and has been a staff nurse since graduating from a 2-year college nursing program 10 years ago. She is married to a lawyer, and they have two children, aged 6 and 8.

The hospital’s inpatient census has been extremely high because of another hospital’s closing. The tension on the nursing floors has increased because of pressures to discharge patients early, lack of professional staff, and an upcoming accreditation visit from The Joint Commission. Because of time restraints, Jane was unable to complete the staff’s annual performance evaluations. However, all nurses received a 5% pay increase. With this increase, the hospital staff is now the highest paid of all the hospitals in the region. Jane believes that the higher pay compensates the nursing staff for their increased workload and related stress levels.

Until recently, Jane had been pleased with Susan’s performance. Susan had demonstrated a willingness to work hard and had made very few, if any, patient-care errors. However, over the past 3 months, Jane has noticed that Susan is not performing at her usual productivity level and appears to argue frequently with the treating physicians and other nurses about the patients’ treatment plans. Jane often hears Susan complaining that “no one listens to me,” “no one wants to hear my opinion,” and “they don’t pay me enough to do this job.”

Susan was once a highly motivated, productive member of the nursing staff. Jane understands that everyone is experiencing more stress than usual because of the increased workload, but what can be done to motivate Susan to return to her prior performance?