ey arise? not on guard against mistakenly e problem itself. What is most likely to happen I What is addressed is a problem symptom and not the causal problem? on 8. Why might we say that Ignoring or even forgetting a problem can itself be considered a decision? 9. What should be the ultimate determinant of how much time and effort is put into any particular decision situation? 10. consensus? What are the essential differences between decision by vote and decision by true Case: More Pleasant Dreams Imagine yourself as night-shift charge nurse on a medical-surgical unit. For several months you have had a problem with a staff nurse whose performance you consider unsatisfactory She seems to continually take advantage of quiet times during her shift to doze off at the nursing station. You have reprimanded her several times for sleeping on the job, and you have reached the point where you believe you can no longer simply scold her for her conduct. Her position, however, is that "it's no big deal," that she's always certain to hear any call signals as long as she's at the nursing station. (Your hospital has a clear policy concerning written warnings, but policy is relatively loose concerning oral warnings; these can be unlimited and issued at your discretion, so you can deliver as many as you believe necessary) For a written warning to become official and entered into an employee's personnel file, it must be agreed to and countersigned by the unit's nurse manager and the director of nursing. You issued the offending nurse two written warnings; both warnings cleared through the unit manager. However, you believe you can go no further without backing from the office of the director of nursing, and there has been no follow-up from that direction. Meanwhile, the employee continues to be a problem. Questions 1. What would your decision be concerning the sleeping employee if it were not necessary to clear such actions through the director of nursing? 2. Assuming you have indeed "hit a wall" as described in the final paragraph of the case, what would you consider doing to try to get some action or support? 3. If you feel stuck with the reality of having your personnel decisions approved-or essentially made-by higher management, what information would you assemble and how would you prepare yourself to try getting a decision favorable to you from your chain of command? What is the director of nursing actually doing by reserving the right to approve or veto 4. your decisions? Case: The Long-Time Employee Assume you have been head nurse of the same medical-surgical unit for nearly 20 years. of the unit's One of your employees, a licensed practical nu