Kelly Brown has been a dedicated nurse within the Midwest Hospital Systems for 10 years, and during these years, she has been well respected by her peers. After many years as a floor nurse, Kelly was given the promotion to head nurse of the surgical unit. Initially, the announcement of her promotion was greeted with "well-deserved" among the nursing staff. This was in line with expectations as the surgical unit was known to be a tightly knit group of dedicated nurses who spent a great deal of time together both in and out of the hospital. Prior to Kelly's promotion, a great deal of mistrust had developed between the nursing staff and those in administrative positions. Over the past few years, the nurses felt they were being taken advantage of by administrators as their workload increased, overtime was cut, and no salary adjustments had been made in 3 years. On numerous occasions, the nurses had complained about their working conditions to the previous head nurse, Mildred, without success. The nurses viewed Mildred as never being able to rectify their problems. For example, when the nurses received a memo from administration telling them they would be asked to work 10-hour shifts instead of the standard 8-hour shifts, Mildred simply told the nurses, "What do you want me to do? They didn't ask for my input." When the nurses heard that all overtime was being cut immediately, Mildred once again simply shrugged at the nurses who complained. Finally, when the nurses loudly complained to the lack of raises in years, Mildred simply responded that times were difficult and the nurses needed to be patient until the economy was more stable. During this time, the nursing staff came to mistrust Mildred's explanations and felt she had become "one of them"an administrator. After a few years, Mildred tired of the complaints and decided to retire. During these years, Kelly had been one of the gang and actively complained about the lack of support from Mildred. She routinely voiced her distrust of anyone in an administrative position and only added to the "us against them" culture that had developed within the surgical unit.

Therefore, when Kelly's promotion was announced many nurses publicly congratulate her, but behind the scenes, it was a different story. Several nurses were heard muttering, "How could Kelly become an administrator?" Another nurse told Kelly, "Just remember who your real friends are and remember to take care of us. Don't do what Mildred did and become one of them." Several other nurses took the opportunity to gain Kelly's ear and asked:

1. Can overtime be changed so we (the nurses) can decide when and how often we need to work?

2. Can salaries be raised to account for the 3 years of no adjustments? Retroactively?

3. Can vacation time be extended?

One of the senior floor nurses was overheard to say, "Now that Kelly is in this new position, perhaps we can make some of the changes around here that we have all been complaining about for years!"

CASE STUDY DISCUSSION QUESTIONS - Answer the following

1. What are the potential advantages and disadvantages of the present situation for Kelly?

2. If you were Kelly, how do you believe this promotion would affect your relationship with your coworkers?

3. What hurdles will Kelly face in her new role as a leader? How should she overcome these hurdles?

4. Will it be possible for Kelly to be seen as a leader within the surgical unit?