Essentials of Nursing Leadership and Management 6th Edition by Ruth Tappen, Sally Weiss

Exercise 8

Shawna, a new staff member, has been working from 7 a.m. to 3 p.m. on an infectious disease floor since obtaining her RN license 4 months ago. Most of the staff members with whom she works with have been there since the unit opened 5 years ago. On a typical day, the staffing includes a nurse manager, two RNs, an LPN, and one technician for approximately 40 patients. Most patients are HIV-positive with multisystem failure. Many are severely debilitated and need help with their activities of daily living. Although staff members encourage family members and loved ones to help, most of them are unavailable because they work during the day. Several days a week, the nursing students from Shawna's community college program are assigned to the floor.
Tina, the nurse manager, does not participate in any direct patient care, saying that she is "too busy at the desk." Laverne, the other RN, says the unit depresses her and that she has requested a transfer to pediatrics. Lynn, the LPN, wants to "give meds" because she is "sick of the patients' constant whining," and Sheila, the technician, is "just plain exhausted." Lately, Shawna has noticed that the other staff members seem to avoid the nursing students and reply to their questions with annoyed, short answers. Shawna is feeling alone and overwhelmed and goes home at night worrying about the patients, who need more care and attention. She is afraid to ask Tina for more help because she does not want to be considered incompetent or a complainer. When she confided in Lynn about her concerns, Lynn replied, "Get real-no one here cares about the patients or us. All they care about is the bottom line! Why did a smart girl like you choose nursing in the first place?"
What is the responsibility of administration?