GUIDELINES

FOR CHOOSING AND ANALYZING A CASE STUDY FOR

PROJECT #3



1. Look through the table of contents in the eBook on Moodle entitled Health
Communication in Practice: A Case Study Approach.

2. Find a decision-focused case that intrigues you; read and examine the case thoroughly.
Some cases are more descriptive and dont address a problem. That type of case wont
work for this project.

3. Read the case a second time. While reading take notes, highlight relevant facts, and
underline key problems. Its probably a good idea to print the case so you can work with
the document offline.

4. Analyze the case by completing the following steps:
a. Identify one key problem.


KEY PROBLEMS:
1. - Medicaid and medicare budget/employee cuts
a. expenses are affecting patient care by leaving patients with not enough and
not receiving the full amount of care they need because of money issues.
b. Patients are being forced to leave the hospital earlier than they should or
wouldve in the past due to recent budget cost due to medicare
c. Patients are getting the full care they need and family members are
assuming that the hospital cares more about their costs and going bank
rupt in debt from using the much unneeded money that they assume that
there family member got worse from the hospital not actually caring about
the needs and proper expensive care the patient needs---- lawsuits will
abrupt from angry family
d. Nurses are wanting to quit there job due to budget cuts that dismissed
many of the health care workers to meet the limitsthis now puts many
jobs on one nurse EX: trained RNs are doing the jobs of the janitors because
they dont have enough time to get the supplies from the supplies store
because there arent as many janitors available to get the supplies needed
to sick patients right away
e. The nurses and doctors dont have enough time to focus to much on one
patient
f. Causes stress for each health care worker who is doing multiple things at
one time so could cause for many malpractice issues and worse could
happen then just the hospital going in debt
g. Could be fixed if the hospital would just try and hire more employees than
normal so at least the patients could be properly cared for and monitored
 for more close descision making on expinsive protocol that could then be
put on the patient paying for half because it has been so closely monitored
and researched that the treatment will help the patient
h. The nurses and doctors are quickly moving thru patients and not realizing
the proper protocol on their conditions which is causing for using more
reasources and spending more money on saving his life when if more
employees were working.. it wouldnt have gotten to the extent of almost
death
i. Also with doctors not paying as much attention to the patients.. they could
be wasting the hospitals money with accidentally ordering scans and xrays
and other unneeded resources quickly when seeing the patient for only a
few mintues bcs they have so many more patients that it isnt letting them
sit and analys the patient for long enough to figure out a cure quicker and
more efficient which is wasting time, money, and effort
j. People under stress do not work well
k. everyone in the hospitalincluding the janitors, doctors, nurses, and
patients are under stress from things being avoided, not having enough
time, not having the time to inform the patient of their issues going on,
misplacing things, nurses staying later than usual and also not getting
food/bathroom usage during their shifts causes very very high cause for
mess ups

2. rob and coping with his super nurse personalityoverworking himself for no
reason ( ** THE ISSUE IM CHOOSING TO ADDRESS)
a. rob is a people pleasure
b. he is a huge help to everyone in the hospital as medicare and Medicaid has
made him do many different positions while running around the hospital
during his shift with almost no time and almost no helping hands from the
other employees since there are none
c. he promises the patients he will go in and talk to them and worries about
pleasing everyone because he worries that he isnt getting his job done
d. being a people pleasure often leads to rob feeling like his head is about to
explode by doing everything everything everyone tells him to do which
leads him to not even have time to sit down or go to the restroom/eat
e. he has a family and younger children at home that he has to go home to
after not being able to sit all day at work from attending to everyones needs
while doing 4 other jobs at once in his job and worrying if everyone else is
doing theirs correctly also
f. it was his anniversy and he is writing his nurses notes from the end of the
day and also corrects another nurses notes out of his way when he doesnt
even need to.. and tells himself he is going to have a talk with her when he
shouldnt be in charge of it
g. even though rob feels like since medicare and Medicaid is now a problem
with budget cuts and employee cuts that it is his duty as a nurse to make
sure everything goes smoothly and gets done-----while he doesnt get paid
anymore than he should
h. rob is one of the nicest nurses I know because he will not say no to anyone
who asks him to do anything and cares so much about everyone except
himself
i. at the end of his work days he has back pains and is exhausted that he
doesnt have the strength to go home and visit with his family so he forgets
about his children sports and is almost late to the anniversy dinner, has to
pick up babysitters and pizza for his kids for an even longer night
j. he makes sure if patients are un happy that he will go and attend to their
needs to they are happy even when he clocks out for the day because he
promised the patient he would visit
k. rob is very very loyal to his patients and all of the patients on his floor
cooroperate with him over the nurses and doctors
l. rob seems like he has push over problems as the nurse who takes his shift
claims it isnt her duty to inform doctors every little change in a patient as
rob does because the nurse says it is also the doctors job and responsibility
to come by and check up on the room and their patients chart history too..
m. rob also made sure to remember to correct her and fix the issues that his
take over nurse made with not informing him of the patient change like rob
did so the doctor wouldnt be upset with her
n. rob also worried about one of the nurses phones going missing and sent
someone else to go on a mission and look for it on their way to the supply
room because he knew it would cut out of the hospitals money cuts and put
them into more bankrupt due to cuts in medicare and Medicaid
o. rob puts so much unneeded stress on himself by trying to do every
profession in the hospital and also doing other peoples jobs such as the
doctors who get to have lunch breaks and bathroom breaks when rob
doesnt
p. he will stop his duties to attend to other peoples and doctors needs when
he could simply say im sorry I cannot
q. rob saying he cannot attend to the multiple needs that he does not need to
do and is not required to do for his job that he isnt getting paid extra for
will then put the issues on the hospital itself
r. as many patients threatened to be transferred to a different hospital with
better care because no one was informing and attending to them but rob
attended to the angry patient out of his way and assisted with their
problems before robs own problems so the patient would be happy and
stay
s. if rob had more employee nurses working with him then he would be able
to afford the time to help the patient and attend to their emotional state as
the other health care workers ignored because they were to busy also
t. rob needs to learn to say no more and also let the doctors do the job their
required to do instead of assuming there are all the nurses in the world to
inform them and also do the little work they could be doing
u. since there arent many nurses and rob is being worked to death then the
hospital can then deal with the issue of patients leaving and feeling like
they arent being fully cared for mostly emotionally, they complain about
 v. rob does do a great job but he isnt the director of all of the issues that can
possibly happen to the hospital because hes should be getting paid for 5
jobs instead of one with all of the hard work hes doing over everyone else
w. the hospital would then notice the issue of patient care because their arent
enough hands with the lazy doctors complaining and ordering everyone
around and getting lunch breaks that the hospital could either hire more
nurses over doctors, or threathen the doctors, or even a small amount of
pay from the doctors to give to the nurses so it would be worth it for the
hard working nurses such as rob and Belinda to keep working like they are
and feeling happy about it because it is benefitting their families back home
and motivating them to want to work for the hard working money they
made each day.
x. Or hire more nurses to decrease the stress of the doctors,nurses, janitors,
patients, and family memebers with making sure that the patients are
properly cared for emotionally at least and more well regulated and
analysied so protocol will be more accurate and extra money from the
hospital wont be spend due to coding of patients or even unneeded xrays or
expensive machines used on patients bcs of to much stress affecting the
nurse or dotor to remember each patient and their details.


b. Why does it exist?

- because rob is a pushover, people pleaser, doing jobs he isnt required to do to make sure
everything gets done

c. Who is impacted by the problem?
- everyone,
- more the hospital- patients threatening to leave due to doctor and other nurses care
- angry family members, patients

d. Who is/are the decision-maker(s)?

- the decision maker is rob because he doesnt have to do everything that the doctors boss
him around to do
- he is taking more than he can handle

e. Who/What entity is responsible for the problem?

- medicare and Medicaid are responsible for the budget cuts with the hospital
- leaving only a minimum amount of workersmaking the supernurses such as rob direct
everyone and tell everyone want to do and also answer to orders
-

5. Evaluate the solutions considered in the case.
a. Which solution seems most feasible? Why?
-MOST FEASIBLES SOLUTIONS:
- have a talk with his fellow workers such as the doctors that boss him around and
give him to much to handle and stress about that he has to much on his hands and will have
to start saying no because he lives for the hospital and wants to help out as much as his
body and soul can handle but doesnt want to be worked to death so the doctors are going
to need to check up on their patients more often instead of taking their time at their lunch
breaks and using the restroom because they are also getting paid a whole lot more
-
b. Which solution seems questionable? Why?

- the questionable solution would be rob quitting and going to another hospital for more
money and more help as he is very valuable to the hospital and the needs of the patients
and also knowing rob with the super nurse attitude, he would miss the large helping hand
he gives and the hospital wouldnt be the same without him
- more help with unneeded duties and questions thrown at him would help better him as a
person greatly


6. Select the solution you think will work.
a. Consider strong supporting evidence based on research and pros and cons
b. Ask yourself: is this solution realistic?

- Also rob is not a workhorse and the doctors really appreciate his help and super
nurse powers as they tell him but after rob keeps agreeing to all of their chores for
him on top of his own work then they will keep continuing to do it thats why he
needs to make sure he isnt a push over because they will use him
- When a patient was coding, rob made sure he ran in to help and starting giving
compressions to the patient while a doctor was ordering residents and nurses to call
for help but rob noticed no one had called and time was passing so he pulled in his
student nurse in to give compressions as an order when she was very afraid but
called for the help so the patient lived because of him.
- People were watching in the hallway and starring and rob jumped in..
- Rob is very valuable to the hospital and everyone knows it with his super nurse
personality that the doctors wouldnt hesitate if he confronted them about giving
more of a hand with their own duties instead of putting them all on rob so he would
have more energy and less stress because he would get his required nurse work
done for the day and also be opened to help with his super nurse qualities on the
side if needed.
- Especially as he saved the hospital from a lawsuit with an upset family members
orders for their grandmother to move rooms for no reason. Rob needs some energy
and patience left over at the end of the day to make the hospital a more better place
while also obtaining to his psychical, emotional, and family needs.






Thinking about writing to the hospital director in charge of billing