Nursing Care is an organization facing a mas- sive change

Learning Goals
One of the most consistent changes in the structure of work over
the past few decades has been a shift from a manufacturing economy
to a service economy. More workers are now engaged in jobs that
include providing care and assistance, especially in education and
medicine. This work is satisfying for some people, but it can also
be highly stressful. In the following sce- nario, consider how a
company in the nursing care industry is responding to the
challenges of the new environment.
Major Topic Areas
? Stress
? Organizational change
? Emotions
? Leadership
The Scenario
Parkway Nursing Care is an organization facing a mas- sive
change. The company was founded in 1972 with just two nursing homes
in Phoenix, Arizona. The com- pany was very successful, and
throughout the 1980s it continued to turn a consistent profit while
slowly ac- quiring or building 30 more units. This low-profile ap-
proach changed forever in 1993 when venture capitalist Robert Quine
decided to make a major investment in expanding Parkway in return
for a portion of its profits over the coming years. The number of
nursing homes exploded, and Parkway was operating 180 homes by the
year 2000.
The company now has 220 facilities in the south- western United
States, with an average of 115 beds per facility and a total of
nearly 30,000 employees. In ad- dition to health care facilities,
it also provides skilled in-home nursing care. Parkway is seen as
one of the best care facilities in the region, and it has won
numerous awards for its achievements in the field.
As members of the Baby Boom generation become senior citizens,
the need for skilled care will only in- crease. Parkway wants to
make sure it is in a good position to meet this growing need. This
means the company must continue expanding rapidly.
The Stress of Caring
The pressure for growth is one significant challenge, but it’s
not the only one. The nursing home industry has come under
increasing government scrutiny following investigations that turned
up widespread patient abuse and billing fraud. Parkway has always
had outstanding patient care, and no substantiated claim of abuse
or ne- glect in any of its homes has ever been made, but the need
for increased documentation will still affect the company. As the
federal government tries to trim Medi- care expenses, Parkway may
face a reduction in funding.
The Problem
As growth has continued, Parkway has remained com- mitted to
providing dignity and health to all residents in its facilities.
The board of directors wants to see re- newed commitment to the
firm’s mission and core values, not a diffusion of its culture. Its
members are worried there might be problems to address. Interviews
with employees suggest there’s plenty to worry about.
Shift leader Maxine Vernon has been with Parkway for 15 years.
“Now that the government keeps a closer eye on our staffing levels,
I’ve seen management do what it can to keep positions filled, and I
don’t always agree with who is hired. Some of the basic job skills
can be taught, sure, but how to care for our patients—a
lot of these new kids just don’t pick up on that.”
“The problem isn’t with staff—it’s with Parkway’s fo- cus on
filling the beds,” says nurse’s aide Bobby Reed. “When I started
here, Parkway’s reputation was still about the service. Now it’s
about numbers. No one is in- tentionally negligent—there just are
too many patients to see.”
A recent college graduate with a B.A. in psychol- ogy, Dalton
Manetti is more stressed than he expected he would be. “These
aren’t the sweet grannies you see in the movies. Our patients are
demanding. They complain about everything, even about being called
patients, probably because most of them think they shouldn’t be
here in the first place. A lot of times, their gripes amount to
nothing, but we have to log them in anyway.”
Carmen Frank has been with Parkway almost a year and is already
considering finding a new job. “I knew there were going to be
physical parts to this job, and I thought I’d be able to handle
that. It’s not like I was looking for a desk job, you know? I go
home after every