The paper "Business Communications of Enron and the University Hospital" is a perfect example of a business case study. Schein (1990) has remarked that a set of behaviours and values can be considered as determinants towards guiding success. Culture, on the other hand, is a set of behaviours, beliefs and values that society is founded on (Kotter and Heskett, 1992). If put in the organisational context, it means culture impacts different groups of people working at the same place and same time through a process of gained values, communication, explanations, knowledge and behaviours.
Schein believes that in today's competitive world organisational culture holds an important place in how organisation work and succeed. Schein explains this in his “ onion model” where culture is considered as several layers of an onion where each layer is glued to the other and the hidden layers denote the invisible aspects of the values and norms. As Enron progressed and its leaders’ aggressiveness got replaced with arrogance, instead of managing the company’ s values and norms, they got themselves managed by the same. This is because founder assumptions of the company ceased to be its shared assumptions and socializing into existing culture became defunct.
This happened through every “ layer of the onion” ; finally resulting in the company's humiliating crash. Answer II: Wong (2002) has argued that Enron raked in escalated figures in what is known as “ smoke and mirrors” , which included indulging in partnerships that were unregulated, losses that were hidden, and revenues that were inflated. Clearly, a culture of self-enrichment and self-dealing prevailed and shareholders, in the process, were taken for a ride. The company, after its merger with Omaha, Nebraska and subsequent diversification into several domains – which led to its meteoric rise – did actually lose its culture because its executives created a culture of deception, corruption, and greed.
The top-level actions transcended down to the bottom-level employees and rather than finding complementing teams, they saw competing fellows in each other. Whatever remained of the culture there became toxic in nature. Subcultures are allowed to thrive to bring about agility in an organisation that is based on the strong foundation of culture. It was not possible for Enron since with its unprecedented success it was losing some part of its culture every day.
O'Reilly (1989) and Saffold (1988) have remarked that strong organisational culture precludes subcultures, which was too late at Enron to happen. Strong hierarchy governed Enron so the definition of a subculture was a weak and meek possibility. Answer III: Organisational culture has awesome power. Enron failed at the internal rather than the external leadership level. The leadership failed to practice, establish, reward and measure the right values. Put differently, the leadership at Enron could not nurture the right culture.
The leadership even failed to take lessons from numerous past debacles which were mostly determined by nurturing the right kind of organisational culture. Even though the company got many things right in the beginning; what mattered, at last, was that it got its culture wrong. Efforts could have been made at Enron to fix the culture in time, preferably at the time of its merger with Omaha. That was the time of its transformation. As Louis Vincent Gerstner, Jr., CEO of IMB, who retired in 2002, has pointed out that it is important for organisations to fix the organizational culture specifically at the time of corporate transformation.
For Enron, the ideal time to understand and execute this cultural transformation was in 1985. It could still have introspected in 1989 when it began natural gas trading, and the least it could have done in 2001 was to avoid implementing its “ rank and yank” performance review process. This vitiated the whole organisation. Case Study 2: University HospitalAnswer I: The University Hospital is beginning a program on differentiated nursing practice. This means the hospital will be expected outcomes from nurses at different levels of expertise, qualifications and accountability.
Across different types of work settings in a hospital, nursing is presumably one of the most demanding ones (Aone, 2000). The first priority of differentiated nursing practice is to give patients the utmost importance. But nurses or care coordinators alone cannot be made solely responsible for the outcomes; the onus lies as much on the hospital as it does on the nurse coordinators. So before being involved in the hospital as the care coordinator, it is important to collect crucial information about the hospital.
First and foremost it is important to check how rapidly and how dramatically has the hospital changed in its healthcare delivery model recently, have the changes been widely adopted and accepted by the allied staff which is directly or indirectly linked with care coordinators' jobs, and has the hospital responded to challenges in work environments previously taken place. Some of these challenges are brought about by biomedical science advances, improved disease management or prevention, the use of new clinical technologies and shifts in healthcare delivery models. Answer II: The most important ambiguity of a care coordinators' role is that it involves a transition to a nurse care manager from being a direct caregiver.
The ambiguity arises primarily because it involves inadequate role definition, ethical challenges that sometimes attain unethical propositions, and a lack of direct previous knowledge. Furthermore, since the role is fraught with ambiguity, the care coordinator stands chances of affecting her job performance and satisfaction. The positive side of the role is that it has come to be recognized as a well-established domain in hospital settings, which is being attributed to transformations in public health nursing that have taken place at the turn of century (Tarhan, 1998).
Today it is the prevalent and accepted model of hospital management, particularly in the acute settings involving multi specialties. The care coordinator continuum is vast and expectations of hospitals with regard to this role are a satisfied patient throughput and utilisation of hospital resources optimally (Zander, 2002). This ambiguity is acceptable as Terra (2007) and Tahan and Campagna (2010) point out that this role is here to stay. Answer III: O'Donnell (2007a, 2007b) has explained ethical concerns of this transition as researched among nurses who underwent this transition, which was further explored by Jamison et al.
(1999) who identified the ambiguity through a social-psychological paradigm. Certain crucial factors determine how this change can be dealt with. The hospitals have to clearly explain boundaries and expectations of the care coordinators, the roles assigned must not be inconsistent in nature, and personal and perceived expectations should be explicitly demarcated. All care coordinators have been direct caregivers not long ago and that is the mold they have been into throughout their professional lives.
As a result of this, it is the responsibility of the programs and/ or hospitals to make the transitions smooth and acceptable without leaving ambiguities and conflicts on a would-be care coordinators' mind. The most effective care coordinator can be the one who has high levels of commitment, deeper passion and an exemplary attitude for empathy for both the role assigned and the patients in need. Answer IV: Both Ms A and Ms B are experts in their fields and are trusted around both by staff and the hospital.
Both Ms A and Ms B have unique qualities which, if put together, can work wonders for the changes that are being instituted at the hospital. While Ms A has been a guiding force in the nursing department, Ms B's capability to manage chaos can be of extreme benefit to the institute, and as well as Ms A. Since this change is considered to be ambiguous, Ms B’ s belief in chaos theory can be a boost for Ms A wherever her steady approach to work is involved in any conflict on account of the change in the hospital.
Given the profile of Ms B in the case study, it is apparent that she does not mind experimenting with new things, which also include new changes. For her change is quintessential which finds its own course as time passes by. In order to bring out the best as a team, both Ms A and Ms B have to respect each other's strengths, adapt them and yet prevent a trespass.
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