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Debbie Vestica decided to look for a new job on a day that should have been filled with joy. She had just completed a master’s degree in nursing and had been given a substantial increase in pay, along with new benefits. Other factors, however, greatly diminished the reward she had just received.
Debbie began working as a nurse in a local pediatric physician’s medical group. Three doctors and three nurses made up the medical staff. Two of the nurses completed training at the licensed practical nurse (LPN) level, while Debbie held the rank of registered nurse (RN). Due to this difference in educational attainment, Debbie was expected to supervise the other two nurses. The problem she faced was that the two nurses often treated her more as a peer, or even as a subordinate, rather than as a supervisor.
To complicate matters, the two LPNs had been on staff for four and five years, respectively, while Debbie had only been employed by the organization for two years. Still, when hired, she was told to assume a supervisory role. At first, Debbie chose not to confront the two more experienced nurses, hoping that over time she would be able to manage them more effectively by not trying to use forceful or directive tactics.
One year later, Debbie discovered that although her pay was slightly above average for RNs in the area, her pay differential with the LPNs was only $3 per hour. She earned $30 per hour ($60,000 per year), whereas the LPNs earned $27 per hour ($54,000 per year). Their pay ranked them above nearly all LPNs in the state. Given the additional duties she was expected to complete, Debbie found the pay differential to be unsatisfactory.
After two years on the job, Debbie began a master’s program designed to achieve the designation of clinical nurse specialist with an emphasis in children’s health. She devoted considerable time and money to obtaining the degree, although the physician’s group did contribute 50% of her tuition and book costs.
On graduation day, Debbie met with the three physicians. They all generously praised her efforts and promised her a new status level that included having her own office in the complex. They also granted her a raise of $7 per hour, raising her annual salary to $74,000, in return for additional duties and responsibilities.
The turning point occurred when Debbie overheard the two LPNs talking in the office break room. Upon finding out about Debbie’s new pay raise and status, the LPNs confronted the three physicians, demanding an additional increase in pay as well. Sensing a major confrontation, the physicians had decided to raise the pay of the two by $5 per hour, to $32 per hour or $64,000 per year. That amount was higher than what Debbie had earned as an RN and as an RN attending graduate school. Believing that she would never receive the proper pay differential that she deserved in this practice, Debbie decided it was time to seek employment elsewhere.
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- Use Herzberg’s two-factor theory to explain Debbie’s level of motivation.
- Use Adams’s equity theory to explain Debbie’s decision to look for work elsewhere.
- Use Vroom’s expectancy theory to explain this situation.
- If you were advising the three physicians in the organization, what would you tell them they should have done when confronted by the two LPNs? Defend your advice.
References:
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Living Guideline
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Evidence-based practice
BMJ Best Practice
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Cochrane Database of Systematic Reviews
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Perth Children’s Hospital. (2022, April). Appendicitis [Emergency Department Guidelines]. Child and Adolescent Health Service. https://www.pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Appendicitis
Department of Health. (n.d.). Who is being active in Western Australia? https://ww2.health.wa.gov.au/Articles/U_Z/Who-is-being-active-in-Western-Australia
Donaldson, L. (Ed.). (2017, May 1). Healthier, fairer, safer: The global health journey 2007-2017. World Health Organisation. https://www.who.int/publications/i/item/9789241512367
NCBI Bookshelf
Rodriguez Ziccardi, M., Goyal, G., & Maani, C. V. (2020, August 10). Atrial flutter. In Statpearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540985/
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