Case Study Guidelines:

Case studies are provided for students to analyze, evaluate and synthesize course material. Each prompt and questions are derived from the course text. Please make sure each case study is written in APA format and style. Follow the directions provided below:


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Gerilynn McDowell is a charge nurse at Central Medical Center (CMC), a large city hospital.  She works the afternoon shift on a general medical and surgical floor supervising registered nurses, licensed practical nurses, and nursing aides. Gerilynn is about to attend her annual performance review with Ruth

Knowlton, the nursing supervisor at CMC. Let us look at how Ruth and Gerilynn are thinking about the performance appraisal that is about to occur.

Gerilynn’s Perspective

Gerilynn has been working at CMC for more than eight years. She was first employed as a registered nurse working in a variety of services, such as intensive care, oncology, and maternity. Last year, Gerilynn became a charge nurse for a general surgical unit in the hospital.  As a charge nurse, Gerilynn supervises all nursing activities on her floor during her shift.

It took a few months for Gerilynn to become comfortable in her supervisory position. She had been friends with many of the nurses in the unit for years and she had trouble establishing a style that combined the proper level of authority with a suitable amount of friendliness. At first, Gerilynn thought she erred by being too chummy and familiar with her nurses, and she felt they often took advantage of her. So, in the last few months, Gerilynn has been working to establish a more businesslike demeanor in the unit.  She has been watching nursing activities carefully (especially charting and other recordkeeping activities) and believes this increased supervision has resulted in a smoother functioning unit. Of course, she has irritated some of the nurses along the way, and a few have requested transfers to other floors or have moved to other local hospitals, but she thinks both morale and efficiency have improved recently and feels much more comfortable in her role as supervisor.

In fact, Gerilynn is almost excited about her upcoming performance review. She feels she has learned a great deal in the last year about effective ways to supervise nurses, and she is eager to share her insights with Ruth.  In fact, Gerilynn is thinking of proposing a training program for new charge nurses so that others will not have to go through the “hit or miss” learning process she was confronted with on the job. She believes that instituting such a training program would be a positive change for the hospital; in fact, she’s interested in taking a leading role in making such a program a key part of the hospital’s training system.

Ruth’s Perspective

Ruth is definitely not looking forward to her meeting with Gerilynn. In fact, Ruth hates the performance appraisal part of her job, and she never looks forward to feedback meetings. But she has put off this meeting with Gerilynn longer than she should have, and certain issues need to be addressed.

Ruth has received some disturbing reports about Gerilynn’s performance in her new supervisory position. At first, she was not concerned–Ruth knows that it is often difficult to make the switch from floor nurse to charge nurse. From what Ruth heard, Gerilynn was making a smooth transition and maintaining the high-quality relationships she had developed over the years. She seemed to be following Ruth’s general rule of management: “Treat your employees with kindness and respect, and they’ll return the favor with hard work.” Then, reports began to indicate that there was a shift in Gerilynn’s behavior. She had become very authoritarian, checking out the minute details of nurses’ charts and riding them about uncompleted paperwork. The pleasant and collegial atmosphere of the floor had been replaced by what one disgruntled nurse called “an armed camp.” Many nurses were requesting transfers to other hospital units and some had even left CMC. With the nationwide nursing shortage, this was definitely a problem that needed to be handled.

Ruth knows that she should have dealt with this issue earlier, but things had been very busy, so she just put it off until the annual performance review meeting. She has a general “performance checklist” to review with Gerilynn, but she is still mulling over how to handle the mote specific problem of Gerilynn’s managerial style. She would hate to have to let Gerilynn go but is afraid it might come to that if things don’t change pretty quickly. Just as Ruth is contemplating this unhappy thought, her secretary lets her know that Gerilynn McDowell has arrived for the annual performance review.

Discussion Questions

What strategies can Ruth use for providing feedback to Gerilynn? Is it possible for Ruth to deliver feedback that will improve Gerilynn’s performance and not cause conflict and dissatisfaction?

What strategies would you recommend to Gerilynn as she enters the performance review meeting? What stance should she take during the meeting? How can she best communicate her ideas about a training program for new charge nurses?

What kind of performance appraisal system would you recommend that Ruth institute in the future? How could she improve on her current feedback style?

What changes should the nursing department at the hospital make to enhance the role development process for nurses? What strategy would you use for instituting a new training program? Would you let Gerilynn play a key role in this program? Why or why not?

What conflict management strategies would you apply to this situation?

  1. Include at least 2 outside sources.