“We might as well have it out while we’re at it!” Wendy stood in the doorway of Tanya’s office, hands on hips, shouting angrily. “I come here and do my job. That’s all I do.”

Tanya sat impassively.

Wendy continued her face red and contorted by anger. “I hate it here because you’re here and in this office!”


Wendy spun around on her heels and walked away. Wendy, a clinic nurse, was angry that Tanya had been promoted to nurse manager. Wendy believed that she deserved the job and was venting the anger that had been building up over the three months since Tanya was promoted.

Tanya suddenly realized she was shaking – she was in a state of shock. The clock on the wall ticked over to 8.45 am, and the recently promoted nurse manager had just completed the day’s list of patients who were to be seen by the doctors in the hospital clinic. As usual, she had been at work since 6.30 am and would be there until well after her scheduled finish time.

Tanya had no time to dwell on the situation. The clinic was due to open in 15 minutes and there were 100 patients to be seen that day. Tanya also had to coordinate and run a ward round of 50 patients. However, she had to get things off her chest and so called a close colleague for advice. “Should I take this to the director of nursing, Linda?” Tanya asked. “But I need to get what happened straight in my head first. I suppose I should write it down, but I’m so busy today…”


Tanya was rattled by the thought of making a big deal of Wendy’s outburst. As she walked quickly across to the clinic with the day’s schedule of patients, she thought about how powerless she felt in dealing with the situation. Maybe it was just a misunderstanding, but if Wendy continued her behavior, it could spread to the whole team in the clinic and that would mean big trouble.

Four months earlier, the previous nurse manager of the clinic had retired. Both Tanya and Wendy were nurses in the clinic and both applied for the positions. Unknown to Tanya, the retiring nurse manager had been grooming Wendy to take over and virtually assured her that the position was hers if she wanted it. As a result, Wendy was confident of being the successful applicant. However, the selection panel who reviewed the applications decided after interviews that Tanya was more experienced, skilled and qualified for the position. One month later, Tanya took up the nurse manager’s job. Wendy became aloof and uncommunicative. She also took a month’s leave to, as she put it, ‘reconsider her position at the clinic’.


Tanya thought that in spite of the disappointment, Wendy would eventually come around. The staff at the clinic were less optimistic. They pointed out that Wendy was not one to let bygones be bygones.

As Tanya entered the clinic, she felt uneasy. As usual, the day was going to be very busy, with many difficult patients and sometimes demanding medical staff. One of the clinic nurses, Freda, greeted her. Despite the bad feeling between Tanya and Wendy, it looked like business as usual.

“How are you?” Freda asked as they checked around the treatment rooms.

“Fine”, Tanya replied. “Just trying to get my head around how to fit today’s patient list and the wad around into the time we have – looks like we are going to have a hectic day.”

“Situation normal then”, joked Freda. The both laughed. Tanya knew that Freda was concerned about Wendy disrupting relationships between staff. Freda had experienced Wendy’s anger during the previous few weeks. Tanya also knew that Freda wanted to know more about Wendy’s outburst that morning.


“Looks like we’re one short today”, Freda piped up. “I just saw Wendy leaving clinic – looked like she was worked up about something – gave me a blast on her way out.” Freda hoped that Tanya would take this as an opportunity to discuss what had happened.


Tanya thought about this but decided to focus on the day’s business. “If Wendy is not in today, we’ll just need to reorganize a little to make sure all the patients are seen”, she replied.

Tanya’s approach to running the clinic was simple. It had a reputation for excellence in patient care that she was determined to maintain and develop. The staff she selected since taking over were well-qualified nurses, dedicated to providing a high level of service. Tanya thought that by recruiting the top talent she could build a team that could run the clinic without close supervision, and could also contribute to coordinating the ward round, running seminars and developing strategies for the future. It also meant that leave could easily be covered, roles could be shared and potential leaders identified. This was why Tanya had recruited Freda, and why a number of recently qualified nurses had been asking to join the clinic team. Sometimes, though, a positive work environment just isn’t enough, thought Tanya darkly. Her mind returned to the question of what to do about Wendy.


Tanya returned to her office at about 11 am and began to think about Wendy. Wendy’s behaviour was obviously causing problems in the clinic and word was spreading around the hospital. She could let this incident go. After all, Wendy had good reason to be disappointed after being led to believe that the nurse manager position was hers. “Am I being too sensitive?” Tanya asked herself. Perhaps she should just take it on the chin and move on. To pursue the matter would mean a formal disciplinary action being brought against Wendy, compulsory mediation and counselling, and brining the senior departmental and hospital managers into the dispute. It also meant a lot of extra paperwork and stress. Tanya pondered these issues as she sat down to tackle the ever-growing list of e-mails in her Inbox.





  1. Using the EVLN model of job dissatisfaction predict and explain Wendy’s future actions and recommend a strategy for Tanya.


  1. Describe Tanya’s causes of stress, and propose a stress management plan for her.



  1. Assess the usefulness of four-drive theory and equity theory in suggesting how Tanya might deal with Wendy and keep the clinic staff motivated.

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