Reference no: EM133371726
Case Study
Reorganization of a Special Supplemental Nutrition Program for a Women, Infants and Children's (WIC) in a Local Health Department: Impacts on Staff
Background:
The WIC program was created in 1972 in response to growing evidence of poor nutrition and related health problems among low-income infants, children, and pregnant women. It is intended to serve as an adjunct to good health care during critical times of growth and development. In addition, WIC was designed to supplement the Food Stamp Program and other programs that distribute foods to needy families https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-02-142/pdf/GAOREPORTS-GAO-02-142.pdf . The federal WIC program provides regulation and funding to state and local WIC agencies.
Competent Professional Authority (CPA): In the local agency (LA), a CPA is authorized to conduct nutrition and health assessments, determine nutrition risk, provide individualized nutrition education and prescribe supplemental foods. The specific role of an individual CPA will depend on his/her education, experience and professional credentials
The following are acceptable credentials/education: • Bachelor's or Master's Degree in Nutrition such as Nutritional Sciences, Community Nutrition, Clinical Nutrition or Dietetics. 4.3-3 9/18 • Registered Nurse Licensed by the Minnesota Board of Nursing pursuant to Minnesota Statutes, Section 148.171 to 148.285. Preference should be given to nurses with a bachelor's degree or higher. • Bachelor's or Master's Degree in Health or Home Economics field with applicable coursework in nutrition The following are acceptable credentials/education: • Bachelor's or Master's Degree in Nutrition such as Nutritional Sciences, Community Nutrition, Clinical Nutrition or Dietetics. 4.3-3 9/18 • Registered Nurse Licensed by the Minnesota Board of Nursing pursuant to Minnesota Statutes, Section 148.171 to 148.285. Preference should be given to nurses with a bachelor's degree or higher. • Bachelor's or Master's Degree in Health or Home Economics field with applicable coursework in nutrition.
Situation
In an effort to improve efficiency in a WIC program within a local health department, a decision was made to combine the roles of nutritionists and public health nurses into a broad category titled Competent Professional Authority. This change meant that nurses could conduct nutritional assessments on clients, a service that previously had been provided only by nutritionists. The reaction from the nutritionists was negative for a number of reasons. The nutritionists felt that nurses were not necessarily trained in the science of nutrition as well as the nutritionists were. As a job security issue, nutritionists suspected that the long term plan was to eliminate all nutritionists in the program and replace them with public health nurses who had a broader skill set. Nurses could also give immunizations, do home visiting, and conduct well child visits. There appeared to be underlying self -identity and esteem issues. The nutritionists took pride in their profession and felt that their professional status was diminished.
The reaction of the public health nurses was mixed. Some saw this new responsibility as adding to their job security. Some saw it only as an additional burden requiring them to do "more with less". Concerns were expressed by both nutritionists and nurses about the adequacy of preparation to conduct nutrition assessments in nursing education. The nurses had been trained at different times in different curricula, so the background in nutrition science was varied. Some nurses just did not see doing nutritional assessments as "part of their job".
The workplace environment had become problematic. There was little cooperation or communication between the two professional groups. Some individuals threatened to quit. Some nutritionists were reluctant to assist in any orientation of the nurses to the nutrition components of the new role. Lines of authority were blurred for nurses as they were deployed in multiple programs with different supervisors. What had previously been a harmonious environment had become a hostile one. Friendly banter, shared lunches and celebrations had ceased. There was concern the lack of communication and team spirit would begin to affect client care.
Questions:
Apply negotiation and mediation skills to address organizational or community challenges identified in the WIC Case Study.
Guiding Questions:
1. As a third party mediator,
How would you prepare for a mediation session?
In what terms would you reconstruct the conflict so that the discussion could be productive?
What are some points of agreement you might suggest for consideration by both parties?
What are some options for agreements that could be starting points (quick wins)?
Develop a possible SMART (Specific, Measurable, Attainable, Realistic and Time-bound) agreement.
Adapted from: https://www.skillsyouneed.com/ips/mediation-skills.html
2. If you were to recommend negotiation between the two parties (without a third party mediator), what guidance would you give to each party?