Running Head: EFCTS OF MNGD CARE ORGS ON RGSTRD NURSES 1

Effects of Managed Care Organizations on Registered Nurses

Rogerian Letter Based on a Case Study
Taylor Majoria
Louisiana State University

Author Note

The following Rogerian letter was written for English 2001, taught by Jean Coco, and addresses

issues raised in the case study Role Negotiation, Stress, and Burnout: A Day in the Life of

Supernurse, published in Health Communication in Practice: A Case Study Approach.

Dear City Hospital,

I am speaking on behalf of the registered nurse, Rob Carter, who works at City Hospital in Three
East. I have shadowed him around on a typical day at work and he has experienced many
overwhelming feelings regarding his work and believes his quality of patient care and sense of
accomplishment is negatively affected. Rob Carter is but one of the millions of registered nurses
experiencing the overwhelming effects that managed care organizations directly place on
hospitals and indirectly place on registered nurses who work at these hospitals. The overworking
of registered nurses seems to arise from the financial restrictions placed on the hospitals.

I am aware the hospital administration must make important decisions involving downsizing
staff and restructuring roles to better accommodate the financial situation set forth by the
managed care organizations. I also believe that the hospital administration is working to make
these decisions with the intent of helping those in need while also working along the tough
guidelines. The goal of the managed care organizations is to manage health care access, cost,
and quality while focusing on disease prevention and health maintenance. The core concept
unifying all forms of managed care is the attempt to control costs by reducing excess use of
health care services.

I can tell you that the hospital administration members and registered nurses have quite a few
things in common. For starters, both parties strive to do the best that they possibly can with the
resources that are available to them. The administration must work to provide the best care they
can for the thousands of patients who need the help of the hospital, the nurses, and the managed
care organizations. The registered nurses, with many new roles and responsibilities, must provide
the best care they can for the patients that need them.

Unfortunately, due to the downsizings of hospital staff, many hospitals run on skeleton crews
(Goodin, H.) which can lead to the unnecessary injury and loss of life of patients (Buiser, M.).
These job vacancies put pressure on nurses to not only do their role as a registered nurse, but also
pick up the roles of the other members of the health care team. Thousands of registered nurses
consider experience signs of burnout and consider leaving the nursing field entirely (Hansen, B.)
I would like to see the relief of registered nurses duties. Perhaps this relief can be achieved by
the redistribution of funding to better accommodate all health care staff. Maybe this can be
achieved by making training or other helpful programs more available for the nursing staff.

After considering the regulations and restrictions that are placed on to the funding and
functioning of the hospital, I seek to find better conditions for all involved. I am willing to
further discuss and negotiate for better outcomes for the nursing staff, the hospital, and the
patients. I am also open to hear your thoughts and opinions on this matter. I believe that by
working together to resolve this matter, both parties will gain a better understanding of each
others views and lead to a solution that will work for both the registered nurses and the hospital.
Please do not hesitate to contact me with suggestions.
References

Apker, J. (2005). Role negotiation, stress, and burnout: a day in the life of supernurse. In Ray, E.
 B. Editor, Health Communication in Practice: A case study approach (pp. 245-260).

Mahwa, NJ: Lawrence Erlbaum Associates.

Buiser, M. (2000). Surviving Managed Care: The Effect on Job Satisfaction in Hospital-Based

Nursing. MEDSURG Nursing, 9(3), 129. Retrieved from http://libezp.lib.lsu.edu/login?

url=http://search.ebscohost.com/login.aspx?

direct=true&db=hch&AN=3323316&site=ehost-live&scope=site

Goodin, H. (2003). The nursing shortage in the United States of America: an integrative review

of the literature. Journal Of Advanced Nursing, 43(4), 335-343. Retrieved from

http://web.a.ebscohost.com.libezp.lib.lsu.edu/ehost/pdfviewer/pdfviewer?sid=c37a5d7b-

4bc1-4ac1-8d02-55bcda1b9387%40sessionmgr4009&vid=12&hid=4107

Hansen, B. (2002, September 20). Nursing shortage. CQ Researcher, 12, 745-768. Retrieved

http://library.cqpress.com.libezp.lib.lsu.edu/cqresearcher/document.php?

id=cqresrre2002092000&type=hitlist&num=4

Include address and full letter heading

Try to include more information from the case study
Put references on separate page