The City Main Hospital Cochin,

The City Main Hospital Cochin, was incurring losses inspite of its rising popularity and increasing number of outdoor patients. The management had been thinking of doing something to solve the problem. As the major burden of the heavy cost was due to the surplus manpower, the simplest solution, according to the Hospital’s Executive Director, was to reduce staff, especially, from the nursing department. The hospital had five floors. The fifth floor was meant for keeping chronic and old age patients under observation”. Like all other floors, this unit had 80 beds with all the excellent facilities and round the clock services of 50 nurses reporting to Lily Joe, the Senior Nurse Manager. The Executive Director knew that over the years the fifth floor as “observation” unit had been only partially utilized. For the last 20 months the floor had never served more than 6 patients at any given time. Naturally the floor with its huge staff was considered under-utilized and to a large extent a unit that could be dispensed with. The Executive Director, Dr. Pandey discussed the matter with the hospital management and suggested that the patients of the fifth floor could be kept in other wards and dosing the fifth floor could avoid recurring losses.
The management agreed to close the fifth floor and decided to terminate the services of its senior manager Lily Joe as her services would be no more required. The management asked Dr. Pandey to remove also those nurses, who were specially appointed for the “observation” unit because of their experience and training in looking after the chronic and elderly patients. A number of meetings with the senior executives were held to plan the closing of the fifth floor. However, discussions brought out a few complicating factors in this regard. Firstly, it was pointed out that no permanent employee of the hospital could, as per the hospital’s practice and service rules, be laid off. The hospital followed the policy of “reassignment”