The first theory that can be applied to the article series “Through Hell and High Water” by Jane O. Hansen is McGregor’s Theory Y. This theory is, “a modern and positive set of assumptions about people. McGregor believed that managers could accomplish more through others by viewing them as self-energized, committed, responsible, and creative beings”[1]. This theory was applied at Tulane hospital not at Charity. Had Theory Y been applied to Charity, their situation would have been improved greatly.
Charity, the public hospital, was left without the basic apparatus necessary to run. In Charity’s case, “There was no orchestrated plan to rescue them. You’re on your own”[2]. Being unable to provide solutions to the problems within the building without support from the outside, rendered Charity helpless against the storm. Had their employees been entrusted with greater freedoms by the organization, they would have been able to utilize and apply their talents efficiently to better meet their own basic needs and the needs of their patients. A proven example of their lack of freedom to take initiative is demonstrated by their refusal to act,
“Inside the hospital, an internal struggle was developing. Younger surgical physicians wanted to consolidate critically ill patients spread over four floors in different intensive care units onto one floor where doctors and nurses could care for them more efficiently. A committee of administrators, appointed before the storm by the hospital’s CEO, resisted. They believed the government would arrive any minute”[3].
Charity’s administrative staff chose to wait for direction from above, which unfortunately, never came. Had they been given the freedom to make choices within the hospital to better fit the needs of the doctors and patients in the middle of the disaster rather than relying on outside help, lives could have been saved. Rather than organizing the patients by need an illness as had been done at Tulane, Charity’s staff awaited direction from the government, “The public hospital, an institution for the needy, had to rely on the government for help and wound up stranded, as did so many of New Orleans’ poorest. For the sickest at Charity, the government never arrived”[4]. This shows a lack of direction and initiative. It is an example of a self-fulfilling prophecy and the Pygmalion effect because there was no expectation that employees break out of their traditional roles. Charity’s staff was expected to perform in a particular way that is all that was done, therefore no initiative was taken.
The hospital that best applied Theory Y was Tulane University Hospital and Clinic. As their employees prepared for the storm, they were given access to all the tools needed for survival and a successful evacuation. At Tulane, when the administration was notified of a need in the hospital, it was met as quickly and efficiently as possible. When in need of helicopters, “How many?” Bovender asked. ‘At least 20.’ ‘Get them’”[5] the request was met immediately. If Tulane had a need there was a support network available to work towards a solution or aid in its implementation. By giving their employees the necessary freedoms and resources as described in McGregor’s Theory Y, Tulane was able to ensure the success of it’s mission whereas Charity was incapable of creating a basic organizational structure or plan due to the limitations placed on its employees and the mistrust of the administration.
The second theory that can be applied to the stories of Charity and Tulane hospitals in New Orleans during Hurricane Katrina is, Maslow’s Need Hierarchy Theory. Maslow’s theory proposes that, “motivation is a function of five basic needs; physiological, safety, love, esteem and self actualization”[6]. This is another example of a theory that was applied at Tulane hospital but was not at Charity. This theory could have improved the situation at Charity had the organization been structured differently.
At Charity hospital the employees were degraded to a point where they were unable to meet their most basic needs rather than being able to pursue love, esteem or self actualization. “Demoralized, they carried the woman back up the outside staircase. They had failed to get even their most critical patient to safety. This is wrong, Sanborn thought. You have to come get these people. She didn’t even know whom she was talking to. But she knew they needed help from some higher power”[7]. Unable to find a rescue boat or charter some mode of transportation to remove patients and personnel from the hospital this young nurse feels she has no one to turn to. Speaking to some unknown, “higher power” and more to herself than to anyone else, this is a prime example of the lack of direction available to employees of Charity hospital. Nurse Sanborn is willing to help others, wants to do what is right, but has not been given the necessary tools to facilitate an evacuation. The organizational structure is lacking in that she cannot report the situation to a superior officer and have that need met. Relying only on themselves, Charity’s staff deteriorates from a functioning hospital to a free for all, where even their most critical patients are not helped. Nurse Sanborn is motivated to preserve the lives of her patients, however according to Maslow’s Need Hierarchy she is barely able to meet her most basic physiological or safety needs. Without direction from the government, hospital employees were left with no structural support to enable them to get through this disaster on their own.
At Tulane hospital the employees were in an environment that encouraged their personal and professional growth. When someone capable of handling the situation arrived to take control, Tulane employees were prepared to sacrifice personal control of the situation to benefit the success of the whole mission. Their ability to do so without feeling threatened or as thought hey were losing control of the situation was due to the fact that they felt secure in their work environment. “By the end of the day, both in Nashville and in Tulane’s darkened command center, the guiding principles were clear: We’re not going to wait for the government to rescue us. We have to rely on ourselves. We won’t take no for an answer”[8]. Tulane employees had their needs satisfied on all levels of Maslow’s Need Hierarchy. Physiological needs were met by the hospital, they were not required to bring their own food and water to work in order to survive the storm as Charity’s employees were asked to do. Their safety was protected at the hospital so fear of “looters and shooters”[9] was not a consideration in their minds. Love of their work enabled them to pull together to seek the best possible solutions to the problems Katrina presented. Esteem was granted to employees based on their talents and credentials, both the Associate Vice President of Operations and Division President of Tulane hospital reached their positions at a young age, which demonstrates Tulane’s willingness to recognize and reward professional accomplishment and talent. This in turn creates a positive work environment conducive to self actualization, which encourages employees to develop new methods and think outside the box. By applying these motivations to their work before and during Hurricane Katrina Tulane was able to preserve a sense of order and civility while saving as many lives as possible as the evacuation took place.
The third theory that can be applied to “Through Hell and High Water” is Herzberg’s Motivator-Hygiene Theory which predicts that “managers can motivate individuals by incorporating ‘motivators’ into an individual’s job”[10]. Herzberg argued that, “people are motivated when their needs for achievement, recognition, stimulating work, and advancement are satisfied”[11]. This was exemplified earlier by the advancement of employees at a young age in Tulane hospital. Unfortunately this is another theory that was not best applied at Charity hospital that may have improved the outcome of their efforts to evacuated the hospital during Hurricane Katrina.
Charity, the public hospital did not apply Herzberg’s Motivator-Hygiene Theory. The theory explains that “the opposite of job satisfaction is not job dissatisfaction, but rather no job dissatisfaction”[12]. Charity depended on their employees to volunteer to work during Hurricane Katrina and required that they bring their own supplies of water and food from home to help them survive for three days. This demonstrates a lack of support from the administration. In an emergency situation the organization is already asking their employees to go beyond the call of duty, in a sense denying employees their basic rights to food and water. Demanding that employees supply these goods themselves, emphasizes a break in the system between what is good for the employee versus what that cost is to the organization.
This was not the case at the private hospital across the street. “At Tulane, administrators made routine preparations, taking inventory and deciding on staffing for their 178 patients”[13]. The administration formed a cohesive organized leadership group at this hospital which gave a feeling of support to Tulane’s employees. In this emergency Tulane’s employees were provided with the most basic feelings of support and safety within their hospital which enabled them to continue working. Even though conditions were strained due to the circumstances, Tulane employees did not feel as if their organization had abandoned them, a feeling all to familiar across the street at Charity.
[1] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. Pp 8.
[2] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch 3.
[3] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 5.
[4] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 1.
[5] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 4.
[6] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. Pp 237.
[7] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 3.
[8] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 4.
[9] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 4.
[10] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. Pp 240.
[11] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. Pp 241.
[12] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. Pp 241.
[13] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 1.
New Orleans: Organizational Behavior II October 23, 2008
Tags: Flood, healthcare, New Orleans
The first theory that can be applied to the second half of Jane O. Hansen’s article series, “Through Hell and High Water” in The Atlanta Journal- Constitution is the Trait Theory of Leadership. This theory argues that great leadership is, “developed through experience and learning”[1]. Leadership between Tulane and Charity is characterized primarily by Dr. Ben deBoisblanc of Charity Hospital and Mel Lagarde, the Hospital Corporation of America’s executive stationed at Tulane. Charity is an example of how this theory was not applied and could have helped the hospital to better deal with the crisis resulting from Hurricane Katrina. Tulane demonstrates how this theory can be successfully implemented when applied appropriately.
Dr. Ben DeBoisblanc was not trained for leadership. As a physician, Dr. Ben’s priority was the health and safety of his patients; not the successful organization of an evacuation. Dr. Ben demonstrates his preference for medicine over administration repeatedly. When offered the opportunity to have four of his sickest patients evacuated, “Dr. Ben consulted with other doctors: Which four should go first?”[2] Consultations are an important part of medical treatment, but not conducive to a swift evacuation. The time this process takes distracts from the executive decision that needs to be made, to get four patients to safety. Dr. Ben uses critical time to confer with his fellow physicians rather than depending on his knowledge base to make an educated decision quickly. Dr. Ben demonstrates, “Intelligence…self-confidence, [high] level of energy and activity”[3] however he fails to show, dominance…[or] task-relevant knowledge”[4]. His choice is the choice of a doctor, not a leader. Later it is discovered, “When the owner of a Missouri-based helicopter company promised to send four helicopters for Charity’s sickest patients, Dr. Ben assumed those choppers would be dedicated to his hospital. But it wouldn’t work that way”[5]. Failing to make this clarification, Dr. Ben realizes too late that those helicopters have already left without his patients. His outrage and later outburst demonstrate Dr. Ben’s passion for the safety and wellbeing of his patients but do not emphasize his qualifications as a strong leader under stress.
The executive in charge of the evacuation at Tulane was Mel Lagarde. He clearly demonstrates the strong leadership qualities described in Trait Theory. Being able to focus on the organization and structure of the evacuation enabled Lagarde to separate himself from the patients in a way that Dr. Ben was not able to. “Dr. Ben was the passionate physician frantic to save his patients. Lagarde was the coolheaded corporate leader who had helped put in motion an effective rescue operation.”[6] This distinction is exemplified in Lagarde’s calm control of the situation. He is in full possession of Kouzes and Posner’s most critical leadership traits, “honesty, forward-looking, inspiring, and competent”[7] he applies these qualities when directing the evacuation action for Tulane and Charity’s patients. Legarde,
“knew the physician [Dr. Ben] was desperate, and he understood why. He had gone down to the seventh-floor holding area and surveyed the scene of sick Charity patients lying on the floor. He’d ordered Tulane staff to find additional oxygen cylinders for patients who were running out. But Dr. Ben kept accusing him of not giving priority to Charity patients, of not understanding how ill they were.”[8]
This situation shows how Lagarde chose to act whereas Dr. Ben chose to talk. Though both men were very successful in their careers, it was Legarde’s job to be a leader, which gave him a competitive edge over Dr. Ben who is first and foremost, a doctor.
The second set of theories that can be applied to Charity and Tulane are, Situational Theories. These theories, “Propose that leader styles should match the situation at hand.”[9] Due to the lack of involvement or support from the government, Charity is not able to implement these theories in its evacuation, though they might have improved the hospital’s results. Tulane’s leadership is trained and prepared to meet with the demands of Hurricane Katrina. Therefore, Tulane is an appropriate example of the success that those appropriately qualified for emergency situations can have when the situation calls for their expertise.
Charity lacked leadership from the government and, “More than 48 hours after losing their emergency power, Charity doctors had abandoned hope that the government would come”[10]. Without the much needed support from above, doctors and nurses were left to their own devices. Charity staff had low situational control, no stable task structure, and in the crisis situation, absolutely no positional power. Lacking all of these tools of leadership as described in Fiedler’s Contingency Model,[11] organization among Charity’s staff broke down. “Holland sympathized with the Charity staff. He knew they couldn’t see the whole picture.”[12] Limited foresight is one of the many shortcomings exposed as Charity’s leadership structure broke down. Dr. Ben was not trained to lead an evacuation or any major non-medical crisis. His leadership style, which enabled him to excel in the operating room, limited his potential for success during the Hurricane.
Mel Lagarde was specifically trained and prepared for the situation in New Orleans, “he was comfortable as a leader. In the midst of crisis, his confidence inspired those around him.”[13] Lagarde took control of the situation, as a task motivated leader he “focused on accomplishing goals.”[14] His method of leadership was precisely what his hospital demanded during Hurricane Katrina, “Tulane’s leaders considered it imperative to know where patients were going and had taken great pains to line up receiving hospitals. But Charity staff were at a different level of desperation. All they cared about was getting their patients out.”[15] Resolving this major concern demonstrates Lagarde’s ability to keep his wits about him under stress. Later his creativity in telling a subordinate, “The next time a government official tries to take one of our choppers…tell him this: I’m sorry, but you can’t do that. This aircraft has already been commandeered by someone else,” shows his ability to think dynamically to resolve issues. This further exemplifies how having a properly trained leader provides the greatest opportunity for the success of the endeavor.
The third theory that can be applied to the later half of “Through Hell and High Water” is, Path-Goal Theory which states, “Leader behaviors thus are expected to be acceptable when employees view them as a source of satisfaction or as paving the way to future satisfaction.”[16] The theory emphasizes how leadership can motivate employees and guide organizational action. “It (1) reduces roadblocks that interfere with goal accomplishment, (2) provides the guidance and support needed by employees, and (3) ties meaningful rewards to goal accomplishment.”[17] The Path-Goal Theory of leadership effectiveness is not demonstrated by Charity hospital as well as it is by Tulane hospital during their evacuations. Charity would have accomplished more of their goals effectively had they applied the Path-Goal Theory to their leadership.
Dr. Ben is unable to meet his own needs due to a lack of structure from the government, which is need two in Path-Goal Theory and therefore he is acting out of his own desperation. “You told me it was going to be 21 patients; you got 33, Montgomery said to Dr. Ben. I told you we’d take critically ill patients, and people who are ambulatory are coming over here.”[18] Dr. Ben is pushing his limits, “the rejection was another reminder of his hospital’s second-class status.”[19] The rewards for this action are that he was able to get 12 extra patients to safety, however in the end it will be held against him and will limit his ability to evacuate more of his patients. Thereby failing all three of the variables expected of a strong leader in Path-Goal Theory. Eventually, Dr. Ben’s antics render him completely useless, “At the end of the day, when the doctor appeared on the roof with a bullhorn, Holland took it from him, then had him removed. Dr. Ben was escorted to the seventh floor, where a Tulane police officer blocked his return with an M-16.”[20] Without considering the contingency factors or “situational variables that cause one style of leadership to be more effective than another”[21] Dr. Ben put himself in a situation where he was completely ineffective. He is unprepared to lead in this situation and with the aggressive tactics that are necessary during medical treatment finds himself unable to lead or even assist his staff on the most basic levels in an administrative crisis.
Lagarde demonstrates his skill in guiding and directing Tulane Hospital by applying the Path-Goal Theory objectives in his leadership during Hurricane Katrina. “After talking to Dr. Ben, Holland directed the Charity physician to clear the evacuation plan with those in charge: Mel Lagarde…and Jim Montgomery, president of Tulane Hospital” (HH 43). Tulane has a clear delineation of power and an organized structure which meets need two of the Path-Goal Theory.
“Lagarde was responsible for the hundreds of people still inside the hospital. Tulane had requested security from the state command post in Baton Rouge, but there was not sign of the National Guard.
That night Lagarde made the decision to move everyone out of the hospital and into Tulane’s Saratoga Street parking garage. With fewer entrances and exits to secure, Tulane guards would have an easier time protecting them.”[22]
The foresight to first request the assistance of the National Guard and then to expedite the process of protecting those in his hospital when that assistance did not arrive meets needs one, two and three of the Path-Goal Theory. It meets path one by creating the safest environment possible for everyone in the hospital. It attains need two by giving direction and clear objectives to staff. This choice meets need three by providing safety to all personnel in a timely fashion, which is both a meaningful reward and a viable goal. Also important to note is, “through it all, he remained calm.”[23] Lagarde handled this situation skillfully and with poise rather than panicking and acting rashly as Dr. Ben did already. By utilizing the tactics described in Path-Goal Theory Lagarde was able to preserve and protect more lives while skillfully giving direction and leadership to both Tulane and Charity hospital’s in the end.
[1] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 512.
[2] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 11.
[3] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 513.
[4] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 513.
[5] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 12.
[6] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 14.
[7] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 513.
[8] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 14.
[9] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 519.
[10] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 15.
[11] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 519.
[12] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 14.
[13] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 15.
[14] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 519.
[15] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 15.
[16] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 521.
[17] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 521.
[18] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 14.
[19] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 14.
[20] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 14.
[21] Kreitner, Robert and Angelo Kinicki. Organizational Behavior. 7. Boston: McGraw-Hill Irwin, 2007. pp 521.
[22] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 16.
[23] Hansen, Jane O.. “Through Hell and High Water.” The Atlanta Journal-Constitution (2006): 1-22. Ch. 16.