The CEO has demonstrated a lack of ability to communicate detail when unveiling a vision for the future of the organization. The CEO frequently discusses ideas for the future of the organization with the leadership team and has the ability to create excitement among the leaders about new ideas and projects. However, there is a lack of follow through and detail regarding how these objectives will be met. This includes failure to give deadlines for having elements of a project finished, so leadership does not have a timeline for achieving many of the objectives required in order to make the CEO’s vision a reality.

The CEO has a tendency to overlook the reality of a situation and ignore certain truths when they contradict an idea he has for how he would like the culture of the organization to be perceived. When there was an increase in patient falls on the units with the largest nurse and nursing assistant staffing shortage the CEO decided to put a process in place where the nurses for the patients had to go and explain the circumstances surrounding the fall and sign a corrective action plan and coaching form related to fall prevention. The issue of falls occurring because of not enough staff came up frequently during these meetings but the CEO instructed the leadership that the idea of staffing shortages creating unsafe working conditions for both patients and staff could not be supported or encouraged. This led to a culture where the staff felt that there input was not valued by the leadership team and was viewed as a contributing factor to continued staff turnover.

The CEO has overburdened the middle management and taken advantage of their loyalty and belief in his vision for the organization leading to burnout for unit managers. The middle management strives to achieve the outcomes required to achieve the visions for the organization that have been presented by the CEO. There are several barriers however to achieving these outcomes, including a clinical staff shortage and lack of feedback on processes and outcomes that are achieved, which has lead to misunderstanding among the leadership team and a lack of direction. All of these barriers been a cause of lack of motivation among the middle managers and have contributed to a culture where the leadership is has become less responsive to staff needs.