Hierarchy at Blue University School of Nursing

Hierarchies in academic and clinical settings often preclude decision-making that results in the best idea. Schools of nursing have inherent hierarchies in both faculty rank and position. Higher ranking, tenured faculty influence promotion and tenure decisions. Junior faculty are frequently silent in fear of retribution. Similarly, new nurses and junior staff in clinical settings may be reluctant to speak up for the same reason. This chapter describes a case that shares both the internal and external dialogues typical among junior and senior faculty. The case illustrates how personal motives and faculty rank can influence participation in decision-making. The case begins with a description of how the situation might unfold without Red Teaming and continues with the same scenario using Red Team methods.