The case study shows that the nurse has low morale because of performance appraisal provided to him. In the comments, the manager focuses only on one event where nurse made a mistake, however all the appraisals were in written report.
Poor work relationship
The nurse did not seem to have good relationship with the people at workplace particularly the management.
Ineffective communication
The nurse did not have any idea about the performance appraisal meeting. The nurse was not even aware of the meeting agenda that it was a performance appraisal meeting.