Chapter 7 Flashcards
1
Q
the issuance of orders, assignments and instructions that enable the nursing personnel to understand what are expected of them.
A
Directing
2
Q
includes supervision and guidance so that in doing a job well, nurses can maximally contribute to the organization’s goals in general and to the nursing service objectives in particular
A
Directing
3
Q
A managers important role is to
A
help subordinates perform in their best of their abilities.
4
Q
it is the final major step taken by the nurse manager to ensure that the organization’s goals are accomplished.
A
Directing
4
Q
The manager must ensure that she has assigned the work properly and that she has gotten the right person for each task that needs to be accomplished.
A
Directing
5
Q
To be able to work well, one should have a _______ in the task that needs to be accomplished, especially if the task is a difficult one that may require ______
A
genuine interest
sustained effort over a period of time
5
Q
Directing goes beyond
A
giving orders and instructions
6
Q
It is also important that the employees chosen by the manager are able to get along______ because directing employees invariably depend on the _______
A
harmoniously
relationships existing among them
7
Q
This is of particular relevance in a nursing care environment where continued interaction among the various employees in the system is______ and necessary for the organization to function properly.
A
inevitable
8
Q
> is the act of issuing of orders, assignments, instructions to accomplish the organization’s goals and objectives.
A
Directing
9
Q
Tools in Directing:
A
Primary tool:
NCP.
Policies,
standards operating procedure
rules and regulations can also be tools.
10
Q
Characteristics of good directions:
A
- Directions must be clear, concise, consistent and complete.
- Explain the rationale well and make sure it is understood.
- The word used indicates their importance ex: must, shall & will. “may” denotes an action. “should” denotes recommendation or mandatory.
- Speak distinctly and slowly. Directions must come across as a request not a command, using specific tone and set of words. Prioritize the task directed to be done by importance and time.
- Avoid giving too many directions at one time.
- Personalize direction and make sure it has been followed.
10
Q
Directing
A
> is the act of issuing of orders, assignments, instructions to accomplish the organization’s goals and objectives.
> it involves the process of getting the organization’s work done.
> it entails explaining what is to be done, to and by whom at what time, how and why the task should be done.
> directing must be consistent with departmental policies to help personnel perform their duties safely and efficiently.
10
Q
Characteristics of the Nursing Care Plan:
A
- It focuses on actions designed to solve or minimize the exciting problem.
- A product of a deliberate systematic process.
- Relates to the future.
- Based upon the identifiable health and nursing problems.
- Focus is holistic.
- It aims to meet all the needs of the patient’s.
11
Q
Principles of delegation:
A
- Select the right person to whom the job is to be delegated.
- Delegate interesting and uninteresting task.
- Provide subordinates with enough time to learn.
- Delegate gradually.
- Delegate in advance.
- Consult before delegating.
- Avoid gaps and overlaps.
12
Q
it is the act of assigning to someone else a portion of the work to be done with corresponding Authority, Responsibility and Accountability (ARA)
A
Delegation
13
Q
What cannot be delegated?
A
- Overall responsibility, authority & accountability for satisfactory completion of all activities in the unit.
- Authority to sign one’s name is never delegated.
- Evaluating the staff or taking necessary corrective or disciplinary action.
- Responsibility for maintaining morale or the opportunity to say a few words of encouragement to the staff especially the new ones.
- Job that are too technical and those that involves trust and confidence.
13
Q
This stems from the managers’ false assumption that delegation may be interpreted as the lack of ability on his or her part to do the job correctly or completely.
A
Under delegating
14
Q
> An assignment is a task done without authority while a delegation is a task done with ARA
A
Delegation
14
Q
Why nurses Manager do not delegate:
A
- Lack of confidence feels that they only could do the task faster and better.
- Fear of loss of control if some of their duties are delegated.
- Mistakes in delegation can be costly
- Failure to delegate wisely increases management costs and contributes to personnel dissatisfaction.
- Fear on the part of the director, of her own ability to delegate.
- Fear of losing control of the staff.
- Fear of failing to get others to the work.
- Fear of criticism
15
Q
Common Delegation Errors:
A
- Under delegating
- Over delegating
- Improper Delegating
16
Q
It unnecessarily burdens the subordinates with tasks that are either inconsequential or irrelevant to the delivery of the goal
A
Over delegating
17
Q
A manager should be able to determine the talents and capacities of his subordinate. Delegation of tasks and responsibilities beyond which the person cannot perform property is
A
Improper Delegating
18
Q
> It is a task oriented in which a particular nursing function is assigned to each worker.
A
Functional nursing
18
> Best use when there are many patients.
Functional nursing
18
Disadvantage of functional nursing:
> Fragmentation of nursing care so holistic care is not achieved.
> Nurse accountability & responsibility is diminished.
> Patient cannot identify who their “real nurse” is
> Nurse-patient relationship is not fully developed.
> Evaluation of nursing care is poor.
> It is difficult to find a specific person who can answer the patients/relatives’ questions.
18
> One nurse is assigned to one client for the delivery of total care.
Total Care/Case Nursing
19
> Suitable for short-term use.
Functional nursing
19
Advantages of functional nursing:
> Work is accomplished in a shorter time.
> Worker learns to work fast.
> Gaining skills faster in that particular task.
19
The duty nurse will be accountable for their own action.
Total Care/Case Nursing
20
The nurse plans, coordinates, implements, evaluates and document the nursing care during the patients illness.
Total Care/Case Nursing
21
> A system of care in which a qualified professional nurse leads a group of nurses in
providing nursing needs of a group of patients through participative effort.
Team Nursing
22
> Assigning of task to team members according to their job description.
Team Nursing
22
> Responsible for the total care of a small group of patients from admission to discharge.
Primary Nursing
23
Primary and secondary nurses are free from administrative & housekeeping
responsibility.
Primary Nursing
24
> Assumes 24 hrs responsibility for nursing care, secondary nurse executes the care
Plan during the afternoon and night shift and on days when the primary nurse is on off
duty.
Primary Nursing
25
Accountability, authority and autonomy rest with the primary nurse. So he communicates directly with the members of the health care team within the hospital and community.
Primary Nursing
25
is the process of guiding and directing the work to be done.
Supervision
26
> It entails motivating and encouraging the staff to participate.
Supervision
27
To most workers, the supervisor is presumed as ________ because of her constant presence and close association with them.
the management
27
Principles of Good Supervision:
a. Good supervision is focused on the improvement of work rather than upgrading the worker.
b. It is based on the lines of authority, organizational philosophy, vision/mission; the job description, policies and standards, the needs of the individual.
c. Focuses on the degree areas of skill: conceptual, technical & interpersonal
d. It is cooperatively planned, and accepts both challenge and change.
e. It uses a democratic process.
f. The ultimate goal of good supervision is to provide safe, effective, quality care.
g. It considers the strength & weaknesses of an employee.
h. Stimulates critical thinking and creativity in patient care.
28
Responsibilities of Supervisors
> Supervisors have the duty to teach and motivate the staff, as well as facilitate their work.
> They should delegate work responsibilities and be available for consultation.
> They should also perform assessment and evaluation of work performance and conditions
29
Orientation:
> Planned & guided activities of an employee in an organization.
- It has to be done in the conference room or training room.
- Starts with the mission, vision, philosophy and objectives of the nursing service.
- Hospital policies on hiring, promotion, transfer, dismissal, job description & updating of license.
30
This practice gives the new staff chance to develop their skills and foster the feeling of acceptance, belongingness and confidence in assuming duties &responsibility.
“Shadowing”/”big sister”/”buddy”
31
They should also perform assessment and evaluation of work performance and conditions
Responsibility of Supervisors
31
is a planned experience to help employees perform effectively, and to enrich their competence in practice, education, administration and research it is re-training them for better performance in areas of Skills, Knowledge, and Attitude (SKA).
Staff Development
32
They should delegate work responsibilities and be available for consultation.
Responsibility of Supervisors
33
have the duty to teach and motivate the staff, as well as facilitate their work.
Responsibility of Supervisors
33
Introduction to the unit personnel’s, unit policies, nursing standards & procedure.
ORIENTATION:
Tour around the hospital & assigned unit.
34
Assigning of clients, evaluation of activities, problems are discussed and implementation of solution.
ORIENTATION:
Tour around the hospital & assigned unit.
35
> Assuming of greater responsibility. Mentors will instill proper values and attitude. Critical thinking to new staff and to take a stand in ethical dilemmas in the unit.
ORIENTATION:
Tour around the hospital & assigned unit.
36
> Give the staff opportunities to ventilate their frustration over role expectations, value
ORIENTATION:
Tour around the hospital & assigned unit.
37
Functions and Staff Development:
A. Maintain staff efficiency and effectiveness
B. Create quality employees;
C. Meet the staffs needs and address their problems, such as deficiencies in knowledge , skills and attitude;
D. Motivated them and improve their self – confidence; and
E. Help prepare them for greater responsibilities, e.g. planning, orientation, continuing education, in-service, patient education, advisory and research.
38
In-service training is education for employees to help them develop their skills in a specific discipline or occupation. In-service training takes place after an individual begins her work responsibilities.
In-service Training and Continuing Education:
39
This activity links the different components of an organization and leads them toward goal achievement.
Coordination
40
It creates harmony on all activities to facilitate success of work. In a well-coordinated organization, everything has been delegated to guard against leaving loose ends.
Coordination
41
Coordination with the Medical services
for clients plan of care.
42
Coordination with the Administrative service
for repairs, maintenance of equipment, requisitions of supply, monthly inventories.
43
Coordination with Laboratory service
for special procedures/preparations, collections of specimen & labelling.
44
Coordination with Radiology service
for proper scheduling of x-rays, and other special procedure.
45
Coordination with the Pharmacy service
for procurement of drugs especially narcotics.
46
Coordination with the dietary service
for the preparation of clients food, list of clients diet, special diets, preference and restrictions.
47
Coordination with the Medical Social services
to assist clients with psycho-socio-economic problems.
48
Coordination with Community Agency, institution & Civic Org.
For follow ups.
49
Coordination with the Medical record service
for accurate documentation, completeness, safety & confidentiality.
50
ensures common understanding.
Communication
51
It is a process by which a message is sent, received and understood as intended.
Communication
52
The barriers to effective communication can be
physical, social or psychological, semantics and interpretations.
52
these are environmental factors that prevent or reduce the opportunities for communication, for example distance and noise.
Physical Barriers
53
Some of the ways to communicate involve
informal talks, planned appointments, telephone calls, interoffice memos, letters, reports, informal staff meeting, planned conferences, mass meetings or general assemblies, bulletin board notices posters, exhibits, displays, and visual aids(Corrado, 1994)
54
they are blocks or inhibitors to communication that rise from the judgments, emotion and social values of people for example stress, trust, fear, defensiveness.
Social/Psychological Barriers
55
there are words, figures, symbols, penmanship, interpretation of messages through signs and symbols. Symbols may have a variety of meaning and the symbolize chosen from among the many.
Semantics
56
Speak slowly, clearly to prevent confusion and have immediate response.
Verbal communication
56
these are defects in communication skills of verbalizing, listening, writing, reading and telephoning.
Interpretations
57
Clear, correct, complete and concise. It comes in the form of memoranda, hospital orders, documentation, records, policies, and procedures.
Written communication
57
Non Verbal communication:
1. Personal appearance
2. Intonation of voice
3. Facial Expression
4. Posture & gait
5. Touch
58
proceed from the team to the patient’s family, community workers, peers, department. (endorsement, rounds, meetings, referrals between dept or services)
Horizontal communication
58
proceeds from the subordinates(staff nurse) to the superiors. (grievance procedure, written report, incidental report, statistical report)
Upward communication
58
Management Levels in Nursing Service
Top level of management is the director and the administrator of nursing service. (administrative)
Middle level is the nurse supervisors and coordinators.
First line managers consist of the head nurses, unit managers, senior staff nurses.
Operating level are the staff nurses, student nurses, nursing attendants.
59
proceeds from an authority or manager to his subordinates. (institutional workers)
Downward communication
60
outward flows throughout different hierarchical levels. (patient, families, relatives, visitors, community)
Diagonal communication
61
is the nurse supervisors and coordinators.
Middle level
61
is the director and the administrator of nursing service. (administrative)
Top level of management
62
managers consist of the head nurses, unit managers, senior staff nurses.
First line
63
are the staff nurses, student nurses, nursing attendants.
Operating level
63
> An important role of the manager is to determine performance in advance and state desired outcome of what has been done.
Evaluation
64
>The purpose of evaluation is
to determine how far or how many of the organization’s objectives were accomplished.
65
Purposes of Evaluation
a. Provide constructive feedback;
b. Determine progress and worthiness of individual nurse for greater responsibilities; and
c. Serve as basis for promotion and increase in salary or other similar rewards.
66
Evaluation is also meant to:
a. Recognize and further develop strengths;
b. Minimize weaknesses;
c. Provide security for patients, personnel, agency and the community; and
d. Develop a fair employment practice and performance appraisal process that is in accordance with law.
67
Different Types of Evaluation
a. Outcome or product evaluation
b. Process evaluation
c. Structure evaluation
68
which takes note of the response of patients after nursing care is done.
Outcome or product evaluation
69
nursing actions are examined, to determine if client goals have been met or have not been met.
Process evaluation
70
the goal is to obtain feedback on the systems such as financial and material resources, nursing personnel, policies and procedures.
Structure evaluation
71
means substituting one thing for another, experiencing a shift in circumstances that causes differences or becoming different from before.
Change
72
Legally Sound Performance Evaluation
a. It should be in writing and carried out at least once a year.
b. The information should be shared with employee.
c. The employee should have the opportunity to respond in writing to the appraisal, and in this connection a mechanism to appeal or question the results of the appraisal must be allowed.
d. The manager should have adequate opportunity to either directly observe the employees job performance during the course of the evaluation period or, in the event of lack of adequate contact, the manager must be able to gather information from other sources.
e. Anecdotal notes on the performance should be kept throughout the evaluation period. These notes should be shared with the employee during the course of the appraisal period.
f. The evaluator should be trained to carry out the appraisal process, including.
- What constitutes reasonable job performance
- How to complete the form and
How to carry out the feedback interview
73
Steps In The Change Process
1. The change process begins or is initiated when one perceives a need for change.
2. This person then initiates group interaction, which is to identify external and internal forces for change.
3. During this interaction, the beneficial activities
a. To state the problem;
b. Identify constraints;
c. List change strategies or possible approaches to problem solving;
d. To select the best change strategy; and finally
e. Formulate as a group a plan for implementation and or develop or select tools for evaluation.
74
________of a system is never a good idea.
Wholesale change
75
After the implementation of the change it is important to then evaluate the overall results of the change and make such adjustments as may be necessary.
last step in the change process
76
strategies for change management are based on the assumption that people are rational and behave according to rational self interest.
Empirical-Rational
77
strategies are based on the assumption that people are consistent to their commitment to socio-cultural norms and values.
Normative Re-educative
78
Resistance to Change (reasons)
> lack of trust
> vested interest
> fear of failure
> loss of status or income,
> misunderstanding
> belief that change is not necessary. The manager may then take steps to handle this resistance.
78
involve the compliance of the less powerful with leadership, plans and direction of the more powerful.
Power-Coercive
79
a natural, inevitable condition and is often a perquisite to change in people and organizations.
CONFLICT
79
This occurs when two or more groups attempt the same goal and only one group can attain them.
Competitive conflict
79
consequence of real or perceived differences in goals, values, ideas, attitudes, beliefs, feelings and actions.
CONFLICT
80
Feeling of unfairness from among the staff.
Intra group
80
defined by a victory for one side and a loss for the other. The process by which such conflict is resolved is determined by an asset of rules.
Competitive conflict
81
This takes place in an environment filled with fear, anger and stress. There is no mutually acceptable set of rules and the goal of each party is the elimination of its opponent.
Disruptive conflict
81
This occurs within one person.
Intrapersonal
81
This takes place between two or more individual.
Interpersonal conflict
81
Conflict arises from differences in
skills, knowledge, values, interest, and scarcity of resources or leadership styles.
82
is a method that represses rather than settles conflict, creating a win-lose situation in which the loser is left feeling angry and antagonisti
. Dominance and Suppression or win-lose strategy
83
is an autocratic, coercive style that often leads to an indirect and destructive expression of conflict.
Restriction
84
is more diplomatic way of suppressing conflict wherein on persuades the opponent to give in to the other side.
Smoothing Behavior
85
creates a situation in which there are no differences.
Avoidance Behavior
86
> resolves conflict by majority vote.
Majority Rule
87
is a method where each side agrees upon solutions that meet everyone’s needs.
Compromise or Consensus Strategy
88
> is a constructive process in which the parties involved recognize that conflict exists and openly try to solve the problem.
Integrative Problem-solving
89
> focuses on goals and attempts to meet the nee ds of both parties.
A Win-Win Strategy
90
> is one in which neither side wins; the settlement reached to both sides.
A Lose-lose Strategy
91
> is regarded as the most effective means of resolving conflict in which it is brought out in the open and attempts are made to resolve it through knowledge in reason.
Confrontation
91
> self sacrifice.
Accommodation
92
> is a technique where conflicting parties give and take on various issues.
Negotiation
93
> seeing mutual attention to the problem & utilized talents of all parties. Focuses on problem solving to find mutual satisfying solutions. It is useful in situation where goals are too important.
Collaboration
93
> Suppression of conflict through authority-obedience approach. The supervisor exerts power at the expense of the subordinate.
Competition
94
> Ignoring of disagreements so that harmony is maintained.
Smoothing
95
> one party is removed to resolve an issue.
Withdrawing
96
> Pursues descriptive bases for the group’s work.
Information Seeker
96
is where the members of this team work together toward achieving goals faster and more productively.
Team Building
96
> One, who redefines problems and offers solutions, clarifies objectives, suggests agenda items and maintains time limits.
Initiator-contributor
96
is a group of people brought together for the purpose of sharing and applying their individual skills towards the achievement of goals.
team
96
> an immediate end to the conflict but leaves the cause of the conflict unresolved.
Forcing
96
Characteristics of an Effective Team
An effective team must be able to:
1. Have define goals,
2. Work cooperatively towards achieving and collaboratively towards achieving these goals,
3. Have agreed goals that reflect members’ needs and values,
4. Have a good definition of its members’ roles.
96
Explores viewpoints that clarify or reflect the values of other members’ suggestions.
Opinion Seeker
96
Predicts outcomes and provides illustrations or expands suggestions, clarifying how they could work.
Elaborator
96
Expands information given by sharing experiences and making inferences.
Information Giver
97
Conveys to group members what their pertinent values should be.
Opinion Giver
98
Links ideas or suggestions offered by others.
Coordinator
99
Summarizes the group’s discussions and actions.
Orienter
100
Appraises the quantity and quality of the group’s accomplishments against set standards.
Evaluator critic
101
Motivates group to accomplish, qualitatively and quantitatively, the group’s goals.
Energizer
102
Supports group activity by arranging the environment and providing necessary tools.
Procedural technician
103
Documents the group’s actions and achievements
Recorder
104
>it involves the process of getting the organization’s work done.
Directing
105
>it entails explaining what is to be done, to and by whom at what time, how and why the task should be done.
Directing
106
>directing must be consistent with departmental policies to help personnel perform their duties safely and efficiently.
Directing
