Exam 2 - Chapter 19 Flashcards
A nurse manager is experiencing conflicts between herself and staff members. She had tried to develop a team by using a shared leadership model to empower the staff. Staff members are functioning:
a. as a team.
b. independently.
c. interdependently.
d. as a group.
ANS: D
A group is a collection of interconnected individuals working together, with a high degree of interdependence, for the same purpose. A team is a unified group that is committed to a common purpose, performance goals, and approach, for which they hold themselves mutually accountable. The conflict indicates that the staff may not be united in a common purpose.
The nurse manager used a mediator to help resolve conflicts on the unit. During the mediation process, the nurse manager saw
signs of potential team building. One key concept of an effective team is:
a. conflict.
b. task clarity.
c. commitment.
d. a designated leader.
ANS: C
Team building involves moving toward a common vision, which requires commitment. Conflict and clarification of tasks are components in the development of this commitment.
A mediator suggested that the nurse manager and staff members decide on a method to resolve conflicts. It is important to have
agreements about how team members will work together because:
a. if there are no agreements, each member will make up rules about how to handle
disagreements and relationships.
b. people are naturally difficult and will not work well together without such
agreements.
c. people will naturally ask for agreements about how to be together.
d. a way to eliminate nonproductive team members must be available.
ANS: A
People must agree on the goals and mission with which they are involved. They have to reach some understanding of how they will exist together. Tenets or agreements such as “I will respectfully speak promptly with any team member with whom I have a problem” go a long way to avoid gossiping, backbiting, bickering, and misinterpreting others. Without agreement, people have implicit permission to behave in any manner they choose toward one another, including angry, hostile, hurtful, and acting-out
behavior.
By following a shared leadership model, the nurse manager believes that staff members will learn to function synergistically. Some teams function synergistically because members:
a. do not volunteer unwanted information.
b. actively listen to each other.
c. listen to the person who believes he or she is an expert.
d. do not speak unless they are absolutely sure they are correct in their views.
ANS: B
Active listening in a group creates synergy in that team members really hear one another’s ideas and share in decision making.
The chief nursing officer decided that the nurse managers need a series of staff-development programs on team building through
communication and partnerships. She understood that the nurse managers needed to build confidence in ways of handling various
situations. The greatest deterrent to confidence is:
a. lack of clarity in the mission.
b. lack of control of the environment.
c. fear that one can’t handle the consequences.
d. fear that the boss will not like one’s work.
ANS: C
Fear of not being able to manage consequences undermines confidence and a sense of competency.
The mediator noticed that tension was still evident between the nurse manager and staff members. He informed the chief nursing
officer that to begin team building, it would be important that everyone:
a. work together in a respectful, civil manner.
b. use avoidance techniques when confronted with a conflict.
c. develop a personal friendship with each other.
d. socialize frequently outside of work.
ANS: A
For team building to occur, team members need to be able to listen actively and respect one another’s opinions, while feeling
comfortable in openly expressing their own.
The state of being emotionally impelled, demonstrated by a sense of passion and dedication to a project or event, describes:
a. commitment.
b. control.
c. willingness to cooperate.
d. communication.
ANS: A
Commitment is described as having a sense of passion and commitment to a project without necessarily having a need to control.
The mediator suggested to the unit staff that a group agreement needed to be made so meetings could become productive. For
example, the group agreement, “We will speak supportively,” prevents:
a. expression of opposing ideas.
b. gossip and making negative comments about absent team members.
c. efforts to ensure that everyone thinks alike.
d. votes that oppose motions.
ANS: B
This is an example of a rule that a team can implement to prevent certain negative behaviors such as gossip, backbiting, and bickering that undermine the productivity and functioning of a group.
The mediator asked each staff member to reflect on his or her communication style. Which of the following best describes communication? Communication:
a. is a reflection of self-analysis.
b. is a result of thoughtful consideration.
c. consists of thoughts, ideas, opinions, emotions, and feelings.
d. focuses on the sender of the message.
ANS: C
Communication involves both senders and receivers and may or may not be a reflection of self-analysis and thoughtful
consideration. It always, however, involves thoughts, ideas, opinions, emotions, and feelings.
The staff development educator developed strategies to help nurse managers actively listen. Guidelines for active listening include which of the following?
a. Speed up your internal processes so that you can process more data.
b. Realize that the first words of the sender are the most important.
c. Be prepared to make an effective judgment of the communication sender.
d. Cultivate a desire to learn about the other person.
ANS: D
Active listening means suspending judgment about what is about to be said and listening to all that is said (and not just the first or last words). It is motivated by a genuine desire to learn about the other person.
The nurse manager was upset with the staff nurse and said, “You did not understand what I said.” Which element in the communication process was she referring to?
a. Feedback between receiver and sender
b. A message channel
c. A receiver who decodes the message
d. A set of barriers that may occur between sender and receiver
ANS: D
Problems can occur at any point in communication and result in miscommunication. In this instance, it can be assumed that there
was a sender, a receiver, a channel, and feedback. In this scenario, barriers such as distractions, inadequate knowledge, differences
in perceptions, and emotions and personality may have resulted in misunderstanding between the manager and the staff nurse.
As the nurse manager on a rehab unit, you are asked to come to the tub room immediately because two nursing assistants are
having a loud disagreement in front of a patient. You ask the nursing assistants to meet you outside and after ensuring that a third
nursing assistant is able to care for the patient, you speak with the two nursing assistants. Which of the following would you ask
first?
a. “How long have you two been working together?”
b. “Have you experienced disagreements like this before?”
c. “How do you think this patient’s perception of her care has been changed?”
d. “What happened to bring on this disagreement today?”
ANS: D
Conflicts are usually based on attempts to protect a person’s self-esteem or to alter perceived inequities in power. When a nurse recognizes upset and reaction, the following steps can be helpful (Sportsman, 2005):
Identify the triggering event (“What happened to bring on this disagreement today?”).
Discover the historical context for each person. Assess how interdependent each person is on the other. Identify the issues, goals, and resources involved in the situation.
Sally (RN) and Melissa (RN) have shared an ongoing conflict since the first day that Melissa worked on the unit. Sally has confided to another colleague that she doesn’t even know why the conflict started or what it was about. This is an example of:
a. how expectations and objectives need to be made clear in team situations.
b. the need to encourage open discussion of disagreements in opinions.
c. the importance of involving all staff in discussions in group settings.
d. the enduring nature of first impressions.
ANS: D
First impressions are lasting and, as Sally indicates to her colleagues, are often an unconscious response.
After staff meetings lately, Sharon, the head nurse, observes her staff in small groups, having animated discussions that end
abruptly when she approaches. Sharon reflects on this observation and realizes that:
a. two very outspoken members tend to dominate discussions in meetings.
b. this behavior is indicative of a high level of communication among her staff.
c. staff members are very committed to the team and have strong opinions.
d. ongoing discussion outside of meetings is conducive to creativity.
ANS: C
When team communication is dominated by a few members, leaving others uninvolved or bored, disagreement is not expressed openly. As a result, team members “stuff” their feelings and wait until after meetings to voice their opinions.
You are charged with developing a new nursing curriculum and are committed to developing a curriculum that reflects the needs of the profession and of the workplace. To address deficits that may already be present in nursing curricula related to the workplace,
you include more content and skills development related to:
a. therapeutic communication with patients.
b. effective communication in the workplace.
c. increased emphasis on sender-receiver dyads.
d. generational differences in communication.
ANS: B
Nursing programs teach therapeutic communications with patients and their families. Little focus, however, is placed on effective communication in the workplace, although communication is essential to building and maintaining smoothly functioning teams.
