fundamentals: chapter 10 Flashcards
chain of command
know:
- who is your supervisor?
- to whom does your supervisor report?
- to whom should you report changes in patient
condition?
- to whom do you go with concerns or complaints?
- who is in charge of scheduling your hours?
- who should you call if you cannot make it to
work?
laissez-fair leader
- does not attempt to control the team
- offers little (if any) direction
autocratic leader
tightly controls team members
democratic leader
- frequently consults with staff members
- seeks staff participation in decision making
attributes of a good leader
- ability to teach
- active listener
- articulate
- assertive
- calm
- considerate
- consistent
- decisive
- excellent clinical skills
- excellent problem solver
- fair
- flexible
- good role model
- good sense of humor
- objective
- open minded
- organized
- responsive
- sensitive
- strong character
- tactful
keys to effective leadership
- collaboration
- effective communication and relationships
- clinical competence and confidence
- organization
- delegation
effective communication
- communicate in direct, concise terms in a tactful, friendly, nonthreatening way
- maintain a supportive work environment
- be specific when assigning tasks (what to do, how to do it, when it should be done)
- treat others how you want to be treated
clinical competence and confidence
essential to having respect of other team members:
- confidence in your ability to perform skills well
- admit when you make a mistake or don’t know something
organization
- plan each day carefully
- have built-in flexibility for unforeseen events
- decision making ability is needed to quickly divide up patients and assign tasks
delegation
- a licensed nurse transfers authority to perform a nursing duty in a specific patient situation
UAPs
unlicensed assistive personnel
- includes unit secretaries, nursing assistants, homemaking aids, housekeeping personnel, and technicians
delegation
- you are accountable for the tasks you delegate
- you must know the capabilities of each person to whom you delegate
- you must know whether the task can be legally delegated
- you must effectively communicate with the person to whom you are delegating
CNO
chief nursing officer
DON
director of nursing
delegation
- you must be familiar with your state’s nurse practice act
- you must know what UAPs can or cannot do
- do not delegate assessment, analysis, planning, or evaluation - these tasks can only be performed by licensed personnel
- interventions requiring judgement should not be delegated
delegation
- effective delegation includes the desired result and a timeline for completion
- delegation does NOT mean giving up responsibility for overall patient care
- provide praise or constructive criticism on how the UAP performed a delegated task
- if UAP performance is poor, document specific facts (not opinions)
beginning leadership roles
- LPNs will perform leadership functions with UAPs
- later on, team leading may be required
advanced leaderships roles
charge nurse:
- training and experience in nursing administration
- responsible for total nursing care of patients on the unit
management skills for the LPN
- time management
- computer skills
- receiving new orders
- taking verbal orders
- documentation for reimbursement
time management
- make a to-do list before starting shift
- list differs based on setting
- devise a time schedule before making rounds
- evaluate effectiveness of time management at end of shift
using the computer
- place orders to various departments
- supplies, meds, labs, housekeeping, etc
- schedule surgery
- construct nursing care plans
- track patient acuity levels
- obtain lab results
receiving new orders
- most facilities use EMR and CPOE
- some still use MAR
- read all orders first
- verbally communicate stat orders to the nurse responsible for carrying them out
- acknowledge each order as it is ordered by the provider and verified by the pharmacist
taking verbal orders
- the joint commission discourages verbal and telephone orders unless absolutely necessary
- verbal orders can only be taken by licensed nurses (only by RNs in some states)
- nurse enters the verbal order on on the physician’s order sheet and marks it as VO (verbal order) or TO (telephone order) with the date, time, first initial, last name, and professional title
- physician must sign written form of the VO as soon as possible (by next day)
- # of VOs must not exceed 20% of total orders
documentation for reimbursement
- all nursing care and equipment used must be documented
- reimbursement rates depend on documentation