Leadership and Delegation Flashcards
Leadership is
different combinations of task and relationship behaviors used to influence others to accomplish goals.
- need to possess knowledge and skills in the art and science of solving problems in work groups, systems of care, and the environment of care delivery (huber)
Laissez-faire leadership
permissive, nondirective orpassive
- delegative type of leadership that allows people to choose what they want to do and how they will do it
Laissez-faire leadership works best when
all members have the same education level & the leader performs the same tasks
group determines their own goals and methods to achieve them
Democratic leadership is
All aspects of the process shared by the group
- leader encourages and assists discussion and group decision-making
participative mgmt
Democratic leadership works best with
members with relatively equal status, strong sense of ownership & achievement by the whole group
Laissez-faire leadership limits
often leaves the group feeling lost & frustrated because of the lack of direction from the leader
Democratic leadership limit
time consuming & inefficient when the members disagree strongly
- Motivating participation is a constant challenge.
Democratic leadership hallmarks
trust, collaboration, confidence, & autonomy
- high levels of commitment in high work ethics
- relationship and person orientation
Authoritarian leadership
provide direction by giving orders without question
Authoritarian leadership
- LEADER IS
Final decisions rest with the leader & the leader alone. Leader maintains control
MICRO MANAGERS
Authoritarian leadership
- negatives
- harbor hostile feelings that they are fearful to express
- use passive-aggressive techniques to try to even the playing field
- feel oppressed
- unable to use their full potential as a worker
Which style emphasizes a high concern for task?
authoritarian
Which leadership style is helpful in a code or crisis situation?
Authoritarian
Servant leadership
encouragement, value diverse opinions, cultivates trust, listen to understand
JESUS
Servant leadership acts with
humility, develops others, thinks long-term
Servant leadership main goal for the leader is to
serve
- listen and truly understand
- clear goals and vision
- think before action
- whole
- acceptance and empathy
Which leadership style thinks long-term?
Servant leadership
Servant leadership hallmarks
servant leader is encouragement
1st = servant - helper - teacher - leader
Transformational leadership
vision, empowerment, charisma, inspiration, intellectual stimulation
Transformational is best when coupled with
transactional
Transformational leadership based on primarily
external forces
Transformational leadership leader causes the followers to
rise above their own needs
- changes the culture as the organization obtains higher levels of effort and satisfaction performance exceeds beyond expectation
Transactional leadership focuses on
management tasks; meets goals; expected social exchange of giving & receiving rewards
In transactional leadership,both parties are
gain something in the relationship
Transactional leadership identifies the needs of the
follower
- reward for expected performance
T/F: Transformative leadership has obtained performance but not exceeded.
False, transactional leadership does not exceed.
Authentic leadership leads based on
what they believe in, values, and principles
- leader legit = honest relationship with followers that value input and ethical foundation
Authentic leaders are
positive people with truthful self-concepts who promote openness
Authentic vs transformational leadership
Authentic = intrinsic valves
Transformational = external forces
Situational leadership
uses a combination of styles based on the current circumstances according to the needs of the group and task needing to be achieved
Bureaucratic leadership
motivated by external sources, relies on organizational policies and procedures for decision making
Key leadership behaviors
respect for individuals
establish trust
sense of direction
resolve conflicts successfully
develop staff strengths
Emotional awareness
Managing your emotions & remaining calm
Helping others manage their emotions
Emotional Intelligence definition
ability to perceive, control, & evaluateemotions
Five components of EI
a. Self-awareness
b. Self-regulation
c. Motivation
d. Empathy
e. Social skills
Highly emotional intelligent managers create
highly positive organizational climates
Skill sets needed by good leaders
self-awareness
self-management
social-awareness “read the room”
relationship mgmt
Self-awareness
aware of ones strengths, weaknesses, style, personality, preferences, etc., has a significant impact on how leaders behave & interact with others
- influence and potential climate
A leader who is not self-aware could lead to
unwanted or undesirable consequences
Self-management
stress
time
organizing skills
problem-solving
decision-making
confidence
self-protection
work-life balance
self-management is the ability to
see how emotions are impacting you,
how to take appropriate action to regulate.
How others’ emotions are impacting them
Social awareness
“read the room”
empathy skill building
Relationship management
use of effective communication with others to disarm conflict, & the ability to develop the emotional maturity of team members
hear and understand perspectives of other people
Ripple Effect of a Great Leader
Leadership affects organizational and individual productivity
Implications for recruitment and retention
Stress can have results in
emotional and physical states
- chaotic environment = fatigue
- lead to chronic conditions
- increase addiction and mental health conditions
Workplace Stress mgmt
Wellness programs
Exercise
Getaway place at work
Mindfulness
Mood apps
Breathwork
Mediation
Sleep on break
Outside work stress mgmt
Setting boundaries
Relaxation
Journaling
Seek expert assistance
Gratitude practice
CBT
Meeting with support system
Counselor
Self care
Health Self-care
Personal time
Sleep
Nutrition
Hydration
Exercise
Support network
I’M SAFE checklist
I =Illness
M=Medication
S=Stress
A=Alcohol and Drugs
F=Fatigue
E=Eating and Elimination
Negative Behaviors and Ineffective Leader traits
Lack trust and transparency
Cannot approach/ talk with them
Poor communication
Incongruency with mission, vision, and purpose
Cannot manage conflict
Destructive self- management
What are the traits of leading a pt?
advocacy
delegation/prioritization
communication
- support a pt and family unit
foster collaboration
- referrals ad follow-ups
- coordinating care
evidence-based practice
- set realistic care
empowering decision-making
Human Caring and Relationship is based on
a) Age
b) Gender
c) Ethnicity
d) Religious beliefs
e) Cultural differences
f) Personal preferences
Human Caring and Relationship act with
assertiveness
Pt’s Rights
Recognize patient’s right to refuse treatment/procedures
Discuss treatment options/decisions with the patient
Provide education to patient and staff about patient rights and responsibilities
Evaluate patient and staff understanding of patient rights
Advocate for patient right and needs
How can you implement safety practices to enhance quality?
isolations, fall bundle, psychosocial, med rights, huddle, communications, sepsis protocol
Time Mgmt Strategies
Block time for rounds
Schedule time to review education, check emails, and other professional responsibilities
Prioritize your to do list
Set realistic goals and deadlines
Develop flexibility and adaptability mindset
adapt remain positive and productive
Overcome procrastination by
select most objectionable task and commit 5 minutes to doing them
Procrastination
category A
assessments, passing meds, treatments, and dressing changes – these are time sensitive
Procrastination
category B
– baths, linen changes, breaks, charting – important but have flexibility in time
Procrastination
category C
cleaning up, organizing the supply room – can be delegated or wait
The nurse needs to practice by what legalities?
State licensure requirements
Scope of practice
Laws pertaining to criminal and civil wrong doing – scope of practice
Ethical codes of practice (Ethics committee)
Policies and Procedures of organization
Self regulation to retain personal accountability
Dilemmas requiring decisions to be made about right and wrong in situations in which an individual has to make a choice between equally unfavorable alternatives.
Provides general guidance
Organizations with ethical teams/liasons
Autonomy
freedom of choice
Nonmaleficience
do no harm
Beneficence
benefit of bettering the pt with a good outcome
Justice
fairness, not biased or stereotyped, equal access to care
Veracity
truthful
Fidelity
keeping a promise and follow through (trust development)
ANA Code of Ethics
nonnegotiable standards as to the ethical obligations and duties for those who enter the nursing profession
Nursing legal rights
Legal issues surrounding refusing treatment (patient rights)
Managing valuables according to policy
Recognizing limitations of self, other, and utilizing resources
Interpreter services
Abuse/neglect/communicable diseases
Providing care within the legal scope of practice
Maintaining HIPAA- confidential client information
- need to know
- Don’t share passwords
- Don’t leave information on a computer screen
Leadership
the ability to inspire others to achieve a desired outcome
Management
process of planning, organizing, directing, and coordinating the work within an organization
Informal leader
help support and move in the right direction
- with no title
Managements’ function
Planning
- need of staff growth, efficiency, motivation, morals, satisfaction
- need of organization, productivity, quality, cost effectiveness, outcomes
organizing resources
staffing
Directing leadership, guiding, and resources with time
Control performance standards with conflict, actions
Business Acumen for Mgmt
Prevention of workplace violence
Staffing, scheduling, and workload
Maintaining the workforce (trends of new staff and pts)
Recruitment and retention
Turnover
Skills, education, staff development
Performance, counseling, coaching
Budgets
Resource management
Unit level outcomes (revenues)
Monetary if get infections down
Marketing
Succession planning
Productivity
Cost containment
Consequences Ineffectiveness Mgmt
Employee Discontent
Decrease Satisfaction
High attrition
Patient Incidents
Adverse Outcomes
Nosocomial infections
Increased Work-Arounds
Goals not met
Decreased Patient Satisfaction Measures
Ineffective use of resources
Communication strategies for leading terms
SBAR
Call-Out - criticals
Check-Back
Hand-off
Brief
Huddle
Debrief
Follow-Up
Followship
interpersonal process of participation
- followers are vital
4 Qualities of Effective Followers
1) Manage themselves well: Ability to think for themselves.
2) Higher purpose: work towards the good of the organization, & to principles & values outside of themselves. What happens if personal values & principles don’t align with the organization? May have to make a change.
3) Strengths: high standards of performance.
4)
TBON job is to
protect the public
Authority
The legal authority to perform a task
- TBON sets
Scope of Practice
The actions, procedures, and processes that are permitted with the terms of the professional licensure
And policies
Supervision
Guiding or monitoring a delegated nursing task
Accountability
Being answerable for one’s own actions
- Always the nurse maintains
Delegator
Registered Nurse (RN)
Delegatee
UAP = unlicensed assistive personnel such as certified nurse assistant, nurse aid, nurse tech, patient care assistant, registered nurse assistant, & medication tech
Delegation
RN directs another health-care team member to perform specific nursing tasks, procedures, and activities that are beyond the person’s traditional role and are not routinely performed by them
Delegation involves achieving
outcome and sharing activities with other individuals who have the authority to accomplish the task
When delegating tasks who maintains accountabilty?
RN
When the RN accepts responsibility for delegating an assignment appropriately, they become
accountable for the delegation process
Accountability looks to see if the RN used his or her
nursing knowledge, critical thinking, and clinical judgment skills in delegating a task
When an RN delegates they **must
SUPERVISE**
Delegation Guidelines
1st Assess the patient
know staff availability, job description
educate staff members
assess and supervise tolerability
- tell the expected/unexpected outcomes
Delegatees practice on
own license (LPNs and LVNs) or, if unlicensed (UAP), within their own level of education
If the RN delegates inappropriately to a person who is clearly not qualified, and the client dies, the
RN and the assistive personnel could both be held liable.
Delegate when
stable
within job description
able to supervise
planned how to monitor
Don’t delegate when
highly invasive or potential to cause significant harm
inadequate time to supervise
- complex and judgement is required
- unpredictable
- creativity and problem-solving needed
Delegate steps
Assess and plan
communicate
ensure supervision
eval and give feedback
- within scope of practice
5 Rights of delegation
Task
Person
Communication
Supervision/Feedback
Circumstances
Right Task to delegate
Do the tasks delegated follow written policy guidelines?
Right person to delegate
Does the person have the right education, right competency and proper qualifications for the tasks?
Right direction/communication to delegate
Are the instructions and outcomes clearly stated? When should the person report changes?
Right supervision to delegate
How can the delegation process be improved? Are the patient goals being achieved?
Right circumstances to delegate
Are the tasks that are being delegated possible without independent nursing judgments?
Any nurse can refuse
accept a task outside their scope of practice
- do not have the skill or knowledge
What can not be delegated?
accountability
- responsibility can
The RN can’t delegate what
Full assessment (LVN only does focused assessment)
Formulation of nursing diagnosis
Formulation of care plans and goals
Delegate any process of the nursing process
Implementing the initial intervention
Evaluation of care
- Teaching
- Assessment
- Planning
- Evaluation
RN obligation to refuse what?
assignments that they are not competent to carry out
delegate nursing tasks to individuals who they believe are unable or unprepared to perform them
The RN can delegate what?
I&O, bath, VS
Perform CPR
CHRONIC / STABLE TO LVN
The RN can’t delegate what?
Initial teaching
ADVICE
EVALUATE
SUCTION
What does the RN need to consider when delegate?
How complex is the patient’s required care?
What level of experience/knowledge/skill/training is required?
Is the patient’s status stable & predictable?
Does the patient have special needs related to any of the following?
- special equipment or technology
- communication challenges
- patient’s physical and mental ability
- psychosocial and cultural aspects
- safety precautions
- infection control issues
How much time does the patient’s care require?
How will the physical location of patients affect time/availability of care?
Are there any personal reasons that a nurse should not be assigned this patient?
What is the Scope of Practice of the health care provider?
What about the Organizational Policies?
RN making the assignment?
Monitor and assess the staff members’ progress of task completion
Provide ongoing monitoring (intermittent)
UAP assigning tasks
- lowest level of skill required for the task
- least complicated task
- most stable client
- chronic illness
Professional Judgement
A process in which the nurse exercises in forming opinion and reaching a clinical decision based upon the analysis of evidence or data (NCSBN)
LVN delegation tasks acceptable
independently in a stable, routine situation
Administers medications - oral, IM, & SQ insulin FOR NCLEX
(excludes IV medications but depends on organization’s policy)
Conducts a focused assessment & monitoring of patient findings
Information provided assists RN to develop nursing diagnosis and monitor patient
Reinforces patient teaching
Conducts nursing procedures based on education & training
i.e. tracheostomy care, suctioning, checking patency of NG tube, administration of enteral feeding, insertion of urinary catheter, subcutaneous insulin injections, and enemas or vaginal irrigations
UAP can do the following
ADL
Ambulation of stable pt
positioning
bed making
specimen collection (stool and sputum)
- no blood specimens
I&O
VS stable
LVNs for NCLEX can not
cannot admission assessments
IVP
nursing diagnosis
most teaching
complex skills
acute conditions
unstable clients
