T1 Flashcards
- Know the different styles of Leadership and the difference between Management, Leading, & Following, and what is the difference between transactional, transformative, and complexity leadership.
Styles of leadership:
Authoritative: These leaders make decisions for the group. They tend to motivate by coercion, with communication occurring down a chain of command. Staff work output is usually high, and this makes it a great style to have in crisis situations.
Democratic: These leaders include the group when decisions are made. They tend to motivate by supporting achievements made by group members and they communicate both up and down the chain of command. Their staff’s work output is usually good because cooperation is valued.
Laissez-faire (a French phrase meaning “leave it alone”): These leaders make few decisions, do very little planning, and rely on their staff’s motivation to get jobs accomplished. Communication goes both ways, but work output may be low unless an informal leader emerges from within the group. However, this style may be effective with professional employees who have personal integrity and accountability.
Management- on the other hand, is the process of “guiding others through a set of derived practices and procedures.” These processes will be evidence based and may be routine; however, they are becoming more complex with additional responsibilities being given to nurse- managers. Managers are generally appointed, hired, or otherwise given the responsibility, whereas leaders emerge from situations. Managing can also refer to control of one’s own individual work and energies.
Leading- is “engaged decision making” connected to the actions used in clinical situations “for which no standardized solution exists” (p.5) With that in mind, realize that any nurse may, in fact, be a leader. Nurses make decisions and problem-solve issues at all levels and in all health care venues. Using one’s individual traits and personal influence to interact constructively in resolving problems is a good definition of nursing leadership.
Following- is being part of the group that is being led or managed. We are all followers at given times, but an effective follower not only contributes to the good of the team, but provides feedback to the manager or leader in order to identify problems and find solutions to them. Following is just as accountable as leading or managing.
Transactional Leadership- leaders focus on immediate problems, maintaining the status quo and using rewards to motivate followers.
Transformative Leadership- leaders empower followers to assume responsibility for a shared goal or vision, and personal development is a secondary outcome.
Complexity Leadership- “Leaders must engage in the behavior and work of complexity leadership with an understanding that interconnectedness and change are normal operating conditions.” To lead effectively, the leader must be in a relationship with the team, a relationship that fosters trust and promotes openness.
: These leaders make decisions for the group. They tend to motivate by coercion, with communication occurring down a chain of command. Staff work output is usually high, and this makes it a great style to have in crisis situations.
Authoritative
: These leaders include the group when decisions are made. They tend to motivate by supporting achievements made by group members and they communicate both up and down the chain of command. Their staff’s work output is usually good because cooperation is valued.
Democratic
(a French phrase meaning “leave it alone”): These leaders make few decisions, do very little planning, and rely on their staff’s motivation to get jobs accomplished. Communication goes both ways, but work output may be low unless an informal leader emerges from within the group. However, this style may be effective with professional employees who have personal integrity and accountability.
Laissez-faire
on the other hand, is the process of “guiding others through a set of derived practices and procedures.” These processes will be evidence based and may be routine; however, they are becoming more complex with additional responsibilities being given to nurse- managers. Managers are generally appointed, hired, or otherwise given the responsibility, whereas leaders emerge from situations. Managing can also refer to control of one’s own individual work and energies.
Management
is “engaged decision making” connected to the actions used in clinical situations “for which no standardized solution exists” (p.5) With that in mind, realize that any nurse may, in fact, be a leader. Nurses make decisions and problem-solve issues at all levels and in all health care venues. Using one’s individual traits and personal influence to interact constructively in resolving problems is a good definition of nursing leadership.
Leading
is being part of the group that is being led or managed. We are all followers at given times, but an effective follower not only contributes to the good of the team, but provides feedback to the manager or leader in order to identify problems and find solutions to them. Following is just as accountable as leading or managing.
Following
- leaders focus on immediate problems, maintaining the status quo and using rewards to motivate followers.
Transactional Leadership
leaders empower followers to assume responsibility for a shared goal or vision, and personal development is a secondary outcome.
Transformative Leadership-
- “Leaders must engage in the behavior and work of complexity leadership with an understanding that interconnectedness and change are normal operating conditions.” To lead effectively, the leader must be in a relationship with the team, a relationship that fosters trust and promotes openness.
Complexity Leadership
- Know key traits of leading, managing, following in nursing.
Effective leaders and managers must have these attributes:
- Focused energy and stamina
- Critical thinking skills
- Responsibility and follow up, personal accountability
- People skills
- Trustworthiness
- Ability to motivate others
- Competence
- Well rounded coping skills (Yoder-Wise, 2011)
Text Book Traits
• Articulating a vision for desired future state
• Seeing possibilities in the mildest of challenges
• Often complex challenges, uncharted, or even dire circumstances
• Communicate effectively, powerfully
• Adapting to new situations and environments
• Use experiences and challenges and judge reasonable risk.
All of the above titles, roles, and behaviors should enhance each other. While some formal positions, such as Charge Nurse or Nurse Manager, require appointment and will have a set of specified duties assigned, all nurses are expected to be competent followers and self-managers (Yoder-Wise, 2011).
To be effective followers, novice nurses need a basic level of skills, knowledge and attitudes and must be able to work as part of a team.
They must be willing to make decisions and take action upon them. They must understand the organizational functioning of their own particular workplace.
All nurses are leaders, managers, and followers in daily client care!
- Understand why Nursing is not always viewed as a Profession and what nurses can do to change that image.
A position is a group of tasks assigned to one individual.
A job is a group of positions similar in nature and in skill level that can be carried out by an individual or a group.
An occupation is a group of jobs, similar in type of work, usually found throughout an industry or workplace.
A professional is one who belongs to and practices a profession.
A profession, then, is a type of occupation that meets the criteria of having the following traits:
• High intellectual level
• High level of individual responsibility and accountability
• Specialized body of knowledge
• Knowledge that can be learned in institutions of higher education
• Public service and altruistic activities
• Public service valued over financial gain
• Relatively high degree of autonomy and independence of practice
• Need for a well-organized and strong organization representing the members of the profession and controlling the quality of practice
• A code of ethics that guides the members of the profession in their practice
• Strong professional identity and commitment to the development of the profession
• Demonstration of professional competency and possession of a legally recognized license
- Be able to explain Emotional Intelligence and its impact on nursing decisions.
Emotional intelligence is the ability of an individual to perceive and manage the emotions of self and others. Nurses must be able to perceive and understand their own emotions and the emotions of their clients and families in order to provide real client-centered care.
To be considered emotionally intelligent, strive for these five traits:
• Have self-awareness: You can identify the emotions you are feeling and you know how they may be altering your perceptions.
• Manage emotions: Your negative emotions -anger, fear, and passive-aggressiveness, can be avoided.
• Motivate yourself: You are inwardly rather than externally driven.
• Be empathetic: You value differences in viewpoints and don’t side with one group versus another.
• Handle relationships: You are socially appropriate.
Emotional intelligence is also an important characteristic of the successful nurse leader, as this leader will have insight into the emotions of members of the team. He or she understands the perspective of others and will encourage constructive criticism and be open to new ideas. The emotionally intelligent leader is able to maintain focus while multitasking. He or she will manage emotions and channel them into a positive direction, which in turn helps the team accomplish its goals.
The emotionally intelligent leader is committed to the delivery of high-quality client care and refrains from judgment in controversial or emotionally charged situations until facts are gathered.
Emotional intelligence is developed through understanding the concept and applying it to practice in everyday situations.
- Be familiar with the ANA code of ethics and with Key Ethics Terms found in Module I.
Code of ethics?
An ethical dilemma?
Code of ethics- Written values of a profession that act as guidelines for professional behavior.
The code includes confidentiality, veracity, justice, beneficence, autonomy, and respect for client privacy.
Nightingale pledged a statement of the ethics and principles in 1893. First published in 1971, 1985- first major revision, 2001- revised to include client’s rights. 2014 is the current code we work under today.
There are several steps in ethical decision-making:
• Identify whether the issue is an ethical dilemma. Does the science collide with morals?
• State the ethical dilemma, including all surrounding issues and individuals involved. Sometimes rephrasing the issues, to yourself or to others, helps clarify its significance.
• List and analyze all possible options for resolving the dilemma, and review implications of each option. Leave no stone unturned!
• Select the option that is in concert with the ethical principle applicable to this situation, the decision maker’s values and beliefs, and the profession’s values set forth for client care. Be prepared to defend and/or justify why that one option was selected.
Although codes of ethics are not considered laws, consistent violations of the code of ethics by a nurse will often result in disciplinary actions ranging from reprimands and fines to suspension of licensure.
An ethical dilemma - problem occurs when something cannot be solved solely by a review of scientific data; it involves a conflict between two moral imperatives. The answer will have profound effect on the situation/client. When facing this situation, ethical decision-making is the process by which a decision is made about an ethical issue.
- Know the difference between Quality Improvement and Quality Management. What is nursing’s role in both?
Quality improvement (QI) consists of systematic and continuous actions that lead to measurable improvements in health related services and in the overall health and/or safety of individual patients.
• Identify the need
• Assemble a team
• Collect the data
• Establish outcome and quality indicators
• Select and implement a plan
• Evaluate
Quality management, then, is the use of performance standards and ongoing quality improvement efforts to achieve high levels of patient safety and satisfaction. AKA: Continuous quality management.
Example: The Institute of Medicine (IOM), in 2000, issued the report “To Err is Human” identifying over 98,000 patient deaths were attributed to medical error. This pointed out to all health care personnel that the problem was not simply related to isolated occurrences, but was much more widespread than first believed. Additionally, hospital administrators and chiefs of staff/chief nursing officers needed to be more accountable for what was happening on the floor (Yoder-Wise, 2011).
Another publication by the IOM was released the following year, identifying aims for providing safer health care in the clinical setting. They state that ALL patient care must be safe, effective, patient-centered, timely, efficient, and equitable
Therefore, it’s imperative that nurses assess:
• Age
• mobility,
• cognitive/sensory awareness,
• emotional state,
• lifestyle
• safety awareness
Nurses must also know procedural safety guidelines and protocols, and be aware of security codes and plans for their particular work space.
Patient health and safety is everyone’s concern. It is the basis for which all nursing care is provided. Simple measures such as
• proper hand washing,
• environmental cleanliness,
• well-functioning and correctly handled machinery
• Achieve high safety goals.
Continuous quality improvement (CQI) is the process of identifying areas of concern (indicators), continuously collecting data on these indicators, analyzing and evaluating the data, and implementing needed changes.
