Unit 4 Delegation/Prioritization/ Nurse as Manager of Care Flashcards
Describe managers and management.
Managers: have formal authority and responsibility to direct the work of employees
Management: is a problem-oriented process to do what is necessary to get the job done by people.
What are the functions of a new nurse and management?
Plan
Organize
Direct
Control
Nurse uses it to manage herself
Management uses it to manage everyone
What are the types of management styles?
Autocratic - directed, controlling, task oriented
Democratic - planning and decision making is shared, flexible, takes time, people oriented, group decision.
Laissez-faire - Permissive, non directive, little planning or decision making
What are the 3 common elements of leadership?
Listening
Patience
Encouraging
What is the difference between the problem solving/nursing process and decision-making process?
Problem solving/nursing process follows set of steps
Decision making is based on values, past experiences, and perceptions of the individual involved.
(You need to know profession, yourself, and situation)
List what should be prioritized.
- Immediate threat to survival
- Threat to safety (Psych needs)
- Problem for which help has been requested (PT wanting pain meds, sitting on chair, etc)
- Other problems discovered
- Potential problems
What legislative do nurses work under?
We work under legislative control of the State Board of Nursing (BON): Practice Act
What does the NJ Board of Nursing regulate and their purpose?
- Primary Licensure Verification
- Rules and Regulations (Practice Act) - laws that guide their practice, each state has their own
- Scope of our practice
[Purposes is to make sure public is protected]
What is standard of care? Who makes it?
Model of established practice that is commonly accepted as correct.
American Nurses Association (ANA)
What are external vs internal standards?
External standards are credentialing programs such as:
Joint commission
ANA
Magnent
Internal standard:
-polices and procedures/job descriptions
What is the ANA Code of Ethics for Nurses?
Moral statement of accountability
Not a legal document
No judgement of bias towards PTs
What are interpersonal skills?
Communication
- verbal
- written
Time Management
- Organization
- Prioritization
Describe SBAR.
Provides framework for communication about a patient.
Situation: 5-10 seconds
Background: Brief history, relevant content
Assessment: What I think
Recommendation: What I need and when
Describe I Pass the Baton.
Introduction
Patient
Assessment
Situation
Safety Concerns
Background Actions Timing Ownership Next
What are the types of conflict resolution?
Avoidance - low cooperation and low competitiveness
Compromise - medium cooperation and competitiveness (ex: trading position)
Collaboration - high cooperation and competitiveness (best conflict resolution)
Accommodation - high cooperation low competitiveness
Competition - high competitiveness and low cooperation
What are time management strategies?
- Learn to say no, use assertive communication
- Communicate directly with the person with whom you have a problem
- Delegation! Delegation!
- Get organized: a place for everything and everything in its place
Describe Delegation.
Transfer of authority to a competent individual for the performance of a task or function.
Passes on responsibility for the performance but NOT the accountability for the process or outcome of the task.
[When you delegate you become a supervisor]
Describe accountability.
Being answerable for what one has done and standing behind that decision and/or action.
What is the delegate responsible for?
Accepting the delegation and for his/her own action carrying out the task.
As a RN, what are you accountable for?
Assessing the patient's needs Planning the desired outcomes Interdisciplinary collaboration Teaching/communicating plan Evaluation of outcomes
(The nursing process) plus education.
Describe assignment/giving an assignment.
The distribution of work including the responsibility and accountability for the performance of the activity or task.
Lateral Move, presumes the skill and judgement are interchangeable between ppl.
Shift of activity from one person to another.
What are the elements of Nurse Practice Acts?
Definition of professional nursing Requirements for licensure Rule making, scope of practice Licensure across jurisdictions Regulation of APN Disciplinary action and due process requirements Accreditation of nursing programs
Describe the APN practice.
Manage wellness and stabilize long term illnesses by:
- Initiating lab and other diagnostic tests
- prescribing or ordering meds and devices
What are the steps in the delegation tree?
- Assessment and plan
- Communication
- Surveillance and supervision
- Evaluation and feedback
What are the 5 rights of delegation?
Right task
Right person
Right communication
Right supervision
Right circumstance
What is the only IV push Rx that LPN’s can give?
Heparin
What can LPN’s NOT do? (Non-delegatable RN tasks)
- Initiate blood transfusion or blood products
- Administer IV antineoplastic meds
- IV push meds except for heparin
- Administer any experimental Rx
- Initial PT teaching
- Accept verbal or telephone orders
- Independently provide care to an unstable PT
- Develop or initiate interdisciplinary treatment plan or discharge planning
- Manually perform defibrillation on a patient
(can use AED or shock advisory mode)
Assessing
Planning
Evaluations
What are the four C’s of communication?
Clear direction
Concise description
Complete information
Correct limits and expectation
How do you give feed-back?
Give specific examples
LISTEN as person speaks
Provide directions and goals
Praise publicly, criticize privately
What are benefits of delegation?
PT satisfaction Nurses' satisfaction Better outcomes Financial benefits Recruitment
What is the Health Care Professional Responsibility and Reporting Enhancement Act (Cullen Law)?
Organizational and personal responsibility for reporting negligent or criminal conduct.
What are the levels of the Health Care Professional Responsibility and Reporting Enhancement Act (Cullen Law)?
Level 1 - always requires reporting to the Board of Nursing (BON)
Conduct that clearly violates expected standards of care and may result in various degrees of harm
Conduct demonstrating pattern of poor judgement or skill
ex: drug diversion, abuse, arrests, med errors
Level 2 - Depending on an analysis of the facts, may require reporting to the BON
(No list for this category, judgement for person making the report based on the relevant factors)
Level 3 -Does not require reporting to the BON
(Low level infractions that do not involve PT care or wrongdoing)
ex: being late to work, general disputes
How many hrs every 2 years does an RN and LPN need to complete in CEUs and who mandates it?
30 hrs
Board of Nursing practice act
