Week 8: Leadership and management

Question 1

RN will base priorities on evidence such as __________

Answer 1

Shift reports
Communication from other members of HC team
Review of EHR
Assessments and patient data 
Patient or family concern

Question 2

How can you prioritize principles in client care

Answer 2

life before limb
acute before chronic
stable before unstable
urgent over non-urgent

Question 3

priority setting framework

Answer 3

Maslow: physiologic, safety and security, love and belonging, self-esteem, self actualization
Airway: 3-5 minutes without oxygen causes irreversible brain damage from anoxia
Breathing: assess breathing effectiveness and intervene: reposition, apply oxygen, administer naloxone ex
Circulation: identify hypotension, dysrhythmia, decreased output, compartment syndrome
Disabilty: evolving neuro disability like a stroke, implement actions to slow down development of a disability
Expoure: reduce risk for hypo or hyper thermia
Safety risk reduction: is there a finding that suggests a risk for airway obstruction, or bleeding or injury. Give priority to responding to whichever risk poses greatest threar. For example: low platelet count, low BP, reduce risks, prirotize giving platelets or red cells before doing a procedure that can cause more bleeding
Survival potential

Question 4

why is delegation used

Answer 4

to have nurses work at their full scope of practice

Question 5

What can RN not delegate

Answer 5

TAPE
T-teach
A-assessment 
P-plan
E-evalation

Question 6

how do you know if u can delegate

Answer 6

Right task.
Right circumstance.
Right person.
Right supervision.
Right direction and communication

Question 7

what can LPN do

Answer 7

Take verbal orders
Start IVs, maintain or remove, and give IV fluids (not blood)
Maintenance includes dressing changes, IV tubing changes, and saline or heparin flushes.
Give vaccines and skin tests
Maintain or discontinue PCAs
Blood sampling from IV devices
*individual organizations may have policies that prohibit functions by an LPN. May do less, can never do MORE

Question 8

what are the five rights to delegation

Answer 8

Right task: relatively non-invasive, repetitive, minimal supervision
Right circumstances: delegated tasks do not require independent nursing judgment
Right person: one who is qualified and competent
Right direction and communication: clear explanation about the task and outcomes and when the delegatee should report back to the RN
Right supervision and evaluation: feedback to assess and improve the process; evaluate patient outcomes

Question 9

LPN can

Answer 9

Trach care on an established trach
Enteral feeds
Inserting foley (if institution allows)
Meds (not IV in all states)
Reinforcing teaching from a standard care plan

Question 10

UAP can

Answer 10

I&O
Vital signs (stable client)
Feeding (no swallow precautions)
ADLs
Positioning
Bedlinen changes
Ambulation

Question 11

Novice nurse barriers

Answer 11

Fear of being disliked, losing control, taking risks, and making mistakes
Lack of confidence
Lack of knowledge

Question 12

__________: ability to guide or influence others to achieve a desired outcome

Answer 12

leadership

Question 13

________-: coordination of resources (time, people, supplies) to achieve outcomes

Answer 13

managment

Question 14

what is power vs authority

Answer 14

Power: ability to motivate people to get things done with or without the formal right granted by the organization

Authority: legitimate right to direct others through an authorized position in an organization (linked to legitimate power)

Question 15

________power- the ability to reward others for complying to what the leader or manager expects

Answer 15

reward

Question 16

________ power – the opposite of reward power – based on fear of punishment

Answer 16

Coercive

Question 17

_______power – based on an official position

Answer 17

Legitimate

Question 18

__________power – follower’s identification with the leader based on respect or admiration

Answer 18

Referent

Question 19

_______power – based on knowledge, skills and information.

Answer 19

expert

Question 20

________ power – person has information that is needed by others

Answer 20

Information

Question 21

Connection power – based on relationship with people who are powerful

Answer 21

connection

Question 22

Have an appointed management position and a formal line of authority and accountability

Answer 22

managers

Question 23

• Challenging the process: your generation needs to

Answer 23

leader

Question 24

Formal leadership

Answer 24

Practiced by the nurse who is appointed to an approved position and is given authority by the organization to act

This person has “legitimate power” based on role

Can be manager, assistant manager, charge nurse, head of committee, chief nursing officers, directors . But a manager might not be a good leader, even if in a formal leadership role such a s a manager Quality specialist

Question 25

Informal leadership

Answer 25

Exercised by the person who has no official authority to act, but is able to influence others in the work group

(i.e. Staff nurse working night shift with good work ethic and is viewed by her peers as a leader on the Unit).

Destiene when she isn’t charge still helps out

Question 26

: makes all decisions with no staff input and uses the position to accomplish goals

Answer 26

Authoritarian

Question 27

: strict chain of command, strict regulations. Union hospital processes are a good example

Answer 27

Bureaucratic

Question 28

: encourages staff involvement in goal setting, problem solving, and decision making. Shared governance good example.

Answer 28

Democratic

Question 29

: provides little direction or guidance and will forgo decision making

Answer 29

Laissez-faire

Question 30

Today’s health care system requires ____________(or participative) management and transformational leadership

Answer 30

democratic

Question 31

transactional leaders

Answer 31

Focuses on day-to-day operations and is happy with the status-quo.
Rewards staff for desired work
Monitors work performance, and corrects as needed
Waits until problems occur, and then deals with it then.
(You do this, I’ll do that)

Question 32

transformational leaders

Answer 32

Commits to the organizational goals & mission; believes in teaching coaching, mentoring; seeks different perspectives; improves the work environment.
Are admired and emulated
Empower the work group
(We will work together to get this done)

Question 33

human skills are also considered

Answer 33

emtional intelligence

Question 34

technical skills is

Answer 34

clinical expertise and nrusing knowledge

Question 35

conceptual skills is

Answer 35

understanding how they fit in overal managment

Question 36

what do leaders do

Answer 36

orgainze
control 
reward
direct
staffing

Question 37

lewin’s stages of change

Answer 37

Unfreezing stage: change agent promotes problem identification and encourages awareness of the need for change
Moving stage: change agent clarifies the need to change, explores alternatives, defines goals and objectives, plans the change, and implements the change plan
Refreezing stage: change agent integrates the change into the organization

Question 38

using OARS

Answer 38

Open-ended questions or statements that require more information than yes or no
Affirmation
Reflection
Summary

Question 39

what is blocking communction

Answer 39

saying you have no idea

Question 40

peculiar mannerism is

Answer 40

ineffective engagement