Week 8: Leadership and management Flashcards
RN will base priorities on evidence such as __________
Shift reports Communication from other members of HC team Review of EHR Assessments and patient data Patient or family concern
How can you prioritize principles in client care
life before limb
acute before chronic
stable before unstable
urgent over non-urgent
priority setting framework
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
why is delegation used
to have nurses work at their full scope of practice
What can RN not delegate
TAPE T-teach A-assessment P-plan E-evalation
how do you know if u can delegate
Right task. Right circumstance. Right person. Right supervision. Right direction and communication
what can LPN do
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
what are the five rights to delegation
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
LPN can
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
UAP can
I&O Vital signs (stable client) Feeding (no swallow precautions) ADLs Positioning Bedlinen changes Ambulation
Novice nurse barriers
Fear of being disliked, losing control, taking risks, and making mistakes
Lack of confidence
Lack of knowledge
__________: ability to guide or influence others to achieve a desired outcome
leadership
________-: coordination of resources (time, people, supplies) to achieve outcomes
managment
what is power vs authority
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)
________power- the ability to reward others for complying to what the leader or manager expects
reward
________ power – the opposite of reward power – based on fear of punishment
Coercive
_______power – based on an official position
Legitimate
__________power – follower’s identification with the leader based on respect or admiration
Referent
_______power – based on knowledge, skills and information.
expert
________ power – person has information that is needed by others
Information
Connection power – based on relationship with people who are powerful
connection
Have an appointed management position and a formal line of authority and accountability
managers
- Challenging the process: your generation needs to
leader
Formal leadership
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
