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
Informal leadership
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
: makes all decisions with no staff input and uses the position to accomplish goals
Authoritarian
: strict chain of command, strict regulations. Union hospital processes are a good example
Bureaucratic
: encourages staff involvement in goal setting, problem solving, and decision making. Shared governance good example.
Democratic
: provides little direction or guidance and will forgo decision making
Laissez-faire
Today’s health care system requires ____________(or participative) management and transformational leadership
democratic
transactional leaders
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)
transformational leaders
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)
human skills are also considered
emtional intelligence
technical skills is
clinical expertise and nrusing knowledge
conceptual skills is
understanding how they fit in overal managment
what do leaders do
orgainze control reward direct staffing
lewin’s stages of change
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
using OARS
Open-ended questions or statements that require more information than yes or no
Affirmation
Reflection
Summary
what is blocking communction
saying you have no idea
peculiar mannerism is
ineffective engagement
