Concept 41 - Leadership

The new director of case management assessed the need to improve the organization's patient satisfaction with the discharge process. Which statement below illustrates the vision that would lead the team to this goal? a. "The department will deliver reliable, collaborative, and compassionate discharge planning services to all patients." b. "The department will hold weekly meetings every Tuesday at 11:00 AM." c. "There will be implementation of a new uniform policy so staff can be readily identified." d. "Staff are encouraged to complain about difficult patients, families, and physicians."

ANS: A A vision is a statement about the long-term desired state for the department. The other choices describe specific actions, not a long-term vision statement.

The main features of complex adaptive systems that are relevant to nursing leadership are a. focused on creating organizational change and looking at the whole versus individual parts. b. defined by efforts of leadership to mandate organizational change. c. autocratic in nature with a top-down structure for change. d. dependent on employees knowing what change is necessary and acting independently.

ANS: A Complexity science posits that interactions of the parts within a system are more important than the individual parts. The autocratic top-down decision-making and mandates do not create a sustainable change. Being dependent on employees knowing what change is necessary and acting independently lacks interaction of leadership to stimulate change and adaptation among employees.

According to situational and contingency theory, which of the following is true? a. The theory challenges the concept that one leadership style is always best. b. The theory supports employee feelings, morale, and feedback during the change process. c. Motivation through inspiration and recognition is the focus for transforming employee behavior. d. A leader is someone who possesses great intelligence and decision-making authority.

ANS: A Situational and contingency theory challenges the assumption that there is "one best way" to lead. "The theory supports employee feelings, morale, and feedback during the change process" describes behavioral leadership. "Motivation through inspiration and recognition is the focus for transforming employee behavior" describes transformational leadership. "A leader is someone who possesses great intelligence and decision-making authority" describes Great Man or Trait theory.

To be an effective nursing leader today requires effective collaboration, which is modeled by which answer below? a. The nursing manager of the observation unit was certain the psychology department would assist the unit with a motivational plan, so she did not request their assistance. b. The nursing manager of the observation unit worked with the psychology department and physical therapy to develop a motivational plan for patients on the unit. c. The nursing director of behavioral health services followed the administrative directive to reduce services and refused to provide services for patients on other units. d. Frustrated by the trend of patients unwilling to work with therapy, the unit manager recommended that these patients be placed on another unit.

ANS: B The nursing manager works collaboratively with other departments to solve the patient care issue. In the other choices, the unit manager does not involve collaboration to resolve the patient concern.

The nursing unit director exhibits the definition of leadership in which of the following responses? a. The nurse manager refers the concern to the director of the department. b. The nurse manager corrects the concern with the patient directly and does not communicate her actions to the staff. c. The nurse manager meets with the staff to discuss the concern and identify solutions. d. The nurse manager tells the staff that they need to correct the situation by tomorrow and leaves the meeting.

ANS: C Leadership is defined as an interactive process that provides needed guidance and direction which is present in the correct answer. The other choices do not involve an interactive process with staff to resolve the concern.

The hospital must reduce the number of readmissions from 11% to 8% in the next year. Which of the following best represents the transformational leadership style in accomplishing this goal? a. The director communicates the goal of reducing readmissions to the hospital operations team and tells them to submit their action plan by the end of the week. b. The organization charters three work teams to identify solutions for the top three causes for readmissions. These teams are given full authority to implement their solution. c. The director of quality develops a vision statement and action plan to achieve the goal. The director works directly with the involved departments to implement the action plan. d. The CEO communicates the goal to the organizational directors and managers and states that they are entrusted to solve the problem.

ANS: C Transformational leaders communicate a vision and motivate employees to accomplish the goal. The director who communicates the goal of reducing readmissions to the hospital operations team and tells them to submit their action plan by the end of the week leaves the solution to achieve the goal to the followers to develop without motivating them. The solution that is left to the work teams to resolve is not an example of transformational leadership. The CEO entrusts the managers and directors to solve the problem without giving them a vision or engaging in the solution with them.

The clinical nurse leader needs to identify the staff who must go home due to low census. Which answer below describes a democratic style of decision making? a. The clinical nurse leader identifies the staff person with the most vacation and asks them to go home. b. The clinical nurse leader tells the last person to show up for their shift to go home. c. The clinical nurse leader decides not to send anyone home because it is too difficult to decide who should lose hours. d. The clinical nurse leader asks the group if any of them would like the opportunity to go home and selects staff who volunteer.

ANS: D Democratic leaders use a participatory style of decision making. In the other choices, the clinical nurse leader makes the decision independent of the staff.

The nurse who is certified as a Critical Care Registered Nurse (CCRN™) represents the unit on the organizational performance improvement team. This is an example of _____ leadership. a. formal b. unit c. organizational d. informal

ANS: D Informal leaders are recognized as leaders because of their capabilities and actions. Formal leaders are recognized because of the position they hold such as director or manager. Unit leadership refers to the leader of the particular unit. Organizational leadership refers to any leader within the organization.