Leadership Final

Critical Elements in Problem Solving and Decision Making

1. Define objectives clearly -Need to know goals or objectives -Decision made without clear objectives that is inconsistent with one's philosophy likely to be poor-quality decision -No clarity about which objective is most important makes decision making more difficult 2. Gather data carefully -ASK QUESTIONS 3. Generate many alternatives -Do not limit decision to just two options -One option is always to do nothing—status quo -Involve others in decision process -Brainstorming -Be open to unique options 4. Think logically -Inference—part of deductive thinking -Faulty logic may lead to poor-quality decision -Overgeneralizing -Affirming the consequences -Arguing from analogy -Use the tools you have available 5. Choose and act decisively -Must accept consequences of choices -Choices not cast in stone -Can be changed as new information is discovered -Learn from each decision for future situations -Evaluate each decision

Overcoming Individual Variations in Decision Making

1. The influence of gender Studies suggest gender plays a role. Women: Uncertainty, doubts, dynamism involved,Concerned about consequences Men:Assign more importance to analysis of information required to carry out decision,Definition of goals or purposes of decision 2. Values -Play a part—consciously or unconsciously -Influence information gathering, information processing, and final outcome -Awareness of personal beliefs and values is an essential component. -Helps the decision maker to overcome bias in his or her choices 3. Life experience -Each person brings past experiences into the decision-making process. -The more mature and broader background can bring more alternatives. -Past decision making will also influence future decisions. -Need to learn from past mistakes -Involve others to act as advisors 4. Individual preference -One alternative may be preferred over others. -Involves greater risk—choose safer alternative -Physical, economic, and emotional risks -Time and energy expenditures -Overcoming involves self-awareness, honesty, and risk taking -Nearly every decision has some element of risk; involves consequences and accountability

Motivation

A passion to work for reasons that go beyond money or status, a propensity to pursue goals with energy and commitment

An important addition to recent theories for solving problems and making decisions is to: A. Define objectives to guide decision making B. Identify the decision C. Collect data D. Implement the solution

A. Define objectives to guide decision making Rationale: Identifying objectives to guide the decision making helps the problem solver determine which criteria should be weighted most heavily in making his or her decision. It helps prevent the decision maker from becoming sidetracked.

Which of the following is not a recognized trait of a transformational leader? A. Traditional manager B. Has a vision C. Committed to vision D. Able to empower others with vision

A. Traditional manager Rationale: The traditional manager is termed a transactional leader; he or she is concerned with the day-to-day operations or transactions. A transformational leader is committed and leads followers toward the future.

A nurse managing a small team of workers would perform all functions of the management process based on the level of his or her responsibilities. A. True B. False

A. True Rationale: A nurse managing a small team of workers would plan patient care, organize the work to be done, provide staffing functions of team building, direct the work by delegating duties and managing any conflict, and provide control by evaluating patient care.

A successful development program to retrain employees is a proactive method to avoid obsolescence of skills. A. True B. False

A. True Rationale: Because of rapid changes in health care, especially in the areas of consumer demands and technology, employees may find that their skills have become obsolete. A successful development program begins to retrain employees proactively, providing them with the necessary skills to remain current in their field and, therefore, valuable to the organization.

A good way to tackle a difficult or complex task is to break it down into smaller tasks. A. True B. False

A. True Rationale: Breaking a difficult or complex task into smaller tasks helps to finish the project on time, helps prevent procrastination, and makes the project appear more manageable.

A more mature individual brings more alternatives to the decision-making process. A. True B. False

A. True Rationale: Each person brings past experiences into the decision-making process. The more mature, the broader his or her background, the more alternatives he or she can identify.

Employees at the lower levels in an organization are at risk of not receiving adequate communication from the higher levels. A. True B. False

A. True Rationale: In large organizations, it is impossible for individual managers to communicate personally with each person. Some employees may perceive that the communication is closed from the higher levels.

To be effective role models for the unit, managers must also be motivated. A. True B. False

A. True Rationale: Managers must be internally motivated before they can motivate others. A burned-out, tired manager will develop a lethargic and demotivated staff. They must do whatever is necessary to restore their motivation to be role models to the staff.

Highly emotional intelligent managers can create highly positive organizational climates." A. True B. False

A. True Rationale: Research done by Momeni (2009) found that emotional behaviors are the primary factors in determining how people in an organization feel about their workplace. His conclusion was that these highly emotional intelligent managers create highly positive organizational climates.

2 Steps in Time Management

Allow Time for planning and establish priorities Complete the highest priority task whenever possible and finish one task before beginning another Reprioritize based on the remaining tasks and on new information that may have been received.

The most frustrating type of leadership can be the: A. Democratic style B. Laissez-faire style C. Authoritarian style

B. Laissez-faire style Rationale: Laissez-faire style can be frustrating because group members may feel leaderless and group apathy and disinterest can occur due to its nondirected leadership.

A _________ is usually assigned to work with a new nurse and is a short-term relationship. A. Role model B. Preceptor C. Mentor

B. Preceptor Rationale: A preceptor is an experienced nurse who provides knowledge and emotional support on a one-to-one basis. Preceptors have a relatively short relationship with the person to whom they have been assigned

Which of the following would not be a strategy for preventing idle chatter for a manager with an open door policy? A. Interrupt gently and ask what the point is B. Working at the nursing station C. Schedule appointments for individuals with patterns of lengthy chatter D. Keep your own comments short and brief

B. Working at the nursing station Rationale: Working at the nursing station can encourage chatter.

Pitfalls in Decision Making

Base decisions on first impression -Confirmation biases Focus on event that leaves strong impression -Preconceived notions or biases Separate out decisions -Make alone -Need input from others

Which of the following is NOT a component of the Marquis-Huston Model for Teaching Critical Thinking? A. Group process B. Didactic theory C. Past experience D. Problem solving

C. Past experience Rationale: The Marquis-Huston Model for Teaching Critical Thinking comprises four overlapping spheres. They are didactic theory, problem solving, group process, and personalized learning

Extrinsic motivation

Comes from outside the person Rewards and reinforcements are given to encourage certain behaviors and/or levels of achievement

Intrinsic motivation

Comes from within the person Can be influenced by others

Transformational Leadership

Committed to group Has vision Able to empower others with this vision Provides energy to move toward future Identifies common values Is committed Inspires others with vision Has long term vision looks at effects empowers others

Decision making

Complex, cognitive process Choose particular course of action More than one possible course Must choose between alternatives Usually triggered by a problem Does not focus on eliminating underlying problem

Competency Assessment as Part of Career Development

Continued competence—challenge in professional nursing No national standards for defining, measuring, or requiring continuing competence in nursing Needs to be proactive The employee needs to identify areas of potential future growth and the manager should assist in identifying strategies that can help the employee achieve or exceed that goal.

The decision tool that allows one to visually examine the alternatives and compare each aspect against the same criteria is a: A. Decision tree B. Payoff table C. PERT D. Decision grid

D. Decision grid Rationale: A decision grid allows the same criteria to be used to analyze each alternative. It is possible to assign a numeric value to each criterion. This would result in a final numeric value that can assist with decision making.

Which of the following is a trait of a leader versus a manager? A. Assigned position by organization B. Manipulate others to achieve goal C. Direct unwilling subordinates D. Have a wider variety of roles

D. Have a wider variety of roles Rationale: A leader carries out many roles. Among other roles, they are often teachers, visionaries, decision makers, and mentors. Leaders have a combination of skills that make others want to follow them

Leadership responsibilities

Decision maker Communicator Evaluator Facillitator Risk taker Mentor Coach Counselor Teacher Critical thinker Buffer Advocate Visionary Forecaster Influencer Creative problem solver Change agent Diplomat Role model Innovator Most important: providing vision and being a mentor

Decision grids

Decision making tool that Allows one to visually examine alternatives and compare each

Payoff tables

Decision making tool that shows: -Cost-profit-volume relationship -Helpful when some quantitative information is available -Must determine probabilities -Use historical data -Do not guarantee correct decision, but assist in visualizing data

The Marquis-Huston Critical Thinking Teaching Model

Didactic theory:Present material Personalized learning:Learning is internalized. Group process: Discussions Problem solving:Formalized approach

Mentors

Distinctive interactive relationship between two individuals Make conscious decision to assist another Instill values and attitudes that accompany each role Lead by example Committing to personal relationship

Priority Setting: 3 categories of prioritization

Do not do" Reflect problems that will take care of themselves, outdated, better accomplished by someone else "Do later" Trivial problems, do not have immediate deadlines "Do now" Most commonly reflect day-to-day operational needs Put off earlier

Rational and administrative decision making (two types of management decision makers)

Economic: -Makes decisions in a very rational manner -Has complete knowledge of the problem or decision situation -Has a complete list of possible alternative -Has a rational system of ordering preference of alternatives -Selects the decision that will maximize utility function Administrative: -Makes decisions that are good enough -Because complete knowledge is not possible, knowledge is always fragmented -Because consequences of alternative occur in the future they are impossible to predict accurately -Usually chooses among a few alternatives, not all the possible ones -The final choice is satisfying rather than maximizing

Frederick Herzberg

Employees can be motivated by work; internal or personal need to meet organizational goals. Separate personal motivators from job dissatisfiers Hygiene or maintenance factors keep employees from being dissatisfied. Reward system must meet both motivation and hygiene needs. Hygiene factors do not motivate, are needed to create environment.

Socialization and the New Nurse

Encourage balanced life Ensure new nurse's values are supported and encouraged Internship versus orientation Assigned to work with preceptor and gradually take on patient assignment

Preceptor

Experienced nurse who provides knowledge and emotional support One-to-one basis Can also be a role model Decrease workload to allow time to work with the new nurse Offer incentive pay Adequate knowledge of adult learning theory Select only preceptors with strong desire to be role models Experienced staff development or supervisory personnel monitor preceptor and preceptee closely

Variables Affecting Organizational Communication

Formal organizational structure Lower levels at risk for inadequate communication at higher levels Employees may perceive the communication is closed at higher levels. Impossible for individual managers in large corporations to communicate personally with each person Subgroups or subcultures also affect what messages are sent and how they are perceived. Gender—significant factor

Leadership styles: Laissez-Faire

Frustrating Group may feel leaderless Little direction from leader-manager Appropriate when problems poorly defined and brainstorming needed Can result in much creativity and productivity

Good time management suggestions

Gather all supplies and equipment before starting an activity Group activities that are in the same location Use time estimates Document as soon as possible after activity completed\ End workday on time

Leadership Theories

Great Man theory Some people are born to be leaders. Trait theories Some people have personality characteristics and strengths that make them better leaders. Ignore effect of followers or situation

Strategies for Creating a Motivating Climate

Have clear expectations for workers, and communicate these expectations effectively Be fair and consistent when dealing with all employees Be a firm decision maker using an appropriate decision-making style Develop the concept of teamwork; develop group goals and projects that will build team spirit Integrate the staff's needs and wants with the organization's interests and purpose Know the uniqueness of each employee; let each know you understand his or her uniqueness Remove traditional blocks between the employee and the work to be done Provide experiences that challenge or "stretch" the employee and opportunities for growth When appropriate, request participation and input from all subordinates in decision making Whenever possible, give subordinates recognition and credit

Daily planning actions

Identify key priorities to be accomplished that day Determine level of achievement you expect for each task Assess staff assigned to work with you Review short- and long-term plans of the unit regularly Plan ahead for meetings; prepare agendas Allow time throughout the day to assess progress Take regularly scheduled breaks Use a planner or appointment book to organize the day

Creating a Motivating Climate

Important to examine organization climates or attitudes that directly influence worker morale and motivation Organizations frequently overtly or covertly reinforce the image that each employee is expendable. Employees are the organization's most valuable asset. Managers must be cognizant of employees' individual values and reward accordingly. Managers create climate that demonstrates positive regard for employees. Positive reinforcement Validate worker's efforts Constant negative feedback results in feeling punished for trying; the employee will give up. Should be consistent among all employees Must represent genuine accomplishment Annual merit pay recognized as "given" by employees

Poor time management leads to

Increased errors Omission of important tasks General feelings of stress and ineffectiveness

Role models

Individuals who inspire others to higher ideals Passive relationship

Stages of the mentoring relationship

Initiation Learning Growth Separation and redefinition

The Organization's Responsibility for Career Development

Integrating needs -Match openings with right employees Establishing career paths -Each successive jobs contain additional responsibilities and duties. -Must be communicated effectively to staff -May lose status when change organizations Disseminating career information Posting job openings -Encourage those who are ready to move up Assessing employees -Use good appraisal system to identify goals of employees Provide challenging assignments -Planned work experience Assign temporary positions to stretch employees Giving support and encouragement -Managers need to look beyond their units and consider the entire organization. Leaders recognize and share talent. Recognizing individual differences -Employees must decide for themselves. -Every person perceives success differently. Developing personnel policies -Recognize when policies and procedures impede success Providing education and training -Positively impacts retention

Characteristics associated with leadership

Intelligence Knowledge Judgement Decisiveness Oral Fluency Emotional Intelligence Personable Adaptability Creativity Cooperativeness Alertness Self confidence Personal integrity Emotional balance and control risk taking Ability Able to enlist cooperation Interpersonal skills Tact Diplomacy Prestige Social Participation Charisma

Brain hemisphere dominance and thinking styles

Left-Brain Thinkers Analytical Linear Language, logic, numbers, sequential ordering Mathematics, reading, planning, organizing Right-Brain Thinkers Creative Intuitive Nonverbal ideation Holistic synthesizing Images, music, colors, patterns Encourage whole-brain thinking Teams comprised of both produce well-rounded decisions. Ensures both intuitive and analytical approaches are used to solve problems Result in better-quality decision making

Leadership styles: Democratic

Less control Decision making involves others. Promotes autonomy and growth in individuals Less efficient quantitatively

Organizational Communication Strategies

Managers must assess organizational communication. Managers must understand the organization's structure and recognize who will be affected by decisions. Communication is not a one-way channel. Communication must be clear, simple, and precise. Senders should seek feedback regarding whether their communication was accurately received. Multiple communication methods should be used. Should not overwhelm subordinates with unnecessary information

Professional Support Systems for the Manager

Managers must constantly monitor their own motivational level. Must be internally motivated before they can motivate others Managers must practice health-seeking behaviors. Self-care -Important strategy for avoiding burnout -Seek time off on regular basis -Separate work life from personal life

Servant Leadership

Most successful managers are servant leaders. Top priority—serving others Three categories: Respect and value one as a unique individual Affirmation of professional judgment and fair treatment regarding workload Collaboration with supervisors and administrators in spirit of willingness

Traditional Problem-Solving Process

Most well-known and widely used 1. Identify the problem. 2. Gather data to analyze causes and consequences. 3. Explore alternative solutions. 4. Evaluate the alternatives. 5. Select the appropriate solution. 6. Implement the solution. 7. Evaluate the results. Effective model Weakness: Amount of time needed for proper implementation Lacks initial objective-setting step Easy to become sidetracked

Herzberg's Motivator and Hygiene Factors

Motivators: Achievement Recognition Work Responsibility Advancement Possibility for growth Hygiene Factors: Salary Supervision Job Security Positive working conditions Personal Life Interpersonal Relationships and peers Company policy Status

Elements of Nonverbal Communication

Must examine in the context of verbal content If verbal and nonverbal are incongruent, the nonverbal is more creditable. Nonverbal behavior frequently misinterpreted Many lead to communication problems Various nonverbal clues *Space -Invisible zone of comfort -Social norm *Environment -Where is the communication occurring *Appearance *Eye contact -Strongly influenced by cultural standards *Posture -Body language *Gestures -Cultural meaning -Can add emphasis or distract -Be careful of touching *Facial expression and timing -Should agree with the message *Vocal expression -Vocal clues such as tone, volume, inflection add to message -Tentative statements sound more like questions than statements. Effective leaders make sure verbal and nonverbal communications agree.

Can Managers motivate?

NO

Characteristics of a Critical Thinker

Open to new ideas Intuitive Energetic Analytical Persistent Assertive Flexible Empathetic Caring Observant Risk Taker Resourceful "outside the box" thinker Creative Insightful Willing to take action Outcome Directed Willing to change Knowledgeable Circular thinking

B. F. Skinner

Operant conditioning and behavior modification People can be conditioned to behave in a certain way based on consistent reward or punishment system. Is reflected today in way many managers view and use discipline and rewards in work setting

Problem solving

Part of decision making, last step Systematic process Always includes decision-making step Attempts to identify root problem May require much time and energy to identify the root problem

Abraham Maslow

People are motivated to satisfy certain needs. People are motivated by needs other than economic security. Motivation is internalized. Management must help employees meet lower needs. Self actualization> Esteem> Social Love>Security and Safety> Psychological/Basic Needs

Schein's model had following assumptions:

People are very complex and highly variable; multiple motives for doing things. Motives do not stay constant; change over time. Goals can differ in various situations. Performance and productivity affected by nature of task and ability, experience and motivation of individuals No single leadership strategy is effective in every situation.

Management Responsibilities

Planning -Determining philosophy, goals, objectives, policies, procedures, and rules -Carry out long- and short-range projections -Determine fiscal course of action -Manage planned change Organizing -Establish structure -Determine most appropriate type of patient care delivery -Group activities to meet goals -Work within structure -Use power and authority appropriately Staffing -Recruiting, interviewing, hiring, orientation -Scheduling -Staff development -Employee socialization -Team building DirectingMotivating -Managing conflict -Delegation -Communication -Collaboration Controlling -Performance appraisals -Fiscal accountability -Quality control -Legal and ethical control -Profession and collegial

Effect of organizational power

Powerful people in organization make decisions based on their own preferences and values. People with little power make decisions based on preference of the powerful. Need balance between limitations of choice and totally independent decision making "Going along"

Individual Responsibility for Staff Development

Professional advancement and personal growth limited by lack of goals or plan Career planning -Evaluate one's strengths and weaknesses -Set goals -Examine career opportunities -Prepare for potential opportunities -Use appropriate developmental activities

Leadership

Profound effect upon organizations Carry out many roles Combination of skills and personality traits -Often do not have delegated authority but obtain power through other means, such as influence. -Have a wider variety of roles than managers -May or may not be a part of the formal hierarchy of the organization -Focus on group process, information gathering, feedback and empowering others -Directs willing followers

Career Stages

Promise: -Early career (first 10 years) -Reality overload common as a result of inexperience -Focus is on role socialization, expertise building, and defining career goals. Momentum -Mid career (11 to 29 years) -Experience, mastery, and accomplishment -Challenge is avoiding stagnation Harvest -Late career -30 to 40 years = prime ->40 years = legacy -Legacy guilt on lifetime of accomplishments and expertise -The goal is to avoid obsolescence by identifying new strategies for contributing to the profession.

Interactional Leadership

Proposed by Schein (1970) Working environment is an open system to which humans respond. System: set of objects, with relationships between objects and their attributes Open system: exchanges matter, energy, or information with environment

Justifications for Career Development

Reduced employee attrition Equal employment opportunity Improved use of personnel Improved quality of work life Improved competitiveness of the organization Obsolescence avoided and new skills acquired Evidence-based practice promoted

Cultural Bridging

Result of ethnic diversity Global migration of all populations A nurse needs to understand the culture of his or her patients to avoid stereotyping. Serving as cultural bridge requires seeking out and respecting other view points. Create work environment where cultural differences are recognized and valued

Manager PREplanning

Staffing schedules Patient care assignments Coordination of lunch- and work-break schedules Coordination of patient care

Managerial Decision-Making Models

Step 1: Determine the decision and desired outcome. Must identify decision to be made Identify who is involved Timeline for the decision Goals and outcomes that should be achieved Identifying objectives helps guide which criteria should be used to determine decision. Step 2: Research and identify options. Identify as many alternatives as possible Step 3: Compare and contrast options and consequences. Use SWOT analysis Strengths Weakness Opportunities Threats Step 4: Make a decision. Rank alternatives from step 3 Step 5: Implement an action plan. Create plan from desirable alternatives or combination of alternatives Step 6: Evaluate results. Identify challenges to successful implementation Evaluate process and outcome

Management:

Successfully controlling something Directing and supervising others Different levels -Are assigned a position by the organization -Have a legitimate source of power due to delegated authority that accompanies their position -Have specific duties and responsibilities they are expected to carry out -Emphasize control, decision making, decision analysis and results -Manipulate people, the environment, money, time, and other resources to achieve the goals of the organization -Have a greater formal responsibility and accountability for rationality and control than leaders -Direct willing and unwilling subordinates

Time wasters

Technology: -Instantaneous, asynchronous communication -Social networking -Offers easy distraction -Need to respond to various method -Need to find balance between need for virtual and face-to-face interaction and between work and personal life Socializing: -Colleagues and personal phone calls -Open door policy -Discourage idle chatter -Do not make self overly accessible -Interrupt -Avoid promoting socializing -Be brief -Make appointments Paperwork overload and poor filing system: -Multiple reports, requests, memos, etc. -Handle each piece once -Handle the day it arrives -Throw away or file -Consider increased use of computerization -Create workspace

Telephone Communication

Telephone Communication is very important. When Communicating by telephone, always follow up with a form of written communication (email or note) to ensure that the message was understood. Written communication is most easily misunderstood (email). When receiving a provider's order over the telephone, repeat what the order is before hanging the telephone up. When receiving a provider's order over the telephone and the provider is difficult to understand, have another nurse listen on another telephone to ensure that the order is correct. Always ask the provider to repeat what was said if you are unsure about the order.

Self Awareness

The ability to recognize and understand one's moods, emotions and drives as well as their effects on others

Empathy

The ability to understand and accept the emotional makeup of other people

Motivation

The force within the individual that influences or directs behaviors

Leadership styles: Authoritarian

Tight control, predictable actions, reduced frustration, feeling of security Productivity usually high Creativity, self-motivation, autonomy reduced Often necessary and appropriate in emergency situations

Transactional Leadership

Traditional manager Concerned with day-to-day operations Focuses on management tasks Is a caretaker Uses trade offs to meet goals Does not identify shared values Examines causes Uses contingency reward

Approaches to Problem Solving and Decision Making

Trial and error Rule of thumb Unconscious process Are not fail-safe methods Make decisions too quickly Do not look at alternatives Many problem-solving models exist.

Channels of communication

Upward: From subordinate to superior Downward: From superior to subordinate Horizontal: From peer to peer Diagonal: Between individuals at differing hierarchy levels and job classifications Grapevine: Informal, haphazard and random, usually involving small groups

Intuitive Decision Making

Used as an adjunct to empirical or rational decision-making models Following one's gut Dark side—misjudgment Decisions should be founded on nursing's scientific knowledge base.

Communication Modes

Written communication Face-to-face communication Telephone communication Nonverbal communication

Emotional Intelligence (EI)

a.k.a. Emotional Quotient (EQ) Understanding and recognizing oneself and others' abilities, perception, and attitudes Develops with age Mental process of appraising and expressing emotions Regulates emotion in self and others Uses emotions in adaptive ways Goal to reach emotional literacy

Critical thinking

a.k.a. reflective thinking Related to evaluation Broader scope than decision making and problem solving Requires conceptualizing, applying, analyzing, synthesizing, and evaluating information More complex; involves higher-order reasoning and evaluation

Socialization and the New Nurse: Anticipatory socialization

carried out in educational settings to help prepare new nurses for their professional roles

Socialization and the New Nurse: Reality shock

conflict and frustration in transition from student to nurse due to different value sets by professional staff involved with socializing new nurse; can lead to burnout and emotional exhaustion

Competence

having the abilities to meet the requirements for a particular role Various resources: State board licensure National certification Performance review Self-administered checklists Record audits Peer evaluation

Socialization and the New Nurse: Socialization

learning the behaviors that accompany each role by instruction, observation, and trial and error

Time management

making optimal use of available time Management of self

Socialization and the New Nurse: Role overload

managers can help new nurses to develop coping skills.

Start the day by:

planning priorities that MUST be accomplished

social skills

proficiency in handleing relationships and building networks; and ability to find common ground

Leader-managers create work environments

that both organizational and individual needs are met.

Self regulation

the ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgement

Communication

the exchange of thoughts, messages, or information, by speech, signals, writing, or behavior Occurs on at least two levels: verbal and nonverbal Many models exist to explain communication.

Who is responsible for finding responsible work?

the individual

What is the organizations responsibility?

to create work environments that appreciate workers for contributing their talent and energy