LEADERSHIP FINAL
What is physical attack or abuse of a nurse known as? What is the consequence?
Class D felony *7 years in prison!
Who should have the right to file grievances?
EVERYONE
What is mandatory overtime?
Employees are forced to work additional shifts, often under threat of patient abandonment
What is used when difference cannot be settled through grievance process?
arbitration
What are common interview mistakes?
arriving too early saying too much wearing wrong colors asking about salary/vacation too early
What is the focus of transition to practice programs?
bridge nursing students from school to employment
What are three forms of workplace violence?
bullying incivility mobbing
What are some common conflict resolution strategies?
compromising competing cooperating smoothing avoiding
What is a lateral transfer?
employee moves to another unit with same role
What is an accommodating transfer?
employee receives same salary with reduction in energy expenditure
What is a downward transfer?
employee takes position within organization that is below her level
Define mobbing
employees gang up on someone
What mainly affects unionization rates?
employees perceptions of their supervision quality
Describe promise
first 10 years of employments (building knowledge, gaining exposure, building confidence)
What should you focus on with conflict? What should you not focus on?
focus on causes of disagreement and not personalities
Define discipline
form of punishment but not the same thing! designed to train a character to bring about desired behaviors
What is Douglas McGregor's Hot Stove Rule?
four elements must be present to make discipline fair
What are group norms?
group-established standards of expected behavior that are enforced by social pressure
What states have the most unions?
hawaii, new york, california, pennsylvania, michigan, and illinois
Define induction
includes all activites that educate new employee about organization
Historically, when does union membership.activity increase and decrease?
increases during high employment decreases during economic recessions
Why is nursing demand expected to grow in the future?
increasing emphasis on preventative health care
What two things does group norms affect?
individual behavior and self-discipline
What are the three phases of employee indoctrination?
induction orientation individual orientation
Define fiscal accountability in healthcare
it should be possible to stay within staffing budget and meets patient needs
What does not disciplining an employee who should be disciplined do?
jeopardizes an organization's morale
What is a common limitation of the interview process?
mixed reliability and validity
Define collective bargaining
negotiation of wages and other conditions of employment by an organized body of employees.
What are common effects of workplace violence?
physical effects (pain) mental distress fatigue depression suicide
What does employee have the right to with grievances?
positive work environment and express discontent responsibly
What is the goal of discipline?
provide motivation to improve (emphasis on changing negative behaviors)
What should always be the last resort with discipline?
termination (only necessary for employees who continue to break rules depsite warnings)
What are some examples of factors that affect staffing needs?
source of nursing pools number of students in school knowledge level of staff budget constraints high patient census
Define diversion
when nurses take drugs designated for patient use
What is closed-unit staffing?
when staff members make a commitment to cover all absences and needed extra help themselves in return for not being pulled from the unit in times of low census
What is the historical relationship of the economy and nursing shortages?
when the economy improves, nursing shortages occur
What is job sharing?
when two part-time employees share one full-time job
What is the most frequent source of narcotics?
workplace theft from machines
What are reentry guidelines for recovering nurse?
employee assigned to day shift for first year, paired with successfully recovered nurse, proof of continuing involvement with AA, and willing to consent to random urine screenings
What two stages occur at the same time?
felt and percieved
What is the effect of too little conflict in work environments?
organizations stasis
What is smoothing?
reduction of emotional component of conflict
What is the major defect of an interview?
subjectivity
What is another term for management development?
succession planning
What are the two forms of career coaching?
short term and long term
What are common scheduling options for healthcare organizations?
1. 10/12 hour shifts 2. premium pay for weekends 3. part-time staffing pool for weekends/holidays 4. job sharing
What are three workload measurement tools?
1. NCH/PPD (nursing care hours/patient day) 2. PCSs 3. workload measurement systems
What are the five generations of nursing?
1. silent generation (1925-1942) 2. baby boomer (1943-1960) 3. gen x (1960-1980) 4. gen y (1980-190) 5. gen z (1996-2015)
What are the three minimum staffing criteria?
1. staffing must meet laws/policies 2. staff must not be excessively fatigued by overtime 3. no patient care in jeopardy
What are two examples of nursing unions?
1. american nurses association 2. united steelworkers of america
For what seven reasons do nurses not join unions?
1. believe unions promote welfare state 2. demonstrate individualism 3. don't believe in unions 4. support of management 5. fear of consequences 6. fear of lost income with strikes 7. fear of peer judgement (viewed as scabs!)
What are three weaknesses of decentralized staffing?
1. can lead to arbitrary treatment 2. not cost-effective b/c staff needs are not holistic 3. more time-consuming for unit manager
How can management avert unions?
1. care for employees 2. communicated policies 3. procedures for handling employee grievances 4. competitive wages 5. job security = job performance
What are other common scheduling options?
1. float pools/supplemental staffing 2. shift bidding
What are the four elements of the hot stove rule?
1. forewarning 2. immediate consequences 3. consistency 4. impartiality
What are two pros of 12 hour shifts?
1. high level of satisfaction (less days worked/more free time) 2. solutions for difficulties with childcare
What are two cons of 12-hour shifts?
1. higher rates of burnout/job dissatisfaction 2. sleep deprivation increases disease risk
For what six reasons do nurses join unions?
1. increases power of the individual 2. increases input into organizational decision making 3. eliminate discrimination/favoritism 4. social need for acceptance 5. required by employer 6. improve patient outcomes
What are the three forms of conflict?
1. intrapersonal 2. interpersonal 3. intergroup
What are three strengths of decentralized staffing?
1. manager retains control 2. staff take requests directly to manager 3. provider greater autonomy/flexibility for staff
What are four types of alternative dispute resolutions?
1. mediation 2. fact-finding 3. due process hearing 4. ombudsperson
What are six reasons for nursing shortages?
1. nationwide downsizing of hospitals 2. aging of nursing workforce 3. accelerating demand for professional nurses 4. inadequate enrollment in nursing programs 5. aging of nursing faculty 6. resignations during pandemic
What four perspectives should a manager be able to see collective bargaining from?
1. organization 2. worker 3. general history 4. personal
What are four strengths of centralized staffing?
1. organization-wide view of staffing needs 2. impartial staffing policies 3. cost-effective 4. increased time for manager for other tasks
What are two weaknesses of centralized staffing?
1. provides less flexibility for worker/doesn't account for special needs 2. managers less responsive to personnel budget control
What are the four common steps in progressive discipline?
1. verbal admonishment (informal) 2. written admonishment (formal) 3. suspension from work without pay 4. dismissal
What makes nursing unions complex?
1. who can belong to them? 2. supervisor definition 3. ethical justification of strikes
If a rule is consistently broken, what two questions should be asked?
1. whose rule is it? 2. do we still need the rule?
What are the three conflict outcomes? Which is most optimal?
1. win-win (optimal) 2. win-lose 3. lose-lose
Nurses must work more than what percent of their time as charge nurse to be ineligible for union protection under NLRA?
15%
In 2018, what percent of nurses belong to unions?
18%
How long do certifications normally last?
5 years
What is collaborating?
An assertive and cooperative means of conflict resolution whereby all parties set aside their original goals and work together to establish a supraordinate or common priority goal (win-win!)
Who states that nurses develop skills through education and experience? (journey from novice to expert)
Benner
TRUE OR FALSE: centralized and decentralized staffing is synonymous with centralized and decentralized decision making
FALSE
TRUE OR FALSE: conflict is always viewed as bad
FALSE (neither good or bad!)
TRUE OR FALSE: nursing unions focus primarily on monetary negotiations
FALSE (staffing, float provisions, scheduling)
TRUE OR FALSE: you should concentrate on agreement with conflict
FALSE (understanding instead!)
Do high interview assessments always correlate with high level job performance?
NO
What law allows employees the right to participate in unions?
National Labor Relations Act (NLRA)
TRUE OR FALSE: PCS participation requires Joint Commission certification
TRUE
TRUE OR FALSE: after the interview, the applicant should send a thank you note
TRUE
TRUE OR FALSE: as a nurse, you have the right to call 911 if abused
TRUE
TRUE OR FALSE: chemical impairment rate is higher with nurses
TRUE
TRUE OR FALSE: consensus is always an appropriate goal in resolving conflicts/negotiation
TRUE
TRUE OR FALSE: high demand for nurses correlates with increased union activity
TRUE
TRUE OR FALSE: manager should not nurture or counsel addicted employee
TRUE
TRUE OR FALSE: never tell the other party you are willing to negotiate totally
TRUE
TRUE OR FALSE: once management is faced with bargaining agent, it can either accept or oppose
TRUE
TRUE OR FALSE: rule breaking is allowed to go unpunished
TRUE
TRUE OR FALSE: subjectivity can never be totally eliminated
TRUE
TRUE OR FALSE: traditional discipline is not constructive in modifying marginal employee behavior
TRUE
TRUE OR FALSE: the slate should be wiped clean at the end of progressive discipline
TRUE (for all but most serious infractions)
TRUE OR FALSE: some level of turnover is desirable
TRUE (infuses fresh ideas!)
TRUE OR FALSE: as RN hours decrease, adverse patient outcomes increase
TRUE (like med errors, patient falls, decreased pt. satisfaction)
TRUE OR FALSE: negative info about applicant is often weighted more heavily than postive
TRUE (most decisions about applicant are made in first 30 seconds)
TRUE OR FALSE: mandatory overtime is neither efficient nor effective in the long or short-term
TRUE (poor staff perceptions about control)
What is arbitration?
a settlement negotiated by an outside party
What is bullying?
abusive conduct that is threatening or intimidating in nature
What are some illegal interview inquiries?
age marital status children race sex preference religion credit status
What other things make healthcare scheduling unique?
agency nurses travel nurses flextime self-scheduling float pools
What is shift bidding?
allows nurses to bid for shifts rather than requiring mandatory overtime
What do you use when parties cannot reach agreement through negotiation?
alternative dispute resolution
What should an applicant always do during an interview?
ask questions for employer!
What are some examples of patient classification systems? (PCS)
bathing, diet, IV fluids, medications, positioning
What is the only state that has enacted mandatory staffing ratios?
california
What is the outcome of avoiding?
conflict remains and remmerges later in worse form
What are three forms of discipline?
constructive destructive self
What is a major part of career management?
continued competency
What is the opposite of competing?
cooperating/accomodating
What are the two forms of staffing?
decentralized and centralized
What is incivility?
describes mistreatment or discourtesy to another person
What are marginal employees?
disrupt unit functioning because work only meets minimal standards
What should leaders prioritize when making staffing decisions
diversity! staff should mirror diversity of patient communitites
What type of conflict is always viewed as bad?
dysfunctional conflict
What is decentralized staffing?
each department is responsible for its own staffing
Define compromising
each party gives up something it wants
What is the goal of a diversion program?
early identification of impaired nurses and treatment services for them
What can emotional nurturing of impaired nurse by manager lead to?
enabling!
What are some tips for negotiation closure?
end on a friendly note hide astonishment at success follow up with a memo
What should selection be based on?
established criteria (not value judgements)
What are examples of incivility?
eye-rolling, nonverbal behaviors, sarcastic comments and extends to physically threatening behaviors
Define conflict
internal or external discord as a result of difference in ideas or values
In unstructured interviews, who talks more?
interviewer
What is the most common method for employee selection?
interviewing
What is the most time-consuming and costliest selection tool?
interviewing
What should mandatory overtime be used as?
last resort!
Describe harvest
late career; establishing a legacy and sage practice
What are the five stages of conflict?
latent, perceived, felt, manifest, aftermath
What are the four types of employee transfers?
lateral downward accomodating inappropriate
What is substance misuse?
maladaptive patterns of substance abuse continued even when faced with problems/danger
What is performance deficiency coaching?
manager works with employee to correct unacceptable behavior
Describe momentum
middle career phase (11-29 years); gaining mastery and establishing a professional track record
How do managers respond to conflict?
non-traditionally! (can no longer afford to avoid/suppress it because its nonproductive)
What is the main task for the nurse with PCS?
note frequency of occurrence of task/activity
What is the formula for calculating nursing hours per patient day?
nursing hours worked in 24 hrs/patient census
Define competing
one party pursues what it wants, regardless of the cost to others (win-lose!)
What is cooperating?
one party sacrifices own beliefs to allow other party to win (win-lose!)
What is avoiding?
parties are aware of a conflict but choose not to acknowledge it or attempt to resolve it
What two things must staffing consider?
patient acuity and expertise of workers
Define recruiting
process of actively seeking out or attracting applicants for existing positions
What should all nurses maintain to reflect their professional growth?
professional nursing portfolio
What are the three career stages?
promise momentum harvest
What is the effect of too much conflict in work environments?
redcued organizational effectiveness
What two aspects carry the most weight when making hiring decisions?
requirements of job and personal bias
What things require staffing policies in healthcare?
sick leave vacations holidays call-offs for low census on-call pay tardiness/absenteeism shift work
Define chemical impairment
resulting from drug or alcohol addiction
What is the most effective form of discpline?
self-discipline (can only occur is subordinates accept rules as valid)
What is the third phase of the management process?
staffing by the leader-manager
What is centralized staffing?
staffing decisions are made by personnel in a central office of staffing center
What should occur at the termination conference?
state facts of case explain termination process ask for employee input end meeting on positive note
What should occur at a disciplinary conference?
state problem explain disciplinary action agreement for plan
What is a grievance procedure?
statement of wrongdoing to follow when one believe a wrong has been committed
What are the two forms of interviews?
structured (better predictor of job performance!) and unstructured
What is the best way to optimize reliability in interviews?
structured and same interview format by all interviewers
What is management development?
system of training people to acquire skills to effectively manage people
Define orientation
teaches activities that are specific to position
What increases the validity within the selection process?
team approach
Define retention
the key to adequate staffing in the long-term (requires positive work environment!)
What is the greatest challenge in consensus building?
time
What is late-stage chemical dependency?
tolerance is developed and employee requires high amounts, experiences no pleasure, and exhibits defensiveness
Define punishment
undesirable event that follows unacceptable behavior
Define individual orientation
unique to each department
What is the best way to overcome interview limitations?
use team approach and use structured format (do multiple interviews!)
What is staffing by acuity?
using a patient classification system to group pts. by characteristics (different hours of nursing care for each patient classification)
What is the expectation of a organizational bullying policy?
zero tolerance
