Leadership Midterm

What is problem solving?

implies something is wrong or at least not right and it needs to be examined to determine the source and generate options to based the decision upon it includes critical thinking and decision making its about finding solutions

What is decision making?

*a complex cognitive process or choosing a particular course of action, the thought process of selecting a logical choice from available options* Implies that there are at least 2 options to have been presented as possibilities for action it is the process of selecting the best option nurses used ADPIE to make decisions and solve problems

What is critical thinking?

*the mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach an answer* a process of making meaning of information through evaluation and judgment it involves analyzing and questioning information--> *improve critical thinking by questioning everything*

Ways to promote ethical behavior (4)

- Separate legal and ethical issues - collab through ethics committees - use IRBs appropriately - Foster ethical work environment

What leader-member exchange theory of leadership?

- good leader is a result of 2-way relationship between managers and employees/leaders and followers -leaders must connect to followers through trust, respect, support, loyalty

Define democratic style (include example)

- includes the group when decisions are made, opinions of others are valued - motivates by supporting staff achievements -work output is usually good quality, good for when cooperation, and collaboration are necessary -communication occurs up and down chain of command -effective when teamwork is needed

Define informed, implied and express consent

- informed: obtained only after the patient receives full disclosure of all pertinent information regarding the surgery or procedure and only if the patient understands the potential benefits and risks associated with doing so. the person(s) giving consent must fully comprehend The procedure to be performed The risks involved Expected or desired outcomes Expected complications or side effects that may occur as a result of treatment Alternative treatments that are available -implied: the physician states in the progress notes of the medical record that the patient is unable to sign but that treatment is immediately needed and is in the patient's best interest. Usually, this type of implied consent must be validated by another physician. -express: A type of informed consent. Express consent is given when patients sign a standard consent form, medical waiver or make a clear verbal statement in an emergency situation. The nurse's role is to be sure the patient has received informed consent and to seek remedy if they have not. ** nurse can only witness consent, that's it that's their job Consent may be given by A competent adult A legal guardian/durable power of attorney An emancipated or married minor A mature minor (varies by state) A parent of a minor child A court order

Define laissez-faire (include example)

-"hands- off" -makes very few decisions and does little planning - motivation is the responsibility of individual staff members -work output is usually low unless an informal leader evolves -communication occurs up and down chain of command -effective with professional employees -ex: those who work from home like in IT departments

Define authoritative style (include example)

-Makes decisions for group -motivates by coercion -work output for staff is usually high, good for crisis or bureaucratic settings (government, armies, code situations) -communication occurs down chain of command -effective for employees with little or no education -staff satisfaction with job goes down

what is contingency theory of leadership?

-a leaders effectiveness is contingent upon how their style matches the situation -*no one leadership style is ideal for every situation* -to be an effective leader, how well does your style match the situation? ex: using a democratic leadership in a group collaboration/teamwork situation = effective

Beneficence vs nonmaleficence

Beneficence is care that is in the clients best interest, these are Actions are taken to PROMOTE GOOD, Nonmaleficence is the nurse's obligation to avoid causing harm to the clients, these are actions are taken to AVOID HARM *if the actions one takes cannot do good, then one should at least take actions that do not harm

Patient rights'

Bill of rights: helps pts feel comfortable in the system, stresses strong pt-provider relationship 2010: Affordable care act: gives pt protection in dealing with insurance companies

Define: -autonomy -veracity -fidelity -beneficence -nonmaleficence -justice -confidentiality -utilitarianism -paternalism

-autonomy: self-determination and freedom of choice -veracity: obligation to tell the truth -fidelity: moral obligation to keep promises -beneficence: Actions are taken to promote good -nonmaleficence: Actions are taken to avoid harm -justice: in pursuit of fairness, "equals" should be treated equally, and "unequals" should be treated according to their differences -confidentiality: keep privilege information private -utilitarianism: The good of the many outweighs the wants or needs of the individual -paternalism: One individual assumes the right to make decisions for another

Theories of Management include: (3)

-bureaucratic, administrative, scientific -they emphasize hierarchy, specialized roles, and single leadership for optimized efficiency in the workplace.

Professional code of ethics

-code of ethics is a set of principles, established by a profession. to guide practitioners -ANA made the first code of ethics for nurse -professional ethics do not have the power of law, they serve as a guide to the highest standard of ethical practices for nurses

what is situational theory of leadership?

-emphasizes there is no ideal style of leadership -it depends on the situation you face and the type of leadership strategy you then choose because of the situation -the most effective leaders change their leadership style to match the situation *leaders should adapt their style to match the situation* *depending on situation, leader will change their style to match it *

Areas requiring nurse-patient advocacy

-end-of-life decisions -technological advances - access to health care - older adults -respect for pt dignity -inadequate consents - provider-patient conflicts -insurance authorizations, denials, coverage delays -patient information disclosure -patient grievance and appeal process

How can nurses advocate?

-help others make informed decisions -act as intermediaries in the environment -directly intervene on others behalf -advocate for social justice

Common causes of RN License Revocation:

-malpractice -practicing medicine/nursing without license -obtaining license by fraud/letting others use your license -felony conviction -participating illegal abortions -not reporting substandard care - caring for patients while under the influences of alcohol/drugs -giving narcotics without order - false holding oneself as a nurse practitioner -working under expired license

What is servant leadership?

-needs of employees, organization, and community first -focus on betterment of subordinates -they share power and empower employees to perform at their best **seek to elevate those in their charge, support their development and nurture their career growth** - its based on the belief that the most effective leaders strive to serve others *these leaders may also develop followers who engage in serving behaviors*

Identify some characteristics of a critical thinker: (7)

-open to new ideas -flexible -caring -observant -think outside the box -intuitive -analytical

The Board of Registered Nursing Protects citizens by:

-rn licensing - monitoring rn educational standards - rn continuing education -disciplining rns ** nursing licensure is a privilege not a right!

3 reasons for change

-solve some problems -make work procedures more efficient -reduce unnecessary workload

Legal Terms: -stare decisis -res judicata -respondeat superior -res ipsa loquitur

-stare decisis: to let the decision stand, decisions are based on precedent -res judicata: thing or matter settled by judgment -respondeat superior: the master is responsible for the acts of his servants -res ipsa loquitur: the thing speaks for itself

What is ethics?

-the systematic study of what a person's conduct and actions should be regarding self, other human beings, and the environment; -it is the justification of what is right or good and the study of what a person's life and relationships should be, not necessarily what they are. -Ethics is a system of moral conduct and principles that guides one's actions regarding right and wrong, oneself, and society at large -*concerend with doing the right thing although it is not always clear what that is!*

What are the Ethical Principles (9):

1. Autonomy 2. Veracity 3. Fidelity 4. Beneficence 5. Nonmaleficence 6. Justice 7. Confidentiality 8. Utilitarianism 9. Paternalism

** 5 COMPONENTS OF EI:

1. SOCIAL SKILLS 2. SELF-REGULATION 3. SELF-AWARENESS 4. EMPATHY 5. MOTIVATION

Principles of organized planning (6):

1. all plans must flow from other plans, short range plans must be congruent with long range plans 2. planning in all areas of the organization must follow the mission, philosophy, and goals of the overall organization 3. planning involves the same process regardless of period involved 4. length of plan is determined by what actions are needed to make plan successful 5. all planning must include an evaluation step and requires periodic reevaluation and prioritization 6. all people and organizational units affected by planning should be included in planning

Mental processes in EI (3):

1. appraising and expressing emotions in self and others 2. regulating emotion in self and others 3. using emotion in adaptive ways

Managerial decision making process (6 steps)

1. determine desired outcome 2. research and identify options 3. compare and contrast these options 4. make decision 5. implement an action plan 6. evaluate results

Problem solving process: (7 steps)

1. identify problem 2. gather data to identify causes and consequences of the problem 3. explore solutions 4. evaluate each solution 5. select appropriate solution 6. implement solution 7 evaluate results *weakness lies in the time it takes to implement (it takes time to weigh pros and cons of each solution)*

managers vs. leaders: (10 differences)

1. mangers- control; leaders influences 2. managers- internal focus (day-to-day tasks); leaders- external focus (look beyond immediate context to focus on broader environment) 3. mangers- today (address current issues and short term goals), leader- tomorrow (setting a vision, future focused and long-term goals) 4. mangers- organizational emphasis; leaders- environmental emphasis 5. managers- employees are liabilities; leaders- followers are valuable human capital/ are resources 6. managers- enforce discipline; leaders- encourage imagination 7. managers- task completion; leaders- provide direction by setting compelling vision 8. managers- prioritize efficiency; leaders emphasize flexibility 9. managers- practicable goals, leaders- visionary, reach for ambitious long term goals 10. mangers regulate and control processes; leaders- drive innovation by fostering a culture of experimentation and continuous improvement

Mental abilities in EI (4):

1. perceiving/identifying emotions 2. understanding emotions 3. managing emotions 4. integrating emotions into thought processes

5 Components necessary to prove Malpractice

1. standard of care is in place 2. theres a failure to meet standard (breech of duty) 3. foreseeability of harm 4. must be a provable correlation between care and harm 5. actual pt injury occurs ** ignorance isnt an excuse, but NOT HAVING ALL THE INFO IN A SITUATION MAY IMPEDE ONE'S ABILITY TO FORSEE HARM **following a physicians order is NOT a defense, nurses have independent responsibility

What's the goal of EI?

= EMOTIONAL LITERACY- being self-aware about emotions and recognize how they influence subsequent action

Which behaviors by a nurse can result in the suspension or revocation of their license? (select all that apply) a. felony conviction for drug use b. failing to report an incident of substandard nursing c. practicing on expired license d. conviction for failure to pay child support e. convicting of malpractice

A, B, C, E, D is a private matter that will not impact their abilities as professional to take care of patients

The following is a component of a TRANSACTIONAL leader a. uses trade-off to meet goals b. identifies common values c. intimates staff d. empowers others

A- IS THE ANSWER b-wrong that is democratic or transformational c-wrong, authoritative d-wrong, transformational

The nurse prepares an in-service regarding ethics in the clinical environment. Which statement exemplifies ethically-appropriate nursing practice? a. A nurse who has accountability completes an incident report when a med error occurs. b. Autonomy is exemplified by the nurse when advising clients that they cannot choose medical tx appropriate for their dx. c. The nurse informs the client that suspected child abuse will not be reported as this breeches confidentiality d. Justice includes the nurse informing the client that health care will not be provided due to lack of insurance

A.

A 94 y/o with ESRD is refusing to take any prescribed mediations. He says, "they make me feel sick and I want to enjoy the rest of my short life". Which of the following response by the nurse is the best? a. You can certainly decide not to take the meds, but first I want to make sure you know why they're prescribed b. the doctor would not have ordered them, if you didnt need them c. I will call the doctor to ask for a different medication, like a shot d. I will have to notify your family

A. the patient is exercising the ethical principle of autonomy, therefore the nurse should respect that

What did the FIRST known leadership theory assume about leaders? a. leaders are born, not made b. some people are more likely to be better leaders than others c. anyone can lead, given the right training and environment d. leadership style is determined by the kind of followers

A. THIS IS THE ANSWER: this is great man theory b. trait theory c. skills theory d. situational theory

Assault vs. Battery

Assault = conduct that makes a person fearful or produces reasonable apprehensions of harm Battery = physical contact that entails injury/ offensive touching a person

Leadership Styles (3 main ones)

Authoritative/autocratic democratic laissez-faire

Derek is an ER nurse manager. He tends to adjust his leadership style based on what is occurring in the fast-paced arena of ER. What leadership theory best describes Derek's leadership style? a. trait b. contingency c. skills d. transformational

B.

Which of the following statements regarding emotional intelligence is false? a. EI is the ability of an individual to perceive and manage the emotions of self and others b. an emotionally intelligent leader manages emotions and channels them in a positive direction c. an emotionally intelligent leader discourages constructive criticism d. self-awareness, self-regulation and empathy are some EI components

C. is FALSE

What is the Nurse Practice Act?

In each state, statutory law directs entry into nursing practice, defines the scope of practice, and establishes disciplinary procedures. its a legal instrument that defines the functions of nursing and sets standard for licensure

What are the 3 types of consent ?

Informed, Implied, express

On the nursing station, the nurse manager and supervisors offer little in the way of direction and support, what management/leadership style is this?

Laissez-faire

What is great man theory of leadership?

Leaders are born, not made leadership traits are innate and can't be learned leaders come forward when most needed ex: Ghandi, MLK, Lincoln, Napoleon, Mandela

Malpractice vs Ordinary Negligence (unintentional torts)

Malpractice aka professional negligence is failure of a person with professional training to act in a reasonable and prudent manner- DO SOMETHING THAT CAUSES INJURY Negligence is the omission of something that a reasonable person would do- FAILURE TO DO SOMETHING

How do we develop EI?

Mayer and Salovey- ei improves with age * the earlier you're emotionally intelligent the easier it will be* goleman- ei can be learned with practice, reflection, feedback

What is the planning hierarchy?

Mission Philosophy Goals Objectives Policies Procedures Rules

Moral distress vs. outrage

Moral distress occurs when ur are directly in the situation, you know the right thing to do but your may not be able to do it Moral outrage occurs when you witness/watch an immoral act being done to someone else but you feel like you can't stop it

MORAL decision making model

M—Massage the dilemma O—Outline options R—Review criteria and resolve A—Affirm position and act L—Look back. Evaluate the decision making

Subordinate Advocacy

Nurse administrators should advocate for other health-care providers (including subordinates) as well as patients, especially when this is related to health and safety. - also can advocate for subordinatesnby creating a work environment that promotes risk-taking and leadership workers then feel empowered to speak up for patients, themselves and their profession

Define moral distress

Occurs when the individual knows the right thing to do but organization constraints make it difficult to take the right course of action (this is a growing concern in healthcare)

Paternalism vs. Utilitarianism

Paternalism: one person makes decisions for another (ex: parent for a child) Utilitarianism: encourages decision-making based on what provides the greatest good for the greatest number of people - suggests the ends justifies the means

What is organizational planning?

Plans form a hierarchy, with the plans at the top influencing all the plans that follow.

Which statement demonstrates the ethical principle of nonmaleficence? a. the client is critically ill and the team is currently doing everything possible to provide the best client care b. I am going to clarify the client's prescription for vancomycin because I noticed an increase in creatine since yesterday c. we need to call a meeting of the ethics committee to decide which critically ill patient is in the most need of the hospitals last ventilator d. the client has the right to refuse procedures as long as they demonstrate understanding of risks and benefits

a- wrong, this is beneifience B. THIS IS THE ANSWER c. d. autonomy

The term that is used to identify the type of law that covers most incidences of malpractice. a. tort law b. statutory law c. administrative law d. legislative law

a.

A wrong committed against a person or property is a tort, T or F?

TRUE

An emotionally intelligent leader refrains from judgment in controversial or emotionally charged situation until facts are gathered. T or F?

TRUE

Ligitation is the process of bringing forth and trying a lawsuit, T or F?

TRUE

The nurse must be able to perceive and understand their own emotions and the emotions of the client and family in order to provide PCC. T or F?

TRUE

Difference between transactional and transformational leaders?

Transactional: -focus on immediate problems -Focuses on management tasks -Is directive and results oriented -Uses trade-offs to meet goals- USE REWARDS TO MOTIVATE -Does not identify shared values -Examines causes -Uses contingency reward Transformational: -EMPOWER AND INSPIRE -Identifies common values -Is a caretaker -Inspires others with vision -Has common, long-term vision -Looks at effects -Empowers others --Transactional leaders focus on tasks and getting the work done. Transformational leaders focus on vision and empowerment.

The nurse who manages an ambulatory clinic is well know as being a visionary leader who is skilled at empowering others with this vision. What type of leader is this?

Transformational

Other categories/characteristics of leaders (2) (can be considered leadership styles)

Transformational Transactional

Vision, mission and philosophy of an organization

Vision: Vision statements are used to describe future goals or aims of an organization. Mission: brief statement identifying the reason that an organization exists. The mission statement identifies the organization's constituency and addresses its position regarding ethics, principles, and standards of practice. Philosophy: flows from the purpose or mission statement and delineates the set of values and beliefs that guide all actions of the organization. The foundation directs all further planning toward that mission.

Define ethical dilemma

a choice between 2 or more undesirable alternatives ex: nurse might experience a moral or ethical dilemma if they were required to provide care or treatments that conflicted with their own religious beliefs. In this case, the nurse would likely experience an intrapersonal moral conflict about whether their values, needs, and wants could or should supersede those of the patient.

What is emotional intelligence quotient (EQ)?

a measure of a person's ability to use and manage emotions in positive ways

What's the Good Samaritan Law?

a nurse is generally not liable for injury that occurs as a result of emergency tx provided that: 1. care is provided at scene of an emergency 2. care is NOT grossly negligent 3. HCP does NOT exceed their training/scope of practice while provided emergency services

Which of the following are behaviors associated with effective leaders? a. problem-solving, priority setting, self-development b. priority setting, critical thinking, skillful communication c. priority setting, skillful communication, passive listening d. critical thinking, fostering self-improvement, tentative (unsure, uncertain)

a- wrong its group development B- IS THE ANSWER c- wrong its active listening d. wrong its group improvement and tentative is wrong, leaders have confidence

Define moral uncertainty

an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is

Define moral indifference

an individual questions why morality in practice is even necessary

What is clinical reasoning?

applying critical thinking to make informed healthcare decisions elements are: -noticing crucial changes in patient status -analyzing these changes and deciding course of action -evaluating responses to modified care

What are the 5 intentional torts?

assault, battery, false imprisonment, defamation, invasion of privacy

The person who generates the lawsuit is known as? a. defendant b. plantiff

b.

Which process best describes leadership? a. planning, organizing, staffing, directing, controlling resources to accomplish specific institutional goals b. influencing behavior of either an individual of group in an effort to achieve goals in a given situation

b.

Which statement is true regarding the Good Samaritan Law? a. HCP are required to stop and provide emergency care b. protection proved is generally limited to emergency situations c. a volunteer at a free clinic is covered by this law d. all care needs are considered an emergency when situations occurs out-of-doors

b.

The type of law that regulates the practice of nursing is: a. common b. public c. civil d. criminal

c.

A new nurse is working in the operating room suite. The nurse notices the surgeon using inappropriate humor concerning the patient under anesthesia. What's the nurse experiencing? a. moral distress b. moral indifference c.moral outrage d. moral uncertainty

c. Moral outrage

Which statement is true regarding decision making? a. scientific methods provide identical decisions by different individuals for the same problems b. personal beliefs can be adjusted for when the scientific approach to problem solving is used c. decisions are greatly influenced by each person's value system d. past experiences have little to do with the quality of the decision

c. decisions are greatly influenced by each person's value system

Which statement is true concerning a critical thinker? a. it is narrower in scope than decision making b. it is a simple approach to decision making c. it requires reasoning and creative analysis d. it is a synonym for problem solving

c. it requires reasoning and creative analysis

What's planned change

change that results from a well-thought-out and deliberate effort to make things happen

Contingency vs. Situational:

contingency:a leader's EFFECTIVENESS is dependent upon how well their style matches the situation situational: a leader SHOULD adapt their style to match the situation

A nurse fails to assist a post-op pt whit ambulation for the first day post-op. The pt falls and fractures a hip. The nurse could be charged with what? a. assault b. battery c. fraud d. negligence

d.

A nurse is arrested for possession of illegal drugs. What type of law governs this activity? a. civil b. private c. public d. criminal

d.

Which of the following competencies are important for the NURSE leader to develop? a. ability to control a situation b. ability to influence a situation c. ability to tolerate a situation d. ability to diagnose a situation

d. ability to diagnose a situation

On the nursing station, staff-members are encouraged to help in the decision-making, with decisions decided upon by the majority, what management/leadership style is this?

democratic

Internal vs. External Whistleblowing

internal: occurs within the organization, reporting up the chain of command external: involves reporting outside the organization, such as to the media or elected official whistleblowers are good for the public, but bad for the organization. Whistleblowing can lead to distrust, they are considered disloyal and can experience negative repercussions

Define advocacy

involves helping others grow and self-actualize trying to empower others rights the actions of an advocate are to inform others of their rights and be sure they have adequate information to based their decisions on

what is skills theory of leadership?

leader-centered perspective puts extreme emphasis on the fact that skills and abilities can be learned and developed (difference between skills and trait theories)

Patient Self-Determination Act (PSDA)

mandates that all health care facilities receiving any type of federal funding (medicare, medicaid) comply with requirements. should include AD and durable power of attorney

What are the 4 main moral issues faces by Nurses? (BONUS: what's the 5th one, which is the most difficult of all moral issues)

moral indifference, uncertainty (aka moral conflict), distress, outrage -BONUS: ethical dilemma

Define moral outrage

occurs when an individual witnesses the immoral act of another but feels powerless to stop it

Workplace advocacy

occurs when the manager assures the work environment is both safe and conducive to professional and personal growth for subordinates

5 functions of management

planning, organizing, staffing, directing, controlling

What are the legal responsibilities of the nurse manager?

report dangerous understaffing, check staff credentials/qualifications, carry out appropriate discipline

What is a SWOT analysis?

strengths- those internal attributes that help an organization achieves its objectives weaknesses- internal attributes that challenge an organization in achieving its objectives opportunities- external conditions that promote achievement of objectives threats- external conditions that threaten achievement of objectives

what is trait theory of leadership?

successful leaders are born with certain traits like intelligence, self-confidence, determination, integrity, sociability these traits predispose them to have good leadership potential leaders can become more successful by developing these key traits (different than great man because you have to born with it you can't develop or improve it)

What is emotional intelligence (EI)?

the ability to perceive, understand, and control one's own emotions as well as others -be empathetic -look at situation from other POVs -be open minded - bounce back from challenges -purse goals despite challenges