Leadership Midterm Exam

Team Nursing

- Similar to democratic leadership - Clear leader - Collaborate to provide care

Philosophy

Flows from the emission statement and describes the beliefs and values of the organization

A nurse in a leadership role is committed to a vision for retention in the medical-surgical unit and is able to empower others with this vision. What form of leadership is this nurse demonstrating?

Tranformational

All people and organizational units that will be affected by a planned change should be included in the planning. T or F?

True

Democratic leader

Want input from others, includes others in decision making, communication travels

Pros to team nursing

- contribute their own special expertise or skills individual worth of staff - Autonomy

Disease management programs

- Goal is to provide early detection and early intervention - reimbursement of high-cost, chronic illnesses

Disadvantages to matrix structure

- slow decision making

Pros for functional nursing

- efficiency - task completed quickly cost effective

Magnet status

"gold standard" for nursing excellence

Shifting binding

- organization sets the opening prices for a shift

Transformational Leader

- Adapt to the individual needs and level of maturity Identifies common values - Is committed - Has long term vision - Looks at effects - Accept feedback - Empowers others

Care Management Model

- Addresses the pt individually - Assists pts in finding resources - Educates pt with med regimens and treatment plans

Full range leadership

- Combines aspects of several leadership styles - Evolves and adapts

Functional nursing

- Complete track rather than care for specific patients - Evolved because of WW2

Great Man Theory

Ground of people, there will be a leader that will rise naturally

Max Weber

- Father of organizational theory - Developed bureaucracy - Predicted organizational growth required formalized procedures - identified need for rules, regulations and structure within organizations

Matrix structure

- Focus on function and product - fewer formal rules - Fewer levels of hierarchy

Informal structure .

- Focuses on employees, their relationships, and informal power - unplanned and roles are not clearly defined

Argyris

employee participation, self-esteem is important

Transformational leaders ____ others, whereas transactional leaders _______ over others

empower; exercise power

Shared governance.

encourages nurse manager/leaders to act as facilitators and coordinators of the nurse staff

Policies

guid procedures and rules that define how specific task should be implemented

Nurse navigator

help patients and their loved ones navigate through healthcare systems by providing information and support

Grapevine communication

informal communication system through which messages are passed in an organization, rumors can come from this

What are obstacles that prevent adults from learning?

institution barriers, time, individual strengths and weaknesses

International Leadership theories

leadership behavior determined by relationship between leader's personality and the specific situation

Matrix organizations

more Lilley to have functional meetings (nurse-specific) and are meetings (department-specific) than to have an all-hands meeting. There is a change initiative that impacts a nursing procedures across the board

Pros of total patient care

- High autonomy & responsibility - Simple and direct - Clear expectations

Cons to team nursing

- Improper implementation will have a negative effect

Unity command

- Indicated by a vertical solid line between positions in the organizational chart - Best described as "one person/one boss" - Employees have one manager to whom they report to and to whom they are responsible

National level

- Nurse practice acts - Health People 2020 - Magnet status

Total patient care

- Oldest model of patient care - Modeled after the private duty nursing - Complete responsibility during time on duty for all patient needs

Organizational Level

- Organizational chart - Mission and philosophy statements

Gulch (management functions)

- Planning - Organizing - Staffing - Directing - Coordinating - Reporting - Budgeting

Servant leadership

- Put employees, customers, and community as highest priority - Focuses on betterment of subordinates

Centrality

- Refers to the location of a position on an organizational chart where frequent and various types of communication occur

Primary Nursing

- Relationship based nursing - On duty the nurse provides total direct care and off duty, the associate nurses follow the primary nurses care

Authentic Leadership

- Self-aware, sense of purpose and passion - Relationship builders - Self-discipline - Congruence among values and beliefs

Decentralized staffing

- Unit managers - considered needs of unit Holiday/vacation time - Monthly schedules - More flexibility

Strength based Leadership

- Uses own strengths - Build followers strengths - work together -relationship building

Cons of Total patient care

- able to alter plan of care - requires skilled personnel

Formal Structure

- aims to provide the best possible coordination or use of resources to accomplish objectives - organizational positions and power -

self scheduling

- allows nurses in a unit to work together to construct their own schedules rather than management schedules

Bandura's Social Learning Theory

- anticipate your staff's need for reinforcement of a new heavier to improve on an ineffective behavior

Bureaucracy

- clear division of labor - hierarchy of authority - impersonal rules

Service line organizations

- small in scale - used in large institutions - Address shortcomings of large bureaucratic organizations - goals determined by the larger organization

Flextime scheduling

- system that allows employees to select time schedules that best meet their personal needs while still meeting work responsibility creates greater employee choices but could end up in over or understaffing easily

Competencies that are important for the nurse leader to develop

Ability to diagnoses a situation, adapt, and communicate

Dotted/broken line

Advisory staff position that provides information and assistance to their manager

What are some of the primary focuses of the health care interprofessional team? (Select all that apply.) Collaborative problem solving Reducing mortality rates Improving quality of life for patients Providing patient-centered care Increasing professional experiences for health care workers

All

A hospital is implementing a new staffing policy aimed at improving patient care outcomes and staff satisfaction. The policy mandates a specific nurse-to-patient ratio for each unit, taking into account the acuity of patients and workload demands. Which action by the nurse manager best ensures successful implementation of the new staffing policy?​ A. Enforcing rigid adherence to the nurse-to-patient ratio without flexibility.​ B. Conducting regular staff meetings to gather feedback and address concerns.​ C. Implementing the policy abruptly without prior notification to the nursing staff.​ D. Assigning nurse leaders to monitor compliance and report any deviations.​ ​ ​

B

Quantum leadership

Builds on transformational leadership. Suggest the environment and content in which people work is complex and dynamic. Environment impacts organizations productivity

A nurse manager is leading a team composed of members from different generations, including Baby Boomers, Generation X, Millennials, and Generation Z. Which approach by the nurse manager is most conducive to fostering effective communication and collaboration among the team members?​ A. Implementing strict hierarchical structures to maintain discipline and order.​ B. Organizing separate training sessions tailored to the preferences of each generation.​ C. Encouraging open dialogue and mutual respect for diverse perspectives.​ D. Assigning tasks exclusively based on the generational background of the staff members.​

C

What is one of the most important differences between case management and disease management? A) Disease management referrals begin in the hospital inpatient setting B) Disease management is a collaborative process to meet patient needs C) High-cost population groups are targeted in disease management D) Disease management treatment is episodic

C

Which aspect of care at a long-term care facility most clearly suggests that a functional model of care delivery is being used? A. One nurse is assigned to provide all of a resident's care during a shift. b. Unlicensed assistive personnels (UAPs) coordinate each resident's care and occasionally delegate to practical nurses. c. Registered nurses perform all assessments while UAPs provide all feeding and hygiene. d. A pairing of one registered nurse and one practical nurse provides all the care for a designated pool of residents.

C

An experienced nurse using contingency theory is orienting a new graduate to the unit. What needs will the nurse meet with the new graduate using this theory? (Select all that apply.)

Coaching, counseling, developing

Solid Horizontal line

Communication between people with similar realms of responsibility/power, but with different functions

Laissez-faire leader

Hands-off communication, group up communication

Human and social Capital Theory

Human Capital - attributes of a person that are product in an economic content Social Capital - wha t group can accomplish together Example: Investing in education and/org Professional development because it will have a pay-off

Flattening the organization

Increasing span of control and decreasing the number of administer levels

Thought leadership

Individuals recognized by peers for the ability to be innovative and have the confidence to promote those ideas. Challenge statues quo

What is the effect on a nurse who experiences a disconnection between personal and organizational values?

Interpersonal conflict and burnout

A manager was informed that a student nurse failed to report a blood glucose level of 49 to the primary nurse. Th primary nurse then blamed the student nurse of putting the patient at risk. Which force is most influencential?

Nurse Practice Act

Management process: - Planning - Organizing - Staffing - Directing - Controlling

Planning: determining philosophy, goals, objectives, policies, procedures, and rules Organizing: establishing the structure to carry out plans, who reports to who Staffing: hiring, firing, orienting staff, interviewing, recruiting Directing: delegating, motivating, help manage conflict Controlling: perform appraisals, fiscal accountability, quality control, legal and ethical control

Solid vertical line

Portray the official chain of command, formal paths of communication/authority

Behaviors associated with effective leaders

Priority setting, critical thinking, skillful communication

Principal Agent Theory

Proposes that not all followers (agents) are motivated to act in the best interest of the leader (principal). The principals need to provide agents with incentives to act in the organizations best interest

Which of the following delineates the set of values and beliefs of an organization's goals and guides the development of the philosophy statement?

Purpose or mission statement

Mission statement

Reflection of the basic nature (purpose) of the organization

A nurse on a busy medical-surgical unit must delegate some care assignments to an experienced nursing assistant. What factor(s) does the nurse consider before delegating the care to the nursing assistant?

State or national standards

Authoritarian leader

Strict, stays within policies guideline, one way communication

Smoothing

The nurse manager attempts to pacify both parties involved in the conflict by focusing on agreements rather than differences

Trait Theory

The people with the specific traits will be the good leaders

McGregor

Therapy X: underlings needed a lot of supervision, are lazy Theory Y: Went in with the mindset that they will do great

How do adults learn?

They are self-directed learners and incorporate past life experiences in their approach to gain knowledge

Contingency Theory

a theory that proposes that the best course of action in any situation depends on the specifics of the situation

Clinical Nurse Leader

advanced generalist with a master's degree who "assumes responsibility for patient outcomes of care" through the use of evidenced based practice and evaluation of models of care delivery.

Flat organizations

charcaterized by accessibility of upper management and a flow of information that is both top-down and bottom-up.

Span of control

number of employees that directly report to one manager - optimal: 3 to 50 but modern theorist say 15 to 20

Organization chart

- defines formal relationships within an organization, consists of solid horizontal and vertical lines that portray authority and lines of communication

Situational and contingency leadership theories

- no leadership style ideal for every situation - Auto- and dem-

Private duty nursing

- not a member of the hospital staff - nurses expected to cook, clean, and perform other household duties

Follett (human relations management era)

- participative decision making/ participative management - managers would have authority with, rather than over, employees

Fayol (management functions)

- planning - Organization - Command - Coordination - Control

Cons to primary nursing

- requires a lot of nurses

Transactional Leader

- Focuses on management task, - Is caretaker - Uses trade-off to meets goals - Does not identify shared values - Focuses on specific task

Mayo (human relations management era)

- Hawthorn effect - knew that they were being evaluates they would do better

Centralized staffing

- Staffing office - Considers entirety of hospital needs - Strict policies

Max Webe (1922)

- Studied large organizations to determine what made them successful - Identified need for rules, regulations, and structure within organization

Cons for functional nursing

- Supervise UAP - fragmented care - may cause overlooking of patients priority needs

Knowles adult learning therapy

- Teaching at the student

A nurse has accepted a position as a staff nurse and will practice primary care nursing. The nurse will be the only RN on the team. What is an appropriate role expectation for role fulfillment? a. Planning nursing care independently of others b. Assigning work according to the expertise of group members c. Being responsible for care planning only during the shift when he or she works d. Carrying out the majority of personal care for assigned patients

B

Stephanie is often seen interacting with the medical intern during coffee breaks and after duty hours. What type of organizational structure is this? A. Staff B. Informal C. Line D. Formal

B

A nurse leader is considering using transformational leadership. What information would the nurse leader need to keep in mind?

Empowerment of both the leader and follower occurs

What is one challenge that the inter-professional team faces

Role confusion

Chunking

presenting two independent teams of information and grouping them together into one unit

Closed-unit staffing

staff members on a unit 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

Are implementation problems common in multidisciplinary teams?

yes