NMNC 4320 - Leadership

interrelated concepts to leadership

- Health care organization - Ethics - Health care quality - Collaboration - Communication - Care coordination - Evidence - Technology & informatics

how is leadership involved in nursing?

- expectation of nurses - basic leadership development training - good clinicians get promoted - good leadership makes everything better

who is a leader?

- promotes a vision - works to achieve goals of that vision

The nurse leader is promoting successful dialogue within the health care team. Which actions of the nurse leader are responsible for this success? SATA 1. Serving as a facilitator 2. Encouraging the sharing of ideas 3. Discouraging the sharing of fears 4. Reacting to changed proposals honestly 5. Assigning different tasks to team members

1. Serving as a facilitator 2. Encouraging the sharing of ideas 4. Reacting to changed proposals honestly

The nurse manager monitors employees' performance and takes punitive action when necessary. Which could be the expected organizational outcomes in this type of leadership? SATA 1. Increased loyalty 2. Adherence to deadlines 3. Increased performance 4. Limited job satisfaction 5. Low-to-stable levels of commitment

2. Adherence to deadlines 4. Limited job satisfaction 5. Low-to-stable levels of commitment

The nurse manager oversees an inexperienced nursing staff. The manager inspires followers through displayed optimism, by providing intellectual stimulation, and by encouraging follower creativity. Which leadership theory is most closely aligned with the manager's approach? 1. Two-factor theory 2. Expectancy theory 3. Transformational theory 4. Situational-contingency theory

3. Transformational theory

Which is the most important skill of the nurse leader? 1. Priority setting 2. Time management 3. Clinical decision-making 4. Clinical care coordination

4. Clinical care coordination

what are some leadership qualities?

Knowledge and Skills Being Fair & Impartial Effective Communication Having Respect for others Having Self-confidence Experienced Fulfilling responsibilities Love of nursing Merciful/humanist Authoritative Influential Providing support Offering solution and methods Able to make decisions Tolerant Able to advocate Able to work with a team

formal leadership

associated with position and authority usually has title has legitimate authority to utilize resources (EX) CNO, Nurse Manager, Charge Nurse/RN, Supervisor, President of nursing association, Chairperson of committee, Dean of College, L3 Coordinator, Cohort rep

what is leadership?

collaborative relationship between leaders & followers that moves individuals, groups, & organizations toward a goal or vision leadership is not limited to authority/position

shared leadership

in some highly developed work teams, leadership responsibilities are shared among members of the group - Work teams - Leadership distributed among team members - Highly interactive - Allows team members to develop

Transformational Leadership

influences and motivates followers through the communication of an inspiring vision - considered the best & most successful leadership method - make people want to do a good job - greater sense of ownership for the work, higher morale - high expectations - inspire and motivate to surpass expectations - focus is long term - develop and transform followers

Which factors are associated with transformational leadership? SATA 1. A shared vision 2. Increased self-worth of followers 3. Doing the work and getting paid 4. Coaching and mentoring by the leader 5. Correction of errors in a reactive manner

1. A shared vision 2. Increased self-worth of followers 4. Coaching and mentoring by the leader

The nurse is explaining the nursing process to a student nurse. Which step of the nursing process would include interpretation of data collected about the client? 1. Evaluation 2. Assessment 3. Implementation 4. Diagnosis

2. Assessment

The nurse observes a dispute between staff members due to differences concerning nursing practices. Which approaches of the nurse leader would be appropriate in building up negotiation "loop-backs" to resolve the conflict? SATA 1. Providing a forum for open discussion 2. Using negotiation procedures and processes 3. Allowing a cooling-off period if the resolution fails 4. Informing of the full consequences of failing to resolve the issues 5. Using political skills to facilitate communication before confrontation

3. Allowing a cooling-off period if the resolution fails 4. Informing of the full consequences of failing to resolve the issues

what are some examples of leadership skills?

Strategic thinking Planning and delivery People management Ability to facilitate change Communication Persuasion and influence

laissez-faire leadership

leader does not intervene in the work and decision-making of the followers - Leader offers little guidance - Followers make decisions - Useful with highly qualified, motivated experts - High level of trust between leader and followers

democratic/participatory leadership

more likely to solicit input from followers, delegate authority for tasks, and share decision-making power with followers - Shared decision making - Delegate authority for tasks - Solicit input from team - Perception of importance fosters commitment to goals - Useful with highly educated and socialized professionals

social power

potential influence of one individual over another Leaders derive their social power from a variety of sources A leader's style influences how he or she will use power. For example, formal leaders' legitimate power is derived, in part, from the position they hold; transactional leaders use reward power, and authentic leaders use informational power

recommended competencies of leaders?

• Personal qualities • Interpersonal skills • Thinking skills • Setting the vision • Communicating • Initiating change • Developing people • Healthcare knowledge (clinical, technical, as a business) • Management skills (EX) planning, organizing • Business skills (EX) finance, marketing

informal leadership

usually related to capabilities & actions - these leaders arise because others recognize their knowledge, trust their judgement, and demonstrate in some way this knowledge and judgement (EX) experienced nurse, rep on a committee, clinical group spokesperson, foley whisperer, IV specialist

An organization having poor work flow was suffering financial losses. A team member introduced creative solutions that were publicly recognized by leadership. Which leadership theory is at work in this scenario? 1. Trait theory 2. Style theory 3. Transformational theory 4. Situational-contingency theory

3. Transformational theory

A client engages in angry outbursts and places excessive demands on the staff. An unlicensed health care worker tells the nurse, "I've had it. I am not putting up with that behavior. I'm not going in there again." Which is the correct response by the nurse? 1. "You need to try to be patient. The client is going through a lot right now." 2. "I'll talk with the client. Maybe I can figure out the best way for us to handle this." 3. "Just ignore it and get on with your work. I'll assign someone else to take a turn." 4. "The client is frightened and taking it out on the staff. Let's think of approaches we can take."

4. "The client is frightened and taking it out on the staff. Let's think of approaches we can take."

autocratic/authoritarian leadership

exercises most, if not all, of the decision-making authority and responsibility for directing the actions of others - Makes all the decisions Task oriented - Clear division between leader and follower - Punishment/reward - Useful when you need a decision quickly

Transactional Leadership

involves the motivation and influence of followers through an exchange - Performance oriented - Clear goals and expectations Reward/punishment - Short term motivation - Useful in crisis situations

What are the stages involved in the model for developing clinical leadership?

Stage 1 - awareness Stage 2 - connecting personally to the role of nurse Stage 3 - initiate leadership within role - iterative Stage 4 - active role within the team as leader Stage 5 - active role as leader is an integrated part of practice

authentic leadership

transparent and ethical, focus on relationships and commitment - Transparent - Ethical - Focused on relationships - Commitment to development of followers

After the completion of training under the newly appointed transactional leader, the nurse manager intends to judge the performance of the new leader through interaction with the staff. Which type of statements would the manager expect to receive when asking about the outcome of training? SATA 1. "We fulfill the task to avoid punishment." 2. "We are paid only after our work is satisfactorily completed." 3. "We have learned much due to coaching provided by the leader." 4. "We have completed many challenging and meaningful assignments." 5. "We tend to minimize errors; otherwise, they get corrected in a reactive manner."

1. "We fulfill the task to avoid punishment." 2. "We are paid only after our work is satisfactorily completed." 5. "We tend to minimize errors; otherwise, they get corrected in a reactive manner."

Which behavior on the part of the nurse helps develop trust among subordinates? 1. Behaving with consistency 2. Creating a "Hall of Honor" to post photos 3. Being expedient in responding to the issues 4. Taking time to celebrate individual accomplishments

1. Behaving with consistency

Hospital management has replaced some equipment to provide more effective treatment. The nurse leader wants the team to support and implement this change successfully. Which actions of the nurse leader are effective in this situation? SATA 1. Conducting a dialogue with the team members 2. Encouraging the team members to develop new skills 3. Inspiring the team members to increase competency in different areas 4. Becoming knowledgeable about the change implemented in the organization 5. Instructing one-half of the team to use the old equipment and the other half to use the new equipment

1. Conducting a dialogue with the team members 2. Encouraging the team members to develop new skills 3. Inspiring the team members to increase competency in different areas

The transformational leader demonstrates charismatic behavior and the careful consideration of the value of every individual in the organization. Which might be the expected organizational outcomes with this type of leadership? SATA 1. Increased loyalty 2. Deadlines met 3. Increased performance 4. Low-to-stable levels of commitment 5. Work supervised and completed according to the rules

1. Increased loyalty 3. Increased performance

Which theory related to leadership is a nontraditional theory that has emerged from the physical and social sciences? 1. Expectancy theory 2. Complexity theory 3. Motivational theory 4. Management theory

2. Complexity theory

Which skill would be most associated with the effective nurse leader? 1. Recognizing her or his own limitations 2. Delegating work appropriately 3. Displaying confidence in her or his knowledge base 4. Respecting the rights, beliefs, wishes, and values of clients

2. Delegating work appropriately

The nursing team is providing care for a client. The team leader develops client care plans and coordinates care among the team members. Which member of the team acts as a team leader? 1. Charge nurse 2. Registered nurse (RN) 3. Licensed practical nurse (LPN) 4. Unlicensed assistive personnel (UAP)

2. Registered nurse (RN)

Which statement reflects the concept of "referent power" to the nurse? 1. The nurse leaders share their power with the direct care nurses in client care. 2. The nurse manager hires the student nurse she advised to work in the agency after graduation. 3. The nurse manager is perceived positively by the student nurse who received an exemplary grade. 4. The direct care nurses demonstrate great skill in teaching clients who have difficulty with self-care activities.

2. The nurse manager hires the student nurse she advised to work in the agency after graduation.

The nurse manager regularly analyzes herself or himself and her or his performance, focusing on developing leadership qualities such as assertiveness, confidence, and task knowledge. Which leadership theory would the manager most likely subscribe to? 1. Style theory 2. Trait theory 3. Transformational theory 4. Situational-contingency theory

2. Trait theory

The nurse who lacks confidence in her performance in a new position is worried about an upcoming review with the nursing director. Which type of power would the nursing director hold in this scenario? 1. Expert power 2. Position power 3. Coercive power 4. Referent power

3. Coercive power

Which theory states that leaders should expand and respond to a dynamic change rather than prescribing and approaching change as a lock-step, pre-prescribed method? 1. Role theory 2. Chaos theory 3. Complexity theory 4. Organizational theory

3. Complexity theory

Which actions would the nurse leader avoid to implement changes effectively? 1. Answering tough questions raised by the staff 2. Asking the staff what is not working well for them 3. Maintaining a rigid boss-employee relationship with the staff 4. Asking questions of the staff related to daily functions

3. Maintaining a rigid boss-employee relationship with the staff

Which action makes the nurse manager also the nurse leader? 1. Implementing best management skills when hiring employees 2. Having financial accountability associated with the organization 3. Screening effectively to select the right employees for the organization 4. Helping employees reach the highest level of their potential excellence

4. Helping employees reach the highest level of their potential excellence

The nursing manager said, "Nurse leaders must also be excellent change managers." Which statement supports this? 1 .Nurse leaders ensure a change that will support only staff. 2. Nurse leaders are only coordinators to bring a change in the system. 3. Nurse leaders can only support clients in changing their behaviors to improve care. 4. Nurse leaders will ensure that the disruption and chaos of change do not affect client care.

4. Nurse leaders will ensure that the disruption and chaos of change do not affect client care.

Which behavior from the nurse leader exhibits charismatic leadership qualities? 1. Using a shared vision as a core of leadership 2. Encouraging innovation and creativity in solving a problem 3. Encountering a situation with the transactional leadership style 4. Possessing an inspirational quality that makes team members attracted to her or him

4. Possessing an inspirational quality that makes team members attracted to her or him

A discussion between a group of team members results in a conflict in an organization. The nurse leader uses an adaptive style to address the conflict. Which theory of leadership is the nurse applying in practice? 1. Trait theory 2. Two-factor theory 3. Hierarchy of needs 4. Situational-contingency theory

4. Situational-contingency theory