Leadership Ch. 8

1. Allow some time to pass to see if the situation resolves. 2. Support both nurses as they work through this issue. 3. Provide any resources the nurses may need to help solve the problem. 4. Intervene if the problem begins to impact client care.

A disagreement has arisen between two staff nurses. Both have discussed the situation with the manager. The manager feels that that problem is likely self-solving. How should the manager approach this situation? Select all that apply.

4. Unit clerks have made 10 transcription errors in the last 6 months.

A group of nurses has been convened to solve a problem. As the first step in this process, the group leader asks for a definition of the problem to be solved. Which statement reflects the best problem statement?

2. This nurse is learning to be creative.

A newly licensed nurse working on a unit committee challenges every detail of a proposal the committee is developing. How should other committee members interpret this behavior?

3. Demonstrate a genuine desire to find our why there is dissention.

A newly promoted nurse manager would like staff to solve problems without relying on preconceived ideas. How should the manager role-model this ability?

2. An underlying assumption

A nurse believes that milk is part of the healthy adult's diet. The nurse frequently offers milk to adults as a between-meal beverage. This action is based on which concept?

1. Provide opportunities for staff to interact with nurses from outside the facility. 2. Give the nurses freedom to design their work environment. 5. Be receptive to ideas even if they seem strange at the beginning.

A nurse manager is committed to establishing an environment that supports critical thinking and creativity. What strategies would help in this effort? Select all that apply.

2. The alternatives are known. 3. The conditions of each alternative are clear.

A nurse manager who is retiring is helping the new manager learn about the position. As part of this education, the current manager has the new manager make all decisions that can be made under certainty. What conditions will these decisions have in common? Select all that apply.

1. The manager has historically used trial and error as a decision-making strategy. 4. The manager uses old ways of thinking to solve the day-to-day issues of the unit.

A nurse manager's supervisor reports that many staff members have complained about the manager's rigidity. What situations reflect this rigidity? Select all that apply.

2. Asking all employees to write down their ideas about a solution

A nurse working in a rehabilitation center notices clients frequently asking for something to drink. Which response indicates the use of creativity in finding a solution to this problem?

2. Critical thinking

A nursing task force has been created to determine whether a new model of differentiated practice would be more effective than the current model. The task force analyzes data as a basis to examine alternatives. Which activity does this represent?

2. Diagnosis

A serious disagreement has arisen between two staff nurses. The unit manager elects not to make a decision regarding the disagreement until more evidence is collected. Which part of the nursing process does this manager's critical thinking reflect?

2. Intuition 4. Past experience

Although the postoperative assessment of a client reveals no abnormalities, the nurse believes the client's condition is deteriorating and orders frequent vital signs. This intervention was made on the basis of which type of problem solving? Select all that apply.

3. Do not critique any ideas presented.

At the beginning of a brainstorming session, the manager lists the rules to be followed. Which rule should be included and enforced?

1. "The day shift just wants to shift work onto the evening shift." 2. "Everyone likes to bathe right before bed." 4. "The physician staff will be upset if we change our morning routine." 5. "If we let them change this, they will want to make lots of other changes, too."

Currently clients on a unit are bathed in the morning between 8:00 am and 11:00 am. The nursing staff is contemplating changing that routine to bathing clients in the evening between 7:00 pm and 9:00 pm. Which statement reflects an underlying assumption that might affect the staff's ability to think critically about this change? Select all that apply.

1. "I am not following the policies and rules well." 2. "I should review the procedure manual." 3. "I'm good at using my previous experiences to guide my decisions."

Part of the facility's performance evaluation is based on the nurse's strength in the three types of decisions. During a nurse manager's performance evaluation the supervisor says, "You are very good at adaptive decisions, but you need to be more precise in routine decisions. When the situation calls for really innovative decisions, you do not seem sure of yourself." How should the manager interpret this information? Select all that apply.

4. Practice the steps of the process as often as possible.

The nurse has determined that in order to provide the highest quality care it is important to become more creative. What is the most effective way for the nurse to increase creativity?

1. Are there different situational effects or contexts to be considered?

The nurse is using critical thinking skills to decide which of several options is the best. Which question is most important for the nurse to take into consideration?

3. Rational decision-making model

The nurse manager generally uses a stepwise method to arrive at decisions that are logical and that serve to maximize the achievement of the desired objective. Which decision-making model does this manager use?

4. Incubation

The nurse manager has scheduled a series of meetings with employees to solve a unit problem. The manager purposefully created a 2-week gap in the meetings to allow which portion of the creative process to occur?

4. Subjective probability

The nurse manager is calculating the cost of offering two bonus incentives to nursing staff for covering call-ins for sickness. After reviewing the statistics, the manager finds that option A is more cost-effective than option B but decides to implement option B because it seems safer. Which option best describes the basis of this decision?

1. Creativity

The nurse manager is challenged to find an innovative way to adequately staff the unit and provide quality nursing care. Which ability would be most useful to the nurse in this situation?

3. Add more information to existing care plans as the study unfolds.

The nursing faculty would like to incorporate problem-based learning into the curriculum. Which action is essential?

3. Gather information to define the problem.

The nursing group has been charged with the task of solving a patient care problem on the units. Which step should this group take first in this process?

3. The nurse manager agrees with a proposed budget that does not provide badly needed new client beds.

Which action by the nurse manager is a demonstration of satisficing?

1. The nurse manager discovers that two clients require the use of a new piece of equipment and that the one the hospital has is the only one in the state.

Which situation requires an adaptive decision?

3. "I would like to thank everyone for your hard work and dedication while we have been short staffed." 4. "I am certain that our new assignment system is going to make the workload more equitable." 5. "I know this week has been rough. I feel a little like sandpaper myself."

Which statement by the formal leader of a nursing unit reflects the personality required to energize the staff and promote creativity? Select all that apply.

1. A decision made by a group is often better than a decision made by one person. 3. Groups can provide more input into the process. 4. A decision made by a group can create a greater obligation to achieve results. 5. Routine decisions are more often made by individuals.

Which statement describes the primary difference between group and individual decision making, besides the number of individuals involved? Select all that apply.

2. "I should practice making decisions by developing potential solutions and then choosing one."

Which statement indicates understanding of how a nurse could improve personal decision-making skills?

1. "We've already talked about this enough. We need to present a united front on this issue." 2. "The medical unit nurses won't like this decision because it is too much work." 3. "Let's all vote yes on this so we can get back to work."

Which statements by a nurse in the emergency department are examples of groupthink? Select all that apply.

1. "I am always curious about why we do things the way we do." 3. "Can you help me understand your perspective a little better?" 5. "I don't think I can make that decision until I have more information."

Which statements exemplify the attributes of critical thinking essential to nurses? Select all that apply.