Management: Exam 2
Describe the role of a manager
- Always assigned position within an organization - Legitimate source of power d/t the delegated authority that accompanies their position - Expected to carry out specific functions - Emphasize control, decision making, decision analysis, and results - Manipulate people, the environment, money, time, and other resources to achieve organizational goals - Have greater formal responsibility and accountability for rationality and control their leaders - Direct willing and unwilling subordinates
list examples of Top Level Managers
- Board of Directors - Chief Executive Officer - Chief Nursing Officer - Administrators
Describe a good manager
- Coordinate resources - Optimize resource use - Meet organizational goals and objectives - Follow rules - Plan, organize, control, and direct - Use reward and punishment effectively to achieve organizational goals
Decentralized Decision Making
- Decision making is diffused throughout the organization, and problems are solved at the lowest practical managerial level - ***In general, the larger the organization, the greater need to decentralize the decision making
Matrix Organizations
- Designed to focus on both the product and the function - Have a formal vertical and horizontal chain of command - Have fewer formal rules and fewer levels of the hierarchy - Can cause slow decision making due to information sharing - Can produce confusion and frustration for workers because of dual-authority hierarchical design
Outcomes of Conflict
- Disturbing issues brought out into the open may avert more serious conflict. - Group cohesiveness may increase as individuals resolve issues. - New leadership may develop as a consequence of resolution. - Results of conflict can be constructive, as occurs when productive outcomes are achieved, or they can be destructive, leading to poor communication and creating dissatisfaction.
Disadvantages of the Organization Chart
- Does not show the informal structure of the organization - Does not indicate the degree oof authority held by each line position - May show things as they are supposed to be or used to be rather than as they are - Possibility exists of confusing authority with status
required elements of a torts?
- Duty - Standard of care - Breach/Negligence - Damage
Formal Organizational Structure
- Emphasis is on organizational positions and formal power - Provides framework for defining on managerial authority, responsibility, and accountability
Stakeholders
- Entities in an organization's environment that play a role in the organization's health and performance or that are affected by the organization - May be both internal and external - Every organization should be viewed as being part of a greater community of stakeholders
Describe a good leader
- Envision future - Communicate visions - Motivate followers - Lead the way - Influence others to accomplish goals - Inspire confidence - Take risks - Empower followers
How to deal with snipers
- Expose them, "smoke them out" - Get group confirmation or denial when criticized - Never let them see the injury - Prepare, prepare, prepare
Centrality
- Extent to which an employee is integrated into the network of interpersonal relationships within the work system - Middle manager often has centrality bc he/she has a broader view of the organization and communicates in many directions - the degree of communication of a management position
what are characteristics of Complainers?
- Feel powerless - Need attention but not action - Points out problems from a non-constructive stance
Medicaid
- Financially indigent is primary population - Majority of recipients are women and children - Administered by states under broad federal guidelines - Covers about 17% of US population - Medical and long-term care coverage for people with disabilities and assistance with health and long-term care expenses for low-income seniors - Health coverage for low income; disability, elderly, pregnant women, children, poverished - Some states cover all adults below a certain threshold; depends on state
Informal Organizational Structure
- Focus is on the employees, their relationships, and the informal power that is inherent within those relationships - Has its own leaders and communication channel (grapevine)
Helpful Tips in Conflict Resolution
- Focus on the causes of the disagreement and not on personalities. - Try to arrive at solutions acceptable to everyone concerned. - Get all the information possible. Differentiate between facts and opinions. - Listen carefully and don't prejudge. - Don't belabor how the conflict occurred. Instead, concentrate on what should be done to keep it from recurring. - Concentrate on understanding and not on agreement.
Good Samaritan Act
- Give immunity from malpractice to those attempting to give assistance at scene of accident - Immunity excluded in cases of professional negligence protects any volunteer giving aid to an injured person in an emergency situation.
Describe the leader: Laissez-Faire/Permissive/Free Rein 🡪 Pacifier
- Hands-off approach - Permissive, little to no control - Motivates by support when requested by the group or individual - Provides little or no direction - Upward and downward communication - Disperses decision making throughout the group - Places emphasis on group - Does not criticize - If group self-motivated and self-directed, can be productive but if not can be frustrating - Appropriate when problems poorly defined, and brainstorming is needed to generate alt solutions
Constructive discipline
- Helps the employee to grow - Is carried out in a supportive, corrective manner - Employee is reassured that punishment is given because of actions and not because of who he or she is as a person - Primary focus is to assist employees to be self-directed
Organizational Climate
- How employees perceive an organization - May be accurate or inaccurate; people in the same organization may have different perceptions about the same organization
Discipline
- Involves training or molding the mind or character to bring about desired behaviors - Often considered a form of punishment but is not the same - Can be a powerful motivator for behavioral change because it is educational and corrective
How do you deal with sherman tanks/attackers?
- Keep fear and anger under control - Avoid an outright confrontation - Step aside; do not be run over - Defend yourself w/o fighting - Politely but firmly cut them off - Maintain eye contact - Body position—get them to sit down
Participatory Management
- Lays the foundation for shared governance, btu they are NOT the same - Implies that others are allowed to participate in decision making over which someone has control. - The act of "allowing" participation identifies for the participant the real and final authority
Types of Organizational Structures
- Line structures - Ad hoc design - Matrix structures - Service line organization - Flat designs
how do you deal with complainers?
- Listen to the complaints - Acknowledge their concerns - Paraphrase or restate for clarification - Move into a problem-solving mode
Advantages of the Organization Chart
- Maps lines of decision-making authority - Helps people understand their assignments and those of their coworkers - Reveals to managers and new personnel how they fit into the organization - Contributes to sound organizational structure - Shows formal lines of communication
Ad Hoc Design
- Modification of the bureaucratic structure - Sometimes used temporarily to facilitate project completion within a formal line organization - Overcomes the inflexibility of line structure - Serve as a way for professionals to handle increasingly large amounts of information - Uses a project team or task approach and is usually disbanded after a project is completed - May result in decreased employee loyalty to the parent organization
Which is the recommended leadership style?
- No one leadership style is ideal for every situation; idea that leadership should vary according to situation or individuals involved suggested 100 yrs ago by Mary Parker Follett - Should be based on nature of situation, skills of manager, and abilities of group members - As people mature, leadership becomes less task focused and more relationship oriented
characteristics of Snipers
- Not as openly aggressive - Weapons: innuendos, digs, non-playful teasing - Hidden attack rather than frontal - Mean to make you look ridiculous - "PASSIVE-AGGRESSIVE"
Shared Governance
- Nurses at every level play a role in the decisions that affect nursing activity throughout the system - Nurse managers move out of traditional industrial model roles into collegial models, becoming moderators of the service process - Usually defined by a structure of rules or bylaws
list examples of Middle Level Managers
- Nursing Supervisors - Nursing Directors - Department Heads
Characteristics of a Critical Thinker
- Open to new ideas - Intuitive - Energetic - Analytical - Persistent - Assertive - Communicative - Flexible - Empathetic - Caring - Observant - Risk taker - Resourceful - "Outside-the-box" thinker - Creative - Insightful - Willing to take action - Outcome directed - Willing to change - Knowledgeable - Circular thinker
Self discipline
- Process by which rules are internalized and become part of the person's personality - and most effective form of discipline - Possible only if subordinates know the rules and accept them as valid
14 Forces of Magnetism for Magnet Hospital Status
- Quality of nursing leadership - Organizational structure - Management style - Personnel policies and programs - Professional models of care - Quality of care - Quality improvement - Consultation and resources - Autonomy - Community and the hospital - Nurses as teachers - Image of nursing - Interdisciplinary relationships - Professional development
What are classic change strategies?
- Rational—Empirical Strategies - Normative—Reductive Strategies - Power—Coercive Strategies
How do you deal with calms?
- Read nonverbal communication - Use open-ended questions - Wait for a response; "clam up" - FSS (Friendly Silent Stare) - Be attentive when they communicate - Avoid polite ending - Use "out of the box" strategies
Span of Control
- Refers to the number of people directly reporting to any one manager and determines the number of interactions expected of him or her - Too many = delay in decision making - Too few = inefficient, top-heavy organization
what are the characteristics of clams?
- Refuse to respond when answer or discussion needed - "maddening" behavior
Flat Organizational Designs
- Remove hierarchical layers by flattening the scalar chain and decentralizing the organization - Continue to have line authority, but because the organizational structure is flattened, more authority and decision making can occur where the work is being carried out - Despite being very flat, often retain many characteristics of a bureaucracy
What can you do about sexual harassment?
- Start with the most direct measure; TELL the person to stop - Put your statement in writing to the person, keeping a copy for yourself - Tell other people, such as family, friends, personal physician, or minister, what is happening and how you are dealing with it - File a formal grievance, which requires filing a written complaint with an official group such as a hearing procedure
what are the characteristics of Sherman Tanks/Attackers
- Strong need to prove themselves right - Very confident - Devalue those who are not confident; do not value people who are not like them - Often demean others - Very opinionated, very direct, assertive
list examples of First Level Managers
- Team Leaders - Charge Nurses - Primary Care Nurses - Case Managers
Complex Critical Thinking
- The mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating info to reach answer/conclusion - Broader scope, more complex than decision making and problem solving
Committees
- Too many = sign of poorly designed organizational structure - Productive committees should have... Appropriate number of members, Prepared agendas, Clearly outlined tasks, and Effective leadership
Organizational Culture
- Total of an organization's beliefs, history, taboos, formal and informal relationships, traditions, values, rituals, and communication patterns; much of an organization's culture is not available to staff in a retrievable source and must be related by others. - Values and behaviors that contribute to the unique social and psychological environment of an organization
Sexual Harassment
- Unwanted sexual advances made in the content of a relationship of unequal power of authority - Individuals subjected to sexually oriented verbal comments, unwanted touching, and requests for sexual favors
Destructive discipline
- Use of threats and fear to control behavior - Employee always alert to impending penalty or termination - Arbitrarily administered and either unfair in the application of rules or in the resulting punishment
Service Line Organizations
- Used in some large institutions to address the shortcomings that are endemic to traditional large bureaucratic organizations - Sometimes called care-centered organizations - Smaller in scale than large bureaucratic systems
List the qualities of a change agent
- Visionary - risk taker - flexible - communicator - creative - sensitive - current
characteristics of Magnet Hospitals
- Well qualified nurse executives in a decentralized environment, with organizational structures that emphasize open, participatory management - Autonomous, self-managing, self-governing climates that allow nurses to fully practice their clinical expertise, flexible staffing, adequate staffing ratios, and clinical career opportunities - Professional practice culture in all aspects of nursing care - Compliance with standards in the ANA's Scope and Standards for Nurse Administrators
Workplace Violence
- When bullying, incivility, and mobbing occur in the workplace - Workplace violence impacts the physical, emotional, and socioeconomic health of employees and threatens pt safety
Conflict Resolution Outcomes
- Win-Win 🡪 **Optimal goal in conflict resolution! - Win-Lose - Lose-Lose
There is a movement to less bureaucratic designs within organizations. List some
- ad hoc - matrix - care-centered systems
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 - cannot happen if both parties do not set aside their original goals - In collaboration, problem solving is a joint effort with no superior-subordinate, order-giving-order-taking relationships. - True collaboration requires mutual respect, open and honest communication, and equitable, shared decision-making powers.
Smoothing
- an individual attempts to reduce the emotional component of the conflict - rarely results in resolution of actual conflict
Punishment
- an undesirable event that follows unacceptable behavior, which may have negative consequences but can be a powerful motivator for change - Ensure to remind employee it is because of actions and not because of who they are
Compromising
- each party gives up something it wants - often a lose-lose situation unless each party willing to give up something of equal value; in order to be win-win both parties must feel like they have won more than the other
Describe the role of a leader
- empower others; maximize workforce effectiveness - Needed to implement the planned change that is part of system improvement - Art of getting things done through others willingly - In the front, moving forward, taking risks, challenging the status quo - not a job title, person's behavior determines if he/she is a leader, not a job title - Often do not have delegated authority, obtain power through other means - Wider variety of roles than manager and may have diff personal goals - Frequently not part of the formal organization - Focus on group process, information gathering, feedback, and empowering others - People follow leaders by choice, not bc they have to
Power—Coercive Strategies
- feature the application of power by legitimate authority, economic sanctions, or political clout of the change agent - People will change when rewarded or when forced by some power-coercive method (accept or leave)
An organization chart represents what?
- formal relationships - channels of communication - authority through line-and-staff positions - scalar chains - span of control.
Medicare A
- funded by social security tax and federal taxes - Financed primarily through employee payroll deductions and employer contributions - Covers inpatient hospital care, limited skill nursing facility, home health, and hospice care; beneficiaries pay a deductible for each inpatient benefit period as well as coinsurance for hospitals and skilled nursing facilities - 65 years old = enrolled in Medicare A (hospital) - Hospital stays covered; some hospice, some home health - Still out of pocket to person covering Medicare A 🡪 Deductible; changes every year
Describe the leader: Democratic/Participative 🡪 Facilitator
- less control maintains - economic and ego awards used to motivate - others are directed through suggestions and guidance - communication flows up and down - decision making involves others - emphasis on "we" - criticism is constructive - appropriate for groups who work together for extended periods, promotes autonomy and growth in individual workers - effective when cooperation and coordination between groups necessary - less efficient quantitatively than authoritative (take more time bc more people have to be consulted)
Incivility
- mistreatment or discourtesy to another person - occurs on continuum from disruptive behaviors such as eye-rolling and other nonverbal behaviors and sarcastic comments to threatening behaviors, such as intimidation and physical violence
Competing
- one party peruses what it wants, regardless of the cost to others - used when one party has more knowledge about topic than other
Cooperating/Accommodating
- one party sacrifices his or her benefits and want to allow the other party to win - **opposite of competing - Loser wants accommodation of the winning party in the future, may cause resentment in future
Avoiding
- parties are aware of a conflict but choose to not acknowledge it or attempt to resolve it - used when cost of dealing w conflict exceeds the benefit of solving it
Rational—Empirical Strategies
- provide evidence or factual information as evidence of the need for change - Used when there is little anticipates resistance or when the change is perceived as reasonable
list some causes of conflict
- role - communication - goal - personality - ethical/value - Poor communication - Inadequately defined organizational structure - Individual behavior (incompatibilities or disagreements based on differences of temperament or attitudes) - Unclear expectations - Individual or group conflicts of interest - Operational or staffing changes - Diversity in gender, culture, or age
Describe the leader: Autocratic/Authoritarian 🡪 Dictator
- strong control is maintained by coercion - others motivated by coercion - others directed with commands - communication flows downward - decision making doesn't involve others - emphasis on difference in status (I & you) - criticism is punitive - well defined group actions that are predictable, reducing frustration and giving sense of security - productivity high, creativity, self-motivation and autonomy reduced - found in large bureaucracies such as armed forces
Medicare B
- subsidized 75% by federal government and 25% by subscribers - Financed largely from federal general funds - Supplementary medical insurance, covers PCP services, outpatient diagnostic tests, certain medical supplies, and equipment, and (since 1998) home health care (prev part A) - Optional for beneficiaries, although most elderly pay the premiums - MediGap policies 🡪 cover some of the deductible and out of pocket cost for Medicare B - Provider agrees to only charge the allowable when agreeing to providing service to pt with Medicare B - Preventative services, Tx medical conditions; NOT hearing, vision, dental
Describe the third stage, refreeze, of the Kurt Lewin's Change Theory. What must the change agent do?
- the change agent assists in stabilizing the system change so that it becomes integrated into the status quo (If incomplete, the change will be ineffective and the prechange behaviors will be resumed) 3-6 months before change will be accepted as part of the system. - Support others so that the change continues
Describe the second stage, movement/change, of the Kurt Lewin's Change Theory. What must the change agent do?
- the change agent identifies, plans, and implements appropriate strategies, ensuring that driving forces exceed restraining forces. (required a lot of planning and intricate timing) - Develop a plan, set goals/objectives, identify areas of support and resistance, include everyone that will be affected, set target dates, develop appropriate strategies, implement the change, be available to support others/offer encouragement, use strategies for overcoming resistance to change, modify the change if necessary
Normative—Reductive Strategies
- use group norms and peer pressure to socialize and influence people so that change will occur - Does not require a change agent to have a legitimate power base; he/she gains power by skill in interpersonal relationships
Describe the first stage, unfreeze, of the Kurt Lewin's Change Theory. What must the change agent do?
- when the change agent convinces members of the group to change or when guilt, anxiety, or concern can be elicited. - Gather data, accurately diagnose the problem, decide if change is needed, make others aware of the need for change
what elements are required for malpractice?
- you must have a duty (there must be a professional nurse-patient relationship)(good samaritan statutes- immunity from malpractice when trying to give assistance at scene of accident) - you must have breached that duty (you must have fallen below the standard of care for a nurse) - Your breach of duty must have been a foreseeable cause of the pt's injury (causation must be proven) - Damages or injury must have occurred
What are the Lewin's rules for implementing change? (3)
1. Change should only be implemented for good reason 2. Change should always be gradual and planned 3. All individuals that may be affected by the change should be involved in planning for the change
TAMARA MCCLEARY'S THREE STEPS FOR ENGAGING EMPLOYEES THROUGH RELATIONSHIP BUILDING
1. Invest the time. Pay attention to more than just results. Connect with people at all levels in the organization every day. Learn their names and their passions. Learn what gets in their way of cooperative teamwork and top performance. Act to reduce those frustrations. 2. Get the data. Don't just monitor performance metrics—monitor data that indicates how happy employees are working in your organization. Use reliable data, like turnover, exit interviews, service levels, and more. Also try to measure other satisfaction metrics, like the degree of trust, the frequency of proactive problem solving, etc. 3. Evaluate the progress of employee engagement, service, and results. Embrace proactive relationship management and pay close attention to my "big three"—engagement, service, and results. If the results are not what you want, refine your approaches, then monitor the impact. Keep those practices that help.
What are the three phases of the Kurt Lewin's Change Theory?
1. Unfreeze 2. movement/change 3. refreeze
what are Kouzes and Posner Five practices for exemplary leadership?
1. modeling the way 2. inspiring a shared vision 3. challenging the process 4. enabling others to act 5. encouraging the heart
Magnet designation is conferred by the ANCC to health-care organizations that exemplify five model components
1. transformational leadership 2. structural empowerment 3. exemplary professional practice 4. new knowledge, innovation 5. improvements; and empirical quality results
What is the % of employee engagement in the U.S.?
30%
defamation
Act of harming or ruining another's reputation
responsibility
Being responsible for one's actions; duty
Satisficing
Choosing an option that is acceptable, although not necessarily the best or perfect.
Centralized Decision Making
Decisions made by a few managers at the top of the hierarchy
what is Intentional torts?
Deliberate acts; a direct invasion of someone's legal rights; managers are responsible for seeing that staff members are aware of and adhere to laws governing intentional torts
Ethical/Values Conflict
Different types of nurses have different value systems
T/F there is small change
F there is no such thing as small change; regardless of the type of change, most change brings feelings of achievement/pride and loss/stress
Medicare
For individuals older than 65 and for certain groups with catastrophic or chronic illness (Elderly, disabled, and renal dialysis patients are most common)
How does cost sharing (deductibles, copayments, coinsurance) impact moral hazard?
Moral Hazard: people over utilizing medical care bc they have insurance that will cover a specific cost
Accountability
Moral responsibility that accompanies a position
Groupthink
Occurs when there is too much conformity to group norms, often resulting in opinions and ideas that may lack merit
Authority
Official power to act and direct the work of others
Unity of Command
One person/one boss in which employees have one manager to whom they report and to whom they are responsible (solid vertical line between positions on organizational chart)
Change Agents
Persons skilled in the theory and implementation of planned change
Pathway to Excellence
Recognizes healthcare organizations with foundational quality initiatives in creating a positive work environment, as defined by nurses and supported by research
Critical Incident Recording
Recording of both positive and negative performance behavior throughout the performance period
Building a New Culture
Success in building a new culture often requires new leadership and/or outside analysis
Scalar Chain
The decision-making hierarchy, or pyramid, is often referred to as a scalar chain
stakeholders
The entities in an organization's environment that play a role in the organization's health and performance, or which are affected by the organization
Kurt Lewin's Change Theory
Three phases through which the change agent must go proceed before a planned change becomes part of the system
Libel
a published false statement that is damaging to a person's reputation; a written defamation
Slander
a spoken false statement that is damaging to a person's reputation
The ICU of a hospital recently lost several long-term nurses who had leadership roles. As a result, the unit is less productive, despite the consistent performance of the remaining nurse leaders. Which action would the management team take to ensure effectiveness and productivity remain consistent in the event of future leadership turnover? a. EST. a leadership succession plan b. encourage remaining nurse leaders to develop new skills c. inspire all team members to work at their highest level d. push the remaining nurse leaders to inspire team members to perform
a.
Which action on the part of the nurse is an example of transactional leadership? a. rewarding the LPN for high performance b. encouraging innovative thinking by the LPN c. encouraging the LPN nurse to transcend self interest d. motivating the LPN nurse by articulating an inspirational vision
a.
a client complains to the nurse manager about a coworker. The nurse manager listens to both the clients and the coworkers sides of the story. Which critical thinking quality is show in this situation? a. fairness b. discipline c. risk-taking d. responsibility
a.
the nurse manager working at a rehab for elderly notices an increase in the incidence of pt falls. The nurse manager reprimands the nurses and staff responsible for the falls and places them on probation. Which term describes the nurse managers leadership style? a. autocratic leadership b. shared leadership c. good clinical leadership skills d. effective interprofessional leadership
a.
The nurse manager shares experiences faced during the journey to leadership with other staff members. Which statement made by the nurse manager appropriately describes barriers faced during the leadership journey? SELECT ALL THAT APPLY a. leadership requires a time commitment b. the title doesnt guarantee good leadership c. leadership requires a mentor who offers advice and criticism d. the concept of leadership involves sharing rewards with the other team members e. leadership mandates leaders take responsibility for an activity with low-outcome achievement
a. b.
After the nurse leader teaches novice leadership skills to a newly appointed leader, which statement made by the new leader would indicate effective learning? SELECT ALL THAT APPLY a. I should resolve all conflict b. I should deal with difficult people c. I should learn how to work in groups d. I should ensure that operations run smoothly e. I should ensure that well-developed formulas are applied to situations
a. b. c.
Which internal factor would leaders consider while implementing any change in an organization? SELECT ALL THAT APPLY a. # of staff b. leader competency c. nurse education level d. financial status of staff e. place at which the organization is located
a. b. c.
Which factor would the nurse associate with transformational leadership? SELECT ALL THAT APPLY a. a shared vision b. increased self-worth of followers c. doing the work and getting paid d. coaching and mentoring by the leader e. correction of errors in a reactive manner
a. b. d.
Which statement accurately describes the role of the nursing manager? SELECT ALL THAT APPLY a. they coordinate the activities of the nursing staff in delivering nursing care b. they use appropriate leadership styles to create a nursing environment for pt and staff c. they investigate ways to improve nursing care and further define and expand the scope of nursing practice d. they provide independent care to women during a normal pregnancy, labor, and delivery, and also provide care for the newborn e. they est an environment for collaborative pt centered care to provides safe and quality care with positive pt outcomes
a. b. e.
Which employee would be competent in critical thinking, leadership, communication, and time management skills? SELECT ALL THAT APPLY a. charge nurse b. student nurse c. RN d. UAP e. LPN
a. c.
The RN, as a transformational leader, assigns a task to another nurse. Which experience would the follower nurse expect to have under the RN transformational leadership? a. increased self-worth b. fulfilling the contract c. coaching and mentoring d. doing the work and getting paid e. performing challenging and meaningful work
a. c. e.
accountability
ability to answer for one's own actions
Related to leadership, which theory is nontraditional and emerged from the physical and social sciences? a. expectancy theory b. complexity theory c. motivational theory d. management theory
b.
Which demonstrates clinical decision making by the nurse? a. I palpated the right hip of the client, which appeared red, and noted a warm feeling b. I identified impaired skin integrity in a pressure ulcer document upon finding redness in the clients hip c. I discussed the use of salt with the client who has a HX of hypotension and suffers from lightheadedness and dizziness d. I assessed weakness and hunger in a client with hx of DM and who suffers with light headedness and blurred vision
b.
Which statement is true of leadership? a. having the title of chief executive officer indicates a good leader b. leadership is an earned honor and an action-oriented response c. playing an administrative role can automatically place the title of leader on an individual d. strengthening the mission of an organization depends purely on the leader
b.
to be effective, which characteristic would be important for the nurse leader? a. autocratic behavior b. problem solving skills c. culture of zero tolerance for violence d. emphasis on inconsistent job performance
b.
When the nurse manager monitors employee's performance and takes punitive action when necessary, which outcome would the organization expect with this type of leadership? SELECT ALL THAT APPLY a. increased loyalty b. adherence to deadlines c. increased performance d. limited job satisfaction e. low-to-stable levels of commitment
b. d. e.
the nurse as a leader would integrate which responsibility? SELECT ALL THAT APPLY a. being accountable for financial matters b. encouraging the direct care nursing to provide input into decisions c. ID charge nurses who have potential to become managers d. being responsibile for the selection, hiring, and orientation of employees e. ensuring day-to-day activities of the staff are correctly planned and executed
b. e.
Upon observing two RN arguing with each other, which action by the RN best represents a leadership quality? a. complaining to management and asking the nurses to go outside b. letting the nurses continue to argue until they resolved the matter c. resolving the matter by assessing the condition and strategizing by reducing the differences d. asking the reason for the nurses argument and reprimanding them for having an argument in the hospital
c.
Which description represents the concept of "leadership" in nursing practice? a. The member contributing optimally but following a peer who is managing in a setting b. the ability to plan and evaluate others in situation where the outcomes are preestablished c. The use of individual traits to interpret the environment in an emerging situation to execute a plan d. the transfer of responsibility for performance of a task from one individual to another while retaining accountability for the outcome
c.
Which effect on followers results from a nurse leader using a transactional leadership style? a. the followers will have increased self worth b. the followers will develop a sense of being valued c. the followers will correct errors in a reactive manner d. the followers will perform challenging and meaningful work
c.
Which initial step would be most appropriate for the nurse leader, as a manager, to take when planning the implementation of a change in care delivery system? a. to set goals regarding the change process b. to plan strategies in implementing the change c. to ID the inefficiency that requires improvement d. to ID any potential solutions for the change process
c.
Which statement indicates effective learning which the RN, as a leader, teaches about leadership roles to a group of NP's? a. I should ID recurring problems b. I should have persistent and vigilant behavior in self and others c. I should use experience and knowledge to judge reasonable risks d. I should maintain esprite de corps in the face of repetitive work tasks when communicating
c.
Which theory holds that leaders act as change catalysts and innovators? a. Role theory b. trait theory c. Quantum theory d. McGregor's theory X
c.
while auditing unit documents, the nurse finds some omissions. WHich term best describes how to discuss the finding and communicate ways to achieve the desired goals with the staff? a. leadership b. followerships c. management d. decision-making
c.
Which quality would the professional nurse need in order to successfully lead and manage a team? SELECT ALL THAT APPLY a. being insensitive b. impending relationships c. exercising self-awareness d. motivating self and others e. managing emotions in self and others
c. d. e.
bureaucracy
characterized by a clear chain of command, rules and regulations, specialization of work, division of labor, and impersonality of relationships.
Assault
conduct that makes a person fearful and produces apprehension of harm
Which action, if taken by a nurse manager, would indicate that the manager is also functioning as a nurse leader? a. implementing best management skills when hiring employees b. having financial accountability associated with the organization c. screening effectively to select the right employees for the organization d. helping employees reach the highest level of their potential excellance
d.
Which is the most important skill of the nurse leader? a. priority setting b. time management c. clinical decision-making d. clinical care coordination
d.
upon receiving a complaint from the pt about a staff member being rude when providing care, the nurse manager, rather than punishes the staff member, listens to the nurse's side of the story and then talks to the pt to clarify the misunderstanding. Which leadership theory did the nurse manager utilize in this scenario? a. trait theory b. two-factor theory c. expectancy theory d. situational-contingency theory
d.
Which feedback given by the RN to the delegate is constructive? SELECT ALL THAT APPLY a. Well done. Nice job b. I expected you to do better c. you can do better when you concentrate d. you performed that procedure safely and professionally e. let me demonstrate a more effective way to perform the task
d. e.
For change to occur change agents must what?
deal appropriately with conflicted human emotions and connect/balance all aspects of organization that will be affected
how are decisions made with decentralized decision making?
decision making is diffused throughout the organization, and problems are solved at the lowest practical managerial level
How are decisions made with centralized decision making?
decisions are made by a few managers at the top of the hierarchy
what are Unintentional torts?
do not require intent, BUT, require an element of harm
Communication Conflict
failing to discuss differences with one another can lead to problems with communication
Industrial age leadership
focused mainly on traditional hierarchal management structures, skill acquisition, competition, and control (the same skills traditionally associated with management) - technical skills, command and control, competition, gaining advantage, gathering facts, what you have (wealth)
Relationship age leadership
focuses primarily on the relationship between the leader and his/her followers, on discerning common purpose, working together cooperatively, and seeking information rather than wealth - adaptive skills, invitation and interdependence, cooperation, discerning purpose, finding meaning, what you know (information)
What are restraining forces of a change?
forces that pull the system away from change
What are the driving forces of a change?
forces that push the system toward change
Magnet-designated organizations demonstrate ____ and ____ than organizations that do not have Magnet status
improved patient outcomes and higher staff nurse satisfaction
battery
intentional and wrongful physical contact person that entails an injury or offensive touching
Personality Conflict
interpersonal opposition based on personal dislike, disagreement, or differing styles
Transactional Leadership
leadership based on an exchange process in which followers are rewarded for good performance and punished for poor performance - other characteristics: focuses on management tasks, is directive and results oriented, use trade-offs to meet goals does not identify shared values, examine causes, and uses contingency reward
Trait Theory of Leadership
leadership depends on the personal qualities or traits of the leader
Transformational Leadership
leadership that generates awareness and acceptance of a group's purpose and mission and gets employees to see beyond their own needs and self-interests for the good of the group - other characteristics: identifies common values, is a caretaker inspires others with vision, has long-term vision, looks at effects, empowers others
what are torts?
legal wrongs committed against a person or property; independent of a contract; that render the person who commits them liable for damages in a civil action
Many organizations are designed around a ____ or a ___ design and have attributes to bureaucracy
line or a line-and-staff
In order for effective change to occur a change agent must what?
make a thorough/accurate assessment of extent/interest in change, the nature/depth of motivation, and the environment
what are examples of Unintentional torts?
negligence and malpractice
Negligence
occurs when medical care providers fail to fulfill their professional obligations. Every medical provider has a duty of care they owe to patients. If they don't fulfill that duty, it may be considered medical negligence.
Which classic change strategies does a change agent usually use?
often the change agent will use strategies from each of these three groups
Goal Conflict
placing personal achievement and advancement above everyone else's can create conflict
what are civil acts of torts?
plaintiff lawsuit to seek compensation for damages suffered from perceived wrong
Too many committees in an organization is a sign of a ____ designed organizational structure
poorly
Responsibility
r/t job assignment and must be accompanied by enough authority to accomplish the assigned task
invasion of privacy
revealing personal information about an individual without his or her consent
mobbing
situation in which a target is selected and bullied by a group of people rather than an individual
What does unity of command mean?
that each person should have only one boss so that there is less confusion and greater productivity
slander
the action or crime of making a false spoken statement damaging to a person's reputation
moral integration
the degree to which members of a group are united by shared beliefs
self-directedness
the extent to which a person is responsible, reliable, resourceful, goal oriented, and self-confident
Laggards
the last consumers to adopt an innovation
false imprisonment
unlawful restraint or restriction of a person's freedom of movement
Role Conflict
when 2 people have same or related responsibilities with ambiguous boundaries