Chapter 11.

A nurse manager is using Homans's framework to evaluate the need for team building in a group appointed to work on accreditation issues. Which strategies should the manager use as part of this evaluation? Select all that apply. 1. Observe group member behaviors during a meeting. 2. Listen to how group members interact with one another. 3. Compare the group to a similar group from the last accreditation cycle. 4. Review the group's final report. 5. Ask a team member how the work of the group is proceeding.

1,2,5 Rationale 1: Activities are an essential component of a group system that should be evaluated. Rationale 2: Interaction is an essential component of a group system that should be evaluated. Rationale 5: Team member attitudes are one of the three elements of Homans's framework.

A nurse manager is focused on team building activities with a group chosen to write new unit policies. As a beginning step in this process, the manager should ask which questions to assess the group's context? SELECT ALL THAT APPLY 1. "How well has this group been able to relate to similar groups across the organization?" 2. "What are the group's current goals?" 3. "How have the members organized the group?" 4. "What is the general culture of the group?" 5. "How complex is the job the group has been assigned?"

2,3,4 Rationale 2: Goals are a part of the group context. Rationale 3: Organizational structure is part of the group's context. Rationale 4: It is important to assess the culture of the group, which is part of its context.

The work of a task force is completed and the leader has compiled a written report of findings and recommendations. What actions are necessary by this leader? Select all that apply. 1. Plan on the leader presenting the report to administrators. 2. Share the report with the full task force prior to presenting it to administrators. 3. Send the report to administrators by e-mail. 4. Brief key administrators regarding the report prior to the administrative presentation. 5. Print and bind the presentation in a professional manner prior to presenting it to the full task force.

2,4 Rationale 2: The full task force should have opportunity to review and comment on the report draft before it goes to the administration. Rationale 4: The leader should meet with key administrators to bring particularly important findings or recommendations to light prior to presenting the report to the full administrative panel.

The nurse manager is leading the monthly staff meeting for the professional nursing staff. Which statements by this leader reflect effective leadership? SELECT ALL THAT APPLY 1. "I will assume responsibility for developing the mission and goals of the group." 2. "I have created an agenda that identifies the amount of time allotted for each step of the problem-solving process." 3. "I realize there will be dissension; however, I prefer that we not take time from our agenda to address it." 4. "The meeting will be called to order at noon and be adjourned in 1 hour." 5. "It is important that each of you is fully engaged in the decision-making process."

2,4,5 Rationale 2: The effective leader begins and ends a meeting on time and promotes adherence to the proposed time allocation. Rationale 4: The effective leader begins and ends a meeting on time and promotes adherence to the proposed time allocation. Rationale 5: Group cooperation and engagement should be promoted.

The group leader often arrives several minutes late to meetings with excuses about workload, telephone calls, or traffic. Today's meeting was scheduled to begin 5 minutes ago and the leader has not arrived. What should the group members do? 1. Call the leader's cell phone to see when arrival is expected. 2. Wait until the leader is 10 minutes late and then cancel the meeting. 3. One of the members should start the meeting. 4. Wait for the leader to arrive.

3 Rationale 3: The work of the committee should not be delayed because the leader is late. One of the members should begin the meeting.

A nurse manager has just posted the membership list for a newly formed quality management task force. Which statement, overheard by the manager, indicates the most potential for problems on the team? 1. "I'm glad I didn't get chosen for this task force. I'm so busy with my kids right now." 2. "I was on one of these teams at my last hospital." 3. "This is certainly an interesting choice of people to put together." 4. "She is such a good nurse; I hope she doesn't work herself too hard."

3 Rationale 3: This statement may reveal that members assigned to the team have problems working together. The manager should be watchful for any personality issues that might arise.

The leader of the task force group announces that tentative plans for Nurses' Week activities have been approved by the hospital administration. The task force has also been given a new task of developing criteria for the nursing awards. What must the group accomplish now? 1. Forming 2. Adjourning 3. Rebuilding 4. Re-forming

4 Rationale 4: In the re-forming stage, the group must refocus its activities and recycle through the four stages. The leader explains the new direction and provides guidance in the process

Which situation best exemplifies the nurse manager as a team leader? 1. The nurse manager posts the unit's positive accomplishments from the past month in the break room. 2. The nurse manager controls the staff meetings so the staff can get back to work quickly. 3. Every year the nurse manager does staff member evaluations to determine pay raises. 4. The nurse manager encourages conjunctive task performance on the unit.

1 Rationale 1: Building the team up by praising team accomplishments best exemplifies the nurse manager as team leader.

A newly hired nurse is asked to join a group working on unit protocols. This nurse is verbal and dominates the conversation of the group. The group leader identifies the disruption this nurse causes as being from which phenomenon? 1. Status incongruence 2. Group isolates 3. Emergence 4. Deviation

1 Rationale 1: Status incongruence means that the status of the newly hired nurse is not congruent with being a dominant player in the group. Status in the group is determined by conforming to group norms that often include higher status for those who have worked in the group for a longer time.

A task force leader says, "At the beginning of our next meeting we are going to do some team-building exercises." Which comment by a group member indicates a need for further education about team building? 1. "I don't see anything wrong with the way our team works. Why do we have to go through team building?" 2. "That should help us meet the goals we have written." 3. "I did some team-building work a long time ago. I probably need a refresher." 4. "I hope the men on our task force will cooperate."

1 Rationale 1: Team-building exercises were originally used to improve interpersonal workplace relationships and this group member may still think of them in that vein.

A group member has failed to complete assigned tasks for three of the last four meetings, despite reminders that incomplete work slows down the entire team. At each meeting the noncompliant member promises to complete tasks for the next meeting. What group actions are likely to occur? Select all that apply. 1. The remaining group members may begin to use manipulation to get the tasks done. 2. The other group members may attack the noncompliant member. 3. Other group members will quietly complete the noncompliant member's work. 4. The remainder of the group will ignore the noncompliant member. 5. The group members will extend patience and understanding to the noncompliant member.

1,2,4 Rationale 1: If rational argument does not work, group members may resort to manipulation of the deviant member. Rationale 2: When lack of compliance increases or slows the remainder of the group, attacks are likely to occur. Rationale 4: This ignoring behavior is a final step of frustration with the noncompliant member.

Which activities are expected from the nurse manager as team leader? Select all that apply. 1. Offering constructive criticism 2. Settling all employee conflicts 3. Encouraging group discussions 4. Facilitate group processes 5. Foster team dependence

1,3,4 Rationale 1: The nurse manager is expected to evaluate the outcomes of the team and to offer constructive criticism about needed improvement. Rationale 3: The nurse manager encourages group discussion. Rationale 4: The leader's influence on group processes may be the determining factor in whether or not the group is effective

A nurse manager has just completed a difficult assignment managing a group that was not cohesive. Which group should the nurse identify as likely having good cohesiveness? SELECT ALL THAT APPLY 1. Nurse who each have 7 to 8 years of experience 2. Nurses who work on different units throughout the hospital 3. Staff nurses who are interested in learning about the task of the group 4. Staff nurses who work with one another on a daily basis 5. Staff nurses who are all between 35 and 40 years of age

1,3,4,5 Rationale 1: This group has similar backgrounds, which will likely mean they have shared values regarding nursing. Rationale 3: People who have specific needs that can be satisfied by involvement with the group are more cohesive. Rationale 4: Those who must interact to achieve their goals and tasks are likely to be cohesive when working in a group. Rationale 5: Similarity in age increases cohesiveness.

A staff nurse is the manager of a command group consisting of other staff nurses, a nurse manager, a physician, and physical therapist. What line authority does the group manager hold? Select all that apply. 1. The group manager has line authority in relation to the group members individually. 2. The group manager has line authority in relation to the other nurses in the group, but not in relation to the other disciplines in the group. 3. The group manager has no line authority in this group. 4. The group manager has line authority in relation to all members of the group except the physician. 5. The group manager has line authority in relation to all member of the group collectively.

1,5 Rationale 1: The manager of a group has line authority within that group. The authority extends to individual members and to the members collectively. Rationale 5: The group manager has line authority in relation to the group members as a group.

A nursing group cannot complete a task assignment because information from another group has not been provided. Because the nursing group cannot complete its task, a group from physical therapy will not be able to complete its task. This is an example of breakdown in which task format? 1. Pooled interdependence 2. Sequential interdependence 3. Reciprocal interdependence 4. Reverse interdependence

2 Rationale 2: In sequential interdependence, activities must be coordinated with others in a designated order.

While providing continuing education about group dynamics and team building, the nurse manager attempts to explain the difference between a group and a team. Which statement by the manager is most effective? 1. A team is bigger than a group. 2. Teams have authority; groups may be informal. 3. A group has similar goals, whereas a team's goals are dissimilar. 4. Groups are formally designated by the organization, while teams are generally informally organized.

2 Rationale 2: Teams have a designated task and line authority. Groups may be either formal or informal.

The chairperson of the nursing faculty leads the monthly meetings of the curriculum committee. This permanent group, which is designed to meet organizational goals, is which type of group? 1. Competing group 2. Command group 3. Task force 4. Informal group

2 Rationale 2: The purpose of a command group is to accomplish tasks in an organization, and these groups are recognized as legitimate organizational entities.

The nurse manager asks staff members to work as a group in planning the activities for Nurses' Week. The nurse manager should report to the supervisor that which type of group has been formed? 1. Command group 2. Task group 3. Competing group 4. Informal group

2 Rationale 2: The purpose of a task group is to deal with specific issues involving a specific need within a given time limit. Because this group is working on "Nurses' Week," the project is time limited.

In a group meeting, one of the members always arrives early and places the chairs in a circle so all members can interact. This person is responsible for confirming that the room is available for the monthly meetings. Which person does this describe? 1. Gatekeeper 2. Procedural technician 3. Coordinator 4. Initiator-contributor

2 Rationale 2: The role of the procedural technician is to support group activities by arranging the environment and providing necessary tools.

The nurse is acting as team leader for a client care conference. Which opening statement is best for this meeting? 1. "We are all here to discuss the issues with this client's discharge. What issues are we facing?" 2. "The issue with this client is the time limit for Medicare to pay has almost expired, and we aren't ready for discharge." 3. "I don't really have time for this meeting today; is there anything I can do to expedite this meeting?" 4. "I will let you all decide what might be best, as I am not really as familiar with this client as I should be."

2 Rationale 2: The team leader is the meeting facilitator, teacher, and client advocate for the patient care conference. The team leader should know the issues with the client and be able to facilitate the meeting by listing those issues.

Which ground rule statements by the leader will help the group meeting stay on task and on time? Select all that apply. 1. "We will wait until everyone who is going to attend is here before we call the meeting to order." 2. "We will always meet on the second Wednesday of the month at 1:00 p.m. as this is the time all members have indicated is most convenient." 3. "If you have information to distribute for discussion, please bring a copy for every member." 4. "We will limit verbal participation to designated key members each week." 5. "You can expect to receive an agenda for the meeting at least 1 week in advance of the meeting."

2,5 Rationale 2: The team leader should arrange to meet in a convenient but quiet place to minimize interruptions and distractions. Rationale 5: The meeting agenda should be distributed at least 1 week in advance.

A nurse manager has been appointed leader of a large task force charged with a complex assignment. What strategies should the manager use? 1. Limit full task force meetings to an initial meeting, a middle meeting, and a final meeting. 2. Lead one of the subgroups established at the first full task force meeting. 3. Develop a work plan with interim deadlines. 4. Set deadlines that are at least 1 week earlier than necessary to give subgroups time to be late.

3 Rationale 3: This work plan will be necessary to keep all subgroups on task

The nurse manager has completed a series of team-building exercises with a command group. Which statement by a group member indicates that cohesiveness is occurring? 1. "I think I understand the work of the group now." 2. "I have gotten to know my group members better during these exercises." 3. "We have so much work to do in this group." 4. "I like the members of the group."

3 Rationale 3: A "we" statement indicates that the group member feels like a part of a cohesive group.

The staff nurse has been appointed to a task force. What can the nurse expect regarding this group? 1. There will be no official leader for the group. 2. The nurse will be working with people from several different departments within the hospital. 3. The assignment will be time limited. 4. The group members will compete for resources for their own units.

3 Rationale 3: A task group is charged with accomplishing a specific time-limited assignment.

Which statement may reveal that the team member making the comment has a hidden agenda? 1. "I don't understand the second of the goals we are discussing." 2. "Are we voting on this outcome or has it already been decided?" 3. "I have to remember to add membership on the team to my resume." 4. "Are there other teams working on similar projects on other units in the hospital?"

3 Rationale 3: Concern over adding items to one's resume could indicate that the team member is more interested in personal achievement than in the goals of the team.

Hospital administration has elected to use TeamSTEPPS as a method of team building. What should the nurse manager tell staff about this training? 1. "This program was developed by a nurse to use specifically in small hospitals." 2. "Teams of nurses will be sent to national training seminars." 3. "You can expect additional efforts to help us keep on track." 4. "This is a simulation-based training similar to the old disaster drills we used to do."

3 Rationale 3: Sustainability is a part of this framework.

This is the first meeting of a task force. What should be the leader's primary objective of this meeting? 1. Determining when the task force has to complete the assignment 2. Identifying the expected outcomes in terms of measurable objectives 3. Asking members if they have time to serve on the task force 4. Establishing a standard of total participation

4 Rationale 4: During the first meeting a standard of total participation should be established.

During the first meeting of a newly created task force, the nurse manager notices that individuals tend to cluster with members of their specific nursing units. The nurse manager begins the meeting with an explanation of the focus of this group. These behaviors are characteristic of which stage of Homans's group process? 1. Norming 2. Storming 3. Performing 4. Forming

4 Rationale 4: Forming occurs in the initial stage of the group process; the members are cautious in approaching each other as they come together as a group.

In which situation would a "meeting before the meeting" be advisable? 1. The nurse is managing a standing committee on the unit. 2. The nurse is meeting with a social group to establish a plan for weight loss by walking. 3. The nurse has written information to distribute to members before the meeting. 4. The nurse expects the disagreement that started in the last meeting to carry over into this meeting.

4 Rationale 4: If there was dissention in the last meeting that may affect this meeting, a meeting before the meeting may be necessary.

The nurse manager has been asked to assemble several groups to work on tasks to improve the unit's performance and client satisfaction scores. This manager would put the fewest people in a group working on which type of task? 1. Additive 2. Disjunctive 3. Divisible 4. Conjunctive

4 Rationale 4: In a conjunctive task, the group succeeds only if all of the members succeed, so it makes more sense to have fewer members on the team. However, the members should be highly qualified for the work.