fundamentals-chapter 10 : leadership, managing, and delegating.

refers to an organization's commitment to accountability and a focus supporting universal safety in health care

just culture

leadership style in which the leader relinquishes all power to the group

laissez-faire leadership

ability to direct or motivate others toward the achievement of predetermined goals

leadership

the act of planning, organizing, directing, and controlling available human resources and financial resources to deliver quality care to patients and families

management

relationship in which an experienced person (the mentor) advises and assists a less experienced person

mentorship

process used to work through conflicts in a way that minimizes negative effects and promotes positive consequences

conflict management

autonomous, accountable professional nursing practice; a characteristic of a democratic leadership style and the heart of a self-governance model of unit organization

decentralized decision-making process

the transfer of responsibility for the performance of an activity to another individual while retaining accountability for the outcome

delegation

power obtained by virtue of a person's position

explicit power

also called directive leadership or authoritarian leadership, involves the leader assuming control over the decisions and activities of the group

Autocratic leadership

power obtained by force of a person's personality that might enable that person to have more power to influence others than designated leaders

implied power

The following list includes basic skills needed for nursing leadership and is not meant to be all inclusive, but instead to serve as a basis for development

*Commitment to excellence *Problem-solving skills, including a clear vision and strategic focus, that allow movement forward toward a creative solution (see the Nursing Advocacy in Action display on page 218) *Commitment to and passion for your work *Trustworthiness and integrity Respectfulness *Accessibility *Empathy and caring *Desire to be of service *Responsibility to enhance the personal growth of all staff

Planned Change: An Eight-Step Process

1) Recognize symptoms that indicate a change is needed and collect data. 2) Identify a problem to be solved through change 3) Determine/analyze alternative solutions to the problem 4) Select a course of action from possible alternatives 5) Plan for making the change 6) Implement the selected course of action to effect change 7) Evaluate the effects of change 8) Stabilize the change

The nurse is conducting an in-serve on change theories. Which example should the nurse include in the presentation illustrating Lewin's three stages of change?

A need for a safer intravenous therapy pump is identified. New intravenous therapy pumps are purchased and training for staff nurses is provided. Intravenous therapy pumps are placed on the nursing unit for client care. Explanation: Lewin's three stages of change are: unfreezing - recognizing need for change; moving - initiating change after planning; and refreezing - making change operational. Identifying a need for new intravenous therapy pumps, training staff to use the pumps, and then placing the pumps for client care is the only option that illustrates Lewin's stages.

The new nurse is having difficulty managing the time required to care for a group of complex clients and is several hours behind in completing nursing interventions. Which intervention should the nurse complete first?

Administer a dose of digoxin that is two hours behind schedule. Explanation: The first step in time management is to determine which tasks are priority. Digoxin is a critical client medication and therefore takes priority over the other options. Dressing changes, discharge orders, and completing facility forms can be delayed until critical tasks are complete.

Which are examples of personal leadership skills necessary for nurse leaders? Select all that apply.

Communication Problem solving Self-evaluation Explanation: Communication, problem solving, and self-evaluation are three of the four basic nursing leadership skills. Religious values are personal and may contribute to a person's strength, but are not included in what is needed for a public leader. No individual nurse can ever know everything there is to know about nursing.

The nurse manager who asks staff members to give suggestions on how to improve collaboration between nurses and health care providers is exhibiting what style of leadership?

Democratic Explanation: The nurse manager who involves staff members in decision-making by asking for suggestions is exhibiting a democratic style of leadership. Autocratic leadership style would be exhibited by a leader who gave staff little opportunity to give feedback or suggestions. Transactional leadership also involves little input by staff into decision-making and is instead focused on providing rewards when tasks are completed. A leader with a laissez-faire style would give all control to staff members to determine how to improve collaboration.

also called participative leadership, is characterized by a sense of equality among the leader and other participants. Decisions and activities are shared. Participants are encouraged to develop their skills and strengths within the group.

Democratic leadership

Which style of leadership is rarely used in a hospital setting because of the difficulty of task achievement by independent nurses?

Laissez-faire Explanation: In laissez-faire leadership, also called nondirective leadership, the leader relinquishes power to the group, such that an outsider could not identify the leader in the group. Autocratic leadership, also called directive leadership or authoritarian leadership, involves the leader assuming control over the decisions and activities of the group. Transformational is often described as charismatic; transformational leaders are unique in their ability to inspire and motivate others. Democratic leadership, also called participative leadership, is characterized by a sense of equality among the leader and other participants.

Lewin identified three stages of change:

Unfreezing: The need for change is recognized. Moving: Change is initiated after a careful process of planning. Refreezing: Change becomes operational or a part of one's everyday life.

Before planning to make a change, a nurse manager should consider the following:

What is amenable to change? Considering this question may reveal a behavior not amenable to change. How does the group function as a unit? Certain forces within a group may favor change, whereas other forces may resist it. Is the person or group ready for change and, if so, at what rate can that change be expected to be accepted? The pace of change must be consistent with the person's or group's readiness to assimilate change. Readiness involves both the ability and willingness to change. In contemporary health care organizations, change is dynamic, persistent, and very challenging. The concept of flexibility previously mentioned is put to a real test in any clinical or managerial arena. Are the changes major or minor? A series of small changes may be more easily accomplished than one large, dramatic change. The nursing leader/manager must support the staff during the difficult task of acquiring new skills and, frequently, new professional identities.

method by which nurses can comfortably and respectfully address conflict in the workplace (rather than avoiding conflict) by creating connections with others to build trust

conflict engagement

deliberate organization of patient care activities between two or more participants (including the patient) to facilitate the appropriate delivery of quality health care services in an efficient person-centered manner; mechanism to make sure that patients get the right care at the right time in the most efficient and cost-effective manner, by the right person in the right setting

care coordination

process of transforming,altering,or modifying something

change

A nurse manager reviews an employee's contribution to the nursing division annually. This process is:

performance appraisal. reference : Performance appraisal is typically conducted annually. Each organization determines a reward structure to define and to acknowledge success. Interpreting quality indicators pertains to evaluation of general client care, not of an individual nurse. An employee's job satisfaction survey is a tool that allows the employee to give feedback on the employee's satisfaction with work, not a review of the employee's contribution conducted by the nurse manager.

: change agent's purposeful, systematic effort to bring about change

planned change

ability to influence others to achieve a desired effect

power

leadership that moves beyond the traditional modes previously experienced by all levels of workers; spawned by the impact of the information age on work and the worker

quantum leadership

philosophy and set of practices that begins with the natural feeling of wanting to serve; its aim is to enrich the lives of individuals, build better organizations, and ultimately creates a more just and caring world

servant leadership

leadership style based on maintaining control by rewarding good behavior and punishing negative or detrimental behavior

transactional leadership

type of leadership in which the person creates revolutionary change and commits to the personal and professional growth of self and others

transformational leadership