Leadership Test 1

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What are Gardner's Tasks of Leading/Managing?

o Envisioning Goals o Affirming Values o Motivating o Managing o Achieving workable unity o Developing trust o Explaining o Serving as a symbol o Representing the group o Renewing

Types of Conflict

• Intrapersonal • Interpersonal • Organizational

Impact of an effective interdisciplinary team goal

• The goal is to produce highly effective interdisciplinary teams that achieve the best outcomes for patients.

What is followership?

• each group member contributes optimally in tandem with other group members to achieve clinical or organizational outcomes. • All team members are expected to fully participate, using their knowledge, skills, and experience to help deal with complex clinical and organizational issues. • In essence, maximal functioning as a team member exemplifies followership. •When in the following role, teamwork is palpable. • Each person acts together with purpose and in a rhythm that addresses the aim at hand.

What are the qualities of a Transformational Leader?

• process whereby the leader attends to the needs and motives of followers so that the interaction raises each to high levels of motivation and morality. • The leader is a role model who inspires followers through displayed optimism, provides intellectual stimulation, and encourages follower creativity.

Effective communication

• promotes optimal patient outcomes. • Equally important is making certain the communication that occurs between healthcare providers and patients and families ensures quality care and patient safety and satisfaction. • Although the communication within healthcare settings is often complex and chaotic, understanding the basic principles of the communication process is essential

Effect on Follower in Transactional vs Transformational

Transactional 1. fulfills the contract or gets punished 2. does the work and gets paid 3. corrects errors in a. reactive manner Transformational 1. shared vision 2. increased self-worth 3. challenging and meaningful work 4. coaching and mentoring 5. sense of being valued

Stages of Conflict

• Frustration...Conceptualization....Action...Outcomes

What are the key traits that leaders possess?

(1) articulating a vision for the desired future state (2) seeing possibilities in the midst of challenging, complex, uncharted, or even dire circumstances (3) communicating effectively, sometimes powerfully, with others (4) adapting to new situations and environments (5) using experience and knowledge to judge reasonable risks.

What traits should a manager possess?

(1) the ability to identify recurring problems and design evidence-based routines to create structure and improve work efficiency (2) persistent and vigilant behavior in self and others (3) communication that maintains esprit de corps in the face of repetitive work tasks. In the workplace, management is needed to provide structure, a sense of purpose, and safety.

Tools and strategies used in an effective team

*These skills protect the team from work overload that might reduce effectiveness and increase risk to patients.* 1. leadership that coordinates the team and initiates planning, problem solving, and process improvement. 2. Also, situation monitoring is used. - This tool focuses on the ability of the nurse to actively scan behaviors and actions of co-workers; it also fosters mutual respect and team accountability, which creates a safety net for the team and patient. Specific skills are taught that increase the ability of each team member to support other team members by accurately assessing their workload and helping them. 3. The last skill set focuses on communication that highlights clear, accurate information exchange among team members, including SBAR, Call-out, and Handoff.

Ineffective team

- fails to clarify the task or objective - few members dominate the discussion and minimize others' contributions - indifferent, bored, tense environment - autocratic and remains with the chairperson - unclear and lacks clarify regarding specific tasks - embers do not listen, ideas are ignored, and overridden - disagreements are ignored or suppressed, voting results and minority is disconnected - actions or voting occurs before examination or resolution of real issues - group avoids any discussion of effective or operation

Effective Team

- tasks or objective is understood and supported by team members - all members participate in discussion and comments are pertinent - informal, comfortable, relaxed - shared and shifted according to expertise - clearly stated, assigned, accepted assignments - members are comfortable with disagreements with no conflict - general agreement reached by consensus - conscious of its own process, ongoing evaluation, assess interferences with team function

What is the definition of leadership?

- use of individual traits and abilities in relationship with others -the ability to interpret the environment/context where a situation is emerging and enter the situation without a predesigned plan

What is the difference between managing and leading?

-Managing is the ability to plan, direct, control, and evaluate others in situations where the outcomes are known or preestablished -where one or more ways of performing have been agreed on based on evidence -where feedback and communication is shared to improve clinical processes and outcomes -where sustained relationships advance consistency of purpose.

What are Bleich's Tasks of Management?

1. Identify systems and processes that require responsibility and accountability, and specify who owns the process. 2. Verify minimum and optimum standards/specifications, and identify roles and individuals responsible to adhere to them. 3. Validate the knowledge, skills, and abilities of available staff engaged in the process; capitalize on strengths; and strengthen areas in need of development. 4. Devise and communicate a comprehensive big-picture plan for the division of work, honoring the complexity and variety of assignments made at an individual level. 5. Eliminate barriers/obstacles to work effectiveness. 6. Measure the equity of workload, and use data to support judgments about efficiency and effectiveness. 7. Offer rewards and recognition to individuals and teams. 8. Recommend ways to improve systems and processes. 9. Use a social network to engage others in decision making and for feedback, when appropriate or relevant.

What are the Rules of Leaders

1. Maintain balance. 2. Generate self-motivation. 3. Build self-confidence. 4. Listen to constituents. 5. Maintain a positive attitude.

Leadership skills necessary for effective collaboration

1. realize their capacity for influence, risk taking, and decision making more fully. 2. understands that the best in a person is tied intimately to the individual's deepest sense of himself or herself—to one's spirit. 3. must touch the spiritual aspect in themselves and others. The same could be said for skillful followers. 4. This may imply involving oneself in team building with the team. The risk in such an endeavor is that the team leader is open to being vulnerable, to being judged by others, and to being wrong.

The nurse manager is assisting the nursing staff with planning, priority setting, and decision-making. Which Gardner's task of leading is being applied in this practice? a) Managing b) Affirming Values c) Motivating d) Developing Trust

A • According to Gardner's tasks of leading, the nurse manager carries out the task of managing by assisting the staff with planning, priority setting, and decision making. Motivating involves inspiring...Affirming involves assisting staff in interpreting organizational values and reinforcing every staff member's personal values to be more attuned with others. Developing trust involves sharing organizational information.

The registered nurse is teaching a group of nursing students about leadership principles. Which statement made by a nursing student indicates the need for further teaching? a) "A leader has a formal position." b) "A leader intervenes with courage." c) "A leader organizes a group of colleagues." d) "A leader does not require a promotion to be considered a leader."

Answer: A • A leader does not necessarily have a formal position to indicate that they are a leader; rather, leadership refers to performance. Leaders are those medical professionals who can intervene with courage when needed. Leaders are also able to organize a group of colleagues to solve an organizational problem. Leadership does not require a promotion.

Organizational Outcomes Transactional vs Transformational

Transactional 1. work is supervised and completed according to rules 2. deadlines are met 3. limited job satisfaction is evident 4. low to stable levels of commitment are typical Transformational 1. increased loyalty 2. increased commitment 3. increased job satisfaction 4. increased morale 5. increased performance

How is Transformational Leader different from a Transactional Leader?

Transactional leadership is: • Contingent reward (quid pro quo) • Punitive • Management by exception (active)—monitors performance and takes action to correct • Management by exception (passive)—intervenes only when problems exist

Leadership behaviors in Transactional Leadership vs Transformational leadership

Transactional: 1. contingent reward (quid pro quo) 2. punitive 3. management by exception (active) - monitors performance and takes action to correct 4. Management by exception (passive) - intervenes only when problems exist Transformational 1. charismatic 2. inspirational and motivational 3. intellectually stimulating 4. individually consideration

What are leadership styles?

o Transactional Leadership o Transformational Leadership

Nursing roles in advocacy

· Act as a liaison between patients and other members of the healthcare team. · Defend patients when their right to quality care is disregarded. · Speak on behalf of patients who are too timid to ask questions or voice their concerns

Nursing roles in informed consent

· Ask about issues concerning informed consent that concern the actual signing of the informed consent document, not the teaching and information that make up informed consent. · Witness to the signing of the informed consent document; they are attesting only to the voluntary nature of the patient's signature. · No duty on the part of the nurse to insist that the patient repeat what has been said or what he or she remembers is present. · If the patient asks questions that alert the nurse to the inadequacy of true comprehension on the patient's part or expresses uncertainty while signing the document, the nurse has an obligation to inform the primary healthcare provider and appropriate persons that informed consent has not been obtained. · A separate issue with informed consent concerns a patient who is part of a research study. o Research is disclosed to the subject or the subject's representative o The federal government mandates the basic elements of information that must be included to meet the standards of informed consent

Nursing roles in confidentiality and information security

· Confidentiality is the right to privacy of the health record. Institutions can reduce potential liability in this area by allowing access to patient data, either written or oral, only to those with a "need to know." Persons with a need to know include physicians and nurses caring for the patient, technicians, unit clerks, therapists, social service workers, and patient advocates. · Nurses should never discuss patients with others who do not have the "need to know". · They must protect and secure client written records and they must also secure electronic records by protecting and not sharing their password and logging off after each entry. · The patient's right of access to his or her health record is another confidentiality issue. o When supervising a patient's review of his or her record, the nurse manager or representative should explain only the entries that the patient questions or about which the patient requests further clarification. The nurse makes a note in the record after the session, indicating that the patient viewed the record and what questions were answered. · Patients also have a right to copies of the record, at their expense o A hospital representative will verify that the copy is a "true and valid" copy of the original record.

Interaction between leaders, managers, and followers

· Each of these terms—leading, managing, and following—represents a distinct aspect of a nurse's role. · Yet the fluidity of a situation may require a change in roles, such as the quietest follower moving into a leadership role when that person's talents are best suited to the situation. · Nurses need to appreciate the complexity of the work situation and be prepared to assume different roles and to do so in a fluid manner rather than in only a defined time, role, or situation.

Nursing roles in client rights

· Fully know about their medical condition and treatments without any withholding of information. · Make autonomous decisions about their medical care including their right to accept and reject any treatments. · Complete freedom from abuse and neglect. Access to emergency services.

Nursing roles in legal practice

· Nurses are advocates for patients and must find a balance while delivering patient care. There are four main principles of ethics: autonomy, beneficence, justice, and non-maleficence

Nursing roles in advanced directive

· Responsible and accountable for assessing educational needs in respect to advance directives and to insure that the clients and staff members have the sufficient knowledge to make sound and knowledgeable decisions relating to these important aspects of client care.

Nursing roles in information technology

· Technology enables healthcare providers to capture standardized data and use it to inform patient care and communicate across a range of clinical settings

What are Bleich's Tasks of Followership?

• 1. Demonstrate individual accountability while working within the context of organizational systems and processes; do not alter the process for personal gain or shortcuts. • 2. Honor and implement care to the standards and specifications required for safe and acceptable care/service. • 3. Offer knowledge, skills, and abilities to accomplish the task at hand. • 4. Collaborate with leaders and managers; avoid passive-aggressive or nonassertive responses to work assignment. • 5. Include evidence-based feedback as part of daily work activities as a self-guide to efficiency and effectiveness and to contribute to outcome measurement. • 6. Demonstrate accountability to the team effort. • 7. Take reasonable risks as an antidote for fearing change or unknown circumstances. • 8. Evaluate the efficiency and effectiveness of systems and processes that affect outcomes of care/service; advocate for well-designed work. • 9. Give and receive feedback to others to promote a nurturing and generative culture.

The registered nurse is teaching the nursing student the qualities that a leader would possess for effectively managing conflicts. Which statement by the nursing student indicates the need for further teaching? a) "I will provide a forum for open discussion." b) "I will ask the staff or clients to learn from the situation." c) "I will immediately resume efforts to resolve the conflict if initial efforts fail." d) "I will motivate followers to use the skills and resources for dispute resolution."

• Answer: C • The effective approach toward managing conflicts as a leader is to provide a "cooling off" period before reconvening if the resolution fails.

Modes of Conflict Resolution

• Collaborating • Competing • Compromising • Accommodating • Avoiding

• Tips for effective communication and addressing conflict

• Develop common language for critical information for handoff communications and communications of changes in a patient's condition. • Use a communication tool such as SBAR to standardize communication. • Use a standardized format for change-of-shift report and handoff communication. • Use a standardized format for report when patients are transferred to other units or facilities • Provide the opportunity for questions and confirmation of understanding of communication. • Have face-to-face communication when possible. • Read back all healthcare provider orders or other pertinent information. • Create a culture of patient safety that has zero tolerance for intimidating and disruptive behavior. • Work in multidisciplinary teams to develop common language. • Develop skills in assertive communication and conflict management. • Recognize that conflict is a necessary and beneficial process typically marked by frustration, different conceptualizations, a variety of approaches to resolving it, and ongoing outcomes. • Assess the work environment to see what behaviors are endorsed and fostered by the leaders. Determine whether these behaviors are worthy of imitation. • Determine any similarities and differences in facts, goals, methods, and values in sorting out the different conceptualizations of a conflict situation. • Assess the degree of conflict resolution by asking questions about the quality of the decisions (e.g., creativity, practicality, achievement of goals, breakthrough results) and the quality of the relationships (e.g., understanding, willingness to work together, mutual respect, cooperation). • Remind yourself of your preferences for resolving conflict (e.g., which of the five approaches do you not use often enough and which do you overuse?) and assess each situation to match the best approach for that type of conflict regardless of which is your favorite approach. • Assist others around you in assessing conflict situations and determining how they can best approach them.

What are interprofessional teams

• Interprofessional teams are essential to quality patient care. • Nurses, physicians, dietitians, social workers, case managers, pharmacists, and physical therapists, to name a few, must work together to achieve cost-effective care while achieving the highest quality of care in the healthcare setting. • This means efforts must be expended to understand the various roles and backgrounds of each profession.

What are essential skills for nurse leaders as it relates to establishing collaboration with others?

• Skills for collaboration • Flexibility • Sharing ideas • Listening • Strong self-concept

What are the traits of an effective follower?

• Traits of followers include acting synergistically with others, being enthusiastic and responsible, speaking and acting with principle and integrity, adding value to the work being accomplished, and questioning decisions and directions that are not congruent with the purpose or values of the group. • The effective follower is willing to be led, to share time and talents, to create and innovate solutions, to take direction from the manager and to role model confidence and professionalism. • Simultaneously, followers must perform their assigned structured duties, which require critical thinking and decision making.


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