13 - Solving problems and influencing positive outcomes

Which statement explains empowerment in nursing leadership? "Multitasking is the way to get things done quickly." "Each leader will be mentoring a staff member." "Goals will be decided by leadership." "There is no need for us to collaborate"

"Each leader will be mentoring a staff member." An essential strategy is for leaders to support staff through mentoring. Mentoring supports through teaching and providing resources when needed. Mentors provide inspiration and motivation to staff members to assist in goals and professional development.

Which statement would most likely to result in creative problem solving? "The patient must choose between receiving treatment or leaving against medical advice." "I asked the provider to order a pain medication, so it's up to them now." "I asked the team for ideas on how to get the patient moving to prevent pneumonia." "I told the family that any further outbursts would result in them being banned from visiting."

"I asked the team for ideas on how to get the patient moving to prevent pneumonia." Seeking solutions from the team to achieve a goal promotes creativity and flexibility and is most likely to result in solving the problem.

Which nurse's statement indicates understanding of effective problem solving? "Standardized protocols mean nurses have fewer decisions to make." "Decreases in hospital's length of stay prevents nurses from performing patient education." "I've never performed spirometry education, so the respiratory therapy will teach both the patient and me." "If physical therapy doesn't ambulate the patients, they are going to develop pneumonia."

"I've never performed spirometry education, so the respiratory therapy will teach both the patient and me." Relying on the interprofessional team to ensure effective patient care is provided, and to support the professional development of the nurse, is an example of effective problem solving.

Which statement, within a nurses' meeting, represents an act of bargaining? "Leadership decided to exchange paid time off hours for the extra hours worked to decrease over budget expenses this quarter." "Leadership will hold a meeting next week that will focus on training you on the proper use of the new infusion pumps." "Please submit your vacation requests by the end of the month for potential approval." "We need to watch our restraint documentation; we are not within our quality improvement (QI) parameters."

"Leadership decided to exchange paid time off hours for the extra hours worked to decrease over budget expenses this quarter." Bargaining is a way individuals can get something of value. Giving PTO hours for hours worked to decrease budget helps to strike a balance between the healthcare system and the nurses who work the hours and institution that give PTO time.

Which statement by the nurse leader supports collaboration efforts of the nursing profession? "Nurses value and respect one another as colleagues." "Nursing care should be based on academic nursing degrees." "Professional development supports collaboration." "The nursing profession does not need to interact with local organizations."

"Nurses value and respect one another as colleagues." Seeing the value and respect for another in the healthcare system will increase the power and influence of the profession of nursing. It is imperative nurses stand together and support on another equally and respectfully.

The local nursing union members approach the chief nursing officer to discuss the contract terms that will soon be up for renewal. The amended terms proposed by the union appear significant and may not be able to be met as written. Which response by the chief nursing officer is best? "I'm sorry I will be unable to satisfy the requests you have included in this contract proposal." "I can work with the administration and will honor all of the requests in this contract proposal." "While each one of the requests is valid, we will have to discuss how we can meet in the middle to satisfy them." "I am not sure what we can do to meet these requests. I am sure it will be addressed by someone who will let you know."

"While each one of the requests is valid, we will have to discuss how we can meet in the middle to satisfy them." The chief nursing officer must consider the interests of the nurses as well as the hospital administration. Therefore, when new requests are made by the nursing union, and the chief nursing officer knows they can't be met, a conversation involving negotiation is the best course of action.

Which statement is a characteristic of empowerment? Select all that apply. One, some, or all responses may be correct. 1. Autonomous practice is the result of a nurse feeling empowered. 2. The impact of nurse empowerment often extends to patients and families. 3. A nurse must be in a formal leadership role to empower others. 4.Empowering others requires organizational knowledge at the system level. 5. A leader empowers their followers by hastening their development.

1. Autonomous practice is the result of a nurse feeling empowered. 2. The impact of nurse empowerment often extends to patients and families. 4.Empowering others requires organizational knowledge at the system level. 5. A leader empowers their followers by hastening their development.

Which technique would a leader use to build trust? Select all that apply. One, some, or all responses may be correct. 1. Finding out the main motivating factors for the nurses on their team 2. Encouraging the team members to openly communicate their frustrations 3. Refraining from asking about their preferred leaders from the past 4. Setting up a social gathering for just the team members outside of work 5. Learning about each of the team members on an individual level

1. Finding out the main motivating factors for the nurses on their team 2. Encouraging the team members to openly communicate their frustrations 5. Learning about each of the team members on an individual level

Which characteristic would be imperative for the development of a positive professional image? Select all that apply. One, some, or all responses may be correct. 1. Having a positive attitude toward work 2. Respecting others with their honorific name 3. Maintaining a positive professional attitude 4. Introducing themselves using their first name 5. Dressing in appropriate professional attire

1. Having a positive attitude toward work 2. Respecting others with their honorific name 3. Maintaining a positive professional attitude 5. Dressing in appropriate professional attire

Which nurse's action would assist in developing political skills? Select all that apply. One, some, or all responses may be correct. 1. Joining a professional nursing organization 2. Participating in the state nursing association 3. Seeking education on shaping and developing policy 4. Focusing on mastering clear and concise communication 5. Running for an appointive position or elective office

1. Joining a professional nursing organization 2. Participating in the state nursing association 3. Seeking education on shaping and developing policy 4. Focusing on mastering clear and concise communication 5. Running for an appointive position or elective office

Which element is necessary for nurses to develop power in the political world? Select all that apply. One, some, or all responses may be correct. 1. Proficiency with technology 2. Awareness of innovation 3. Knowledge of social trends 4. Advanced practice preparation 5. Knowledge of economics 6. Holds a management role

1. Proficiency with technology 2. Awareness of innovation 3. Knowledge of social trends 5. Knowledge of economics

Before the manager can evaluate resolution of high-pressure injury rates on the unit, which element would the manager define? Select all that apply. One, some, or all responses may be correct. 1. The way skin assessments will be performed 2. Number of pressure ulcers on other managers' units 3. The person who will conduct the assessments 4. Types of pressure ulcers 5. Measurable goal for the chosen intervention

1. The way skin assessments will be performed 3. The person who will conduct the assessments 5. Measurable goal for the chosen intervention

After having problem-solving discussions with the nurses, which instruction might the manager change? Select all that apply. One, some, or all responses may be correct. 1. Wear the scrub color mandated by policy. 2. Avoid leaving the unit for meal breaks. 3. Perform intraosseous insertion according to the practice act. 4. Violators of the nonsmoking policy will face disciplinary action. 5. Round in the patients' rooms every hour.

2. Avoid leaving the unit for meal breaks. 5. Round in the patients' rooms every hour.

To support staff through change, which strategy would the manager use? Select all that apply. One, some, or all responses may be correct. 1. Share individual frustrations with the staff 2. Participate in implementing the change 3. Help staff recognize the benefits 4. Encourage discussion of concerns 5. Show understanding of staff who refuse change

2. Participate in implementing the change 3. Help staff recognize the benefits 4. Encourage discussion of concerns

Which manager's comment is conducive to problem solving? Select all that apply. One, some, or all responses may be correct. 1. "We need to address the staffing concerns before we go any further." 2. "I've tried that before, and physicians don't usually go for it." 3. "We need to discuss how this will impact night shift differently from day shift." 4. "Have we talked about the effect this will have on surgery patients?" 5. "I don't think new nurses are willing to change their schedules."

3. "We need to discuss how this will impact night shift differently from day shift." 4. "Have we talked about the effect this will have on surgery patients?"

To be considered a positive healthcare representative, which attribute is essential? Arriving to work 5 to 10 minutes before the shift to be on time Communicating in the hallway about healthcare concerns Texting at the nurse's station during visiting hours Conversing with patient's family about the nursing shortage

Arriving to work 5 to 10 minutes before the shift to be on time Being on time represents a positive professional model of a healthcare provider. Setting the tone of the environment is important for a leader to do, so the team will follow suit.

Which approach would be necessary for a novice manager to earn trust of the staff members? Being available for the team on a regular basis Communicating when there is a concern Multitasking during the team meeting Working frequently with office door closed

Being available for the team on a regular basis Being present and available for the staff will build appreciation and trust for one another.

Which statement describes a fishbone diagram? Causes are categorized on the bones. and the effects are on the head of the fish. Concerns are listed in the body, and the person responsible is the head of the fish. The main bones are the effects of the problems listed on the smaller bones. The tail of the fish is the cause, and the head of the fish is the effect.

Causes are categorized on the bones. and the effects are on the head of the fish. This statement is accurate, as causes are listed on the main bones, issues that contribute are on the smaller bones, and the head represents the effects.

While responding to the American Medical Association (AMA), which method would be an effective way for nurses to exercise their political power? Participating in summit meetings with other nursing leaders Educating legislators about the nursing profession Training in a hospital and carrying out doctors' orders Supporting the development of the registered care technologist

Educating legislators about the nursing profession Educating legislators is the most effective way for nurses to exercise their political power because it allows them to educate legislators about the nursing profession and advocate for the profession

Which nurse manager's action is most effective for promoting patient safety? Reviewing an error to determine preventive measures Encouraging staff to report near-misses Reporting fall rates at monthly staff meetings Identifying errors that occur on other units

Encouraging staff to report near-misses Reporting near misses allows the manager to anticipate problems and develop ways to prevent them, promoting safety before an adverse event occurs.

Which nurse manager's action would demonstrate caring? Providing everyone on the team the same form of recognition when they exceed expectations Expressing compassion and empathy when interacting with team members Avoiding asking any follow-up questions when having conversations with team members Evaluating all team members together in one review process

Expressing compassion and empathy when interacting with team members A nurse manager shows compassion and empathy by engaging in topics of team member's interest, remembering previous discussions between the staff, and investing in conversation with the staff.

Which approach would be used to develop a coalition? Standing alone and representing the goal Inviting others to represent a common goal Assigning others to represent the same goal Mandating others to represent the same goal

Inviting others to represent a common goal An important approach is to invite individuals who have common interest and goals to develop a coalition.

When negotiating in the political arena, which strategy would the nurse use? Sticking to personal political beliefs Not negotiate by using trade-offs Knowing the pros and cons Accepting what is offered

Knowing the pros and cons Knowing both sides of the spectrum exercises power in the political arena. Investing knowledge in both political parties represents value in understanding the importance of the topic.

To manage the narcotic inventory with new technology, which solution is most feasible? Most expensive, fast implementation, meets regulatory requirements Moderate cost, slow to implement, may not gain regulatory approval Moderate cost, fast implementation, meets regulatory requirements Least expensive, fast to implement, may not gain regulatory approval

Moderate cost, fast implementation, meets regulatory requirements The most feasible solution would be implemented quickly, would meet the regulatory requirements, and would be moderate in cost.

When attending their first professional event in a social setting, which behavior would promote the nurse's political savvy? Networking with the attendees, regardless of their formal title and role Standing back and quietly observing the event Participating in a fervent conversation with others Showing an authoritative demeanor toward the other invited guests

Networking with the attendees, regardless of their formal title and role Networking is essential in leadership characteristics and helps to achieve goals. Networking allows thoughts and ideas to be shared in the healthcare arena. It allows nurses to meet others who may be able to influence and support healthcare.

Match the terms to the situations they represent. Nurse calls family to the hospital when end-of-life is near - [Decision-making; Professional judgment; Problem solving; Creativity] Nurse negotiates a compromise after the patient refuses dialysis - [Decision-making; Professional judgment; Problem solving; Creativity] Nurse does not administer blood pressure medication due to hypotension - [Decision-making; Professional judgment; Problem solving; Creativity] Nurse arranges to take patient outdoors to visit with their pet - [Decision-making; Professional judgment; Problem solving; Creativity]

Nurse calls family to the hospital when end-of-life is near - Decision-making Nurse negotiates a compromise after the patient refuses dialysis - Problem solving Nurse does not administer blood pressure medication due to hypotension - Professional judgment Nurse arranges to take patient outdoors to visit with their pet - Creativity

Which relationship represents the use of objective and subjective data in problem identification? Objective data are more useful than subjective data for evaluating outcomes. Objective data are used to define the problem, and subjective data are used for monitoring the problem. Objective data provide the facts that support whether subjective data are accurate. Objective data are influenced by beliefs, while subjective data are more reliable.

Objective data provide the facts that support whether subjective data are accurate. Objective measurements can confirm or refute ideas that are generated from discussions of subjective beliefs and opinions.

To understand a problem, which manager's action is most effective? Considering a similar experience in their own career Using their intuition to determine the cause Obtaining feedback from staff and observing the process Meeting with the quality improvement team

Obtaining feedback from staff and observing the process Getting feedback from staff and observing the processes leading to the problem is the most effective action to achieve understanding.

Which purpose statement would apply to the 5 Whys analysis technique? Identify the fastest solution to a problem. Determine who is responsible for a problem. Pinpoint the root cause of a problem. Identify other problems that may arise.

Pinpoint the root cause of a problem. Often completed during a root cause analysis, the main purpose of the 5 Whys is to keep communicating until the root cause of the problem is identified. This technique is completed by asking "why" five times about the event that occurred.

Which method would the team use to evaluate solutions? Make a pros and cons list and ask the executive team to choose the solution Rank solutions based on criteria for outcomes and consequences Conduct confidential voting to select the most preferred solution Rank solutions according to price and select the cheapest one

Rank solutions based on criteria for outcomes and consequences Ranking solutions on a clearly defined set of criteria allows the team to choose the best solution with the fewest undesirable consequences.

To become involved in policy development, which action would the nurse take? Participating in the general political voting process Joining a national nursing organization Running for office at any government level Becoming an active member in the state's nursing association

Running for office at any government level Due to the intimate involvement in the government process, running for office is the best way for a nurse to become directly involved with policymaking.

Match the problem to the representative scenario. Shortage of unlicensed assistive personnel (UAP) - [Manpower; Methods; Machines; Materials] Some nurses prefer to obtain their own vitals, others want UAP - [Manpower; Methods; Machines; Materials] Several vital sign monitors are tagged for maintenance - [Manpower; Methods; Machines; Materials] Shortage of blood pressure cuffs and temperature probe covers - [Manpower; Methods; Machines; Materials]

Shortage of unlicensed assistive personnel (UAP) - Manpower Some nurses prefer to obtain their own vitals, others want UAP - Methods Several vital sign monitors are tagged for maintenance - Machines Shortage of blood pressure cuffs and temperature probe covers - Materials

After an adverse event occurs, which collected information would be considered subjective? Dates when the adverse event occurred Staff involved with the adverse event Staff's report of the event's contributing factors Number of patients involved in the adverse event

Staff's report of the event's contributing factors Until a root cause analysis is conducted, staff opinions surrounding the cause of an adverse event are considered conjecture and thereby are subjective.

Which action would the manager take if unsafe consequences occur during use of the new intravenous (IV) pumps? Stopping the use of the pumps and restarting the problem-solving process Instructing staff to track malfunctions and injuries caused but taking no further actions Stopping the unsafe part of the process and conducting problem solving directed at that step Asking staff to try their own solutions to work around the problem

Stopping the unsafe part of the process and conducting problem solving directed at that step In case unsafe consequences occur, the manager should eliminate the unsafe practice or part of the process and begin working toward another solution.

Which approach would nurses utilize when facing a trivial problem that is beyond their control and does not impact patients? Venting about the problem with colleagues Writing an email to the chief nursing officer Taking no action toward the problem Seeking the advice of a private attorney

Taking no action toward the problem Purposeful inaction is an appropriate way to respond to a problem that does not impact patient safety or is not important. Also, when the concerns are beyond the nurse's control, it is best to follow the "do nothing" approach.

Which feedback is consistent with the application of practice of Cialdini's theory of influence? The nursing team doesn't see value in change. The multidisciplinary teams have strong relationships. The nursing team prefers traditional methods. The nurse works individually to get things done.

The multidisciplinary teams have strong relationships. It is significant for nurses to have relationships with all healthcare providers. Integrating teams is an essential component of the healthcare field, providing the ability to include all in the decision-making.

Which situation represents a volatility, uncertainty, complexity, and ambiguity (VUCA) environment? Supply prices have steadily increased during the pandemic. Uninsured patient numbers have decreased due to the Affordable Care Act. The ongoing shift to outpatient care has been affected by an increase in severity of illness. Nurse vacancy rates have increased due to the nursing shortage.

The ongoing shift to outpatient care has been affected by an increase in severity of illness. This is the best example of VUCA since the once predictable shift to outpatient has been upended by patients with increased severity of illness, which resulted in unpredictable inpatient volumes.

Which statement describes transactional influence? The leadership originates with the followers. Active listening techniques are utilized by the leader. The primary focus is on the results of the followers. The influence is guided by vision and empathy.

The primary focus is on the results of the followers. Transactional leadership is a direct approach to leadership that focuses on the tasks accomplished by the follower that are assigned by the leader.

Which unit observation provides the manager an opportunity to solve a nursing-related problem? Frequent complaints about staffing Fears about workplace violence Underutilization of barcode medication scanning Positive staff responses to thank-you notes

Underutilization of barcode medication scanning The observation of rare use of barcode scanning will provide the manager an opportunity to intervene since it is within their influence and can be improved at the unit level.

Which concern is the nurse leader most likely to resolve? Physicians reducing the number of orders for patients receiving narcotics Hospital leaders deciding the need for bachelor's degrees for all nurses Unit nurses inconsistently performing bedside shift reporting Administrators decreasing security personnel to reduce operating costs

Unit nurses inconsistently performing bedside shift reporting Inconsistent bedside reporting is a concern within the nurse leader's span of control. They have the knowledge to resolve this concern and the authority to improve the process.

Which question is the starting point for identifying the cause of a problem? How can we change the outcome? Why do we need to change the process? Why is this problem occurring? Who is responsible for the problem?

Why is this problem occurring? Asking why the problem occurs, then asking why for each answer is the starting point for identify the root cause of a problem.