Nursing Leadership Final

Which aligns with the delegation right of circumstance? A patient is acutely ill with a high acuity level. The patient assignment is routine and includes standardized care. The nurse conducts a follow-up inquiry about a completed task. A nurse states that a patient may have low blood pressure.

A patient is acutely ill with a high acuity level.

organizing

After the plan has been developed, the manager coordinates the work to be done while avoiding duplication of effort. In a hospital setting, the RN organizes the care to be delivered to patients. The RN delegates care to other health care team members, including LPNs and UAPs, matching team member's skills to the patient's needs to ensure care is delivered in the most expedient and cost-effective manner.

The RN acts as a patient advocate during the course of treatment (ANA, 2010b). The knowledge and relationship the nurse has with the patient makes the nurse responsible for speaking on the patient's behalf.

As a patient advocate, the RN educates patients about their conditions, purposes, and expected treatment outcomes. This education can: Empower patients to act as their own advocates. Improve their knowledge, cooperation, and compliance with their treatment plan. Facilitate their interest in seeking further information on their own and discussing treatment options with their health care provider. Provide patients the awareness they need about medication purposes, side effects, and treatment responses that need to be reported in a timely manner to prevent harmful consequences.

Which leadership style is most useful in a health crisis situation? Autocratic Bureaucratic Democratic Laissez-Faire

Autocratic

Fourth Leadership style

Bureaucratic

Which leadership style is demonstrated when a nurse manager relates to staff members impersonally and relies heavily on policies and procedures to direct work processes? Bureaucratic Democratic Laissez-Faire Autocratic

Bureaucratic

The nurse who determined that the patient's care was too complex to delegate to the UAP demonstrated which right of delegation? Circumstance Supervision Task Person

Circumstance

Which nurse leader requires certification? Clinical nurse leader Case manager Financial resource manager Collaborative team leader

Clinical nurse leader

Which nurse updates patient care plans based on patient outcomes and evidence-based findings? Nurse manager Clinical nurse leader Case manager Patient care coordinator

Clinical nurse leader

When the RN gives the UAP specific instructions about an assignment, which right of delegation is the nurse demonstrating? Circumstance Supervision Communication Person

Communication

Which management skill is the foundation for nursing practice? Communication Professionalism Business skills Humility

Communication

The American Organization of Nurse Executives (AONE, 2005) has outlined the necessary skills that nurse leaders and managers must possess:

Communication and relationship building Health care environment knowledge Leadership Professionalism Business skills

A nurse manager who informs a nurse about a salary increase for excellent performance is demonstrating a concept from which leadership theory? Behavioral Contemporary Trait Situational

Contemporary

When a nurse leader proposes multiple solutions to a problem, even though some solutions seem unrealistic, which leadership quality is the nurse leader exhibiting? Creativity Dedication Integrity Openness

Creativity

Which statement is true about democratic leadership? Decision-making can be time consuming. Collaboration is infrequent. Leaders make the decisions. Conclusions are rarely reached.

Decision-making can be time consuming.

When the nurse manager stays longer than needed to ensure staff members have appropriate resources for their shift, the manager is displaying which leadership quality? Dedication Openness Integrity Magnanimity

Dedication

Right Circumstance

Delegation depends on the patient care situation. The nurse evaluates a situation and determines whether it is appropriate for delegation. Depending on the unit type and patient acuity, the nurse may elect to negotiate a modified assignment or a different staffing combination.

A leader suggests to staff members the formation of a shared governance council related to professional practice. This leader is exhibiting which leadership style? Democratic Autocratic Laissez-Faire Bureaucratic

Democratic

Which leader believes that employees want to participate in decision-making? Bureaucratic Laissez-Faire Autonomous Democratic

Democratic

The nurse manager recognizes staff members are busy and assists with admissions and discharges. Which function was the nurse manager demonstrating? Directing Planning Controlling Organizing

Directing

Trait theories

Early leadership theories focused on the traits of leaders proposed that leaders were born with the personality traits necessary for leadership, which few people were thought to possess. classified into three categories: intelligence, personality, and ability Specific qualities of good leaders included good interpersonal skills, self-confidence, and a willingness to take risks.

Which is the best resource for nurses to access when unsure about assignments that can be legally delegated to UAPs? Immediate supervisor Chief nursing officer Facility legal manual Employee job descriptions

Employee job descriptions

Interpersonal Roles

Figurehead Leader Liaison

The nurse serving in which role helps prevent waste and misuse of patient supplies? Financial resource manager Collaborative team member Clinical nurse leader Case manager

Financial resource manager

What role did the nurse manager exhibit by giving the patient his wound care supplies that would have been otherwise discarded when he was discharged? Financial resource manager Clinical nurse leader Case manager Patient care provider

Financial resource manager

Leadership and management are used interchangeably.

However, although the concepts are related, they are different in definition and in practice.

The nurse who takes responsibility for coordinating the staff schedule is demonstrating which type of leadership? Informal Appointed Formal Assumed

Informal

Which question should the RN ask before delegating the task of ambulating the patient to a UAP? Can the UAP complete the task by the end of the nursing shift? Will the UAP be able to judge the patient's ability to walk without falling? Is the assignment within the UAP's ability to perform safely? Has the patient ambulated to the bathroom before today?

Is the assignment within the UAP's ability to perform safely?

Before delegation of nursing tasks, the nurse must consider and ask these questions:

Is this task within the RN scope of practice, knowledge, and skill? Is this task within the scope and abilities of the person to whom it is being delegated? Is this task something that can be delegated? Are there adequate resources available to the delegate to complete the task? Does the patient's condition require ongoing or frequent assessment or intervention? What are the potential risks to patient safety related to this task? Does this task entail assessment, evaluation, or nursing judgment?

Which are useful to nurses learning how to safely delegate to others in the employment setting? Select all that apply. Job descriptions Nurse practice acts Hospital policy manual Personnel policy manual Legal department manual

Job descriptions Nurse practice acts Hospital policy manual

When a nurse gives credits to those who achieve their goals which leadership quality does the nurse possess? Magnanimity Dedication Integrity Openness

Magnanimity

Which responsibilities are involved in the right of supervision when the RN delegates to a UAP? Monitoring, evaluation, and feedback Assessment, planning, and visualization Direction, management, and observation Communication, inspection, and follow-up

Monitoring, evaluation, and feedback

Who is ultimately accountable when delegated patient assignments are not completed? Unit manager Delegatee Nursing supervisor Nurse

Nurse

Which quality is displayed when a new nurse approaches the manager with an idea about how to solve a problem with the dietary department, and the manager encourages the nurse to schedule a meeting to discuss over coffee? Openness Integrity Dedication Humility

Openness

business skills and business sense

Part of quality care is ensuring that the care patients receive is cost-effective. The nurse manager must understand concepts of budgeting, staffing, marketing, and information management. Human resource management is equally important. The skillful nurse manager understands the interactions between these elements and their influence on achieving expected outcomes in an economically responsible manner.

The nurse's leadership roles consist of:

Patient Care Provider Patient Advocate Case Manager Clinical Nurse Leader Financial Resource Manager Collaborative Team Member

When the nurse improves a patient's knowledge of and compliance with the treatment plan, what role has the nurse performed? Patient advocate Case manager Nurse manager Team member

Patient advocate

Staff members recognize which competency in nurse managers who ensure patients are at the center of decisions in health care organizations? Professionalism Business sense Leadership aptitude Patient advocate

Professionalism

Which leadership theory adapts to a management style to different groups and populations? Situational Behavioral Trait Contemporary

Situational

The nurse consults with the UAP to determine if an assigned task was completed. Which of the Five Rights of Delegation does this represent? Supervision Person Task Circumstance

Supervision

Right Supervision

Supervision means monitoring an activity being carried out by someone else and making sure that it is performed correctly. Supervision does not mean that the nurse has to directly observe the delegate carry out the assigned task. However, the nurse does conduct periodic follow-up inquiries with the individual to ascertain that the task is being completed, that instruction clarification is provided, and that the assignment is adjusted if necessary.

Which rights are included in the Five Rights of Delegation? Select all that apply. Task Circumstance Supervision Condition Assignment Scope of Practice

Task Circumstance Supervision

Prior to delegating an assignment to an LPN/LVN or UAP, the nurse must identify which factors? Select all that apply. Task required Patient stability Care complexity Type of care Medical diagnosis

Task required Patient Stability Care complexity Type of care

Right Person

The definition of delegation states that a task must be assigned to a competent person in a selected situation. Most states have a certification process for UAP. LPNs or licensed vocational nurses (LVNs) are licensed. Work settings have job descriptions and approved skills or competency lists as part of the hiring and orientation process. In working with a group of people, the nurse becomes knowledgeable about individual UAP or LPN skills, strengths, and weaknesses.

Right Communication

The first component of supervision is communication. The ANA and NCSBN (2005) state that communication regarding delegation should be clear, concise, correct, and complete. The information that needs to be communicated includes the specific data to be collected, along with methods for reporting; the activities to be carried out, along with patient-specific instructions and limitations; and the expected outcomes, possible complications, and specific timelines for reporting the information. Cultural differences should be considered when communicating tasks.

Which statement is the third principle of delegation? The person to whom the assignment was delegated cannot delegate it to someone else. The assignment must be within the delegatee's scope of practice, knowledge, and skill level. The patient's condition must be such that it does not require ongoing or frequent assessment or intervention. If the delegatee does not carry out the assignment in a satisfactory manner, the RN is responsible.

The person to whom the assignment was delegated cannot delegate it to someone else.

The manager who makes threats of punishment to motivate staff members is exhibiting which management style? Situational Transformational Theory X Theory Y

Theory X

Which leadership theory is dependent on personality? Behavioral Trait Contemporary Situational

Trait

A nurse leader who rewards health care team members in order to gain their cooperation is which type of leader? Transactional Charismatic Transformational Behavioral

Transactional

Right Task

Wise use of skills and knowledge available through support staff frees the RN to perform the aspects of care that only a nurse can do. The RN must remember to delegate tasks that do not require nursing judgment. Only tasks that are routine and do not require variation from a standardized procedure should be delegated, such as bathing or obtaining vital signs on stable patients.

The clinical nurse leader (CNL), a newer nursing role, has

a master's degree and a certification from the American Association of Colleges of Nursing (AACN) Commission on Nurse Certification. Oversees patient care or provides direct patient care using evidence-based practice, evaluates patient outcomes, and updates care plans.

Leadership

ability to guide, influence, or direct others. also the ability to motivate and influence others while maintaining relationships to achieve a goal.

Case managers

assist patients in the health care process as they move through the health care system. The bedside nurse also acts as a case manager by beginning discharge planning on admission. During the admission process, data is gathered from the patient and family, which contains important information regarding the patient's existing conditions, functional ability, and areas of difficulty or lack of function, as well as disease knowledge.

bureaucratic leader

assumes that employees are motivated by external forces. This type of leader relies on policies and procedures to direct goals and work processes. The nurse tends to relate impersonally to staff and exercises power based on established rules.

Mintzberg's Behavioral Model of Management

based on two assumptions: first, that the majority of a manager's time is spent in human relations second, that managers are more reactive than proactive. These two assumptions provided the basis for three behavioral categories: Interpersonal roles informational roles decision roles

The necessary competencies that nurse leaders and managers must possess are

communication and relationship building, health care environment knowledge, leadership, professionalism, and business skills.

Decisional Roles

entrepreneur disturbance handler resource allocator negotiator

Magnanimity

giving credit where credit is due. Good leaders reflect the work and success of accomplishing a goal by crediting those who helped reach it. accept personal responsibility for failure to accomplish objectives. gives credit to other health care team members who were instrumental in reaching goals.

Kurt Lewin (1951)

identified three basic styles of Leadership: Autocratic Democratic Laissez-faire

Theory Y-style managers think:

if employees are satisfied in their work, they will view it as being as acceptable as play. that satisfied workers are capable of self-direction, self-control, and initiative. given the proper conditions, employees will accept and seek out responsibility on the job.

Informational Roles

monitor disseminator spokesperson

Knowledge

of the health care environment is essential for the nurse manager. This environment includes trends in the local market area as well as state and national trends. The nurse manager's awareness of regulations and patient care standards is vital so that clinical policies and procedures implemented at the unit level are in compliance with regulatory body expectations.

A primary nursing role is that of

patient care provider. Nurses must be able to plan, organize, deliver, and evaluate nursing care for patients. Effective communication with other members of the health care team (providers, certified nurse aides, etc.) is another essential nursing role. An example of this role is an RN who assesses, plans, coordinates, and provides care for a group of patients on a hospital unit. The RN also delegates certain tasks to other members of the health care team.

Situational theories

proposed that leaders changed their approach depending on the situation, taking into account factors such as group characteristics, type of business, and the economic climate

Management

the process of coordinating others and directing them toward a common goal. task-oriented

Which nurse leader uses coercion to ensure staff members accomplish unit goals? Autocratic Behavioral Trait Situational

Autocratic

Which does the X-style manager believe? Personnel consider work like play. Workers are capable of self-direction. Staff members take initiative. Employees are motivated by punishment.

Employees are motivated by punishment.

The nurse exhibits which role when actively monitoring patient costs and preventing waste? Resource manager Formal leader Financial officer Case manager

Resource Manager

Douglas McGregor (1960) identified and categorized managers as having

Theory X or Theory Y characteristics

Qualities of Effective Managers

self-belief, self-awareness, self-management, personal integrity, and motivation for improvement (Hiscock and Shuldham 2008) Additionally, Hiscock and Shuldham describe how important it is for nurse leaders to concentrate on the patients, rather than themselves, to deliver quality patient-focused care. Nurses also need to have the passion and drive to improve the current state of things in order to provide higher levels of quality in the care delivered to patients.

Professionalism

the ability to hold others and oneself accountable for actions and outcomes. aware of and holds high standards of ethics. Patient advocacy is part of this skill. The nurse manager is responsible for ensuring that the patient is the center of all decisions in the health care organization.

Which level of managerial work does Mintzberg's Contemporary Model describe? Select all that apply. Role Information People Action Identity

Information People Action

Which function of a manager is similar to the nursing process? Planning Organizing Directing Coordinating

Planning

A nurse is very busy caring for five patients. Which tasks can the nurse delegate to a UAP? Select all that apply. Assessing a 17-year-old's pain Shampooing a 23-year-old's hair Bathing a 41-year-old who is incontinent Ambulating a 50-year-old after surgery Vital signs on a 35-year-old with hypertension

Shampooing a 23-year-old's hair Bathing a 41-year-old who is incontinent Ambulating a 50-year-old after surgery

Which statements are true about leaders? They hold formal positions of authority Their power lies in building relationships Their position involves coordinating others They share a common vision with followers They use interpersonal skills to influence others

Their power lies in building relationships They share a common vision with followers They use interpersonal skills to influence others

Manager's Position

includes accountability and responsibility for completing tasks in the work environment. exhibit accountability when they are ultimately answerable and responsible for their own actions and the actions of those directly under their supervision.

Creativity

is the ability to think differently. leader examines all possible solutions to a problem, even if at first glance they appear to be unrealistic or outside the norm. This ability allows the nurse leader to inspire followers to consider broader visions and goals.

Theory X-style managers believe:

the average person dislikes work and will avoid it if given the opportunity. subordinates must be closely supervised, directed, and coerced into doing their work. threatening punishment helps motivate employees. most workers value job security and have little ambition beyond it.

Integrity

the quality of having clear ethical principles and aligning one's actions with the stated values.

Six qualities of effective leaders identified by Bennis (2003) are:

Integrity Dedication Magnanimity Humility Openness Creativity

Effective nurse leaders possess which qualities? Select all that apply. Integrity Humility Openness Education Charisma

Integrity Humility Openness

What role did the nurse exhibit by following the family's request of labeling a child's favorite blanket, and communicating the request to others both verbally and in the child's EHR? Patient advocate Case manager Resource manager Clinical supervisor

Patient advocate

The ANA describes delegation as the transfer of responsibility. What does the transfer of responsibility allow the competent person such as the UAP to do? Perform a selected task in a selected situation Make decisions about tasks to be delegated. Reassign tasks to other qualified persons. Complete similar tasks without supervision.

Perform a selected task in a selected situation

skill

developed aptitude managers must have those needed to carry out a specific task or job in a work environment.

Mintzberg's Contemporary Model of Management

incorporates knowledge, experience, and managerial values. also describes managerial work at three different levels rather than by role. The three different levels are: information people action.

controlling

involves comparing expected results of the planned work with the actual results. In the nursing process, evaluation is comparable to controlling. Evaluation is the process by which outcomes are compared with goals. In the situation of patient care, the patient's progress is measured on the basis of goals set forth in the nursing care plan. The nurse manager participates in organization-wide monitoring of quality of care through the hospital's quality management processes. These processes help to determine care standards and monitor the quality of care delivered.

Humility

is the ability to recognize that no one is superior to another. Effective leaders recognize their own worth while respecting the worth of those around them. The nurse in a leadership position recognizes the valuable contributions made by others and thus helps foster community.

Leadership

not only a quality but also a skill. the application of personal traits to promote change. It is the willingness to take action, motivate others with words, and lead by example.

QSEN Focus Alert - The nurse exhibits teamwork and collaboration when

recognizing the contributions of other team members in helping the patient achieve health goals and when assuming the role of a team member or leader, depending on the situation.

Openness

refers to the leader's ability to listen to other points of view without prejudging or discouraging them. An effective leader considers other's opinions with an open mind because a wider variety of solutions to problems is offered. nurse leader encourages creative solutions by providing an environment in which people feel comfortable "thinking outside the box." A nurse leader maintains approachability for others when questions arise.

The nurse manager reviews monthly urinary tract infection rates to determine if rates have declined after implementing new infection control procedures. Which management function is the nurse demonstrating? Controlling Planning Organizing Directing

Controlling

If a nurse manager complains within hearing distance of a patient's family, which leadership quality does the manager need to develop? Integrity Humility Magnanimity Openness

Integrity

Which leadership function is demonstrated when the nurse manager determines a set of actions to address hospital-acquired pressure ulcers? Planning Organizing Directing Controlling

Planning

Transformational leaders

inspire people to follow their lead work toward transforming an organization with the help of others. These individuals think the interaction between leaders and followers can raise both to higher levels of morality and motivation

Dedication

is the ability to spend the time necessary to accomplish a task. Effective leaders persist in working toward accomplishment of a goal even when doing so is difficult. They encourage others to continue working toward the goal. Persevere through difficult situations to provide care that helps patients reach their goals.

Behavioral theories

proposed that leaders learned certain behaviors. focused more on what leaders did, rather than on the characteristics they innately possessed. Task-oriented behavior and consideration of others

Fayol's Functions of Management

provide a framework to help nurses understand how effective managers function. functions of management, including: planning, organizing, directing, and controlling.

Communication

the foundation of nursing practice. essential for the nurse manager and each nurse working with patients. The development of this skill is important because the nurse must be able to obtain information, relay a plan, delegate, and evaluate a plan of care. The nurse develops relationships with patients, families, co-workers, other health care professionals, and managers as necessary for functioning in the work environment.

Directing

the management function that ensures the work of the organization is done. Clear direction is essential for smooth operation of any nursing unit. Examples can be seen on nursing units as the charge nurse or unit manager coordinates admissions, discharges, and patient assignments, while the RN often directs the work of LPNs and UAPs in the course of patient care. Skills required for efficient and clear direction include: good communication organization delegation.

Information

the manager brings to the role a collection of experiences, knowledge, values, and competencies. The manager then develops a framework for the job, which includes the purpose of the job, the work to be done, and the way it should be performed. includes communicating and controlling. The manager gives and receives information and then uses that information to manage the work of others. The nurse manager accomplishes this through staff meetings, message boards, and one-on-one interactions with staff.

Action

the manager directs the work of others and works with other departments to gain the resources necessary to achieve the work unit's objective. Example: manager contacts the central supply department to get additional dressing supplies when the unit runs short.

In a joint statement by the ANA and NCSBN in 2005, the ANA describes delegation as

the transfer of responsibility, and the NCSBN calls it a transfer of authority. This transfer allows a competent individual the authority to perform a selected nursing task in a certain situation. The nurse maintains accountability - in that the nurse is ultimately responsible for making certain the care was completed. Additionally, any significant findings during the performed task such as skin integrity alterations, shortness of breath, or changes in a patient's condition should be reported to the nurse. The nurse is responsible for assessing patient alterations or changes and addressing them in the plan of care as well.

laissez-faire leader

thinks that employees are motivated by their own desire to do well. provides little or no direction to followers, who develop their own goals and make their own decisions. Few policies and procedures are in place. usually does not succeed in highly structured organizations such as hospitals. most useful in situations in which employees are highly educated, trustworthy, motivated, and experienced. A nurse in a leadership position who uses this style of leadership assigns patient care and expects all team members to set goals for the day and manage their time to complete the assignment. Successful implementation of this leadership style in nursing requires a highly efficient and reliable staff, such as a specialized operating room nursing team with a history of working together on a set type of cases.

Financial Resource Manager

using supplies wisely, preventing waste, and controlling costs to manage charges for the patient. For example, a nurse who is going to perform a dressing change on a patient in the hospital should only use the necessary supplies needed for that procedure. Once supplies are taken from the clean utility room into a patient's room, they cannot be returned if not used because they are considered contaminated even if unopened. The nurse has a responsibility to the patient to be aware of the costs incurred for prescribed therapies. In order for this to occur, nurses must have financial awareness and understanding of Medicare, Medicaid, and insurance provisions.

Collaborative Team Member

works in collaboration with other health care team members such as health care providers and other allied health colleagues for the patient's benefit. The American Nurses Credentialing Center (ANCC, 2014) recognizes the importance of nursing collaboration with other health care disciplines along with health care organizations to develop the Magnet Recognition Program.

Prior to delegating the nurse should:

Identify the task to be performed and the specific time frame for the task to be completed. Assess the patient, type of nursing care needed, complexity and frequency of care needed, patient stability, and assessments of other providers. Determine that all of these apply: The task requires no nursing judgment outcomes are reasonably predictable there is no need to alter the procedure for task completion the task does not require critical decisions and complex observations repeated nursing assessments are not required the consequences of delegating the task are not a risk to the patient. It is important to remember to follow up with the delegatee to ensure task completion and proper documentation.

The ANA and NCSBN (2005) identified Five Rights of Delegation.

Right task: a task that is within the scope of practice for the delegatee. Right circumstances: appropriate patient setting, available resources, and other relevant factors are considered. Right person: the right person is delegating the right task (RN) to the right person (Certified Nurse Aide) to be performed on the right patient. Right direction or communication: a clear, concise description of the task, including its objective, limits, and expectations. Right supervision: appropriate monitoring, evaluation, intervention, and feedback.

Democratic Leader

believes that employees are motivated by internal means and want to participate in decision-making. The primary function of the leader in this situation is to foster communication and develop relationships with followers. view themselves as equal to their followers, even if they hold formal positions of authority. Followers usually are satisfied with this type of leadership and feel that their ideas are valued. However, this type of leadership is not appropriate in a crisis environment, when decisions must be made rapidly and without debate. Nurses who are in charge during a shift may have patient assignments and work with other health care team members to provide care. These nurses may see themselves as equals with other team members and may consult with other nurses. This style of leadership can be utilized in unit council meetings, where nurses collaborate to identify solutions to common problems.

planning function of a manager

comparable to the assessment, diagnosis, and planning steps of the nursing process. Planning includes four stages: Setting goals Assessing the current situation and future trends Setting the plan Converting the plan into an action statement The nurse assesses the patient during the planning function of management. The patient's medical diagnosis and prognosis are considered. The nurse works with the family to decide on the best course of action in light of the information gathered, and a plan is formulated, which includes the list of nursing interventions necessary to accomplish the goals.

Autocratic Leader (Authoritarian)

exercises strong control over subordinates assumes that external forces, such as the need for approval from the supervisor and the need to avoid punishment, motivate employees. demands respect and obedience from employees. If necessary, uses coercion to ensure goal accomplishment. This is a strict form of leadership that is useful in crises. A nurse may use this style when taking charge after a patient is found unresponsive. (In this situation, it is helpful to have a leader who takes control and directs other members of the health care team.)

first principle of delegation is that

nurses must have knowledge of the Nurse Practice Act in the state where they are licensed. Each state's Nurse Practice Act defines the RN scope of practice and defines appropriate delegation. The employing organization's policy and procedure manual is a second resource that addresses delegation. Employers must have job descriptions for each job that states the limitations and responsibilities of each position. Delegation information is also located in journal articles and on the NCSBN website.

The second principle of delegation is that

the RN cannot delegate assessment, planning, evaluation, or accountability of an assigned task. Even though the task has been assigned, the RN is ultimately responsible for making certain the delegatee has performed the task in a safe, satisfactory, and appropriate time frame and manner. Even if certain tasks are delegated to others, the RN is ultimately responsible for patient assessments.

People

the manager focuses on leading and linking people. Leading entails motivating and encouraging others to take action. Linking occurs when the manager networks with individuals outside the work unit to communicate needs and to develop liaisons. Nurse managers motivate the staff to provide high-quality patient care, and they network through multidisciplinary meetings in the hospital and in the community.

The third principle of delegation is that

the person to whom the assignment was delegated cannot delegate that assignment to someone else. The delegating RN needs to be notified immediately if the person cannot carry out the assigned task. This ensures that the task is either reassigned to another team member or is completed by the delegating RN.

Transactional leaders

use reward and punishment to gain the cooperation of followers. An advantage is that employees know exactly what is expected. A reward such as a salary increase or bonus is given if employees meet or exceed job expectations. Employee failure can lead to negative consequences such as reprimands, or position and/or job loss. This type of leadership focuses on getting the job done or making change happen. Rewards other health care team members who provide safe and effective care. Reprimands are given to those who do not meet safe patient care performance goals.