Chapter 10: Leading, Managing, and Delegating
The primary responsibility of the nurse manager is to... A. create plans and budgets B. direct discharge planning C. provide direct pt care D. evaluate nursing care plans
A.
How should a nurse leader best address nurses' resistance to a change in the shift-scheduling protocol on their hospital unit? A. explain the cost savings that the change will bring for the hospital B. allow those who remain unconvinced to temporarily opt out the proposed change C. explain the benefits of the change and elicit honest feedback D. put the matter to a vote and respect the wishes of the majority
C.
Conflict resolution strategies
avoiding, collaborating, competing, compromising, cooperating/accommodating, and smoothing
What to consider when delegating care
capabilities of the UAP, stability of the pts condition, complexity of the action, potential for harm, predictability of the outcome, and overall context of the pts needs
Leadership qualities
charismatic, dynamic, enthusiastic, poised, confident, self-directed, flexible, knowledgeable, and politically aware
Leadership skills
commitment to excellence, problem-solving skills, commitment to and passion for your work, trustworthiness and integrity, respectfulness, accessibility, empathy and caring, and responsibility to enhance personal growth of all staff
Decentralized management status
decisions are made by those who are most knowledgeable about the issues being decided and nurses are intimately involved in concerning pt care
5 key practices for servant leaders
develop your vision, listen and learn before speaking and acting, envision and invest in others' greatness, give away your power, and build community by developing strategic relationships
Autocratic leadership style
direct leadership; control is efficient but also develop resistance towards leaders
A nurse is in charge of a large group of employees on a busy surgical floor. Today's care must be completed early due to a special event involving most of the employees. Which management style would work best in this situation? A. authoritarian B. coercive C. democratic D. Laissez-faire
A.
April and Sara are nurse managers for different units in the hospital. They are planning for a major change to occur in both units. Sara tells April she has identified a key power player on her unit. Which of the following describes what Sara means by this term? A. a regular employee who is a natural leader B. an employee who will resist change C. someone in whom Sara can confide D. someone who spreads untrue rumors
A.
A staff nurse works on a medical unit where staff retention is very high. There is a a sense of equality between the leader and the staff nurses. The unit decisions and activities are shared between the leader and the group. The designated nurse leader practices which of the following leadership styles? A. democratic B. transformational C. Laissez-faire D. autocratic
A. democratic
The RN on a busy telemetry floor is delegating tasks to a UAP. Which task is appropriate for the UAP to complete? A. assessing a pt's wound B. bathing a combative pt C. taking an order over the phone from a physician D. inserting an indwelling urinary catheter
B.
A nurse manager is trying to resolve a conflict between day and night shifts. She wants to convince the involved persons to set aside their differences, determine a priority common goal having to do with improved pt care, and accepted mutual responsibility for achieving this goal. The nurse manager is using which of the following types of conflict resolution? A. avoiding B. collaborating C. compromising D. competing
B. collaborating
A nurse is considering applying for a leadership role on her medical unit. She asks her colleagues what they consider to be good personal leadership skills. Which of the following would be appropriate? (select all that apply) A. knowledge of all nursing B. religious values C. communication D. problem solving E. self-evaluation
C, D, and E
A nurse manager must provide care to her pts and her employees under the constraints of her resources. That involves maintaining the financial constraints of her division. What term best describes this scenario? A. management B. allocation C. resource management D. financial management
C.
Lewin's theory of change
unfreezing- the need for change is recognized moving- change is initiated after a careful process of planning refreezing- change becomes operational
Roles of a nurse manager
planning, organizing, staffing, directing, and conrolling
Explicit power
power by virtue of position
Implied power
power due to other factors, such as personality
Democratic leadership style
everyone has a sense of equality, and leaders explore staff ideas and take those into account
Overcoming resistance to change
explain proposed change, list advantages of the change, relate the change to a person's beliefs or values, provide opportunities for open communication and feedback, indicate how change will be evaluated, introduce change gradually, and provide incentives for commitment to change
Centralized management structure
senior managers generally make decisions with little input from the group
Transformational leadership style
stimulate practice environments and challenge others to grow and learn
Transactional Leadership Style
task oriented, jobs that people have in marketing and sales where they get commission for achieving a certain number of cells
Reasons for resistance to change
threat to self, lack of understanding, limited tolerance for change, disagreement about the benefits of change, and fear of increased responsibility
The role of the UAP is...
to work in a supportive role to the RN
5 model components of magnet status
transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovation, and improvements and empirical quality results
The designated charge nurse on the telemetry unit organizes and facilitates the unit meetings; however, during most of the meetings, another RN runs the show and influences staff decisions just by her charisma and personality. Her person to lead is defined by which of the following terms? A. implied B. explicit C. situational D. democratic
A. implied Rationale: Implied power arises when a person who has no assigned role assumes a leadership role by virtue of their own personality and charisma. The designated charge nurses official assigned role give her explicit power by virtue of that assignment. Situational and democratic are types of leadership not power.
How might one define leadership? A. leadership is the process of planning, organizing, directing, and controlling activities B. leadership is the process by which the leader shares power with others C. leadership is the process of interviewing, hiring, and firing personnel D. leadership is the process of guiding, educating, motivating, and directing others
D.
Laissez-faire leadership style
non direct and allows the group to lead while someone guides them
Karen Wolf, RN, is the charge nurse on the orthopedic unit. She believes in giving the staff as much power as possible. The nurses are allowed, among other things, to create their own work schedules, provide dates and times for unit meetings, and create the agendas, to which Karen contributes. Karen's style of leadership can be described as which of the following? A. Laissez-faire B. democratic C. autocratic D. transformational
A. laissez faire Rationale: In laissez faire leaders the leader relinquishes power to the group. Autocratic leadership involves the leader assuming complete control. Democratic leadership displays a sense of equality among the leader and other participants. Transformational leaders create intellectually stimulating practice environments and challenge themselves and others to grow personally and professionally and to learn.
Servant leadership style
focuses on justness and caring where the care is placed on the followers and the leader doesn't worry about their won needs just the needs of others
Achieving self knowledge
identify your strengths, evaluate how you accomplish work, clarify your values, determine where you belong and what you can contribute, and assume responsibility for relationships
Developing leadership responsibilities
mentorship, preceptorship, nursing organizations, and continuing education
The nurse has recently been promoted to nurse manager on an oncology unit and has decided to be the sole decision maker regarding issues that concern the unit. Which type of leadership style is the nurse embodying? A. democratic B. autocratic C. quantum D. Laissez-faire
B. autocratic
The nurse manager for a surgical unit is planning a significant change in how the unit functions. They plan to include some things that will help the staff overcome any resistance to the change. Which of the following might help overcome resistance to the nurse manager's planned change? A. demand loyalty and commitment B. provide incentives, such as time off C. refuse to hear any discussion D. threaten to end staff's employment
B.
A RN severs as the chair of the Nursing Practice Committee for the hospital. The meetings don't have planned agenda: members of the committee who are interested in a specific topic feel free to suggest it and then lead to subsequent discussion. This chairman's leadership style could be termed what? A. democratic B. Laissez-faire C. autocratic D. decentralization
B. Rationale: Little or no direction is provided in laissez-faire management: coworkers develop their own goals, make their own decisions, and take responsibility for their own management.
A nurse manager tells her staff that they need to increase response time to pt requests by 5 minutes, beginning tomorrow. The time to begin this activity has been established by the manager and her staff. This action involves goal setting. What leadership style is noted with the implementation of goal setting? A. institutional governance B. participative leadership C. directive leadership D. shared governance
B. Rationale: Participative leadership involves followers in goal setting, problem solving, and decision making.
In a nursing unit, the RN delegates nursing tasks to the nursing assistant. Keeping in mind the delegation guidelines, which of the following statements denotes the right direction for the nursing assistant? A. Discontinue the IV solution. B. Dispose of the disconnected IV set. C. Check the infusion rate. D. Inspect the site for thrombophlebitis.
B. Rationale: The nurse should provide all the necessary information to carry out the assigned task. The other statements do not follow the delegation guidelines in the right directions. The tasks mentioned in the other instructions are not a nursing assistants role.
A nurse manager informs the staff members during a meeting that UAP will no longer be allowed to check pt's blood glucose levels. The nurse manager informs the group that this is a new policy on the unit, and discussions will not change the enforcement of this policy. Which type of leadership style is the nurse manager demonstrating? A. transformational B. autocratic C. democratic D. Laissez-faire
B. autocratic Rationale: autocratic leadership is where the leader assumes complete control of activities and decisions of the group. Democratic leadership is characterized by a sense of equality among the leader and other participants. Laissez faire the leader relinquishes power to the group. Transformational leadership can create revolutionary change and may be directed by a charismatic leader who has a unique ability to inspire and motivate others.
Which of the following nurse leaders most clearly exemplifies transformational leadership? A. a leader who prioritizes the fact that every member of the team is considered valuable and equal B. a leader who prioritizes the delegation of leadership to the individual members of the group C. a leader who is dynamic, inspiring, and promotes change by the power of her convictions D. a leader who is careful to thoughtfully assess the issues and principles surrounding a problem prior to acting
C. Rationale: Transformational leaders can create revolutionary change.
A staff nurse works on a surgical unit where the nurse leader allows the staff to make all decisions and direct themselves. The staff nurses fill out the work schedule and sometimes there are days where the unit is short staffed. The staff nurse feels the unit needs better leadership. The nurse leader is practicing which of the following leadership styles? A. transformational B. democratic C. autocratic D. Laissez-faire
D. Rationale: Laissez-faire is also called non directive leadership where the leader relinquishes power to the group.
The charge nurse on a unit receives a report that a LPN is taking pt's narcotics and hiding them in the nurse's lounge. The charge nurse disregards the report and continues to work on a scheduled task. Which conflict style is the charge nurse using? A. compromising B. accommodating C. avoiding D. collaborating
C. avoiding
A nurse manager and the charge nurse have two employees who disagree with the accomplishment of pt care. The manager determines a mutually agreed upon time to discuss this situation with all the members involved. This activity is called what? A. problem solving B. pt protection C. conflict resolution D. delegation
C. conflict resolution
Following a MI, a pt begins to recognize the need to increase exercise, eat a low fat diet, and implement relaxation techniques. According to Lewin, this is an example of what type of change? A. prizing B. refreezing C. unfreezing D. movement
C. unfreezing Rationale: Unfreezing is the recognition of the need for change and dissolution of previously held patterns of behavior
The nurse manager for the psychiatric unit sees that there are major conflicts between the day and night shift staff. The nurse manager suggests that each shift put aside their differences for a time and determine a common major goal. Which of the following conflict resolution styles does the nurse manager display? A. competing B. smoothing C. avoiding D. collaborating
D.
What to consider when delegating nursing care
pts condition, complexity of the action, potential for harm, degree of problem solving necessary, level of interaction required with the pt, capabilities of the UAP, and availability of professional staff to accomplish the workload
