Leadership final

Rights and Responsibilities in Grievance Resolution

Both parties have rights and responsibilities to be heard and to listen. ❖ Employee has not only the right to a positive work environment but also a responsibility to express discontent responsibly. ❖ The manager has a right to expect employees to follow the rules but must make sure employees know and understand the rules

For a nurse leader, what is the optimal goal in resolving conflict between team members? Prevent further conflict on the same issue Create a win-win solution for all Prevent violence Demonstrate managerial skills

Create a win-win solution for all

performance managment

Appraisals are eliminated as the manager places his or her efforts into ongoing coaching, mutual goal setting, and the leadership training of subordinates. ❖ The performance management calendar is generally linked to the organization's business calendar.

Factors Influencing Effective Performance Appraisal

Appraisals should be based on predetermined standards. ❖ The appraisal tool must adequately and accurately assess job performance. ❖ Employees should have input into development of the standards. ❖ Employees must know the standards in advance. ❖ Employee must know the sources of data gathered for the appraisal. ❖ The appraiser should be someone who has directly observed the employee's work. ❖ The appraiser should be someone who the employee trusts and respects

External climate of communication

Includes external factors such as the weather, temperature, timing, status, power, authority, and the organizational climate itself

Internal climate of communication

Includes internal factors such as the values, feelings, temperament, and stress levels of the sender and the receiver

discipline vs. punishment

Involves training or molding the mind or character to bring about desired behaviors o Is often considered a form of punishment but is not quite the same thing as punishment ❖ Punishment o An undesirable event that follows unacceptable behavior, which may have negative consequences but can be a powerful motivator for change

conflict

Results from real or perceived differences in mutually exclusive goals, values, ideas, attitudes, beliefs, backgrounds, feelings, or actions.

Strategies to Ensure Performance Appraisal Accuracy

Develop self-awareness regarding own biases and prejudices. ❖ Use appropriate consultation. ❖ Gather data adequately over time. ❖ Keep accurate anecdotal records for the length of the appraisal period. ❖ Collect positive data and identify areas where improvement is needed. ❖ Include employee's own appraisal of his or her performance. ❖ Guard against the halo effect, horns effect, central tendency trap, and Matthew effect!`

Skinner's Operant Conditioning

Development consists of the pattern of behavioral changes that are brought about by rewards and punishments operant conditioning and behavior modification demonstrated that people could be conditioned to behave in a certain way based on a consistent reward or punishment system. reinforcers and punishers

Developing Standards for Performance Appraisal

Employees should have some input into developing the standards or goals on which their performance is judged. ❖ If employees believe the appraisal is based on their job description rather than on whether the manager approves of them, they are more likely to view the appraisal as relevant.

Elements that affect proper delegation in today's diverse health care work force include, but are not limited to

communication, space, social organization, time, environmental control, and biological variations. These variations are referred as "cultural phenomena."

engagement

occurs when workers are involved in, enthusiastic about, and committed to their work and workplace. not a priority till last decade Organizations and teams with higher employee engagement and lower active disengagement perform at higher levels and have better employee r The term used to describe an employee's emotional commitment to the organization and its goals is employee engagement.

overjustification effect

offering excessive rewards can lead to a decrease in intrinsic motivation. The tendency of extrinsic motivation to interfere with intrinsic motivation is known as

trait rating scales

rates an individual against some standard A method of rating a person against a set standard, which may be the job description, desired behaviors, or personal traits ❖ Probably the most widely used of the many available appraisal methods

Behaviorally Anchored Rating Scale (BARS)

rates desired job expectations on scale of importance

job dimension scales

rates the performance on job requirements

assertive communications

reflect, repeat assertive message, point out implicit assumption, restate message, question

avoiding

responding to conflict by withdrawing from open discussion

authority

right to act and empower

Delegation vs. Assignment

simply as getting work done through others or as directing the performance of one or more people to accomplish organizational goals. It is not the same as assignment, which involves distributing work to a qualified person or persons for implementation of a specific activity or set of activities within their job description

reflective Practice or Clinical Coaching

the manager or mentor meets with an employee regularly to discuss aspects of his or her work. ❖ Both individuals determine the agenda jointly, with the goal of an environment of learning that can span the personal and professional aspects of the employee's experience.

Determining when not to delegate involves a clear understanding of ________________________ because it defines professional legal limitations and scope of practice.

the nurse practice act

t or f The negotiation strategies mirror that of the nursing process.

true

halo effect

when the appraiser lets one or two positive aspects of the assessment or behavior of the employee unduly influence all other aspects of the employee's performance

The nurse is the manager of a telemetry unit that is undergoing restructuring, resulting in the need for the nursing staff to accommodate both the telemetry unit and the medical rehab unit. Most of the staff on the telemetry unit have worked there for many years, and this change will create conflict. At what stage does this conflict exist? Felt conflict stage Manifest conflict stage Perceived conflict stage Latent conflict stage

The stage where conflict hasn't happened yet but you know it is coming is referred to as latent conflict.

assigning

•Allocating tasks appropriate to the individual's job description

responsibity

•An obligation to accomplish a task

workplace violence

■Bullying ■Incivility ■Mobbing ■Nurse Hazing

To increase the likelihood that the increased delegation required in today's restructured health-care organizations does not result in an unsafe work environment, organizations should have

(a) a clearly defined structure where RNs are recognized as leaders of the health-care team, (b) job descriptions that clearly define the roles and responsibilities of all workers, (c) education programs that help personnel learn the roles and responsibilities of coworkers, and (d) training programs that foster the development of leadership and delegation skills

intrinsic vs extrinsic motivation

- Extrinsic Motivation: this occurs when we are motivated to perform a behavior or engage in an activity in order to earn a reward or avoid a punishment Rewards and reinforcements are given to encourage certain behaviors and/or levels of achievement - Intrinsic Motivation: involves engaging in a behavior because it is personally rewarding; essentially, performing an activity for its own sake rather than the desire for some external reward Often influenced by family unit and cultural values The intrinsic motivation to achieve is directly related to a person's level of aspiration. Extrinsic motivation is motivation enhanced by the job environment or external rewards.

•Active communication involves these elements

-Message -Sender -Mode -Receiver -Feedback Effective communication requires the sender to validate what receivers see and hear.

verbal communication

. Assertive communication reduces stress, improves productivity, and contributes to a healthy workforce. Aggressive communication is generally direct, threatening, and condescending passive-aggressive communication is an aggressive message presented in a passive way. Assertive communication is not rude or insensitive behavior; rather, it is having an informed voice that insists on being heard.

The Disciplinary Conference

. State the problem clearly. 2. Ask the employee why there has been no improvement. 3. Explain the disciplinary action to be taken. 4. Describe the expected behavioral change. 5. Get agreement to and acceptance of the plan.

group task roles

1. Initiator. Contributor who proposes or suggests group goals or redefines the problem; may be more than one initiator during the group's lifetime 2. Information seeker. Searches for a factual basis for the group's work 3. Information giver. Offers an opinion of what the group's view of pertinent values should be 4. Opinion seeker. Seeks opinions that clarify or reflect the value of other members' suggestions 5. Elaborator. Gives examples or extends meanings of suggestions given and how they could work 6. Coordinator. Clarifies and coordinates ideas, suggestions, and activities of the group 7. Orienter. Summarizes decisions and actions; identifies and questions departures from predetermined goals 8. Evaluator. Questions group's accomplishments and compares them with a standard 9. Energizer. Stimulates and prods the group to act and raises the level of its actions 10. Procedural technician. Facilitates group action by arranging the environment 11. Recorder. Records the group's activities and accomplishments

Herzberg's Motivation-Hygiene Theory

A need theory that distinguishes between motivator needs (related to the nature of the work itself) and hygiene needs (related to the physical and psychological context in which the work is performed) and proposes that motivator needs must be met for motivation and job satisfaction to be high. motivators - achievement, possibility for growth, recognition, work hygiene - salary, supervision, status, personal life, status, job security When hygiene factors are met, there is a lack of dissatisfaction, not an existence of satisfaction. Likewise, the absence of motivators does not necessarily cause dissatisfaction.

Victor Vroom's Expectancy Theory and motivation

A theory that individuals will behave in a certain manner based on an expected outcome - based on social values expectancy - effort - performance - reward - valence Vroom argued that a person's expectations about his or her environment or a certain event will influence behavior, and thus motivation. The motivation is connected to the expected outcome; if a reward is inherent in a certain behavior (and the reward has some value or preference) one may be willing to take the risk in the behavior

Rules

As few rules and regulations as possible should exist in the organization. ❖ All rules, regulations, and policies should be regularly reviewed to see if they should be deleted or modified in some way. ❖ If a rule or regulation is worth having, it should be enforced. When rule breaking is allowed to go unpunished, groups generally adjust to and replicate the low-level performance of the rule breaker. ❖ If a rule is consistently broken, one needs to ask the following: 1. Whose rule is it? 2. Do we still need the rule? Not disciplining an employee who should be disciplined jeopardizes an organization's morale

The nurse manager on a busy unit that has recently been experiencing shift conflicts. As the staff can have different opinions on conflicts, what is the best first step to take to resolving conflict?

Assessing what factors are affecting the judgment of the people involved in the conflict

Strategies for Becoming an Effective Coach

Be specific, not general in describing behavior that needs improvement. ❖ Be descriptive, not evaluative, when describing what was wrong with the performance. ❖ Be certain that the feedback is not self-serving but meets the needs of the employee, ❖ Direct the feedback toward behavior that can be changed. ❖ Use sensitivity in timing the feedback and make sure employees understand feedback.

Strategies to Create an Environment of Self-Discipline

Clearly written and communicated rules and regulations ❖ Atmosphere of mutual trust ❖ Judicious use of formal authority ❖ Employee identification with organizational goals

six cultural phenomena that must be considered when working with staff from a culturally diverse background

Communication: especially dialect, volume, use of touch, and eye contact Space: interpersonal space differs between cultures Social organization: family unit of primary importance in some cultures Time: cultures tend to be past, present, or future oriented Environmental control: cultures often have either internal or external locus of control Biological variations: susceptibility to diseases (e.g., Tay-Sachs) and physiologic differences (e.g., height and skin color)

The nurse-manager of a surgical unit must hire travel RNs to work during busy times. Knowing that travel nurses typically receive higher hourly salaries as well as completion bonuses for the 13-week assignment, the manager anticipates regular staff will have animosity toward these nurses. The manager has a plan to allow the regular staff to have every weekend off (because part of the travel nurse's contract states that the nurse may be required to work each weekend during the contracted time frame). What type of conflict resolution strategy is the manager using? Compromising Avoiding Competing Smoothing

Compromising is a strategy that is used whereby each party may give up something that is wanted and is usually a win-win situation for the parties involved.

A nurse manager determines that a nurse on the team comes from a future-oriented culture. What task may be best delegated to this nurse?

Future-oriented cultures focus on goals to be achieved and are more visionary in their approach to problems. Strategic planning might be best delegated to a person from this culture. Overseeing daily stocking supplies and making assignments for the unit would best fit the present-oriented person. A retrospective study is best delegated to a person of past-oriented culture

Confronting the Chemically Impaired Employee

Gather as much evidence as possible of employee's impairment. ❖ Immediate confrontation is necessary if manager suspects employee may be impaired and thus poses a risk to clients. ❖ Denial of the impairment or use of defense mechanisms should be expected; manager should not nurture or counsel the employee. ❖ The manager should outline the plan for the employee to overcome chemical impairment. ❖ The goal of a diversion program is to protect the public by early identification of impaired nurses and by providing these nurses access to appropriate intervention programs and treatment services.

The Disciplinary Process for Unionized Employees

Generally entails more procedural, legalistic safeguards for administering discipline and a well-defined grievance process for employees who believe that they have been disciplined unfairl

5 rights of delegation

Right task One that is delegable for a specific patient Right circumstances Appropriate patient setting, available resources, and other relevant factors considered Right person Right person is delegating the right task to the right person to be performed on the right person. Right direction/communication Clear, concise description of the task, including its objective, limits, and expectations Right level of supervision Appropriate monitoring, evaluation, intervention, as needed, and feedback

A nurse is planning to delegate tasks to members of a transcultural team. Which tasks would the nurse consider environmental control when delegating to these members?

Routine tasks that are done every day, Tasks that require imagination, vision, and strategic planning, Tasks with a degree of predictability requiring independent thinking to accomplish

Douglas Mcgregor's Theory x and y

Theory X: assume people dislike work, lack ambition, prefer to be led - motivated by fear and money Theory Y: assume people are willing to work, like responsibility, are self-directed - motivated by variety of reward - need only general supervision Theory Y is not a "better" management style than Theory X; the style which is "best" depends on the variables inherent in a given situation points out the importance of a manager's assumptions about workers on the intrinsic motivation of the worker.

Late-Stage Chemical Dependency #1

Tolerance is developed by the employee to the chemical, and the individual needs the chemical in greater amounts and more often to achieve the same effect. ❖ The individual characteristically exhibits high defensiveness. ❖ Employee must continually use the substance even though he or she generally no longer gains pleasure from it. The manager should not assume the role of counselor or treatment provider or feel the need to diagnose the cause of the chemical addiction. The manager's role is to clearly identify performance expectations for the employee and to confront the employee when those expectations are not met.

Types of Performance Appraisal Tools

Trait rating scales: rates an individual against some standard ❖ Job dimension scales: rates the performance on job requirements ❖ Behaviorally anchored rating scales: rates desired job expectations on a scale of importance to the position ❖ Checklists: rates the performance against a set list of desirable job behaviors Essays: a narrative appraisal of job performance ❖ Self-appraisals: an appraisal of performance by the employee. Self-appraisal is not easy for many employees because they often undervalue their own accomplishments or feel uncomfortable giving themselves high marks in many areas. ❖ Management by objectives: employee and management agree upon goals of performance to be reached. ❖ Peer review: assessment of work performance carried out by peers

destructive discipline

Use of threats and fear to control behavior ❖ Employee always alert to impending penalty or termination ❖ Arbitrarily administered and either unfair in the application of rules or in the resulting punishment

A nurse manager is faced with a conflict situation. One of the nurse manager's team members is confused about their hospital responsibilities. This team member is shy and doesn't ask for direction, leading to a lack of communication that decreases the quality of patient care. What questions should the nurse manager ask to analyze the situation? (Select all that apply.)

What individual factors are involved?, Who are the people involved?, What environmental factors are involved?

david mcclelland's basic needs theory

argued that people are motivated by three basic needs: •Need for Achievement - actively focus on improving what is; they transform ideas into action, judiciously and wisely, taking risks when necessary •Need for Affiliation - focus their energies on families and friends; their overt productivity is less because they view their contribution to society in a different light from those who are achievement oriented •Need for Power - motivated by the power that can be gained as a result of a specific action. They want to command attention, get recognition, and control other

A new nurse on a medical-surgical unit has an uncomfortable encounter with one of the RNs. Both the RN and the new nurse realize that the encounter was trivial and decide to ignore that it occurred. What type of conflict strategy management is being used? Avoidance Cooperating/Accommodating Smoothing Competing

avoidance

managment by objective

employee and managment agree upon goals of performance to be reached The employee and supervisor meet and agree on the principal duties and responsibilities of the employee's job. ❖ The employee sets short-term goals and target dates in cooperation with the supervisor or manager. ❖ Both parties agree on the criteria that will be used for measuring and evaluating the accomplishment of goals. ❖ The employee and supervisor meet regularly to discuss progress. ❖ The manager's role is supportive, assisting the employee to reach goals by coaching and counseling. ❖ During the appraisal process, the manager determines whether the employee has met the goals. ❖ The entire process focuses on outcomes and results, and not on personal traits.

group building and maintenance roles

encourager, harmonizer, compromiser, gatekeeper and expediter, standard setter, group observer and commentator, follower Encourager. Accepts and praises all contributions, viewpoints, and ideas with warmth and solidarity Harmonizer. Mediates, harmonizes, and resolves conflict Compromiser. Yields his or her position in a conflict situation Gatekeeper. Promotes open communication and facilitates participation by all members Standard setter. Expresses or evaluates standards to evaluate group process Group commentator. Records group's process and provides feedback to the group Follower. Accepts the group's ideas and listens to discussion and decisions

communication

he exchange of thoughts, messages, or information, as by speech, signals, writing, or behavior

Maslow Motivation Theory

hierarchy of needs Self-actualization, the pinnacle of the hierarchy, occurs when an individual maximizes his or her potential, doing the best that he or she can do Self-Actualized People 1. Embrace the unknown and the ambiguous 2. Accept themselves, together with all their flaws 3. Prioritize and enjoy the journey, not just the destination 4. While inherently unconventional, do not seek to shock or disturb 5. Are motivated by growth, not by the satisfaction of needs 6. Have purpose 7. Are not troubled by the small things 8. Are grateful 9. Share deep relationships with a few but also feel identification and affection towards the entire human race 10. Are humble 11. Resist enculturation 12. Are not perfec Because of Maslow's work, managers began to realize that people are complex beings, and rather than just being motivated by economics, their many needs motivating them at any one time

360-degree evaluation

includes an assessment by all individuals within the sphere of influence of the individual being appraised.

Conflicts resulting from differing or contradictory beliefs among two or more individuals are known as

intergroup conflicts

3 of 5 The unit manager of a medical-surgical unit undergoing restructuring changes realizes that to create a more controlled transition for your staff, it will be necessary to incorporate the conflict resolution strategy known as "smoothing". Smoothing is best defined as: looking toward something that the parties in conflict are in agreement about. slang for avoiding. declaring a resolution to the strategy that may be perceived as lose-lose but is in the best interest of the unit. the transfer of an aggressive employee to another unit.

looking toward something that the parties in conflict are in agreement about.

Substance Misuse

maladaptive patterns of psychoactive substance abuse indicated by continued use even when faced with recurrent occupational, social, psychological, or physical problems as well as use in dangerous situations.

Recommendations for gender-neutral communication

may may need to •Listen to objections and suggestions •Listen without feeling responsible •Suspend judgment until information is in •Explain your reason •Not yell women may need to •State your message clearly and concisely •Solve problems without personalizing them •Say what you want without hinting •Eliminate unsure words like "sort of and nonwords like "truly" •Not cry

Gender differences in communication

men tend to: •Interrupt more frequently •Talk more, longer, louder, and faster •Disagree more •Focus on the issue more than the person •Boast about accomplishments •Use banter to avoid a one-down position Women tend to •Wait to be noticed •Use qualifiers (prefacing and tagging) •Use questions in place of statements •Relate personal experiences •Promote consensus •Withdraw from conflict

vroom's expectancy theory equation

motivational force - extent person is likely to engage in certain course of action = expectancy - belief that increase effort will increase performance x instrumentality - belief increase performance will increase outcomes x valence - extent to which the outcome is desirable

organizational communication strategies

must assess organizational communication, understand structure and recognize who will be affected, not a one way channel, feedback if recieved, use multiple modes, dont overwhelm with unnecessary infomration

Skinner's Operant Conditioning response types

neutral operants - responses that do not alter probability reinforcers - increase probability of repeatition - positive or negative punishers - decrease prob of repeatition

most trust worthy communication

nonverbal

recency effect

occurs when recent issues are weighed more heavily than past performance.

horns effect

occurs when the appraiser allows some negative aspects of the employee's performance to influence the assessment to such an extent that other levels of job performance are not accurately recorded

day-to-day feedback

one of the best methods for improving work performance and building a team approach.

management phases

planning, organizing, staffing, directing, controlling

performance management include

policies, objectives, standards, appraisial process, reward and remuneration strategy, manaing underperformance and discipline,

peer review

potential for developing professional accountability but is often difficult to implement because it requires risk taking to avoid becoming simply an exercise of advocacy

t or f conflict is necessary

true

the LPN will

•1. Contribute to the nursing assessment by collecting, reporting and recording objective and subjective data in an accurate and timely manner. •2. Participate in the development of the plan of care/action in consultation with a Registered Nurse. •3. Participate in the assisting and giving of safe direct care. •4. Participate in establishing and maintaining a therapeutic nurse/client relationship. •5. Seek resources for patients/clients with cultural, physical or language barriers. •6. Contribute to the evaluation of the responses of individuals or groups to nursing interventions and participate in revising the plan of care where appropriate. •7. Communicate accurately in writing and orally with recipients of nursing care and other professionals.

Barriers to successful communication

•Ability of sender •Content •Method of communication •Skills and attitude of the receiver •Organizational factors •Cultural attitudes •Noise •Perceptions, prejudices and stereotypes •Inappropriate target for message •Technical capabilities

Promotion as strategy to create motivating climate - Elements to Prevent Negative Outcomes

•Assure the staff that established promotion polices will be followed consistently; determine promotion and selection criteria •Determine whether recruitment will be internal (current knowledge) or external (new ideas/new energy) •Ensure a pool of candidates that exists •Determine how unchosen candidates will be notified •Determine how employee releases to take new positions are to be handled

Strategies to Create a Motivating Climate

•Be a firm decision-maker using an appropriate decision-making style •Be fair and consistent •Know the uniqueness of each employee •Be clear in expectations and communicate effectively •Develop the concept of teamwork and collaboration •Reward desirable behavior •Provide experiences to "stretch" the employee toward growth •Worker Engagement •Worker Empowerment •Positive Reinforcement •Performance Appraisals •Incentives (what does staff value) •Rewards(even in seemingly meaningless categories) •Establish Strong Employee-Supervisor Relationships (basic factor with staff engagement and motivation)

1996 Health Insurance Portability and Accountability Act (HIPAA)

•Called for protection and privacy of medical information, including any information about a patient, whether oral or recorded in any form or medium, that is created or received by a health-care provider, health plan, public health authority, employer, life insurer, school or university, or health clearing house

Elements Affecting Delegation to a Transcultural Work Team

•Communication •Space •Social organization •Time •Environmental control •Biologic variations

Clear Communication and Delegation

•Define the task clearly. • •Delineate end results, time frame, and standards. • •Delegate the objective, not the procedure.

Causes of Underdelegating

•Fear that delegation may be interpreted as a lack of ability to do the job completely or correctly •A desire to complete the job •Fear that subordinates will resent delegated work •Lack of experience in the job •Enjoyment of the work delegate before overwhelmed

Stages of Group Formation

•Forming •Storming •Norming •Performing •Adjourning

Why Delegate?

•Getting work done through others •Directing to accomplish organizational goals •Giving someone else the authority to complete a task or action on your behalf •Transfer or hand-off to a competent individual,

Strategies for Successful delegation

•Identify necessary skill and education levels •Plan ahead •Select and empower capable personnel •Communicate goals clearly •Set deadlines and monitor progress •Be role model and provide guidance •Evaluate performance •Reward accomplishment

National patient safety goals

•Improve staff communication: Get important test results to the right staff person on time. •Record and pass along correct information about a patient's medicines

Delegating to Unlicensed Assistive Personnel (UAP) Potential Costs

•Liability for negligence •Issues for task delegation oJob description oKnowledge base oDemonstrated skills •Accountability for patient outcomes

motivational theorists

•Maslow—hierarchy of needs •Skinner—operant conditioning/behavior modification •Herzberg—motivator/hygiene theory •Vroom—expectancy model •McClelland—basic needs - 3 basic needs and motivation •Gellerman—"stretching" •McGregor—Theory X and Y - manager assumption and motivation

motivation

•May be defined as the force within the individual that influences or directs behavior •managers cannot directly motivate subordinates. The leader can, however, create an environment that maximizes the development of human potential.

The Delegatee's Responsibility

•Must accept only tasks that match their competency •Must maintain competency for delegated responsibility •Must communicate with nurse in charge of patient •Must carryout accepted task correctly and competently

Licensed Nurse Responsibilities

•Must determine when and what to delegate •Must communicate with delegatee •Must be available for guidance and questions •Must follow-up with patient •Must provide feedback to delegatee

Resistance to Delegation

•Not seeing subordinate's perspective •Subordinate feels unprepared for responsibility •Resistance to authority •Over-delegation

Variables Affecting Organizational Communication

•Number of levels that need to communicate •Power and status •Gender

Causes of Overdelegating

•Poor time management •Insecurity in the ability to perform a task •Insensitive to staff workload

Positive Reinforcement-A Powerful Motivational Strategy-

•Positive reinforcement must be specific or relevant to a particular performance. •Positive reinforcement must occur as close to the event as possible. to be specific. Instead of just saying, "We really are grateful for the good job you do around here," the approach might be, "I really appreciate how you dealt with the difficult patient last night. Your effort really made a difference." There appears to be a perceived threshold beyond which increasing the incentive results in no additional meaning or weight.

Elements of Nonverbal Communication

•Space •Environment •Appearance •Eye contact •Posture •Facial expression and timing •Vocal expression

Causes of Improperly Delegating

•Wrong time, to the wrong person, or for the wrong reason • •Beyond the capability of the person, or something the manager should do •Decision making without providing adequate information In delegation, the responsibility for a task can be transferred from the licensed person to the NAP, but accountability is shared by both.

Saul Gellerman's (1968) Theory of "Stretching"

•suggested that individuals should be periodically "stretched" to do tasks more difficult than they are used to doing. The challenge of "stretching" is to energize people to enjoy the beauty of pushing themselves beyond what they think they can do. •Give employees authority to make decisions; "participating" Another method, participation, entails actively drawing employees into decisions affecting their work

handoff

•transfer of responsibility between caregivers of similar training (RN to RN, LPN to LPN).

nightingale pledge

■ I will abstain from whatever is deleterious and mischievous, and will not take . . . any harmful drug

Destructive Negotiation Tactics

■Ambiguous or inappropriate questioning ■Gestures of helplessness ■Intimidation ■Manipulation ■Ridicule ■Flattery ■Aggression

collaborating

■An assertive and cooperative means of conflict resolution whereby all parties set aside their original goals and work together to establish a supraordinate or common priority goal True collaboration requires mutual respect; open and honest communication; and equitable, shared decision-making powers

smoothing

■An individual attempts to reduce the emotional component of the conflict.

compromising

■Each party gives up something it wants. ■Rewards are divided between parties ■Mutually exclusive situations in play

negotiation closure

■End on a friendly note ■Restate the final decision ■Hide astonishment at your success ■Make the other party feel that he/she also won ■Follow up with a memo

negotiation

■Frequently resembles compromise when used as a conflict negotiation strategy ■Emphasis is on accommodating differences between the parties.

Seeking Consensus

■It is always an appropriate goal in resolving conflicts and in negotiation. ■All parties support, or at least do not oppose, an agreement. ■The greatest challenge in consensus building is time.

Negotiation Terminology

■The very least for which a person will settle is often referred to as the bottom line. ■Trade-offs are secondary gains, often future-oriented, that may be realized as a result of conflict. The manager also must look for and acknowledge hidden agendas—the covert intention of the negotiation

steps for conflict resolution

■Understand the conflict. ■Communicate with the opposition. ■Brainstorm possible resolutions. ■Use an impartial mediator. ■Explore alternatives. ■Cope with stressful situations and pressure tactics. ■Choose the best resolution.

constructive discipline

❖ Helps the employee to grow ❖ Is carried out in a supportive, corrective manner ❖ Employee is reassured that punishment is given because of actions and not because of who he or she is as a person. ❖ Primary focus is to assist employees to be selfdirected in meeting organizational goals.

Performance Deficiency Coaching

❖ Manager actively brings areas of unacceptable behavior or performance to the attention of the employee and works with him or her to establish a short-term plan to correct deficiencies.

performance appraisal

❖ Performance appraisals are used to determine how well employees are performing their job. Therefore, appraisals measure actual behavior and not intent. ❖ Because of past experiences, performance appraisal interviews are highly charged, emotional events for most employees. ❖ However, when accurate and appropriate appraisal assessments are performed, outcomes can be very positive.

termination

❖ Termination should always be the last resort when dealing with poor performance but is necessary for employees who continue to break rules despite repeated warnings. ❖ Termination is always difficult for the employee, manager, and unit; however, the cost in terms of managerial/employee time and unit morale of keeping such an employee is enormous.

The Formal Grievance Process

❖ The steps are generally outlined in union contracts or administrative policies. ❖ It typically entails progressive lodging of complaints up the chain of command. ❖ If differences are not settled in formal grievance process, the dispute generally proceeds to arbitration.

Effective Performance Appraisals

❖ There should be no surprises in the appraisal conference. The effective leader coaches and communicates informally with staff on a continual basis, so there should be little new information at an appraisal conference. ❖ Employees must know in advance what happens if standards are not met. ❖ Employees must know how information will be obtained to determine performance level.

marginal employees

❖ These employees disrupt unit functioning because the quantity or quality of their work consistently meets only minimal standards. ❖ These employees often make tremendous efforts to meet competencies yet usually manage to meet only minimal standards at best. ❖ Traditional discipline is generally not constructive in modifying their behavior.

t or f workplace violence is decreasing among health care worker

false

criteria for delegation to an unlicensed assistive personnel

frequently reoccur, perform accourding to standarized sequence of steps, inovle little or no modification from one pt to another, no involve ongoing assessment, predicatble outcome, does not endanger, allowed by agency

feedback

greatest manager tool to change behavior

GRRRR as a listening tool

greeting, respectful listening, review, recommend or request, reward

Types of Alternative Dispute Resolution (ADR)

-Mediation -Fact-finding -Due process hearings -Ombudsperson

Roles Commonly Assumed by Group Members

1. Aggressor. Expresses disapproval of others' values or feelings through jokes, verbal attacks, or envy 2. Blocker. Persists in expressing negative points of view and resurrects dead issues 3. Recognition seeker. Works to focus positive attention on himself or herself 4. Self-confessor. Uses the group setting as a forum for personal expression 5. Playboy. Remains uninvolved and demonstrates cynicism, nonchalance, or horseplay 6. Dominator. Attempts to control and manipulate the group 7. Help seeker. Uses expressions of personal insecurity, confusion, or self-deprecation to manipulate sympathy from members 8. Special interest pleader. Cloaks personal prejudices or biases by ostensibly speaking for others

Four Common Steps in Progressive Discipline

1. Verbal admonishment 2. Written admonishment 3. Suspension from work without pay 4. Dismissal ❖ When using progressive discipline, for all but the most serious infractions, the slate should be wiped clean at the conclusion of a predesignated period.

Ombudsperson

A person who hears and investigates complaints by private individuals against public officials or agencies

Profile of Impaired Nurse

May vary greatly ❖ Typically, behavior changes are seen in the following three areas: o Personality/behavior changes o Job performance changes o Time and attendance changes

Reentry Guidelines for the Recovering Nurse

No psychoactive drug use is tolerated. ❖ The employee should be assigned to day shift for the first year. ❖ The employee should be paired with a successfully recovering nurse whenever possible. ❖ The employee should be willing to consent to random urine screening with toxicology or alcohol screens. ❖ The employee must give evidence of continuing involvement with support groups such as Alcoholics Anonymous or Narcotics Anonymous. Employees should be encouraged to attend meetings several times each week. ❖ The employee should be encouraged to participate in a structured aftercare program. ❖ The employee should be encouraged to seek individual counseling or therapy as needed.

competing

One party pursues what it wants, regardless of the cost to others

cooperating/accomodating

One party sacrifices his or her beliefs and wants to allow the other party to win

supervising

Providing guidance and direction, oversight, evaluation and follow-up

the conflict process model

Sources of Conflict > Conflict perceptions and emotions > Manifest Conflict > Conflict Outcomes

the termination conference

State the facts of the case and the reason for termination. 2. Explain the termination process. 3. Ask for the employee's input and respond calmly and openly. 4. End the meeting on a positive note, if possible. The grievance procedure is essentially a statement of wrongdoing or a procedure to follow when one believes that a wrong has been committed. All employees should have the right to file grievances about disciplinary action that they believe has been arbitrary or unfair in some way.

Pitfalls in Performance Appraisal

Subjectivity is a factor. ❖ Tendency to be lenient ❖ Inadequate record keeping ❖ "Recency effect"

Accountability

The act of accepting ownership for the results or lack thereof.

The Importance of Self-Care in relationships

The attitude and energy level of managers directly affects the attitude and productivity of their employees. A burned-out, tired manager will develop a lethargic and demotivated staff.

McGregor's Hot Stove Rule

The following four elements must be present to make discipline as fair and growth-producing as possible: Forewarning Immediate consequences Consistency Impartiality

self discipline

The process by which rules are internalized and become part of the person's personality ❖ Highest and most effective form of discipline ❖ Self-discipline is possible only if subordinates know the rules and accept them as valid

the first rule of management is

delegation

Thomas-Kilmann Conflict Mode Instrument

designed to assess an individual's behavior in conflict situations in which the concerns of different people appear to be incompatible; it explores two dimensions: assertiveness and cooperativeness, which are then used to define 5 specific methods of dealing with conflicts

4th phase of managment

directing doing phase components: - creating motivation, commuication, managing conflict, facilitating collaboration, complying with employment laws coordinating activating

The common errors noted in delegation include

failure to delegate, failure to release control, inadequate or unclear directions, and lack of follow-up or supervision

t or f Negotiation closure ends with restating the final decision in order to assess individual understanding of the resolution.

false

can managers directly motivate

no