Management and Leadership Exam 1

Laissez-faire leader qualities

- Apathetic - Either permissive and fosters freedom or is inept at guiding a group

Storming stage

- Can be conflict: some willingness to accept the group goals and objectives, but there are still differences in opinion, competition for recognition and attempts to influence the group

Systems theory

- Changing one part of a system inevitably affects the whole system - Changes in one part of the system affect other parts, creating a ripple effect within the whole - The success of all workers within the system is dependent on managements capability to orchestrate the delicate balance of each component for optimization of the entire system

Complexity/chaos theory vs. previous management theories

- Complexity: includes the fact that the natural world does not operate like clockwork - Previous: heavily emphasized rationality, predictability, stability, setting a mission, determining strategy and eliminating deviation

Authoritarian leadership style

- Decisions are made solely by the leader, who tends to dictate tasks and techniques to followers - Leaders tell the followers what to do and how to do it

Democratic leadership style

- Decisions are made through group discussion and decision - Leader encourages and assists discussion and group decision making - Human relations and teamwork are the focus - Leader shares responsibility with the followers by involving them in decision making

Factors central to successful nursing leadership

- Formal and informal power - Access to information and resources - Opportunity to grow from new challenges - Supportive organizational cultures in which nurses are valued for their expertise - Visibility, responsiveness, a passion for nursing and business astuteness shown by nurse leaders - Respectful and collaborative teamwork - Adequate compensation representing value - Valued for our expertise: practicing to fullest capability, a part of the change processes and consulted when something happened in our practice

Formal vs. informal power

- Formal: someone who is in a position of power - Informal: if someone is very skilled, you respect/admire them and consider them a leader and someone you can go to for help

Ad hoc team

- Formed to solve a specific problem. When the problem has been solved, the team dissolves

Forming stage

- Group needs direction in defining tasks, goals and objectives - Members are unclear regarding their respective roles in the group - Chaotic and confusing

Challenges with Laissez-faire leadership style

- It is based on non-interference so a clear decision may never be formulated - Followers may need greater structure than the leader gives them

Transactional leadership

- Leader functions as the caregiver ole and is focused on day-to-day operations - Focused on the maintenance/management of ongoing and routine work - Social exchange: one thing is exchanged for another, generally to accomplish daily work

Transformational leader

- Leader who motivates followers to perform to their full potential over time by influencing a change in perceptions and by providing a sense of direction - Use charisma, individualized consideration and intellectual stimulation to produce greater effort, effectiveness and satisfaction in followers - Grow and develop others by empowering them

Contingency theory

- Managers need to consider the situation and all its elements when making a decision - Managers need to act on the key situational aspects with which they are confronted - "It all depends" decision making: the "best" style of leadership/management depends on the situation

Laissez-faire leadership style

- Promotes freedom for group or individual decisions - Minimum leader participation

Nursing strategies to resolve conflict

- Recognize conflict early - Be proactive - Actively listen - Remain calm - Define the problem - Seek a solution

Core concepts of the complexity theory

- Self-organization - Interaction - Emergence - System history - Temporality

Role of leader in the complexity theory

- Serve their people with vision and guidance to see the interconnectedness of the whole system, - Gain and communicate a shared identity and then be able to allow the organization ownership of that identity

Challenges with democratic leadership style

- Takes longer than authoritarian because group consensus needs time and facilitation - People with different professional backgrounds, personal biases, and psychological needs are working together to focus on the problem and next action steps - Motivating participation is a constant challenge

What is the focus of the complexity theory?

- The behavior over time of certain complex and dynamically changing systems - The predictability of the behavior of systems that perform in regular and predictable ways under certain conditions but in other conditions change in irregular and unpredictable ways, are unstable, and move further away from starting conditions unless stopped by an overriding constraint - Stable and unstable behavior - Welcome disorder as a partner, use instability positively

Chaos theory

- The behavior that is unpredictable in spite of certain regularities - Identify organizational goals and to make decisions facilitating goal achievement - The future is so unpredictable that long-term planning is not helpful. Rather, it is suggested that managed look for instability and complex interactions among people so that learning occurs and the best result emerges - Interconnectedness of the parts of the whole suggests that communication among the people - Experiences of change, information overload, entrenched behaviors, and chaos reflect human reactions to organization as living systems that are adapting and growing - Complexity and a sense of things being beyond one's control create a search for a simpler way of understanding and leading organizations - Simple systems may give rise to complex behavior, and complex systems may exhibit simple behavior

Joint decision making

- The entire group decides, whether by two-thirds vote, simple majority, consensus or some other process - Team members have as much influence as the leader - Every voice is heard and valued equally

Authoritative decision making

- The leader makes the decision - There is input from others but not a vote

Factors in effective impersonal communication

- Thoughts, feelings, perceptions, values - Experiences, education, roles, skills and abilities - Gender, genetics, culture, upbringing, history - Personality, voice, presentation, style - Your voice, body language, facial expression, eye contact, demeanor, and behavior - Blending external (not under your control) and and internal factors

Consultative decision making

- When decisions involve employee participation, but the leader still makes the final deacon alone - Group members may make certain recommendations, but these must then go the leader who makes the final decision - More participation from group members than authoritarian but the ultimate decision is not under the control of the group members

Delegated decision procedure

- When the leader allows participants to make the final decision - Leader sets up basic parameters to follow - Leader does not have the authority to veto or override unless they are convinced the decision made would compromise safety or organizations well-bent

The nurse should plan which goals of the termination stage of group development? Select all that apply. 1. The group evaluates the experience. 2. The real work of the group is accomplished. 3. Group interaction involves superficial conversation. 4. Group members become acquainted with one another. 5. Some structuring of group norms, roles, and responsibilities takes place. 6. The group explores members' feelings about the group and the impending separation.

1, 6

Effective meetings checklist for leaders

1. Identify the purpose of the meeting: information dissemination, opinion seeking, problem seeking 2. Prepare an agenda and related materials: identify time needed for each item on the agenda 3. Identify the category of each agenda item: for information, for development, for implementation, for change in the system 4. Set the size of the group and identify type of members included 5. Carefully select members based on skill and expertise 6. Distribute agenda and related materials such as previous minutes well in advance of meeting with instructions for assignments due and materials to be reviewed before the meeting 7. Start on time and finish on time 8. Listen carefully and summarize discussion and assignments at the end of the meeting 9. Ensure balanced dialogue by all members 10. Process the interactions 11. Control the flow of interactions 12. Keep the meeting directed toward accomplishing objectives

The graduate nurse is interviewed by the manager of a unit and is told that the manager's leadership style is laissez-faire or one of letting the staff nurses make the decisions about the unit's operations. Which question by the graduate nurse indicates the best understanding of the laissez-faire leadership style? 1. "As the manager, do you maintain control and make all decisions?" 2. "As the manager, do you assume a passive, nondirective approach?" 3. "As the manager, do you facilitate decision making within the group?" 4. "As the manager, do you change style according to the needs of the group?"

2

The nurse is developing an educational session on client advocacy for the nursing staff. The nurse should include which interventions as examples of the nurse acting as a client advocate? 1. Obtaining an informed consent for a surgical procedure 2. Providing information necessary for a client to make informed decisions 3. Providing assistance in asserting the clients human and legal rights if the need arises 4. Including the clients religious and cultural beliefs when assisting the client in making an informed decision 5. Defending the clients rights by speaking out against policies or actions that might endanger the clients well-being

2, 3, 4, 5

The nurse manager meets with the staff nurses and announces that management has developed a new policy and procedure that is significantly different from old practices. Which statement by the nurse manager reflects the manager's use of legitimate power? 1. "The health care system services a client population that presents particular challenges. The changes made will enhance client safety and reduce errors." 2. "If you don't follow the new policy and procedure, I'll have no choice but to give you a notice about poor performance, which could lead to termination of your employment." 3. "Every manager has the responsibility to see that these new policies and procedures are followed 100% of the time. Please join me in this organization's effort to continue to improve quality care." 4. "You're just going to have to trust me on this one. I was a member of the committee that wrote the policy and procedure, and there are good reasons why the specific nursing actions need to be done this new way."

3

The nurse is developing a hospital policy on guidelines for telephone and verbal prescriptions. Which guidelines should the nurse include in the policy? Select all that apply. 1. Avoid using all abbreviations. 2. Verbal prescriptions are rarely acceptable. 3. Clarify any questions with the primary health care provider. 4. Repeat the prescribed prescriptions back to the primary health care provider. 5. Cosigning the prescription by the primary health care provider is not necessary. 6. If the prescriber is the client's primary health care provider, documentation is unnecessary.

3, 4

The home health nurse is religiously opposed to homosexuality and cannot care for a client diagnosed with human immunodeficiency virus (HIV). The nurse then leaves the client's home. Which statement accurately identifies the nurse's rights and actions? Select all that apply. 1. The nurse has the moral right to leave the client's home at any time. 2. The nurse has a legal right to inform the client of any barriers to providing care. 3. The nurse has a duty to protect self from client care situations that are morally repellent. 4. The nurse has a duty to provide competent care to assigned clients in a nondiscriminatory manner. 5. The nurse has the right to refuse to care for any client on religious grounds if competent care coverage is arranged.

4, 5

What is a "system"

A network of interdependent components that work together to try to accomplish the aim of the system

Goal of chaos theory

A self-managed system with people capable of engaging in cooperative behavior, using feedback to learn and adapt, self-organizing and operating with flexibility

In an effort to improve glycemic control of hospitalized patients, a hospital puts together a team of doctors, nurse managers, nurses, and pharmacists. The goal of the group is to implement a standardized glycemic management protocol to be used throughout the hospital. This type of a team is an example of a:

Ad hoc team

Primary work team

All types of patient care teams

The staff members working at the trauma center have characterized their nurse manager as task oriented and directive. Which leadership style does the nurse manager exhibit?

Authoritarian

What type of decision making style: a patient is undergoing cardiac arrest and there is no time for discussion. The leader takes control and directs the team

Authoritative

Legitimate power

Based on a persons position within an organization or society

Interpersonal communication

Communication between 2 or more individuals involving face-to-face interaction while all parties are aware of the others on an ongoing basis - Each person sends and receives information while continually adapting to the other actors

Leadership team

Consists of leaders at the executive or unit levels

What type of decision making style: task forces, quality committees and shared governance councils

Consultative decision making

The nurse is seeking a leadership style that will empower staff to achieve excellence. Which leadership style should the nurse select to achieve this goal?

Democratic

Authoritarian leaders are characterized by ______

Giving orders

Norming stage

Greater agreement on the task goals as the group develops cohesiveness and adjusts to the group and task

How does shifting to systems theory help managers?

Helps view, analyze and interpret patterns and events through the lens of interrelationships of the parts and coordination of the whole

The nurse manager calls a meeting of unit staff members to discuss ways to improve the timeliness of patient discharge. The nurse manager and group decide that the use of an admit/discharge nurse would help improve patient flow. This is an example of what kind of decision procedure?

Joint

When is authoritarian decision making ineffective?

Non-emergencies because it can generate cynicism and employee disengagement

Pros and cons of authoritarian leaders

Pros: can be very efficient, especially in crisis or during a code situation Cons: can create hostility an dependency among followers, may stifle creativity and innovation

Two principle characteristics of chaos

Randomness and complexity

Authoritarian leadership style emphasizes high concern for _______

Task

What is the aim of a system?

That everybody gains, not one part of the system at the expense of any other

Complexity theory explains ______

The behavior of the whole system

Performing stage

The members are thinking as one and willingly performing the task - Camaraderie and team spirit as the group becomes self-managing

What is the managers job with the chaos theory?

To reveal and handle the mostly hidden dynamics of the system and forge a direction for the organization as a complex adaptive system