UNIT 3: LEADERSHIP, DELEGATION AND CHANGE Flashcards
1
Q
What are leadership styles?
A
Defined as different combinations of task and relationship behaviors used to influence others to accomplish goals
2
Q
What is laissez-faire leadership style?
Think “lazy”
A
Delegative type of leadership that allows people to choose what they want to do and how to do it.
- Works best when all members have the same education level & the leader perfomrs the same tasks.
.
3
Q
What is a downfall of the laissez-fiare style leadership?
A
Often leaves the group feeling lost & frustrated because of the lack of direction from the leader
4
Q
What is a democratic leadership style?
A
Democratic- All aspects of the process shared by the group
1. Works best with members with relatively equal status, strong sense of owndership and achievement by the whole group.
Instructor notes: Hallmarks of this style are trust, collaboration, confidence & autonomy. Followers of this.system have a high level of commitment to the institution resulting in high work ethic. LEADER encourages and assists discussion and group descion making. LEADER listens to input from the group to make decsion.
5
Q
What are some downfalls of the democratic leadership style?
A
- Motivating partcipation is a constant challange
- Can be time consuming & inefficient when the members disagree strongly
6
Q
What is an authoritarian leadership style?
A
- Provides direction by giving orders without question
- Findal decisions rest with the leader & the leader alone. Leader maintains control
Instructor notes: The authority consists of micro managers who closely monitor everything that the group members do and often make on the spot changes when they believe there is a better way of doing something.
7
Q
What is a downside of an authoritairan leadership style?
A
People who work under this style of leadership usually harbor hostile feeling that they are fearful to express, use passive-aggressive techniques to try and even the playing field & feel oppressed & unable to use their full potential as a worker
8
Q
Which leadership style emphasizes a high concern for task and is helpful in a code situation?
A
Authoritarian
9
Q
What is a servant leadership style?
A
Is a leadership philosphy in which the main goal of the leader is to serve. Helps people with life issues, think you, not me, thinks long-term.
The hallmark of a servant leader is encouragement. First to be a servant, helper, teacher & then leader. Listen & truely understand, being clear on goals and vision. Always think before reacting.
10
Q
What is a transformational leadership style?
A
- Vision, empowerment, charisma, inspiration, intellectual stimulation
- Best coupled with transactional style. Vision is the essennce of transformational leadership based primarly on** “EXTERNAL FORCES”** not intrinsic values. Have to have a BUY IN from followers.
- Leader causes the followers to rise above their own needs. This changes the culture as the organization obtains higher levels of effort and satisfaction.
4.
11
Q
What is a transactional leadership style
A
- Focus on managment of tasks, meets goals, expected social exchange of giving & receiving rewards. Both parties gain in the relationship
- **Identifies the needs of the followers. Provides rewards to meet those needs in exchange for expected performance = effort produced. Performance is obtained but not exceeded. **
12
Q
What is an authentic leadership style?
A
- Lead based on what they believe in, values and principles
- It is an approach to leadership that emphasizes builidng the leaders legitmacy through honest relationships with followers which value their input and are built on eithical foundation
- Generally, authentic leaders are postive people with truthful self-concepts who promote openess
- Based on “INTRINSIC” values”, not external forces.
- Lead by inspiration, not soley buy-in or external forces
13
Q
What is a situational leadership style?
NOT AS IMPORTANT
A
- uses a combination of styles based on the current circumstances according to the needs of the group and task needing to be achieved
14
Q
What is a beuraucratic leadership style?
Not as important as other
A
- Motivated by external sources, relies on organizational policies and procedures for decision making
15
Q
What are key leadership behaivors?
A
- Show respect for individuals
- Establish trust
- Provide a sense of direction
- Resolve conflicts successfully
- Develop staff strengths
16
Q
What is emotinal intelligence?
A
Defined as the ability to perceive, control & evaluate emotions
17
Q
What are the five components that make up emotional intelligence?
Think EMESSS
A
- Self-awareness
- Self-Regulation
- Motivation
- Empathy
- Social Skills
E:Emotional intelligence 5 components
M: Motivation
E: Empathy
S: social awareness
S: Social skills
S: Self regulation
18
Q
What is self-awareness?
A
Being aware of one strengths, weakness,style, personality, perferences., etc, has a significant impact on how leaders behave & interact with others.
Beling self- aware, a leader can consciously influence the situation & potential climate of the group.
19
Q
What can having no self-awareness lead to?
A
Unwanted or undesirable consequences
20
Q
What is self-managment?
A
- Stress managment, time management, organizing skills, problem solving, decsion making, confidence, self protection & preservation (work-life balance)
21
Q
What should we know about social awareness?
A
- You can learn to tap into what others are thinking and feeling, knowing very well that most people do not understand or have trouble putting into words thier own thoughts and feelings. However, even if people cant verbalize their emotions, they will always show them to you. Through social awareness, employees feel heard & apprciated.
22
Q
What should we know about relationship managment?
A
- Use of effective communication with other to disarm conflict & the ability to develope the emotional maturity of team members.
- This means you are able to withhold your opinions, assumptons, and beliefs long enough to effectively HEAD and UNDERSTAND the persepectives of the other people
23
Q
What should we know about stress and time management?
A
- Stress as a postive or negative can hve results in emotional and physical states
- change fatiue in a choaotic environment
- Can lead to chronic conditions
- Increases addiction and mental health conditions
24
Q
What are some workplace strats for stress managments?
A
- Wellness programs
- exercise
- getaway place at work
- mindfullness
- mood apps
- breathwork
- medication
- sleep on break
25
What are some strats for stress managment outside of work?
1. Setting boundries
2. relaxation
3. jounaling
4. Seek expert assistance
5. Gratitude practice
6. CBT
7. Meeting with support team
8. Counselor
9. Self care
26
What are some negative behaviors of ineffective leaders?
1. Lack trust and transparency
2. Incongruecny with mission, vision, and purpose
3. Cannot approach/talk with them
4. Connot manage conflict
5. Poor communication
6. Destructive management
27
How do we as the nurse lead our patient?
1. Advocacy
2. Delegation/priortization of care
3. Communication
4. Fostering interprofesssional collaboration
5. implementing EBP
6. Empowering decision making
28
How can we be a leader to the patient?
1. Coordinate care
2. provide direct care
3. Collab for referrals
4. Supporting a patient and family unit
5. Arranging access for services by referrals
6. Problem recognition
29
What do we need to know about human caring and relationships?
1. Relate to patients and significant others in a manner that illustrates caring for the well-being
2. Engage in activities that demonstrate caring for the patient such as listening to the patients needs and spending time with the patient. Include the patient in their plan of care
3. Within the confines of the law ang agency protocols, implement behaviors that show respect for the patient's uniqueness using interventions specific to
- Age
- gender
- ethinicity
- religious belief
- cultural diff
- personal preferences
4. Use non-discriminatory principles to guide nursing care of individuals (physiological, spiritual, and cultural needs)
5. Act with assertiveness
30
What is the role of the nurse with patient rights?
1. Recognize patients right to refuse treatment/procedures
2. Discuss tx options/decsions with the patient
3. Provide education to patient and staff about patient rights and responsibilites
4. evaluate patient and staff understanding of patient right
5. Advocate for patient rights and needs
31
What are some stats to address patient needss?
1. Appropriate delegation to perform tasks to improve patient outcomes
2. Effective interprofessional communication strategies
3. Mentoring and coaching through care managment
4. Utilization of current best evidence in practice
5. Patient and family centered care culturally approrptiate
6. Implementing safety practices to enhance quality
7. prevent missinformation
32
What should we know about organizing workload?
Time management of acuity, tasks, resources
Proper resource managment in combination with good use of time impacts cost effective care. Time managment requires an ability to anticipate the day;'s activities, combine activities when possible, and not to be interrupted by nonessential activites. The RN must priortize what to do first, making it quick and efficient
33
What are some basic steps in managing workload?
1. Allow for planning and establishing priorties
2. Complete the highest priority task whenever possible
3. Finish one task before beginning another
4. Reprioritize based on the reamining tasks and on new information that may have been recieved
34
What are some strats for time managment?
1. Block time for rounds
2. Schedule time to review education, check emails, and other professional responsibilities
3. Priortize your to do list
4. Set realistic goals and deadlines
5. Develop flexiblity and adaptability.
35
Good time managment skills include
1. Arrive early or on time to prepare the little things
2. Make a daily list
3. Allow time for planning & establishing priorites
4. Delegate as appropriate
5. Break down tasks into smaller steps to overcome procrastination
6. Take breaks when you can even if you dont need one
7. anticipate patient needs
8. Recognize when you are feeling overwhelmed, take a min, reach out to peer, take some deep breaths and so on
36
How can we overcome procrastination?
Select the most objectalble tasks to be done and commit to 5 mins doing it.
List tasks into categories
1. Cat A- assessments, passing meds, tx and dressing changes- these are time senstive
2. Cat B- baths, linen, breaks, charting- important but have flexibility in time
3. Cat C- cleaning up, organizing the supply room, can be delegated or wait
37
What are some legalities and ethics we need to know?
1. State licensure requirements
2. Scope of practice
3. Laws pertaining to criminal and civil wrong doing
4. Ethical codes of practice
5. Policies and procedures of orgnaiztion
6. Self regulation to retain personal accountablity
7. Dilemmas requiring decsions to be made about right and wrong in situations in which an individual has to make a choice between eqally unafavorable alternatives
8. Provides general guidance
9. Organizations with ethical teams/liasions
38
What are some ethical principles?
1. Autonomy: independance or freedom
2. Nonmaleficence: Do no harm
3. Beneficence: An act of charity, mercy, kindness with strong connotation of doing good to others including moral obigation. Nurses action should promote good
4. Justice
5. veracity: quality of being true/honest
6. fidelity: Faithful/loyal
39
What are some common areas of issues in legal rights and responsibilities?
1. Legal issues surrounding refusing treatment (patient rights)
2. managing valuables according to policy
3. Recognizing limitations of self, other, and utilizing resources
4. Interpreter services
5. Abuse/neglect/communicable disease
6. Providing care within the legal scope of practice
7. Maintaining HIPPA-confidential client info
40
What is leadership?
The ability to inspire others to achieve a desired outcome
41
What is managment?
The process of planning, organizing, directing & coordinating the work within an organization
42
What are the functions of managment?
1. Planning
2. Organizing
3. Staffing
4. directing
5. Controlling
43
Managment is a blance of?
| broad
1. Needs of staff- growth, effciency, motivation, morale, satisfaction
2. Needs of organzation- productivity, quality, cost effectiveness, outcomes
44
What is a managers role?
1. Prevention of workplace violence
2. Staffing, scheduling, and workload
3. Maintaing the workforce
- recruitment and retention
- turnover
- skills, education, staff development
- Performance, counseling, coaching
4. Budgets
5. resource managment
6. Unit level outcomes (revenues)
7. Marketing
8. Succession planning
9. Productivity
10. Cost Containment
45
What are some consequences of ineffective managment?
1. Employee discontent
2. decrease satisfaction
3. High Attrition
4. Patient incidents
5. Adverse outcomes
6. Nosocomial infections
7. Increased work-arounds
8. Goals not met
9. Decreased patient satisfaction
10. Ineffective use of resources
46
Good communication for leading teams includes?
1. sbar
2. call-out
3. check-back
4. handoff
47
Followers vs. leaders?
1. Followship is defined as an interpersonal process of partcipation
2. Followers are the flip side of leadership
3. without followers there is no leadership
4. Followers are vital because they accept or reject the leader and determine the leaders personal power
5. Leadership involves cooperation and collaboration where the relationship between followers and leaders is interactive to enhanvce effectiveness
48
What are 4 essental qualities of effective followers?
1. Manage themselves well: ability to think for themselves
2. Higher purpose: work towards the good of the organization, & to principles & values outside of themselves.
3. Strengths: high standards of performance
49
The purpose of TBON?
Protect and promote the walfare of the people
50
What is authority in terms of delegation?
The legal authority to perform a task
51
What is scope of practice?
The actions, processes that are permitted with the terms of the professional licensure
52
What is supervision in terms of delegation?
1. Guiding or monitoring a delgated nursing task
53
What is accountability?
Being anwserable for ones own actions
54
Who is the delgator
RN
55
Who is the delegatee?
UAP: such as certified nurse assistant, nurse tech, patient care assistant, registered nurse assistant, & med tech
56
What is delegation?
1. When the RN directs another health-care team member to perform specific nursing tasks, procedures, and activites that are BEYOND, the person traditional role and are not routinely performed by them
examples:
1. Delegates medication administration to an LVN
2. Delegates measurement of intake and output to a UAP
57
When an RN delegates they must....
Supervise
58
Delegation guidelines
1. Assess the patient
2. Know the staff availablity
3. Know the job description
4. Educate the staff member
5. Is the patient/tsk predictable and uncomplicated
59
What should keep in mind with delegation?
1. Delegates do not practice on the RNs license
2. Delegatees practice on their own license (LPNs and LVNs) or, if unlicensed (UAP), within their own level of education
3. Assistive personallel, when they agree to accept the delegated task, are responsbile for their own actions in performace of the task.
If RN delegates inappropriate to a person who is clearly not qualified, and the client dies, the RN and the assitve personal could both be held liable.
60
Delgate when?
1. Patient is stable
2. Task is within workers job description
3. You're able to teach and supervise
4. You've planned how to monitor
61
Don't delegate when:
1. Thinking, complex assessment, and judgement are required.
2. There is an unpredictable outcome
3. increased risk of harm
4. Creativity and problem solving are required
62
Delegation steps:
1. Assess and plan
2. Communicate
3. Ensure surveillance and supervision
4. Evaluate and give feedback
63
What are the 5 rights of delegation?
1. Right task
2. Right situation
3. Right worker
4. Right direction and communciation
5. Right teaching, supervision and evaluation
64
When delegating try to avoid:
1. Assigning tasks that are highly invasive or have the potential signficant physical harm to clients
2. assigning tasks when there is inadequate time to safely monnitor or evaluate the practice of the person performing the tasks
65
What should we know about the right task in the 5 rights of delegation?
1. Do the tasks delegated follow written policy guidelines
66
What should we know about right person in the 5 rights of delegation?
1. does the person have the right education, right competency and proper qualifications for the tasks
67
What should we know about right direction or communication of the 5 rights of delegation?
1. Are the instructions and outcomes clearly states, when should the person report changes?
68
What should we know about right supervision or feedback in the 5 rights of delegation
1. How can the delegation process be improved? Are the patient goals being acheived?
69
What should we know about right circumstances in the 5 rights of delegation?
1. Are the tasks that are being delegated possible without independent nuring judgment
70
What is accountablity?
Is the process in which indviduals have an obligation or duty to act and are aswerable for their actions. Accountability involbes assuming only the responsibilities that are within ones scope of practice.
Any nurse should refuse to accept a task that is outside their scope of practiice or for which they do not have the expected skill or knowledge level
71
What are some restrictions on delegation?
The RN CANNOT delegate any part of the following
1. Full assessment (LVN only does focused)
2. Formulation of nursing diagnosis
3. Formulation of care plans
4. Delegate any process of the nursing process
5. implementing the inital intervention
6. eval of care
72
What is the pnumonic to remember what the nurse must do in order to delegate?
TAPE
T: Teaching
A: Assessment
P: Planning
E: Evaluation
73
The RN making the assignments should
1. Monitor and assess the staff memebers progress of task completion
2. Provide ongoing monitoring (intermittent)
74
Assignment guidelines
1. How complex is the pts required care
2. what level of experience/knowledge/skill and training is required
3. is the patients status stable & predictabe
4. Does the patient have special needs related to any of the following
- special equipment or tech
- communicaiton challanges
- patients physical and mental ability
- psychosocial and cultural aspects
- safety percautions
- infeciton control issues
5. How much time does the pts care require
6. how will the physical location of the patients affect time/availb. of care
7. any personal reasons that the nurse shoule not be assigned this patient
8. scope of practice of HCP
9. Organizational policy
75
Assigning task to UAP according to the nclex.
1. Look for the LOWEST level of skill required
2. Look for the LEAST complicated task
3. Look for the most STABLE client
4. Look for the client with the CHRONIC illness
76
What is professional judgment?
A process in which the nurse exercises forming opinion and reaching a clinical decsion based upon the analysis of evidence or data
77
What is shared accountability? and what should we know
1. Accepting ownership for the results
2. being responsible for action or inactions of self and others in contect of delegation
3. the nurse is accountable for delegation decisions and the process as well as total nursing care provided
4. Unlicensed personal are accountable for his/her actions only.
78
LVN/LPN guidelines
1. Can funciton independantly in a stable routine situation
2. Administers meds oral, im & sub q
- Excludes IV meds but depends on organization
3. Conducts focused assessment & monitoring of pts findings
4. Reinforces patient teaching
5. Conducts nursing procedures based on education and training
79
UAP can do the following
1. ADL
2. Ambulation of stable pt
3. Positioning
4. bed making
5. speciment collection (stood, sputum, NO BLOOD)
6. I&O
7. Vitals (STABLE)
Once the UAP accepts a task the UAP has also accepted accountability for his/her role in the delegated task
80
LPNs and LVNs cannot
1. Do admission assessments
2. Give IV push meds
3. Write nursing dx
4. cannot do most teaching
5. cannot do complex skills
6. cannot take care of patients with acute conditions
7. cannot take care of unstable patients
