destructive behavior are ignoring a policy, denying a problem, avoiding a staff
member, and criticizing staff in public.
Examples of constructive behavior are encouraging the group to identify
and solve the problem, expressing appropriate feelings, and offering to help out
. Describe styles of
conflict management. ·
very unassertive and uncooperative because people who avoid neither pursue
their own needs, goals, or concerns immediately nor assist others to pursue
theirs. It only ensures that conflict is postponed and has a tendency to
escalate in intensity.
· Accommodating – people neglect their
own needs, goals and concerns (unassertive) while trying to satisfy those of
others (cooperative). It has element of being self-sacrificing and simply
obeying orders or serving. People who use this may feel disappointment and
· Competing – people pursue their own
needs and goals at the expense of others. They use whatever power, creativeness
that are available to “win”.
· Compromising- involves both
assertiveness and cooperation on the part of everyone and requires maturity and
confidence. Negotiating is a learned skill that is developed over time and it
is more like trading. Compromise is very often the exchange of concessions as
it creates a middle ground.
· Collaborating- the most
time-consuming approach, is the most creative stance. It is both assertive and
cooperative because people work creatively and openly to find the solution that
most fully satisfies all important concerns and goals to be achieved
-Goals of conflict management:
1. to eliminate
or decrease the conflict
2. to meet the
needs of the patient, family/significant others, & the organization
3. to ensure that all parties feel
positive about the resolution so that future work together can be productive
How does bullying
behavior sometimes manifest itself on a nursing unit? ·
Bully is associated with psychological and physical
stress, underperformance, professional disengagement, increased job turnover,
and the potential for diminished quality of care. Verbal abuse toward others
like putting down another. New graduates reported feeling undervalued by other
nurses and reported having learning opportunities blocked; many felt neglected
and given too much responsibility without the appropriate support.
How does assigning
and delegating differ? ·
refers to the work each person is to accomplish in a designated work period. It
consists of patient care expectations and unit-related activities. Another
meaning relates to assignment as the transference of both responsibility and
accountability. Assigning—ANA states that assignments is
the distribution of work that each staff member is responsible for during a
given work period. The staff member is assigned both the accountability and
responsibility. The nurse manager is accountable only for making the
assignment and selecting who will be responsible for the care of the patients.
It is the staff nurse is accountable and responsible for actually provided the
care. Staff nurses cannot make assignments.
· Delegation is a critical skill for
accomplishing care in a timely manner.
act of delegation requires at least 2 people, work, and some kind of transfer
of authority and responsibility to perform the work. Accountability is not
abdicated but instead remains fixed with the delegator. The nurse is
merely sharing responsibility and legal accountability still rests with
him/her. Staff nurses can delegate.
What are the
differences in leading, managing, and following? ·
is the process of engaged decision making linked with actions taken in the face
of complex, unchartered or perilous circumstances present in clinical
situations for no standardized solution exists
· Management is an engaged process of
guiding others through a set of derived practices and procedures that are
evidence-based and known to satisfy pre-established outcomes based on repeated
· Followership is engaging with others
who are leading or managing by contributing to problem identification,
completing tasks, and providing feedback for evaluation.
How should a nurse
manager utilize critical thinking?
When they use delegation decision making and their other functions like
budgeting. Critical thinking is a process of examining
underlying assumptions, interpreting and evaluating arguments, imagining, and
exploring alternatives, and developing relative criticism for the purpose of
reaching a reasoned, justifiable conclusion. In nursing it means constantly
striving to find a better way by focusing on two key questions: What are the
outcomes? And how can we do better? A nurse manager should use critical
thinking to make decisions and problem solve for those he/she is responsible
for so that. He/she should use it for direct care, advocating for the patient,
in coordinating care, working with other staff to resolve issues on the unit,
to ensure that quality, safe care is provided on the unit, and to collaborate
functions of a manager. ·
objectives and goals for each area and communicates them to the persons who are
responsible for attaining them
· Organizes and analyzes the
activities, decisions, and relations needed and divides them into manageable
· Motivates and communicates with the
people responsible for various jobs through teamwork
· Analyzes, appraises and interprets
performance and communicates the meaning of measurement tools and their results
to staff and superiors
· Develops people, including self
management, participatory management, leadership learned) Staff should participate in as much of the
planning and establishment of goals and decision making as possible. Allowing the staff to participate in the core
functions of management the organization would be more effective. Nurse manager should seek out stagg members
ideas and ask them to assist with planning.
The staff can be nutured to gain greater leadership competency. Pg 7 Finkleman
. How can a nurse
manager prepare staff members for a visit from The Joint Commission?
can prepare staff members for a visit from TJC by setting up practice
evaluations of the hospital, let the staff know what is expected for them to
know, and have in-services for the staff.
There are many different
roles the nurse manager may play in this. Examples include: providing feedback
on performance, participation in their own performance appraisal, collecting
data, awareness of errors and applying this to their practice, assisting with
analysis of data, and using conclusions from quality analysis to improve their
practice. Assign standards to team leaders. Team leaders should delegate work to
team members. Conduct quarterly "mock" surveys to gauge compliance.
Fix any opportunities for improvement identified during the mock survey. Form a
specially designated team to perform weekly rounds in different areas to
monitor compliance. Monitor progress in a grid-type form, with columns for
standard, performance, due date, action plan, follow-up and assigned person(s).
A nurse leader should be able to...
Accurately assess, createsolutions, guide employees, direct employees to carry out goals at min risk to patient and themselves., and project an air of confidence.
motivate and encourage others.
work with others to achieve goals.
assess and develop new opportunities for nursing.
adapt and develop new roles and skills as health system changes.
understand broader health and socail system within which nursing functions.
have external awareness.
contribute and influence health and public policy.
How does leadership and management differ?
A leader makes decisions and takes action in situations when there is no bovious solution.
A manager guides using eveidenced based practice and procedures.(protocol)
A good follower should..
An effective leader has...
Vision-ideas for the future
influence- trust from employees
power- change behaviors, use consistency, tell what you will do and do it.
values-should be congruent with the facility
key management functions
*maintains day to day functions. Thinks short term.
Comparing managers and leaders
managers maintain current state; leaders focus on change
managers focus on efficiency, are concerned with structure, and have a short range view of things
leaders have a long term range perspective(future), focus on people never want to maintain the current level
leaders have authortiy from their influence
managers have authority from position in the organization
key leadership roles
expert- have knowlege(power)
administrator-know how efficient things are, policy and procedures, computer system, budgets, knows peoples strengths.
people person- training, goals
strategist-change agent (smooth transitions)
levels of management
first level : unit manager or charge nurse
middle level: director of critical care services
upper level: chief nurse executive
Gardner's Tasks of leadership
envisioning goals(for staff-realistic)
affirming values(gives direction and purpose and get priorities straight.)
motivating-can promote change
achieving workable unity
serving as a symbol
representing the group
Bleich's tasks of managemnt
identify processess relating to patient care
decide max and min standars
validate knowledge skills and abilities of staff
develop big pic plan
eliminate obstacles to work effectiveness
measure out workload equitably(equally)
reward and recognize
recommend ways to improve
use informal network to engage employees
no imput from lower level employees
performance will be rewarded or punished depending
wants employees to think "outside the box"
considers each employees needs and abilities
wants to change organization and employees.
Asks why is it done this way and how can it be done more effectively?
Helps employees set up realistic goals.
Extra effort is rewarded and important.
Is a role model of desired behavior
pays attention to people and their personal ongoings
higher level of staff satifaction and patient.
Able to reatin staff
has vision and a mission.
lets staff be involved in leadership
has increased recognition of the staff
-modern management; participatory management.
-staff should participate in planning and goal development
-Staff should have autonomy
-leaders are made!
EXAMPLE:Staff nurses should provide imput into planning and changes that might be necessary Seek out staff ideas and ask them to assist with planning.
Fiedlers Contingency theory
-relationship of leader to team
- amount of confidence employees have in the leader is critical and inspires loyalty
- position power -power of leader has becasue of his/her position in the facility.
-best situation-positive leader-employee relations, highly structured tasks, high level of position of power.
* situation changes affect of leadership.
Ineffective approaches to leadership
autocratic-* works well in emergencies* issues orders.
bureaucratic-rigid, gives orders, relies on policies and rules
Laissez-faire-hands off; can result in no leadership and lack of guidance.
Management Grid Model Styles of Leadership
Impoverished-Leader has limited interest. Work requirements are at minimum level.
Country CLub-Interested in people. Friendly.Productivity not a concern.
Authority-obedience-Get job done Not personable.
Organization man-balance necessityto accomplish with maintaining morale
Team-very concerned with productitvity and about staff morale and satisfaction.
Connective Leadership Theory
Leader collaborates within the hospital and amoung other oraganizations in the community.
the more connections that occur, the more successful the leader will be.
Emotional Intelligence Theory
Self- Awareness cluster- understanding
feelings and applying accurate self assessment. Recognize feelings and how they affect others. Identify strengths and limitations.
Self-Management Cluster- managing
internal emotions, impulses and resources.
self control- handle their own emotions and expresses emotions appropriately.
- letting others know one’s values and principles, intentions and feelings and
acting in ways that are consistent with them. Forthright about mistakes and confront others about their lapses. Conscientiousness- Leader is careful, self-disciplined, and ensures that responsibilities are met.
Adaptability- open to new ideas, search out challenges and opportunities, and use them to move forward. “thinks
outside the box”. Risk is not a barrier to moving forward. Achievement drive-optimistic striving to continually improve
Initiative- a step ahead at all times and seem to seek out opportunities
before others are aware of them.
Social Awareness Cluster- empathy- being aware of others feelings,
needs, and concerns. Service Orientation-ability
to identify a clients unstated needs and concerns and then match them to
products or services. Organizational
Awareness- able to identify group feelings and organizational needs, which
helps the leader develop coalitions and network.
Relationship Management Cluster-developing others- leader knows when staff is ready for further development.
Influence- ability if a leader to persuade others. Communication- ability to communicate emotions and facts, listen, share info, and encourage sharing info.
Conflict Management- requires negotiation and the ability to see outside the box.
Visionary leadership- can develop a
vision and includes staff in the vision for success.
Change Catalyst- See change as opportunity, recognize barriers to change and remove them whenever possible, challenge the status quo, and involve as many of the staff as possible in change process.
Building Bonds- make connections with others, build trust, and recognize the importance of
Collaboration and teamwork.
Quantum Thinking Approach
- multiple solutions
-input from multiple people on a situation
-Creativity required for the team to be successful
-Future is uncertain.
-Sensitive to indicators of change
-Analysis of info
shouldn’t predict future-no one knows it anyhow. Leaders should be keen to
hints of change and respond when need be. Be able to translate info to used to