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nurses manage care by
- working 1-on-1 with pt
- coordinating care with others
- providing leadership
effectively managing pt care requires
- organizational resources and routines
- providing direct pt care and time management
- collaborating with team memers.
new nurse entry level competencies
- demonstrate nursing knowledge and display confidence
- demonstrate knowledge of roles, responsibilities, and functions of a nurse
- recognize own limitations and see support of validation of decisions as needed
are good communicator, manages conflict, knowledgeable, role model, uses participatory approach in decision making, delegates appropriately, sets objectives/guides staff, displays caring and sympathy, motivates, and is flexible
magnet recognition program
empower the nursing team to make changes and bee innovative resulting in a strong collaborative relationship among team members and improved pt quality of care outcomes
Team Nursing- Nursing care delivery model
- RN leads team of RNs, practical nurses and CNA: Team members provide direct pt care under supervision and develop pt care plans, coordinates care among team members, and provides care requiring complex nursing skills.
- hierarchical communication from charge nurse to charge nurse, charge nurse to team leader and team leader to team members
- decision making occurs at clinical level
Total pt care- Nursing care delivery model
- RN is responsible for all aspects of care for one or more pts during a shift of care.
- care can be delegated and the RN works directly with the pt, family, and team members.
- high number of RN needed.
- pt satisfaction is high
Primary Nursing- Nursing care delivery model
- One primary RN assumes responsibility for caseload. works with a limited amount of pts
- communication is lateral from nurse to nurse and from caregiver to caregiver.
- flexible model uses a variety of staffing levels and mixes.
the case manager
is an advanced practice nurse who helps improve pt outcomes via specific interventions
decentralized management means
- that decision making occurs at the level of the staff including:
- responsibility: duties and activities an individual is employed to perform.
- autonomy: independent decisions about pt care
- authority: legitimate power to give commands and make final decisions specific to a give position
- accountability: answerable for the actions
transfers responsibility while remaining accountable for outcomes, requires knowing which skills can be transgered, and results in improved quality of pt care, improved efficacy, increased productivity, and an empowered staff.
5 rights of delegation
- Right: Tast
- the nurse must know each employees capabilities.
- identify tastk, analyze skill and knowledge needed to accomplish the task, assign task, periodically evaluate the deligation
3 elements necessary for healthy work enviornments
- effective communication
- collaborative relationships
- promotion of nurses decision making.
is generally regarded as the best way to resolve conflict because it reduces competition and avoidance without excessive accommodation or collaboration.
Six strategies of conflict resolution
- agree on a common goal
- change the pronouns to we
- listen actively
- position equally-all parties sitting or standing
- set ground rules for the discussion
- limit the number of people in the discussion
The YOU message
- places blame, tells the listener about themselves, attacks
- The listener feels: put down, attacked, defensive
- reacting by: pulling away, shutting of, discounting, attacking back
- talks about the speaking YOU OWN IT
- does not attack
- makes the speaking right.
- "I observe that"
essential components for a successful team effort
shared goals, commitment to pt care, accountability for pt outcomes, and open communication about interventions
Chain of command
The line of authority and responsibility along which orders are passed within the nursing department, hospital, and between different units
The 4 steps to the chain of command
- talk to the charge nurse or team leader (clinical instructor)
- Unit or department of nursing (DON)
- chief nursing officer (CNO)