Nursing Management - Exam 1

cdunbar4's version from 2017-05-18 00:33


Question Answer
Conflict isCatalyst for change; inherent in human relationships; potential to develop/deepen relationships
3 types of conflictIntrapersonal (usually a component of all conflicts); Interpersonal (most common type); Organizational (institutional initiatives, policies, codes of conduct, role differentiation, ethical/moral dilemmas)
4 stages of conflict1. Frustration -perceptions of goals being blocked
2. Conceptualization -different interpretations of situation
3. Action -behavioral response (do nothing, deal with it, escalate, increase anger, hostility, engaging in dialog)
4. Outcomes -degree to which mutual goals were achieved and subsequent relationships among participants
Most common cause of failure to resolve problems?
What 2 outcomes are used to assess how well a conflict has been resolved-Degree to which important goals were achieved
-Nature of subsequent relationship among those involved
5 modes of conflict resolutionAvoiding (unassertive/uncooperative); Accommodating (unassertive/cooperative); Competing (assertive/uncooperative); Compromising (assertive/cooperative); Collaborating (assertive/cooperative)
Avoiding (no-win)- appropriate use-trivial/temp issues or when other issues are more important; potential negative outcomes > potential benefits
-when no chance of obtaining needs/wants or when others may be better able to resolve
-to cool down, distance, or gather more info
Accommodation (win-lose)- appropriate use-others have better solution or when issue is more important to others
-to “build credits” for future or to preserve harmonious relationships
-when already outmatched or when letting others learn from their mistakes will not cause severe damage
Competing (win-lose)- appropriate use-quick, decisive action needed or when individual/group is right about vital issues
-unpopular action needs to be taken or when trade-offs may continue conflict
Compromising (lose-lose)- appropriate use-when two powerful sides are committed strongly to perceived mutually exclusive goals
-in time crunch, when temp solution needed, or when conflict isn’t worth major confrontation
-when collaborating and competing fail
Collaborating (win-win)- appropriate use-when creative, integrative solutions that address both sides goals/needs are important (commitment to group)
-when learning/growing through cooperation result in ↑empathy or when being honest about difficult emotional issues that interfere w/ morale/growth
-when identifying, sharing, & merging vastly different viewpoints
Modes most used by people w/ ↑emotional intelligence? With low?Collaborating; Accommodating
Lateral/horizontal violence Conflictual behavior btwn individuals with equal power; results in ↑errors, ↑stress, ↓confidence, ↓job satisfaction
BullyingPower differential between instigator & recipient (real or perceived); Hostile work environments affect patient care/outcomes; Nursing students & new grads –vulnerable
Unresolvable conflicts (polarities)Viewpoints are too far apart to resolve (abortion, gun control, etc)
Formingforming of a group, most team members are positive and polite at this stage
Stormingmembers start to push against boundaries est. in the forming stage (many teams fail at this stage)
Normingmembers start to resolve differences, appreciate colleagues' strengths, & respect leader’s authority
Performingteam’s hard work leads, without friction, to the achievement of the goal
Adjourningproject end; some members may find this stage difficult, esp. if their future seems uncertain
Strategies to deal w/ conflict as new grad RN on hospital unitdetermine if procedure is unsafe/will cause patient harm. Try not to avoid addressing conflict – this only puts is off, doesn’t resolve it


Question Answer
Leadershave vision/purpose (the big picture), see possibilities among complexities, effective communicators, adapt to new situations/events & provide direction, take risks
Managersplan, organize, & direct; budget; praise/discipline/evaluate personnel; serve as good role model, provide direction & sense of purpose; develop & inspire followers
Followersact synergistically w/ others, question decision & direction, act assertively w/ leaders, collaborate w/ managers, support the leader, & set limits to what they will do
Leaders & Managers should beeffective communicators (active listening, ↑emotional intelligence), engaged w/ others, positive role models, acting w/ principal/integrity, encouraging participation
Emotional intelligencesocial skills, interpersonal competence, psychological maturity, self-awareness & insight, manage emotions, empathetic & sensitive to others
Historical development of leadership/motivation/management theoriesNEED ANSWER
Trait TheoryCertain physical & emotional traits are crucial for inspiring other/to be good leaders & managers. Some believe traits cannot be learned and they're innate, others believe that traits can be developed; Sometimes referred to as “Great Man” theory
Situational-Contingency TheoryLeadership effectiveness depends on the relationship among 1: the leaders task at hand 2: interpersonal skills, 3: favorableness of the work situation.; Leaders are viewed as able to adapt their style according to the presenting situation
Transformational TheoryLeader as role model, who inspires, develops, encourages, supports, creates enthusiasm, empowers, responsive to customers, promotes research and evidence based work
Herzberg’s Motivational Theory1. Hygiene – salary, status, security, working conditions
2. Motivators –achievement, recognition, job satisfaction
Systems thinking theory as a principle of Complexity TheoryChaos as order; Ideal is operating of the edge of chaos; Beneath the randomness chaos is orderly; Systems are open & readjust to accommodate unplanned change
Affirming Values as a task of leadershipAssisting pt/family to sort out & articulate personal values in relation to health problems & the effect of these problems on lifestyle adjustment
Compare the roles of leader and manager and how the roles are taught
Discuss transactional and transformational leadership theory-based approaches
Describe the emerging workforce, born between 1977 and 1995 and known as Generation Ys
The 3 classic Leadership Styles and when they are most appropriate
Empowermentthe process of assisting others to uncover their own inherent abilities, strengths, vigor, wholeness, and spirit
Discuss how organizational culture influences organizations and managers
Shared governance & role of manager(think Magnet status) – Decentralizing organizations, flattening organization structure, Participative & empowering management

Cultural Diversity/Change

Question Answer
Cultural diversityvast range of cultural differences among people/groups
Cultural sensitivityaffective behaviors in individuals; capacity to feel, convey, react to ideas, habits, customs or traditions unique to a group of people
Culturally competent careability of the health care worker to constantly strive to achieve the ability to affectively work within the cultural contexts of a client
Culturedevelops over time & is responsive to its member & their environment; members learn it/share it; it is essential for survival & acceptance; change may be slow/difficult
Change in nursing, in terms of chaos & adapting to rapid changeIt is pervasive, unavoidable, unstoppable, and even good at times; Nurses must learn to deal with & not prevent change
2 approaches to change & identity if planned or chaos1. Linear: planned change, occurs in sequential & directional manner
2. Non-linear: chaotic change, fluid & complex d/t number of interactions
Kurt Lewin’s theory of 3 stages to ensure lasting change1. Unfreezing: awareness of opportunity, need, or problem; Overcoming the desire to keep things the same
2. Moving: the actual change w/ facilitators & barriers
3. Refreezing: sustaining the change over time; doesn’t revert to way it’s always been done
Responses to Change, include organizational culture & staff readinessUsu initial reluctance/resistance but response may be positive/willing; Organization culture: readiness, innovations, empowered staff, encouragement to be change agents; Dialogue is key!; Resistance to change is common when change threatens personal security
How to reduce resistance to change-Assess readiness; Approach depending on perceived/real barriers; Determine strategies by organizational culture
-Positive attributes: Flexible, Adaptive, Tolerates ambiguity & uncertainty
Human response to change-Innovators: thrive on change
-Early adopters: sought out for advice/info on changes
-Middle adopters: accept change (neither first nor last)
-Laggards & rejecters: oppose/sabotage change


Question Answer
Err is Human reportpublic became aware of 48,000 to 96,000 deaths per year in hospitals d/t errors
Hallmark To Err is Human reportacknowledgement that errors commonly occurred because of system errors rather than individual practitioner incompetence
2003 Institute of Medicine report suggested to replace education silosHealth Professions Education: A Bridge to Quality; recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, & leadership
5 Competencies of Health Professionals, per the IOM (2003)Patient-centered care; EBP; Quality assurance; Interdisciplinary teams; Informatics
Only national designation built on research & acknowledging nursing excellenceMagnet recognition program
Incivility behaviorsignoring, silent treatment, rolling eyes, yelling, insulting, criticizing, personal attacks, gossiping, physical attacks
Industry w/ highest number of nonfatal occupational illnesses & injuries in private sectorNEED ANSWER
Identify if verbal or physical forms of violence were reported more often (2008)NEED ANSWER
Identify the Threat from Within that suggests violence is perpetrated between those at the same level of authorityNEED ANSWER
List some possible outcomes that impaired interpersonal relationships at work can result in for nurses (Farrell, 1997)NEED ANSWER

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