Nursing Management - Exam 1

olanjones's version from 2017-05-22 19:01


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, engage in dialog)
4. Outcomes -degree to which mutual goals were achieved & subsequent relationships among participants
Most common cause of failure to resolve problemsImproper identification of the problem/issue; this makes problem recognition and identification the most vital steps
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 intelligence (EI)social skills, interpersonal competence, psychological maturity, self-awareness & insight, manage emotions, empathetic & sensitive to others
Historical development of leadership/motivation/management theoriesTheories developed over time & depend both on context & who is in charge. In agrarian times the monarchy served to provide leaders (Great Man Theory by Aristotle - leaders are born, not made), as the industrial age occurred another method to determine leadership was needed & leading to new leadership theories
Trait TheoryCertain physical & emotional traits are crucial for inspiring other/to be good leaders & managers. Some believe traits cannot be learned and are innate (as in “Great Man” theory) , others believe that traits can be developed
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 & evidence based work
Herzberg’s Motivational Theorysatisfaction (meet need for personal development) & dissatisfaction (meet need to avoid unpleasantness/ discomfort) at work arise from different factors & are not simply opposing reactions to the same factors
1. Hygiene – salary, status, security, working conditions (may lead to dissatisfaction)
2. Motivators –achievement, recognition, job satisfaction (may lead to 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 & manager & how the roles are taughtManager is a designated leadership position that can be taught using traditional teaching techniques; Leadership is an ability role, if being taught then usu by reflections of rich personal experiences
Discuss transactional and transformational leadership theory-based approaches-Transactional: traditional "boss" image, employees understand that a superior makes the decisions w/ little or no input from subordinates; relies on power or the organization, formal authority to reward/punish performance
-Transformational: inspirational vision that changes the framework of the organization, employees are encouraged to transcend their own self-interest; involves communication that connects w/ employees' ideas in a way that causes emotional engagement
Describe the emerging workforce, born between 1977 & 1995 & known as Generation Y-Generation X (1960-early 1984ish): often latch-key kids, divorce was common & job stability was no longer guaranteed
-Generation Y (1980-2000): grew up w/ lots of information/technology, have experienced terrorism & natural disasters, are culturally diverse & view education as key to success (some may be referred to as Millennials)
The 3 classic Leadership Styles & when they are most appropriate-Authoritarian: makes all major group decisions & demands compliance; good when decision needs to be made quickly or when project/situation is particularly stressful
-Laissez-Faire: only minimally involved, basically sitting back & let group function on its own; good in settings such as science laboratories or established companies with long-term employees (but often least effective style)
-Democratic: encourage group discussion & believe in decision-making through consensus; good in worker-owner corporations, public university, or cooperative social group/organization
Empowermentthe process of assisting others to uncover their own inherent abilities, strengths, vigor, wholeness, and spirit
Discuss how organizational culture influences organizations & managersOrganizational culture is usu expressed formally as an institutions mission statement, values, philosophy but may also be thought of as the day-to-day experience of staff. When there is congruity btwn the expressed & experienced culture staff is usu happy but if not they may be confused, frustrated, have poor morale
Shared governance & role of manager(think Magnet status) – Decentralizing organizations, flattening organization structure, Participative & empowering management
To be successful it is important to "Know Thyself"
how can this be achieved
manage your manager, ask/find out what manager wants, reflection on self & relationships (improve EI), know your strength/weakness, use empathy


Question Answer
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 silos"Health 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 sectorHealthcare, specifically employees in general medical and surgical hospitals (according to 2007 BLS survey)
Identify if verbal or physical forms of violence were reported more often (2008)Verbal (In a Nursing Management survey - 80% of respondents reported some form of violence in workplace, verbal were reported most often)
Identify the Threat from Within that suggests violence is perpetrated between those at the same level of authorityHorizontal/lateral violence; In 2008, TJC strengthened requirements in leadership standards for dealing w/ disruptive behavior citing studies that intimidating & disruptive behaviors contribute to poor pt satisfaction & preventable adverse outcomes
List some possible outcomes that impaired interpersonal relationships at work can result in for nurses (Farrell, 1997)insomnia, PTSD, depression, physical/psychological health complaints; ↓nurse's ability to deliver optimal pt care & compromise pt safety

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