The nurse manager has asked that all staff nurses develop effective leadership competencies. How should the staff nurses interpret this request?
1.
... [Show More] This is an unrealistic expectation, because only managers are leaders.
2. If the nurses learn about and use relevant leadership and management theories and styles this is possible.
3. In order to become leaders, the staff nurses will have to emphasize control, competition, and getting the job done.
4. Unless the staff nurses possess the traits of a natural born leader, this is an unrealistic expectation.
Answer:
2. If the nurses learn about and use relevant leadership and management theories and styles this is possible.
Rationale:
1: A nurse does not need to have a formal management position with a management title to be a leader; if nurses demonstrate leadership competencies, they are considered nurse leaders.
2: In today's health care environment, nurses must have knowledge of relevant leadership and management theories and styles. This knowledge helps nurses emerge as leaders. Nurses are also leaders of their own nursing practices.
3: Control, competition, and getting the job done are past theories and styles and are not as useful in today's environment.
4: Leadership is a skill that can be learned.
Peter Drucker's view of management stimulated the shift toward the realization of the importance of participatory organizations. Which option provides a scenario that is an example of a participatory organization?
1. The control of the organization is centralized, and decisions are made by upper-level management.
2. Staff nurses are expected to provide support and nurturing for management's decisions.
3. The organization's approach to leadership is autocratic and bureaucratic.
4. Staff nurses provide input into planning and changes for their own unit.
Answer:
4. Staff nurses provide input into planning and changes for their own unit.
Rationale:
1: In participatory organizations, the control of the organization is decentralized and many decisions are made by those "on the front lines" of the organization.
2: The theory is that the staff should be nurtured to promote greater leadership competency.
3: According to Drucker, when staff participate in the core functions of management, the organization is more effective.
4: According to Drucker, when staff participate in the core functions of management such as planning and changes for their own units, the organization is more effective.
Which behavior demonstrates the nurse's competency as an emotionally intelligent leader?
1. The nurse is proficient in technical skills.
2. The nurse relies on policies, not options.
3. The nurse supports team members.
4. Productivity is not a major concern.
Answer:
3. The nurse supports team members.
Rationale:
1: While technical skill is important for all nurses, it is not a hallmark of a competent leader.
2: Chaos theory states that solutions are not always clear and policies might not always be applied easily; other options might need to be considered.
3: In Emotional Intelligent theory, team members support each other and feel supported by the team leader.
4: This statement reflects the country club leadership style.
Describe the primary focus of a manager in a knowledge work environment.
1. Developing the most effective teams.
2. Taking risks.
3. Routine work.
4. Understanding the history of the organization.
Answer:
1. Developing the most effective teams.
Rationale:
1: The most important focus of this manager is on developing and supporting effective teams, utilizing the knowledge of many.
2: Risk taking is a part of knowledge work, but is not the most important of this manager's tasks.
3: Knowledge work is a combination of routine and non-routine work, so the manager will have focus on the routine. This is not the manager's most important focus.
4: Understanding the history of the organization is important as it will help the manager work within the organization, but it is not the most important focus.
A very young nurse has been promoted to nurse manager of an inpatient surgical unit. The nurse is concerned that older nurses may not respect the manager's authority because of the age difference. How can this nurse manager best exercise authority?
1. Use critical thinking to solve problems on the unit.
2. Give assignments clearly, taking staff expertise into consideration.
3. Understand complex health care environments.
4. Maintain an autocratic approach to influence results.
Answer:
2. Give assignments clearly, taking staff expertise into consideration.
Rationale:
1: Critical thinking is important for every RN, not just a manager 2: Giving clear assignments is a characteristic of authority. The young nurse who takes staff expertise into consideration when making assignments is likely to be more successful in leading the group.
3: Nurse managers do work in complex health care environments but must create an appropriate organizational environment as a way of exercising authority.
4: In autocratic leadership, one person has all of the power. This is not a good approach for a younger leader to adopt when working with a group of older, more experienced nurses.
What statement, made in the morning shift report, would help an effective manager develop trust on the nursing unit?
1. "I know I told you that you could have the weekend off, but I really need you to work."
2. "The others work many extra shifts, why can't you?"
3. "I'm sorry, but I do not have a nurse to spare today to help on your unit. I cannot make a change now, but we should talk further about schedules and needs."
4. "I can't believe you need help with such a simple task. Didn't you learn that in school?"
Answer:
3. "I'm sorry, but I do not have a nurse to spare today to help on your unit. I cannot make a change now, but we should talk further about schedules and needs."
Rationale:
1: To develop trust, managers who make promises to staff must keep the promise.
2: This statement implies that the staff nurse is not a team player. It also sets up one nurse against the remainder of the staff. Effective managers must be fair and supportive with all staff.
3: This manager is standing up for staff by not allowing another unit to take a nurse today.
4: This statement is belittling to the staff nurse. This attitude does not demonstrate trust that staff performances will be effective.
The nurse has just been promoted to unit manager. Which advice, offered by a senior unit manager, will help this nurse become inspirational and motivational in this new role?
1. "If you make a mistake with your staff, admit it, apologize, and correct the error if possible."
2. "Don't be too soft on the staff. If they make a mistake, be certain to reprimand them immediately."
3. "Give your best nurses extra attention and rewards for their help."
4. "Never get into a disagreement with a staff member."
Answer:
1. "If you make a mistake with your staff, admit it, apologize, and correct the error if possible."
Rationale:
1: Managers need to be honest and forthcoming with staff, which includes taking responsibility for one's own actions and errors. This also provides a positive role model for the staff.
2: When errors occur, the manager should use the opportunity for improvement, not punishment.
3: When staff feel some staff are given extra credit, staff will feel uncomfortable with the manager and resentment will build.
4: Staff need to feel that they can share their feedback, positive or negative, and not feel threatened when they disagree with the manager.
The nurse wishes to improve personal Emotional Intelligence (EI) in hopes of a promotion to nurse manager. Which skills are important for this nurse to improve? Select all that apply.
1. Self-confidence.
2. Knowledge base of nursing.
3. Proficiency in technical skills.
4. Empathy.
5. Ability to initiate change.
Answer:
1. Self-confidence.
4. Empathy.
5. Ability to initiate change.
Rationale:
1: EI competencies are self-confidence, empathy, change catalyst, and visionary leadership.
2: While this is an important aspect of professional nursing, it is not a competency of EI.
3: While this is an important aspect of professional nursing, it is not a competency of EI.
4: EI competencies are self-confidence, empathy, change catalyst, and visionary leadership.
5: EI competencies are self-confidence, empathy, change catalyst, and visionary leadership.
Compare and contrast manager roles and leadership roles by choosing the options that are more aligned with the manager role. Select all that apply.
1. Focus is change.
2. Have the ability to influence others.
3. Control the environment.
4. Focus is on people.
5. Focus on efficiency.
Answer:
3. Control the environment.
5. Focus on efficiency.
Rationale:
1: The manager accepts the status quo, while the leader challenges it.
2: The manager controls people, while the leader influences
3: The manager controls the environment, patient care, and the staff that deliver that care.
4: The leader focuses on people while the manager focuses on systems and structure.
5: Managers focus on efficiency, while leaders focus on effectiveness.
Typically the nurse manager of a unit uses a participatory style of leadership. Today a patient suffered a cardiac arrest; the manager took over the patient's care, issuing orders, and expecting staff to obey them immediately. Which type of leadership did this manager exhibit today? Select all that apply.
1. Bureaucratic.
2. Autocratic.
3. Permissive.
4. Directive.
5. Authoritarian.
Answer:
2. Autocratic.
4. Directive.
5. Authoritarian.
Rationale:
1: This style is focused on organizational rules and policies.
2: Autocratic, directive, and authoritarian are all terms used to describe leadership in which the leader makes the decisions for the group, issues direct orders, and expects staff to immediately obey. This is an appropriate leadership style in emergencies such as a cardiac arrest.
3: This is a "hands-off" approach.
4: Autocratic, directive, and authoritarian are all terms used to describe leadership in which the leader makes the decisions for the group, issues direct orders, and expects staff to immediately obey. This is an appropriate leadership style in emergencies such as a cardiac arrest.
5: Autocratic, directive, and authoritarian are all terms used to describe leadership in which the leader makes the decisions for the group, issues direct orders, and expects staff to immediately obey. This is an appropriate leadership style in emergencies such as a cardiac arrest.
There have been several patient complaints that the staff members of the unit are disorganized and that "no one seems to know what to do or when to do it." The staff members concur that they don't have a real sense of direction and guidance from their leader. Which type of leadership is this unit experiencing?
1. Autocratic.
2. Bureaucratic.
3. Laissez-faire.
4. Authoritarian.
Answer:
3. Laissez-faire.
Rationale:
1: Autocratic and authoritarian leaders make decisions for the group and assume people are incapable of making independent decisions. While this is not always a good leadership style, it is unlikely the complaints in this scenario would occur.
2: Bureaucratic leaders depend upon policy and rules. This is not always a good style of leadership, but it is unlikely the complaints in this scenario would occur.
3: This style of leadership can be so detached that there is no direction or real leadership. This will often be reflected in the work of the staff and the perceptions of the patients.
4: Autocratic and authoritarian leaders make decisions for the group and assume people are incapable of making independent decisions. While this is not always a good leadership style, it is likely the complaints in this scenario would occur.
The nursing student clinical group is attending the first clinical session of the semester. What nursing care delivery model can these students most usually expect to follow?
1. Total patient care model.
2. Functional nursing model.
3. Primary nursing model.
4. Care management model.
Answer:
1. Total patient care model.
Rationale 1: Typically, student nurses follow the total patient care model and provide all of the care for a patient while in the clinical area. This model may be altered slightly to accommodate the student's progress in the nursing program or the policies of the facility. For example, the nursing student may provide all care except giving IV meds.
Rationale 2: Functional nursing is a task-oriented approach where staff members are assigned to provide a specific task, such as wound care.
Rationale 3: In primary nursing, the RN assumes 24-hour responsibility for planning, directing, and evaluating the patient's care, from admission to discharge.
Rationale 4: The care management model, which is similar to case management, focuses on the needs of the integrated delivery system.
This morning, the RN is assigned to administer medications to all of the patients on the medical-surgical unit. From this assignment, the RN knows that this organization adheres to which type of patient care delivery model?
1. Total patient care model.
2. Functional nursing model.
3. Primary nursing model.
4. Care management model.
Answer:
2. Functional nursing model.
Rationale 1: The staff working for an organization that uses the total patient care model are assigned to provide all of the care for a patient while in the clinical area.
Rationale 2: Functional nursing is a task-oriented approach where staff members are assigned to provide a specific task, such as passing out medications for the unit.
Rationale 3: IN primary nursing, the RN assumes 24-hour responsibility for planning, directing, and evaluating the patient's care, from admission to discharge.
Rationale 4: The care management model, which is similar to case management, focuses on the needs of the integrated delivery system.
What is a disadvantage of using the team approach for care delivery?
1. The team leader might not have the necessary leadership skills required to successfully lead the team.
2. There is a risk that care will be fragmented.
3. This approach often leads to greater staff dissatisfaction, with staff members feeling they are just grinding out tasks.
4. This approach may lead to decreased collaboration and redundancy in patient care.
Answer:
1. The team leader might not have the necessary leadership skills required to successfully lead the team.
Rationale 1: Using the team approach requires that the team leader have the necessary leadership skills to coordinate and delegate patient care.
Rationale 2: The team approach helps keep care from becoming fragmented.
Rationale 3: In this approach, each team member can contribute his or her own special expertise or skill in caring for the patient.
Rationale 4: There is generally a greater amount of collaboration and less redundancy or care.
The nurse is interviewing for a position in a newly opened hospital. Which observation would best indicate to this nurse that the organization follows a shared governance model?
1. Among the documents provided by the human resources department is an organizational chart of the nursing department, indicating that the director is the highest-ranking member.
2. Conversation with a staff nurse reveals that the nurse feels empowered in making patient care decisions.
3. The mission statement of the hospital describes centralized power.
4. A staff nurse mentions that each individual staff member has complete autonomy.
Answer:
2. Conversation with a staff nurse reveals that the nurse feels empowered in making patient care decisions.
Rationale 1: This documents that the hospital follows the classical theory of organization.
Rationale 2: Shared governance increases each nurse's influence over the organization, empowering staff.
Rationale 3: This is a classical organizational model.
Rationale 4: Although the shared governance model does provide some autonomy, there is also an understanding that staff are expected to collaborate and function cooperatively with both management and colleagues. [Show Less]