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Nursing students enrolled in a leadership and management course attend clinical on a surgical unit. As they are planning their day, they note one student has a complex patient with multiple medications and the need for frequent turning, pressure injury wound care, and tube feedings. Which action by the group best reflects effective teamwork and coordination?
- A. Asking patients to prioritize what they want to accomplish each day
- B. Including a 'nice to do' for every 'need to do' task on the list
- C. Front loading' their schedules with 'must do' priorities
- D. Scheduling times to assist the student with the complex patient
Correct Answer: D
Rationale: The students use teamwork and collaboration to appropriately coordinate patient care; this is the best response. By asking the patient to prioritize what they want to accomplish each day, the nurse is demonstrating an effective time management technique. To manage time, the nurse should establish goals and priorities for each day, differentiating 'need to do' from 'nice to do' tasks; the nurse should include the patient in this process. The nurse should also establish a time line, allocating priorities to hours in the workday in to keep track of falling behind and correct the problem before the day is lost.
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After observing conflicts between nurses about scheduling, a nurse manager compliments the nurses for achieving the monthly goal of no patient falls. What strategy for conflict resolution did the manager display?
- A. Collaborating
- B. Competing
- C. Compromising
- D. Smoothing
Correct Answer: D
Rationale: The manager who avoids conflict by complimenting the parties and avoids disagreements is using smoothing to reduce the emotion of the conflict. The original conflict is rarely resolved with this technique. Collaborating is a joint effort to resolve the conflict with a win-win solution. All parties set aside previously determined goals, determine a priority common goal, and accept mutual responsibility for achieving this goal. Competing results is a win for one party at the expense of the other group. Compromising occurs when both parties relinquish something of equal value.
The nurses at an acute care hospital participate in a committee focused on achieving Magnet status. Which action do the nurses suggest to help achieve this goal?
- A. Centralizing the decision-making and scheduling process
- B. Promoting self-governance at the unit level
- C. Deterring professional autonomy to promote teamwork
- D. Promoting evidence-based practice over innovative nursing practice
Correct Answer: B
Rationale: Magnet hospitals use a decentralized decision-making process, self-governance at the unit level, and respect for and acknowledgment of professional autonomy. In Magnet hospitals, 14 characteristics, the Forces of Magnetism, have been recognized that identify quality patient care, excellent nursing care, and innovations in professional nursing practice.
A nurse manager who is working to institute the SBAR communication process for all health care providers is meeting resistance to the change. How does the manager best approach the resistance?
- A. Containing the anxiety in a small group and moving forward with the initiative
- B. Explaining the change and listing the advantages to the person and the organization
- C. Reprimanding those who oppose the new initiative and praising those who willingly accept the change
- D. Quickly introducing the change and involving staff in implementation of the change
Correct Answer: B
Rationale: Change is ubiquitous, as is resistance to change. The manager should explain the proposed change to all affected, list the advantages of the proposed change for all parties, introduce the change gradually, and involve everyone affected by the change in the design and implementation of the process. The manager should not use the reward/punishment style to overcome resistance to change.
A nurse manager is planning to update a health care provider's office from paper to electronic health records (EHR) by using the eight-step process for planned change. Place the following actions in the order in which they should be initiated:
- A. The nurse devises a plan to switch to EHR.
- B. The nurse records the time spent on written records versus EHR.
- C. The nurse attains approval from management for new computers.
- D. The nurse analyzes all options for converting to EHR.
- E. The nurse installs new computers and provides an in-service for the staff.
- F. The nurse explores possible barriers to changing to EHR.
- G. The nurse follows up with the staff to check compliance with the new system.
Correct Answer: B,F,D,C,A,E,G
Rationale: Planned change involves the following steps: (1) recognize symptoms that indicate a change is needed and collect data, (2) identify a problem to be solved through change, (3) determine and analyze alternative solutions, (4) select a course of action from possible solutions, (5) plan for making the change, (6) implement the change, (7) evaluate the change, and (8) stabilize the change.
A charge nurse on the step-down unit will likely use which leadership style during resuscitation efforts for a cardiac arrest?
- A. Democratic
- B. Laissez-faire
- C. Servant
- D. Autocratic
Correct Answer: D
Rationale: Autocratic leadership assumes control over the decisions and activities of the group, such as taking charge of emergencies, dictating schedules and work responsibilities, and scheduling mandatory in-service training. Polling other nurses is an example of democratic leadership, which is characterized by a sense of equality among the leader and other participants, with decisions and activities being shared. In laissez-faire leadership, the leader relinquishes power to the group and encourages independent activity by group members. Examples of laissez-faire leadership style are allowing the nurses to divide up the tasks and encouraging them to work independently.