CNML & NE-BC study note guide with
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According to Bridges, what are the components of transitions? - ANS ~Three overlapping
stages
~Endings more significant than beginnings
~Tendency to focus on benefits of the beginning
~Emotions are strongest around loss
~When endings are not addressed the repressed feelings emerge in other ways
According to Lewin you must first unfreeze the team to create enthusiasm for a change. What is
the best way for a manager to do that? - ANS A nurse manager can create momentum for a
change by providing staff with opportunities to articulate their dissatisfaction with the current
state and make suggestions for how to improve the existing system.
According to the principals of Crisis Management, what do front line workers need? - ANS
Front line workers need training, empowerment, and support after the crisis.
Describe Total Quality Management (TQM)? - ANS TQM originated in the 1950's in
factories as a process for quality, which focused on doing things right the first time rather than
checking for mistakes. TQM was based on the concept that faulty systems primarily cause
failures, not people (Deming, 1989).
Due to low census you have been asked to combine your unit with another. What are the first
steps the nurse manager should take? - ANS If asked to combine units to save money the
first thing the nurse manager should do is talk to the nurse manager whose unit is being
combined and begin to develop a transition strategy. Together they should anticipate the
response from their staff and organize a staff task force to begin to address the issue. Ideally
this task force could be a part of shared governance.
How can a manager run an effective meeting when the staff are too busy with patient care to
leave the unit? - ANS In today's environment not all staff can attend face-to-face meetings
because of work and personal responsibilities that impact their availability. Nurse manager need
to be creative in finding other ways to deliver information including on-line meetings,
teleconferences, blogs, electronic discussion groups, and shared governance councils.
How can a nurse manager create an environment where creativity, innovation, and change are
embraced by the staff? - ANS The best way for a nurse manager to create an environment
where creativity, innovation, and change are embraced by the staff is to form an innovation task
force and solicit suggestions. The manager must also reward staff who demonstrate creativity
and innovation in whatever way the individual staff would appreciate it.
,How can you avoid the storming stage? - ANS It actually is not a good idea to try and avoid
the storming stage. Storming is a normal part of change and helps the individuals to understand
the details of the mission. The emotional intensity of the storming dialogue can be improved by
recognizing that conflict is a healthy part of change and brings potential issues to the forefront.
Avoiding the issues could hinder long-term success. A way to improve the dynamics is to
develop ground rules for effective dialogue with the group early on.
How do highly effective people communicate? - ANS Highly effective people (Covey, 1990)
seek first to understand the other person, before they try to explain their position on the issue.
How do you create a safe environment for a cause analysis project? - ANS The way to
create a safe environment for a root cause analysis team is to have a skilled facilitator who sets
ground rules and creates a safe environment where everyone can speak honestly. Leadership
must also make a commitment not to punish employees who give honest feedback.
How do you create a zero tolerance policy for safety related to patient falls? - ANS To
create a zero tolerance policy for patient falls the nurse manager should talk to the shared
governance quality chair and ask them to explore with staff what the issues are related to
patient falls on their unit. Based on staff feedback the approach could include evidence based
practices related to patients falls; hiring more staff, including sitters to watch the high risk
patients; and instituting hourly rounding to include documenting patient fall prevention checks.
How important are the words in communication. - ANS Mehrabian (1981) suggested that in
volatile situations people only hear 7% of the words that are being said. The other 55% of
communication is body language and 38% the tone.
How should you design a meeting to discuss a topic that involves a lot of tension and opinions?
- ANS When preparing a meeting that could contain a lot of tense discussions it is important
to be sensitive to the tension regarding the topic and ask staff for input for agenda topics. Then,
create an agenda that clearly explains the topics for the meeting, so people have time to
prepare for the discussion. It is best to hold the meeting face-to-face and create an atmosphere
where people feel safe to express their opinions.
How should you handle a team in the storming stage? - ANS In the storming stage conflict
is high, so as leader your best response would be to accept that storming is a normal stage of
development and remind the team of their mission. Then create a safe environment for staff to
share their feelings and move toward an acceptable solution based on the common vision.
Senior staff refusing to work night shifts because they have seniority is an example of which
stage of the change process? - ANS Senior staff refusing to work night shifts because they
have seniority is an example of Storming.
, What are examples of Proactive Teamwork? - ANS Examples of Proactive Teamwork
include staff helping each other during surges, participating on quality focus projects, and
discussing patient care options.
What are some communication problems that can lead to patient errors? - ANS Some
communication problems that can contribute to patient errors include handwritten notes that are
difficult to read; verbal orders over the phone; using abbreviations that are not approved;
reluctance to approach certain co-workers; and discussing important patient care information in
noisy locations.
What are some disadvantages to staff being involved in decision making? - ANS When staff
are involved in a decision both sides have to agree to the solution. Staff no longer have the
manager to blame if they don't like the decision. However, the final decision is usually better and
more successfully implemented when staff are involved in the process.
What are some things to consider when using PowerPoint for a presentation? - ANS When
using PowerPoint for a presentation you should keep your wording brief and use illustrations to
keep the audience interested. Too many bullets, graphics, and animation can actually detract
from your presentation.
What are some ways a good change agent transforms an organization? - ANS A good
change agent is well educated on the topic of change theory and the particular thing they are
attempting to change. They anticipate opposition and have good responses prepared in
advance. They focus on what is ending for people and provide opportunities for people to
express their concerns about the changes.
What are some ways to minimize the risk of errors? - ANS The risk of errors can be
minimized by reducing unnecessary steps in a process, so the procedures are easier to follow.
Automated systems such as an electronic medical record also reduce the risk of human error.
What are the advantages of using e-mail to communicate information? - ANS E-mail
provides a way to send one message to a large audience in a timely way. There is an electronic
record that the message was received and read, which may be easier than trying to assemble a
large group of people for a face-to-face meeting on an important topic. Unfortunately, the
negative aspect of e-mail is you do not know if staff understand the information from just reading
the e-mail.
What are the attributes of a good change agent? - ANS Being a successful change agent
requires goof listening skills, patience to allow people to adopt the change at their own pace, the
ability to facilitate groups effectively, and good communication skills.
What are the best ways to reduce rumors and gossip? - ANS The best ways to reduce
rumors and gossip is to have a staff meeting with all the staff, discuss the issue, then develop a
task force to come up with some solutions including a no-tolerance policy for spreading rumors
100% complete solution
According to Bridges, what are the components of transitions? - ANS ~Three overlapping
stages
~Endings more significant than beginnings
~Tendency to focus on benefits of the beginning
~Emotions are strongest around loss
~When endings are not addressed the repressed feelings emerge in other ways
According to Lewin you must first unfreeze the team to create enthusiasm for a change. What is
the best way for a manager to do that? - ANS A nurse manager can create momentum for a
change by providing staff with opportunities to articulate their dissatisfaction with the current
state and make suggestions for how to improve the existing system.
According to the principals of Crisis Management, what do front line workers need? - ANS
Front line workers need training, empowerment, and support after the crisis.
Describe Total Quality Management (TQM)? - ANS TQM originated in the 1950's in
factories as a process for quality, which focused on doing things right the first time rather than
checking for mistakes. TQM was based on the concept that faulty systems primarily cause
failures, not people (Deming, 1989).
Due to low census you have been asked to combine your unit with another. What are the first
steps the nurse manager should take? - ANS If asked to combine units to save money the
first thing the nurse manager should do is talk to the nurse manager whose unit is being
combined and begin to develop a transition strategy. Together they should anticipate the
response from their staff and organize a staff task force to begin to address the issue. Ideally
this task force could be a part of shared governance.
How can a manager run an effective meeting when the staff are too busy with patient care to
leave the unit? - ANS In today's environment not all staff can attend face-to-face meetings
because of work and personal responsibilities that impact their availability. Nurse manager need
to be creative in finding other ways to deliver information including on-line meetings,
teleconferences, blogs, electronic discussion groups, and shared governance councils.
How can a nurse manager create an environment where creativity, innovation, and change are
embraced by the staff? - ANS The best way for a nurse manager to create an environment
where creativity, innovation, and change are embraced by the staff is to form an innovation task
force and solicit suggestions. The manager must also reward staff who demonstrate creativity
and innovation in whatever way the individual staff would appreciate it.
,How can you avoid the storming stage? - ANS It actually is not a good idea to try and avoid
the storming stage. Storming is a normal part of change and helps the individuals to understand
the details of the mission. The emotional intensity of the storming dialogue can be improved by
recognizing that conflict is a healthy part of change and brings potential issues to the forefront.
Avoiding the issues could hinder long-term success. A way to improve the dynamics is to
develop ground rules for effective dialogue with the group early on.
How do highly effective people communicate? - ANS Highly effective people (Covey, 1990)
seek first to understand the other person, before they try to explain their position on the issue.
How do you create a safe environment for a cause analysis project? - ANS The way to
create a safe environment for a root cause analysis team is to have a skilled facilitator who sets
ground rules and creates a safe environment where everyone can speak honestly. Leadership
must also make a commitment not to punish employees who give honest feedback.
How do you create a zero tolerance policy for safety related to patient falls? - ANS To
create a zero tolerance policy for patient falls the nurse manager should talk to the shared
governance quality chair and ask them to explore with staff what the issues are related to
patient falls on their unit. Based on staff feedback the approach could include evidence based
practices related to patients falls; hiring more staff, including sitters to watch the high risk
patients; and instituting hourly rounding to include documenting patient fall prevention checks.
How important are the words in communication. - ANS Mehrabian (1981) suggested that in
volatile situations people only hear 7% of the words that are being said. The other 55% of
communication is body language and 38% the tone.
How should you design a meeting to discuss a topic that involves a lot of tension and opinions?
- ANS When preparing a meeting that could contain a lot of tense discussions it is important
to be sensitive to the tension regarding the topic and ask staff for input for agenda topics. Then,
create an agenda that clearly explains the topics for the meeting, so people have time to
prepare for the discussion. It is best to hold the meeting face-to-face and create an atmosphere
where people feel safe to express their opinions.
How should you handle a team in the storming stage? - ANS In the storming stage conflict
is high, so as leader your best response would be to accept that storming is a normal stage of
development and remind the team of their mission. Then create a safe environment for staff to
share their feelings and move toward an acceptable solution based on the common vision.
Senior staff refusing to work night shifts because they have seniority is an example of which
stage of the change process? - ANS Senior staff refusing to work night shifts because they
have seniority is an example of Storming.
, What are examples of Proactive Teamwork? - ANS Examples of Proactive Teamwork
include staff helping each other during surges, participating on quality focus projects, and
discussing patient care options.
What are some communication problems that can lead to patient errors? - ANS Some
communication problems that can contribute to patient errors include handwritten notes that are
difficult to read; verbal orders over the phone; using abbreviations that are not approved;
reluctance to approach certain co-workers; and discussing important patient care information in
noisy locations.
What are some disadvantages to staff being involved in decision making? - ANS When staff
are involved in a decision both sides have to agree to the solution. Staff no longer have the
manager to blame if they don't like the decision. However, the final decision is usually better and
more successfully implemented when staff are involved in the process.
What are some things to consider when using PowerPoint for a presentation? - ANS When
using PowerPoint for a presentation you should keep your wording brief and use illustrations to
keep the audience interested. Too many bullets, graphics, and animation can actually detract
from your presentation.
What are some ways a good change agent transforms an organization? - ANS A good
change agent is well educated on the topic of change theory and the particular thing they are
attempting to change. They anticipate opposition and have good responses prepared in
advance. They focus on what is ending for people and provide opportunities for people to
express their concerns about the changes.
What are some ways to minimize the risk of errors? - ANS The risk of errors can be
minimized by reducing unnecessary steps in a process, so the procedures are easier to follow.
Automated systems such as an electronic medical record also reduce the risk of human error.
What are the advantages of using e-mail to communicate information? - ANS E-mail
provides a way to send one message to a large audience in a timely way. There is an electronic
record that the message was received and read, which may be easier than trying to assemble a
large group of people for a face-to-face meeting on an important topic. Unfortunately, the
negative aspect of e-mail is you do not know if staff understand the information from just reading
the e-mail.
What are the attributes of a good change agent? - ANS Being a successful change agent
requires goof listening skills, patience to allow people to adopt the change at their own pace, the
ability to facilitate groups effectively, and good communication skills.
What are the best ways to reduce rumors and gossip? - ANS The best ways to reduce
rumors and gossip is to have a staff meeting with all the staff, discuss the issue, then develop a
task force to come up with some solutions including a no-tolerance policy for spreading rumors
