With Complete Solutions
. A grievance brought by a staff nurse against the unit manager
requires mediation. At the first mediation session, the staff nurse
repeatedly calls the unit manager's actions unfair, and the unit
manager continues to reiterate the reasons for her actions. What
would be the best course of action at this time?
a. Send the two disputants away to reach their own resolution.
b. Involve another staff nurse in the discussion so as to clarify
issues.
c. Ask each party to examine her own motives and issues in the
conflict.
d. Continue to listen as the parties repeat their thoughts and
feelings about the conflict. Correct Answers ANS: C
Ury, Brett, and Goldberg outline steps to restoring unity, the
first of which is to address the interests and involvement of
participants in the conflict by examining the real issues of all
parties.
REF: Page 17
1.A nurse manager of a 20-bed medical unit finds that 80% of
the patients are older adults. She is asked to assess and adapt the
unit to better meet the unique needs of the older adult patient.
Using complexity principles, what would be the best approach to
take in making this change? Correct Answers a. Leverage the
hierarchical management position to get unit staff involved in
assessment and planning.
b. Engage involved staff at all levels in the decision-making
process.
,c. Focus the assessment on the unit, and omit the hospital and
community environment.
d. Hire a geriatric specialist to oversee and control the project.
ANS: B
Complexity theory suggests that systems interact and adapt and
that decision making occurs throughout the systems, as opposed
to being held in a hierarchy. In complexity theory, every voice
counts, and therefore all levels of staff would be involved in
decision making
2. A unit manager of a 25-bed medical/surgical area receives a
phone call from a nurse who has called in sick five times in the
past month. He tells the manager that he very much wants to
come to work when scheduled but must often care for his wife,
who is undergoing treatment for breast cancer. According to
Maslow's need hierarchy theory, what would be the best
approach to satisfying the needs of this nurse, other staff, and
patients?
a. Line up agency nurses who can be called in to work on short
notice.
b. Place the nurse on unpaid leave for the remainder of his wife's
treatment.
c. Sympathize with the nurse's dilemma and let the charge nurse
know that this nurse may be calling in frequently in the future.
d. Work with the nurse, staffing office, and other nurses to
arrange his scheduled days off around his wife's treatments.
Correct Answers ANS: D
Placing the nurse on unpaid leave may threaten physiologic
needs and demotivate the nurse. Unsatisfactory coverage of
shifts on short notice could affect patient care and threaten the
,needs of staff to feel competent. Arranging the schedule around
the wife's needs meets the needs of the staff and of patients
while satisfying the nurse's need for affiliation.
REF: Page 10
4. At a second negotiation session, the unit manager and staff
nurse are unable to reach a resolution. It would now be best to:
a. Arrange another meeting in a week's time so as to allow a
cooling-off period.
b. Turn the dispute over to the director of nursing.
c. Insist that participants continue to talk until a resolution has
been reached.
d. Back the unit manager's actions and end the dispute. Correct
Answers ANS: B
According to the principles outlined by Ury, Brett, and
Goldberg, a "cooling-off" period is recommended if resolution
fails.
REF: Page 17
5. The manager of a surgical area has a vision for the future that
requires the addition of RN assistants or unlicensed persons to
feed, bathe, and walk patients. The RNs on the staff have always
practiced in a primary nursing-delivery system and are very
resistant to this idea. The best initial strategy in this situation
would include:
a. Exploring the values of the RN group in relationship to this
change.
b. Leaving the RNs alone for a time so they can think about the
change before they are approached again.
, c. Dropping the idea and trying for the change in another year or
so.
d. Hiring the assistants and allowing the RNs to see what good
additions they are. Correct Answers ANS: A
Leadership involves engaged decision making around a vision
that is based on evidence and tacit knowledge. Influencing
others requires emotional intelligence in domains such as
empathy and handling relationships.
REF: Pages 6, 7
A charge nurse on a busy 40-bed medical/surgical unit is
approached by a family member who begins to complain loudly
about the quality of care his mother is receiving. His behavior is
so disruptive that it is overheard by staff, physicians, and other
visitors. The family member rejects any attempt to intervene
therapeutically to resolve the issue. He leaves the unit abruptly,
and the nurse is left feeling frustrated. Which behavior by the
charge nurse best illustrates refined leadership skills in an
emotionally intelligent practitioner?
a. Reflect to gain insight into how the situation could be handled
differently in the future.
b. Try to catch up with the angry family member to resolve the
concern.
c. Discuss the concern with the patient after the family member
has left.
d. Notify nursing administration of the situation. Correct
Answers A