NR 446 Week 1 Exam 1 Pre-Class Questions (SUMMER 2023/2024) ELABORATION WITH ANSWERS

NR 446 Collaborative Healthcare (Summer 2023) Must be handwritten or typed! *Ensure that you understand the concepts involved in each section & are able to apply them to clinical scenarios Chapter 1: Decision Making, Problem Solving, Critical Thinking, and Clinical Reasoning: Requisites for Successful Leadership and Management 1. Describe the following terms: o Decision making: A complex, cognitive process of choosing a particular course of action; the thought process of selecting a logical choice from all available options. o Problem solving: A part of decision making; systematic process focusing on analyzing a difficult situation involving higher-order reasoning and evaluation. o Critical thinking: The mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach an answer or conclusion. 2. Describe at least 10 characteristics of a critical thinker: 1. Insight is the deep understanding of a person or thing. 2. Intuition is the ability to understand something instinctively or immediately without the need for conscious reason. 3. Empathy is the ability to understand and share the feelings of another. 4. Willingness to act kind of speaks for itself but as nurses we must be willing and able to make decisions and act for our patients. 5. Creativity is the ability or power to create things like care plans, etc. 6. Self-awareness means you have made and are constantly updating an accurate appraisal of your personality, motivations, strengths, and weaknesses. 7. Courage is the mental or moral strength to virtue, persevere, and withstand danger fear, or difficulty. 8. Sensitive is defined as having or displaying a quick and delicate appreciation of other feelings. 9. Energetic is defined as showing or involving great activity or vitality. 10. Objectivity is defined as a lack of favoritism towards one decision or another or a lack of bias. 3. How do the following methods of learning help develop problem solving and decision-making skills? o Case studies: Provide stories that facilitate learning. o Simulation: Provide opportunities for learning with no risk to live patients or real organizational performance. o Problem-based learning: Provides opportunities for learners to address and learn from authentic problems vicariously. 4. Describe the steps involved in the nursing process: o Assessing, or gathering information and data. NR 446 Collaborative Healthcare (Summer 2023) o Diagnosing with a nursing diagnosis that represents a clinical judgement concerning human response to health conditions/life processes, or a vulnerability for that response, by an individual, family, group, or community. o Planning provides the directions for interventions and caring for the patient based on assessments and nursing diagnosis. o Implementing involves action or doing and the actual carrying out of nursing interventions outlined in the plan of care. o Evaluation focuses on the effectiveness of the nursing interventions by reviewing the expected outcomes to determine if they were met by the time frames indicated. 5. List and briefly describe each critical element in decision making:   o Define objectives clearly means to pause and reflect on the purpose of the decision that is to be made, a decision made without a clear objective in mind can be a poor-quality decision. o Gather data carefully because decisions are based on this knowledge and information gathered, we must insure it is thorough and accurate. o Take the time necessary to decide; it is proven that slower more controlled deliberation is needed when outcomes have significant consequences. o Use an evidence-based approach by reaching outside the current sphere of knowledge and ensure the use of best practice. o Generate many alternatives to the problem currently being solved, do not limit yourself to two choices and remember not doing anything is also always an option. o Think logically means to draw inferences from information and carefully think through the information and the alternatives. o Choose and act decisively meaning there comes a time we must act on our decision and evaluate the outcomes. Chapter 2: Classic Views of Leadership and Management 6. Compare and contrast leadership versus management distinctions (display 2.1) o o o o o o o o o o Leadership Inspires change Requires vision Requires imagination Requires abstract thinking Requires ability to articulate Requires an aptitude to sell Requires understanding of the external environment Requires risk taking Requires confidence in the face of uncertainty Accountable to the entire organization o o o o o o o o o o Management Manages transformation. Requires tenacity. Requires specifics. Requires concrete data. Requires ability to interpret. Requires an aptitude to teach. Requires understanding of how work gets done inside the organization. Requires self-discipline Requires blind commitment to completing the task at hand Accountable to the team. 7. Compare and contrast leadership versus management components (display 2.4) o o o o Leadership Are assigned a position by the organization Have a legitimate source of power due to delegated authority that accompanies their position Have specific duties and responsibilities they are expected to carry out Emphasize control, decision making, decision analysis, and results o o o o Management Often do not have delegated authority but obtain power through other means, such as influence Have a wider variety of roles than managers Focus on group process, information gathering, feedback, and empowering others May or may not be part of the formal o o Manipulate people, the environment, money, time, and other resources to achieve the goals of the organization Have a greater formal responsibility and accountability for rationality and control than leaders o o o hierarchy of the organization Emphasize interpersonal relationships Direct willing followers Have goals that may or may not reflect those of the organization o Direct willing and unwilling subordinates 8. Briefly describe each phase of the management process: • Planning: determining philosophy, goals, objectives, policies, procedures, rules; carrying out long- and short-range projections; determining a fiscal course of action; managing planned change • Organizing: establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals; working within the structure of the organization and understanding and using power and authority appropriately • Staffing: recruiting, interviewing, hiring, and orienting staff; scheduling, staff development, employee socialization, and team building • Directing: may incorporate several functions; human resource management responsibilities (motivating, managing conflict, delegating, communicating, facilitating collaboration) • Controlling: performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control 9. Describe the different types of leaders & describe at least one clinical example of where each are useful (ex. code blue situation): • Authoritarian: results in well-defined group actions that are usually predictable, reducing frustration in the work group and giving members a feeling of security. Productivity is usually high, but creativity, self-motivation, and autonomy are reduced. Authoritarian leadership is frequently found in very large bureaucracies such as the armed forces. o Strong control is maintained over the work group. o Others are motivated by coercion. o Others are directed with commands. o Communication flows downward. o Decision making does not involve others. o Emphasis is on difference in status (“I” and “you”). o Criticism is punitive. • Democratic: appropriate for groups who work together for extended periods, promotes autonomy and growth in individual workers. Democratic leadership is particularly effective when cooperation and coordination between groups are necessary. Studies have shown, however, that democratic leadership may be less efficient quantitatively than authoritative leadership. o Less control is maintained. o Economic and ego awards are used to motivate. o Others are directed through suggestions and guidance. o Communication flows up and down. o Decision making involves others. o Emphasis is on “we” rather than I and you. o Criticism is constructive. • Laissez-faire: can be frustrating; group apathy and disinterest can occur. However, when all group members are highly motivated and self-directed, this leadership style can result in much creativity and productivity. Laissez-faire leadership is appropriate when problems are poorly defined, and brainstorming is needed to generate alternative solutions. o Is permissive, with little or no control o Motivates by support when requested by the group or individuals o Provides little or no direction o Uses upward and downward communication between members of the group o Disperses decision making throughout the group o Places emphasis on the group o Does not criticize 10. Compare and contrast a transactional versus transformational leader: (table 2.2) o o o o o o Transactional Leader Focuses on management tasks Is committed Uses trade-offs to meet goals Does not identify with shared values Examines causes Uses contingency reward o o o o o o Transformational Leader Identifies common values Is a caretaker Inspires others with vision Has long-term vision Looks at effects Empowers others Chapter 3: Twenty-First Century Thinking about Leadership and Management 11. Describe the four leadership domains: o Strategic thinking: effective leaders keep everyone focuses on a long-term future o Influence: effective leaders can sell ideas, develop political support, and get people to rally behind a project or an initiative o Relationship building: effective leaders are able to unite a group of disparate individuals into a team that works towards a common goal o Execution: effective leaders know how to get things done by translating plans into action 12. Describe the 5 levels of Jim Collins’ Level 5 Leadership: o Level 1: highly capable individual - leader makes high-quality contributions with their work; possesses useful levels of knowledge; and has the talent and skills needed to do a good job o Level 2: contributing team member - leader uses knowledge and skills to help their team succeed; works effectively, productively, and successfully with other people in their group o Level 3: competent manager - leader can organize a group effectively to achieve specific goals and objectives o Level 4: effective leader - leader can galvanize a department or organization to meet performance objectives and achieve a vision o Level 5: great leader - leader has all of the abilities needed for the other four levels, plus a unique blend of humility and will that is required for true greatness 13. What does being a servant leadership mean? Servant leadership means serving others, including employees, customers, and the community, as the number one priority. 14. What is emotional intelligence mean? Emotional intelligence is critical for building a cooperative and effective team. Emotional intelligence refers to the ability to use emotions effectively and is required by leaders/managers to enhance their success. 15. Describe the 5 components of emotional intelligence: o Self-awareness: ability to recognize and understand one’s moods, emotions, and drives as well as their effects on others o Self-regulation: ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgement o Motivation: a passion to work for reasons that go beyond money or status; pursue goals with energy and commitment o Empathy: ability to understand and accept the emotional makeup of others o Social Skills: proficiency in handling relationships and building networks; an ability to find common ground 16. Describe how having emotional intelligence is essential to being a nurse. Emotional intelligence is essential to being a nurse because you appraise and express emotions in the self and others, regulate emotions in self. Chapter 20: Delegation 17. Summarize the role of a leadership in delegation: The role of leadership in delegation includes getting work done through others, directing the performance of one or more people to accomplish organizational goals, giving someone else the authority to complete a task or action on your behalf, transfer or hand-off to a competent individual, the authority to perform a task or activity in a specific setting or situation. 18. Summarize the role of a manager in delegation: The role of management in delegation includes sharing accountability for delegated tasks, is knowledgeable regarding legal liabilities of subordinate supervision, develops and implements a periodic review process for all delegated tasks, provides recognition or reward as appropriate for the completion of delegated tasks. 19. Explain each of the five rights of delegation: o Right Task: one that is delegable for a specific patient. o Right Circumstances: appropriate patient setting, available resources, and other relevant factors considered. o Right Person: Right person is delegating the right task to the right person to be performed on the right person. o Right Direction/Communication: Clear, concise description of the task, including its objective, limits, and expectations. o Right Supervision: Appropriate monitoring, evaluation, intervention, as needed, and feedback 20. Describe how the common delegations errors occur and how to prevent them: o Underdelegating: fear that delegation may be interpreted as a lack of ability to do the job completely or correctly; a desire to complete the whole job himself or herself; fear that subordinates will resent delegated work; lack of experience in the job or with delegation, or the need to control or be perfect; enjoyment of the work. o Overdelegating: poor management of time; spending too much time trying to get organized; insecurity in the ability to perform a task. o Improper delegating: wrong time, to the wrong person, or for the wrong reason; beyond the capability of the person, or something the manager should do; decision making without providing adequate information. 21. Describe the scope of practice for unlicensed assistive personnel: In assigning tasks to UAP, the RN must be aware of the job description, knowledge base, and demonstrated skills of each person. The UAP has no license to lose for “exceeding scope of practice” and nationally established standards to state what the limits should be for UAP in terms of scope of practice do not exist. 22. Describe the common tasks generally considered appropriate to delegate to nursing assistive personnel (display 20.4) 1. Frequently recur in the daily care of a client or group of clients 2. Are performed according to an established (standardized) sequence of steps 3. Involve little or no modification from one client-care situation to another 4. May be performed with a predictable outcome 5. Do not inherently involve ongoing assessment, interpretation, or decision making which cannot be logically separated from the procedure(s) itself 6. Do not endanger the health or well-being of clients 7. Are allowed by agency policy/procedures 23. Describe the appropriate response if a nurse experiences subordinate resistance: Resistance is a common response by subordinates to delegation. One of the most common causes of subordinate resistance to, or refusal of, delegated tasks is the failure of the delegator to see the subordinate’s perspective. Resistance to delegation may also occur when tasks are overdelegated in terms of specificity. 24. Describe the following cultural considerations to consider when working with a multicultural work team: o Communication: is greatly affected by cultural diversity in the workforce because dialect, volume, use of touch, context of speech, and kinesics such as gestures, stance, and eye movement all influence how messages are sent and received o Space: refers to the distance and intimacy techniques that are used when relating verbally or nonverbally to others o Social organization: refers to the importance of a group or unit in providing social support in a person’s life o Time: cultural groups can be past, present, or future oriented o Environmental control: refers to the person’s perception of control over his or her environment (internal locus of control) o Biological variations: refers to the biopsychosocial differences between racial and ethnic groups, such as susceptibility to disease and physiologic differences