YW: Chapter 1 (Leading, Managing and
Following)
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?
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. Engage involved staff
at all levels in the decision-making process.
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.
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. - ANS d. Work with the nurse, staffing office, and other nurses to
arrange his scheduled days off around his wife's treatments.
Placing the nurse on unpaid leave may threaten the nurse's capacity to meet 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.
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. - ANS
c. Ask each party to examine her own motives and issues in the conflict.
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.
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. - ANS a. Arrange another meeting in a
week's time so as to allow a cooling-off period.
According to the principles outlined by Ury, Brett, and Goldberg, a "cooling-off" period is
recommended if resolution fails.
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. - ANS a.
Exploring the values of the RN group in relationship to this change.
Influencing others requires emotional intelligence in domains such as empathy, handling
relationships, deepening self-awareness in self and others, motivating others, and managing
emotions. Motivating others recognizes that values are powerful forces that influence
acceptance of change. Leaving the RNs alone for a period of time before implementation does
not provide opportunity to explore different perspectives and values. Avoiding discussion until
the team changes may not promote adoption of the change until there is opportunity to explore
perspectives and values related to the change. Hiring of the assistants demonstrates lack of
empathy for the perspectives of the RN staff.
Following)
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?
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. Engage involved staff
at all levels in the decision-making process.
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.
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. - ANS d. Work with the nurse, staffing office, and other nurses to
arrange his scheduled days off around his wife's treatments.
Placing the nurse on unpaid leave may threaten the nurse's capacity to meet 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.
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. - ANS
c. Ask each party to examine her own motives and issues in the conflict.
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.
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. - ANS a. Arrange another meeting in a
week's time so as to allow a cooling-off period.
According to the principles outlined by Ury, Brett, and Goldberg, a "cooling-off" period is
recommended if resolution fails.
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. - ANS a.
Exploring the values of the RN group in relationship to this change.
Influencing others requires emotional intelligence in domains such as empathy, handling
relationships, deepening self-awareness in self and others, motivating others, and managing
emotions. Motivating others recognizes that values are powerful forces that influence
acceptance of change. Leaving the RNs alone for a period of time before implementation does
not provide opportunity to explore different perspectives and values. Avoiding discussion until
the team changes may not promote adoption of the change until there is opportunity to explore
perspectives and values related to the change. Hiring of the assistants demonstrates lack of
empathy for the perspectives of the RN staff.
