,Chapter 01: Leading, Managing, and Following
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Yoder-Wise: Leading and Managing in Nursing, 7th Edition
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MULTIPLE CHOICE d
1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults.
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dShe is asked to assess and adapt the unit to better meet the unique needs of the older adult
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dpatient. Using complexity principles, what would be the best approach to take in making
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dthis change? d
a. Leverage the hierarchical management position to get unit staff involved in
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assessment and planning.
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b. Engage involved staff at all levels in the decision-making process.
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c. Focus the assessment on the unit, and omit the hospital and community
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environment.
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d. Hire a geriatric specialist to oversee and control the project.
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ANS: B d
Complexity theory suggests that systems interact and adapt and that decision making occurs
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throughout the systems, as opposed to being held in a hierarchy. In complexity theory,
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every voice counts, and therefore, all levels of staff would be involved in decision making.
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REF: d d Page 8 d TOP: AONE competency: Communication and Relationship-Building
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2. A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who
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dhas called in sick five times in the past month. He tells the manager that he very much
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dwants to come to work when scheduled but must often care for his wife, who is undergoing
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dtreatment for breast cancer. According to Maslow’s need hierarchy theory, what would be
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dthe best approach to satisfying the needs of this nurse, other staff, and patients?
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a. Line up agency nurses who can be called in to work on short notice.
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b. Place the nurse on unpaid leave for the remainder of his wife’s treatment.
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c. Sympathize with the nurse’s dilemma and let the charge nurse know that this nurse d d d d d d d d d d d d d
may be calling in frequently in the future.
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d. Work with the nurse, staffing office, and other nurses to arrange his scheduled days
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off around his wife’s treatments.
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ANS: D d
Placing the nurse on unpaid leave may threaten the nurse’s capacity to meet physiologic
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needs and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could
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affect patient care and threaten the needs of staff to feel competent. Arranging the schedule
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around the wife’s needs meets the needs of the staff and of patients while satisfying the
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nurse’s need for affiliation.
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REF: d d Page 10 d TOP: AONE competency: Communication and Relationship-Building
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,3. A grievance brought by a staff nurse against the unit manager requires mediation. At the
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dfirst mediation session, the staff nurse repeatedly calls the unit manager’s actions unfair,
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dand the unit manager continues to reiterate the reasons for her actions. What would be the
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dbest course of action at this time?
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a. Send the two disputants away to reach their own resolution.
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b. Involve another staff nurse in the discussion so as to clarify issues.
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c. Ask each party to examine her own motives and issues in the conflict.
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d. Continue to listen as the parties repeat their thoughts and feelings about the
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conflict.
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ANS: C d
Ury, Brett, and Goldberg outline steps to restoring unity, the first of which is to address the
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interests and involvement of participants in the conflict by examining the real issues of all
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parties.
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REF: d d Page 16 d TOP: AONE competency: Communication and Relationship-Building
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4. At a second negotiation session, the unit manager and staff nurse are unable to reach a
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d resolution. It would now be best to: d d d d d d
a. Arrange another meeting in a week’s time so as to allow a cooling-off period.
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b. Turn the dispute over to the director of nursing.
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c. Insist that participants continue to talk until a resolution has been reached.
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d. Back the unit manager’s actions and end the dispute.
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ANS: B d
According to the principles outlined by Ury, Brett, and Goldberg, a “cooling-off” period is
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recommended if resolution fails.
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REF: d d Page 16 d TOP: AONE competency: Communication and Relationship-Building
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5. The manager of a surgical area has a vision for the future that requires the addition of RN
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dassistants or unlicensed persons to feed, bathe, and walk patients. The RNs on the staff have
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dalways practiced in a primary nursing–delivery system and are very resistant to this idea.
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dThe best initial strategy in this situation would include:
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a. Exploring the values and feelings of the RN group in relationship to this change.
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b. Leaving the RNs alone for a time so they can think about the change before it is
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implemented.
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c. Dropping the idea and trying for the change in a year or so when some of the
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present RNs have retired.
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d. Hiring the assistants and allowing the RNs to see what good additions they are.
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ANS: A d
, Influencing others requires emotional intelligence in domains such as empathy, handling
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drelationships, deepening self-awareness in self and others, motivating others, and managing
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demotions. Motivating others recognizes that values are powerful forces that influence
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dacceptance of change. Leaving the RNs alone for a period of time before implementation
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ddoes not provide opportunity to explore different perspectives and values. Avoiding
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ddiscussion until the team changes may not promote adoption of the change until there is
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dopportunity to explore perspectives and values related to the change. Hiring of the
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dassistants demonstrates lack of empathy for the perspectives of the RN staff.
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REF: Page 7 | Page 15
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TOP: AONE competency: Knowledge of the Health Care Environment
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6. As the RN charge nurse on the night shift in a small long-term care facility, you’ve found
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dthat there is little turnover among your LPN and nursing assistant (NA) staff members, but
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dthey are not very motivated to go beyond their job descriptions in their work. Which of the
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dfollowing strategies might motivate the staff and lead to greater job satisfaction?
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a. Ask the director of nursing to offer higher wages and bonuses for extra work for
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dthe night LPNs and NAs.d d d d
b. Allow the LPNs and NAs greater decision-making power within the scope of their
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dpositions in the institution. d d d
c. Hire additional staff so that there are more staff available for enhanced care and
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dindividual workloads are lessened. d d d
d. Ask the director of nursing to increase job security for night staff by having them
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dsign contracts that guarantee work.
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ANS: B d
Hygiene factors such as salary, working conditions, and security are consistent with
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Herzberg’s two-factor theory of motivation; meeting these needs avoids job dissatisfaction.
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Motivator factors such as recognition and satisfaction with work promote a satisfying and
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enriched work environment. Transformational leaders use motivator factors liberally to
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inspire work performance and increase job satisfaction.
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REF: Page 9 | Page 10
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TOP: AONE competency: Communication and Relationship-Building
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7. As the nurse manager who wants to increase motivation by providing motivating factors,
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dwhich action would you select?
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a. Collaborate with the human resource/personnel department to develop on-site d d d d d d d d
daycare services.
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b. Provide a hierarchical organizational structure. d d d d
c. Implement a model of shared governance. d d d d d
d. Promote the development of a flexible benefits package. d d d d d d d
ANS: C d
Complexity theory suggests that systems interact and adapt and that decision making occurs
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throughout systems, as opposed to being held in a hierarchy. In complexity theory, every
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voice counts, and therefore all levels of staff would be involved in decision making. This
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principle is the foundation of shared governance.
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