Leadership Chapters 13 & 14 – Flashcards

When an RN is asked to accept an assignment that he or she may not be qualified to perform, the nurse should: a. accept the assignment as appropriate if assigned by a legitimate power. b. be primarily concerned with the number of patients being assigned. c. ask how other nurses have handled the assignment in the past. d. determine whether he or she is familiar with the types of patients being assigned.

One workplace issue—the nursing shortage—is caused by several complex issues, including: a. movement of nurses into acute care settings. b. the use of unlicensed assistive personnel to replace RNs. c. a mass of Baby Boomers who have chosen nursing as a career. d. an aging nursing workforce.

Studies conducted to determine enrollment trends in nursing schools have found that in the last years: a. a greater number of individuals chose nursing as a career but could not meet entrance requirements. b. more young people chose to enter the profession of nursing. c. fewer career opportunities exist in the profession of nursing and fewer opportunities are projected to exist for women. d. men have dominated the profession, and women feel that they have experienced discrimination.

Qualified nursing school applicants have continued to be turned away, limiting enrollment due to a shortage of faculty, which is attributed to several factors, including: a. nursing faculty are subject to high levels of burnout and job dissatisfaction. b. only the number of faculty in Associate Degree programs remain stable. c. the mean age of nursing faculty continues to decrease and older faculty mentors have left the profession. d. increasing job competition from higher paying clinical sites, even as the economy recovers.

The key to organizational success for health care facilities is: a. hiring younger, more energetic nurses. b. offering incentives such as sign-on bonuses. c. hiring highly qualified advanced practice nurses. d. retaining professional nurses.

A new graduate nurse is applying for the exciting first position and states, "I am only applying to Magnet hospitals because those work environments: a. attract physicians who are the best health care providers to improve quality of care." b. require all registered nurses to be certified in the area of practice." c. not only attract but also retain professional nurses." d. discourage nurses from advancing their current level of education and I don't want to return to school for many years."

Which situation would be considered a workforce advocacy issue that is reportable to the state nurses association or the Center for American Nurses if it is not resolved at the local level? a. Nurses prefer to wear navy blue scrubs, but the institution requires burgundy scrubs, which interferes with autonomy. b. The cafeteria often serves fried vegetables rather than healthier baked vegetables, causing the potential for hyperlipidemia. c. The hospital pharmacy does not fill employee prescriptions upon receiving them; instead, they fill employee prescriptions after all inpatient prescriptions have been filled. d. The key needed to change the sharps container is locked in the supervisor's office after 3 PM on weekdays and all day on weekends, which prevents changing of the container when needed and places nurses at risk for needlesticks.

A newly hired nurse is asked to serve on a committee formed to recruit and retain nurses. At the committee meeting, the nurse learns that: a. older nurses are being encouraged to retire so that younger, more efficient nurses can practice. b. Magnet hospitals are able to attract nurses with sign-on bonuses and flexible work hours but fail to retain nurses because insufficient autonomy over professional practice is provided. c. multitasking is seldom desired by the younger generation of nurses. d. many younger workers are less concerned with longevity and are willing to change institutions to achieve professional advancement and flexible work hours.

Hospitals surveyed nurses who terminated their employment to determine why they chose to leave. One of the most common reasons for leaving was: a. decreased pay for alternative shifts. b. that the nurse/patient ratio prevents safe care. c. that most facilities are choosing an all-RN staff, which decreases opportunities for advancement. d. that agency and foreign nurses are favored by administration over full-time nursing staff.

A nurse is concerned about safe staffing levels at a facility and observes that several units have no RN coverage but instead have RNs who float among several units. In determining whether this staffing concern should be reported to an outside agency, the nurse understands that, with whistle-blowing: a. reporting unsafe staffing levels to The Joint Commission provides protection from the employer. b. keeping copies of documented inappropriate staffing patterns in the nurse's personal file is illegal. c. when observing inappropriate staffing, the nurse should record her personal thoughts concerning the outcomes. d. one should seek guidance from a trusted individual who can provide an objective point of view.

The occupational health and safety nurse would like to develop programs designed to decrease mortality and morbidity among the workforce. When considering factors related to mortality among health care workers, the nurse should focus efforts on prevention of: a. suicide. b. violence related injury. c. bloodborne disease. d. ergonomic hazards.

According to the Needlestick Safety and Prevention Act (2000): a. employers ask nurses in managerial positions to evaluate safe needle devices. b. registered nurses who sustain a needle stick are required to pass a test before resuming medication administration. c. each state must determine the type of safe needle devices to be used. d. employers are required to document how and where a sharps injury occurred, including the brand of device that was involved.

A nurse is concerned because novice nurses are having their orientation period shortened and are being placed in charge nurse positions. The nurse has documented unsafe care and decisions by these novice nurses. To be protected from retaliation by the employer, this nurse must "blow the whistle" by: a. holding a public forum in the agency cafeteria to discuss concerns. b. reporting concerns to state and/or national agencies regulating the agency. c. calling coworkers outside the workplace to informally discuss wrongdoing. d. contacting The Joint Commission to report unsafe conditions.

A nurse is concerned about a trend in the hospital to regularly "float" nurses to different areas of the hospital based on staff shortage regardless of recent experience in caring for the population on the unit. When deciding to accept a staffing assignment in this situation, the nurse considers a "safe harbor." What is meant by "safe harbor"? a. In an emergency situation, nurses may move patients to one location designated to be areas safe from natural disasters or acts of terrorism. b. Nurses work in teams to care for patients who have no communicable disease and do not pose a safety issue due to infection. c. Horizontal violence is not tolerated and nurses report any form of violence to administration. d. It is written a notice about recurrent staffing issues that allows nurses to continue to care for patients placed in their care but protects their nurse's license while an investigation is conducted.

The Institute of Medicine report (2011): a. recommended that only physicians have the legal privilege to prescribe medications. b. called for increasing the number of baccalaureate-prepared nurses in the workforce to 80% by 2020. c. called for a minimum staffing ratio be in place in no later than 10 years. d. called for nurse technicians to provide care during the nursing shortage.

The priority intervention to improve work-related quality of life for nurses is to: a. provide safe harbors for unjust or unsafe work assignments. b. improve nurse physician communications. c. require professional development courses for bedside nurses. d. determine strategies to improve vertical working relationships between staff nurses and nursing administration.

Nurses entering the workforce at a large urban hospital soon began volunteering for excessive overtime. A focus group found that upon graduation, many of these nurses purchased expensive cars and furniture. They lacked skills in managing their checkbook and were often unable to pay recurring bills; this finding would be relevant to which component of the Workforce Advocacy Ecosystem Model? a. Staffing b. Workflow design c. Organizational factors d. Personal and social factors

An acute care facility values job satisfaction among its registered nurses.by implementing a shared governance model. Which element is a fundamental characteristic of this model? a. Administration has an open door policy b. Established dispute resolution process c. Implementation of mandatory reporting d. Nurses have an active role in patient care decision making

When reading about nursing as a career, a student is interested in learning about violence in the profession. Which statement accurately reflects violence in health care and the profession of nursing? a. Nursing is the most trusted profession and therefore violence is rare. b. All nurses should be advocates for violence prevention programs. c. Physical violence between peers constitutes lateral violence; however, verbal assault is not recognized as violence. d. Professional organizations have recognized a need to evaluate all nurses for the risk of committing acts of violence.

Managers at an acute care facility value the contributions of their aging nursing workforce and make recommendations to accommodate for an aging nursing workforce. They institute for which changes? (select all that apply) a. Supplies such as dressing change and Foley catheter kits are placed on the nursing unit. b. Teamwork and development of new roles such as admission nurse are encouraged. c. Daycare centers for sick children are put into place to prevent the stress of having to find alternative daycare. d. Assistive devices for lifting as recommended by ANA's Handle with Care are made available. e. A work-design consultant is hired to redesign the nursing unit to reduce wasted motion. ANS: A, B, D, E Placing supplies in a decentralized area prevents the fatigue that would be caused by the need to retrieve items from a distant location. Nurses are integral to quality and their contributions should be noticed. Ill-designed units contribute to fatigue and inability of aging nurses to perform efficiently. Mentoring is one way to acknowledge skills of the aging workforce.

A nurse is interviewing for a job and recently read the American Nurses Association's (ANA) recommendation for questions to ask regarding before accepting employment. Which questions should the nurse ask? a. Do you have flexible scheduling? b. What are the expectations for advancement? c. How long do staff nurses stay before resigning? d. What is the mission of the parent organization? e. Does the organization have a means for staff nurses to have an active role in decision making by participation and accountability for the outcomes of practice decisions?

Nurses who are expected to work overtime as dictated by their employer are being subjected to a ___________ hazard in the workplace.

Nurses in a unionized hospital are paid "compensatory pay" when working holidays equal to the number of hours worked with no extra compensation. Although they have suggested changes during the annual survey of employee satisfaction, management refuses to consider another system for compensatory pay. A trained member listened to both nurses and management to make recommendations that were not legally binding. This type of settlement is termed: a. picketing. b. binding arbitration. c. mediation. d. grievance.

A nurse has been asked to serve as the charge nurse on the evening shift. The agency where the nurse is employed is considering unionization. If the charge nurse position is accepted, this nurse: a. can be represented by the union because charge nurses are not considered part of the management team. b. is part of the management team, so union participation would be a conflict of interest. c. can file a grievance that will be arbitrated automatically by the union. d. is ineligible for collective bargaining activities that deal with unfair labor practices.

A nurse has heard rumors that other nurses are interested in unionizing but knows little about the purpose of unions. The nurse's first action is to: a. contact an arbitrator who has worked with other nurses in unions. b. picket the agency where employed to gain inside information as to why unionization is sought. c. sign the dual-purpose union authorization card. d. review the National Nurses United website for collective bargaining information.

Nurses in a nonprofit hospital have expressed an interest in forming a union to secure fair wages and ensure client safety. To form a core support group of nurses, the union organizer can conduct meetings to gather initial information: a. away from the worksite with a group of managers to learn both sides of the situation. b. at the worksite with staff nurses who are respected leaders. c. in homes or local businesses with staff nurses. d. after photographing management meeting to discuss their strategies to decrease interest in unionization.

Mandatory overtime and reduction in RN staff have resulted in decreased client satisfaction and a sentinel event. Management is unwilling to discuss a change in staffing, and collective bargaining interest is sparked. A nurse is approached to sign a union authorization card. If signed, the card: a. authorizes the union to serve as his or her legal representative. b. indicates that the person is requesting additional information about collective bargaining. c. indicates the nurse desires to share information about grievances. d. gives permission for union dues to be deducted from pay.

A group of RNs wish to seek union representation that would protect all workers in the agency including nonlicensed assistive personnel and non-nursing employees such as nutritionists and dietary workers. The type of union being sought is the strongest collective group and is known as a(n): a. occupational union. b. industrial union. c. union shop. d. right-to-work bargaining organization.

Physical therapists are represented by a union, nurses are represented by a separate union, and pharmacists have yet another union within a single agency. This type of union representation is known as: a. occupational unionism. b. industrial unionisms. c. union shop. d. power sharing.

Historically, what movement most influenced unionization in American health care agencies/hospitals? a. Immigration laws protected foreign employees from discrimination in hiring or discharge on the basis of national origin and citizenship status. b. Women entered the workforce, gaining voice to support unions. c. The Industrial Revolution led to poor working conditions and the need to protect workers. d. Nurses were exposed to communicable diseases, which led to death and disability.

In recent Gallop Polls, nurses were voted as the most honest with the highest ethical standards of all professions. How does this degree of professionalism affect nurses' desire to participate in organized strikes? a. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client safety initiatives. b. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization. c. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession. d. Nurses who strike can be legally punished for abandonment and negligence, considered to be professional misconduct.

A concern that nurses were being asked to perform tasks that went beyond the state's nurse practice act was brought to the union's attention. Nurses were informed that either mediation or binding arbitration will be used to resolve the issue. A novice nurse asks about the difference between these techniques and is informed that: a. mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor. b. binding arbitration is a formal discussion between labor and management in which the arbitrator's recommendations are compulsory. c. mediation uses a trained person to negotiate a legally binding plan. d. binding arbitration requires both labor and management to participate in discussions on the least destructive approach to allow self-governance by employees.

A large corporation employs nurses all over the United States. Nurses in one agency learned that fellow nurses in another agency are striking because they are required to work 16-hour shifts to cover for nurses who have left due to unsafe staffing practices. The union of the nonstriking agency nurses decides to stop work to support the nurses who are striking; thus, this union: a. is placing nurses at risk for a lawsuit because their direct employer did not cause the strike. b. must be an industry union representing both parties. c. is participating in a sympathy strike, which, if done correctly, is legal. d. must pay for any losses incurred by the agency during the strike.

A group of nurses interested in unionizing decides to contact the largest union in the United States representing registered nurses, which is the: a. American Nurses Association. b. United American Nurses. c. National Nurses United. d. National Labor Relations Board.

A nurse is interested in working in a large trauma center that is unionized but does not want to join the union or pay fees. She accepts the position but is not required to join or pay fees to the union based on which law? a. National Labor Relations Act b. Right-to-work law c. National Labor Relations Act d. Taft-Hartley Act

A group of nurses are assembling outside a hospital protesting the use of foreign nurses after several nurses were terminated due to what the hospital called recurring "decreased census." The nurses carry signs with messages asking potential patients to seek care elsewhere. The local newspaper picked up the story, and the hospital is receiving negative press. The nurses are participating in: a. picketing. b. collective bargaining. c. a strike. d. arbitration.

A hospital is seeking a 2.5% wage reduction for all nurses as part of a new balanced budget plan; however, the plan provides for raises for upper-level management. This plan resulted in a call for a union to protect the nurses. When the union representative arrives, what questions should the nurses ask? (select all that apply) a. Will the dues be used to support charity care when clients are unable to pay? b. How effective has the union been in representing nurses' best interest? c. What percent of dues pays union personnel salaries? d. Are dues used to promote research for terminally ill clients? e. If arbitration is unsuccessful and a strike occurs, will nurses receive compensation during the strike?

A hospital refused to purchase a better grade of utility gloves, even after learning that the cheaper utility gloves are easily punctured during routine use. This unsafe situation led nurses to seek unionization. During the pre-election phase for unionization, which actions by union representatives are prohibited by the National Labor Relations Board? (select all that apply) a. Scheduling a meeting in the agency's cafeteria to determine employees' interest in unionization b. Distributing nondocumented information that female nurses receive lower annual performance evaluations than do male nurses c. Distributing information about the benefits of unionization and grievances in a public parking garage located across from the hospital d. Suggesting to workers the likelihood of job loss should the union not win the election e. Signing authorization cards for employees who are on leave

It is important to realize that nurses may seek unionization if: (select all that apply) a. physicians rotate on-call coverage among group members for complicated long-term clients. b. scheduling is presented that provides adequate staffing on holidays by rotation of time off for holidays among nurses. c. incident report trends indicate medication errors are caused by shift reports being taped and heard after nurses from the prior shift have left the unit. d. physicians, nurses, nutritionists, and physical therapists visit concurrently with clients to plan care. e. staff development activities are planned daily at 8 AM for 2 consecutive days to educate staff on new cardiac monitoring procedures while following normal staffing patterns.

Mandatory overtime and reduction in RN staff have resulted in decreased client satisfaction and a sentinel event. Management is unwilling to discuss a change in staffing, and collective bargaining interest is sparked. During the pre-election period, what actions by management are prohibited? (select all that apply) a. Seek individuals to spy on coworkers who are possible union supporters. b. Photograph employees participating in information sessions about unionization. c. Visit managers outside work to gain their perception of popularity of unionization. d. Threaten that, should the union win, the company will relocate when there is no intention to relocate. e. Require employees to declare their position on unionization prior to pick up paychecks.