Nursing Management

Novice to expert
Ch. 23
Five stages of proficiency in the development of skill acquisition and performance within the domain of clinical nursing practice that frames a transition from reliance on abstract principles of the new learner to becoming an involved performer who is engaged in a situation.
Objective
Ch. 23
An identifiable, measurable act that implements one’s goal and is typically short termed
Priority setting
Ch. 23
Establishing superiority in rank, a preferential rating, or the state of “coming frist” in order or ahead of others in a process by which that order will represent the execution of the ranked items
Energy management
Ch. 23
Ensuring that the right amount of effort matches the right task to optimize an outcome while gauging the amount of personal energy expended or taxed to achieve the desired result.
Goal
Ch. 23
A tangible, measurable, and attainable act in a specific period of time. It has broad-term results, experiences or achievements toward which someone is willing to work.
Time management
Ch. 23
The development of processes and tools that increase efficiency and productivity within the set standard of time.
Maslow’s heirarchy
Ch. 23
Priority setting framework.
1. Physiological/Basic Needs 2. Safety 3. Love/Belonging 4. Esteem 5. Self-actualization
ABC framework
Ch. 23
Priority setting framework
All tasks assigned to letters. A: high priority, B: medium priority, C: low priority
Pareto (80/20) framework
Ch. 23
Priority setting framework
Suggests 80% of time expended produces 20% of results, and 20% of time expended produces 80% of results. Idea is to determine the “vital few” and eliminate “trivial many” tasks. This concept is to focus on one or two tasks @ a time.
Continuum framework
Ch. 23 pg 519
Priority setting framework
Based on 4 continuums. (Intrinsic importance, urgency, delegation, visitations) Each individual continuum is ranked on scale of 1-4, ranging from very important to unimportant and can be eliminated.
Steps to Time Management
Ch. 23
1. Planning *most important. 1 minute planning = 10 minutes productivity
2. Organizing
3. Implementing
Change Agent
p 352
Lewin (1951) Rules for change
1. Change should be implemented only for good reason
2. Change should always be planned and implemented gradually
3. Change should never be unexpected or abrupt
4. All people who may be affected by the change should be involved in planning for the change
Stages of change (Lewin 1951)
p 353
1. Unfreezing stage
2. Moving stage
3. Refreezing stage
Unfreezing stage of change
p 353
Promotes problem identification, encourages awareness of the need for change. Change agent’s responsibilities during this stage are: gather information about the problem, accurately assess the problem, decide if change is necessary, make others aware of need for change
Moving stage of change
p 353
Change agent clarifies the need to change, explores alernatives, defines goals and objectives, plans and implements change plan. Change agents responsibilites are: identify areas of support and resistance, set goals & objectives, include everyone affected in planning, implement change plan, be available to help/support/encourage others through process, evaluate change and make modifications if needed
Refreezing stage of change
p 353
The change agent integrates change into organization so that it becomes the “status quo”. If refreezing stage is not completed, people may go back to old behaviors. Change agent’s reponsibilites: require and enforce compliance with process, support and encourage others until change is no longer viewed as new but as status quo.
Role Model
p 499
Not an interactive process. A staff nurse can be a role model from a novice, but have no interaction with the novice.
Mentor
p 499-500
Mentors are experienced nurses who must be willing to commit to a 6-month relationship with the novice. They help the novice recognize limitations, assets and raise their confidence. Mentors help novices set and reach realistic goals, build self-confidence, and professional satisfaction
Leaders
Ch 17
May not have formal authority but are still able to influence others. Guides people and groups to accomplish goals.
Managers
Ch. 17
Appointed for formal line of authority. Coordinates people. times, and supplies to achieve desired outcomes in a defined area of responsibility.
Power vs Authority
Ch 17
Power is the ability to motivate people to get things done with or without formal right. Authority is the legitimate right to direct others through an authorized position
Democratic
Ch. 17
Management theory: encourages staff involvement in goal setting, problem solving, and decision making
Authoritarian
Ch. 17
Management theory: makes all the decisions with no staff input and uses the authority of the position to accomplish goals.
Laissez-faire
Ch. 17
Management theory: provides little direction or guidance and will forego decision making.
5 management functions
Planning, Organizing, Staffing, Directing, Controlling.
Different phases of process can occur simultaneously. Process should be circular with manager always working toward improvement in quality, patient safety, and satisfaction.
Transformational leadership
Ch. 17
Provides mentoring to individual staff members on the basis of need, imparts meaning and challenge to work, are admired and emulated, committted to organizational goals, communicates vision and direction
Transactional leadership
Ch. 17
Concerned with the day-to-day operations of the facility/unit.
Informal Leadership
Ch 17
Person has no official authority to act but is able to influence a group.
Strategies: understand their source of power, invovle them in decisions and change, do not ignore attempts to undermine teamwork and change. May need to counsel them
Positive reinforcement
Ch. 17 – see p 344 Box 15-5
Be specific with praise given for particular task
Occur as close as possible to time of the achievement
Be spontaneous and unpredictable
Be given for a genuine accomplishment
Interpretation of Communication
Ch 15
Recognize that any reaction from the reciever may be biased by past experiences. If reciever acts unexpectedly, investigate reason.
Ad hominem abusive
Ch 15
Logical fallacies: Attack the person instead of the issue, speaker hopes to discredit the other person by calling attention to some irrelevant fact
Appeal to common practice
Ch. 15
Logical fallacies: Something is ok because most people do it, could lead to significant legal and professional problems

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