Nursing Leadership And Management STUDY NOTES

Management of Care ASSIGNMENT, DELEGATION AND SUPERVISION Evaluate delegated tasks to ensure correct completion of activity. Evaluate effectiveness of staff members�time management skills. CASE MANAGEMENT: Practice and advocate for cost effective care. CONCEPTS OF MANAGEMENT Manage conflict among clients and health care staff. Identify roles/responsibilities of health care team members. ESTABLISHING PRIORITIES Apply knowledge of pathophysiology when establishing priorities for interventions with multiple clients. Prioritize the delivery of client care. PERFORMANCE IMPROVEMENT (QUALITY IMPROVEMENT): Participate in performance improvement projects and quality improvement processes. CHAPTER 1 Managing Client Care Managing client care requires leadership, management skills, and knowledge to effectively coordinate and carry out client care. To effectively manage client care, a nurse must develop knowledge and skills in several areas, including leadership, management, critical thinking, clinical reasoning, clinical judgment, prioritization, time management, assigning, delegating, supervising, staff education, quality improvement, performance appraisal, peer review, disciplinary action, conflict resolution, and cost-effective care. Leadership and management • Management is the process of planning, organizing, directing, and coordinating the work within an organization. • Leadership is the ability to inspire others to achieve a desired outcome. • Effective managers usually possess good leadership skills. However, effective leaders are not always in a management position. • Managers have formal positions of power and authority. Leaders might have only the informal power afforded them by their peers. • One cannot be a leader without followers. LEADERSHIP LEADERSHIP STYLES Most can be categorized as authoritative, democratic, or laissez-faire. The nurse might need to use any of these leadership styles depending on the situation. Authoritative • Makes decisions for the group. • Motivates by coercion. • Communication occurs down the chain of command, or from the highest management level downward through other managers to employees. • Work output by staff is usually high: good for crisis situations and bureaucratic settings. • Effective for employees with little or no formal education. Democratic • Includes the group when decisions are made. • Motivates by supporting staff achievements. • Communication occurs up and down the chain of command. • Work output by staff is usually of good quality when cooperation and collaboration are necessary. Laissez-faire • Makes very few decisions, and does little planning. • Motivation is largely the responsibility of individual staff members. • Communication occurs up and down the chain of command and between group members. • Work output is low unless an informal leader evolves from the group. • Effective with professional employees. CHARACTERISTICS OF LEADERS • Initiative • Inspiration • Energy • Positive attitude • Communication skills • Respect • Problem-solving and critical-thinking skills • A combination of personality traits and leadership skills • Leaders influence willing followers to move toward a goal. • Leaders have goals that might differ from those of the organization. • Transformational leaders empower and inspire followers to achieve a common, long-term vision. • Transactional leaders focus on immediate problems, maintaining the status quo and using rewards to motivate followers. • Authentic leaders inspire others to follow them by modeling a strong internal moral code. Emotional intelligence • Emotional intelligence is the ability of an individual to perceive and manage the emotions of self and others. • The nurse must be able to perceive and understand their own emotions and the emotions of the client and family in order to provide client-centered care. • Emotional intelligence is also an important characteristic of the successful nurse leader. • Emotional intelligence is developed through understanding the concept and applying it to practice in everyday situations. The emotionally intelligent leader: • Has insight into the emotions of members of the team. • Understands the perspective of others. • Encourages constructive criticism and is open to new ideas. • Manages emotions and channels them in a positive direction, which in turn helps the team accomplish its goals. • Is committed to the delivery of high-quality client care. • Refrains from judgment in controversial or emotionally- charged situations until facts are gathered. MANAGEMENT The five major management functions are planning, organizing, staffing, directing, and controlling. PLANNING: The decisions regarding what needs to be done, how it will be done, and who is going to do it ORGANIZING: The organizational structure that determines the lines of authority, channels of communication, and where decisions are made STAFFING: The acquisition and management of adequate staff and staffing mix DIRECTING: The leadership role assumed by a manager that influences and motivates staff to perform assigned roles CONTROLLING: The evaluation of staff performance and evaluation of unit goals to ensure identified outcomes are being met CHARACTERISTICS OF MANAGERS • Hold formal positions of authority and power • Possess clinical expertise • Network with members of the team • Coach subordinates • Make decisions about the function of the organization, including resources, budget, hiring, and firing Critical thinking Critical thinking is used when analyzing client issues and problems. Thinking skills include interpretation, analysis, evaluation, inference, and explanation. These skills assist the nurse to determine the most appropriate action to take. • Critical thinking reflects upon the meaning of statements, examines available data, and uses reason to make informed decisions. • Critical thinking is necessary to reflect and evaluate from a broader scope of view. • Sometimes one must think “outside the box” to find solutions that are best for clients, staff, and the organization. Clinical reasoning • Clinical reasoning is the mental process used when analyzing the elements of a clinical situation and using analysis to make a decision. The nurse continues to use clinical reasoning to make decisions as the client’s situation changes. • Clinical reasoning supports the clinical decision-making process by: ⃝ Guiding the nurse through the process of assessing and compiling data. ⃝ Selecting and discarding data based on relevance. ⃝ Using nursing knowledge to make decisions about client care. Problem solving is a part of decision-making. Clinical judgment • Clinical judgment is the decision made regarding a course of action based on a critical analysis of data. • Clinical judgment considers the client’s needs when deciding to take an action, or modify an intervention based on the client’s response. • The nurse uses clinical judgment to: ⃝ Analyze data and related evidence. ⃝ Ascertain the meaning of the data and evidence. ⃝ Apply knowledge to a clinical situation. ⃝ Determine client outcomes desired and/or achieved as indicated by evidence-based practices. PRIORITIZATION AND TIME MANAGEMENT • Nurses must continuously set and reset priorities in order to meet the needs of multiple clients and to maintain client safety. • Priority setting requires that decisions be made regarding the order in which: ⃝ Clients are seen. ⃝ Assessments are completed. ⃝ Interventions are provided. ⃝ Steps in a client procedure are completed.