PDF Solutions Manual for Leadership and Management for Nurses 5th Edition by Finkelman

Chapter 1: Conceptual Base for Leadership and Management

LEARNING OUTCOMES AND SUGGESTED CLASSROOM AND CLINICAL ACTIVITIES

LEARNING OUTCOME 1

Examine The Future of Nursing report, and their relevance to nursing leadership and outcomes.

Suggestions and Strategies for Classroom Experience

 Ask the students to review The Future of Nursing report and its recommendations. Divide students into teams and assign the recommendations to each team (due to class size there may be teams that have the same recommendation). What is the relevance of each recommendation to nursing leadership? Review the Progress Report and the website https://campaignforaction.org.

Suggestions and Strategies for Clinical Experience

 Have students ask nursing staff if they know about The Future of Nursing report, and if so, what do they know.

 Ask students to identify one aspect of The Future of Nursing report or an aspect from the website and observe if or how it is implemented in a practice setting. Discuss their choices and observations.

LEARNING OUTCOME 2

Interpret the implications of change in the healthcare delivery system on nursing leadership

Suggestions and Strategies for Classroom Experience

 Ask students to describe how they react to change. Then have them apply this information about themselves to how they might respond in the workplace.

Suggestions and Strategies for Clinical Experience

 Ask students to identify areas of change or areas that they think are in need of change in their clinical experiences, and how they think staff will respond.

LEARNING OUTCOME 3

Analyze the key modern leadership theories compared to older theories, and understand their implications for nursing leadership, management, and transformational leadership.

 Select two of the competencies needed to be an effective leader and discuss how each one is relevant to nursing. This can be done in teams, during class, or as a written assignment.

 Ask students to explain why transformational leadership is considered to be the most effective leadership style and how it integrates other styles.

Suggestions and Strategies for Classroom Experience

 Prepare 3 × 5 cards, each with a name of a theory on it. Have students work in teams. Students each select one of the cards without knowing the content and then role-play that theory in response to a hypothetical case study.

Suggestions and Strategies for Clinical Experience

 Ask students to identify types of leadership that they see demonstrated in clinical areas and have them provide examples.

LEARNING OUTCOME 4

Compare and contrast characteristics, roles, and responsibilities of leaders and managers.

Suggestions and Strategies for Classroom Experience

 Have students develop a list of critical manager and leader descriptors to use when reviewing the descriptions of nurse manager positions. Ask students to get a copy of a nurse manager position description from a clinical site. So that all students do not go and ask for the same documentation, students can volunteer to get these documents from clinical sites and share them with the class. In class, students can compare and contrast the position descriptions.

 Ask students to compare and contrast AONE, ANA, and AACN competencies in a written assignment.

 Students can collect examples of how the image of nursing is portrayed in the media (e.g., in newspapers, magazines, television, radio, print ads, film). What is the image portrayed? Why is the image important to the nursing profession and to healthcare delivery?

Suggestions and Strategies for Clinical Experience

 Clinical faculty can ask students for feedback about key persons on the units (e.g., nurse manager, team leader, and others). Compare and contrast management and leadership qualities. Advise students that they should continue doing this in all clinical settings to build on their appreciation of manager and leader roles. Remind students about privacy and confidentiality and making respectful, constructive comments. Names should not be used.

 Ask students to determine if the factors described as important in developing a positive work environment by nurse leaders are applied in the work setting (clinical site) and provide examples.

 Discuss what types of competencies the HCO uses for its nurse managers.

 Ask students for examples of comments they have heard from patients and their families that describe what nurses do. Discuss the examples and implications for the nursing image and the profession itself.

LEARNING OUTCOME 5

Analyze critical aspects of the preparation and development of nurse leaders and managers.

Suggestions and

Strategies

for Classroom Experience

 Ask students to write a brief response to the following question: What is your opinion of new graduates in management positions?

 Ask students if managing care is the same as being a nurse manager and to explain their rationale.

Suggestions and Strategies for Clinical Experience

 Observe how one staff nurse demonstrates leadership in practice. Discuss in clinical conference.

KEY CHAPTER CONCEPTS

1. The Future of Nursing report emphasizes the need for more nursing leadership and makes eight recommendations related to education, practice, leadership, and research. In response to The Future of Nursing, the Robert Wood Johnson Foundation (RWJF) and the American Association of Retired Persons (AARP) partnered to establish The Future of Nursing: Campaign for Action. The Center to Champion Nursing in America analyzes established data sets to evaluate the status of the work that has been done to meet the report’s recommendations to transform healthcare for the 21st century. The center also publishes updates on its website. This collaboration includes more than 80 healthcare, nursing, business, and consumer organizations, as described on its website, CampaignforAction.org

2. Examples of changes in healthcare are identified in Box 1-1.

3. Nurse leaders might or might not be in formal management positions. To accomplish leadership competency, nurses need to have an understanding of relevant leadership and management theories and styles. A historical review of the stages of leadership theory development indicates that there are four stages, which are highlighted in Box 1-2. Autocratic, bureaucratic, and laissez-faire approaches are still found in some organizations. These theories are not considered to be as effective in the current healthcare delivery system.

4. Typically, the theories of the past emphasized control, competition, and getting the job completed; creativity was not a key part. The modern leadership theories and styles have their base in earlier theories, but they have been developed further as the needs of organizations changed, requiring different types of

leaders and managers. Emphasize three general types of leadership approaches: autocratic, bureaucratic, and laissez-faire. See Box 1-3.

5. Deming’s theory emphasizes groups and teamwork and team ownership of work.

6. Drucker’s theory emphasizes participatory management and that leadership can be nurtured. Staff should participate in as much of the planning and establishment of goals and decision making as possible.

7. Contingency theory focuses on situational variables that affect the leader–member relationship, task structure, and position power.

8. Management grid theory emphasizes five styles that focus on production and concern for people; they include impoverished leadership, country club leadership, authority obedience leadership, organizational “man,” and team leadership.

9. Connective leadership theory focuses on caring. Interconnectedness is a key element in healthcare today with an increasing emphasis on the continuum of services to meet the needs of patients and communities.

10. The theory of emotional intelligence emphasizes feelings, self-awareness, and emotional competence. Emotional competencies are learning abilities or job skills that can be learned.

11. Knowledge management theory emphasizes the importance of knowledge work, interprofessional collaboration, and accountability. This new age of knowledge growth requires workers to use information to produce knowledge, solve problems, and meet organizational goals.

12. Leadership 2.0 is a more current theory, combining many elements from other theories.

13. Servant leadership, collaborative leadership, and complexity leadership are more current views today, engaging staff in complex work environments and adaptation.

14. Transformational leadership theory focuses on the need for leaders to embrace change, reward staff, guide staff in understanding its role and the importance of a positive work environment, and work toward developing a self-aware staff that is able to take risks to improve. It emphasizes empowerment and is the most accepted theory today.

15. Transformational leadership is the leadership style recommended by the Institute of Medicine (IOM)/National Academy of Medicine (NAM).

16. Qualities that have been identified in transformational leaders are selfconfidence, self-direction, honesty, energy, loyalty, commitment, and the ability to develop and implement a vision. Empowerment is important. The transformational leader who has these qualities can lead staff during times of creative development but also can ensure that operational issues are addressed.

17. To cope with change, healthcare organizations need transformational leaders who express vision and creativity and empower staff.

18. Constant change in the healthcare delivery system requires nurses to be flexible in their role—to step outside the box.

19. Management levels are first, middle, and upper.

20. The key management functions are planning, organizing, leading, and controlling.

21. Managers maintain equilibrium; leaders manage change.

22. A manager is in a formal position in an organization; leaders do not have to be in a formal position; one can be an informal leader. Authority for a manager originates from the position held in the organization—for example, a nurse manager—while authority for a leader results from the ability to influence.

23. Key leader roles are expert, administrator, people person, and strategist for the future. Through these roles, the leader emphasizes quality and effective performance.

24. Myths about leadership persist, such as everyone can be a leader, leaders deliver business results, and leaders are coaches.

25. The image of nursing is improving, and along with this comes greater visibility of nurse leaders; however, more needs to be done to improve the image of nursing, as it has a great impact on recruitment and retention and the development of nurse leaders.

26. Nurses become leaders through a variety of methods. Simple promotion, as noted in comments about the Peter Principle, has not always been helpful, as it often takes the best practitioners away from direct care into an area in which they do not excel.

27. Leaders need to be developed by other nurse leaders through methods such as identifying potential candidates, helping them set goals, and providing mentorship and additional education, both academic and within the organization. Professional organizations also need to develop leaders.

28. Some key skills and competencies that make for effective managers and leaders include the following: critical-thinking and communication skills, ability to guide staff in using clinical resources and judgment, team-building, flexibility, collaboration, delegating, and ability to evaluate effectively.

29. Managers who are leaders need to care for their staff and develop trust. Transformational leadership has an impact on staff retention and productivity and impacts quality of care. We have a shortage of nurse leaders.

30. The AACN recognizes the need to incorporate more leadership development in graduate and undergraduate nursing programs. Leadership is required for all nursing positions.

31. The ANA states that leadership is a critical part of the nursing profession. Every nurse needs to develop leadership qualities and competencies.

32. The AONE states that nursing leadership plays a very important role in creating the work environment that attracts and keeps nurses. Leaders need to empower their staff and exemplify leadership.

33. Multiple strategies are needed to develop nursing leadership.

34. What difference does the value of the nurse clinical leader position make?

APPLYING LEADERSHIP AND MANAGEMENT

BSN and Master’s Essentials: Application to Content

This chapter identifies which Essentials apply to the chapter content. This information is primarily for the instructor, but students should understand how these nursing education standards apply to the chapter content and the nursing profession.

My Hospital Unit: An Evolving Case Experience

The following is the description of the My Hospital feature: Before you begin this book and the related course, you will need to take the first step to engage yourself in this topic by creating your own virtual clinical unit. In what type of unit would you want to serve as a nurse manager? Within this unit, you will reflect on content in each chapter as you build your knowledge of leadership and management in nursing and then apply that knowledge as you apply the Institute of Medicine’s five healthcare professions core competencies. You will be the nurse manager on the unit. Once you create the framework for your unit, you cannot make changes in the information that describes your unit unless you are doing so in response to a specific learning activity. You have to work within this description just as you would if you were nurse manager on a real unit instead of a virtual unit.

 How do you create your own virtual unit? First, you need to put your description in writing. Respond to the following questions as you describe your unit. Keep a record of the description and then your responses per chapter as you manage your unit.

 Name your unit.

 What services are provided in the unit? (It can be acute care or ambulatory care, e.g., medical [may be sub-specialty such as respiratory], surgical [may be a subspecialty such as orthopedics], OR, ER, ICU, obstetrics, pediatrics, behavioral health, etc.)

 What is the size of the unit (number of beds)? What is the size of the hospital (fewer than 100, 100–200, 200–300, more than 300 beds)?

 Is it an urban or rural hospital? Is it an academic-teaching hospital, private, or government owned?

 How long have you been the nurse manager?

 What types of shifts do you have currently on the unit (8-, 10-, or 12-hour shifts, a mix)?

 What hours/days do you typically work?

 Briefly describe at least four registered nurses (RN) and four unlicensed assistive personnel (UAP). Decide if you have licensed practical/vocational nurses (LPN/LVN); if so, describe several. In the description, give first names, a description of their personalities, and current performance.

 You have a unit secretary. Name the unit secretary and briefly describe his or her personality and current performance.

 You have nursing and medical students on your unit.

 Create a floor plan for your unit. Indicate if rooms are single or double and the location of work areas.

You are now ready to get into textbook content. At the end of each chapter, you will be asked to go to your unit and engage in interactive questions related to changes or problems that may be occurring in your unit or in your hospital. This learning activity will help you apply the content and examine issues as if you were a nurse manager. This chapter feature can be used in a variety of ways within a course. Students can be asked to complete this per chapter and submit in writing and/or use in team discussions in the classroom or online. This is an evolving case that provides students with the opportunity to apply content and be creative in how they accomplish this. Students should maintain a record of their work per chapter and build on previous responses from one chapter of My Hospital Unit experience to the next.

Engaging in the Content: Critical Thinking and Clinical Reasoning and Judgment

See Discussion Questions and Application Exercises at the end of the chapter. Online options are noted.

Chapter Features: Case Studies, Applying Evidence-Based Practice, and Observational Experiences

Case Studies and Applying Evidence-Based Practice features may be used in both classroom and online formats. The last slides in the PPT include the questions related to each of these chapter features. They may be integrated into the lecture or deleted. Students should be asked to review the case and the EBP feature information in order to respond to the questions. This may be done as an individual student written activity, team discussion in the classroom, team discussion in an online course, or as a classroom discussion. Students should obtain the reference for the EBP feature to complete the learning activity.

ADDITIONAL CASE

This case is not found in the textbook. It may be used for individual or team assignments, as a written assignment, or as classroom or online team discussions. It may also be used as an essay question for exams.

Case:

The director of staff education in an acute care hospital is meeting with the nurse managers and nurse executives to discuss the need for additional staff development focused on leadership and management. During the discussion, the group disagreed on the statement made by one of the nurse managers: “Nurse managers serve as managers, not as leaders. Our leaders are the nurses in the executive and director positions. We need to focus on management.” Several participants in the meeting not only disagreed, but also said all nurses need to be leaders. The discussion was quite active. The CNO called the meeting to an end with the following questions directed at everyone. She asked that the group meet again in a week and that everyone consider

their responses to her questions, noting that this needs to be cleared up before a staff development plan can be made.

Questions:

1. What is leadership, and why is it important?

2. Is a nurse manager a leader? (Provide rationale.)

3. What might be examples of problems related to having managers who are not leaders?

4. What is the impact of the Peter Principle?

5. Do all nursing staff need to demonstrate leadership? (Provide rationale.)