Nursing Management

Why is Management & Leadership important in Nursing?
Nurses supervise unlicensed personal
Nurses can supervise others (Charge, supervisor, manager)
Nurses can supervise the pt assigned to their care
No matter what role nurse is in, it is a people business
Role
An organized set of behaviors that are attributed to a specific person or position
*Pt care, charting, education, delegation, managing, pt advocate
Management
The process of effectively working with people
*Appointed official position/ doing things right
Leadership
Activity influencing others to cooperate towards a common goal
*Informal, can be appointed, mostly unofficial
*Doing the right things
Difference Between Leadership & Management
Leader selects & assumes role
Leader is way of behaving to cause others to respond bc they want to, not have to
*Leader focuses on getting everyone together to get same process done
Manager is assigned or appointed to the role
Management is a problem-oriented process with similarities to the nursing process
*Manager focuses on the process
Functions of Management/Leadership
Planning- what is to be done
Organizing- how it is to be done
Directing- who is to do it
Controlling- when & how it will be done
Autocratic
Do it my way
Democratic
Majority rules
Laissez-Fair
Laid back
Management Style
No style works in every situation
Leadership MUST be compatible with task, setting, situation
To be a GOOD leader you must be credible AND competent
Have awareness, assertiveness, & accountability
Types of Power
Legitimate
Referent
Reward
Coercive
Expert
Informational
Connective
Motivational
Legitimate Power
Earned the right
Referent Power
Respect/ person has power
Reward Power
People rewarded for actions
Coercive Power
Forced
Expert Power
Knowledgeable
Informational Power
Always knows whats going on
Connective Power
More personal (connected with people)
Motivational Power
Person motivated you
Developing Leadership Style
Continue to LEARN & GROW
Seek a role model/mentor
Maintain personal physical resources
Retain an OPEN mind & develop flexibility
Demonstrate respect & consideration for others
Believe in yourself
Nurses Communications
Pt
MD
Health care disciplines (RT, OT, PT, social worker, etc)
Other Nurses
Unlicensed personal
Family
*Must have knowledge & skill to communicate effectively & safely with ALL
Patient Communication
Educate:
Disease process
Health care
Medications
Help them understand what MD told them
MD-RN Communication
Nurses are taught to be narrative & descriptive (talk in care plans)
MD taught to solve problems-want just the “headlines”
*Verbal (repeat), orders, updates, notes in charts, written, critical labs, telephone
*BE ORGANIZED (thought & communication)
*BE COMPETENT (technically & socially)
Time Management
ABC’s & Life threatening
ANA Definition of Delegation
The transfer of responsibility for the performance of an activity from on individual to another, with the former retaining accountability for the outcome (RN responsible)
*You are NOT super nurse, it is ok to delegate APPROPRIATE tasks
5 Rights for Delegation
Right Task
Right circumstance
Right person
Right direction
Right supervision
*Must have ALL 5 rights to delegate
*Pt stable- check 5 rights then delegate
*Pt NOT stable- DO NOT DELEGATE as much
Things to Consider before Delegation
Pt condition
Complexity of task
Potential for harm
Level of problem solving needed
Predictability of task outcome
Degree of pt/family interaction required
Are infection control measures required?
Right Task
Be aware of institutions policy on delegation & what unlicensed personal can do
Be aware of state practice guidelines
Can NOT delegate- Assessments, Teaching, Care Plans
Right Circumstance
Can you determine the strengths & weaknesses of team members?
*Assign based on strengths
*Encourage best care possible
*Ask about competency levels
Right Person
*Task MUST be
Withing scope of RN
Fall within role expectations of person delegating to
The person must be competent enough
Congruent with legal requirements, professional standards, & instructional policy
Not place pt safety as risk
Right Direction
How do you make sure person delegated to understands?
*Provide direction that is:
Clear
Concise
Correct
Complete
Right Supervision
Ask for persons input FIRST
Give credit for accomplishments & effort
Share perceptions with others
Explore different POV
Agree on a plan for the future, include FU time
Causes of Conflict with Delegation
Role conflict- 2 people w/ same responsibilities
Communication Conflict- failing to discuss differences
Goal conflict- Perception one person has placed his/her advancement ahead of others
Personality conflict- 2 or more people unable to resolve
Common Areas of Conflict
Quality of care
Tx decisions
Family involvement
Staff inconsistency
Conflict Resolution
Competition
Avoidance
Accommodation
Compromise
Collaboration
LPN Responsibilities in Acute Care (Hospitals)
PO meds
Shift assessments (never admission/initial)
Reinforcement (ONLY) of RN teaching
*Unstable pt should NOT be assigned to LPN
*Can change depending on institution
LPN Responsibility in Extended Care (Nursing Home)
PO medication
Admission Assessment
Telephone/verbal orders
Shift assessment
Teaching
LPN Can NEVER
IVP medications
Start blood or blood product transfusion
NO EDUCATION IN ACUTE CARE