Leadership PVN 151 Day 4 September 30, 2014

Leadership PVN 151 Day 4 September 30, 2014
Resume Due Review for Midterm Intro to Management

Resume Leadership Midterm Review
Your Resume is Due today Your grade will be posted after I get the results from Graduate Services Resume Leadership Midterm Review

Resume What you need to know for the test -
What should you include? What should you leave out? How do you get it noticed? Resume What you need to know for the test - The Do’s Use action verbs instead of the personal pronoun “I,” and use an active, rather than passive, verb tense as much as possible when listing your job duties and accomplishments. For instance, instead of writing, “My company has provided me with five years of experience developing product packaging,” say, “Over five years’ experience developing packaging for a cosmetics company.” Your bullets should be short and to the point. Avoid lofty and redundant language, puns and wordplays. The goal of a resume is to communicate your abilities clearly and concisely, not test the hiring manager’s ability to get your jokes. It’s also best to format your resume chronologically. According to research by our company, executives prefer work histories listed in reverse chronological order rather than grouped by skills or job function. There are times when it’s necessary to arrange your resume by skills or job function—both are good options for those who have large gaps in their work history or are trying to break into a new field. But in general it’s best to use the traditional (chronological) approach, beginning with your most recent job and working backward. Remember to tailor your resume for each opportunity by highlighting key achievements and qualifications that relate specifically to the position. Often this may be as simple as reordering bullet points to emphasize certain skills and expertise. In addition, include terms you find in the job description. If you’re applying for a junior graphic designer position and the advertisement for the job includes “project manager” and “experienced with corporate clients,” integrate those phrases into your resume (as long as they’re true, of course!). Many companies electronically screen resumes for keywords, so you can boost your visibility by adopting any applicable phrases. If you’re sending your resume via standard mail—something many candidates do to stand out from those who submit their materials online—use high-quality, 100% bond stationery and an appropriate color. For example, if you’re applying for a job at an advertising agency, you could choose a shade other than the traditional ivory; that’s not the case if you’re sending your resume to a conservative corporation. No matter where you’re applying, thetypeface you use should be simple and easy to read. - See more at:

Resume What format and presentation should you use?
What part does a cover letter play? Do you need to include one? The Don’ts Don’t include a vague laundry list of job duties on your resume. Hiring managers already know the day-to-day responsibilities of a designer. Instead, list the ways in which you’ve benefited previous employers and the concrete contributions you made. Be as specific as possible: “Lead designer for award-winning annual report,” for example. Don’t list an unprofessional address on your resume, such as or Set up a new box, if necessary, that uses only your name or a combination of your name and numbers in the address. Along the same lines, don’t provide a link to your personal website or photographs of you and your friends at your bachelor party. You want to convey a professional image and avoid getting too personal. Remember not to overlook the little things: Even if design is your focus, a resume marred by typos, misspellings or grammatical mistakes sends a message to potential employers that you lack attention to detail. It is always a good idea to use the computer’s spell-check function and ask a friend or relative to review your resume for accuracy. Last, don’t list references or write “references available on request.” (This is debatable some want references so do whatever Brandy asks for) Interviewers assume that you will provide these contacts when asked. However, do give each of your references a copy of your resume to remind them of your achievements. A well-crafted resume is the key to a great first impression with potential employers. Once you have the do’s and don’ts down, you’ll be one step closer to landing the position you want. - See more at:

Good Resume Bad Resume Image URL: Image URL:

Sample Question - Resume
A student is really anxious to get everything they have ever done on their resume but they have way to much “stuff” to fit on one page. The student needs to remember (select all that apply) Margins should be at least 0.5 inches on all 4 sides Paper should be brightly colored to get their attention ‘legal sized paper may be used when you have a lot to share Standardized cover letters are the professional way to make a first impression Include in the cover letter that after researching other positions this is the one the student prefers You need to know this even though it isn’t on the study guide - Question 40 The answer is A and E You need to have ample margins – 1” is preferred and a statement that this is your preferred position should be included in your cover letter It can’t be “B” because the paper should never be colored but if you want to make a real impression use heavy bond paper, and “C” is incorrect because you NEVER use legal sized paper If you have too much put some of it into your portfolio and only include what relates specifically to this job application – match your resume to what was posted in the advertisement “D” is wrong because that is a form letter and you want this to be original and specific to the person that will be interviewing you

The Interview Tell me about your work experience
What can’t an employer ask? The Interview Do you have kids? What religious holidays do you celebrate? What can an employer ask? Tell me about your work experience Question You need to know this It is illegal for the recruiter or interviewer to ask number of children or dependents prior to making a job offer. Any questions that reveal your age, race, national origin, gender, religion, marital status and sexual orientation are off-limits. "State and federal laws make discrimination based on certain protected categories, such as national origin, citizenship, age, marital status, disabilities, arrest and conviction record, military discharge status, race, gender, or pregnancy status, illegal. Any question that asks a candidate to reveal information about such topics without the question having a job related basis will violate the various state and federal discrimination laws," Lori Adelson, a labor and employment attorney and partner with law firm Arnstein & Lehr, tells Business Insider. "However, if the employer states questions so that they directly relate to specific occupational qualifications, then the questions may be legitimate. Clearly, the intent behind the question needs to be examined." If you are asked any inappropriate questions, Adelson advises not to lie, but, instead, politely decline to answer. "Could they not give you a job because of that? Sure. But if they do, they would be doing exactly what they're not supposed to do." Have you ever been arrested? An employer can't actually legally ask you about your arrest record, but they can ask if you've ever been convicted of a crime. Depending on the state, a conviction record shouldn't automatically disqualify you for employment unless it substantially relates to your job. For example, if you've been convicted of statutory rape and you're applying for a teaching position, you will probably not get the job. Are you married? Although the interviewer may ask you this question to see how much time you'd be able to commit to your job, it's illegal because it reveals your marital status and can also reveal your sexual orientation. What religious holidays do you practice? Employers may want to ask you this to see if your lifestyle interferes with work schedules, but this question reveals your religion and that's illegal. They can ask you if you're available to work on Sundays. Do you have children? It is unlawful to deny someone employment if they have children or if they are planning on having children in the future. If the employer wants to find out how committed you will be to your job, they should ask questions about your work. For example, "What hours can you work?" or "Do you have responsibilities other than work that will interfere with specific job requirements such as traveling?" What country are you from? If you have an accent, this may seem like an innocent question, but keep in mind that it's illegal because it involves your national origin. Employers can't legally inquire about your nationality, but they can ask if you're authorized to work in a certain country. Is English your first language? It's not the employers lawful right to know if a language is your first language or not. In order to find out language proficiency, employers can ask you what other languages you read, speak, or write fluently. Do you have any outstanding debt? Employers have to have permission before asking about your credit history. Similar to a criminal background history, they can't disqualify you from employment unless it directly affects your ability to perform the position you're interviewing for. Furthermore, they can't ask you how well you balance your personal finances or inquire about you owning property. Do you socially drink? Employers cannot ask about your drinking habits because it violates the Americans With Disabilities Act of 1990. For example, if you're a recovering alcoholic, treatment of alcoholism is protected under this act and you don't have to disclose any disability information before landing an official job offer. When was the last time you used illegal drugs? It's illegal for employers to ask you about past drug addiction, but they can ask you if you're currently using illegal drugs. A person who is currently using drugs is not protected under ADA. For example, an employer may ask you: Do you currently use illegal drugs? What illegal drugs have you used in the last six months? How long have you been working? This question allows employers to guess your age which is unlawful. Similarly, they can't ask you what year you graduated from high school or college or even your birthday. However, they can ask you how long you've been working in a certain industry. What type of discharge did you receive in the military? This is not appropriate for the interviewer to ask you, but they can ask what type of education, training, or work experience you've received while in the military. Image URL: Image URL: Image URL:

When should you start scheduling them?
The Interview When should you start scheduling them? Question Wait till after you have sat your NCLEX to schedule interviews. You don’t want to get hired as a CAN because then they will just keep working and paying you as a CAN and letting you do nurse work for them for nothing.

The Interview How to be more successful at them How to prepare
What to take When to arrive The Interview See the complete Guide to interviewing on the class page under handouts. You’ll want to accomplish two things during your interviews. First, you should evaluate if this is an organization in which you would like to work, and 2) second, you must convince the interviewer that you are fully qualified for the position you are seeking. Research the organization and do anything else that will demonstrate you are the best qualified candidate for the job you are seeking. How can you ensure that you will demonstrate your relevant skills? How can you help your potential employer realize that you are the best fit for this job? If there is one thing to remember about interviews, it’s this — the potential employer believes from reading your resume that you have the minimum qualifications for this position. It is believed that you can do this job! That realization should boost your confidence. The purpose of an interview is to: • convince the employer that you are the most qualified candidate for the job and that you will fit in with the rest of the staff • evaluate whether on not this position is right for you. PREPARING FOR THE INTERVIEW Know your personal and professional goals and what you can contribute to the organization. You should have already completed a thorough self-assessment. During the interview, employers look for people who have done their career planning, are aware of what they want, and know where they are going. They expect you to know how your academic preparation, previous work experiences, and other activities meet the needs of the job for which you are interviewing. In preparing for your interview, be sure you can answer these questions: o How do my strengths, interests, and work values relate to the requirements of this position? o To what extent are my goals compatible with the objectives of this position and the mission of this organization? o Will this position provide what I’ve identified as important (opportunity for work-life balance, training, advancement potential…) (If you are having trouble answering these questions, schedule an appointment with graduate Services) II. Research the hiring organization. Researching employers will help you make a better impression. Research the organization (including its mission, financial stability, recent awards and compliance record). Find out through networking, reviewing online resources, and by reading articles in trade journals, newspapers, and business periodicals. After your research is complete, you should be able to answer these questions about the hiring organization: What is the reputation of this organization? Is it financially sound? What is its reputation with regard to treatment of nurses? How does it support continuing education? Be sure to find answers to questions of your own as well. III. Know your worth. Before your interview, you should determine the average salary and bonus level for the position you’re seeking and other benefits information that can help you to negotiate effectively. To gauge this, find out the market value for your skills at similar-sized organizations in the same geographic area. For a first position, you may not have much negotiating room, however, it’s important to have as much information as possible. IV. Review your resume. Because a resume creates an image of who you are, it’s to your advantage to have one that shows how your experience makes you a suitable employee. As you review your resume, select experiences that you believe are relevant for the position you are seeking. For example, if the position you are seeking will include training others, be sure to be able to discuss any training you’ve provided in the past. Remember, anything on your resume is fair game. V. Practice your responses to interview questions. Prior to the interview, you should decide what you want to communicate so that the employer understands your capabilities, experience, achievements, and skills. For help in this area, contact the Graduate Services. During your appointment, you can practice your interview skills, and obtain honest feedback about the quality of your responses. Overall, most interview questions come from an employer’s concern with three basic questions: What can you do for us? Why do you want to work with us? What are you like once we’ve gotten to know you? (See PDF For details) In order to prepare for behavioral interview questions, you should know your strengths, be ready to offer examples of past actions and results, listen carefully, fully understand the question before answering, ask for clarification if needed, make your answers as specific as possible, and be genuine. (again see PDF for examples and details) VI. Be aware of illegal interview questions. VII. Prepare your own questions for the interviewer. Even though for most of the interview you are responding to the interviewer’s queries, keep in mind that the meeting is a two-way street — you are also interviewing the employer. As such, it isn’t an interrogation, but a conversation between two or more individuals with a similar agenda, i.e., to determine if you have the skills, knowledge, motivation, values, and interest to do the job well (Bolles, 1998). Prior to the interview, you should create a short list of questions for the employer based on your earlier research and any concerns you might have. Here are some examples: o Describe a typical day on the job. o Is there room for advancement?—be careful here. You don’t want to sound like you see this position only as a stepping stone. o Describe the ideal candidate for this job. o To whom would I report, and what is his/her supervisory style? o What are the training opportunities? o How is performance evaluated and how often? o How does this position fit into the organizational structure? o What are the primary tasks of this position? VIII. Know your interviewer(s) and meeting location. During the phone call to set up the interview, find out the names and titles of all the people with whom you will be meeting. Get correct spelling and pronunciation as well as the location and length of the interview. Ask if there are any special items you should bring. If you are not familiar with the location of the interview, make a test run a few days before. Be sure to find out where parking is located. IX. Remember the basics. Once you have reviewed and completed the above steps to prepare for your interview, you are ready for the big day. But remember the basics! For example, be sure to get a good night’s sleep and eat properly. Also, dress in clothes that you feel confident and comfortable wearing and make sure they’re clean and pressed. Do not wear nurse’s whites. It’s better to dress somewhat formally than the interviewer. On the day of the interview, arrive 15 minutes early so you can relax, review your surroundings, and visit a restroom to check your appearance

Sample Interview question
The graduate nurse arrives for her first interview and is feeling great about it until the interviewer asks which illegal question? a. “Have you been convicted of a crime other than a minor traffic violation?” b. “We are very interested in hiring you but you do understand the position is contingent on the results of the pre-employment physical and background check?” c. “What do you consider to be your major weaknesses for this particular position?” d. “Because you are applying for a position in the operating room, you must be able to be on call. How many children do you have responsibility for at home?” D_ 3. Correct: It is illegal for the recruiter or interviewer to ask number of children or dependents prior to making a job offer. Incorrect: a. Employers can ask questions about criminal convictions but not arrests. b. Job offers are contingent on the applicant passing required tests and background check. c. Interviewers often seek to determine individual candidates self-evaluation of skills needed for the position.

Vocabulary

what legal standing does it have? Can it be ignored?
Advanced Directive What is it? Legal standing – what legal standing does it have? Can it be ignored? What is your nursing obligation? An advance directive explains the specific health care measures a person wants if he or she has a terminal illness or injury and is incapable of indicating whether to continue curative and life-sustaining treatment, or to remove life support systems. The person must develop the advance directive while he or she is able to clearly and definitively express himself or herself verbally, in writing, or in sign language. It must express the person's own free will regarding his or her health care, not the will of anyone else. It does not affect routine care for cleanliness and comfort. In Oregon, the Health Care Decisions Act (ORS and ORS ) allows an individual to preauthorize health care representatives to allow the natural dying process if he or she is medically confirmed to be in one of the conditions described in his or her health care instructions. So can it be ignored ? The long and short of it is – IF you have a vociferous family that wants you to be on life support and you have not designated a specific person to speak for you should you become incapacitated then YES your advanced directive can be ignored because the hospitals and doctors do not want to have to deal with litigation just to let you have your wishes fulfilled. Your nursing obligation is to be your patient’s advocate and it is never so important as when they cannot speak for themselves.

a. preserving cord blood for possible future needs of a child.
Sample question – Advanced Directive A patient asks, “What is an advance directive?” The nurse explains that examples of advance directives are: (Select all that apply.) a. preserving cord blood for possible future needs of a child. b. providing instructions that life-sustaining medical procedures should be withheld in the event of a terminal situation. c. giving someone the legal right to act on one’s behalf when one becomes incapacitated. d. completing hospital admission paperwork before being admitted to the hospital. Question 46 B, C Correct: Advance directives document an individual’s desires regarding end-of-life care. These wishes are generally stated through the execution of a formal document known as the living will. Right-to-die statutes vary from state to state; therefore, nurses must become familiar with their state-specific statute. Incorrect: a. Advance directives identify client wishes in terms of the right to die; they are not directives to help prevent illness or terminal illness. d. Completing hospital paperwork is part of the preadmission process. The client could bring his or her living will to the hospital on admission, but this document would have been prepared prior to the admission and is not part of the hospital documentation paperwork

Advocate What does Advocate mean? What are the nursing implications?
Question 5 1 a process whereby a nurse or other health care professional provides a patient with the information to make certaindecisions, usually related to some aspect of the patient's health care. 3. pleading a cause on behalf of another, such as a nurse pleading for better care of a patient or for the patient's desires to behonored. Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier. Not everyone appreciates the nurse who steps forward on patients’ behalf, however. Nurses can lose their jobs or worse. A recent criminal case brought against two Texas nurses posed a threat to the critical role all nurses play as advocates. Two nurses identified practices by a physician that they felt put patients at risk. They brought up their concerns within the organization, Winkler County Memorial Hospital in Kermit, Texas, where they both had worked for more than 20 years. But when their concerns were not addressed and the situation remained unresolved, they reported the physician to the Texas Medical Board. Both nurses lost their jobs’ and they were charged with misuse of official information. The charges were dropped against Vicki Galle, RN, and a jury acquitted Anne Mitchell, RN, after deliberating for less than an hour. The Texas Nurses Association helped raise more than $50,000 for their defense. Remember me saying that you needed to have the strength of your convictions? If you don’t believe it in your gut are your going to have the strength to stand up for your patients when you could suffer bad consequences? Image URL:

Burnout What is it? What causes it? How is it recognized?
How is it treated? Question 48 Burn out is: Physical, emotional, and spiritual exhaustion among care givers Professional burnout is generally described as prolonged stress that impairs one's ability to perform his or her job in demanding situations. *Precursors to professional burnout include, but are not limited to, employee workload, chronic fatigue, compassion fatigue, balance between family and career, sickness absence, and loss of confidence. *Administrators must watch for early signs of professional burnout to improve retention and promote employee morale. Burnout is also known as compassion fatigue – you have given until there are no reserves even for yourself. You have defied Maslow’s heirarchy and gave your last for someone else and there is nothing to sustain you. Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed and unable to meet constant demands. As the stress continues, you begin to lose the interest or motivation that led you to take on a certain role in the first place. Burnout reduces your productivity and saps your energy, leaving you feeling increasingly helpless, hopeless, cynical, and resentful. Eventually, you may feel like you have nothing more to give. Most of us have days when we feel bored, overloaded, or unappreciated; when the dozen balls we keep in the air aren’t noticed, let alone rewarded; when dragging ourselves out of bed requires the determination of Hercules. If you feel like this most of the time, however, you may have burnout. You may be on the road to burnout if: Every day is a bad day. Caring about your work or home life seems like a total waste of energy. You’re exhausted all the time. The majority of your day is spent on tasks you find either mind-numbingly dull or overwhelming. You feel like nothing you do makes a difference or is appreciated. The negative effects of burnout spill over into every area of life—including your home and social life. Burnout can also cause long-term changes to your body that make you vulnerable to illnesses like colds and flu. Because of its many consequences, it’s important to deal with burnout right away. Dealing with Burnout: The "Three R" Approach Recognize – Watch for the warning signs of burnout Reverse – Undo the damage by managing stress and seeking support Resilience – Build your resilience to stress by taking care of your physical and emotional health The difference between stress and burnout Burnout may be the result of unrelenting stress, but it isn’t the same as too much stress. Stress, by and large, involves too much: too many pressures that demand too much of you physically and psychologically. Stressed people can still imagine, though, that if they can just get everything under control, they’ll feel better. Burnout, on the other hand, is about not enough. Being burned out means feeling empty, devoid of motivation, and beyond caring. People experiencing burnout often don’t see any hope of positive change in their situations. If excessive stress is like drowning in responsibilities, burnout is being all dried up. While you’re usually aware of being under a lot of stress, you don’t always notice burnout when it happens. (Read article at : Warning signs and symptoms of burnout Burnout is a gradual process that occurs over an extended period of time. It doesn’t happen overnight, but it can creep up on you if you’re not paying attention to the warning signals. The signs and symptoms of burnout are subtle at first, but they get worse and worse as time goes on. Think of the early symptoms of burnout as warning signs or red flags that something is wrong that needs to be addressed. If you pay attention to these early warning signs, you can prevent a major breakdown. If you ignore them, you’ll eventually burn out. Physical signs and symptoms of burnout Feeling tired and drained most of the time Lowered immunity, feeling sick a lot Frequent headaches, back pain, muscle aches Change in appetite or sleep habits Emotional signs and symptoms of burnout Sense of failure and self-doubt Feeling helpless, trapped, and defeated Detachment, feeling alone in the world Loss of motivation Increasingly cynical and negative outlook Decreased satisfaction and sense of accomplishment Behavioral signs and symptoms of burnout Withdrawing from responsibilities Isolating yourself from others Procrastinating, taking longer to get things done Using food, drugs, or alcohol to cope Taking out your frustrations on others Skipping work or coming in late and leaving early Recovering from burnout Sometimes it’s too late to prevent burnout—you’re already past the breaking point. If that’s the case, it’s important to take your burnout very seriously. Trying to push through the exhaustion and continue as you have been will only cause further emotional and physical damage. While the tips for preventing burnout are still helpful at this stage, recovery requires additional steps. Burnout recovery strategy #1: Slow down When you’ve reached the end stage of burnout, adjusting your attitude or looking after your health isn’t going to solve the problem. You need to force yourself to slow down or take a break. Cut back whatever commitments and activities you can. Give yourself time to rest, reflect, and heal. Burnout recovery strategy #2: Get support When you’re burned out, the natural tendency is to protect what little energy you have left by isolating yourself. But your friends and family are more important than ever during difficult times. Turn to your loved ones for support. Simply sharing your feelings with another person can relieve some of the stress. The other person doesn’t have to ret to “fix” your problems; he or she just has to be a good listener. Opening up won’t make you a burden to others. In fact, most friends will be flattered that you trust them enough to confide in them, and it will only strengthen your friendship. Burnout recovery strategy #3: Reevaluate your goals and priorities Burnout is an undeniable sign that something important in your life is not working. Take time to think about your hopes, goals, and dreams. Are you neglecting something that is truly important to you? Burnout can be an opportunity to rediscover what really makes you happy and to change course accordingly. Coping with job burnout The most effective way to combat job burnout is to quit doing what you’re doing and do something else, whether that means changing jobs or changing careers. But if that isn’t an option for you, there are still things you can do to improve your situation, or at least your state of mind. Actively address problems. Take a proactive rather than a passive approach to issues in your workplace, including stress at work. You’ll feel less helpless if you assert yourself and express your needs. If you don’t have the authority or resources to solve the problem, talk to a superior. Clarify your job description. Ask your boss for an updated description of your job duties and responsibilities. Point out things you’re expected to do that are not part of your job description and gain a little leverage by showing that you’ve been putting in work over and above the parameters of your job. Ask for new duties. If you’ve been doing the exact same work for a long time, ask to try something new: a different grade level, a different sales territory, a different machine. Take time off. If burnout seems inevitable, take a complete break from work. Go on vacation, use up your sick days, ask for a temporary leave-of-absence—anything to remove yourself from the situation. Use the time away to recharge your batteries and take perspective. Image URL:

Delegation Who can do it? Who cannot do it? Who can be delegated to?
So, who can delegate? Doctor to nurse Nurse to nurse RN to RN RN to LPN LPN to LPN Nurse to unlicensed Aide/ family RN to CNA LPN to CAN RN to patient LPN to patient RN to family member LPN to family member Image URL:

Delegation 5 Rights of Delegation Right Task Right Circumstances
Right Person Right Direction Right Supervision and Evaluation 5 Rights of Delegation You need to know this Right Task Not all tasks can be delegated – you would not delegate an appendectomy but you could delegate changing a baby’s diaper Right Circumstances If there is no where for someone who doesn’t know what they are doing to set things out and carefully go through the directions this is not the time or place to be delegating Right Person If the person you want to delegate to has no frontal lobe development they are not the right person Right Direction If the directions are not clear and concisely written out and if they have not been spoken to the delegate in a well understood and repeated back manner you have not given the right direction Right Supervision and Evaluation Without supervision and evaluation there can be no delegation because you do not know what they actually know or how well they can actually do the task Image URL:

Delegation - How is it done?
Determine a task that can be done by non licensed individual Write out clear and concise instructions and have them reviewed by another person for clarity and thoroughness Find a person with the ability and capability to learn the task and do it successfully 4. The person chosen to be delegated to has to be willing to take on the responsibility 5. Teach the skill/task 6. Have the delegate explain in their own words your instructions and 7. then do a return demonstration of the skill 8. Schedule times for monitoring task being performed and evaluations.

What must the nurse do once delegation occurs?
Monitor And evaluate Image URL:

A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel. What is the best way for the nurse to determine competency of the delegatee? a. Actually observe the delegatee perform the assigned task. b. Ask the delegatee how many times he/she has performed the task. c. Ask the patient if the care provided was satisfactory. d. Ask other nurses if they feel the delegatee is competent. question 9, 22, 27, 36, 38, 47,

A Correct: The best way for the nurse to determine the competency of LPNs or UAPs is to observe them perform the task and check on them regularly throughout the shift. Incorrect: b. Asking the delegatee may inform the nurse of how many times the task has been performed but will not provide evidence of competency. c. Patients may be able to rate their satisfaction with care but cannot judge the competency of the LPN or UAP. d. The opinion of other nurses can be used to validate the nurse’s findings, but only firsthand observation can provide evidence of competency.

External Force (s) What is it ( are they)?
How do they relate to nursing? Question 41 - inference One thousand seven hundred and eighty-nine facilities closed over this time period (1999–2005). The average annual rate of closure was about 2 percent of facilities, but the rate of closure was found to be increasing. The external forces impacting the closures of nursing homes include, but are not limited to, where federal funding is spent – medicare, medicaid, social security., an increase in the aging population and a decrease in the number of nursing students graduating, corporate models changing form long term to short term return on investments.

HIPAA Question 2

Leadership What is it?

Midterm Exam

A nurse is on break and checking emails
A nurse is on break and checking s. One contains a picture of a celebrity who is a patient in the hospital, and on the same floor, where the nurse works. Included with the photo is a message, “check out my Facebook,” which contains additional photographs of the patient. The nurse immediately deletes the picture to prevent having to report the “friend” to supervisors. Based on the action of the nurse who received the message, which statement is correct? a. The nurse is not at risk for having his/her license suspended since removing the photos made them temporary and invisible to all others. b. Because the nurse did not send the message and immediately deleted the photo, there is no risk for discipline. c. Failing to report receiving the message places the nurse at risk for discipline. d. Because the patient is on the same floor as the one on which the nurse works, the information can be ethically and legally shared. _ C _ 1. Correct: Failing to report the image can result in discipline. Incorrect: a. Removing a posting or a picture from a website does not make it unavailable because it is retrievable. b. Nurses who have received patient pictures and not immediately reported the problem have been subject to the same discipline as nurses who sent the pictures. d. Information posted on social media can be viewed by others who are not providing health care—even the public.

Which nurse best portrays nursing as a “knowledge worker”?
_a_ 2. Correct: Nursing scrubs have become a popular alternative to the traditional white uniform; clean wrinkle free matching scrubs presented a professional image. Small stud earrings reduce risk of injury to nurse when caring for confused or combative patients. Incorrect: b. Mismatched scrubs may be interpreted as someone who doesn’t take an interest in the profession or lacks time management. c. White uniforms have been replaced by scrubs in most healthcare facilities. The apron was used by student nurses from the past who also were restricted from wearing jewelry. Having the hair pulled back continues today to adhere to infection control policies that prevent hair from entering sterile fields or falling in patients personal space. Many feel the white uniform is associated with a time when nurses had less voice in patient care and were “handmaidens” to physicians. d. Caps were discontinued due to infection control. Most healthcare agencies prohibit nurses from visible piercing other than one small stud earring per ear. Which nurse best portrays nursing as a “knowledge worker”? a. Nurse in matched scrubs with lab coat, hair back, small stud earrings b. Nurse in mismatched scrubs, no lab coat, large hoop earrings c. Nurse in white uniform with apron with no jewelry/hair back d. Nurse with nose ring and eyebrow piercing with starched white uniform and cap Not on final

A new graduate arrives for the first interview feeling prepared and excited about beginning a nursing career but quickly becomes concerned when the recruiter asks which illegal question? _D_ 3. Correct: It is illegal for the recruiter or interviewer to ask number of children or dependents prior to making a job offer. Incorrect: a. Employers can ask questions about criminal convictions but not arrests. b. Job offers are contingent on the applicant passing required tests and background check. c. Interviewers often seek to determine individual candidates self-evaluation of skills needed for the position. a. “Have you been convicted of a crime other than a minor traffic violation?” b. “We are very interested in hiring you but you do understand the position is contingent on the results of the pre-employment physical and background check?” c. “What do you consider to be your major weaknesses for this particular position?” d. “Because you are applying for a position in the operating room, you must be able to be on call. How many children do you have responsibility for at home?” 39

Which message would be appropriate to leave on answering systems?
_ A _ 4. Correct: A professional or appropriate message that lets the person know they have reached the correct number and that you will return the call as soon as available. Incorrect: b. Some music is offensive to callers, especially if it has a message that is contradictory to their beliefs or has lewd messages—a message like this may end the interview before it begins. c. This message implies the applicant is more important person than the caller and does not request caller to leave a message. d. This message asks the interviewer to leave information that is discussed during the interview. Which message would be appropriate to leave on answering systems? a. “You have reached Jane Doe at Please leave your name and number and I look forward to returning your call as soon as possible.” b. Music that has messages that might be offensive to some callers downloaded as the response when applicant is unavailable. c. “Hi, I’m not here. Sorry you missed me. Call again.” d. “I am interviewing for positions, hope to be home soon. If you are calling about an interview, please leave your name, number and possible positions available.” Not on final

B, C, E 5. Correct: b. Core solutions to the nursing shortage include providing incentives for minorities and men to enter nursing. c. Core solutions to the nursing shortage include obtaining grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs. e. Core solutions to the nursing shortage include developing ad campaigns that target younger students. Incorrect: a. Determining why few African-American women enter graduate school would not result in a greater number of nurses entering and staying in practice. d. Job satisfaction among nurses is currently high. Which actions would result in a greater number of nurses entering and staying in practice, given today’s state of nursing? (Select all that apply.) a. Determine why few African-American women enter graduate school. b. Provide incentives for minorities and men to enter nursing. c. Obtain grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs. d. Survey nurses to determine why their job satisfaction is lower than that of other health care professions. e. Develop ad campaigns that target younger students. Not on final

d. Members are appointed. Incorrect:
_ A, C, D Correct: a. The board of nursing ensures that nursing licenses are granted and renewed. c. The board of nursing assigns disciplinary action when provisions of the nurse practice act are violated. d. Members are appointed. Incorrect: b. The National Council of State Boards of Nursing constructs the licensure examination. e. Certification examinations are administered by the American Nurses Credentialing Center A group of graduates were just notified that they had successfully passed the licensure examination. During the orientation process at the hospital, one asks, “I am looking at my license, but I don’t really know the duties performed by the board of nursing.” The staff development nurse explains that the board of nursing:(Select all that apply.) a. grants nursing licensure. b. constructs the licensure examination. c. assigns disciplinary action when the nurse acts in a manner that results in harm to a patient. d. members are appointed. e. conducts certification examinations for advanced practice nurses.

preserving cord blood for possible future needs of a child. b.
_B, C 7 Correct: Advance directives document an individual’s desires regarding end-of-life care. These wishes are generally stated through the execution of a formal document known as the living will. Right-to-die statutes vary from state to state; therefore, nurses must become familiar with their state-specific statute. Incorrect: a. Advance directives identify client wishes in terms of the right to die; they are not directives to help prevent illness or terminal illness. d. Completing hospital paperwork is part of the preadmission process. The client could bring his or her living will to the hospital on admission, but this document would have been prepared prior to the admission and is not part of the hospital documentation paperwork. A patient asks, “What is an advance directive?” The nurse explains that examples of advance directives are: (Select all that apply.) a. preserving cord blood for possible future needs of a child. b. providing instructions that life-sustaining medical procedures should be withheld in the event of a terminal situation. c. giving someone the legal right to act on one’s behalf when one becomes incapacitated. d. completing hospital admission paperwork before being admitted to the hospital. Know this

C, D, E 8. Correct: c. Internal dialogue establishes a means for the graduate to recall achievements that will lead to success in the first nursing position. d. Jobs such as cashier at a convenience store or dog-sitting can demonstrate responsibility such as handing cash or arriving on time. e. Arriving too early may cause the recruiter to feel rushed and arriving too late may demonstrate lack of time management and professionalism. Incorrect: a. The primary goal for the first job is to find good match that fits the nurse’s abilities, lifestyle, and career aspirations. b. Interviews should be set up prior to graduation. A new graduate nurse is preparing for an interview for her first position and knows that: (Select all that apply.) a. the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school. b. appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position. c. self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners. d. work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio. e. it is best to arrive 10 to 15 minutes before the scheduled interview dressed for success. 39

A, E 9. Correct: a. Ample margins—minimum of 0
A, E 9. Correct: a. Ample margins—minimum of 0.5 inch (1 inch preferred)—should be used on all four sides to prevent appearing cluttered. e. A statement declaring this position is one’s first choice should be included. Incorrect: b. The paper should be white or ivory and on heavy bond paper, never bright colored. c. Legal size paper is not acceptable. Seek help from a professional to determine what to include and what can be placed in a portfolio. d. The applicant should write from their own perspective and writing style tailored to the position A nurse preparing a resume for the first position is anxious to demonstrate all achievements, which included completing a rigorous accelerated program and maintaining a high GPA while also serving in many community projects and leadership positions. The applicant finds it impossible to include all the accolades on one page and researches tips for professional cover letters and resumes and learns: (Select all that apply.) a. margins should be at least 0.5 inch on all four sides, making conciseness important. b. paper should be bright colored to catch the attention of the recruiter. c. legal size paper may be used when applicants have many accolades or extensive work history. d. standardized cover letters present a professional image as opposed to those that stress the applicant’s perspective too heavily. e. include in the cover letter that after researching other position, this is the applicant’s preference. know

Actually observe the delegatee perform the assigned task.
A_ 10. Correct: The best way for the nurse to determine the competency of LPNs or UAPs is to observe them perform the task and check on them regularly throughout the shift. Incorrect: b. Asking the delegatee may inform the nurse of how many times the task has been performed but will not provide evidence of competency. c. Patients may be able to rate their satisfaction with care but cannot judge the competency of the LPN or UAP. d. The opinion of other nurses can be used to validate the nurse’s findings, but only firsthand observation can provide evidence of competency. A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel. What is the best way for the nurse to determine competency of the delegatee? a. Actually observe the delegatee perform the assigned task. b. Ask the delegatee how many times he/she has performed the task. c. Ask the patient if the care provided was satisfactory. d. Ask other nurses if they feel the delegatee is competent. know

A certified nurse's aide (CNA) has been reported to the nurse manager for refusing to wash her hands between giving clients their morning care. Which of the following statements by the nurse manager would be the most effective? Choose one answer. _C_ Solution: c. "Forgetting to wash your hands between clients can lead to spread of infection." The employee needs to realize the unwanted behavior has consequences for the client. An employee may not realize the reason for the policy. A better understanding may prevent the behavior in the future. The employee must understand the consequences if the behavior does not change but this should not be communicated in a threatening manner. a. "If I hear of any more instances of your not washing your hands, I will write you up.". b. "Why do you refuse to wash your hands?". c. "Forgetting to wash your hands between clients can lead to spread of infection.". d. "Do you need a class on hand washing?

A few individuals on your usually high performing team have been underperforming in minor ways for a few weeks but you have said nothing so far. What would you do now? _B_ 12. Answer = B “ B “ is best because not all individuals are poor performing. A is second best as at least you can talk about lower overall team performance (which may make those people most responsible lift their performance – without others knowing who is involved). C looks OK on the surface but not so good in allowing the team member to decide what to do next (after all you are the leader and should be inviting input rather than decisions). D is also not very helpful from a leadership perspective as it lets the situation drift. a. Call the whole team together to discuss the need for better performance than the past few weeks. b. Talk to lower performing people on the team individually (one at a time). c. Ask one of the more trusted and longer experienced people on team what they think you should do.. d. . Do nothing at this stage as performance has yet to really suffer badly Not on final

_D_ Let the staff ventilate her feelings and ask how she can be of help. Reaching out and helping the staff is the most effective strategy in dealing with burn out. Knowing that someone is ready to help makes the staff feel important; hence her self-worth is enhanced. Kathleen knows that one of her staff is experiencing burnout. Which of the following is the best thing for her to do? A. Advise her staff to go on vacation. B. Ignore her observations; it will be resolved even without intervention C. Remind her to show loyalty to the institution. D. Let the staff ventilate her feelings and ask how she can be of help. What is burnout?

Her former manager demonstrated passion for serving her staff rather than being served. She takes time to listen, prefers to be a teacher first before being a leader, which is characteristic of a. Transformational leader b. Transactional leader c. Servant leader d. Charismatic leader _c . Answer: (C) Servant leader Servant leaders are open-minded, listen deeply, try to fully understand others and not being judgmental ? 7

One leadership theory states that “leaders are born and not made,” which refers to which of the following theories? a. Trait b. Charismatic c. Great Man d. Situational _c_ Answer: (C) Great Man Leaders become leaders because of their birth right. This is also called Genetic theory or the Aristotelian theory

She came across a theory which states that the leadership style is effective dependent on the situation. Which of the following styles best fits a situation when the followers are self-directed, experts and are matured individuals? a. Democratic b. Authoritarian c. Laissez faire d. Bureaucratic _c 16. Answer: (C) Laissez faire Laissez faire leadership is preferred when the followers know what to do and are experts in the field. This leadership style is relationship-oriented rather than task-centered. Not on final

She knows that there are external forces that influence changes in his unit. Which of the following is NOT an external force? a. Memo from the CEO to cut down on electrical consumption b. Demands of the labor sector to increase wages c. Low morale of staff in her unit d. Exacting regulatory and accreditation standards _C_ 17. Answer: (C) Low morale of staff in her unit Low morale of staff is an internal factor that affects only the unit. All the rest of the options emanate from the top executive or from outside the institution. ? 41

True or False Transformational leadership is a leadership style where leaders create an inspiring vision of the future, motivate their followers to achieve it, manage implementation successfully, and develop the members of their teams to be even more effective in the future _A_ 18. ( A) True Transformational leadership is a leadership style where leaders create an inspiring vision of the future, motivate their followers to achieve it, manage implementation successfully, and develop the members of their teams to be even more effective in the future 10 , 12 , 23, 26,

True or False Good leaders lead by example
_A_ True Good leaders lead by example . They do what they say, and say what they do. These types of leaders are trustworthy, and show integrity. They get involved in daily work where needed, and they stay in touch with what's happening throughout the organization. Great leaders don't just sit in their offices and give orders; they demonstrate the actions and values that they expect from the team. True or False Good leaders lead by example Important but not on final

_B 20 . False autocratic → focuses on teamwork and workgroup participation in decision-making, leader collaborates with others in making decisions. This is false. It should be autocratic → retains all authority, makes all decisions and establishes one-way communication with the work group. True or False autocratic → focuses on teamwork and workgroup participation in decision-making, leader collaborates with others in making decisions.

PVN 151 – Leadership and Management
Review for Final Everything is fair game from term 1 through Ethics PVN 151 – Leadership and Management

5 “Rights” of Delegation
What are they? What do they mean? How do they work? What are the nursing implications? Who should you delegate to? Are there ever any considerations besides skill in delegating? ? 27

What are the nursing implications?
Advocate What does this mean? What are the nursing implications? How is it done?

American Nurses Association (ANA’s) Code of Ethics -
What is it? What does it mean to the nurse and the patient? First, the nurse is expected to practice kindness and respect, regardless of who is receiving his or her communication. The Code of Ethics for Nurses was developed as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession. Whistleblowers: Troublemakers or Virtuous Nurses? [PDF] by Vicki D. Lachman Whistleblowing: Role of Organizational Culture in Prevention and Management [PDF]

American Nurses Association (ANA’s) Code of Ethics -
What does it mean to the nurse and the patient? The therapeutic use of self is expected in this provision. In every human interaction, we communicate one of three statements: ? 14 Practical Use of the Code Found at:

In every human interaction, we communicate one of three statements:
1. Go away, my world would be better without you. 2. You are an object, a task to be done, you mean nothing to me. 3. You are a person of worth, I care about you (Fowler, 2008, p. 6).

In every human interaction, we communicate one of three statements:
What do a nurse’s touch, look, and actions communicate? Do they convey respect for the person receiving care? (On line handout “Practical Use of the Nursing Code of Ethics”) ? 3

Autonomy What does it mean?
Autonomy is the right to self-determination. What are the Nursing implications? ? 3

Autonomy What are the Nursing implications?
“Patients have a moral and legal right to determine what will be done with their own person; to be given accurate, complete, and understandable information in a manner that facilitates an informed judgment; ? 3

to be assisted with weighing the benefits, burdens, and available options in their treatment, including the choice of no treatment; to accept, refuse, or terminate treatment without deceit, undue influence duress, coercion, or penalty; ? 3

and to be given necessary support throughout the decision making and treatment process” (ANA, 2001, p. 8). This support may involve calling a physician to come and re-explain the procedure, or assuring the surrogate who signed the consent has the best interest of the patient in mind. This is a nursing obligation 34 inference

Beneficence Act for the patient’s benefit Relieve pain and suffering
Keep society safe Primary obligation in health care—Is ancient!! Concept - inference

Case Manager - What does a case manager do?
Case management nurses are registered nurses who coordinate all aspects of the care of individual patients. They ensure proper utilization of services and resources as well. Case managers provide assistance within, between, and outside of facilities. Nurses working in case management facilitate outstanding patient care using fiscally responsible strategies. They are experts at obtaining resources. Elimination - ? 15

Charge Nurse Charge nurses supervise and support a nursing staff while also treating a limited number of patients. Charge nurses are responsible for maintaining a high level of patient care, evaluating other nurses and acting as an educational resource for nurses. They are both leaders and managers

Charismatic Leader What are the characteristics of a Charismatic Leader? The Charismatic Leader gathers followers through dint of personality and charm, rather than any form of external power or authority ? 7

How is it used in nursing?
Collaboration What does it mean? How is it used in nursing? When preparing care plans who is the most important person for the nurse to collaborate with? ? 8

Critical Thinking What is it?
Critical thinking is the disciplined, intellectual process of applying skillful reasoning as a guide to belief or action. ? 17, 24,

Critical Thinking How is it done?

Critical Thinking Reasoning: the action of thinking about something in a logical, sensible way. Evaluating: form an idea of the amount, number, or value of; assess. - you must evaluate your work load, your employees, yourself and your resources – if you don’t know what you have or the capabilities of those working with you, you will be unable to manage anything effectively Problem solving: As the manager when there is a problem your employees will look to you for a solution. If they are not looking to you for a solution you are no longer leading them because they have determined one of two things either they have no faith that you can help them or they believe you don’t care. Either way you have lost them. Decision making : When you’re in charge you make the decisions. Analyze : After you have made your decision and implemented your plan you must analyze the results – were you successful in your endevours? Were your patients satisfied with your efforts? Were your employees successful in what they did? Do they feel successful? Image URL:

Critical Thinking What are the nursing implications?
In nursing, critical thinking for clinical decision-making is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care. A manager needs to be able to think critically and solve complex problems.

Sample Question In which of the following examples is the nurse not applying critical thinking skills in practice? The nurse considers personnel experience in performing intravenous (IV) line insertion and ways to improve performance. b. The nurse uses a fall risk inventory scale to determine a patient's fall risk. c. The nurse observes a change in a patient's behavior and considers which problem is likely developing. . d. The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care. ANS: d The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care.

Delegate What does it mean? What are the nursing implications?
This word us used in 7 questions and answers you need to know and understand its meaning and how its nursing implications, that’s why it was listed in 2 different forms on your list.

Ethical What does it mean and what are the nursing implications?
We had a guest speaker who spent a large portion of her presentation on this subject. What did you learn? The state of Oregon uses the ANA Code of ethics which can be found at And you can read an excellent article – “Practical use of the Code of Ethics” in the handouts on line

What is Ethics? Principles of right conduct within a social system
Systematic way to form value judgments on human actions Is organized and reflective Is NOT intuitive or based on “gut feeling” Principles of right conduct within a social system Critical concept: We make judgments all the time What results from these judgments?

Healthcare Ethics If you want more see her presentation on line
Bioethics Clinical ethics In clinical care settings Ethics of the encounter between clinician and patient Research ethics Organizational ethics If you want more see her presentation on line ? 3, 6, 14, 16,

Why was it included here?
Jargon What is it ? Why was it included here? Nurses get in a hurry and use alphabet soup instead of real words or terms their patients don’t understand – that’s why its included. Jargon is technical speak that anyone not in that specialty is unlikely to understand. Using it leads to miscommunication. Even in the medical field their can be miscommunication because the same term may be used for totally different things in different specialties. Who knows what ROM stands for? You are studying Maternal Child what do you think it stands for? - Rupture of Membranes But if you were working on a Med/Surg unit it would mean Range of Motion Totally different meanings and the same abbreviation.

Malpractice What does it mean?
JCAHO defines malpractice as "improper or unethical conduct or unreasonable lack of skill by a holder of a professional or official position; often applied to physicians, dentists, lawyers, and public officers to denote negligent or unskillful performance of duties when professional skills are obligatory. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) defines negligence as a "failure to use such care as a reasonably prudent and careful person would use under similar circumstances." JCAHO defines malpractice as "improper or unethical conduct or unreasonable lack of skill by a holder of a professional or official position; often applied to physicians, dentists, lawyers, and public officers to denote negligent or unskillful performance of duties when professional skills are obligatory. Malpractice is a cause of action for which damages are allowed."4 Malpractice is defined variously under state nurse practice acts, institutional policies, and federal guidelines such as JCAHO standards, all of which may be taken into consideration in court. - See more at:

Malpractice What does it mean? What are the nursing implications? (next slide) ? 1, 2, 13,

Malpractice What are the nursing implications? Nursing malpractice occurs when a nurse fails to competently perform his or her medical duties and that failure harms the patient. There are a variety of ways that a nurse can harm a patient -- from administering the wrong drug to failing to notify a doctor when something is really wrong. In nursing malpractice cases, often a key issue is who is liable for the nurse's misdeeds -- the doctor or the hospital. Whoever is liable will be responsible for compensating the patient for the nurse's misdeeds. Nursing malpractice occurs when a nurse fails to competently perform his or her medical duties and that failure harms the patient. There are a variety of ways that a nurse can harm a patient -- from administering the wrong drug to failing to notify a doctor when something is really wrong. In nursing malpractice cases, often a key issue is who is liable for the nurse's misdeeds -- the doctor or the hospital. Whoever is liable will be responsible for compensating the patient for the nurse's misdeeds. When Does Nursing Malpractice Occur? Like malpractice involving doctors, nursing malpractice happens when a nurse does not fulfill duties in a way that a normally competent nurse in the same situation would -- and that negligence injures the patient. (Keep in mind that not every mistake or unfortunate event that happens in a hospital or doctor's office rises to the level of negligence. To learn more about what constitutes medical malpractice, read Nolo's article Medical Malpractice Basics.) Nursing malpractice can happen in a variety of situations, but below are some of the most common. Doing or Saying Nothing When Action Is Required Nurses are often the frontline for a patient. If the patient has a sudden emergency, a nurse may be liable if he or she doesn't take appropriate immediate steps. This may involve actions like administering a medication or calling for help. Similarly, a nurse is under a duty to monitor a patient's condition. If the nurse notices something of concern, or should notice it, then the nurse may be liable for malpractice for not notifying the attending doctor. Injuring a Patient With Equipment A nurse will be liable for malpractice if he or she injures a patient with a piece of medical equipment. This can happen in a variety of ways, like knocking something heavy onto the patient, burning the patient, or leaving a sponge inside the patient after surgery. Improper Administration of Medication Administering medication according to the doctor's orders is a common nursing task. If the nurse fails to follow the orders, she or he will be liable for malpractice if the patient is injured. The nurse may also be liable for negligently following otherwise proper orders, like injecting a medication into muscle instead of a vein or injecting the wrong patient. Who Is Responsible for Nursing Malpractice? Often, a key issue in nursing malpractice cases revolves around who is responsible for the nurse's negligent acts: the hospital or the attending doctor. More canNursing malpractice occurs when a nurse fails to competently perform his or her medical duties and that failure harms the patient. There are a variety of ways that a nurse can harm a patient -- from administering the wrong drug to failing to notify a doctor when something is really wrong. In nursing malpractice cases, often a key issue is who is liable for the nurse's misdeeds -- the doctor or the hospital. Whoever is liable will be responsible for compensating the patient for the nurse's misdeeds. More can be found at

Sample Question Failure to keep the care plan updated
A nurse is caring for a client with a fractured arm who has just received a plaster caster. Identify the situation that would put the nurse at the highest risk for malpractice a suit. Failure to keep the care plan updated b. Notifying the physician that the client is having pain in his arm c. Failure to note that the client’s fingers are cold with a bluish color d. Charting that the client did not respond to the pain medication

Manager What is a manager? What are their duties? What do they do?
How do they do their job? What skills do they need to have? What management styles are there and how do they differ? What is the difference between a leader and a manager? ? 7, 18, 21, 23, 24, 26, 41, 42, 43, 44,

Management Vs Leadership
Manager's job is to plan, organize and coordinate; leader's job is to inspire and motivate Manager administers; leader innovates Manager is a copy; leader is an original Manager maintains; leader develops Manager focuses on systems and structure; leader focuses on people Manager relies on control; leader inspires trust (Warren Bennis, 1989) ? 12, 21, 22, 24, 26, 31, 34,

Manager Does a manager ever lead? The Answer is Yes
But they each have their own duties and goals to accomplish and ways to accomplish them. ? 7, 18, 21, 23, 24, 26, 44,

Sample Question A nurse manager wants his nursing unit to be a place where all nurses want to work, where patient satisfaction is high, and care Is innovative and interdisciplinary. Staff are encouraged to chair taskforces to improve quality of care and he counsels staff in areas of measuring patient outcomes. Other managers want to mimic this manager’s approach to improve their own units. This nurse is which type of leader? a. Transformational b. Transactional c. Laissez-faire d. Authoritative

Negligence What is it? a nurse is required to exercise the same ordinary or reasonable care as all other health practitioners to ensure that no unnecessary harm comes to the patient. Failure to meet this standard subjects nurses to medical malpractice liability. ? 37,

Negligence How is it different from malpractice?
It is a specific kind/act of malpractice.

Negligence How is it different from malpractice?
Documentation describing negligent behavior often uses terms such as failure to, lack of, incomplete, ineffective, and improper. The categories of negligence are: failure to follow standards of care, failure to use equipment in a responsible manner, failure to communicate, failure to document, failure to assess and monitor, and failure to act as a patient advocate Documentation describing the negligent behavior often used terms such as failure to, lack of, incomplete, ineffective, and improper. The categories of negligence are: failure to follow standards of care, failure to use equipment in a responsible manner, failure to communicate, failure to document, failure to assess and monitor, and failure to act as a patient advocate - See more at:

Nonmalfeasance What is it?
Those who missed the guest speaker should review her slides ? 3,

Nonmaleficence Do no harm An decision is required
Stopping a medication shown to be harmful Refusing to provide a treatment that has not been shown to be effective Increased opioid prescriptions = increased opioids on the street An decision is required To act or not Doing nothing may cause harm According to the CDC opioid prescribing has increased 3 fold in the last 20 years.

Nurse Delivery Systems
What are they? A nursing care delivery system defines how work is organized, how nursing staff are deployed, and who does what in providing nursing care. ? 9, 49

Nurse Delivery Systems
What are they? Primary nursing. Team nursing. Functional nursing. Total Patient Care. Delivery systems identify who has the accountability for nursing care and clinical outcomes. Delivery systems provide the organization, rules and structure that define responsibility and accountability (who does what). Total Patient Care. The oldest system for organizing patient care. Commonly used in intensive care unit (ICU) and postanesthetic care unit (PACU). in TPC an RN is responsible for planning, organizing, and performing all aspects of nursing care. TPC provides a high degree of autonomy, clear lines of responsibility and accountability, holistic patient care, unfragmented care. TPC is not cost effective. It requires abundant availability of nurses. Functional nursing. Specific tasks are assigned to nurses. The nurse assigned to a specific task has to carry it out at all patients. Registered nurses (RNs) carry out complex nursing tasks. The idea behind functional nursing is that there is a specialist for each task. The head of the ward assigns the different tasks to specific nurses based on the nursing care plans for the different patients. Team nursing. Care is given by a team composed of registered nurses (RNs), Licensed Practical (or Vocational) Nurses (LPNs) and certified nursing assistants (CNAs). In this model, most direct bedside care is given by the CNAs while the RNs spend more of their time at the nursing station. When a ward is organized according to the team nursing system, the nurses are divided in a number of teams. Each team has to provide care for a fixed group of patients. By doing so nurses have a close relation with the patients they have to take care for. Each team has a team leader who is responsible for the performance of the team. Each ward has a supervisor, which is responsible for the whole ward. Nurses like working in teams. Primary nursing. All nurses are RNs. They do personal care as well as care planning, documentation, etc. CNAs assist the nurses, but do not have autonomous roles in patient care. This approach can provide better continuity and more expertise than the Team Nursing model. Primary nursing is a method of nursing practice which emphasizes continuity of care by having one nurse provide complete care for a small group of inpatients within a nursing unit of a hospital.

Nurse Practice Act What is it?
We talked about this on Day 2 and it was on Quiz 1 – question4 How does it affect your nursing practice? ? 4, 19, 20, 29, 30, Why are there laws regulating nursing? The practice of nursing requires specialized knowledge, skill, and independent decision making. Nursing careers take widely divergent paths - practice focus varies by setting, by type of client, by different disease, therapeutic approach or level of rehabilitation. Moreover, nurses are mobile and sophisticated and work in a society that is changing and asymmetrical for consumers. The result is that the risk of harm is inherent in the provision of nursing care. Because nursing care poses a risk of harm to the public if practiced by professionals who are unprepared or incompetent, the state, through its police powers, is required to protect its citizens from harm. That protection is in the form of reasonable laws to regulate nursing. More than 100 years ago, state governments enacted laws which protect the public’s health and welfare by overseeing and ensuring the safe practice of nursing. All states and territories have enacted a nurse practice act (NPA). Each state’s NPA is enacted by the state’s legislature. The NPA itself is insufficient to provide the necessary guidance for the nursing profession, therefore, each NPA establishes a board of nursing (BON) that has the authority to develop administrative rules or regulations to clarify or make the law more specific. Rules and regulations must be consistent with the NPA and cannot go beyond it. These rules and regulations undergo a process of public review before enactment. Once enacted, rules and regulations have the full force and effect of law. Although the specificity of NPAs varies among states, all NPAs include: Authority, power and composition of a board of nursing Education program standards Standards and scope of nursing practice Types of titles and licenses Requirements for licensure Grounds for disciplinary action, other violations and possible remedies (From: ) Every state has there own board of nursing and each has a similar post this just seemed to be the clearest.

Nursing Code of Ethics What is it? Where do you find it?
? 14, 16, Oregon predominately uses the ANA’s Code of ethics but you can find (mixed into everything else) the particulars at: Here is some of what is posted there: 3) Standards related to the licensed nurse’s responsibilities for ethics, including professional accountability and competence. The licensed nurse: (a) Has knowledge of the statutes and regulations governing nursing, and practices within the legal boundaries of licensed nursing practice; (b) Accepts responsibility for individual nursing actions and maintains competence in one's area of practice; (c) Obtains instruction and supervision as necessary when implementing nursing practices; (d) Accepts only nursing assignments for which one is educationally prepared and has the current knowledge, skills and ability to safely perform. (e) Accepts responsibility for notifying the employer of an ethical objection to the provision of specific nursing care or treatment. (f) Maintains documentation of the method by which competency was gained, and evidence that it has been maintained. (g) Ensures unsafe nursing practices are reported to the Board of Nursing and unsafe practice conditions to the appropriate regulatory agency(s); (h) Retains professional accountability when accepting, assigning, or supervising nursing care and interventions; (i) Demonstrates honesty and integrity in nursing practice; (j) Promotes and preserves clients’ autonomy, dignity and rights in a nonjudgmental, nondiscriminatory manner that recognizes client diversity; (k) Maintains appropriate professional boundaries; and (l) Protects confidential client information, and uses judgment in sharing this information in a manner that is consistent with current law. (4) Standards related to the licensed nurse’s responsibilities toward nursing technology. The licensed nurse: (a) Acquires and maintains knowledge, skills and abilities for informatics and technologies used in nursing practice settings; and (b) Promotes the selection and use of informatics and technologies that are compatible with the safety, dignity, and rights of the client. (5) Standards related to the licensed nurse’s responsibility to assign and supervise care. The licensed nurse: (a) Assigns to another person, tasks of nursing that fall within the nursing scope of practice and/or the work that each staff member is already authorized to perform; (b) Supervises others to whom nursing activities are assigned by monitoring performance, progress, and outcomes. (c) Ensures documentation of the activity; (d) Matches client needs with available, qualified personnel, resources and supervision; (e) Provides follow-up on problems and intervenes when needed; (f) Evaluates the effectiveness of the assignment and the outcomes of the interventions; and (g) Revises or recommends changes to the plan of care as needed. The Code of Ethics for Nurses was developed as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession. To learn more about the creation of the Code of Ethics, purchase a copy of your own, or view the nursing Code of Ethics online, please refer to the links listed below. ( see also “Practical use of the Code of Ethics” in the handouts on line Assisted suicide, as understood nationally and as defined in Oregon's Death with Dignity Act, is the act of providing prescription medication to a terminally ill patient at his request for the purpose of effecting a peaceful death. The patient requesting aid in dying must have full capacity to make medical decisions, make the request himself, and administer the medication himself.2 The medication prescribed, usually a sedative/hypnotic, causes deep sleep, leading to eventual cessation of respiration. Oregon's law, which technically is a physician-assisted suicide law, has many safeguards in place to ensure adherence to the intent of the law: * The person must make several requests for assisted suicide, with at least 15 days between the first and last request. * Two physicians must determine that the person is competent. * The person must be provided with information about hospice. See more at: Things to be considered (not all inclusive) Ethical decision making with residents and families • Ethical issues in grief, death, and dying • Ethical issues in pain management • Ethical issues in palliative care Ethical issues with AIDs, etc. • Ethics in health services and health disparities (health care access) HIPPA and privacy ethics • Leadership and management ethics • Personal ethics

Do you remember? Lets look at the slide you first saw it on
Nursing Process What is it? How does it work? Do you remember? Lets look at the slide you first saw it on ? 25

Nursing process = problem-solving process
Assessment Examine Analysis and Dx Consider Plan Find a solution Implement Plan Implement Solution Evaluate ? 25 This is slide 35 from the “PVN 151 – Leadership and Management – third attempt” that is in the lecture notes on line The nursing process is a problem solving process – you must assess the problem, analyze it and determine what the cause is, plan how to deal with it or solve it, try your plan, and evaluate the effectiveness of your plan This has proven quite effective in managing difficult and complex decisions as well You need to know Nursing process = problem-solving process and includes : assessment, analysis and diagnosis, planning, implementation, evaluation; has proven to be effective to manage the complex decisions.

Policy What is it? “course of action to be
followed by a government, business, or institution to obtain a desired effect” (Nies and McEwen, 2011, p. 200). ? , 42

Policy What are the nursing implications? Policy, politics, and legislation are influences that determine the nursing care to individuals, families and communities.

is at risk for HIPAA violations. c.
Sample Question The nurse caring for a patient states, “Your blood pressure is dangerously high. Are you taking antihypertensive medicine?” The patient states, “ I can’t afford my medicine. I have no insurance.” The nurse states “I feel really sorry for that patient. I wish it wasn’t against policy to give her money.” The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that “She was so sick last evening when she came to the ED. I can’t believe they don’t provide insurance. I can’t give her money but you all can help.” This nurse: a. is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines. b. is at risk for HIPAA violations. c. has properly followed policy and protected the patient by not using her name. d. is demonstrating the logical fallacy of slippery slope. The answer is B - I know this is more of a HIPAA question than a policy but it’s a sample question , I also know that we haven’t talked about the National Council of State Boards of Nursing or its policy on social Media but for those who are interested they have a policy - Correct: The National Council State Board of Nursing’s policy on social media prohibits posting of patient information on social media sites. This patient could be identified by knowing where she works and the fact that she was seen in the ED the day before. Incorrect: a. The nurse is showing empathy but she violated patient confidentiality when she put the patient’s occupation, place of work, and fact she was seen in ED the night before on Facebook. c. It is against policy to place any patient information on social media. d. Slippery slope is the belief that one event will inevitably follow another without any real support for that belief PTS: 2 DIF: Application REF: p. OBJ: TOP: HIPAA

Prioritization What is it? ? 8, 9,

Prioritization How is it done? ? 42,

Prioritization What are the nursing implications?

Sample Question A nurse hopes to improve time management skills using the ABC prioritization approach. Which tasks would be prioritized as “B”? (Select all that apply.) a. Turn in time sheet due in 3 days. b. Review dress code policy to give feedback before appointment in the morning. c. Perform blood glucose test on a patient admitted with Kussmaul respirations and change in level of consciousness. d. Complete patient teaching prior to discharge in 2 hours. e. Review procedure for inserting a PIC line to assist with procedure later this morning. So we haven’t talked about the ABC prioritization system but using your critical thinking skills what do you think it means?

Critical thinking – ABC prioritization system – what is it?
A = Most important and time sensitive B = Important and has to be dealt with today but not critical C = This can wait for another day So now that we know what that system is lets analyze the question

Sample Question A nurse hopes to improve time management skills using the ABC prioritization approach. Which tasks would be prioritized as “B”? (Select all that apply.) a. Turn in time sheet due in 3 days. b. Review dress code policy to give feedback before appointment in the morning. c. Perform blood glucose test on a patient admitted with Kussmaul respirations and change in level of consciousness. d. Complete patient teaching prior to discharge in 2 hours. e. Review procedure for inserting a PIC line to assist with procedure later this morning. So which of these are As, Bs, and Cs? What is “a.”? “a” is obviously a C because it doesn’t need to be done for another 3 days Which is an A? C is an A because this patient is in trouble and must be dealt with immediately That leaves us B, D, E to look at B needs to be done today because the appointment is in the morning and you won’t have time the next day to react to it effectively D needs to be done today and before B because the patient is leaving in 2 hours E has to be done today because the activity takes place today but it isn’t as urgent as the patient being discharged So using our parameters for ABC the answer is everything that falls in the B standard are “B, D, and E” ANS: B, D, E Correct: b. Task that fall within Priority B include the medium-value items, such as tasks that are not urgent but most likely will not “fall” off the list. Since the dress code must be reviewed and feedback constructed for a morning appointment, this would be level B, it is not urgent nor will it likely fall off the list. d. Completing patient teaching for a patient to be discharged in 2 hours must be completed but does not take priority over “A” tasks. e. Reviewing a procedure to be performed later in the day is Level “B”. Incorrect: a. Turning in a time sheet due in 3 days is level C. c. Performing a blood sugar test on an unstable patient is level A. PTS: 2 DIF: Application REF: p. OBJ: 2 TOP:

Example: Placing an IV or foley catheter
Procedure What is it? Nursing implications Can you give me an example? ? 15, 17, 42, 46, At the very least you need to understand that a procedure is a specific group of actions that a nurse will do to accomplish a specific goal. Nursing procedures are standardized actions used by nurses to achieve a high level of patient care for specific goals/interventions. By creating routine responses to medical situations, nursing procedures keep nurses on task, and allow them to ensure that patients are getting the care they need. The guidelines reflect years of experience and collaboration between doctors, nurses, and other medical personnel. Nursing procedures establish priorities of care so that nurses can work quickly to stabilize a patient, focusing on critical issues first and moving to less serious medical problems. They also act as a checklist which can be used to confirm that every step necessary for the patient's well being has been taken, and that these steps have been followed in the right order. These procedures also dictate the number of patients a nurse can care for at once, the maximum hours in a day a nurse can work, and the way in which the nurse handles administrative duties like charting. Example: Placing an IV or foley catheter California it has a more specific meaning Standardized procedures are the legal mechanism for registered nurses, nurse practitioners to perform functions which would otherwise be considered the practice of medicine. Standardized procedures must be developed collaboratively by nursing, medicine, and administration in the organized health care system where they will be utilized. Because of this interdisciplinary collaboration for the development and approval, there is accountability on several levels for the activities to be performed by the registered nurse, nurse practitioner.

Servant Leader What is a servant leader?
the servant-leader shares power, puts the needs of others first and helps people develop and perform as highly as possible. Servant leaders are open-minded, listen deeply, try to fully understand others and are not judgmental Any questions? ? 7,

Standards of Care What are they?
Standards of care define actions that are permitted or prohibited in most nursing interventions. These standards are accepted as legal guidelines for appropriateness of performance. What are the nursing implications? We talked about standards of care in Quiz 1 What are they? ? 2, 4, 19, 20,

This is direct from your vocabulary list
Team Leader This is direct from your vocabulary list “This nurse leads the team-usually of 4 to 6 members-” It was on your vocabulary list, we used it in BINGO those who have done clinical have had to do it and write it up. I expect you all to know it. ? 8, 9, 30, 49

Team Leader - Team Nursing
If you have a team leader you must have team nursing What is team nursing? Use your definition of team Leader to define team nursing – this is critical thinking – if you understand one you can make an inference about the other

Sample Question Team nursing Is done by a nurse and a CNA
Provides care to a group of patients by a group of nurses and CNAs Is when 1 nurse has 8 patients to care for Defined in the Nurse Practice Act ANS: B Provides care to a group of patients by a group of nurses and CNAs

Transactional Leader What is a transactional leader?
How does a transactional leader differ from a transformational leader? ? 7, 10, 26,

Transactional vs transformational
Identifies common values Is committed Inspires others with vision Has long-term vision Looks at effects Empowers others Focuses on management tasks Is a caretaker Uses trade-offs to meet goals Does not identify shared values Examines causes Uses contingency reward ? 7, 10, 12, 23, 26,

What are the 5 Rights of Delegation?
5 Rights of Delegation Right Task Right Circumstances Right Person Right Direction Right Supervision and Evaluation ? 27

Who should a nurse delegate to?
The person with: the right attitude The right aptitude The right capacity the person they want to develop. ? 31, 36, 38,

What is a Hospital Ethics Committee and what do they do?
An Ethics Committee in hospitals is an advisory group appointed by the Hospital Medical Executive Board. The multidisciplinary ethics committee represents the hospital and the community it serves. ? 6 An Ethics Committee in hospitals is an advisory group appointed by the Hospital Medical Executive Board. The multidisciplinary ethics committee represents the hospital and the community it serves. An ethics committee is made up of doctors, nurses, lawyers and clergy, which can get together to help families or health care workers when difficult ethical questions arise. So if you have an ethical question about a pt’s right to refuse medication who would you go to? The hospital ethics committee.

What is the Nursing Code of Ethics and where do you find it?
The Code of Ethics tells nurses how they should behave ethically, What our responsibilities are to our patients and the profession You can read it at - Question 14, 16, see also “Practical use of the Code of Ethics: in the handouts on line

Reasoning Evaluating Problem Solving Decision Making Analyze
What are the components of critical thinking and how do you use them to achieve critical thinking? Reasoning Evaluating Problem Solving Decision Making Analyze ? 17, 24 Slides PVN 151 – Leadership an Management – Third attempt – on line Reasoning: the action of thinking about something in a logical, sensible way. Evaluating: form an idea of the amount, number, or value of; assess. - you must evaluate your work load, your employees, yourself and your resources – if you don’t know what you have or the capabilities of those working with you, you will be unable to manage anything effectively Problem solving: As the manager when there is a problem your employees will look to you for a solution. If they are not looking to you for a solution you are no longer leading them because they have determined one of two things either they have no faith that you can help them or they believe you don’t care. Either way you have lost them. Decision making : When you’re in charge you make the decisions. Analyze : After you have made your decision and implemented your plan you must analyze the results – were you successful in your endevours? Were your patients satisfied with your efforts? Were your employees successful in what they did? Do they feel successful? Image URL:

What skills does it take to be a manager?
A manager must: Plan Organize Staff ? 7, 18, 21, 24, 26, 44, Slide 31 – Leadership and Management - third attempt- Planning includes defining goals and objectives, developing policies and procedures; determining resource allocation; and developing evaluation methods. Organizing includes identifying the management structure to accomplish work, determining communication processes, and coordinating people, time and work. Staffing includes those activities required to have qualified people accomplish work such as recruiting, hiring, training, scheduling and ongoing staff development.

What skills does it take to be a manager?
A Manager is a Decision Maker and Problem Solver she needs to be able to: Think Critically and solve complex problems Be a Good Nurse Have Effective Communication Skills Slide 47 , 49 – Leadership and Management – third attempt We keep talking about critical thinking – are you all sure you understand what that means? Critical thinking is the disciplined, intellectual process of applying skillful reasoning as a guide to belief or action (Paul, Ennis & Norris). In nursing, critical thinking for clinical decision-making is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care (Heaslip). ( from: ) Technical skills—such as clinical expertise and nursing knowledge. Human skills—the ability and judgment to work with people in an effective leadership role.

Sample Question A nurse is hoping for a promotion and seeks the help of a coach to improve time management skills. The first task assigned by the coach is for the nurse to list all external distractors that prevent organization and completion of tasks. The nurse would include: (include all that apply) a. waiting for oncoming shift to start walking rounds. b. failure to delegate tasks to the Licensed Practical Nurse and Unlicensed Assistive Personnel and instead, completing task herself. c. talking with a patient’s family member who is also a personal friend. d. spending time thinking about the vacation to the beach. e. using the Internet to read about a new drug that will be administered; then taking time to look for news about the profession, new legislation about the Patient Protection and Affordable Care Act, and new uniforms for the season. .41. This is missing the include all that applies on the test ANS: A, C Correct: a. Waiting, such as for meetings or oncoming shift, is an external distraction. c. Socializing with visitors is an external distraction. Incorrect: b. ineffective delegation is an internal distraction. d. Daydreaming about an upcoming vacation is an internal distraction. e. Surfing the Internet after using it wisely to ensure patient safety is an internal distractor. PTS: 2 DIF: Application REF: p. OBJ: TOP:

What is the Nursing process give the components, Assessment Analysis and diagnosis planning implementation evaluation ? 25 The nursing process is a problem solving process – you must assess the problem, analyze it and determine what the cause is, plan how to deal with it or solve it, try your plan, and evaluate the effectiveness of your plan This has proven quite effective in managing difficult and complex decisions as well Nursing process = problem-solving process and includes : assessment, analysis and diagnosis, planning, implementation, evaluation; has proven to be effective to manage the complex decisions.

Nursing Process - what they mean and how to use them
ASSESSMENT ANALYSIS AND DIAGNOSIS PLANNING Implementing EVALUATION ASSESSMENT Gather information about the situation Identify the problem; separate the symptoms Identify people and groups involved Identify cultural and environmental factors Encourage input from involved parties ANALYSIS AND DIAGNOSIS Analyze results of information gathered Identify, clarify, and prioritize the actual problem (s) Determine if intervention is appropriate PLANNING Identify as many solutions as possible Elicit participation from people or groups affected Review options and consider safety, efficiency, costs, quality, and legal issues Consider positive and negative outcomes Remain open-minded and flexible when considering options IMPLEMENTING Communicate plans to everyone affected Be sure plans, goals, and objectives are clearly identified Maintain open, two-way communication with staff Support and encourage compliance among all staff EVALUATION Maintain open communication with all involved Was the decision successful? What might have made it better? Identify evaluation criteria in the planning Identify who is responsible for evaluation, what will be measured, and when it will take place

How does the nursing process compare to the steps of problem solving?
Nursing process = problem-solving process Nursing Process Problem Solving Process Assessment Examine Analysis and Dx Consider Plan Find a solution Implement Plan Implement Solution Evaluate Slide Leadership and management third attempt

Problem solving how its done
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ASSESSMENT Gather information about the situation
Identify the problem; separate the symptoms Identify people and groups involved Identify cultural and environmental factors Encourage input from involved parties ? 18, 44

Identify people and groups involved
ASSESSMENT Identify people and groups involved Identify cultural and environmental factors Encourage input from involved parties

ANALYSIS AND DIAGNOSIS
Analyze results of information gathered Identify, clarify, and prioritize the actual problem (s) Determine if intervention is appropriate

PLANNING Identify as many solutions as possible Elicit participation from people or groups affected

PLANNING Review options and consider safety, efficiency, costs, quality, and legal issues Consider positive and negative outcomes Remain open-minded and flexible when considering options

IMPLEMENTING Communicate plans to everyone affected
Be sure plans, goals, and objectives are clearly identified

IMPLEMENTING Maintain open, two-way communication with staff
Support and encourage compliance among all staff

EVALUATION Identify evaluation criteria in the planning
Identify who is responsible for evaluation, what will be measured, and when it will take place

EVALUATION Maintain open communication with all involved
Was the decision successful? What might have made it better?

What are the 5 “Rights ” of delegation?
Right Task Right Circumstance Right Person Right Direction Right Supervision and Evaluation ?27 Slide 144 Bingo - Leadership and Management – 2nd attempt 5 Rights of Delegation Right Task Right Circumstances Right Person Right Direction Right Supervision and Evaluation

Explain the role of the practical nurse in delegation guided by the nurse practice act.
The LPN must assess the task to be delegated - is it a task that someone else can do, the patient for stability of condition, the ability of the staff to do the task, Staff attitude about being delegated to , your ability to give the directions clearly both verbally and in written form, and whether they can provide adequate super vision and evaluation ? 9, 22, 27, 36, 38 The nurse practice act can be found in the on line handouts as “Standards and Scope of Practice for the Licensed Practical Nurse “

What does it take to have effective communication?
? 24, 44

Effective Communication Skills
Communication Skills a Manager needs Provide Structure A manager must develop a structure for communication in the workplace. This means mapping the communication channels for each aspect of business. For example, employees must understand whom they must go to for approval after completing a project. Solve Problems Together To cultivate team spirit, managers must lead team members in solving problems together. A manager who leads as a dictator will keep team members from using their talents, feeling appreciated and communicating as a team. A good leader seeks input from team members and leads brainstorming sessions in which they collaborate on solutions. This ensures team members feel invested in solving the problems. Practice Strong Visual Communication Presenting data visually helps managers communicate the information better -- if they do it well. Graphs, charts and tables should help people understand information immediate An overabundance of information in one image makes them confusing, so managers should include only the most crucial information in such an image. This means ensuring they have a clear purpose for the image, not just adding it to make a presentation look flashy. What type of graph/ table might you use a charge nurse? Assignment sheet? VS sheet? Those are usually written in table formats. Practice Conflict Management A good manager develops a conflict-management policy to address conflicts before they start. Additionally, he communicates the protocol to employees so they will take responsibility for managing conflicts wisely. He must be a good listener to solve conflicts, and he should refrain from taking sides. Assuring employees he has an open-door policy will encourage them to turn to him for assistance. Consider Cultural Issues A manager must understand how cultural backgrounds affect communication. An employee from a different culture or subculture may perceive the manager's words and actions differently than someone from the manager's culture. A good manager strives to learn what is polite and acceptable, both verbally and non verbally, in the cultures and subcultures of her employees. Cultivate Extraverted Qualities A manager must also strive to communicate confidently, knowing when to be firmer and when to be more relaxed. In a meeting with his team, for instance, he must make eye contact with all team members, speak assertively, maintain confident posture, and speak with emphasis, not in a monotone. Practice Strong Written Communication Finally, a strong manager strives to have clear, concise and well-organized writing. She also strives to keep her in-office correspondence free from typos as well as inaccurate statements. Strong writing helps employees to see their manager as more professional. Image URL:

Effective Communication – How Do You Do It?
Learn to Listen Be Aware of Other Peoples Emotions Empathize Encourage Simply put, “effective communication” means that whatever is written or spoken must be as clear and understandable to people with disabilities as it is for people who do not have disabilities. This is important because some people have disabilities that affect how they communicate. (ADA Communication Tool Kit retrieved 09/30/2014 from: Learn to Listen (from: Listening is not the same as hearing; learn to listen not only to the words being spoken but how they are being spoken and the non-verbal messages sent with them. Use the techniques of clarification and reflection to confirm what the other person has said and avoid any confusion. Try not to think about what to say next whilst listening; instead clear your mind and focus on the message being received. Your friends, colleagues and other acquaintances will appreciate good listening skills. Be Aware of Other Peoples Emotions Be sympathetic to other people's misfortunes and congratulate their positive landmarks. To do this you need to be aware of what is going on in other people’s lives. Make and maintain eye contact and use first names where appropriate. Do not be afraid to ask others for their opinions as this will help to make them feel valued. Consider the emotional effect of what you are saying and communicate within the norms of behaviour acceptable to the other person. Take steps to become more charismatic. See our page: Emotional Intelligence for more information. Empathize Empathy is trying to see things from the point-of-view of others. When communicating with others, try not to be judgemental or biased by preconceived ideas or beliefs - instead view situations and responses from the other person’s perspective. Stay in tune with your own emotions to help enable you to understand the emotions of others. If appropriate, offer your personal viewpoint clearly and honestly to avoid confusion. Bear in mind that some subjects might be taboo or too emotionally stressful for others to discuss. Encourage Offer words and actions of encouragement, as well as praise, to others. Make other people feel welcome, wanted, valued and appreciated in your communications. If you let others know that they are valued, they are much more likely to give you their best. Try to ensure that everyone involved in an interaction or communication is included through effective body language and the use of open questions. More on body language, non-verbal communication and questioning. Do not say the first thing that comes into your head but instead take a moment and pay close attention to what you say and how you say it. Focus on the meaning of what you want to communicate. Aim to increase understanding by considering how your message might be received by the other person. By communicating clearly, you can help avoid misunderstandings and potential conflict with others. By speaking eloquently you will come across as more intelligent and mature. Be aware of the messages you are sending via non-verbal channels: make eye contact and avoid defensive body language. Present information in a way that its meaning can be clearly understood. Pay particular attention to differences in culture, past experiences, attitudes and abilities before conveying your message. Avoid jargon and over-complicated language; explain things as simply as possible. Request clarification if unclear about a message. Always avoid racist and sexist terms or any language that may cause offence.

Effective Communication – How Do You Do It?
Use Humor . Treat People Equally Attempt to Resolve Conflict Maintain a Positive Attitude and Smile Use Humour Laughing releases endorphins that can help relieve stress and anxiety; most people like to laugh and will feel drawn to somebody who can make them laugh. Don’t be afraid to be funny or clever, but do ensure your humour is appropriate to the situation. Use your sense of humour to break the ice, to lower barriers and gain the affection of others. By using appropriate humour you will be perceived as more charismatic. Treat People Equally Always aim to communicate on an equal basis and avoid patronising people. Do not talk about others behind their backs and try not to develop favourites: by treating people as your equal and also equal to each other you will build trust and respect. Check that people understand what you have said to avoid confusion and negative feelings. Encourage open and honest feedback from the receiver to ensure your message is understood and to avoid the receiver instead feeding back what they think you want to hear. If confidentiality is an issue, make sure its boundaries are known and ensure its maintenance. Attempt to Resolve Conflict Learn to troubleshoot and resolve problems and conflicts as they arise. Learn how to be an effective mediator and negotiator. Use your listening skills to hear and understand both sides of any argument - encourage and facilitate people to talk to each other. Try not to be biased or judgemental but instead ease the way for conflict resolution. Maintain a Positive Attitude and Smile Few people want to be around someone who is frequently miserable. Do your best to be friendly, upbeat and positive with other people. Maintain a positive, cheerful attitude to life: when things do not go to plan, stay optimistic and learn from your mistakes. If you smile often and stay cheerful, people are more likely to respond positively to you. From:

1. The purpose of licensing laws for LPN/LVNs is to
limit the number of LPN/LVNs. b. prevent malpractice. c. protect the public from unqualified people. d. increase revenue for the state board of nursing. 1. ANS: C The purpose of licensing laws for LPN/LVNs is to protect the public from unqualified practitioners

2. A nurse could be cited for malpractice in the event of
: B Standards of care dictate that a nurse must be aware of all the properties of drugs administered. Compazine is a phenothiazine. Giving out confidential information is a HIPAA violation; refusing to give an excessively large narcotic dose is not considered malpractice because you might have a really good reason. Good Samaritan laws protect anyone giving aid to an injured motorist. a. refusing to give 60 mg of morphine as ordered. b. giving Compazine to a patient allergic to phenothiazines. c. dragging an injured motorist off the highway and causing further injury. d. informing a visitor about a patient’s condition.

3. When confronted with an ethical decision, the nurse must observe the first fundamental principle of C The first fundamental principle is respect for persons. a. autonomy. b. beneficence. c. respect for people. d. nonmalfeasance.

4.The new LPN/LVN is very concerned regarding what should or should not be done for patients. Select the answer that will provide this information for her. a. state nurse practice act b. standards of care c. scope of nursing practice d. professional organizations B Standards of care define what should or should not be done for patients.

5. The nurse who diligently works for the protection of patients’ interests is functioning in the role of C A nurse accepts the role of advocate when, in addition to general care, the nurse protects the patient’s interests. a. caregiver. b. health care administrator. c. advocate. d. health care evaluator.

B The nurse should seek the advice of the hospital ethics committee.
6.The nurse, when seeking advice while attempting to make an ethical decision involving the patient’s right to refuse medication, would most appropriately consult B The nurse should seek the advice of the hospital ethics committee. a. a minister or priest. b. the hospital ethics committee. c. her supervisor. d. a more experienced nurse.

Transformational leader b. Transactional leader
7. Her former manager demonstrated passion for serving her staff rather than being served. She takes time to listen, prefers to be a teacher first before being a leader, which is characteristic of Transformational leader b. Transactional leader c. Servant leader d. Charismatic leader c Servant leader Servant leaders are open-minded, listen deeply, try to fully understand others and not being judgmental

8. Which of the following is the best guarantee that the patient’s priority needs are met?
Checking with the relative of the patient b. Preparing a nursing care plan in collaboration with the patient c. Consulting with the physician d. Coordinating with other members of the team b Preparing a nursing care plan in collaboration with the patient The best source of information about the priority needs of the patient is the patient himself. Hence using a nursing care plan based on his expressed priority needs would ensure meeting his needs effectively.

Each patient as listed on the worksheet
9. When Harry uses team nursing as a care delivery system, he and his team need to assess the priority of care for a group of patients, which of the following should be a priority? Each patient as listed on the worksheet b. Patients who needs least care c. Medications and treatments required for all patients d. Patients who need the most care d Patients who need the most care In setting priorities for a group of patients, those who need the most care should be number-one priority to ensure that their critical needs are met adequately. The needs of other patients who need less care can be attended to later or even delegated to assistive personnel according to rules on delegation.

Focuses on management tasks b. Is a caretaker
10. Ms. Castro learns that some leaders are transactional leaders. Which of the following does NOT characterize a transactional leader? Focuses on management tasks b. Is a caretaker c. Uses trade-offs to meet goals d. Inspires others with vision d Inspires others with vision Inspires others with a vision is characteristic of a transformational leader. He is focused more on the day-to-day operations of the department/unit.

having responsibility to direct others v
11. Stephanie delegates effectively if she has authority to act, which is BEST defined as: having responsibility to direct others v b. being accountable to the organization c. having legitimate right to act d. telling others what to do c Having legitimate right to act Authority is a legitimate or official right to give command. This is an officially sanctioned responsibility

12. Stephanie considers shifting to transformational leadership
Stephanie considers shifting to transformational leadership. Which of the following statements best describes this type of leadership? a. Uses visioning as the essence of leadership. b. Serves the followers rather than being served. c. Maintains full trust and confidence in the subordinates d. Possesses innate charisma that makes others feel good in his presence. a Uses visioning as the essence of leadership. Transformational leadership relies heavily on visioning as the core of leadership.

3. A nurse is caring for a client with a fractured arm who has just received a plaster caster. Identify the situation that would put the nurse at the highest risk for malpractice a suit. Failure to keep the care plan updated C Failure to note changes that indicate a circulatory problem, could be used against the nurse if complications arose from treatment - this is an unintentional torts – or Malpractice Failure to keep the care plan updated Notifying the physician that the client is having pain in his arm Failure to note that the client’s fingers are cold with a bluish color Charting that the client did not respond to the pain medication

Improves self-health care Protects the patient's confidentiality
14. You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A non-nursing colleague asks about this code. Which of the following statements best describes this code? Improves self-health care Protects the patient's confidentiality Ensures identical care to all patients Defines the principles of right and wrong to provide patient care. A The code of ethics for nurses is composed and published by ANA (American Nursing Association) Defines the principles of right and wrong to provide patient care.

b Advocate trying to convince the family to honor the patient’s wishes
15. A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: Educator Advocate Caregiver Case manager b Advocate trying to convince the family to honor the patient’s wishes

16. True or False Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: American Nurses Association's (ANA's) Code of Ethics True Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: American Nurses Association's (ANA's) Code of Ethics

17. In which of the following examples is the nurse not applying critical thinking skills in practice? The nurse considers personnel experience in performing intravenous (IV) line insertion and ways to improve performance The nurse uses a fall risk inventory scale to determine a patient's fall risk The nurse observes a change in a patient's behavior and considers which problem is likely developing The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care. d The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care

Disregard what she feels and continue to work independently
18. Katherine is a young Unit Manager of the Pediatric Ward. Most of her staff nurses are senior to her, very articulate, confident and sometimes aggressive. Katherine feels uncomfortable believing that she is the scapegoat of everything that goes wrong in her department. Which of the following is the best action that she must take? Identify the source of the conflict and understand the points of friction Disregard what she feels and continue to work independently Seek help from the Director of Nursing Quit her job and look for another employment. A Identify the source of the conflict and understand the points of friction . This involves a problem solving approach, which addresses the root cause of the problem.

19. The document that defines and limits the scope of nursing practice in that state is
standards of care. b. regulation of practice. c. American Nurses Association code. d. nurse practice act. D It is the nurse’s responsibility to know the nurse practice act in his or her state.

20. The new LPN/LVN is very concerned regarding what should or should not be done for patients. Select the answer that will provide this information for her. a. state nurse practice act b. standards of care c. scope of nursing practice d. professional organizations B Standards of care define what should or should not be done for patients.

21. One difference between a leader and a manager is that a:
Correct: The terms leadership and management are often used interchangeably, and it is difficult to discuss one without discussing the other. However, these roles have specific traits unique to themselves. The manager is the coordinator of resources (time, people, and supplies) needed to achieve outcomes. Incorrect: Authority is the legitimate right to direct others that is given to a person by the organization through assignment to an authorized position such as a nurse manager. b. It is the nurse leader who has the ability to guide or influence, as well as to motivate and inspire, others on the team. d. Managers are assigned responsibility for accomplishing the goals of an organization. a. leader has legitimate authority. b. manager motivates and inspires others. c. manager focuses on coordinating resources. d. leader focuses on accomplishing goals of the organization.

Unlicensed assistive personnel (UAP)
22. A patient is admitted with hypotension, shortness of breath, flushing, and hives. All levels of staff have been trained to assess vital signs. Given budget restrictions and proper delegation rules, to which care provider would the RN delegate the task of obtaining the initial blood pressure reading? A - Correct: The patient’s condition is not stable; therefore, the skills of an RN are required. Incorrect: b. The assessment expertise of an RN is needed because of the unstable nature of the patient’s condition. c. Obtaining a baseline set of vital signs for an unstable patient would be considered high-risk delegation for a UAP. d. The patient’s condition is very dynamic; assessments will have to be completed by the RN on admission and then as indicated by the stability of the patient. a. RN b. LPN/LVN c. Unlicensed assistive personnel (UAP) d. Use the blood pressure obtained in the ambulance, because it was assessed via electronic monitoring.

23. A manager a. Leads by example b. Gives bed baths c. Transforms their employees d. Handles the day-to-day operations to achieve a desired outcome D A manager Handles the day-to-day operations to achieve a desired outcome Incorrect: Is incorrect because leaders lead – managers mange Is incorrect because while a manager under unusual circumstances might give a bed bath it is not in her regular scope of duties Is incorrect because that is a function of a transformational leader not a manager

24. A manager needs to have what skills (select all that apply)
A, B, C A manager needs to be able to think critically and solve complex problems. Critical thinking is the disciplined, intellectual process of applying skillful reasoning as a guide to belief or action. In nursing, critical thinking for clinical decision-making is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care. They need to be able to communicate effectively as they will be directing others in what needs to be done and when it needs to be done as well as dealing with patients, family, other departments, and administration. The manager also needs to be a good nurse – compassionate, caring, and have strong skills – this will enable them to help their staff when necessary, act as a mentor, preceptor and coach. Also it enables them to understand the needs of their staff when making assignments. a. Critical Thinking b. Effective Communication Skills c. Strong Nursing skills d. Be able to intubate a patient

25. What is the nursing process?
Assessment, evaluate, plan, implement Assess, diagnose, implement , plan Assessment, Analysis and diagnosis, plan, implement plan, evaluate Look at the patient, talk to the family, make a care plan C Assessment, Analysis and Diagnosis, Plan, Implement plan, Evaluate

26. A nurse manager wants his nursing unit to be a place where all nurses want to work, where patient satisfaction is high, and care is innovative and interdisciplinary. Staff are encouraged to chair taskforces to improve quality of care and he counsels staff in areas of measuring patient outcomes. Other managers want to mimic this manager’s approach to improve their own units. This nurse is which type of leader? A Correct: Transformational leaders mentor followers through a vision and are admired and emulated. Incorrect: b. Transactional leaders are concerned with day-to-day activities rather than visionary leadership. c. Laissez-faire leadership lack vision, provide little guidance and feedback. d. Authoritative leadership accepts little or no input from staff, makes decisions alone. a. Transformational b. Transactional c. Laissez-faire d. Authoritative

27. What are the 5 “Rights” of delegation?
Right patient, right medication, right dose, right time, right route Right person, right patient, right task, right attitude, right place Right task, right circumstance, right person, right directions, right supervision and evaluation Right place, right time, right circumstance, right person, right doctor C 5 Rights of Delegation Right Task Right Circumstances Right Person Right Direction Right Supervision and Evaluation

28. A nurse tells a patient, “This PM you are going for an abdominal A&P, an H&H, as well as an IV pyelogram. Please sign these consent forms.” The use of medical jargon can cause: C Jargon is terminology unique to people in a special type of work and is not understood by everyone. Although jargon does speed communication and is clear to those who know it, it may be misinterpreted and not understood by all people. a. understanding. b. speed in communication. c. misinterpretation. d. clarity in the message.

B The LPN/LVN functions under the Nurse Practice Act.
29. The document in which the role and responsibilities of the LPN/LVN are identified is the: B The LPN/LVN functions under the Nurse Practice Act. a. NLN Accreditation Standards. b. Nurse Practice Act. c. NAPNE Code. d. American Nurses’ Association Code.

30. Team nursing Is done by a nurse and a CNA
Provides care to a group of patients by a group of nurses and CNAs Is when 1 nurse has 8 patients to care for Defined in the Nurse Practice Act B Provides care to a group of patients by a group of nurses and CNAs

31. Leadership is defined as
The coordination of people, time, and supplies to achieve desired outcomes, Seeing that resources are used appropriately – with conservation in mind Maintaining control of the day-to-day operations The art of getting others to want to do something you are convinced should be done D The art of getting others to want to do something you are convinced should be done

32. Which of the following statements is NOT true about performance appraisal?
A. Informing the staff about the specific impressions of their work help improve their performance B. A verbal appraisal is an acceptable substitute for a written report C. Patients are the best source of information regarding personnel appraisal D. The outcome of performance appraisal rests primarily with the staff. C Patients are the best source of information regarding personnel appraisal. The patient can be a source of information about the performance of the staff but it is never the best source. Directly observing the staff is the best source of information for personnel appraisal.

33. Ethical means A. The way one should act/ behave B. Doing what is required by law C. Doing what the patient’s family asks even if it isn’t what the patient wants D. Defines the principles of right and wrong to provide patient care A Ethical means “The way one should act/ behave” Nurses are charged with using ethical concepts in their delivery of patient care. Ethical concepts include providing care which is good, correct, and rational.

34. An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation? a. Autocratic b. Democratic c. Laissez-faire d. Referent A Autocratic – there isn’t time to discuss and reach consensus things have to be done immediately

D Ethical is ““The way one should act/ behave””
Always doing what your charge nurse asks without question b. Doing what the family wants because it will keep the patient alive c. Doing what is required by law d. “The way one should act/ behave”

Administer an enema for an elective surgery patient.
36. Which task is most likely to be considered in a state’s practice act as appropriate to delegate to a LPN/LVN if the patient’s condition is stable and competence in the task has been established? a. Administer an enema for an elective surgery patient. b. Administer an antiarrhythmic medication IV while interpreting the patient’s rhythm on the cardiac monitor. c. Develop a plan of care for a stable patient admitted for observation after a head injury. d. Teach a patient how to instill eye drops for glaucoma. A Correct: The RN who is delegating must consider the following: (1) the delegatee’s current workload and the complexity of the task, (2) whether the staff member is familiar with the patient population and with the task to be performed, and (3) whether the RN is able to provide the appropriate level of supervision. The delegation decision-making tree would also support delegation of this task. Incorrect: b. Administration of an antiarrhythmic drug requires the skill of an RN to evaluate outcomes, especially when it is administered IV because of its fast rate of distribution. c. Only an RN can develop the patient’s plan of care, although others may assist in updating information. d. The task of teaching is limited to RNs

37. The nurse caring for a patient states, “Your blood pressure is dangerously high. Are you taking antihypertensive medicine?” The patient states, “I can’t afford my medicine. I have no insurance.” The nurse states “I feel really sorry for that patient. I wish it wasn’t against policy to give her money.” The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that “She was so sick last evening when she came to the ED. I can’t believe they don’t provide insurance. I can’t give her money but you all can help.” This nurse: B Correct: The National Council State Board of Nursing’s policy on social media prohibits posting of patient information on social media sites. This patient could be identified by knowing where she works and the fact that she was seen in the ED the day before. Incorrect: a. The nurse is showing empathy but she violated patient confidentiality when she put the patient’s occupation, place of work, and fact she was seen in ED the night before on Facebook. c. It is against Negligence to place any patient information on social media. d. Slippery slope is the belief that one event will inevitably follow another without any real support for that belief a. is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines. b. is at risk for HIPAA violations. c. has properly followed policy and protected the patient by not using her name. d. is demonstrating the logical fallacy of slippery slope.

38. When choosing to delegate, the nurse should delegate the task to the most qualified person or to the person he or she wishes to: A Correct: Delegating is giving other people tasks to be accomplished. The benefits of delegation involve (1) assisting in developing the initiative, skills, knowledge, and competence of others; (2) maintaining the level of responsibility and decision-making of others; (3) freeing time for more important tasks; (4) extending results that can be accomplished from what one person can do alone to what he or she can manage through others; and (5) ensuring that completing the task is cost effective. Incorrect: b. Delegating an activity to a person for promotion is not appropriate; the act of delegating requires multiple considerations, and promotion is not one of them. c. Delegating to punish a person is not appropriate; that person may sabotage the goal to be accomplished. d. Delegating is a process that is used to attain a goal, not to reward a person for a job well done a. develop. b. promote. c. punish. d. reward.

39. A new graduate nurse is preparing for an interview for her first position and knows that: (Select all that apply.) C, D, E Correct: c. Internal dialogue establishes a means for the graduate to recall achievements that will lead to success in the first nursing position. d. Jobs such as cashier at a convenience store or dog-sitting can demonstrate responsibility such as handing cash or arriving on time. e. Arriving too early may cause the recruiter to feel rushed and arriving too late may demonstrate lack of time management and professionalism. Incorrect: a. The primary goal for the first job is to find good match that fits the nurse’s abilities, lifestyle, and career aspirations. b. Interviews should be set up prior to graduation a. the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school. b. appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position. c. self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners. d. work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio. e. it is best to arrive 10 to 15 minutes before the scheduled interview dressed for success.

40. A nurse preparing a resume for the first position is anxious to demonstrate all achievements, which included completing a rigorous accelerated program and maintaining a high GPA while also serving in many community projects and leadership positions. The applicant finds it impossible to include all the accolades on one page and researches tips for professional cover letters and resumes and learns: A, E Correct: a. Ample margins—minimum of 0.5 inch (1 inch preferred)—should be used on all four sides to prevent appearing cluttered. e. A statement declaring this position is one’s first choice should be included. Incorrect: b. The paper should be white or ivory and on heavy bond paper, never bright colored. c. Legal size paper is not acceptable. Seek help from a professional to determine what to include and what can be placed in a portfolio. d. The applicant should write from their own perspective and writing style tailored to the position. a. margins should be at least 0.5 inch on all four sides, making conciseness important. b. paper should be bright colored to catch the attention of the recruiter. c. legal size paper may be used when applicants have many accolades or extensive work history. d. standardized cover letters present a professional image as opposed to those that stress the applicant’s perspective too heavily. e. include in the cover letter that after researching other position, this is the applicant’s preference.

41. A nurse is hoping for a promotion and seeks the help of a coach to improve time management skills. The first task assigned by the coach is for the nurse to list all external distractors that prevent organization and completion of tasks. The nurse would include: A, C Correct: a. Waiting, such as for meetings or oncoming shift, is an external distraction. c. Socializing with visitors is an external distraction. Incorrect: b. ineffective delegation is an internal distraction. d. Daydreaming about an upcoming vacation is an internal distraction. e. Surfing the Internet after using it wisely to ensure patient safety is an internal distractor. a. waiting for oncoming shift to start walking rounds. b. failure to delegate tasks to the Licensed Practical Nurse and Unlicensed Assistive Personnel and instead, completing task herself. c. talking with a patient’s family member who is also a personal friend. d. spending time thinking about the vacation to the beach. e. using the Internet to read about a new drug that will be administered; then taking time to look for news about the profession, new legislation about the Patient Protection and Affordable Care Act, and new uniforms for the season.

42. A nurse hopes to improve time management skills using the ABC prioritization approach. Which tasks would be prioritized as “B”? (Select all that apply.) a. Turn in time sheet due in 3 days. b. Review dress code policy to give feedback before appointment in the morning. c. Perform blood glucose test on a patient admitted with Kussmaul respirations and change in level of consciousness. d. Complete patient teaching prior to discharge in 2 hours. e. Review procedure for inserting a PIC line to assist with procedure later this morning. B, D, E Correct: b. Task that fall within Priority B include the medium-value items, such as tasks that are not urgent but most likely will not “fall” off the list. Since the dress code must be reviewed and feedback constructed for a morning appointment, this would be level B, it is not urgent nor will it likely fall off the list. d. Completing patient teaching for a patient to be discharged in 2 hours must be completed but does not take priority over “A” tasks. e. Reviewing a procedure to be performed later in the day is Level “B”. Incorrect: a. Turning in a time sheet due in 3 days is level C. c. Performing a blood sugar test on an unstable patient is level A.

Resources that need to be managed include: (Select all that apply.)
People Time Supplies Patients Vendors A, B, C Resources include the: personnel, time, and supplies needed to accomplish the goals of the organization. Incorrect: D, E Patients are not resources they are customers A vendor is not a resource

Authority from the organization Strong nursing skills
44. What skills/ abilities must a good manager have?: (Select all that apply.) Authority from the organization Strong nursing skills Strong problem solving skills Effective Communication skills Where does she fit into the organization B, C, D, E A good manager must have: Strong nursing skills Strong problem solving skills Effective Communication skills, and Know where she fits into the organization Incorrect: A Authority is given it is not a skill

Margins should be at least 0.5 inches on all 4 sides
45. A student is really anxious to get everything they have ever done on their resume but they have way to much “stuff” to fit on one page. The student needs to remember (select all that apply) Margins should be at least 0.5 inches on all 4 sides Paper should be brightly colored to get their attention ‘legal sized paper may be used when you have a lot to share Standardized cover letters are the professional way to make a first impression Include in the cover letter that after researching other positions this is the one the student prefers A and E The answer is A and E You need to have ample margins – 1” is preferred and a statement that this is your preferred position should be included in your cover letter It can’t be “B” because the paper should never be colored but if you want to make a real impression use heavy bond paper, and “C” is incorrect because you NEVER use legal sized paper If you have too much put some of it into your portfolio and only include what relates specifically to this job application – match your resume to what was posted in the advertisement “D” is wrong because that is a form letter and you want this to be original and specific to the person that will be interviewing you

46. A patient asks, “What is an advance directive
46. A patient asks, “What is an advance directive?” The nurse explains that examples of advance directives are: (Select all that apply.) a. preserving cord blood for possible future needs of a child. b. providing instructions that life-sustaining medical procedures should be withheld in the event of a terminal situation. c. giving someone the legal right to act on one’s behalf when one becomes incapacitated. d. completing hospital admission paperwork before being admitted to the hospital B, C Advance directives document an individual’s desires regarding end-of-life care. These wishes are generally stated through the execution of a formal document known as the living will. Right-to-die statutes vary from state to state; therefore, nurses must become familiar with their state-specific statute. Incorrect: a. Advance directives identify client wishes in terms of the right to die; they are not directives to help prevent illness or terminal illness. d. Completing hospital paperwork is part of the preadmission process. The client could bring his or her living will to the hospital on admission, but this document would have been prepared prior to the admission and is not part of the hospital documentation paperwork

Actually observe the delegatee perform the assigned task.
47. A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel. What is the best way for the nurse to determine competency of the delegatee? A Correct: The best way for the nurse to determine the competency of LPNs or UAPs is to observe them perform the task and check on them regularly throughout the shift. Incorrect: b. Asking the delegatee may inform the nurse of how many times the task has been performed but will not provide evidence of competency. c. Patients may be able to rate their satisfaction with care but cannot judge the competency of the LPN or UAP. d. The opinion of other nurses can be used to validate the nurse’s findings, but only firsthand observation can provide evidence of competency. a. Actually observe the delegatee perform the assigned task. b. Ask the delegatee how many times he/she has performed the task. c. Ask the patient if the care provided was satisfactory. d. Ask other nurses if they feel the delegatee is competent.

48. Burnout is (Select all that apply.):
Emotional exhaustion, A sickness healed through medication Physical exhaustion, Spiritual exhaustion All of the above Correct: A, C, D Burnout is when the nurse has given all that she has physically, emotionally, and spiritually and she has totally bankrupted her self. She is no longer able to continue on. Incorrect: It is not “B” because it is not an illness that can be cured by medication which eliminated “E”

49. Team Nursing, and Primary Care Nursing are Nursing Delivery Systems
True False A - True Team Nursing, and Primary Care Nursing are Nursing Delivery Systems - True

50. A Leader (Select all that apply.):
Often doesn’t have delegated authority Emphasizes interpersonal relationships Directs willing follower(s) Determines a task that can be done by a non licensed individual All of the above A, B, C A leader often doesn’t have delegated authority they lead by the shear power of their personality, they frequently emphasize interpersonal relationships, and they direct willing followers Incorrect: D-Determining a task to asign an unskilled worker is not part of leading that is managing therefore E is wrong as well

Leadership PVN 151 Day 4 September 30, 2014

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Leadership PVN 151 Day 4 September 30, 2014

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