Leadership SG 1

A complete set of vocabulary flashcards covering leadership, management, clinical judgment, delegation, quality improvement, conflict resolution, and holistic care based on the lecture notes.

Management

The coordination of organizational work using formal authority and power through planning, organizing, staffing, directing, and controlling.

Leadership

The process of inspiring others toward desired outcomes, which can exist without formal management authority or title.

Autocratic Leadership

A leadership style where the leader makes group decisions, uses coercion for motivation, and communicates down the chain of command.

Democratic Leadership

A leadership style where the leader includes the group in decisions, supports achievements, and communicates up and down the chain of command.

Laissez-Faire Leadership

A permissive leadership style with minimal planning and few decisions made by the leader, leaving staff responsible for motivation.

Transactional Leader

A leader who focuses on immediate problems, maintains the status quo, and uses rewards to motivate followers.

Transformational Leader

A leader who empowers followers and inspires a shared long-term vision.

Bureaucratic (Authentic) Leader

A leader who models a strong internal moral code and leads by example.

Situational Leader

A leader who adapts their leadership style to the situation, potentially combining autocratic and democratic approaches.

Emotional Intelligence

The ability to perceive, understand, and manage emotions in oneself, clients, families, and team members to support quality client care.

Planning

The management function determining what must be done, how it will be done, and who will do it.

Organizing

The management function establishing the authority structure, communication channels, and decision-making structure.

Staffing

The management function that handles staff acquisition, staff management, and staffing mix.

Directing

The management function focused on influencing and motivating staff to accomplish organizational goals.

Controlling

The management function that evaluates staff performance, evaluates goals, verifies outcomes, and conducts audits.

Critical Thinking

The foundational skill for clinical decisions involving questioning, synthesis, intuition, analysis, evaluation, and inference to examine data and seek solutions.

Clinical Reasoning

The process of analyzing clinical situations, making decisions, and continuing reasoning as a client's status changes.

Clinical Judgment

A clinical decision based on data analysis that considers client needs, client responses, and desired outcomes.

Tanner Model

A clinical judgment model consisting of four phases

Noticing

Interpreting

Responding

Reflecting

Nursing process

Assessment

Analysis

Planning

Implementation

Evaluation

PN process

Data collection

Planning

Implementation

Evaluation

ATI Clinical Judgment Action Model

A model linking NCLEX clinical judgment with nursing education through six actions:

Recognize cues

Analyze cues

Generate solutions

Take actions

Evaluate outcomes.

ATI Clinical Judgment Action Model (RAGTE) vs Tanner Model (NIIRR)

Recognize cues:

• Assessment

• Noticing

Analyze cues:

• Analysis

• Interpreting

Generate solutions:

• Planning

• Interpreting

Take actions:

• Implementation

• Responding

Evaluate outcomes:

• Evaluation

• Reflecting

Maslow's Hierarchy (Prioritization)

A prioritization framework placing physiological needs like airway, breathing, and circulation before safety, security, and socialization.

ABC Framework

A prioritization framework focusing on Airway first, Breathing second, and Circulation third, sometimes including Disability and Exposure.

Foundation for clinical decisions

Skills:

• Questioning

• Synthesis

• Intuition

• Application

• Creativity

• Interpretation

• Analysis

• Evaluation

• Inference

• Inductive reasoning

• Deductive reasoning

• Explanation

Analyze client problems

Examine available data

Use reasoning

Consider broad perspectives

Seek solutions for:

• Clients

• Staff

• Organization

Critical Thinking

Analyze clinical situations

Make decisions

Continue reasoning as client status changes

Develop through accumulated knowledge and skills

Includes:

• Assessing data

• Compiling data

• Selecting relevant data

• Discarding irrelevant data

• Applying nursing knowledge

• Problem-solving

Clinical Reasoning

Clinical decision based on data analysis

Considers:

• Client needs

• Client response

Nurse actions:

• Analyze data and evidence

• Interpret data and evidence

• Apply knowledge

• Determine desired or achieved outcomes

Clinical Judgment

Five Rights of Delegation

Guidelines for safe delegation consisting of

Right Task

Right Circumstance

Right Person

Right Direction/Communication

Right Supervision/Evaluation.

Consider:

• Repetitiveness

• Required supervision

• Invasiveness

Follow:

• Standards of practice

• Legal guidelines

• Facility policy

• Available resources

Right:

• AP assists client with pneumonia to use bedpan

Wrong:

• AP administers nebulizer treatment

Right Task

Assess:

• Client status

• Care complexity

• Team-member workload

Right:

• AP obtains vital signs on stable postoperative client

Wrong:

• AP obtains vital signs after naloxone for respiratory depression

Right Circumstance

Verify:

• Scope of practice

• Competence

• Training

Review performance

Remediate deficiencies

Right:

• PN administers enteral feeding to client with head injury

Wrong:

• AP administers enteral feeding to client with head injury

Right Person

Communicate:

• Data to collect

• Reporting method

• Reporting timeline

• Findings requiring reporting

• Specific task

• Client-specific instructions

• Expected result

• Follow-up expectations

Right:

• AP assists room 312 client with shower before 0900

• AP reports completion

Wrong:

• AP assists room 312 client with morning hygiene

Right Direction/Communication

Delegating nurse:

• Provides direct or indirect supervision

• Gives clear expectations

• Monitors performance

• Provides feedback

• Intervenes for unsafe practice

• Evaluates client outcomes

• Evaluates task completion

• Identifies quality improvement needs

• Identifies additional resource needs

Right:

• Delegate ambulation to AP

• Observe safe ambulation

• Give feedback

Wrong:

• Delegate AP supervision to another AP

Right Supervision/Evaluation

Assignment Despite Objection (ADO)

A legal protection and union form filled out by a nurse to formally protest an unsafe staffing assignment.

Direct Observation of Procedural Skills (DOPS)

An educational assessment tool used by an evaluator to grade a nurse's technical skills.

Quality Improvement Process

A systematic process involving standard development, issue identification, interprofessional team analysis, benchmark comparison, root cause analysis, and corrective action.

Outcome vs Structure vs Process Indicators

Quality improvement indicators that measure client outcomes.

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Quality improvement indicators evaluating the setting and available resources.

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Quality improvement indicators evaluating how care is delivered.

Outcome Indicators

Quality improvement indicators that measure client outcomes.

Structure Indicators

Quality improvement indicators evaluating the setting and available resources.

Process Indicators

Quality improvement indicators evaluating how care is delivered.

Root Cause Analysis

A problem-solving process commonly used for sentinel events to examine surrounding factors, cause relationships, and underlying root causes.

Core Measures

National standardized measures from The Joint Commission used to improve outcomes, measure results, and support accreditation.

Structure Audit

An audit evaluating the care environment and available resources.

Process Audit

An audit evaluating the actual care provided to clients.

Outcome Audit

An audit evaluating the results or outcomes of nursing care.

Novice Stage (Benner)

The initial stage of nursing practice characterized by minimal experience, reliance on theoretical knowledge, and rule-based practice.

Advanced Beginner Stage (Benner)

The nursing stage where a nurse performs many tasks independently, demonstrates basic clinical judgment, and utilizes prior experience.

Competent Stage (Benner)

The nursing stage reached after 2 to 3 years of practice, characterized by analytical care planning, increased skill, and outcome anticipation.

Proficient Stage (Benner)

The nursing stage marked by significant experience, holistic understanding, strong critical thinking, and rapid recognition of unexpected changes.

Expert Stage (Benner)

The advanced nursing stage characterized by extensive experience, intuitive decision-making, and minimal reliance on explicit rules.

Progressive Discipline

A stepwise disciplinary process for minor infractions moving sequentially from informal reprimand to written warning, suspension, and termination.

Latent

The stage of conflict where underlying risk factors or preconditions are present.

Perceived

The stage of conflict where a problem is logically recognized by the involved parties.

Felt

The stage of conflict where emotional responses such as stress or anxiety develop.

Manifest

The stage of conflict where open, observable actions or communication take place.

Aftermath

The stage of conflict representing the positive or negative short- or long-term effects following resolution.

Avoiding/Withdrawing Strategy

A lose-lose conflict resolution strategy where the conflict is ignored, appropriate mainly for minor issues.

Smoothing Strategy

A lose-lose conflict resolution strategy that emphasizes agreement while leaving the core conflict unresolved.

Competing/Coercing Strategy

A win-lose conflict resolution strategy where one party wins at the expense of others, useful for rapid decisions.

Cooperating/Accommodating Strategy

A lose-win conflict resolution strategy where one party yields something so that the other party gains.

Collaborating Strategy

A win-win conflict resolution strategy where both parties pursue a shared goal together.

Assertive Communication

Direct, honest, nonthreatening communication that respects rights, uses 'I' statements, and treats others as equals.

Cost-Containment vs Cost-Effective Care

A systems-focused financial strategy aimed at controlling overall organizational expenses and setting spending caps.

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A value-focused approach to care that explicitly measures and maximizes clinical outcomes relative to financial cost.

Cost-Containment

A systems-focused financial strategy aimed at controlling overall organizational expenses and setting spending caps.

Cost-Effective Care

A value-focused approach to care that explicitly measures and maximizes clinical outcomes relative to financial cost.

Holism

The view that an integrated whole has a reality independent of and greater than the sum of its parts.

Holistic Nursing Model

A care model where a patient's spiritual nature and needs are brought into equal focus with their cognitive and physiological needs.

Undifferentiated Faith

The spiritual development stage during infancy where trust, hope, and love develop through early caregiving.

Intuitive-Projective Faith

The spiritual development stage for ages 3–6 where faith is shaped by stories, examples, emotions, and imitation.

Mythic-Literal Faith

The spiritual development stage for ages 7–12 where beliefs and religious stories are understood concretely to reinforce belonging.

Synthetic-Conventional Faith

The spiritual development stage for ages 13–20 where faith helps form identity and worldview influenced by experiences outside the family.

Individuative-Reflective Faith

The spiritual development stage for ages 21–30 where personal beliefs become independent, reflective, and self-defined.

Conjunctive Faith

The spiritual development stage for ages 31–40 where spiritual maturity grows alongside social awareness and conscience.

Universalizing Faith

The spiritual development stage for ages 40 and older centered on universal love, justice, and concern for all humanity.

Task Factors Before Delegation

Predictability:

• Routine?

• Predictable outcome?

• New treatment?

Potential harm:

• Bleeding risk?

• Aspiration risk?

• Unstable client?

Complexity:

• Complex task?

• Legally permitted?

• Required skill present?

Problem-solving:

• Nursing judgment required?

• Unique assessment required?

Client interaction:

• Psychosocial support needed?

• Education needed?

Delegation Limits

Nursing process

Client education

Clinical judgment

Tasks Delegated to AP

ADLs

Bathing

Grooming

Dressing

Toileting

Ambulation

Feeding without swallowing precautions

Positioning

Routine tasks

Bed making

Specimen collection

Intake/output

Vital signs for stable clients

Similar-age roommate

Tasks Delegated to PN

Monitor findings for RN assessment

Reinforce standard teaching

Tracheostomy care

Suctioning

Check NG tube patency

Enteral feedings

Insert urinary catheter

Administer medications

• IV medications excluded in some states

Immediate Tasks

Analgesic or antiemetic administration

Unstable client assessment

Time-Specific Tasks

Routine medications

Vital signs

Blood glucose checks

End-of-Shift Tasks

Ambulation

Routine dressing changes

Time Savers vs Time Wasters

Document care soon after completion

Group nearby activities

Estimate task duration

Gather equipment before procedure

Plan and prioritize

Delegate when needed

Use team approach

Complete difficult tasks when energy high

Limit poorly timed interruptions

Set realistic standards

Finish one task before starting another

Break large tasks into smaller tasks

Use written care plan

Socialize during breaks

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Delay all documentation until shift end

Repeated supply-room trips

Perform care without considering other responsibilities

Begin procedure without needed equipment

Manage by crisis

Under-delegate

Avoid asking for help

Procrastinate

Accept lower-priority tasks

Set unrealistic expectations

Start multiple incomplete tasks

Ignore skill deficits

Provide care without a plan

Socialize during client care

Progressive Discipline

First	Informal reprimand and improvement plan
Second	Written warning and policy review
Third	Suspension with or without pay
Fourth	Termination