Transitions Exam 2 (to study)

Which document states that nurses are required to "create an ethical environment and culture of civility and kindness, treating colleagues, coworkers, employees, students, and other with dignity

and respect"?

Code of Ethics for Nurses with Interpretive Statements

What percentage of workplace violence incidents are significant enough to warrant physical intervention?

1/3 or 33%

The Ecological Occupational Health Model of Workplace Assault outlines six components related to workplace violence, name them:

1. Pt factors

2. Personal worker factors

3. Workplace (hospital/unit) factors

4. Work environment

5. Acts of WPV

6. WPV consequences

What does the word "STAMPEDAR" stand for?

- Staring

- voice Tone & volume

- Anxiety

- Mumbling

- Pacing

- Emotions

- Disease process

- Assertive / non-assertive behaviors

- Resources

When de-escalation techniques are not effective and a person's behavior escalates to physical violence, what should only be used as a last resort?

Physical restraints

Define incivility according to the American Nurses Association

Rude & discourteous actions of gossiping & spreading rumors, & of refusing to assist a coworker

Define bullying according to the American Nurses Association

Repeated, unwanted, harmful actions intended to humiliate, offend, and cause distress in the recipient

Which classification of violence is most common in healthcare settings (according to Gosselin and Ireland)?

Client (pt) - on - worker

______________________, ________________________, and ______ _________________

are the commonly reported interventions aimed at reducing incivility and bullying behaviors in the nursing workplace.

- Education, training, & skill building

Primary WPV

- Involves education & other measures to identify & reduce vulnerabilities

- Improving interpersonal & interprofessional relationships

Secondary WPV

Reduce harm once an incident of WPV has begun

Tertiary WPV

Decrease consequences associated with a WPV event

Individuals who witness workplace violence and do not acknowledge it, individuals who choose to ignore it, and individuals who fail to report it are in fact doing what?

Perpetuating it

In the American Nurses Association 2015 publication Nursing: Scope and Standards of Practice, how many standards address the obligation of RNs to act in a manner that is consistent with maintaining the personal safety, civility, and respect of patients, coworkers, and other individuals?

6

Clinical ladder programs were originally designed by nursing leadership to ______________, _________________, and _____________ bedside nurses.

- Promote, retain, and reward

Progression within a clinical ladder program is demonstrated by the bedside nurses' ability to meet defined criteria in

- Clinical excellence, including skills & competence

- Professional expertise through increased education or pt-focused project execution

Which framework has been used by many organizations as a foundation for designing a clinical ladder program?

Patricia Benner's novice to expert framework

Describe the overarching theme that is essential for the success of a clinical ladder program

Organizational culture

Describe the subthemes that contributed to the success of a clinical ladder program

- Education & experience

- Competence & critical thinking

- Compensation & institutional cost

- Job satisfaction & retention

Evidence suggests that clinical ladder programs are more successful when participation is

Voluntary

What is the purpose of peer review?

To ensure that pt care is being delivered according to clinical practice standards, achieving an optimal level of quality.

What is the ultimate goal of peer evaluation?

Empowering nurses to hold each other accountable for high quality care, which leads to an increase in autonomy, competency, and professional growth

List the practice principles of nursing peer review

- A peer is someone of the same rank

- Peer review is practice focused

- Feedback is timely, routine, & a continuous expectation

- Peer review fosters a continuous learning culture of pt safety & best practice

- Feedback is NOT anonymous

- Feedback incorporates the nurse's development stage

List the different types of peer review

- In the moment collaboration

- Just in time feedback

- Holistic peer evaluation

State the differences among the different types of peer review

- In the moment collaboration→ nurses work together as partners; real time feedback

- Just in time feedback→ delivered immediately after an event; offers concrete & credible suggestions

- Holistic peer evaluation→ given at a set time; providers reflection on practice over time

Define what is meant by each letter in a SMART goal

Specific

Measurable

Achievable

Realistic

Time constrained

Authentic leadership is rooted in what discipline?

Positive psychology

State the values that are the underpinnings of authentic leadership

- Honesty

- Trust

- Integrity

Name three common relational leadership styles

- Transformational

- Servant

- Authentic

State the constant characteristics of authentic leaders

- Self-awareness

- Internalized moral perspective

- Relational transparency

- Balanced decision making

This leadership style has a commitment to a vision and empowers others to achieve that vision

Transformational

What degree, at a minimum, should top level management positions hold?

Master's degree

The foundation of leadership on a nursing unit is based on what position?

The leader

What is the relationship between nursing staff satisfaction and patient satisfaction?

If nursing staff have effective leadership then they have higher satisfaction → higher patient satisfaction

Leadership style affects staff __________________ and _______________________

Satisfaction and retention

______________________ and _____________ - _________________________ are among the greatest challenges leader have to face

Communication and relationship-building

Creating a _____________ _________ _______________________ is vital for nurse leaders to promote nurses' professional growth and physical and psychological health.

Healthy work environment

What two major leadership styles were identified to help leaders inspire and motivate nurses?

1. Authentic

2. Transformational

Definition of "Nurses Eat their Young"

Behavior that is directed by one peer toward another that harms, disrespects, and devalues the worth of the recipient while denying them their basic human rights

Are Men or Women More Likely to Self-Report Lateral Violence?

Men

What % do you think of New Graduate nurses Left their 1st position because of Lateral Violence and poor resolution of coworker conflict?

60%

Oppression theory

- When 2 groups exist and one has more power than the other, oppression occurs and dominant group becomes more powerful

3 "qualities" that make up the Oppressed Group Model

- Low Self-Esteem

- Feelings of Powerlessness

- Self-hatred

Physical effects of LV

- Weight loss/gain

- Sleeplessness

- Illnesses

Emotional/Psychological effects of LV

- Depression

- Anxiety

- Low self-esteem

- Feelings of isolation

- Low morale

- Substance abuse

- Suicidal behaviors

Professional & Organizational effects of LV

- Lower job satisfaction

- Burnout

- Decreased employee productivity

- Higher sick leave

- Absenteeism

- Leaving the organization (increased staff turnover)

Effect of LV on Pts

- Poor communication

- Poor pt care

- Pt safety

Regulatory Agencies for Nursing

- Joint commission

- OSHA

3 Strategies for Reducing LV

1. Education

2. Leadership

3. Policy & environmental change

3 Strategies for Reducing LV: 1. Education

- 1st step in prevention

- Self-reflection

- Learn about your organizations policies

- Learn teamwork

- Take care of yourself

- How to address/intervene (assertiveness training)

- Consequences

Cognitive Rehearsal

- Interrupt the violence

- The person who receives inappropriate behavior stops, stays calm, and avoids processing the event as a personal insult

Possible Responses to Lateral Violence in the Workplace

- Verbal abuse

- Nonverbal abuse

- Overhearing someone talking about you

- Backstabbing

- Lack of respect

Define Performance

- Execution of an action

- Something accomplished

- The fulfillment of a promise, claim, or request

Define Performance Appraisal

- The process by which a manager examines and evaluates an employee's work behavior by comparing it with present standards, documents the results of the comparison and uses the results to provide feedback to the employee to show where improvements are needed and why

Define Performance Management

- Focuses on the performance of an organization, a department, employee, or processes that build a product or services

- Includes activities which ensure that goals are consistently being met in an effective and efficient manner

Define Peer Review

Process by which nurses systematically evaluate the quality of nursing care provided by peers as measured against professional standards

Define Self-Evaluation

An employee does a self-assessment of their own perceptions about their performance compared with stated objectives and expectations

Performance Management vs. Performance Appraisal

Management:

- Dynamic, continuous process

- Improves organizational effectiveness

- Strategic goals

Appraisal:

- Annual event

- Formal review

- Last step in the performance process

Goals of Performance Appraisal

- Improve performance

- Improve communication

- Reinforce positive behavior

- Communicate about & ultimately correct negative or less-than-optimal behaviors

- Provide a basis for rewards

- Identify learning needs & develop personnel

- Identify a basis for termination

Steps for a Performance Appraisal

Step 1: Assess institutional & personal needs & set goals

Step 2: Establish objectives and time frames

Step 3: Assess progress

Step 4: Evaluate progress

What is an Informal Appraisal?

- Day-by-Day supervision or coaching

- Recognizing the individual for a job well done

What is a Formal Appraisal?

- Starts when an individual is hired & ends when they leave

- Done annually

- Includes written documentation

- Formal meeting w/ manager

Components of a Comprehensive Appraisal System

- Job description

- Staff development

- Reward system

Performance Appraisal Methods: Critical Incidents Method

Written record of + & - performance

Performance Appraisal Methods: Management by Objectives

Jointly set goals that are developed & later evaluated

Performance Appraisal Methods: Narrative Methods

Manager writes a statement about employee's performance

Performance Appraisal Methods: Graphic Rating Scale Form

Manager rates employee on a continuum based on a set criteria

Performance Appraisal Methods: Behaviorally Anchored Rating Scales

Performance is rated both quantitatively & qualitatively

Problems with the Performance Appraisal System

- Sources of error

- Tied to compensation

- Employees lack motivation

- Manager & employee don't agree on results

- Management reluctance

- No performance documentation

Alternative Types of Performance Appraisal

- 360 degree evaluation

- Peer review

- Self-evaluation

Employee Feedback & Development

- Counseling

- Coaching

- Mentoring

Define Leadership

Process whereby an individual influences a group of individuals to achieve a common goal

Key Components of Leadership

1. Leadership is a process

2. Leadership involves influence

3. Leadership occurs in groups

Leadership Theories: Trait

Focuses on identifying specific characteristics of leaders

Leadership Theories: Attitudinal

Measures attitudes toward leader behavior

• Impoverished

• Country Club

• Authority-obedience

• Organizational man

• Team

Leadership Theories: Situational

Focuses on observed behaviors of leaders and how leadership styles can be matched to situations

Leadership Styles: Relationship Oriented

- Freedom for subordinates

- Democratic

- Subordinates are allowed to fxn w/in limits

Leadership Styles: Task Oriented

- Authority by the leader

- Authoritarian

- Subordinates are told of the leader's decision

Tranformational leadership

- These leaders cause the followers to rise about their own needs → changing the culture & obtaining higher levels of effort & satisfaction

- Institutional Culture: performance beyond expectation & altered institutional culture

Transactional Leadership

- Leaders identify the needs of followers & providers rewards to meet those needs in exchange for expected performance

- Institutional Culture: effort produced & performance obtained is an expected

4 Components of Authentic Leadership

1. Self-awareness

2. Relational transparency

3. Balanced decision-making

4. Internalized moral perspective

Assigned vs Emergent Leadership

Assigned:

- Occupy a specific position in an organization

Emergent:

- Not assigned by position

Define Referent Power

- Based on followers' identification and liking for the leader

- Ex: Oprah

Define Expert Power

Based on followers' perceptions of the leader's competence

- Ex: nurse educator

Define Legitimate Power

Associated with having status or formal job authority

- Ex: police officer directing traffic

Define Reward Power

Derived from having the capacity to provide rewards to others

- Ex: bonuses & promotions

Define coercive power

Derived from having the capacity to penalize or punish others

- Ex: giving someone a bad assignment

Organizational Power: Position vs Personal

Position:

- Legitimate, reward, coercive

Personal:

- Referent, expert

Management vs Leadership

Produces order & consistency

- Planning & budgeting

- Organizing & staffing

- Controlling & problem solving

Produces change & movement

- Establishing direction

- Aligning ppl

- Motivating & inspiring