Leadership

Leadership

-using individual traits and personal power to interact constructively to resolve problems
-engaging and influencing others
-involves critical thinking, action, and advocacy

Management

-ensuring that people have the necessary resources to get the job done
-leader skills are not required

Clinical nurse leader (CNL)

A highly skilled master's degree-prepared nurse who has completed advanced studies in clinical care with a focus on the improvement of quality outcomes for specific patient populations at the point of care.

Followership

-engaging with others who are leading or managing by contributing to the work that needs to be done
-not a bad thing!!!

Emotional intelligence

an individual's capacity to know themselves and others

Restructuring

-fundamental changes to an organization to achieve greater efficiency or profit
-can be stressful to staff and patients without proper leadership, management, and followership

Appreciative inquiry

-how people question and solve problems
-leverages strengths and positivity

Cycle of appreciative inquiry

definition, discovery, dream, design, destiny

Great Man (Trait) theory

-leaders are born, not made
-innately have a certain set of physical and emotional characteristics that are crucial for inspiring others

Style (behavioural) leadership theory

-considers how leaders behave rather than their traits
-behaviours may be task or relationship oriented
-behaviours can be learned

Situational-contingency leadership theories

-leaders' ability to read the situation and act differently according to different situations
-includes the path-goal theory and the situational leadership theory

Transformational leadership theories

-leaders set higher goals for the group and work together to achieve them
-visionaries
-the four Is (idealized influence, intellectual stimulation, individuated consideration, and inspiration)

Transactional Leadership

-based on leader-follower exchange and a power dynamic (rewards for effort)
-effective managers (the traditional boss)

Authentic leadership theory

-leaders are aware of their own values and moral convictions and are constantly realigning their actions to match their values (moral awareness)
-does not involve consideration of others
-transparent and truthful

Leadership and management competencies

-managing the business
-leading within
-leading people

Mentor

someone who models behaviour, offers advice and criticism, and coaches a mentee to develop a personal leadership style

Imposter phenomenon

self doubt in one's ability to function adequately in one's role

Complexity Science

-how systems adapt and function
-NOT the complexity of the decision to be made

Six Ps of social media use

-professional
-positive
-patient/person free
-protect yourself
-privacy
-pause before you post

Strategic planning

-envisioning the future and developing procedure to actualize that future
-proactive, vision-oriented
-creative and innovative

Strategic planning process

-assessment of internal and external environment
-review mission statement, philosophy, goals, and objectives
-identification of strategies
-implementation
-evaluation

Environmental assessment

-carried out to understand the specific internal and external forces that influence the health care setting
-uses strengths, weakness, opportunity, threat (SWOT) analysis

External environment factors

sociocultural, economic, technological, political/legal, etc.

Internal environment factors

the health care organization's structure, size, programs, financial/human resources, etc.

Mission statement

-reflects the purpose and direction of the health care organization
-defines the core values, patients served, and services offered

SMART goals

Specific, measurable, agreed on, realistic, timely

LEADS framework

-lead self
-engage others
-achieve results
-develop coalitions
-systems transformation

Entrenched workforce

-Baby Boomer generation (generation X)
-prefers a leader who believes in the process of change and is professional

Emerging workforce

-Millennials (generation Y) and generation Z
-prefers a leader with good people skills and a nurturing attitude

Ethics

-specific rules for what is "right vs. wrong"
-involves moral practices, beliefs, and standards
-three branches: meta, normative, and applied

Morality

-code of conduct accepted by a society, group, or individual
-general principles regarding "right vs. wrong"

Meta-ethics

explores the meaning and function of moral language

Normative ethics

concerned with the standards most people use to guide their behaviours (i.e., murder is wrong)

Applied ethics

relates ethical principles to real-life moral issues

Relational Ethics

-ethical questions that take place in relationships (what should I do for others)
-involves engaged interactions, mutual respect, embodied knowledge, uncertainty, vulnerability, and interdependence

Bioethics

-focuses on philosophical questions about science and human life, often in the context of healthcare
-includes autonomy, justice, beneficence, and nonmaleficence

Autonomy

-freedom and right to choose what will happen to one's own person
-informed consent
-must be mitigated by enactment of relational ethics to avoid focusing on an individual at the expense of others

Justice

the concept that everyone should be treated equally and fairly

Moral justice

those who are poor/sick require more help than those who are healthy and have adequate resources

Distributive justice

the benefits and burdens of society should be distributed in a just manner

Social justice

the fair distribution of society's benefits, responsibilities, and consequences for all

Beneficence

-the concept that actions should do good
-achieved through quality, competent, and compassionate care

Nonmaleficence

-the concept that actions should do no harm
-achieved through practice, administration, education, and research

CNA code of ethics

1. Providing safe, compassionate, competent and ethical care

2. Promoting health and well-being

3. Promoting and respecting informed decision making

4. Preserving dignity

5. Maintaining privacy and confidentiality

6. Promoting justice

7. Being accountable

ICN code of ethics

-nurses and people
-nurses and practice
-nurses and the profession
-nurses and coworkers

Confidentiality

ethical and legal obligation to uphold the privacy and security of personal information

Moral uncertainty

-indecision, lack of clarity, or inability to know what the moral problem is
-feeling uneasy and uncomfortable

Ethical violation

action or failure to act that breaches fundamental duties and neglects moral obligations

Ethical dilemma

-occurs when there are equally compelling reasons for and against two or more possible courses of action
-choosing one course of action means something else is relinquished

Moral distress

-occurs when the individual knows the right thing to do but fear or other circumstances make it difficult to take the right course of action
-provokes feelings of guilt, concern, or distaste

Ethical committees

-a forum for discussing ethical issues and to generate feasible solutions to those issues
-provide guidance for clinical ethical decision making

Process of ethical decision-making

-clarify the need for a decision
-identify those involved and arrange a meeting with them
-include an impartial facilitator in the meeting
-identify areas of agreement and disagreement
-offer resources
-seek outside advice (if necessary)
-make a decision and implement it

Interprofessional team

-comprises members from different clinical disciplines with specialized knowledge, skills, and abilities who work together towards a common goal to meet the needs of a patient population

Collaborative practice

interprofessional process for communication and decision-making that enable separate and shared knowledge and skills

Scope of practice

activities nurses are educated and authorized to perform, as established through legislated definitions of nursing practice

Accountability

the obligation to account for one's actions

"Controlled acts" scope of practice model

-not bound by elusive scope of practice
-describes specific acts rather than a role
-an act that is not controlled can be performed by anyone

CIHC competency framework

-interprofessional communication
-patient centered care
-role clarification
-team functioning
-collaborative leadership
-interprofessional conflict resolution

Factors affecting collaboration

-systemic (policies, funding, power/control, education, government involvement)
-organizational (common agenda, resources, knowledge/skills, information sharing)
-interpersonal (role clarification, attitudes, beliefs, relationships, communication)

Delegation

achieving performance of care outcomes for which you are accountable and responsible by sharing activities with other individuals who have the appropriate authority to accomplish the work

Group vs. team

-a group is a collection of individuals who have a unifying relationship -a team is a group of people who share a common and are accountable to each other

Self-managing team

-the manager sets the overall direction and goal/outcome
-the members of the team determine the direction, strategies, and focus needed to achieve the goal/outcome

Self-directing team

-the manager identifies the goal/outcome
-members of the team the direction, strategies, methods, and focus needed to achieve the goal/outcome

Self-governing team

-there is no manager
-team decides everything collectively

Ingroup

-those at the core of the decision-making, power, and influence
-individuals in the ingroup cooperate more and work harder

Outgroup

-those who are not part of they key group
-individuals in the outgroup are withdrawn and work alone
-can cause conflict if someone from the outgroup wants to be in the ingroup

Synergy

-individuals work together to produce results and achieve a common goal that could not have been achieved by any one individual
-efforts of the whole team are greater than the individual contributions of its parts

Dualism

-view of two opposing sides or parts (right or wrong)
-limits the broad spectrum of possibilities that exist in between

Positive communication model

-use "I feel.." instead of blame
-use "I think..." instead of judgement
-use "I would like" instead of making unreasonable requests

S-TLC

-conflict resolution process
-stop, think, listen, communicate

Factors affecting effective communication

-stress
-communication barriers
-communication pitfalls

Communication barriers

-distractions
-inadequate knowledge
-poor planning

Communication pitfalls

-actions and behaviours that create distrust and decrease self-worth of the receiver
-making others wrong, being defensive/patronizing, placing judgement/blame, etc.

SBAR

-situation
-background
-assessment
-recommendation

Active listening

completely focusing on the individual who is talking and listening without judgement

Reflective practice

-active and careful consideration of a belief, knowledge, issue, or concern
-learning from experience

Mindfulness

the state of being alert and actively paying attention in the present moment to experience the moment to the fullest

Intrapersonal conflict

occurs within the individual because of actual or perceived pressures from incompatible goals or expectations

Interpersonal conflict

occurs between two or more individuals due to a difference of opinion, priority, or approach

Organizational conflict

-discord that arises about policies, procedures, codes of conducts, or accepted norms
-may be due to hierarchical structure and role differentiation among employees

Stages of conflict

-frustration
-conceptualization
-action
-outcomes

Categories of conflict

-facts
-goals
-approaches
-values

Avoidance conflict style

-unassertive and uncooperative
-unable to pursue own needs/goals and not assisting others in pursuing theirs
-postpones/prolongs conflict, which may escalate its intensity

Accommodating conflict style

-neglecting one's own needs/goals to try and satisfy those of other people
-self sacrificing approach

Competing conflict style

-pursuing own needs/goals at the expense of others
-may involve power, defensiveness, aggression, or cruelty

Compromising conflict style

-involves both assertiveness and cooperation by everyone to reach a successful negotiation
-requires maturity and confidence
-preferred method of conflict resolution

Collaborating conflict style

-involves both assertiveness and cooperation to work creatively and openly towards a solution that fully satisfies everyone
-time consuming

Mediation

-using a trained impartial third party to assist with conflict resolution
-involves separating the people from the problem, focusing on interests, inventing options for mutual gain, and using objective criteria

Lateral (horizontal) violence

aggressive and destructive behaviour or psychological harassment perpetuated by one colleague toward another colleague

Bullying

aggressive and destructive behaviour or psychological harassment perpetuated by someone with real or perceived power

Watson's Caring Theory

-caring is an essential component of nursing
-carative factors guide the core of nursing and should be implemented in healthcare
-carative factors are those aspects of care that potentiate therapeutic healing and relationships

Carative Intentions

1. Humanistic-altruistic system of values

2. Faith-Hope

3. Sensitivity to self and others

4. Helping-trusting-caring relationships

5. Expressing positive and negative feelings

6. Creative problem-solving caring process

7. Transpersonal teaching-learning

8. Creating a healing environment for physical and spiritual self

9. Assisting with basic human needs

10. Open to mysteries and miracles

Relational leadership model

-emphasizes the importance of relationships
-leaders are knowledgeable and self-aware
-purposeful, inclusive, empowering, ethical, and process-oriented

Linear change theories

-diffusion of innovations theory
-unfreezing, change, refreezing theory
-Havelock's 6 step change model

Diffusion of innovations theory

-seeks to explain how, why, and at what rate new ideas and technology are accepted
-innovators, early adopter, early majority, late majority, laggards

Unfreezing, changing, refreezing theory

-unfreezing (awareness of a need/problem that requires action)
-change (solution leads to incorporation of new practices)
-refreeze (acceptance/adoption of new methods)

Havelock's 6 step change model

-building relationships
-diagnosing the problem
-acquiring relevant resources
-choosing the solution
-gaining acceptance
-stabilizing the innovation and generating self-renewal

Non-linear change theories

-nursing process
-chaos theory
-medicine wheel

Nursing process

-assessment
-diagnosis
-planning
-implementation
-evaluation

Chaos theory

-the behaviour of complex systems is extremely sensitive to changes
-slight changes of randomness can lead to consequences of a much greater scale, making it difficult to predict future outcomes