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UNIT tt; use systems thlllking The Critical Triad: Decision Making, Management, and Leadership 1

1 Decision Making, Problem Solving, Critical Thinking, and Clinical Reasoning: Requisites for Successful Leadership and Management 2

" jElice-based clinical and Decision Making, Problem Solving, Critical Thinking, and Clinical Reasoning 3-,cilsmbership In profeSSional Vicarious Learning to Increase Problem-Solving and Decision-Making Skills 4

Theoretical Approaches to Problem Solving and Decision Making 7

_ . :nG development strategic Critical Elements in Problem Solving and Decision Making 11

Individual Variations in Decision Making 15

Overcoming Individual Vulnerability in Decision Making 18

Decision Making in Organizations 19

Decision-Making Tools 20

Pitfalls in Using Decision-Making Tools 24

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.r-,Summary 24

Key Concepts 25

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2 Classical Views of Leadership and Management 32 - '\'Jr"~s Ins[Jlule (2013). Managers 33 ___ Jdlc 20. 2013. from http://

Leaders 34

Historical Development of Management Theory 35

Historical Development of Leadership Theory (1900 to Present) 39

Interactional Leadership Theories (1970 to Present) 42

Integrating Leadership and Management 47

Key Concepts 48

Additional Learning Exercises 49

3 Twenty-First-Century Thinking about Leadership and Management 53

New Thinking about Leadership and Management 54

Transition from Industrial Age Leadership to Relationship Age Leadership 63

Leadership and Management for Nursing's Future 65

Key Concepts 66

Additional Learning Exercises and Applications 66

xv

xvi

7

CONTENTS

UNIT II UNI

Foundation for Effective Leadership and Management Ethics, Law, and Advocacy 69

4 Ethical Issues 70

Types of Ethical Issues 72

Ethical Frameworks for Decision Making 74

Principles of Ethical Reasoning 75

American Nurses Association Code of Ethics and Professional Standards 79

Ethical Problem Solving and Decision Making 80

The Moral Decision-Making Model 84

Working toward Ethical Behavior as the Norm 86

Ethical Dimensions in Leadership and Management 88

Integrating Leadership Roles and Management Functions in Ethics 89

Key Concepts 90

Additional Learning Exercises and Applications 90

5 Legal and legislative Issues 94

Sources of Law 95

Types of Laws and Courts 96

Legal Doctrines and the Practice of Nursing 97

Professional Negligence 98

Avoiding Malpractice Claims 101

Extending the Liability 102

Incident Reports 104

Intentional Torts 104

Other Legal Responsibilities of the Manager 105

Legal Considerations of Managing a Diverse Workforce 111

Professional Versus Institutional Licensure 112

Integrating Leadership Roles and Management Functions in Legal and Legislative Issues 113

Key Concepts 114

Additional Learning Exercises and Applications 114

6 Patient, Subordinate. and Professional Advocacy 117

Becoming an Advocate 118

Patient Advocacy 120

Patient Rights 121

Subordinate and Workplace Advocacy 124

Whistleblowing as Advocacy 125

Professional Advocacy 127

Integrating Leadership Roles and Management Functions in Advocacy 131

Key Concepts 132

Additional Learning Exercises and Applications 133

5

CONTENTS xvii

UNIT III ~ Ethics, Law, Roles and Functions in Planning 137

7 Strategic and Operational Planning 138

Looking to the Future 140

Proactive Planning 142

Strategic Planning 144

Organizational Planning: The Planning Hierarchy 146 al Standards 79 Vision and Mission Statements 147

The Organization's Philosophy Statement 148

Societal Philosophies and Values 151

Individual Philosophies and Values 151

Goals and Objectives 153 - ~Ihics 89 Policies and Procedures 155

Rules 157

Overcoming Barriers to Planning 157

Integrating Leadership Roles and Management Functions in Planning 158

Key Concepts 158

Additional Learning Exercises and Applications 159

8 Planned Change 162

The Development of Change Theory: Kurt Lewin 164

Lewin's Driving and Restraining Forces 166

A Contemporary Adaptation of Lewin's Model 167

Classic Change Strategies 167

Resistance: The Expected Response to Change 169

Planned Change as a Collaborative Process 171

The Leader-Manager as a Role Model during Planned Change 171

Organizational Change Associated with Nonlinear Dynamics 172

Organizational Aging: Change as a Means of Renewal 174

Integrating Leadership Roles and Management Functions in Planned Change 175

Key Concepts 176

Additional Learning Exercises and Applications 177

9 Time Management 181

Three Basic Steps to Time Management 183

Personal Time Management 191

Integrating Leadership Roles and Management Functions in Time Management 195

Key Concepts 195J::acy 131 Additional Learning Exercises and Applications 196

xx CONTENTS

UNIT V Roles and Functions in Staffing 333

15 Employee Recruitment. Selection, Placement. and Indoctrination 334

Predicting Staffing Needs 336

Is There a Current Nursing Shortage? 336

Recruitment 338

Interviewing as a Selection Tool 339

Tips for the Interviewee 348

Selection 349

Placement 353

Indoctrination 354

Integrating Leadership Roles and Management Functions in Employee Recruitment, Selection, Placement, and Indoctrination 358

Key Concepts 358

Additional Learning Exercises and Applications 359

16 Socializing and Educating Staff for Team Building in a Learning Organization 363

The Learning Organization 365

Staff Development 366

Learning Theories 367

Assessing Staff Development Needs 371

Evaluation of Staff Development Activities 372

Shared Responsibility for Implementing Evidence-Based Practice 373

Socialization and Resocialization 373

Overcoming Motivational Deficiencies 380

Coaching as a Teaching Strategy 381

Meeting the Educational Needs of a Culturally Diverse Staff 382

Integrating Leadership and Management in Team Building through Socializing and Educating Staff for Team Building in a Learning Organization 383

Key Concepts 384

Additional Learning Exercises and Applications 384

17 Staffing Needs and Scheduling Policies 388

Unit Manager's Responsibilities in Meeting Staffing Needs 390

Centralized and Decentralized Staffing 390

Complying with Staffing Mandates 391

Staffing and Scheduling Options 393

Workload Measurement Tools 397

The Relationship between Nursing Care Hours, Staffing Mix, and Quality of Care 401

Managing a Diverse Staff 402

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4dd"ioN:! _",­

CONTENTS xxi

octrination 334

-5 Employee 358

:::-::.:: :e 373

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-'C~ h Socializing .:: _ 2~ _ation 383

Generational Considerations for Staffing 403

The Impact of Nursing Staff Shortages upon Staffing 404

Fiscal and Ethical Accountability for Staffing 405

Developing Staffing and Scheduling Policies 406

Integrating Leadership Roles and Management Functions in Staffing and Scheduling 407

Key Concepts 408

Additional Learning Exercises and Applications 408

UNIT VI Roles and Functions in Directing 413

18 Creating a Motivating Climate 414

Intrinsic Versus Extrinsic Motivation 416

Motivational Theory 417

Creating a Motivating Climate 422

Strategies for Creating a Motivating Climate 424

Promotion: A Motivational Tool 426

Promoting Self-Care 428

Integrating Leadership Roles and Management Functions in Creating a Motivating Climate at Work 429

Key Concepts 430

Additional Learning Exercises and Applications 431

19 Organizational, Interpersonal, and Group Communication 436

The Communication Process 438

Variables Affecting Organizational Communication 440

Organizational Communication Strategies 441

Communication Modes 443

Elements of Nonverbal Communication 444

Verbal Communication Skills 446

Listening Skills 449

Written Communication within the Organization 450

The Impact of Technology on Contemporary Organizational Communication 452

Communication, Confidentiality, and Health Insurance Portability and Accountability Act 454

Group Dynamics 457

Integrating Leadership and Management in Organizational, Interpersonal, and Group Communication 459

Key Concepts 460

Additional Learning Exercises and Applications 461

xxii CONTENTS

20 Delegation 466

Delegating Effectively 468

Common Delegation Errors 471

Delegation as a Function of Professional Nursing 473

Delegating to a Transcultural Work Team 479

Integrating Leadership Roles and Management Functions in Delegation 480

Key Concepts 481

Additional Learning Exercises and Applications 482

21 Effective Conflict Resolution and Negotiation 487

The History of Conflict Management 489

Categories of Conflict: Intergroup, Intrapersonal,

Negotiation 500

Integrating Leadership Skills and Management Functions

and Interpersonal 490

The Conflict Process 493

Conflict Management 495

Managing Unit Conflict 498

Alternative Dispute Resolution 505

Seeking Consensus 506

in Managing Conflict 506

Key Concepts 507

Additional Learning Exercises and Applications 507

22 Collective Bargaining, Unionization, and Employment Laws 514

Unions and Collective Bargaining 516

The Nurse as Supervisor: Eligibility for Protection Under the National

Effective Labor-Management Relations 526 a,"c ::-c·­

Historical Perspective of Unionization in America 517

Union Representation of Nurses 518

American Nurses Association and Collective Bargaining 519

Employee Motivation to Join or Reject Unions 520

Averting the Union 522

Labor Relations Act 523

Union- Organizing Strategies 524

Managers' Role During Union-Organizing 525

Steps to Establish a Union 526

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Employment Legislation 528 SCIO, ore Ci~ ­

State Health Facilities Licensing Boards 535

Integrating Leadership Skills and Management Functions When Working with Transfe'f1r~ -: Collective Bargaining, Unionization and Employment Laws 536 Grievance ,=-=

Key Concepts 536 Disciplining -r

Additional Learning Exercises and Applications 537

CONTENTS xxiii

-_

UNIT VII Roles and Functions in Controlling 541

23 Quality Control 542

Defining Quality Health Care 545

Integrating Leadership Roles and Management Functions with Quality Control 565

Quality Control as a Process 546

The Development of Standards 548

Audits as a Quality Control Tool 551

Standardized Nursing Languages 553

Quality Improvement Models 554

Who Should Be Involved in Quality Control? 556

Quality Measurement as an Organizational Mandate 556

Centers for Medicare and Medicaid Services 559

Medical Errors: An Ongoing Threat to Quality of Care 562

Key Concepts 566

Additional Learning Exercises and Applications 568

24 Performance AppraIsal 573

Using the Performance Appraisal to Motivate Employees 575

Using Leadership Skills and Management Functions in Conducting Performance Appraisals 591

Strategies to Ensure Accuracy and Fairness in the Performance Appraisal 576

Performance Appraisal Tools 579

Planning the Appraisal Interview 587

Overcoming Appraisal Interview Difficulties 587

Performance Management 590

Coaching: A Mechanism for Informal Performance Appraisal 590

Becoming an Effective Coach 591

Key Concepts 591

Additional Learning Exercises and Applications 592

25 Problem Employees: Rule Breakers, Marginal Employees, and the Chemically or Psychologically Impaired 596

Constructive Versus Destructive Discipline 599

Self-Discipline and Group Norms 600

Fair and Effective Rules 600

Discipline as a Progressive Process 601

Disciplinary Strategies for the Nurse-Manager 604 - '/orking with Transferring the Problem Employee 609

:- _6 Grievance Procedures 610

Disciplining the Unionized Employee 611

xxiv CONTENTS

The Marginal Employee 612

The Chemically Impaired Employee 614

Recognizing the Chemically Impaired Employee 615

Integrating Leadership Roles and Management Functions through Dealing with Problem Employees 622

Key Concepts 623

Additional Learning Exercises and Applications 623

Appendix 627

Solutions to Selected Learning Exercises 627

Index 637

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