Leadership Exam 1 PDF
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University of Cincinnati
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This document reviews leadership concepts, including mental models and different leadership styles. It discusses task behavior, relationship behavior, and cognitive, behavioral, and process competencies. Different leadership theories and historical context of nursing are also touched upon.
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TEST #1 REVIEW SHEET Definition of leadership: An influence relationship among leaders and followers who intend real changes and outcomes that reflect their shared purposes. Module 1 Leadership Concepts Explain a mental model and basicall...
TEST #1 REVIEW SHEET Definition of leadership: An influence relationship among leaders and followers who intend real changes and outcomes that reflect their shared purposes. Module 1 Leadership Concepts Explain a mental model and basically how it works o How you think will determine how you act o Governs how we interpret experiences, react to situations, and act in response to other people o **A leader must be able to change a mental model when presented with a better one o Keep an open mind and think critically, see the big picture Explain the two concepts of leadership regarding “Task behavior” and “Relationship behavior” o Task behavior: DOING o Relationship behavior: BEING Understand the three leadership competencies: Cognitive competency, behavioral competency, and process competency. o Cognitive: Diagnosing, “Reading” the situation o Behavioral: Adapting, “Reacting” to the situation o Process: Communication, “Responding” to the situation Define the three basic leadership styles: o Autocratic: Coach makes all decisions, “Do X” ▪ Directive ▪ Gives orders to others o Laissez-faire: Limited input from coach, “Do X or Y as you see fit” ▪ Complete freedom for group o Democratic: Shared decision making with the coach, “Which is best, X or Y?” ▪ Makes decisions through group discussions ▪ Builds teamwork Describe the difference between strategic and tactical leadership o Strategic: Broad; focuses on the direction of the organization (Chief nursing officer) o Tactical: Short term; focuses on specifics of carrying out the vision (Nurse managers) If given a scenario, be able to identify the reason a leader was derailed. Module 2 History of Nursing History of Professional Nursing o In the beginning, who primarily provided nursing care and where did it occur? ▪ Traditionally home-based care ▪ Nursing was often delegated to poor uneducated women o How did the concept of “hospitals” develop? ▪ Care moved from the home into central buildings run by religious orders o Who is attributed with the development of modern nursing practice? ▪ Florence Nightingale Describe the ways in which nursing is an ART, SCIENCE, and BLEND of both o Art ▪ Fosters therapeutic relationships ▪ Promoting a care environment ▪ Communication ▪ Demonstrating empathy ▪ Creativity in tailoring care ▪ Responding to patient needs, spoken and unspoken o Science ▪ Using theories to describe, explain, or predict ▪ Collecting objective data ▪ Relying on research evidence ▪ Application of critical thinking ▪ Utilization of technology and technical skills Followership Name different types of followers and their characteristics according to Kelley’s Model of Followership (sheep, alienated, effective, yes people, survivors) o Sheep ▪ Dependent, uncritical thinker ▪ Passive in the organization o Alienated ▪ Independent, critical thinker ▪ Passive in the organization o Effective ▪ Independent, critical thinker ▪ Active in the organization o Yes people ▪ Dependent, uncritical thinker ▪ Active in the organization o Survivors ▪ In the middle Define the term “managing up”. o Consciously and deliberately developing a meaningful, task-related, mutually respectful relationship with your direct supervisor If given a scenario, be able to identify which of the four tactics for managing up is being used (Be a resource, View leader realistically, Help the leader, Build a relationship) o Be a resource ▪ Determine leaders needs ▪ Provide needs before they have to ask ▪ Tell leader your strengths so they can utilize o View the leader realistically ▪ No one is perfect ▪ Respect leader as a person ▪ Do not criticize leader when talking with others ▪ Be willing to disagree occasionally o Help them be a good leader ▪ Ask for advice and guidance ▪ Thank them ▪ Tell them what you think ▪ Compliment what you like to reinforce behavior o Build a relationship ▪ Interact with leader outside requesting help ▪ Build trust ▪ Be open Module 3 Leadership Theory Name the 4 major leadership phases (Great Man, Behavioral, Contingency, Interactional) What is the basic principle behind Great Man Theory? Born leaders Leaders guide with courage and modeling What is the basic principle behind Trait Leadership Theory? Certain traits make a great leader General intelligence, initiative, interpersonal skills, adaptable, energetic and focused, self- confident, integrity, creative Be able explain the following Situational/Contingency Theories Fiedler’s Contingency Model Performance of any group depends on the leader’s style in terms of motivation and relationship to the subordinates and the favorability of the situation Name and explain the three “contingencies” which this theory considers o Task structure ▪ Extent to which takes performed are specific, clear and explicit o Leader-member relations ▪ Degree to which subordinates trust and respect for leader o Position power ▪ Extent to which leader has formal authority over subordinates House’s Path-Goal Model Based on interplay between leadership style and tasks behavior, and follower readiness to participate Explain House’s Path-Goal Theory Hersey and Blanchard’s Situational Leadership Theory Leadership style dependent on: amount of support needed (relational behavior), amount of direction required (task behavior), and developmental level (maturity) Be able to determine which style of leadership would be appropriate if given a scenario: o (S1) telling o (S2) selling o (S3) participating o (S4) delegating Interactional Leadership Theories Define a transactional model of leadership o Focuses more on near term than long term o Favors policy, structure, and rules o Rewards and punishments Define the four parts of the transformational model of leadership o Idealized influence ▪ Lead by example and set the expectations o Intellectual stimulation ▪ Encourage learning and growth o Individualized consideration ▪ Coaching and empowering to success o Inspirational motivation ▪ Inspiring to go to new heights Contrast the two models Law & Ethics Nurse Practice Act (NPA) – Laws which define nursing o Who creates the NPA? ▪ Written by each individual state legislature ▪ Signed by governors o Is the NPA the same for all states? ▪ No o What are a nurse’s responsibilities when it comes to the NPA? ▪ Duty to protect patients ▪ Following standards and scope of practice ▪ Understanding the NPA of the state you work in If given a scenario, be able to correctly identify: negligence, malpractice, assault, battery, false imprisonment, sexual harassment Be able to identify the 4 required components to establish liability: o Nurse has responsibility to care for patient o Nurse failed to uphold that responsibility o That failure results in patient injury o The patient suffers actual harm Be familiar with HIPAA and patient privacy laws Understand the process of informed consent and the nurse’s role in the process o Consent can be witnessed by nursing personnel o The process of ensuring there is consent obtained and complete can be delegated to nursing personnel o Parent or guardian can provide informed consent for minors Be able to explain the legal documents: o Advance directives ▪ **Documentation must be provided before actions are (or are not) taken o Living will ▪ Directs medical care in the event that an individual does have have the ability to do so themselves CPR, DNR, Intubation and mechanical ventilation, artificial nutrition and hydration o Medical power of attorney ▪ Names a person of trust to make medical decisions on a persons behalf in the event that they are unable to do so for themselves If given a scenario, select the correct ANA Code of Ethics which applies Be able to identify which ethical principle applies if given a scenario” o Autonomy o Beneficence o Justice o Veracity o Confidentiality Be able to identify unethical nursing actions Module 4 Emotional Intelligence Be able to explain the differences in responses of followers when leaders lead with love vs fear o Love ▪ HEART – meets 5 employee needs ▪ Hear and understand me ▪ Even if you disagree with me, don’t make me wrong ▪ Acknowledge the greatness in me ▪ Remember to look for my loving intentions ▪ Tell me the truth with compassion o Fear Explain internal vs external Locus of Control o Internal – I control my own destiny ▪ Self motivated ▪ Participate more ▪ Persistent ▪ More rationale then emotional ▪ Take responsibility for outcomes o External – THEY control my destiny ▪ Wait for luck to strike ▪ Look to others for solutions ▪ Easily defeated ▪ Quick to obey people of power ▪ Victim mentality Explain the difference between terminal and instrumental values o Terminal ▪ Belief about what is worthy of pursuing o Instrumental ▪ What are you willing to do to get to those terminal goals Be able to determine the type of perceptual distortion being used if given a scenario: o Stereotyping ▪ Using broad categorization for one individual o Halo effect ▪ Grand perception of a person based upon one positive attribute o Projection ▪ Overestimating the degree to which others agree with us o Perceptual Defense ▪ Protecting yourself from characteristics or situations which make a person uncomfortable Explain emotional intelligence and list the four steps o Emotional Intelligence – Ability to perceive, identify, understand, and successfully manage emotion in self and others ▪ Self-awareness ▪ Self management ▪ Social awareness ▪ Social skills Moral Courage Be able to determine the level of moral development if given a scenario o Preconventional ▪ Follows rules to avoid punishment o Conventional ▪ Lives up to expectations of others ▪ Upholds laws o Postconventional ▪ Follows internalized universal principles of justice and right ▪ Acts in an independent and ethical manner regardless of expectations of others Be able to identify sources one can use to find personal courage ( o Higher purpose o Strength from others o Harness frustration/anger o One step at a time Be able to identify characteristics of a moral leader o Distinguishes right from wrong o Seeking the just, the honest, the good o Seeks the right conduct in pursuit of goals o Uplifts people and enhances lives o Zero tolerance for ethical violations Critical Thinking Explain the difference between critical thinking and problem solving o Critical thinking ▪ Conceptualizing issues and forecasting outcomes ▪ Involves identifying and overcoming obstacles both now and later ▪ May require out of the most thinking to identify potential solutions that aren’t immediately obvious (Inductive reasoning) o Problem solving ▪ Identifying immediate obstacles ▪ Concrete or conceptual thinking ▪ Deductive reasoning ▪ Solving problems Explain where critical thinking is used during the decision process to solve a problem o Used when analyzing information Be able to identify which type of question is being asked o Factual ▪ Questions with answers o Opinion ▪ Questions which ask preference o Reasoning ▪ Questions which require knowledge synthesis Be able to identify the six steps to successful critical thinking o Observe and ask questions o Interpret and analyze evidence o Self-regulate o Inference o Evaluate and explain o Tolerate ambiguity Decision-making Be able to identify the levels of decision making a leader can engage in o Direct ▪ I decide o Indirect ▪ I decide through you o Delegation ▪ You decide o Purposeful Inaction ▪ No one decides o Collaboration ▪ We all decide Be able to identify a decision-making error if given a scenario o Failure to launch ▪ Too much time spent identifying the problem o Erratic Approach ▪ Not being systematic o Grandstanding ▪ Overconfidence in own decision making abilities o Lack of foresight ▪ No clear objective/purpose Be able to correctly identify the decision-making trap if given a scenario o Anchoring trap ▪ Giving the strongest consideration to the first thing you hear o Status-quo trap ▪ When what has worked in the past seems like the best idea o Sunk cost trap ▪ Refusing to change because there is too much time/money invested in it already o Confirming evidence trap ▪ When decision makers seek out information that supports an existing point of view while ignoring contradictory evidence Module 5 Communication Know the four steps of effective communication o Message sent o Message received o Message acknowledged o Response delivered Understand the relationship between Verbal vs. non-verbal communication If given a scenario, be able to correctly identify which of the 8 Leadership Skills are being used o Adaptability of style o Active listening o Transparency o Clarity o Using open-ended questions o Empathy o Open body language o Receiving and using feedback Culture is a perspective through which communication is filtered. Strategies for bridging culture differences in communication include: o Develop mindfulness o Be flexible o Tolerate ambiguity and uncertainty o Resist stereotyping o Ask questions o Be other oriented The most important skill in effective communication: listening If given a scenario, be able to correctly identify which mode of communication would be most appropriate o Face-to-face – Low risk miscommunication o Phone o Email o Text – High risk for miscommunication Be familiar with the communication tools: o SBAR ▪ Situation, background, assessment, recommendation o CUS ▪ Concerned, uncomfortable, safety hazard o DESC ▪ Describe situation, express how it makes you feel, suggest other alternatives, state consequences in terms of impact on goals Explain the communication importance of: o Hourly rounding ▪ 5 Ps ▪ Improves pt safety and satisfaction o Bedside shift report ▪ SBAR Autonomy Be able to define nursing autonomy o Ability to act according to ones knowledge and judgement, providing nursing care within the full scope of practice as defined by existing professional, regulatory and organized rules o Ability to have freedom to make decisions about patient care Know the three enhancers of autonomy o Supportive management ▪ Communication ▪ Support during conflict ▪ Encouraging nurses to lead o Education o Experience Know the three detractors of autonomy: o Autocratic management ▪ Non-supportive, non-participative o Doctor’s desire to maintain control o Workload EBP Definition and 3 components that must be considered in EBP o Problem solving approach to the delivery of health care that integrate the best evidence from well-designed studies and patient care data, and combines it with patient preferences and values and nurses expertise 1. Best evidence 2. Patient preferences and values 3. Nurses experience Familiarity with the Evidence Pyramid (What is the best level of evidence for answering a clinical question?) o Meta analysis is BEST Components of an EBP question o Population, Intervention, Comparison, Outcome, Time Know keys to getting clinicians to adopt EBP changes o Strong evidence, need to change, change offers an advantage Stress and Burn out Be able to explain the difference between stress and burnout o Stress is a negative emotional experience – inevitable o Burnout is the condition of physical and emotional fatigue after doing a difficult job for a long time Be able to identify triad symptoms of burnout o Emotional exhaustion o Disassociation – Mental exhaustion o Cynicism o Physical exhaustion Identify burnout prevention strategies o Improved time management and organizational skills o Seeking advice o Reflection o Discussing with another o Education o Workload management Be able to identify Leadership responsibilities to prevent burnout o Manage workload o Focus on meaning of work o Empowerment o Promote social interaction o Enforce responsibility breaks o Create healthy working culture