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284 Cards in this Set
- Front
- Back
Decision making |
the thought process of selecting a logical choice from the available options |
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Problem solving |
part of decision making/is a systematic process that focuses on analyzing a difficult situation |
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Critical thinking AKA Reflective Thinking |
the mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach an answer or conclusion |
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Components of Critical Thinking |
Insight, intuition, empathy, and the willingness to take action |
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Clinical Reasoning |
When nurses integrate and apply different types of knowledge to weigh evidence, critically think about arguments and reflect upon the process used to arrive at a diagnosis |
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Components that improve problem solving and decision making |
Case studies, simulation, and problem-based learning (PBL) |
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Case Studies |
provide a more interactive, learning experience for students than the traditional didactic approach |
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Simulation AKA Discrete Event Simulation |
Using computer simulation to imitate the operation of a real-life system such as a hospital |
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PBL |
Problem Based Learning learners meet in small groups to discuss and analyze real-life problems. Thus, they learn by problem solving |
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Marquis-Huston Model for teaching critical thinking |
four overlapping spheres, each being an essential component for teaching leadership and management. |
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Four Components of Marquis-Huston Model |
didactic theory component,a formalized approach to problem solving and decision making, the group process,material must be made real for the learner |
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Experiential learning provides |
mock experiences that have tremendous value in applying leadership and management theory |
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Heuristics |
make decisions too quickly and fail to systematically examine a problem or its alternatives for solution |
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What method does Heuristics use? |
trial-and-error methods or a rule-of-thumb approach to problem solving |
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What increases clinical reasoning? |
a structured approach to problem solving and decision making |
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Weakness of Traditional Problem-Solving Process |
the amount of time needed for proper implementation |
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Nursing Process |
Assessment Diagnosis Planning Implementation Evaluation |
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Weakness of the Nursing Process |
not requiring clearly stated objectives |
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Recognition-Primed Decision (RPD) Model |
to explain how people can make effective decisions under time pressure and uncertainty. |
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Naturalistic Decision Making |
attempts to understand how humans make relatively quick decisions in complex, real-world settings such as firefighting and critical care nursing without having to compare options |
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a Poor-Quality Decision is likely when... |
a decision lacks a clear objective or if an objective is not consistent with the individual’s or organization’s stated philosophy |
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Facts can be misleading if... |
presented in a seductive manner, if they are taken out of context, or if they are past oriented |
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Best Practices in Nursing are... |
Evidence-based practices |
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PICO |
patient or population, intervention, comparison, and outcome |
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PICO Format |
used in EBP to guide the search for the current best evidence to address a problem |
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The goal in brainstorming is to |
think of all possible alternatives, even those that may seem “off target” |
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Inference |
a conclusion reached on the basis of evidence and reasoning |
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Overgeneralizing |
occurs when one believes that because A has a particular characteristic, every other A also has the same characteristic. |
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Affirming the Consequences |
one decides that if B is good and he or she is doing A, then A must not be good. |
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Arguing from Analogy |
This thinking applies a component that is present in two separate concepts and then states that because A is present in B, then A and B are alike in all respects. |
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Left-Brain Thinkers |
Analytical/Linear better at processing language, logic, numbers, and sequential ordering |
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Right-Brain Thinkers |
excel at nonverbal ideation and holistic synthesizing better at handling images, music, colors, and patterns |
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Lower-Left-Brain Dominance Characteristics |
Highly organized and detail oriented prefer a stable work environment and value safety and security over risk taking. |
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Upper-Right-Brain Dominance |
big picture thinkers frequently rely on intuition to solve problems and are willing to take risks to seek new solutions to problems. |
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Lower-Right-Brain Dominance |
sympathetic, kinesthetic, and empathetic and focus more on interpersonal aspects of decision making |
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expert networks |
communities of top thinkers, managers, and scientists—to help them make decisions. |
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Courage |
is particularly important and involves the willingness to take risks. |
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Sensitivity |
Good decision makers seem to have some sort of antenna that makes them particularly sensitive to situations and others. |
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Energy |
People must have the desire to make things happen |
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Creativity |
Successful decision makers tend to be creative thinkers, they develop new ways to solve problems |
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Most management decisions are made by |
using the administrative man model of decision making. |
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PERT |
Program Evaluation and Review Technique |
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Decision Grid |
allows one to visually examine the alternatives and compare each against the same criteria. |
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Payoff Tables |
have a cost–profit–volume relationship and are very helpful when some quantitative information is available |
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Decision Tree |
decisions are often tied to the outcome of other events |
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Consequence tables |
Lists the objectives for solving a problem down one side of a table and rates how each alternative would meet the desired objective |
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Logic models |
are schematics or pictures of how programs are intended to operate |
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PERT is a popular tool to determine |
The timing of decisions Essentially a flowchart that predicts when events and activities must take place if a final event is to occur |
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Decision tools exist to |
Help make more effective decisions but don't adequately allow for the human element in management |
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The rational approach to problem solving begins |
with a fixed goal and ends with an evaluation process |
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Naturalistic decision making blends |
intuition and analysis |
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Evidence-Based Nursing Practice integrates |
the best evidence available to achieve desirable outcomes |
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The successful decision maker understands |
that gender, personal, individual values, life experience, preferences, willingness to take risks, brain hemisphere dominance, and predominant thinking style have on alternative identification and selection |
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The critical thinker is aware |
of areas of vulnerability that hinder successful decision making and makes efforts to avoid the pitfalls of faulty logic in his or her data gathering |
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The act of making and evaluating decisions |
increases the expertise of the decision maker |
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Using a systematic decision-making or problem- solving model reduces |
heuristic trial-and-error or rule-of-thumb methods and increases the probability that appropriate decisions will be made |
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Two major considerations in organizational decision making are |
how power affects decision making and whether management decision making needs to be only satisficing |
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SWOT |
strengths, weaknesses, opportunities, and threats |
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management emphasizes |
control of hours, costs, salaries, overtime, use of sick leave, inventory, and supplies |
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leadership increases |
productivity by maximizing workforce effectiveness |
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Define Management |
the act or manner of guiding or taking charge - or handling, direction, or control |
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Management is the process of |
leading and directing all or part of an organization through the deployment and manipulation of resources |
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“father of scientific management” |
Frederick W. Taylor |
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Traditional “rule of thumb” |
means of organizing work must be replaced with scientific methods |
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The role of managers, or functional foremen |
was to plan, prepare, and supervise |
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POSDC |
Planning, Organizing, Staffing, Directing, Controlling |
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Planning |
Encompasses determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change. |
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Organizing |
Includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals. |
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Staffing functions |
Consist of recruiting, interviewing, hiring, and orienting staff. Scheduling, staff development, employee socialization, and team building are also often included as staffing functions. |
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Directing |
usually entail human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration. |
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Controlling functions include |
Performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control |
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human relations era developed |
the concepts of participatory and humanistic management, emphasizing people rather than machines. |
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Mary Parker Follett |
was one of the first theorists to suggest basic principles of what today would be called participative decision making or participative management |
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Hawthorne effect indicated |
that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention |
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Theory X managers believe |
that their employees are basically lazy, need constant supervision and direction, and are indifferent to organizational needs. |
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Theory Y managers believe |
that their workers enjoy their work, are self-motivated, and are willing to work hard to meet personal and organizational goals |
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Taylor |
Scientific Management Theory |
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Weber |
Bureaucratic Management Theory |
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Fayol |
Management Functions Theory |
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Gulick |
Activities of Management Theory |
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Follett |
Participative Management Theory |
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Mayo |
Hawthorne Effect Theory |
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McGregor |
Theories X & Y |
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Argyris |
Employee Participation Theory |
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basis for most leadership research
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Great Man theory and trait theories |
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The Great Man theory |
asserts that some people are born to lead, whereas others are born to be led. It also suggests that great leaders will arise when the situation demands it |
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Trait theories assume |
people have certain characteristics or personality traits that make them better leaders than others |
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Authoritarian leadership results in |
well-defined group actions that are usually predictable, reducing frustration in the work group and giving members a feeling of security. Productivity is usually high, but creativity, self-motivation, and autonomy are reduced |
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Examples of Authoritarian Leadership |
very large bureaucracies such as the armed forces |
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Democratic leadership promotes |
autonomy and growth in individual workers. to both positive nurse and patient outcomes since they emphasize the leader’s ability to create positive relationships within the organization. |
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Laissez-faire Leadership |
is appropriate when problems are poorly defined and brainstorming is needed to generate alternative solutions. |
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Nelson and Burns |
That organizations and their leaders have four developmental levels and that these levels influence productivity and worker satisfaction. Reactive/Responsive/Proactive/High-Performance Teams |
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Reactive Leader |
focuses on the past, is crisis driven, and is frequently abusive to subordinates |
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Responsive Leader |
is able to mold subordinates to work together as a team, although the leader maintains most decision-making responsibility |
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Proactive Leader |
the leader and followers become more future oriented and hold common driving values. Management and decision making are more participative. |
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High Performance Teams |
maximum productivity and worker satisfaction are apparent |
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Collaborative Practice Matrix |
highlights the framework for thedevelopment and ongoing support of relationships between and among professionals working together |
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Transactional Leader |
traditional manager, concerned with the day-to-day operations |
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Transformational Leader |
manager who is committed, has a vision, and is able to empower others with this vision |
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Modeling the way |
Requires value clarification and self-awareness so that behavior is congruent with values |
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Inspiring a shared vision: |
entails visioning which inspires followers to want to participate in goal attainment. |
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Challenging the process |
Identifying opportunities and taking action. |
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Enabling others to act |
Fostering collaboration, trust, and the sharing of power |
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Encouraging the heart |
Recognize, appreciate, and celebrate followers and the achievement of shared goals. |
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full-range leadership theory |
suggests that there are ninefactors impacting leadership style and its impact on followers; five are transformational, three are transactional, and one is a nonleadership or laissez-faire leadership factor |
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5 Transformational Factors of Full-Range Leadership Theory |
inspirational motivation idealized influence (attributed) intellectual stimulation idealized influence (behavior) individualized consideration |
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3 Transactional Factors of Full-Range Leadership Theory |
Contingent reward Active management-by-exception Management-by-exception passive |
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1 Laissez-Faire Factors of Full-Range Leadership Theory |
Nonleadership |
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Inspirational Motivation |
inspirational motivation, is characterized by the leader’s articulation and representation of vision. |
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Idealized influence (attributed) |
relies on the charisma of the leader to create emotional ties with followers that build trust and confidence |
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Idealized Influence (behavior) |
Results in the leader creating a collective sense of mission and values and prompting followers to act upon these values |
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Intellectual Stimulation |
leaders challenge the assumptions of followers’ beliefs as well as analyze subordinates’ problems and possible solutions |
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Individualized Consideration |
occurs when the leader is able to individualize his or her followers, recognizing and appreciating their unique needs, strengths, and challenges |
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Contingent Reward |
the leader is task oriented in providing followers with meaningful rewards based on successful task completion |
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Active Management-By-Exception |
suggests that the leader watches and searches actively for deviations from rules and standards and takes corrective actions when necessary |
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Management-By-Exception Passive |
describes a leader who intervenes only after errors have been detected or standards have been violated |
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The Management Process |
include planning, organizing, staffing, directing, and controlling |
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Classical, or traditional, management science focus on |
production in the workplace anddelineating organizational barriers to productivity |
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the human relations era of management science emphasized concepts of |
participatory and humanistic management |
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Three primary leadership styles have been identified |
authoritarian, democratic, and laissez-faire |
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Situational or Contingency Leadership Theory |
the leader-manager must assume a variety of leadership styles, depending on the needs of the worker, the task to be performed, and the situation or environment |
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interactional leadership theory focuses more on |
leadership as a process of influencing others within an organizational culture and the interactive relationship of the leader and follower |
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Effective Leader-Manager |
integrating leadership skills with the ability to carry out management functions |
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Strengths-Based Leadership |
Focuses on development/empowerment of workers strengths as opposed to identifying problems, improving under-performance, and addressing weaknesses |
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Positive Organizational Scholarship |
focuses on successful performance that exceeds the norm and embodies an orientation towards strengths and developing collective efficacy in organizations |
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Level One Jim Collin's |
Highly capable individual - makes high quality contributions to their work |
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Level Two Jim Collin's |
Contributing team member - Uses knowledge and skills to help the team succeed |
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Level Three Jim Collin's |
Competent Manager - organizes a group and effectively achieves set goals |
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Level Four Jim Collin's |
Effective Leader - Organization to perform objectives and achieve a vision |
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Level Five Jim Collin's |
Great Leader - all abilities of previous levels with a blend of humility and will - which leads to true greatness |
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Greenleaf argued that: |
to be a leader, one must be a servant first |
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Principle Agent Theory |
Suggests that not all followers (agents) are inherently motivated to act in the best interest of the principal (leader or employer) |
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Human Capital |
the attributions of a person which are productive in some economic context - private/social return |
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Human Capital Theory |
suggests that individuals and/or organizations will invest in education and professional development if they believe that such an investment will have a future payoff |
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EI/EQ |
the ability to perceive, understand, and control one's own emotions as well as those of others |
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EI develops with age and consists of three mental processes |
Appraising/Expressing emotions in self and others - Regulating emotion in self and others - Using emotions in adaptive ways |
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Five Components of Emotional Intellegence |
Self-Awareness, Self-Regulation, Motivation, Empathy, Social Skills |
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Emotional Literacy |
Being self-aware about one's emotions and recognizing how they influence subsequent action |
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Authentic Leadership/ Congruent Leadership |
in order to lead, leaders must be true to themselves and their values and act accordingly |
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Five Distinguishing characteristics of Authentic Leaders |
Purpose-Values-Heart-Relationships-Self Discipline |
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Balanced Processing |
Analyzing data rationally before making decisions |
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Internalized Moral Perspective |
suggests that authentic leader is guided by internal moral standards that then guide his/her behavior |
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Relational Transparency |
Opening sharing feelings and information appropriate to a situation |
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Thought Leadership |
applies to a person who is recognized among his/her peers for innovative ideas and who demonstrates the confidence to promote those ideas |
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Quantum Leadership |
suggests leaders must work together with subordinates to identify common goals, exploit opportunities, and empower staff to make decisions for organizational productivity occurs |
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Industrial Age Leadership |
Focused primarily on traditional hierarchial management structures, skill acquisition, competition, and control |
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Relationship Age Leadership |
focuses primarily on the relationship between the leader and his/her followers, working together cooperatively, and seeking information rather than wealth |
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Strengths-Based Leadership focuses on: |
development/empowerment of worker's strengths as opposed to identifying problems, improving under performance, and addressing weaknesses and obstacles |
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Servant Leadership is |
contemporary leadership model that puts serving others as a first priority |
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Quantum leadership suggests that |
the environment and context in which people work is complex/dynamic and has a direct impact on organizational productivity |
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thought leaders attract followers by: |
their risk taking and vision in terms of being innovative |
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Thought leadership refers to |
any situation whereby one individual convinces another to consider a new idea, product, or way of looking at things |
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Authentic leadership suggests that |
in order to lead, leaders must be true to themselves and their values and act accordingly |
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Emotional intelligence refers to the |
ability to use emotions effectively and is considered by many to be critical to leadership and management success |
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Human capital represents |
the capability of the individual |
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Social capital represents |
what a group can accomplish together |
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Principal agent theory suggests that |
followers may have an informational (expertise or knowledge) advantage over the leader as well as their own preferences, which may deviate from those of the principal |
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Servant leadership is a |
contemporary leadership model that puts serving others as the first priority |
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Level 5 leadership is characterized by |
knowledge, team building skills, the ability to help groups achieve goals, humility, and the empowerment of others through servant leadership |
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Ethics is a system |
of moral conduct and principles that guide a person’s actions in regard to right and wrong and in regard to oneself and society at large |
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Moral indifference occurs when |
an individual questions why morality in practice is even necessary
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Moral uncertainty or moral conflict occurs when |
an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is |
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moral distress occurs when |
the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action |
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Moral outrage occurs when |
an individual witnesses the immoral act of another but feels powerless to stop it
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moral or ethical dilemma |
which may be described as being forced to choose between two or more undesirable alternatives |
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Ethical frameworks |
guide individuals in solving ethical dilemmas. They do not solve the ethical problem but assist in clarifying personal values and beliefs
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Utilitarian/Consequentialist Theory (teleological) |
Provide the greatest good for the greatest number of people |
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Rights based Theory (deontological) |
Individuals have basic inherent rights that should not be interfered with |
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Duty based Theory (deontological) |
A duty to do something or to refrain from doing something |
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Intuitionist Theory (deontological) |
Each case weighed on a case-by-case basis to determine relative goals, duties, and rights |
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Duty-based reasoning is an |
ethical framework stating that some decisions must be made because there is a duty to do something or to refrain from doing something |
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Rights-based reasoning is based on |
the belief that some things are a person’s just due (i.e., each individual has basic claims, or entitlements, with which there should be no interference) |
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Intuitionist framework allows the |
decision maker to review each ethical problem or issue on a case-by-case basis, comparing the relative weights of goals, duties, and rights. |
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Ethical Relativism suggests that |
individuals make decisions based only on what seems right or reasonable according to their value system or culture |
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Ethical Universalism holds that |
ethical principles are universal and constant and that ethical decision making should not vary as a result of individual circumstances or cultural differences. |
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Autonomy |
Promotes self-determination and freedom of choice |
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Paternalism |
One individual assumes the right to make decisions for another |
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Beneficence |
Actions are taken in an effort to promote good |
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Nonmaleficence |
Actions are taken in an effort to avoid harm |
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Veracity |
Obligation to tell the truth |
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Confidentiality |
Keep privileged information private |
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Fidelity |
Need to keep promises |
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Utility |
The good of the many outweighs the wants or needs of the individual |
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Justice |
Seek fairness; treat “equals” equally and treat “unequals” according to their differences |
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Professional Code of Ethics is |
a set of principles, established by a profession, to guide the individual practitioner |
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MORAL |
Massage the dilemma - Outline Options - Review Criteria and Resolve - Affirm Position and Act - Look Back |
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Massage the dilemma |
Collect data about the ethical problem and who should be involved in the decision-making process. |
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Outline options |
Identify alternatives, and analyze the causes and consequences of each |
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Review criteria and resolve |
Weigh the options against the values of those involved in the decision. This may be done through a weighting or grid |
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Affirm position and act |
Affirm position and act: Develop the implementation strategy. |
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Look back |
Evaluate the decision making |
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IRB are |
primarily formed to protect the rights and welfare of research subjects. They provide oversight to ensure that individuals conducting research adhere to ethical principles that were articulated by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. |
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IRB |
Institutional Review Board |
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Four of the most commonly used ethical frameworks for decision making are |
utilitarianism, duty-based reasoning, rights-based reasoning, and intuitionism. |
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Guides to the highest standards of ethical practice for nurses are |
Professional codes of ethics and standards for practice |
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constitution is |
a system of fundamental laws or principles that govern a nation, society, corporation, or other aggregate of individuals. |
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Statutes/Statutory Law/Legislative law |
laws that are passed by the state or federal legislators and that must be signed by the president or governor |
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Administrative Agencies |
the rules and regulations established by appointed agencies of the executive branch of the government (governor or president) |
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Court Decisions/Tort Law |
this is court mode law and the courts interpret the statutes and set precedents; in the United states, there are two levels of court: trial court and appellate court |
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Criminal Cases |
The individual faces charges generally filed by the state or federal attorney general for crimes committed against an individual or society |
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Civil Cases |
One individual sues another for money to compensate for a perceived loss |
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Preponderance of the Evidence |
The burden of proof required to be found guilty in a civil case |
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Administrative Cases |
an individual is sued by a state or federal governmental agency assigned the responsibility of implementing governmental programs. |
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Stare Decisis |
Means to let the decision stand. Uses precedents as a guide for decision making. |
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The nurse must avoid two pitfalls in determining if Stare Decisis should apply to a given situation |
1.The previous case must be within the jurisdiction of the court hearing the current case 2.the court hearing the current case can depart from the precedent and set a landmark decision |
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Res Judicata |
“thing or matter settled by judgment.” It applies only when a competent court has decided a legal dispute and when no further appeals are possible |
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plaintiff |
is the injured party |
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defendant |
is the professional who is alleged to have caused the injury |
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Negligence |
is the omission to do something that a reasonable person, guided by the considerations that ordinarily regulate human affairs, would do—or as doing something that a reasonable and prudent person would not do. |
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Reasonable and prudent |
The average judgment, foresight, intelligence, and skill that would be expected of a person with similar training and experience. |
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Malpractice—Professional Negligence |
Failure of a person with professional training to act in a reasonable and prudent manner |
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Standard of Care |
represent the skills and learning commonly possessed by members of the profession and generally are the minimal requirements that define an acceptable level of care. |
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Duty to Use Due Care |
the care that should be given under the circumstances (what the reasonably prudent nurse would have done) |
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Failure to Meet Standard of Care |
Not giving the care that should be given under the circumstances |
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Foreseeability of Harm |
the nurse must have reasonable access to information about whether the possibility of harm exists |
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a direct relationship between failure to meet the standard of care (breach) and injury can be proved |
patient is harmed because proper care is not given |
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Injury |
actual harm results to the patient |
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Joint Liability |
in which the nurse, physician, and employing organization are all held liable |
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Respondeat Superior |
“the master is responsible for the acts of his servants.” |
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Doctrine of Charitable Immunity |
nonprofit hospital cannot be sued by a person who has been injured as a result of a hospital employee’s negligence. |
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Governmental Immunity |
governmental immunity provides that governments cannot be held liable for the negligent acts of their employees while carrying out government activities. |
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Personal Liability |
Which says that every person is liable for his or her own conduct |
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Incident Reports or Adverse Event Forms |
are records of unusual or unexpected incidents that occur in the course of a client’s treatment. |
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Torts |
Legal wrongs committed against a person or property, independent of a contract, that render the person who commits them liable for damages in a civil action. |
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Assault |
is conduct that makes a person fearful and produces a reasonable apprehension of harm. “threatening a person, with the present ability to carry out the threat” |
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Battery |
is an intentional and wrongful physical contact with a person that entails an injury or offensive touching. |
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Simple Assault |
“If there was a threat but no physical contact, the charge" |
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Simple Assault and Battery |
When there is a physical injury, no matter how slight, the charge |
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False Imprisonment |
is the restraint of a person’s liberty of movement by another party who lacks the legal authority or justification to do so |
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Defamation |
is communicating to a third party, false information that injures a person’s reputation. |
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libel. |
When defamation is written |
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Slander |
When defamation is spoken |
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product liability |
When a product is involved, negligence does not have to be proved. This strict liability is a somewhat gray area of nursing practice |
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Informed Consent |
can be given only after the patient has received a complete explanation of the surgery, procedure, or treatment and indicates that he or she understands the risks and benefits related to |
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PERSON(S) GIVING CONSENT MUST FULLY COMPREHEND |
1. the procedure to be performed 2. the risks involved 3. expected or desired outcomes 4. expected complications or side effects that may occur as a result of treatment 5. alternative treatments that are available |
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CONSENT MAY BE GIVEN BY |
1. a competent adult 2. a legal guardian or individual holding durable power of attorney 3. an emancipated or married minor 4. Mature minor (varies by state) 5. parent of a minor child 6. court order |
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Implied Consent |
in which the physician states in the progress notes of the medical record that the patient is unable to sign but that treatment is immediately needed and is in the patient’s best interest. |
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Express Consent |
from patients by witnessing patients sign a standard consent form. |
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Advance Directives (ADs) |
written instructions regarding desired end-of-life care |
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Durable Power of Attorney |
names your health-care proxy, someone you trust to make health decisions if you are unable to do so |
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Good Samaritan laws |
health-care providers are typically protected from potential liability if they volunteer their nursing skills away from the workplace, provided that actions taken are not grossly negligent and if the health-care worker does not exceed his or her training or scope of practice in performing the emergency services. |
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License |
is a legal document that permits a person to offer special skills and knowledge to the public in a particular jurisdiction when such practice would otherwise be unlawful. |
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sources of law include |
constitutions, statutes, administrative agencies, and court decisions |
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Nurse practice acts |
define and limit the practice of nursing in each state |
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Advocacy |
helping others to grow and self-actualize—is a critically important leadership role. |
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actions of an advocate |
are to inform others of their rights and to ascertain that they have sufficient information on which to base their decisions. |
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Nurses may act as advocates by |
helping others make informed decisions, by acting as an intermediary in the environment, or by directly intervening on behalf of others |
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The nursing values central to advocacy emphasize |
caring, autonomy, respect, and empowerment |
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it is important for the patient advocate to be able to differentiate between |
controlling patient choices (domination and dependence) and in assisting patient choices (allowing freedom). |
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Patient’s Bill of Rights has three key goals: |
1.To help patients feel more confident in the US healthcare system 2.To stress the importance of a strong relationship between patients and their health-care providers 3.To stress the key role patients play in staying healthy by laying out rights and responsibilities for all patients and health-care providers |
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The American Recovery and Reinvestment Act of 2009 (ARRA) |
maintains and expands HIPAA guidelines as they are related to patient health information privacy and security protections. |
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Genetic Information and Nondiscrimination Act (GINA) |
making it illegal for health insurers or employers to discriminate against individuals based on their genetic information |
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Subordinate advocacy |
suggests that nurse administrators should advocate for other health-care providers (including subordinates) as well as patients, especially when this is related to health and safety. |
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workplace advocacy |
the manager works to see that the work environment is both safe and conducive to professional and personal growth for subordinates. |
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Internal whistleblowing |
occurs within an organization, reporting up the chain of command |
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External whistleblowing |
involves reporting outside the organization such as the media and an elected official |
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Leader-managers must be willing to advocate for |
whistleblowers, who speak out about organizational practices that they believe may be harmful or inappropriate.network groups, where colleagues meet to discuss professional issues and pending legislation. |
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network groups |
where colleagues meet to discuss professional issues and pending legislation |
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Delegation can be defined simply as |
getting work done through others or as directing the performance of one or more people to accomplish organizational goals. |
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Joint Statement on Delegation |
intended to support nurses in using delegation safely and effectively. It is a skill that must be taught and practiced for proficiency. |
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The mark of a great leader is when he or she can |
Recognize the excellent performance of someone else and allow others to shine for their accomplishments. |
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Why Plan Ahead with Delegation? |
always be sure to carefully assess the situation before delegating and to clearly delineate the desired outcomes. |
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Why Communicate Goals Clearly with Delegation? |
includes identifying any limitations or qualifications that are being imposed on the delegated task. |
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Responsibility is |
shared when a task is delegated. |
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Common Delegating Errors |
Underdelegating Overdelegating Improper delegating |
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Reasons for Underdelegating |
1.The individual’s false assumption that delegation may be interpreted as a lack of ability on his or her part to do the job correctly or completely 2.The individual’s desire to complete the whole job personally due to a lack of trust in the subordinates |
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Reasons for Overdelegating |
1.They are poor managers of time, spending most of it just trying to get organized 2.They feel insecure in their ability to perform a task |
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Improper Delegation includes |
Delegating at the wrong time, to the wrong person, or for the wrong reason, includes delegating tasks that are beyond the capability of the person to whom they are being delegated or that should be done by someone with greater expertise, training, or authority. |
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5 Rights of Delegation |
Right Task-Right Circumstances-Right Person-Right Direction-Right Level of Supervision |
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Right task |
One that is delegable for a specific patient |
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Right circumstances |
Appropriate patient setting, available resources, and other relevant factors considered |
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Right person |
is delegating the right task to the right person to be performed on the right person |
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Right direction/communication |
Clear, concise description of the task, including its objective, limits, and expectations |
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Right level of supervision |
Appropriate monitoring, evaluation, intervention, as needed, and feedback |
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Reasons for Resistance Against Delegation |
1. UAP has too much on plate 2. UAP wants to "test the water" of delegator 3. Overdelegation |
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Communication |
The first of the cultural phenomena, is greatly affected by cultural diversity in the workforce because dialect, volume, use of touch, context of speech, and kinesics such as gestures, stance, and eye movement all influence how messages are sent and received. |
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Space |
is the second cultural phenomenon influencing delegation, refers to the distance and intimacy techniques that are used when relating verbally or nonverbally to others. |
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Social Organization |
refers to the importance of a group or unit in providing social support in a person’s life |
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The fourth cultural phenomenon affecting delegation is |
Time |
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Past-oriented cultures |
are interested in preserving the past and maintaining tradition. |
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Present-oriented cultures |
Focus on maintaining the status quo and on daily operations. |
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Future-oriented cultures |
focus on goals to be achieved and are more visionary in their approach to problems. |
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Environmental control |
the fifth cultural phenomenon, refers to the person’s perception of control over his or her environment (internal locus of control). |
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biological variations |
refers to the biopsychosocial differences between racial and ethnic groups, such as susceptibility to disease and physiologic differences. |