Nursing Trends and Issues

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Nursing Trends and Issues

• NPN 215

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• WHAT LIES BEHIND US AND WHAT LIES BEFORE US ARE
  TINY MATTERS COMPARED TO WHAT LIES WITHIN US.
• Oliver Wendell
  Holmes

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Leadership

• Defined process of influence
• Any person in an organization can be a leader.
• Characteristics contained in most persons who are
  leaders
• passionate
• curious
• intelligent
• flexible
• self confident
• have ability to support others

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Leadership

• True leadership is not based on the traditional
  views of having authority, command, and power
• Success of a leader depends on
• Positive interactions between leaders and
  followers
• The leaders and the followers must have a
  reciprocal relationship

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Types of Leadership

• Formal
• A person in a position of influence or authority,
  or who has a sanctioned role within the
  organization
• Informal
• A person who demonstrates leadership and has
  influence even though he or she is not in the
  leadership role

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Leadership Styles

• Autocratic
• Laissez-faire
• Democratic
• Employee centered

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Management

• Define a process of coordinating actions,
  directing actions, and assigning resources
• Purpose perform these tasks in order to achieve
  the goals of the organization
• Management focuses on issues such as costs,
  productivity, staffing, and effectiveness
• Management doses not equal leadership, but
  leadership may play a role in management

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Management

• Functions
• Planning
• Staffing
• Organizing
• Directing
• Controlling
• Decision making

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Leadership versus Management

• Concepts are not interchangeable
• Leaders do the right thing and managers do things
  right
• Leaders get other people to do something and
  managers get other people to do what they do not
  want to do
• Management works within the system, and leaders
  work on the system
• You manage things and lead people
• The 2 do not need to work against each other, as
  this describes, but leaders can be managers and
  managers can be leaders
• Leadership is the preferred way, in todays
  world, to get things done in health care

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Characteristics of a Nurse Leader

• Experts in a particular field of nursing
• Generalists
• Self-reliant
• Connectivity
• Flexibility
• Can disseminate information rapidly
• Develops and maintains strong trust and
  interpersonal connections with staff, peers,
  patients, and other professionals
• Builds up and supports team members skills and
  strengths
• Thrives on uncertainty and chaos

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Direct Patient Care Nursing

• Charge nurse or clinical supervisor
• Expanded staff nurse role
• May be permanent or temporary
• Functions as a liaison to management
• Tasks shift coordination, quality care,
  problems solver, help with prioritizing and
  making decisions
• More limited authority and scope of
  responsibility than the manager

• Staff nurse
• No formal management or leadership rank
• Works to manage patient care
• Uses skills of management and leadership when
  working with other staff nurses and assistive
  personnel
• Supervise to ensure quality patient care
• Delegates tasks to others appropriately
• Motivates staff

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LPN as Managers

• You must always direct, handle, and organize care
  to the patients you are assigned to care for
• You have the skills to function as 1st line
  managers
• Basic nursing skills and the nursing process
• Time management
• Use of resources and how to learn new information
• Communication skills
• Ethical and legal aspects of patient care
• Stress management
• How to participate in a clinical evaluation

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Power vs Authority

• Power means being able to make change, or to
  prevent change from happening. Nurses have the
  power to take resources and use them to benefit
  patient care. Power is linked with expertise in
  nursing
• Authority is the right to act or to command the
  actions of others. It comes with the job of
  nursing because we cannot function without it,
  and the amount is based on the Nurse Practice Act

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Delegation and Assignment

• Delegation is the transfer of responsibility for
  the performance of an activity from one
  individual to another while retaining
  accountability for the outcome.
• Assignment is the downward or lateral transfer of
  both the responsibility and accountability of an
  activity from one individual to another

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Accountability and Responsibility

• Accountability is being responsible and
  answerable for actions and inactions of self or
  others in the context of delegation
• Responsibility is the obligation involved when
  one accepts an assignment

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Organizational Chart

• State licensing board
• Board of directors
• CEO
• Ethics committee
• Nurse manager
• Charge nurse
• Staff RN
• LPN
• Nursing assistant

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Communication

• Communication is an essential skill for leaders
• Giving information is not communication
• Communication involves the sender, the message,
  the receiver and feedback from the receiver
• Use simple exact language
• Use direct communication
• Make sure the communication channels are open

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Communication, cont.

• Types of communication
• Written
• Non-verbal
• Negative or hostile
• Therapeutic
• Aggressive
• Passive
• Passive-aggressive
• Assertive

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Assertiveness

• Are we handmaidens to the physicians
• Traditionally LPNs are not assertive
• Assertive communication is the ability to express
  yourself and protect your rights without
  violating the rights of another person
• Nurse managers who are assertive are more
  effective than those who are not

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10 Basic Rights of Women in the Health Field
(Melodie Chenevert)

• You have the right to be treated with respect
• You have the right to a reasonable work load
• You have the right to an equitable wage
• You have the right to determine your own
  priorities
• You have the right to ask for what you want

• You have the right to refuse without making
  excuses or feeling guilty
• You have the right to make mistakes and to be
  responsible for them
• You have the right to give and receive
  information as a professional
• You have the right to act in the best interest of
  the patient
• You have the right to be human