The Management Role of the Licensed Practical/Vocational Nurse Chapter Twelve The Management Role of the Licensed Practical/Vocational Nurse

Management Roles Management role of LPNs changes constantly Work of LPN always involves leadership skills Always clarify the scope of responsibility and role expected to be fulfilled

Management Styles Everyone has a personal management style Determine an effective but flexible leadership style Authoritarian High concern for tasks done Low concern for the people who perform the tasks Make all decisions in workplace

Management Styles Authoritarian Permissive or laissez-faire Does not allow for creative thinking or new ideas This management style is good in emergency situations Permissive or laissez-faire Exact opposite of authoritarian style An absence of leadership Does not require employee accountability

Management Styles Democratic or participative Strong valuing of the people on the team Gathers information from other team members Identifies individual responsibilities Takes more time than other management styles

Communication Important skill for a manager Verbal communication Exchange of ideas and understanding through spoken words Nonverbal communication Ability to share messages without using words Body posture, facial and hand expressions

Communication Communicating with patients Normal aging changes that affect communication Slower speech, presbycusis, presbyopia, slower responses Successful communication with older adults must be based on respect for them as people

Communication Communicating with patients (cont.) Strategies Do not approach the person from the side Place yourself on eye level Reach out and touch the person if appropriate Speak at a normal rate Choose setting without disturbing or distracting noises

Communication Strategies (cont.) Communicating with the families Repeat questions or comments Listen carefully Communicating with the families Recognize the emotional environment of the family Listen to them before you begin providing information Spend time with family members

Communication Communicating with the families (cont.) Find a quiet place to talk Facilitate sharing of information from other health-care providers Families are as important as the person

Communication Interdisciplinary team communication Important to have effective communication between team members Be prepared to discuss information with team Be ready to justify your concerns or requests Nurse is patient advocate

Additional Communication Skills Assertive communication skills Assertive behavior is most effective response Assertive response must not violate the rights of another person Use statements “I feel,” “When you,” “We should”

Additional Communication Skills Active listening Requires listening to what is being said Do not prepare a defense Show support for other person’s feelings Clarify the problem and negotiate a solution

Planning Hoop Planning process never ends Planning is an intelligent process of thinking based on facts and information Plan must always be re-evaluated Planning process consists of assessment, goal setting, implementation, and evaluation

Planning Hoop Assessment Goal setting Identify problem or potential problem that concerns you Determine what knowledge is lacking Goal setting Preparing a plan to resolve a management problem Goals should be meaningful and carefully thought out

Planning Hoop Implementation Evaluation Crisis management Performance of plan Evaluation Plan must be evaluated for its effectiveness Crisis management Occurs when manager does not take the time to plan

Priority Setting Priority is determined after assessment of the situation Need to think of the entire organization when determining priorities Two categories Concerns that relate to patient or resident care Concerns that relate to the process of running the business of the institution Concerns need to be listed as a need or a want

Managing Personnel Nurse manager is responsible for hiring and evaluating employees Interview Exchange of information Determine applicants’ Dependability, skills, willingness to assume responsibilities, adaptability, willingness and ability to work with others

Managing Personnel Interview (cont.) Employee evaluation Be specific and direct in your comments Develop interview guide Employee evaluation All organizations have an established process for evaluating employees First evaluation may come at 3 months, 6 months, or 12 months

Managing Personnel Employee evaluation (cont.) Based on five basic assumptions: Assist employee to improve management of workload Employee appraisal is a difficult process No one likes the current form; a perfect form does not exist Information must be gathered on daily basis Appraisal made by supervisor

Managing Personnel Employee evaluation (cont.) Should avoid Leniency error Recency error Halo error Evaluation process is crucial to growth and stability of organization

Making Care Assignments Making effective assignments is crucial to any clinical area Successful care assignments match the worker with the older person in a manner that allows for the best nursing care to be administered and received When making assignments, consider skills of employees

Making Care Assignments Use Benner’s From Novice to Expert theory to assess skills of CNA Novice Advanced beginner Competent Proficient Expert

Making Care Assignments Novice CNA should be assigned to an expert CNA who can assist with care when needed Expert CNAs should be assigned to the most challenging older adults More effective to assign the same employee to an older person for several days in succession

Making Care Assignments Delegation Goal is to delegate tasks while maintaining quality patient and resident care Familiarize yourself with the Nurse Practice Act for the state where you work Become familiar with the policy and procedures and job descriptions for your facility

Making Care Assignments Delegation (cont.) Five rights of delegation Right task Right circumstance Right person Right direction Right supervision Delegate routine work that can be done by someone else

Providing Education to Employees Assist with continuing education of employees Assist with increasing and maintaining the skills of the employee Provide adequate orientation to new employees Provide mentoring program for new employees

Managing Quality of Care Joint Commission on Accreditation of Hospitals (JCAH) American Nurses Association National League of Nursing Total Quality Management (TQM)