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Timby/Smith: Introductory Medical-Surgical Nursing, 11/e
Chapter 6: Leadership Roles and Management Functions
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Leadership and Management
Qualities related to character and behaviors Guide and influence others Effective leader qualities Gain respect Communication skills Motivate others
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Relationship of Leadership and Management
Management: assigned functions Coordinate and direct resources Effective management Long-term thinking Influence others Politically astute Embrace change or modifications
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Leadership Styles Autocratic
Manager: strong control over work group; focus is on accomplishing task Democratic Manager as colleague; decision making by work group Emphasis on communication, consensus, teamwork Laissez-faire or permissive management Manager leaves group to set goals; least structure and control
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Question An LPN/LVN in a healthcare facility is using an autocratic leadership style. What should the nurse do when dealing with an emergency situation? A) Refer to a procedural manual on actions to be taken. B) Discuss with the RN steps to follow to manage the situation. C) Instruct the staff on duties they need to do. D) Encourage all staff to be involved in the situation.
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Answer C) Instruct the staff on duties they need to do. Rationale: Autocratic leadership entails strong control by the nurse over the staff. The focus is on accomplishing tasks. This helps in providing immediate attention to the client and handling the situation without confusion.
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Power and Leadership Power: ability to control, influence, or hold authority Types Reward power: ability to grant favors or rewards Coercive or punishment power Threaten or punish someone who fails Legitimate power: virtue of management position Expert power Knowledge, expertise, or experience
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Power and Leadership—(cont.)
Types—(cont.) Referent power Association with others who are powerful; physicians Informational power Person has information that others have to accomplish goal. Connection power Networking; collaboratively working toward a goal
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Question A nurse is considered powerful by her peers because her relative is the administrator of the facility. Which of the following best describes the type of power exhibited? A) Coercive power B) Referent power C) Informational power D) Reward power
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Answer B) Referent power Rationale: Referent power concerns the power a person has because of his or her association with others who are powerful.
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The LPN/LVN as Leader/Manager
LPN/LVN roles: works with RN and have appointed task Extended roles: team leaders, office managers Primary functions Delegation: accomplishing work through others Supervision: judgment about clinical assignments and delegating Responsibility: obligated to certain activities or duties Accountability: answerable for consequences for actions
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Question The LPN/LVN is having an exceptionally busy shift on the skill nursing unit. Which of the following tasks is the LPN/LVN justified in delegating to an unlicensed care provider? A) Emptying a client’s Foley catheter and reporting the output to the LPN/LVN B) Changing the wound dressing and reporting the color of the drainage C) Assessing the amount of edema in the client’s lower extremities D) Giving pain medication to the client with chest pain
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Answer A) Emptying a client’s Foley catheter and reporting the output to the LPN/LVN Rationale: Emptying a Foley catheter bag and reporting the volume is within the scope of an unlicensed care provider.
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Challenges to Leading and Managing
Reluctance to delegate Inability to move out of patient care Miscommunication of directions and outcomes Desire to be liked by coworkers Solutions Education about role Focus is client needs; accountability
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Question What is the most important thing the nurse should consider when identifying an appropriate person to whom to delegate? A) Whose turn it is to be delegated B) The cost of the delegated task C) The qualifications of the person to carry out the task D) Whether the person has done the task before
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Answer C) The qualifications of the person to carry out the task Rationale: Nurse managers should be knowledgeable of the individual’s qualifications to whom they are delegating to validate if they are capable of completing the delegated task.
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Collaboration for LPN/LVN
Team effort to achieve outcomes Maintain open and effective communication Directing care Contribute to decision about care; care conferences Assist in solving problems; unit meetings Support management of unit—channels of communication
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Advocacy Role for LPN/LVN
Promoting cause of another person or organization Functions Understanding rights of clients Remaining informed Contributing to provision of information and education Supporting client’s decision Communicating with other professionals
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Resource Management LPN/LVN responsibility: controlling use of resources and recognizing when resources are inadequate Rising costs factors New technologies Constructions Salaries Medications and equipment Acuity measures
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Time Management Steps for organizing time
1) Plan and establish priorities. 2) Completing high-priority tasks. 3) Reassess and reprioritize. Techniques: assess expectations, worksheets, multitask, delegate Prioritize
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