NUR 428 requires that you are prepared for class which includes completion of these study guide questions, as well as those at the end of the chapters.
1. read the chapter and review summary at end of chapter
2. answer these questions and those at the end of the chapter. Some questions will require limited investigation beyond the text.
Chapter 1: Introduction to Nursing Management
1. Why are all professional registered nurses managers?
2. What key issues are of concern in health care delivery today?
3. What are the three primary characteristics of integrated health care systems? Their focus and goal? How is payment handled?
4. What is the difference between managed care and integrated health care systems?
5. Why is being a nurse manager in today's health care environment especially challenging?
Chapter 2: Organizational Theory and Design
1. What is an organization?
2. Define: simple structure, machine bureaucracy, divisionalized and adhocracy organizational designs. Provide examples of each from the local community.
3. Contrast line and staff positions in organizations.
4. Review the classical, neoclassical, systems, contingency and chaos theories of organizations. In chart
a. the era during which it was prominent. c. its main elements.
b. leading proponents of the theory. d. aspects of the theories you see in play today
5. How is the local hospital classified, in terms of ownership? The Health Department?
6. What do the vertical and horizontal dimensions of organizational structure represent? (not in text)
a. What is span of control?
b. What characterizes a centralized structure? Decentralized?
7. Identify the six most common health care organizations. Which is the newest? Provide examples from the local community.
8. Distinguish among HMO, PPO and POS in managed care.
9. Describe the following organizational structures: functional, service-integrated, hybrid, matrix, parallel, shared governance, and self-organizing structures. Which structure is most the most empowering to nurses?
10. Provide examples of vertical and horizontal integration in the local community. Of diversification.
11. Do you agree with the idea that "downsizing" is "rightsizing"? Why or why not?
Provide examples of redesign, restructuring and reengineering.
12. How do the mission statement and philosophy of an organization compare--which is more complex?
13. Distinguish between organizational climate and organizational culture. Why must a nurse manager be aware of both?
Chapter 3: Nursing Care Delivery Systems
1. Differentiate among the following methods of organizing care, identifying advantages and disadvantages of each:
d. case management
e. differentiated practice
f. patient-centered care
2. Which method of organizing care is mostly linked with managed care?
3. Be prepared to determine which system would be most appropriate to use in selected situations.
Chapter 4: Leading and Managing
1. Distinguish between a leader and a manager.
2. Can leadership skills be learned?
3. Provide examples of the following bases of power available to the nurse manager in exerting leadership:
Which of the above bases of power are position or personal?
4. Describe characteristics of the following leadership styles identified in Lewis and Lippitt’s theory:
a. autocratic or authoritarian
b. democratic or participative
c. permissive or laissez-faire
5. Of the four dimensions in Likert's System 4 Model of Management, which would be the most empowering of others and the most effective in today's health care environment? In the Blake and McCanse Managerial Grid which style? In the Tannebaum and Schmidt Continuum?
6. Contingency theories built upon Behavioral theories by adding what factor?
7. Review Fiedler's Contingency Model of Leadership.
a. When, according to Fiedler, is a leader most effective??
b. Describe the three situational characteristics that Fiedler identified as influencing success. Which was considered to be the most important? The least?
8. What element did Hersey and Blanchard add to Fiedler's Contingency Model? Illustrate how this model could be used by a team Leader or Nurse Manager, with staff of varying levels of job maturity.
9. The Vroom-Yetton normative, or prescriptive model of leadership is essentially what kind of model?
a. What three basic questions must the nurse manager consider in using this model? Be prepared to apply the model in a clinical situation.
10. Review the Path-goal theory of leadership. According to this theory, what is the nurse manager's role as a leader?
a. Differentiate among expectancy, instrumentality and valence that serve as the concepts in the motivational theory underlying the path-goal theory.
b. The four types of leader behaviors identified in the Path-goal theory are: supportive, directive, achievement-oriented and participative. With which staff in a contemporary nursing team with whom would each of these leader behaviors be especially effective?
11. Consider the contemporary theories of leadership that are based upon the quantum leadership concept.
a. Provide examples of charismatic, transactional and transformational leadership.
b. For what purpose do "connective leaders" use their interpersonal skills? Why?
c. Upon what principles is shared leadership based? Servant leadership?
12. Define the four basic functions of management.
a. Provide examples of contingency and strategic planning that are not in the text, either from personal or professional experiences.
b. What are six key elements to successful directing? Which do you feel is the most important? Why?
13. Review Mintzberg's theoretical work described on pp. 60-62.
a. Mintzberg based his work on what two premises about the manager's essential function?
b. What three categories of roles did he identify as essential to being a manager?
14. In your own words, what are the six functions of the nurse manager, according to the AONE?
15. Provide examples of a first-level, middle-level and upper-level nurse managers in various settings (e.g. hospital, health department, etc) and their typical responsibilities. A charge nurse. A staff nurse.
Chapter 5: Legal and Ethical Issues
1. Why is it critical to remember that there is a difference between legal and ethical guidelines?
2. What document provides a framework for nurses making ethical decisions?
3. Does knowledge of ethical theories and principles provide the answer to ethical dilemmas?
4. Differentiate between the philosophical approaches of the two main bodies of ethical theories:
b. utilitarianism (teleology)
c. Give an example of how two people following these two different views might handle the same situation differently (not the example in text).
5. Distinguish between selected principles r/t ethical decision making, providing an example of each that is not in the text:
a. autonomy c. beneficence
b. nonmaleficence d. distributive justice
6. Other than the supreme law of the land, the constitution, what other broad categories of laws are derived from the legislative, judicial and executive branches of the government?
a. Provide examples of each that are not given in the text
7. Another way to categorize law is by public or private. Identify the types that fall within each category.
8. Which category of tort law has the most implications for nursing practice?
a. In order for violation of this law to be proven, what four elements must be proven?
b. How could the other category of tort law be violated in practice?
9. How can misinterpretation of the concepts of "personal liability", "vicarious liability" and "respondeat superior" lead to liability problems for the practicing nurse?
10. Illustrate an instance of corporate liability not in the text.
11. Distinguish between licensure and registration.
12. Changes currently occurring in licensure relate to a) uniform licensure requirements, and b) multistate licensure. Define each and discuss briefly the implications for nursing practice.
13. Is the Patient's Bill of Rights legally binding?
a. What rights does this document protect? Give examples not in text.
14. What alternatives did the Patient's Self-Determination Act of 1990 create? Which one is not identified in the text?
15. There are multiple legal issues that concern RNs. Consider those discussed in the text.
a. What legality must a nurse keep in mind when delegating to UAPs?
b. Which individual in the nursing department is responsible to assure safe staffing?
c. What legal concern is there in relation to policies and procedures?
d. What is the legal "Catch 22" in using job reassignment (floating) to assure adequate staffing?
What are the options of the nurse being reassigned?
16. What standard requires nurse managers to confront unsafe practice?
17. A number of acts and legal guidelines have been established that protect employees' rights. Identify the main focus of the following:
a. Civil rights Act, 1964 c. EEOC guidelines e. OSHA, 1970
b. ADEA of 1967 d. ADA, Title I, 1990
Chapter 6: Power and Politics
1. Differentiate between "politics" and "policy."
2. The text discusses the effect of politics in the workplace, government, financing and in the organization. Essentially, it all comes down to having impact on what one thing in health care?
3. Your text discusses how politics is the art of "influencing." What broad strategies are identified by the authors, as essential to this art? (Hint: there are at least four.)
5. Power. Which behaviors that the authors cite as developing "principle-centered" leadership do you feel nurses, as a whole, are using? Not using?
a. What strategies could we use to get more of these behaviors into action?
b. What two bases of power are there particular to political effort?
c. Why is image important in development of power? Vision?
6. Why is the application of power, politics and marketing essential in the nurse manager role?
7. What are the "power points"? Illustrate how you could use them to lobby for a political change in your organization
Chapter 7: Budgeting and Resource Allocation
1. Why are nursing departments under such pressure, budgetary-wise?
2. What does planning help to do with the budgeting process?
3. What does the controlling aspect of budgeting accomplish? There are two techniques used for controlling budgetary performance.
a. What is variance (in a budgetary sense)? Why is it such a critical figure?
b. What aspect of the budget does position control cover?
4. What is the usual budgetary period?
5. Describe the basic differences between incremental (line-by-line) and zero-based approaches to budgeting.
6. Differentiate between operating and capital budget. What is the other term for operating budget? Define what constitutes the salary part and the non-salary part of the operating budget?
7. How can a nurse manager make staff more aware of their impact on the budget?
Chapter 8: Effectiveness, Efficiency and Productivity
1. Why have the definition and measurement of nursing productivity become such priorities for nurse managers?
2. What hampers the effectiveness of health care organizations in today's environment?
3. What constitute health care inputs? Outputs? Effectiveness? Efficiency?
4. How is the concept "case mix" used in relation to a hospital's output?
5. How may quality of output be measured, in terms of effectiveness?
6. Describe briefly the following methods of measuring nursing productivity, and their associated advantages & disadvantages:
a. resources per patient day, nursing hours per patient day, salary costs per patient day and standardized patient days
7. What is missing from utilization rates that make them a less useful tool for measuring productivity?
8. How can the greatest productivity gain be achieved in use of inputs?
a. How does the nurse manager use the patient classification system in this?
b. How does making staff substitutions help? Its disadvantages?
c. How can the nurse manager control use of supplies and equipment to increase productivity?
9. What elements comprise the "technology" that the nurse manager can change to increase productivity of care?
a. How can the nurse manager assess if changes in the care process have been effective in increasing productivity?
Chapter 9: Quality Management
1. Distinguish TQM from CQI.
2. Compare the QM philosophy with that of its predecessor, QA (in class content).
3. Who was the first to push quality assurance in nursing? Who created TQM?
a. What are the core characteristics of TQM? Provide examples of each.
b. What is the process used in TQM called? What are its four major players?
4. What law and agencies mandate quality monitoring?
5. Contrast the philosophies of quality assurance and quality improvement.
6. Explain standard, process and outcome standards.
7. Describe when you should use the two main approaches to audit.
8. Define "risk management program."
a. What are its primary purposes?
b. Who will have risk management responsibilities in today's health care organization?
9. Why are incident reports used?
a. What is essential to remember when documenting on the incident report form and in the nurses notes?
b. What is the key role of the nurse manager in a patient incident/potential liability situation?
Chapter 10: Problem Solving and Decision Making
1. How do problem-solving, decision-making and critical thinking compare, in terms of breadth and depth?
a. What are the components of critical thinking?
b. What are the two main differences between problem-solving and decision-making?
c. Which is most akin to the nursing process?
2. List at least three methods of problem-solving; provide an e.g. of each (not from the text).
3. When is it advantageous for the nurse manager to use the group in decision-making?
a. What are possible disadvantages to group decision-making?
b. How might you, as a nurse manager, help your staff to avoid "groupthink?"
c. A nurse manager wants to use the brainstorming techniques in decision-making, but the staff can't find a common time to meet. What other strategy would be more appropriate?
4. Provide examples of the three types of decisions from your own clinical experience.
5. In situations of decision-making by a nurse manager, under which condition(s): certainty, risk or uncertainty, does decision making occur the most?
6. What three processes can be used in making decisions?
a. Differentiate between the decision-making strategies of "satisficing" and "optimizing." In which of the three decision making processes are “satisficing” and “optimizing” decisions most likely to occur? Which strategy is the more likely to have better long term effect? Why?
7. What type of decisions can artificial intelligence make?
8. Describe how nominal group, Delphi, statistical aggregation, brainstorming and synectics group decision-making are implemented. What are their advantages/disadvantages?
9. Identify at least three stumbling blocks to problem-solving and decision-making.
10. What are some of the characteristics of creative people?
a. How can a nurse manager develop creativity in staff?
Chapter 11: Communication and Conflict
1. Provide examples not found in the text of the four directions of communications in organizations.
2. What must nurse managers keep in mind about the following, as they communicate within the organization?
a. gender influences
1) Select one strategy for becoming more "androgynous" in communicating professionally that you feel is essential. Why?
b. culturally diverse workforce
1) How can a nurse manager improve upon knowledge of different cultures and interpretation of cultural messages?
c. organizational culture and climate
1) In a situation of downsizing, what would be the best way to communicate the decision to close a unit to the staff?
3. Provide a scenario (not found in the text) illustrating: aggressive, assertive and patronizing communication.
4. What key principles does the nurse manager remember in communicating with: subordinates, superiors?
5. If a superior says no to a request, what communication strategies can you use?
6. Which communication strategy recommended for use in attempting to discuss a problem with a supervisor do you feel is most critical? Why?
7. What is a key principle to remember in communication with personnel of other departments?
8. Illustrate with a scenario the key principles nurse managers need to follow in communicating with clients and families.
9. Illustrate how to communicate with a difficult person.
10. Provide examples of intrapersonal, interpersonal, intragroup and intergroup conflict in a health care setting.
11. Differentiate between conflict and competition.
a. How do competitive and disruptive conflict differ?
12. Provide examples of when conflict is positive, negative in an organization.
13. Why is learning how to deal with conflict important for nurses in managerial positions?
14. Study Filley's "Conflict Process" model.
a. What is considered to be the most important antecedent condition in today's health care environment?
b. Think of situations of conflict you have observed in the practice setting (not the text) that r/t:
1) unclear roles?
2) competition for scarce resources? internal and external competition for scarce resources?
3) differences in values and beliefs?
4) task interdependency: pooled, sequential or reciprocal?
5) distancing mechanisms or differentiation?
6) unifying mechanisms?
7) structural conflict?
c. Differentiate between perceived and felt conflict
d. Distinguish between the two main types of behaviors that can be manifested as a result of conflict: overt and covert. Give examples.
15. Define and give examples of how a nurse manager may use the following strategies to manage conflict:
a. suppression d. avoiding g. negotiation j. confrontation
b. withdrawal e. forcing h. collaboration
c. smoothing f. competing I. compromise
16. Which of the strategies is most recommended? Which would most likely lead to a:
c. win-win "resolution"?
17. Summarize the basic rules for managing conflict into 2 or 3 principles.
Chapter 12: Using Management Information Systems
1. What are some benefits of using automated systems?
2. What are some obstacles to using automated systems?
3. Distinguish between a management information system and a hospital information system..
5. Distinguish between patient monitoring systems and patient management systems.
6. Why is telehealth technology important in today’s health care environment?
Chapter 13: Stress and Time Management
1. What is stress? How can it be both positive and negative in nature?
2. What is the effect of too little or too much stress?
3. Describe how the following factors can act as antecedents to stress: job factors, manager behaviors, organizational factors and the changing health care environment.
4. How might deficiency focusing, necessitating, low skill recognition, intrarole conflict, interrole conflict, role ambiguity, role underload and underutilization contribute to reality shock, burnout?
5. What are some warning signs of too much stress that the nurse manager should be aware of in self and staff?
6. Give examples of personal and organizational ways to cope with stress.
7. What effect will prolonged stress of staff have on the smooth operation of the nursing unit (and with what problems will the nurse manager have to deal)?
8. Consider the "time wasters" identified in the text. To what ones, if any, do you feel you are susceptible?
9. From the principles of time management discussed in the text, identify which ones might be appropriate to resolve the identified time wasting problems (table 13-1).
10. How can one control interruptions? Cut down time spent on phone calls? Cut down on drop-in visitors? Be better organized, personally? Handle paperwork?
Chapter 14: Effective Delegation
1. When you delegate to someone, what are you assigning them? What are you not assigning them?
a. How does delegating differ from giving directions (work allocation)?
2. What are the four principles of delegation?
3. What five steps must the nurse manager follow, in delegating to staff? What is a key point to remember in each step?
a. Step five serves as a means to give the subordinate feedback about their performance of a delegated task, but what other important purpose does it also serve?
4. Why are delegation decision making trees such as illustrated in fig. 14-1, and the NYSNA version, important?
5. What should the delegator do as a last component of describing the task, before getting agreement to do the task from the delegate?
6. Review the obstacles to effective delegation. Which ones have you used, or had used toward you? What could have been done differently?
7. What responsibilities should a nurse manager never delegate to subordinates?
8. Provide an illustration of underdelegation, reverse delegation and overdelegation, not from the text.
9. What are two essential ingredients in delegating to a subordinate, in terms of the liability issue?
Chapter 15: Building and Managing Teams
1. Why must nurse managers be skillful at building and managing teams and work groups? Why are some nurse managers not skillful at this?
2. Distinguish among command, task groups, committees, task forces, teams, competing and ordinary interacting groups. Give an example of each.
a. Give an example of a task group that has vertical, lateral and diagonal membership.
b. What kind of authority do teams have in an organization?
3. Of the five stages of group development, where do the following occur: establishment of the leader; expected behaviors of group members, and the actual work?
a. At which stage should the leader be more directive? A facilitator? A conflict manager?
4. Consider the content on team building and be prepared to provide strategies in a scenario.
5. A nurse manager is forming a team to staff a new unit. What questions should the nurse manager consider in forming the team?
a. What four conditions are essential for effective teams to develop?
6. What is the most important norm that a group establishes, especially on a nursing unit? Distinguish between “norms” and “roles”.
a. What is the nurse manager's role in this, as a leader? How can the nurse manager be most effective?
7. Define types of group tasks: additive, disjunctive, divisible and conjunctive.
8. Have you ever observed the "status incongruence" phenomenon? Why did it happen?
9. How can nurse managers/leaders support effective communication in their work groups?
10. What factors contribute to group cohesiveness?
a. What are some positive effects of group cohesiveness? Negative effects?
11. What makes a nurse manager a successful team leader? Do you agree? Why? Why not?
12. From a nursing unit's perspective, give examples of the levels of interdependence with other groups for: pooled, sequential and reciprocal.
13. What is the key step in conducting meetings, regardless of their type?
a. From the chart on page 245, what other guidelines do you feel are critical? Why?
b. What kind of actions outlined in the chart facilitate: (1) task completion and (2) group relations?
14. How does preparation for the work of a task force differ from that for a committee?
a. What is a key norm to establish in the first meeting of the task force?
b. What kind of position should the leader of the task force assume toward the issue under study?
Chapter 16: Initiating and Managing Change
1. What is the primary stimulus to change in health care delivery today?
2. Why is the nurse viewed as a primary candidate for change agent?
3. Why is the nurse, as a change agent, an entrepreneur?
4. Provide an example of using Lewin's Force Field Model for effecting change.
a. What is the primary focus of the change agent in this model?
5. How does the focus of Lippitt's change model differ from Lewin's?
a. What skills are essential to the change agent in this model?
6. What reality does Roger's Diffusion of Innovations change model recognize that the others do not?
a. To be successful in implementation of change, Rogers stresses what two important principles?
7. Why might we say that using the nursing process as a framework for an eclectic model for change is a given?
8. To get people to recognize the need for change, what might a leader have to do?
9. What two strategies, when used in combination, may implement change more effectively?
10. Review the change agent strategies discussed in the text (power-coercive, empirical-rational and normative-educative). In what type of situations would each of them be appropriate? Not appropriate?
11. Review the list of change agent skills. Which do you see as important? Why?
12. Scan the list of statements "typical" of resistors to change.
a. Have you seen these used in clinical practice? Describe.
b. If you saw it dealt with, describe that also. Was it handled effectively, according to the guidelines in the book? Why or why not?
13. List the positive and negative aspects of resistance to change.
14. What are the four key "politically astute" strategies that are recommended to increase acceptance of change?
Chapter 17: Recruiting and Selecting Staff
1. What two people, or departments share responsibility for recruiting nurses?
2. What are the basic steps in the recruiting process?
3. Why is a physical exam of the prospective employee important, from the organization's perspective?
4. What does the job analysis determine?
5. Briefly, describe 5-6 methods of job analysis.
6. What, according to the authors, can generally serve as the best indirect recruiting tool?
7. Where is the best place to start recruiting?
a. What strategy do most health care organizations eventually have to use?
8. What are the different ways an organization can recruit?
a. What is an advantage/disadvantage of employee referrals?
9. What is the preferred principle to follow in selling the organization to candidates?
10. Why is cross-training becoming more popular as a recruitment strategy?
11. What are the purposes of the interview?
a. Which is the most important part of the interview?
12. Which principles of effective interviewing do most managers tend not to follow well?
13. In a limited-time situation, which aspect of the interview process should be focused on most heavily?
14. What is the purpose of reviewing the candidate's application before the interview?
15. How should the interviewer project themselves to the candidate?
16. Why are interviewer guides an essential tool?
17. What is the difference between "behavioral simulations" (not discussed in text) and "work sample questions" in the interview process?
18. What should the interviewer be sure to do, in closing the interview?
19. If staff is involved in interviewing candidates what legal guidelines must they be oriented to, to follow?
20. What 3 things should the interviewer weigh in comparing candidates?
21. What does Title VII of the Civil Rights Act of 1964 state is illegal in making a decision to hire?
a. When is there an exemption to this legal guideline?
b. What is adverse impact?
22. Why are references often perceived as having little validity?
23. Give an example of negligent hiring.
Chapter 18: Allocating Staff Resources
1. Describe the three approaches taken toward patient classification systems.
2. Differentiate among: Medicus, GRASP and ARIC (commonalties and differences).
3. Regardless of which system is used, what must be assured?
4. What is an FTE? Be prepared to calculate FTEs, given a situation.
5. What data is used to determine staffing mix?
6. What factors lead to the varying distributions of staffing needs over shifts, days of the week?
7. Who is responsible for developing unit staff schedules? Be prepared to develop a staffing schedule, using different shifts.
8. What alternatives are there to cover staffing shortages? Identify advantages/disadvantages of each.
9. What makes high turnover rates in nursing so expensive to the employing institution?
10. Why is it often difficult to determine why nursing staff are leaving?
11. Which type of turnover should concern the nurse manager the most?
12. Staff turnover can lead to negative and positive consequences for remaining nursing staff. Name some.
13. Consider the factors associated with the March & Simon model of employee voluntary turnover (perceived desirability of movement and perceived ease of movement). Give examples of situations you have experienced or observed that reflect any of these factors.
14. What can (and cannot) a RN-M do to affect the factors associated with the March and Simon Model concerning turnover?
Chapter 19: Performance Appraisal
1. Differentiate between the focus of content and process theories of motivation.
2. Identify the primary theorist and key concepts of the following "content" motivation theories:
a. need hierarchy
3. Identify the primary theorist and key concepts of the following "process" motivation theories:
a. reinforcement c. equity
b. expectancy d. goal setting
4. Provide examples of the following operant conditioning strategies, as a nurse manager could use them:
a. positive reinforcement c. extinction
b. negative reinforcement d. shaping
5. What type of reinforcement schedule is more effective and has a slower extinction of learned behavior?
6. What is the problem in always assigning hard tasks to your best worker? What is the preferred way to reward high performers? (Infer answers from text.)
7. Even if staff are highly motivated, what must the nurse manager still do to assist the staff to perform?
8. What constitutes the performance appraisal process?
9. Ideally and practically speaking, why are performance appraisals done?
10. What law particularly guides implementation of performance appraisal?
a. Name at least 4 mandates within the law to help ensure performance appraisal is non-discriminatory.
11. Describe, briefly, the difference between "absolute" and "comparative" evaluation approaches.
12. What are the main advantages/disadvantages of the trait, results and behavior-oriented approaches to performance appraisal?
a. Which is the most commonly used?
13. What are the main advantages/disadvantages of these methods of performance appraisal: rating scales, essays, behavior-oriented rating scales forced distribution, and results?
14. What are "critical incidents"?
a. In the development of which performance appraisal method are they used?
b. In what other sense are they used in performance appraisal? What are three common errors associated with this use?
15. Who, traditionally, has been in charge of doing performance appraisals of staff nurses? What is the newer trend?
16. Describe the following possible performance appraisal problems: leniency error, recency error, halo error, ambiguous evaluation standards & written comments problems.
17. How should the nurse manager prepare for the performance appraisal interview? Describe behaviors nurse managers can use in conducting the performance appraisal interview, to improve it.
Chapter 20: Enhancing Employee Performance
1. When will an organization commit money to staff development?
2. What are the reasons to have educational programs for staff?
3. What is a needs assessment and how should it be done?
4. What kind of theory is social learning theory and upon what other theory does it build?
5. What does the Marx "relapse prevention" model emphasize as necessary for learning to occur?
6. How do the four basic concepts identified by Knowles in his adult education theory differ between adults and children?
7. Who has responsibility for staff development? Which two areas especially involve the nurse manager?
8. Why is use of preceptorships an attractive orientation technique to new nurses?
a. What could be disadvantages of this technique to: the organization, the preceptor & the new nurse? (not in text)
9. How does mentoring differ from preceptorships?
10. What is the most widely used educational method in staff development?
a. What are its advantages/disadvantages?
11. Why should evaluation of staff development programs be done?
a. Apply the four criteria for evaluation of staff development programs to a sample program.
12. What considerations r/t culturally diverse personnel must be addressed to assist these staff to perform their jobs effectively?
13. When should a nurse manager intervene if there are problems with a staff person's job performance?
14. With both coaching and policy violation interviews, what common behaviors are expected from the nurse manager?
a. What area should a nurse manager not initiate discussion about, in either interview?
15. What is the primary reason for disciplining employees?
a. Name at least three key principles must be followed in the disciplinary process?
16. What must be assured, in the process of termination of an employee?
17. Be prepared to analyze a situation requiring coaching or disciplining, and to implement the process.
Chapter 21: Managing Selected Personnel Problems
1. Give examples of: "Bull or A-Bomb", "Killer Angel or Know-It-All" behaviors. What negative effect will these behaviors have on the other staff?
2. What are the basic principles for managing the "disgruntled employee"?
3. What is the primary cause of disciplinary actions by State Boards of Nursing?
4. Identify some of the signs of chemical dependency that may be seen in the impaired nurse.
5. Why should first-line nurse managers share suspicions about a chemically impaired nurse with their immediate supervisor?
a. In confronting the suspected substance abuser, what approach should be taken?
b. What must be done if the (suspected) impaired nurse refuses to go for evaluation? if the nurse is obviously impaired while on duty?
6. What law applies to intervention with suspected substance abusers?
a. What legal guideline must be followed in getting reports about the impaired nurse's recovery?
b. Are abusers entitled to sick leave?
c. How is it recommended that return to work be handled?
7. How can staff absenteeism negatively affect quality of care and fellow RNs?
8. Differentiate between "voluntary" and "involuntary" absenteeism.
a. What is used as an indirect estimate of voluntary absenteeism?
9. Give some examples of "attendance barriers" you have experienced.
10. Of the factors that may influence an employee's motivation to attend, which can and cannot the nurse manager influence?
a. How can the labor market affect employee attendance?
b. Which is the better aspect to consider on interviewing a candidate: to evaluate potential absenteeism problems, personal characteristics or past behavior? Why?
11. How may an nurse manager, organization improve employees' ability to attend?
12. What are some creative alternatives to the traditional approach of the employee losing unused sick days beyond the max allowed?
a. Why are creative options needed?
13. What does the Family and Medical leave Act (FMLA) of 1993 state must be provided for employees?
Chapter 22: Collective Bargaining
1. In the collective bargaining arena, which Acts have favored employees? Employers?
2. The 1974 amendments to the Taft-Hartley specify what kind of time-frame if unionized heath care workers choose to change or terminate their contract? To strike? Why?
3. What are the four primary steps in establishing a union?
4. Once there is a contract in place, what are the roles of the union representative? The nurse manager?
5. Can health care employees organize in patient care areas?
6. What are the basic steps in the grievance procedure? What happens if time frames are not met?
7. Can RNs unionize with LPNs?
8. What is the legal issue of concern in relation to the use of labor-management committees?
9. What is the major issue underlying the debate about State Nurses' Associations acting as collective bargaining agents?
a. What is the role of the district nurses' association in collective bargaining efforts of the state nurses' association? (Answer can be inferred from text) Why?
1. WHAT POINTS CAN YOU TAKE WITH YOU NOW TO USE IN YOUR TRANSITION TO THE "REAL" WORLD, AS A STAFF NURSE OR MANAGER?
2. HOW DO THE THEORY AND EXERCISES WHICH WE HAVE BEEN DISCUSSING HELP YOU TO UNDERSTAND WHERE NURSE MANAGERS "ARE COMING FROM" SO IT IS NOT A "WE-THEY" ATMOSPHERE, BUT RATHER, A TEAM ATTITUDE?
ã 2001 Dr. Rachel Pollow