NR 446 Edapt Week 4 Leading Team The Work Culture

Name

Chamberlain University

NR-446 Collaborative Healthcare

Prof. Name

Date

Leading Team Work Culture

Nurses can mitigate burnout by adopting effective self-care habits. Taking accrued time off is essential for recharging away from work. Conversely, consistently working overtime and neglecting to ask for help from colleagues can exacerbate feelings of burnout. Advocacy plays a critical role in nursing, promoting both individual and collective growth. Nurse leaders must advocate for their patients, staff, and the nursing profession itself, ensuring that their voices are heard and valued.

Advocacy

Advocacy is a cornerstone of the nurse leader’s responsibilities. Just as nurses advocate for their patients, leaders must also stand up for their team and the nursing profession. This includes understanding legislative impacts on healthcare and participating in efforts to improve workplace conditions. Key responsibilities in advocacy include:

• Valuing Autonomy: Leaders must promote autonomy and empowerment within their teams.
• Understanding Employee Needs: Recognizing and respecting employees’ goals and concerns fosters a cohesive healthcare team.
• Communicating Concerns: Managers should convey employee feedback to organizational leadership.
• Supporting Quality Improvement: Emphasizing quality over blame cultivates a positive work environment.

Emotional Intelligence

Nurse leaders must grasp the importance of emotional intelligence (EI), which encompasses the ability to navigate complex interpersonal dynamics effectively. Unlike cognitive intelligence (IQ), EI focuses on managing relationships and emotional responses. The five key components of emotional intelligence include:

1. Self-awareness: Recognizing and understanding one’s emotions and their impact on others.
2. Self-regulation: Controlling disruptive emotions and impulses.
3. Motivation: Pursuing goals driven by passion rather than monetary gain.
4. Empathy: Understanding others’ emotional needs.
5. Social skills: Building strong relationships and networks.

While IQ often correlates with professional success, research suggests that emotional intelligence is a more crucial determinant of effective leadership and teamwork.

Self-Care in the Workplace

An engaged workplace starts with the leadership’s commitment to self-care. Nurse leaders who model self-care practices—such as maintaining a healthy lifestyle and seeking support for stress—create an environment that prioritizes well-being. To combat burnout, leaders should encourage their teams to take breaks and use time off. This approach not only enhances individual morale but also fosters a collaborative and supportive work culture. Effective self-care practices can reduce absenteeism and enhance overall workplace outcomes.

Table: Summary of Key Concepts

Controlling Client Experiences

Controlling a client’s experience does not enhance communication effectiveness. Instead, increasing emotional intelligence is likely to improve a nurse’s performance by enhancing the ability to empathize without internalizing emotions, manage personal feelings, accurately interpret and respond to the emotions of others, and make informed decisions about client care. Since complete elimination of workplace stress is unfeasible, it is crucial to focus on managing and mitigating stressors effectively.

The Inclusive Workplace

Creating a diverse and inclusive workplace is a critical responsibility for nurse managers. Understanding the significance of diversity and inclusion helps foster a safe and supportive work culture. Vroom’s expectancy model highlights that intrinsic motivation and social values play vital roles in employee motivation, contrasting with operant conditioning, which focuses on observable behaviors.

To cultivate an inclusive workplace, managers should recognize each employee as a unique individual, motivated by distinct factors. Identifying both individual and collective values is essential for implementing effective reward systems. Positive feedback should be prioritized over negative feedback to enhance employee morale and satisfaction.

Guidelines for Promotion Selection

When promoting employees, managers should adhere to specific guidelines to ensure a fair and motivating selection process. These include:

• Clear Criteria Communication: Clearly outlining promotion and selection criteria.
• Candidate Pool Preparation: Identifying and preparing a diverse pool of candidates.
• Notification Protocols: Ensuring all candidates are informed of their status after selections are made.
• Transparent Delays: Communicating any delays in promotion decisions to allow other candidates to consider opportunities.

Encouraging voluntary applications for promotions rather than pressuring employees fosters genuine commitment to new roles.

Understanding Diversity and Inclusion

Diversity encompasses the unique identities of each nurse, shaped by various factors such as race, gender, socioeconomic status, and sexual orientation. Inclusion, on the other hand, involves valuing these differences and creating a culture that supports every individual’s contributions. This includes fostering a respectful environment where all voices are heard in decision-making processes.

Addressing Nursing Workforce Diversity

The nursing workforce does not reflect the broader population in terms of diversity, particularly concerning the representation of BIPOC and LGBTQIA+ communities. Actively recruiting nurses from these underrepresented groups is essential for creating a more inclusive environment. Currently, nursing demographics are predominantly female, heterosexual, and Caucasian, with a noticeable lack of diversity in other identities.

Questions for Institutional Assessment

When assessing diversity within an institution, key questions should be addressed:

• Mission Statement: Does the mission explicitly prioritize diversity?
• Action Plans: How is this mission reflected in actionable goals?
• Representation: How many diverse voices are included in decision-making?
• Leadership Support: How does administrative leadership demonstrate commitment to diversity initiatives?

These questions are pivotal in guiding organizations toward achieving greater representation in their nursing staff.

Chamberlain University’s Commitment

Chamberlain University’s social justice commitment emphasizes advocating for diversity and addressing systemic bias within its programs. Key actions include:

• Expanding Diversity: Investing in diverse student and faculty recruitment.
• Addressing Bias: Regularly reviewing processes to eliminate systemic bias.
• Transparent Communication: Sharing action plans and progress toward diversity goals.
• Collaborative Partnerships: Partnering with organizations that align with their values to tackle public health challenges.

Stereotypes and Diversity in Leadership

Stereotypes can undermine efforts to promote inclusivity. For instance, if a nurse manager selects a female nurse for a party planning role solely based on gender, they may be reinforcing a stereotype about women being naturally suited for nurturing tasks. This implicit bias fails to recognize the diverse strengths individuals can bring, regardless of gender.

When assessing diversity in leadership, hiring candidates from underrepresented backgrounds, such as BIPOC and LGBTQIA+ communities, is vital for fostering diverse perspectives that enhance decision-making.

Responding to Underrepresentation

A nurse identifying as a member of the LGBTQIA+ community may express feelings of underrepresentation. If a manager dismisses these concerns based on the nurse’s appearance, this reflects a lack of awareness about the complexities of diversity, highlighting the need for ongoing education about inclusion.

Conclusion

In conclusion, fostering an inclusive workplace in nursing requires commitment to understanding diversity, clear communication, and a focus on individual and collective needs. By implementing thoughtful strategies for recruitment, retention, and promotion, nursing leaders can create a more equitable and representative workforce.

References

• Vroom, V. H. (1964). Work and Motivation. Wiley.
• Goleman, D. (1995). Emotional Intelligence: Why It Can Matter More Than IQ. Bantam Books.

NR 446 Edapt Week 4 Leading Team The Work Culture

• Chamberlain University. (n.d.). Social Justice Commitment. Retrieved from Chamberlain University.

NR 446 Edapt Week 2 Communication and Leadership

Name

Chamberlain University

NR-446 Collaborative Healthcare

Prof. Name

Date

Communication and Leadership

Effective communication is central to leadership, encompassing both verbal and nonverbal cues. In face-to-face interactions, both the sender and receiver are attuned to various cues, allowing for a mutual understanding of the message. For example, if one person is distracted by a noise, the other person is likely to notice and understand why a response may be delayed. However, in virtual meetings, the potential for misinterpretation of nonverbal cues increases. For instance, if one participant is muted during a call and is suddenly distracted by noise from their environment, the other participant may misinterpret the lack of engagement. As more environmental and nonverbal cues are removed from communication—such as in phone calls without video or written correspondence—the significance of verbal cues becomes heightened. Verbal communication involves the use of spoken or written words, whereas nonverbal communication includes all other forms, such as tone of voice, eye contact, physical appearance, gestures, and posture.

The challenge of written communication arises from the absence of nonverbal and contextual cues, which can lead to varied interpretations by the reader. When sending written communications, leaders must ensure clarity, avoiding biased or confusing language. The use of technical terminology should be limited and only employed when addressing colleagues who are familiar with those terms. Furthermore, leaders must communicate potentially upsetting news—like changes in leadership or benefits—timely and with sensitivity, being available to address any questions and support their team through the transition.

Tips for Better Written Communication

To enhance written communication, leaders should:

1. Use clear, simple, and professional language, ensuring grammatical correctness.
2. Adhere to organizational style and approval requirements.
3. Employ spelling and grammar checking tools.
4. Utilize bulleted lists and headings instead of lengthy paragraphs.
5. Clearly outline the main point at the start of the message.
6. Review and revise the message, focusing on tone and clarity.
7. Share drafts with colleagues for feedback, as an additional perspective can catch errors and improve readability.

Information Versus Communication

Information transmission is generally one-way, formal, and devoid of emotional nuance. This type of communication often flows downward, sharing policies and organizational updates without requiring acknowledgment from the receiver. In contrast, communication involves a two-way exchange of information, incorporating verbal and nonverbal elements, along with feedback (Marquis & Huston, 2021). A pre-existing relationship can facilitate a better understanding of the shared information.

Table: Communication Types and Their Characteristics

Variables Impacting Organizational Communication

Several factors influence how effectively communication occurs within an organization:

1. Formal Organizational Structure: Communication may be hindered by time zones and cultural differences in large organizations.
2. Quality of Communication: As messages pass through multiple levels, their accuracy may be compromised.
3. Quantity of Communication: In larger organizations, excessive written communication may lead to skepticism about transparency.
4. Spatial Distance: The physical distance between communicators can impact the effectiveness of verbal exchanges.
5. Varied Cultures and Subcultures: Communication styles differ among diverse cultures, influencing interaction within teams.
6. Gender Dynamics: Perceptions about gender can affect how messages are interpreted.
7. Power/Status: Hierarchical differences may impact communication efficacy, especially if employees feel undervalued.

Technology and Organizational Communication

The role of technology in facilitating communication has both advantages and drawbacks:

1. Internet: Provides access to current evidence-based information, though it also poses risks of misinformation.
2. Intranet: Offers immediate access to organization-specific information, but may lack organization and searchability.
3. Wireless Local Area Networking: Enables device connectivity but can be hindered by interference.
4. Social Media: Serves as a rapid communication method but raises concerns regarding privacy violations.

Confidentiality of Communication

Compliance with HIPAA mandates safeguarding patient information to prevent violations, which can incur substantial penalties. Nurses must maintain professional boundaries and use privacy settings to separate personal and professional online presence, reporting any potential breaches of confidentiality to relevant authorities.

Managing Conflict

Conflict in the workplace can manifest in various forms, including intrapersonal, interpersonal, and intergroup conflict. Understanding the stages of conflict—latent, perceived, felt, manifest, and aftermath—can assist leaders in addressing issues before they escalate. Effective conflict management strategies include competing, collaborating, compromising, avoiding, smoothing, cooperating, assertiveness, and cooperativeness.

Nurse Relationships

Nurse-client relationships are foundational for quality care, as nurses act as liaisons between clients, families, and healthcare teams. Positive relationships among nurses foster collaboration and enhance patient safety. Communication and respect between nurses and healthcare providers are essential for effective teamwork, while interdisciplinary collaboration ensures comprehensive patient care.

Workplace Violence

Workplace violence can take many forms, including nurse-to-nurse violence, client-to-nurse violence, and external threats. Horizontal violence, often characterized as workplace bullying, can harm morale and lead to unsafe environments. Addressing these issues is critical to fostering a safe and productive workplace.

Impact of Workplace Violence

Workplace violence affects not only the individuals directly involved but also contributes to higher staff turnover, decreased work productivity, and compromises the overall safety and quality of client care. It is essential for organizations to implement zero-tolerance policies to ensure the safety of employees, staff, visitors, and clients. By establishing clear and comprehensive policies, organizations can protect their workforce and foster a culture of respect and safety.

Alternative Dispute Resolution (ADR) Strategies

Nurse leaders, in collaboration with legal teams, may recommend ADR strategies to preserve privacy and avoid costly legal actions. These strategies include:

• Mediation
• Fact-finding
• Arbitration
• Due process hearings
• Use of ombudspersons

Learning more about these negotiation strategies can help healthcare professionals navigate workplace conflicts effectively.

Managing Conflict in the Workplace

Communication

Effective communication is critical when managing conflict in the workplace. To address conflicts:

• Arrange a time and place to talk with the other person privately.
• Focus on behaviors and events rather than personal attributes, using phrases like “When this happens…” instead of “When you do….”
• Practice active listening and allow for pauses in the conversation.
• Identify and discuss areas of agreement and disagreement to work towards resolution.

Action Plan

To manage conflicts:

• Prioritize issues based on their importance to each party.
• Develop a collaborative plan starting with the most important conflict.
• Follow through on the plan with a cooperative mindset.
• Celebrate small successes, recognizing each person’s contributions to resolution.

Employee Performance Improvement

Types of Performance Management

• Coaching focuses on tasks and actions and is essential for experienced nurses to mentor new nurses. This relationship helps nurses analyze daily challenges and develop career goals (Marquis & Huston, 2020).

• Motivation can be either intrinsic or extrinsic. Managers play a vital role in creating a motivating environment by being supportive and interactive. Motivation directly influences the quantity and quality of work (Cherry & Jacob, 2013).

Discipline

Evaluating employee performance through annual reviews helps identify deficiencies and areas for improvement. If standards are not met, managers have the authority to initiate disciplinary action, ensuring that corrective measures align with organizational policies. For serious offenses, such as client mistreatment or substance misuse, immediate termination may be necessary. Lesser infractions should follow a progressive discipline model, allowing employees opportunities to correct behavior before further action is taken.

Progressive Discipline

Disciplinary Conference

During a disciplinary conference, the manager should clearly state the reason for disciplinary action, allow the employee to respond, and explain the rationale for the consequences. A Performance Improvement Plan (PIP) may be presented to outline expectations for change, including specific steps and timelines for improvement.

Colleague Impairment and Substance Misuse

Nurses, like professionals in other fields, are vulnerable to substance misuse. Impaired nurses may struggle to provide safe care, potentially endangering clients. Factors contributing to nurse impairment include stress, access to medications, and caregiver burnout. It is critical for organizations to educate staff about policies addressing substance misuse and to offer assistance programs to support recovery.

Client Care Indicators

• Inconsistent work quality
• Frequent medication errors
• Inconsistent or incorrect charting
• Increased narcotic sign-outs

Behavioral Indicators

• Slurred speech, impaired motor coordination
• Mood swings, frequent accidents, or personal issues
• Denial of the problem or refusal to comply with investigations

Taking Action

It is important for nurses to familiarize themselves with organizational policies on substance misuse. If a colleague or supervisor appears impaired, it is essential to report the issue through appropriate channels, such as Human Resources or another supervisor. Nurses have a moral obligation to protect clients, colleagues, and the profession by addressing substance misuse when it arises.

Treatment and Diversionary Programs

Various treatment and diversionary programs are available to support impaired nurses, including Employee Assistance Programs (EAPs), peer assistance, and state-mandated intervention programs. These programs offer alternative approaches to discipline, focusing on recovery and professional rehabilitation.

References

Cherry, B., & Jacob, S. R. (2013). Contemporary nursing: Issues, trends, and management. Elsevier Health Sciences.

NR 446 Edapt Week 2 Communication and Leadership

Marquis, B. L., & Huston, C. J. (2020). Leadership roles and management functions in nursing: Theory and application. Lippincott Williams & Wilkins.

NR 446 Edapt Week 1

Name

Chamberlain University

NR-446 Collaborative Healthcare

Prof. Name

Date

Collaborative – Week 1 Key Concepts

Differences Between Leaders and Managers

Leaders are visionaries who articulate a compelling picture of what is achievable and inspire others to work towards realizing that vision. They empower individuals to engage in a larger purpose, often adopting distinct roles that enhance team dynamics. Leaders prioritize group processes, believing that cohesive teams can accomplish far more collectively than individuals can alone.

In contrast, Managers concentrate on establishing, measuring, and achieving organizational goals. They serve as implementers who ensure tasks are completed efficiently. Managers are process-oriented and rely on coordinating various resources—including personnel, time, and finances—to meet set objectives.

Varied Leadership Roles

Leadership encompasses various roles, as illustrated in Display 2.3 of the Leadership Text. These roles include:

• Counselor
• Teacher
• Critical thinker
• Buffer
• Advocate
• Visionary
• Director
• Decision maker
• Communicator
• Evaluator
• Facilitator
• Risk taker
• Mentor
• Energizer
• Priority setter
• Coach

Leadership Theories

Leadership theories vary significantly, with three prominent styles being Authoritarian, Democratic, and Laissez-Faire.

• Authoritarian leadership involves a leader making unilateral decisions without considering staff input, often employing negative reinforcement and punishment to enforce compliance. While this approach may seem rigid, it can be effective in emergencies requiring rapid decision-making.

• Democratic leadership fosters open communication and encourages staff participation in decision-making, promoting a sense of accountability and shared responsibility among team members.

• Laissez-Faire leadership is characterized by minimal direction or supervision from the leader, who adopts a hands-off approach. This style can lead to a lack of proactive changes and typically results in reactive quality improvements.

Understanding Emotional Intelligence (EI)

Emotional Intelligence (EI) is defined as the ability to recognize and understand one’s own emotions while engaging with others. This awareness can enhance interpersonal interactions and improve team dynamics.

Delegation in Nursing

The Five Rights of Delegation

Effective delegation is guided by five key rights, which include:

Delegating vs. Assigning

• Delegating involves transferring the authority to perform specific nursing activities to a competent individual while retaining accountability. Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) can delegate tasks to Unlicensed Assistive Personnel (UAP).

• Assigning designates responsibility for executing specific tasks to individuals qualified to perform them. RNs assign tasks to other RNs and LPNs, while LPNs assign to other LPNs.

Supervising and Accountability

Supervision entails directing, monitoring, and evaluating the performance of tasks by other healthcare team members.

Accountability refers to the obligation to accept responsibility for one’s actions. Licensed nurses remain accountable for appropriate assignments and delegation, while individuals to whom tasks are assigned are responsible for executing them correctly.

Seven Rights of Medication Administration

When administering medication, it is essential to adhere to the following rights:

1. Patient
2. Drug
3. Dose
4. Time
5. Route
6. Reason
7. Documentation
8. Right to refuse

Managing Medication Errors

In the event of a medication error, the nurse’s first priority is to assess the patient for any injuries and provide immediate care to prevent further harm.

Minimum Requirements for a Medication Order

For any medication order to be valid, it must include the following elements:

1. Full name of the patient
2. Date and time of the order
3. Name of the medication
4. Ordered dosage
5. Form of the medication
6. Route of administration
7. Time or frequency of administration
8. Signature of the ordering physician

Transcribing Orders

Verbal orders are acceptable only in emergencies or when a physician cannot write their own orders. The date and time must be documented, along with the physician’s name and the person transcribing it.

Telephone orders are used when the physician is not present for direct assessment but require immediate guidance for patient care. These orders should also be documented with the date, time, physician’s name, and the transcriber’s signature.

Understanding the State Nurse Practice Act

The Nurse Practice Act delineates the scope of nursing practice and may vary between states, yet all must comply with federal regulations. The Board of Nursing has the authority to suspend or revoke a nursing license if an individual violates this act.

Scope of Nursing Interventions

Certain interventions are exclusive to RNs, such as:

• Initial assessments
• Patient education
• Reporting IV site phlebitis
• Blood transfusions
• Initiating IV fluids
• Performing Glasgow Coma Scale assessments
• Initiating care plans
• Administering Rhogam injections

Interventions that both RNs and LPNs can perform include:

• Trach care
• Observing IV sites
• Dressing changes
• Wound care
• Suctioning
• Inserting urinary catheters
• Checking NG tube patency
• Medication administration
• Collecting sterile specimens
• Reinforcing client teaching
• Follow-up teaching

Tasks Delegated to Unlicensed Assistive Personnel (UAP)

UAPs can be delegated tasks such as:

• Activities of daily living
• Transferring patients
• Ambulation
• Feeding
• Positioning
• Collecting non-sterile specimens
• Taking vital signs (for stable clients)
• Recording intake and output
• Bathing

Considerations as Charge Nurse

As a charge nurse, patient assignments should consider:

• Patient status, ensuring those needing frequent monitoring are closer to the nursing station.
• Mental status, particularly for confused or disoriented patients.
• Necessary equipment for room setup.
• Whether patients require a negative or positive pressure room.

When assigning a float nurse, the charge nurse should be aware of:

• The float nurse’s prior experience and specialty.
• The patient ratio that the float nurse can manage effectively.

Priorities as a Float Nurse

Upon being assigned to a new floor, a float nurse should prioritize:

• Familiarizing themselves with the unit’s specialty and patient types.
• Locating essential areas such as the medication room and supply room.
• Understanding patient ratios.
• Learning the unit’s operational procedures.
• Identifying the location of the crash cart.
• Knowing who the charge nurse is for the shift.

SBAR Communication

SBAR is a standardized communication tool designed for conveying critical and urgent information. It stands for Situation, Background, Assessment, and Recommendation.

• Situation: Introduce yourself and the patient, briefly stating the issue.
• Background: Provide context, including the patient’s diagnosis and treatment history.
• Assessment: Summarize the patient’s current condition and the perceived problem.
• Recommendation: Suggest new treatments or changes and provide recommendations for further action.

Effective Change of Shift Reports

The most effective type of change of shift report is a bedside report, allowing for direct patient engagement.

Discharge Planning

Discharge planning begins at the time of admission, ensuring a smooth transition from hospital to home.

Role of the Case Manager

A case manager plays a critical role in discharge planning by performing program referrals, addressing patient needs, and developing strategies for ongoing care.

Critical Pathways in Patient Care

Critical pathways are established protocols that outline the expected recovery trajectory for patients with similar conditions. They guide the care provided both in the hospital and post-discharge.

Interdisciplinary Team Functions

The interdisciplinary team consists of various professionals, each with distinct functions:

• Registered Nurse (RN): Responsible for direct patient care, assessments, and care coordination.
• Medical Doctor (MD): Provides medical diagnoses and treatment plans, often specializing in specific fields.
• Speech Pathologist: Assists patients with communication and swallowing disorders.
• Wound Care Nurse: Specializes in the assessment and treatment of complex wounds.
• Dietitian: Evaluates and manages patients’ nutritional needs.
• Occupational Therapist (OT): Aids patients in regaining independence in daily activities.
• Physical Therapist (PT): Focuses on improving physical functioning for patients with musculoskeletal issues.
• Chaplain: Addresses the spiritual and emotional needs of patients.
• Social Worker: Helps with issues related to access to care, housing, and social support.
• Case Manager: Coordinates care plans and ensures comprehensive service delivery.

Delegation Worksheet

Activities of daily living

Transfer to chair/bed/stretcher

Ambulating

Tracheostomy care

Suctioning

Feeding

Measuring vital signs

Checking IV site

Inserting an indwelling catheter

Administering medications

Conclusion

Understanding the differences between leadership and management, alongside the principles of delegation and effective communication, is vital for ensuring quality patient care. Effective collaboration among healthcare team members enhances patient outcomes and fosters a supportive work environment.

References

American Nurses Association. (n.d.). Nursing: Scope and standards of practice. Retrieved from [insert URL].

Bishop, M. (2020). Leadership in nursing practice. Journal of Nursing Management, 28(5), 1050-1058. https://doi.org/10.1111/jonm.12838

NR 446 Edapt Week 1

Smith, L. (2019). Emotional intelligence and its impact on nursing leadership. Nursing Management, 50(8), 26-32. https://doi.org/10.1097/01.NUMA.0000553708.52239.02