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NURSING LEADERSHIP & MANAGEMENT

NURSING LEADERSHIP & MANAGEMENT. PROFESSOR MARIANNE MCAULEY. Morning all students 8 AM to 12:30 PM Afternoon full-day students Self-Study sign attendance sheet with professional assistant assignment due within one week assignments in my mailbox: R106

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NURSING LEADERSHIP & MANAGEMENT

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  1. NURSING LEADERSHIP & MANAGEMENT PROFESSOR MARIANNE MCAULEY

  2. Morning • all students • 8 AM to 12:30 PM • Afternoon • full-day students • Self-Study • sign attendance sheet with professional assistant • assignment due within one week • assignments in my mailbox: R106 • assignments returned to your mail folder DAY WORKSHOP

  3. 5:00 PM – 9:50 PM • 5 hour workshop is instead of Pediatric Clinical this week • L/M Clinical – instead of Pediatric clinical those weeks • 2 full shifts for L/M Clinical • Receive a night off from Pediatric Clinical • Arrange with Pediatric Instructor EVENING WORKSHOP

  4. Review Agency Schedules • Directions • Uniform Policy • Health Forms in Trunk of Car • HIPPA Privacy Compliance • Attendance & Lateness Policy • absences • call unit & me (451-4152) • Department of Health or JCAHO Visit • Late Assignment Policy THE CLINICAL EXPERIENCE

  5. Complete preceptor evaluation form • Include comments!!!!! • Separate one for each preceptor is required • Appendix A • Collect student evaluation form from preceptor on last day – sealed envelope • Appendix B • RETURN BOTH TO MRS. MCAULEY • Put in your brown envelope with your assignment ROLE OF PRECEPTOR

  6. See appendix C • Bring these with you to clinical • Change of Shift Report • Report all abnormal findings • Report normal physical findings relevant to patient’s diagnosis • Describe nursing interventions done during your shift CLINICAL OBJECTIVES

  7. Delegation • review CNA assignment sheets • Issues to consider • Interdisciplinary Team Meetings • Documentation • 24 hour reports, Medicare Notes, Admissions, Discharges, Transfers, Incident Reports • Preceptor co-signs your signature • No medications CLINICAL OBJECTIVES

  8. Picking up of doctor’s orders • Staff education: in-service project for CNAs (certified nursing assistants) • 15 minutes – done on 2nd day CLINICAL OBJECTIVES

  9. Economics of health care • Staff Redesign • NCLEX WHY L & M?

  10. Physiological integrity needs of clients • Psychosocial integrity needs of clients • Promotion and maintenance of health • Management and coordination of the care environment • www.ncsbn.org NCLEX-RN TEST PLAN

  11. Integrating Leadership/Management into an Associate Degree Nursing Program • Management introduced 1st semester • Capstone in last year • Workshop • 2 full shifts with a preceptor running a patient care unit Leaders Are Mostly MadeNOT Born

  12. The Great Communicator • listening skills • articulation skills • oral • writing • Be An Assertive Communicator What are the Skills of Effective Leaders?

  13. understands the work of others • appreciates the work of others • credible - performs well • persuasive, enthusiastic • increases cohesiveness among team members The Team Player

  14. Inspires others to reach goals • Uses power to motivate others The Motivator

  15. A nursing task is transferred to an individual competent to perform the task • The delegator remains accountable for the task The Delegator

  16. Follow the five rights of delegation • National Council of State Boards of Nursing • Right task • Right person • Right communication • Right supervision • Right circumstances How to Increase Your Expertise as a Delegator?

  17. What is the difference between the scope of practice of the RN & LPN? • Look at the NYS Nurse Practice Act • Article 139 of the Education Law • http://www.emsc.nysed.gov/sss/Laws-Regs/Health_Services/Nurse_Practice_ • Act-full.htm Is It the Right Task?

  18. What tasks can be delegated to the UAP? • Health-related activities not in the legally protected scope of nursing practice • Do not involve professional judgment or critical thinking • Results are predictable Is It the Right Task?

  19. The guidelines regarding the utilization of licensed nurses and unlicensed assistive personnel in the delivery of nursing care • NYSNANYONE – 2003 • http://www.nysna.org/images/pdfs/ practice/scope/rn_uap_guidelines03.pdf Is It An Appropriate Health Related Activity?

  20. The Staff Educator: in-services • The Change Maker: institutes change • The Evaluator: evaluates the work of others • The Problem Solver: resolves conflicts • The 21st Leader: vision More Skills of Effective Leaders

  21. Management • Working with and through others • Achieve organizational objectives • Leadership • Influencing the activities of a group • Toward goal achievement • Best manager is a good leader How Do Leadership & Management Differ?

  22. Manager administers, Leader innovates • Manager relies on control, Leader inspires trust • Manager has a short-range view, Leader a long-range perspective • Manager does things right, Leader does the right thing Differences between Managing and Leading

  23. Legitimate - leader’s formal position in organization • Reward – underutilized • leader’s ability to reward follower’s • Coercive – don’t use this • follower’s fear of punishment TYPES OF POWER

  24. Referent - follower’s identification with leader • confidence • power dressing • What qualities do you have that give you this power? • Expert - leader’s specialized knowledge TYPES OF POWER

  25. Understanding Self • self-assessment • Knowledge • Learning • role models • Emotional Intelligence • assess yourself Effective Leader and Manager Formula

  26. Set of skills that includes excellence at listening, empathy, handling upsets • Midbrain – center for emotions • A different set of skills than IQ abilities • Helps workers stay in positive emotional range • Can learn these skills with practice EMOTIONAL INTELLIGENCE

  27. Leaders born, not made • Physical, psychological , personal characteristics define leaders • Charismatic theory - leaders possess charisma Great Man or Trait Theory

  28. Autocratic • Democratic • Laissez-Faire BEHAVIORAL THEORIES

  29. Leader dominates group • Commands rather than makes suggestions • Maintains strong control • Sometimes punitive AUTOCRATIC STYLE

  30. Leader is passive, nondirective, inactive • All decision making left to group • Little, if any, leader guidance or support LAISSEZ-FAIRE STYLE

  31. Group participates in decision making • Leader acts as facilitator • Leader has concern for group members DEMOCRATIC STYLE

  32. See appendix D • Demonstrate an Authoritarian Manager • Demonstrate a Laissez-Faire Manager • Demonstrate a Democratic Manager • Provides privacy, listens, uses open-ended questions, involves employee in goal setting, offers suggestions for improvement ROLE-PLAYSLEADERSHIP STYLES

  33. Assess the situation • Assess the group members • Select the style or blending of styles best for the situation Situational Leadership

  34. DEVELOPING NEW SKILLS

  35. Required competency of ADN education • Follow the Nursing Process when you teach • Use the Lesson Plan Rubric as a guide • Hand this in with your lesson plan • See appendix E STAFF EDUCATION

  36. Use the Nursing Process • Assess: the first day • select topic with guidance of preceptor • Ideas: handwashing, infection control, nosocomial infections, heat exhaustion • Self Care: stress management, body mechanics • review procedure manuals INSERVICE PROJECTA WIN-WIN FOR ALL

  37. Plan: during the week • develop the lesson plan - have 2 copies • typewritten, professional appearance • 1 copy to preceptor • LIV – Room 307 – Margaret Kelly’s mailbox • 1 copy to me (R 106) • Implement: the second day • eating & learning is fun • use audio-visual aids/handouts • absent: schedule make-up INSERVICE PROJECTA WIN-WIN FOR ALL

  38. Evaluate: • Develop a written quiz for the CNAs with at least 1 question for each objective • Staple a copy of this to the lesson plan • a quiz is part of the lesson plan • Develop a teacher evaluation form so that the CNAs can rate you • Staple a copy of this to the lesson plan • A teacher evaluation is part of the lesson plan INSERVICE PROJECTA WIN-WIN FOR ALL

  39. Cover Sheet • topic, date, agency • presenter - your name • Objectives • Content Outline • Written Quiz • Teacher Evaluation Form • Attendance Sheet - GOES TO AGENCY • See appendix F COMPONENTS OFA LESSON PLAN

  40. AGENCY • Lesson plan • Lesson plan includes a copy of the quiz & the teacher evaluation form • Attendance sheet • Give lesson plan to preceptor • LIV – put in Margaret Kelly’s mailbox in Room 307 • MRS. MCAULEY • Lesson plan • Lesson plan includes a copy of the quiz & the teacher evaluation form • Quizzes completed by CNAs • Evaluations completed by CNAs • Preceptor evaluation • Include comments • Student evaluation • Leave in my mailbox in R106 • Returned to your student mail folder in R111 Checklist for in-service project2 brown envelopes

  41. Focused on the learner:CNAs • Measurable - Use action verbs • use words like state, describe, list, explain • DON’T use words like understand or know • Time component HOW TO WRITE OBJECTIVES

  42. 1. By the end of the in-service the CNAs will be able to state the causes of pressure ulcers • 2. By the end of the in-service the CNAs will be able to identify residents at risk • 3. By the end of the in-service the CNAs will be able to describe methods to prevent pressure ulcers • REFER TO EXAMPLES WHEN WRITING YOUR OBJECTIVES EXAMPLES OF OBJECTIVES

  43. COGNITIVE • PSYCHOMOTOR • AFFECTIVE • Objectives can be all the same type or a mix TYPES OF OBJECTIVES

  44. Knowledge, facts Example: CNAs will state 3 methods to prevent pressure ulcers by the end of the in-service COGNITIVE OBJECTIVES

  45. Skills • Example: • CNAs will demonstrate proper handwashing by end of in-service PSYCHOMOTOR OBJECTIVES

  46. Emotions, feelings • Example: • CNAs will express feelings about caring for a dying client by end of in-service AFFECTIVE OBJECTIVES

  47. Outline format – don’t write a narrative • Comprehensive – give a detailed outline • Number objectives to match the content • It should be very clear what content goes with each objective CONTENT OUTLINE

  48. Objective: • 1. By the end of the in-service the CNA will list factors that increase the risk for pressure ulcers • Content Outline: • 1. a. immobility • creates pressure on skin over bony prominences b. poor nutrition - protein needed to repair skin c. incontinence – chemicals break down skin d. confusion – can’t move self, may be unable to express pain or discomfort EXAMPLE OF CONTENT OUTLINE

  49. Objective: • 2. By the end of the in-service the CNA will state 3 methods to prevent pressure ulcers • Content Outline: • 2. a. repositioning • Every 2 hours • Avoid shearing, dragging b. proper nutrition • Record all intake, assist to feed as needed c. keep skin clean & dry • Inspect skin daily, toilet or change frequently EXAMPLE OF CONTENT OUTLINE

  50. Quiz • multiple-choice, true-false • state in positive, all choices same length • Which of the following would be most helpful to prevent pressure ulcers? (obj 1) • Changing the resident’s position every 2 hours • Having the resident drink milk daily • Keeping the resident OOB for the shift • Using lotion to massage the skin over bony prominences EVALUATION OF KNOWLEDGE

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