UTA NURS 4223 Leadership Exam 1
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| Leadership | The process of influencing people to accomplish goals
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| What influences people | character and integrity
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| Framework for most leadership research prior to mid-1940s | Great Man & Trait Theories: “Some people are born to lead” and a certain set of personality traits of great leaders could be described
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| Great Man & Trait Theories | “Some people are born to lead” and a certain set of personality traits of great leaders could be described
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| Behavioral Theories | Autocratic or Authoritarian; Democratic, Participative or Shared; Laissez-Faire, Permissive or Free Rein
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| Autocratic or Authoritarian Leader | Task-oriented, control over group, downward communication, decisions made by leader, emphasis on status, punitive
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| Democratic Leader | less emphasis on control, motivate by ego and economic rewards, direction by suggestions, foster 2-way communication, group decision-making, emphasis on “we”
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| Laissez-Faire Leader | permissive, little control, little or no direction, emphasis on people, free communication, dispersed decision-making, no criticism
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| Transformational Leadership | ability to look at what the group has in common; identifies common values, is committed, has long-term vision, inspires others with vision, and empowers others
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| Law of situation | developed by Mary Follet; Leadership style should vary based on situation/individuals involved. Situation should determine directives given after problem known by everyone.
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| Leadership process (defined by Hersey) | a function of the leader, the followers, and situational variables.
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| Management (defined by Marquis-Huston) | the process of leading and directing all or part of an organization through the deployment and manipulation of resources
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| Scientific Management theory | developed by Taylor; uses the scientific method to organize work—one best way to complete tasks; emphasis on productivity; workers viewed as “economic animals” and did not consider “human element”
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| Classical management theory (Bureaucracy) | developed by Weber; formal authority, chain of command, consistent rules and regulations, “structure”; presumed >efficiency was achieved through rules/regs
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| Hawthorn Effect | identified by Mayo in study on workplace physical and environmental influences on workers’ productivity and motivation; demonstrated that workers are more productive when they know they are being observed
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| The Management Process | developed by Fayol; Planning > Organizing > Staffing > Directing > Controlling
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| Planning stage of management process | determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change
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| Organizing stage of management process | establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals.
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| Staffing stage of management process | recruiting, interviewing, hiring, orienting staff, scheduling, staff development, employee socialization, and team building.
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| Directing stage of management process | human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration
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| Controlling stage of management process | performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control
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| Human Relations Management | developed the concepts of participatory and humanistic management, emphasizing people rather than machines
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| Theory X and Theory Y | developed by McGregor; assume that managers role is to gather the necessary resources (including people) to meet organization goals
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| Theory X managers | believe that their employees are basically lazy, need constant supervision and direction and are indifferent to organizational needs
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| Theory Y managers | believe that their workers enjoy their work, are self-motivated, and are willing to work hard to meet personal and organizational goals
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| Contingency approach | developed by Fred Fieldler; relationship between followers and leaders influenced by manager’s ability to lead well
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| Interactional leadership theory | leadership behavior is generally determined by the relationship between the leader’s personality and the specific situation
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| Theory Z | consensus decision making, fitting employees to jobs, job security, slower promotions, examining long-term consequences, quality circles, guarantee lifetime employment, establishment of strong bonds of responsibility, and holistic concern for workers
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| Transformational leadership vs. Transactional | transactional leaders focus on tasks and getting the work done. Transformational leaders focus on vision and empowerment.
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| Full-range leadership theory | suggests that there are nine factors impacting leadership style and its impact on followers; five transformational, three transactional, and one nonleadership
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| Servant Leadership | developed by Greenleaf; to be a great leader, one must be a servant first
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| Principal Agent Theory | interactive leadership theory that suggests that not all followers (agents) are inherently motivated to act in the best interest of the principal (leader or employer)
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| Human capital theory | suggests that individuals and/or organizations will invest in education and professional development if they believe that such an investment will have further payoff
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| Human capital vs. social capital | human capital represents the capability of the individual. Social capital represents what a group can accomplish together.
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| Emotional intelligence | the understanding and recognition of oneself and others’ abilities, perception and attitudes
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| 5 components of emotional intelligence | self-awareness, self-regulation, motivation, empathy, social skills
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| Authentic leadership | in order to lead, leaders must be true to themselves and their values and act accordingly
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| Congruent leadership | a match between the activities, actions, and deeds of the leader and the leader’s values, principles, and beliefs
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| 5 distinguishing characteristics of the Authentic Leader | purpose, values, heart, relationships, self-discipline
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| Thought leadership | a person who is recognized among their peers for innovative ideas and who demonstrates the confidence to promote those ideas
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| Quantum leadership | builds upon transformational leadership and suggests that leaders must work together with subordinates to identify common goals, exploit opportunities, and empower staff to make decisions for organizational productivity to occur
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| Cultural bridging | seeks out and respects other view points and creates a work environment where cultural differences are recognized and valued
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| Industrial age leadership vs. relationship age leadership | industrial age focused primarily on traditional hierarchical management structures, skill acquisition, competition, and control. Relationship age focused primarily on the relationship between the leader and followers.
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| Leaders vs. Managers | leaders not always formal, have wider variety of roles, and people focused. Managers are always assigned formal position, have legitimate source of power, have specific role responsibilities, and focus on control/use of resources
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| Integrated Leader/Managers | developed by Gardner; think longer term; look outward; influence others beyond own group; emphasize vision, values, and motivation; politically astute; think in terms of change and renewal; empower others
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| Baby Boomers vs. Generations X and Y | boomers view long hours as evidence of loyalty and hard work, Gen X and Y try to have more work/life balance (flexible hours, more vacation time, continuous training, and telecommuting options) by leveraging technology to work more efficiently
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| Two keys areas of personal growth and development that are fundamental to leadership success | self-confidence, and a positive attitude
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| Lateral transfer | one staff person moving to another unit, to a position with a similar scope of responsibilities, within the same organization
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| Downward transfer | someone takes a osition within the organization that is below his/her previous level
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| Accommodating transfers | allow someone to receive a similar salary but with a reduction in energy expenditure
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| Inappropriate transfer | solving unit personnel problems by transferring problem employees to another unsuspecting department
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| Steps to Personal Goals Setting | create “big picture” and identify large-scale goals; break goals down into smaller and smaller targets; then start working on achieving goals
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| SMART Goals | S – Specific (or Significant); M – Measurable (or Meaningful); A – Attainable (or Action-Oriented); R – Relevant (or Rewarding); T – Time-bound (or Trackable)
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| ANA/NCSBN definition of delegation | the process for a nurse to direct another person to perform nursing tasks and activities
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| Delegation process | identify task, indentify skills and levels, select most capable/appropriate person, communicate goal, empower the delegate, set deadlines, monitor progress, provide guidance, evaluate performance, reward accomplishment
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| 5 rights to delegation | right task, right circumstance, right person, right direction/communication, right supervision/evaluation/follow-up
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| Criteria for delegation | must assess, task must be delegated using sound nursing judgment, can be performed safely, instructed UAP or verified competency, doesn’t require licensed person, adequately supervise, periodically evaluate
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| Ineffective delegation | under delegation, over delegation, improper delegation, reverse delegation
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| Causes of under delegation | false assumption that delegation may be interpreted as a lack of ability; desire to complete the whole job personally due to lack of trust in subordinates; lack of experience; failure to anticipate the help needed; difficulty assuming the manager role
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| Causes of over delegation | poor time management; insecurity in ability to perform task
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| Causes of improper delegation | delegating at the wrong time, to the wrong person, or for the wrong reason; delegating tasks and responsibilities beyond the capability of the person being delegated to or that should be done by the manager
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| Causes of resistance to delegation | failure to see subordinate’s perspective; lack of knowledge, information, skill or ability; fear of failure; resistance to authority; over-delegation of tasks; lack of positive incentives for motivation
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| Nationally established standards for UAPs | there are none
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| Problem-Solving and Decision-Making Process Similarities | define the problem, gather information, analyze information and explore alternatives, develop solutions, make a decision, implement, and evaluate
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| Problem-Solving and Decision-Making Strategies | trial and error; experimentation; past experience; intuition
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| Problem solving styles | Adaptation-Innovation Theory; Adaptors; Innovators
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| Adaptation-Innovation Theory | problem solving strategy that suggests two types of problem solvers: Adaptors and Innovators.
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| Adaptors | use tried and accepted ways, rarely challenge rules, methodical efficient, and less risk-taking
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| Innovators | seek solutions in creative and challenging ways; think ‘outside the box’; promote change; higher risk-taking
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| Creative Problem Solving principles | deferred judgment (suspending bias, judgment, and evaluation) and divergent-convergent thinking (being open to exploring possibilities)
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| Intuitive Problem Solving Novice Nurses vs. Experts | Novice nurses rely more on deliberate thinking while experts rely more on instinct and “gut” feelings and looking for patterns.
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| “thin slicing” (Gladwell, 2005) | how experts draw on years of experience and a deep knowledge of their field to make rapid decisions using the thinnest slice of information
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| Group Problem Solving Disadvantages | can become so stagnant that they don’t allow new ideas and generate change
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| Risky Shift | a group is willing to take greater risks than individuals would do on their own (e.g., mob mentality)
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| Frequent Errors in Decision Making & Problem Solving | failing to consider possible outcomes; lacking a clear objective or goal; faulty data gathering (information withheld or not ample); limiting options; faulty logic (over-generalizing); excessive delay; refusal/failure to act
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| Satisficing vs. Maximizing | satisficing is ‘good enough for now’ while maximizing must be done well initially
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| Types of decisions | routine (well-defined, common issues), adaptive (need modifications to usual methods), innovative (unusual problems needing creative solutions)
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| Rational or Normative Decision-Making Model | have good information and anlysis-allows for logical decision making
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| Descriptive or Bounded Rationality Decision-Making Model | fairly complete info but limited by time, energy, and or money or other resources
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| Political Decision-Making Model | considers needs of stakeholders and ‘Power Brokers’
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| Critical Thinking | aka reflective thinking; “a set of cognitive skills” including “interpretation, analysis, evaluation, inference, explanation, and self-regulation”
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| Communication | the complex exchange of thoughts, ideas, or information on at least two levels: verbal and nonverbal
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| Goal of communication | to approach as closely as possible a common understanding of the message sent and the message received
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| Variables affecting organizational communication | spatial distance; different subgroups or subcultures; differing authority and status; work structure; organizations in a constant state of flux
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| Channels of communication | downward (primarily directive), upward (allows employee input), lateral/horizontal (between individuals or departments at same level), and diagonal (between individuals or departments at different levels)
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| Assertive communication | allows people to express themselves in direct, honest, and appropriate ways that DO NOT INFRINGE ON ANOTHER PERSON’S RIGHTS
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| Passive communication | occurs when a person suffers in silence, although he or she may feel strongly about the issue; a nonassertive and manipulative way to send a message
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| Aggressive communication | expressing oneself in a direct and often hostile manner that infringes on another person’s rights; generally oriented to a “winning at all costs” mentality
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| Passive-Aggressive communication | an aggressive message presented in a passive way; limited verbal behavior with incongruent nonverbal behavior
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| SBAR | a technique used to improve the communication between members of the health care team: Situation, Background, Assessment, Recommendations
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| Communication process | the person who is the source of the communication encodes it into a message, and transmits it through a channel. The receiver decodes the message, and, in one way or another, feeds back understanding or a lack of understanding to the source.
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| KISS principle | Keep It Simple and Straightforward
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| Advocacy | helping others to grow and fulfill their potential
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| Nursing values central to advocacy | right to autonomy, right to hold personal values, access to information, act on behalf of clients who are unable to advocate for themselves, empowerment of patients and subordinates to make their own decisions
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| Advocacy vs. Paternalism | advocacy is assisting patient choices (allowing freedom) vs. Paternalism is controlling patient choices (domination and dependence)
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| Subordinate advocacy | manager helps resolve ethical and job related problems and live with the solutions at the unit level
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| Workplace advocacy | part of subordinate advocacy; ensuring the work environment is both safe and conducive to professional and personal growth for subordinates
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| Failure to Rescue | poor outcome of care that occurs when staff fail to identify potential complications early and take appropriate actions
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| What is needed to rescue patients | competent staff (critical thinkers); enough staff to spend time with patients; ability to mobilize resources
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| Interacting with the media | respect/meet deadlines; assume will be fair/ accurate; have key facts/figures ready; limit key points to 2-3 bullet points; avoid technical jargon; speak confidently and truthfully; avoid inflammatory arguments or blame setting; provide contact info
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| Formal dimensions of power | Relational Aspect, Dependency Aspect, Sanctioning Aspect
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| Relational aspect of power | suggests power related to relationships between 2 or more individuals
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| Dependency aspect of power | particularly evident in organizations; interdependence between units/staff
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| Sanctioning aspect of power | direct manipulation of another’s outcome (rewards, punishments, peer pressure)
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| Reward power | giving something of value (praise, pay raise, promotion)
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| Punishment (coercive) power | force against the will; ability to threaten punishment and deliver penalties
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| Legitimate power | position power; right to command; authority; most common source of power
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| Expert power | unique skills/personal abilities
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| Referent power | subtle; based on admiration or respect for an individual or association with powerful others; comes from others
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| Referent power vs. charismatic power | referent power is gained only through association with powerful others whereas charisma is a more personal type of power
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| Informational power | obtained when people have information that others must have to accomplish their goals
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| Most common source of organizational conflict | communication problems, organizational structure, and individual behavior within the organization
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| Categories of Conflict | intrapersonal, interpersonal, intergourp
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| Stages of Conflict | Antecedent/Latent, Perceived, Felt, Manifest, Aftermath
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| Antecedent/latent conflict stage | conditions exist (short staffing, poor pay, inadequate support)
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| Perceived conflict stage | conflict recognized by individual (may be able to be resolved at this stage
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| Felt conflict stage | emotionalized (anger/fear/mistrust)
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| Manifest conflict stage | action is taken
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| Conflict aftermath stage | positive or negative feelings linger (may be worse than original conflict if handled poorly
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| Competition strategy to resolve conflict | One party pursues what it wants regardless of the cost to other person
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| Accommodation strategy to resolve conflict | One party sacrifices his or her beliefs and wants, to allow the other party to win
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| Smoothing strategy to resolve conflict | an individual attempts to reduce the emotional component of the conflict
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| Avoidance strategy to resolve conflict | parties are aware of a conflict but choose not to acknowledge it or attempt to resolve it
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| Compromise strategy to resolve conflict | each party gives up something it wants
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| Collaboration strategy to resolve conflict | an assertive and cooperative means of conflict resolution whereby all parties set aside their original goals and work together to establish a common priority goal
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| When to intervene in a conflict | the conflict gets to a place where it is creating a distraction, interference in workflow, or becomes a threat to patient safety or unit function
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| Alternative Dispute Resolution (ADR) | mediation, fact finding, arbitration, due process hearings, and use of ombudsperson
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| Power | that which enables one to accomplish goals
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| Power vs. authority | power is the capacity to act whereas authority is the right to command
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| Power-building strategies | personal energy, powerful persona, pay entry fee, determine powerful, learn culture, use org. priorities, increase skills/knowledge, broad vision, use experts/seek counsel, be flexible, be visible/have voice, toot own horn, sense of humor, empower others
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| Authority-power gap | gap that sometimes exists between a position of authority and subordinate response
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| Planned change | deliberate, intentional effort by change agent to create something new
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| Unplanned change or change by drift | haphazard; random; unexpected; occurs over time as people enter/leave the system
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| Good reasons for change | to solve some problem; to make work procedures more efficient; and to reduce unnecessary workload
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| Change agent | persons skilled in the theory and implementation of planned change
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| Managers vs. Leaders | managers continue the status quo while leaders embrace change
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| Lewin’s Rules for Implementing Change | should only be implemented for good reason; always be gradual; be planned and not sporadic or sudden; and all individuals who may be affected should be involved in planning for the change
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| Lewin’s Change Theory steps | unfreezing, movement, freezing
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| Lewin’s Change Theory unfreezing stage | must by pass defense mechanisms to change existing mind-set (assessment)
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| Lewin’s Change Theory movement stage | period when change happens; may be confusing and unsettling as old habits are challenged (planning and implementation)
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| Lewin’s Change Theory freezing stage | new mindset and habits stabilized; comfort levels return (evaluation/implementation)
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| Lewin’s Force Field Model | describes change as a dynamic balance of forces working in opposing directions within a field, such as an organization; for change to occur, forces (driving and restraining) must be altered
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| Driving forces | facilitate change
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| Restraining forces | impede change
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| Roger’s Theory of Planned Change | described 5 factors that determine successful planned change: relative advantage, compatibility, complexity, trialability, observability
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| Roger’s relative advantage | degree to which change is deemed preferable to status quo
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| Roger’s compatibility | degree to which change is compatible with groups existing values
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| Roger’s complexity | degree to which change is perceived as difficult to use/understand
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| Roger’s trialabilty | degree to which change can be tested on a limited basis
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| Roger’s observability | degree to which the results of a change are visible to others
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| reason people resist change | lack of trust; also vesting interest in status quo, fear of failure, loss of status or income, misunderstanding, rigidity
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| Pesut responses to change | individuals are either crusaders (innovators and early adopters) or tradition bearers (prefer status quo and/or may resist) in response to their propensity to seek change
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| Porter-O’Grady’s single most important factor in how people accept change | the manager’s behavior
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| Audit | systematic exam of a record, process, structure, environment or account to evaluate performance
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| Types of audits | retrospective, concurrent, prospective (how future performance will be affective), outcome, process, and structure
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| Most common audits | outcome, process, structure
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| Outcome audit | what results occurred as a result of specific interventions (e.g., patient falls, hospital-acquired infections, pressure ulcers, restraints, patient satisfaction)
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| Process audit | measures how nursing care was provided (e.g., efficient, best practice, how being carried out, policies/procedures being followed)
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| Structure audit | looking at the patient care environment: structure (e.g., lighting, beds, flooring) and environment of care (e.g., staffing ratios, staffing mix, ED wait times)
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| Quality improvement | target ongoing and continually improving quality
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| Quality assurance | target currently existing quality
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| Total quality management | never ending process, everyone can improve
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| Quality | the degree to which services for individuals and populations increase the likelihood of desired healthcare outcomes and are consistent with current professional knowledge
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| Quality control | activities that evaluate, monitor, or regulate services rendered to customers
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| Quality control vs. Risk management | moved health care from a model of identifying failed standards, problems, and “problem people” (risk management) to Proactive organizations where problems are prevented and care improvements are continuously made (quality control)
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| Leapfrog Group standards | CPOE system, evidence-based hospital referral, ICU physician staffing, Leapfrog safe practices
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| Number one cause of Sentinel Events | poor communication
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| Workplace violence | incident that leads one to believe that he/she has been harmed by the experience (e.g., favoritism, verbal abuse, abusive correspondence, bullying, pranks)
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| 5 steps to handling patient complaints | acknowledge the incident and apologize; quick follow-up; personal contact; immediate restitution; document facts
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| Organizational structure | the way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions
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| Span of control | number of people reporting to one manager; optimal range is 3-50 depending on manager’s expertise
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| Line Organizational Structure | Bureaucratic designs found frequently in healthcare organizations
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| Ad hoc Organizational Structure | modification of bureaucratic design sometimes used temporarily to facilitate project completing
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| Matrix Organizational Structure | focused on both product and function; formal vertical and horizontal chain of command
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| Flat Organizational Structure | more authority and decision making occurs where work is done
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| Organizational Climate | system of symbols and interactions unique to each organization; ways of thinking, behaving, and believing that members of a unit have in common
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| Organizational Culture | how employees perceive the organizations; how it feels to be part of the unit or organization; perceptions may differ and may be accurate or inaccurate
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| Organizational Climate vs. Culture | Climate is the system of symbols and interactions unique to each organization (how the organization thinks, behaves, and believes) while Culture is how employees perceive the organization (how it feels to be part of the organization)
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| Shared Governance | innovative and idealistic organizational structure that empowers employees within the decision-making system (giving nurses more authority and control over nursing practice)
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| Participatory Management | implies that others are allowed to participate in decision making over which someone has control
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| Shared Governance vs. Participatory Management | Shared governance empowers employees to make decisions while participatory management allows employees to participate in decision making, but still has someone who has control and makes final decisions
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