Leadership and Management Hints

Hints Leadership and Management Terms in this set (52) Who should explain a surgical procedure to a pt? THE HCP RN should make sure that the operative permit is signed and on the chart. It is NOT the RN's responsibility to explain the procedure to the client. Good Samaritan Act? Means of protecting a nurse when he or she is performing emergency care If the nurse carries out a provider's prescription that she is not prepared for and does not inform the provider about her lack of preparation? The nurse is solely responsible for any damages. If nurse informs HCP of her lack of preparation in carrying out a prescription and carries out the prescription anyway? The nurse and the physician are liable for damages Can the nurse alter the prescription dosage of drug? NEVER. Nursing judgement cannot be substituted with medical judgement. If she believes the dosage is wrong, she should inform the health care provider, record the response of the provider, inform the nursing supervisor, refuse to carry out wrong prescription. What should a nurse do if she believes a provider's prescription is made with poor judgement? - i.e. she doesn't believe the pt needs a tranquilizer. Record that the health care provider was notified and that the prescription was questioned. Carry out the prescription as ordered. Nurse Practice Acts governs policies related to making assignments. E.g for a sterile dressing change: Should be done by an RN or LPN-licensed practical nurse, who has been checked off this procedure. What does assertive communication start with? "I need" rather than "you must" Motivation comes from within an individual. What can a nurse leader provide? Nurse leader can provide an environment that will promote motivation through positive feedback, respect, and seeking input. Look for responses that demonstrate these behaviors. What kind of style does effective leadership require? Assertive communication=democratic/participative. Does not require passive=laissez faire/permissive or aggressive= authoritative/autocratic. What are characteristics of nursing manager? 1) Authority 2) Accountability 3) Responsibility 4) Leadership 5) Commitment to quality. What are the skills of nursing manager? 1) Communication- act as liaison between clients and others. Engage in conflict resolution 2) Organization- review management outcomes and plan overall strategies to address client problems. 3) Delegation- identifies role/responsibilities of health care members of the team. 4) Supervision- supervises care provided by others. 5) Critical thinking- serves as resource person to other staff When delegating to the right person, what qualities should the nurse be aware of the delegetee? Appropriate: 1) education 2) training 3) skills 4) experience 5) demonstrated and documented competence Do UAPS generally perform invasive or sterile procedures? NO!!!! NO WAY RN is accountable to adhering to the 3 basic aspects of supervision when delegating to other health care personnel such as LPN's, graduate nurses, inexperienced nurses, student nurses, UAP's. What are 3 aspects of supervision? 1) Direction and guidance 2) Evaluation/monitoring 3) Follow up. Nurse process: Assessment, analysis, diagnosis, planning, evaluation, and any activity requiring nursing judgement- may not be delegated to UAP. Where do delegated activities of the nursing process fall under for a UAP? Under the implementation phase of nursing process. How should nurses prioritize on which patient to see and assess first? 1. Which patient is most critically ill? 2. Which client is more likely to experience a significant change in condition? 3. Which client requires assessment specifically by an RN. What are high priorities when assigning rooms for clients? (1) Infection and safety. Must analyze the desired outcomes. Should be based on the nurses abilities, the individual client's needs, and the needs of the entire group of assigned clients. Client with infection?Should not share room with immuno-compromised or surgical patient. Lewin's Change Theory: Unfreezing Moving Refreezing Unfreezing: initiation of change. Moving: motivation toward a change Refreezing: implementation of a change Change causes anxiety. What does an effective nurse do? Uses problem solving skills to recognize factors such as anxiety that contribute to resistance to change and uses decision making and interpersonal skills to overcome that resistance. Interventions that demonstrate these skills include: seeking input, showing respect, valuing opinions, and building trust. In a disaster and bioterorrism management, nurse must consider what? Community and the individual Biological agents? Anthrax, ricin, radiation, smallpox, botulism, pneumonic plague, sarin, inhalation tularemia, and viral hemorrhagic agents- ie ebola. 3 levels of disaster management: Disaster preparedness, disaster response, disaster recovery Levels of prevention in disaster management? Primary: develop disaster plan, train rescue workers in triage and first aid, educate personnel about shelter management, educate public. Secondary: Triage, treatment of injuries, treatment of other conditions like mental health, shelter supervision. Tertiary: Follow up care for injuries, follow up care for psychological issues, recovery assistance, prevention of future disasters. Triage color code system: Red: most urgent, 1st, life threatening injuries, can't delay treatment. Yellow: urgent, second priority. injuries with systemic effects and complications. Can delay for 30-60 minutes. Green: Third priority. Minimal injuries with no systemic complications. Can wait several hours. Black: Dying or dead. Catastrophic injuries. No hope for survival, no treatment. Nurse manager: acts to achieve the goals of safe, effective client care within the overall goals of a health care facility. Surgical permit: must be written, obtained voluntarily, and explained to the client- i.e. informed consent must be obtained. Minors: 14 and up: must agree to tx along with their parents. Emancipated minors- can consent to tx themselves. Person in "loco parentis" person standing in for a parent with a parent's rights, responsibilities, and duties in case of minor or incompetent adult. Is written consent necessary to provide or perform medical treatment? No. Tx can be done if client has been fully informed, client voluntarily consents to procedure, or if unconscious- immediate tx is necessary to safe life or limb. Two identifies: giving blood, taking blood, medications. Incompetent person: Have the legal status of a minor; cannot vote, make contracts or wills, drive a car, sue or be sued, hold a professional license. Assault: Mental or physical threat WITHOUT touching- i.e. forcing a client to take their medication Battery: TOUCHING, with or without the intent to do harm- i.e. striking a patient. Defamation: Divulgence of privileged information or communication, i.e. through charts, conversations, or observation Fraud: Willful and purposeful misrepresentation that could cause or has caused loss or harm to a person or property- i.e. providing false credentials to a person, describing a myth regarding tx- i.e. no pain in procedure or placebo has no side effects. Negligence: Performing an act that a reasonable or prudent person would no perform. Malpractice: Negligence by a professional personnel- i.e. professional misconduct or unreasonable lack of skill in carrying out professional duties. Four elements to prove malpractice or negligence: 1) Duty 2) breach of duty 3) injury/damages 4) causation False imprisonment: Confinement of a person without authorization Exposure of a person: Exposure or discussion of a person after feather- after right, pt has the right to be unobserved, excluded from unwarranted operations, and protected from unauthorized touching. Anthrax: Not spreadable from person to person. Transmission: Inhalation of powder, spores, undercooked meats from infected animals S/sx: sores, painless blisters, ulcers with black centers. GI problems. Inhalation: leads to cold and flu symptoms. TX: 60 day course of ABX. Vaccine given to Armed Forces, lab workers, those who go to contaminated site. Pneumonic Plague: Spreadable from person to person Transmission: aerosol released into envinroment. Respiratory droplets. Found in rodents and their fleas S/SX: rapidly developing pneumonia, bloody or watery sputum, abdominal pain, NV, fever, weakness. Leads to shock, respiratory failure, rapid death. TX: ABX for 7 days at least Botulism: Not spreadable from person to person Transmission: food: ingests toxin. Wound: bacteria in wound secretes toxin. S/SX: double, blurred vision, slurred speech, difficulty swallowing, descending muscle weakness. TX: may require mechanical ventilation, no vaccine, antitoxin to reduce severity of disease. Smallpox: Spreadable from person to person Transmission: Aerosol into environment, contact with infected person- direct or prolonged face to face, bodily fluids, contaminated objects. S/SX: high fever, V, HA, bodyaches, rash that progresses to raised bump and pus filled blisters that crust and scab and fall off. Leaves pitting scar. TX: Supportive therapy. No proven TX. ABX tx for secondary infections Inhalation Tularemia: Not spreadable person to person Transmission: Insect bites, handling of sick or dead animals, contaminated food or water, inhalation of bacteria. S/SX: skin ulcers, panful and swollen lymph glands, D, mouth sores, pneumonia. Can also get respiratory failure, bloody sputum, chest pain, difficulty breathing, chills, HA, muscle aches, dry cough, joint pain. TX: ABX 10 days-2 weeks Viral Hemorrhagic Fever (ebola, lassa, dengue, yellow, Marburg). Spreadable person to person Transmission: bodily fluids, close contact, objects contaminated by bodily fluids. S/SX: fever, exhaustion, muscle aches, bleeding under skin, or from body orifices, shock, CNS malfunction, seizures, coma, renal failure. TX: no cure. supportive tx. Ricin: Not spreadable person to person poison from leftover castor beans. Deliberate act of poisoning by inhalation or injection. Can contaminate water or food supply. S/SX: Respiratory symptoms- tightness of chests, fever, N,pulmonary edema, resp failure. Death. VD, bloody, hallucinations, seizures, hematuria, organ failure TX: supportive care. Death in few days. Sarin: Spreadable person to person Human made chemical. Clear, odorless, tasteless. Can evaporate into gas. Exposed through skin, eyes, inhalation. Clothing can release sarin for 30 mins after contact S/SX: runny nose, eyes, pupils, drooling, blurred vision, ALOC , D, reap problems, sweating, convulsions, paralysis, death. TX:can recover if mild to mod, if severe: death Radiation: not spreadable person to person comes from external ike sun or x-rays, nuclear bomb such as Chernobyl. Exposure is cumulative, effects may not be seen for years. Acute radiation sundrome: NVD, bone marrow depletion, flu symptoms, infections, loss of appetite, bleeding, skin reddening, may lead to CA.