Leadership and Management in Nursing

by Grohar-Murray, Mary Ellen; Dicroce, Helen R.

ISBN13:

9780838556436

ISBN10:

0838556434

Format:

Paperback

Pub. Date:

9/1/1991

Publisher(s):

Prentice Hall

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Leadership and Management in Nursing
Leadership and Management in Nursing
Leadership and Management in Nursing

Preface	p. xvii
Acknowledgments	p. xix
Contributors	p. xxi
Reviewers	p. xxiii
Leadership	p. 1
The New Health Care System; Challenge to Nursing Leadership	p. 3
Introduction	p. 3
Key Concepts	p. 4
Managed Care	p. 5
Health Care Reform	p. 5
Managed Care Characteristics	p. 7
Managed Care Organizations	p. 9
Health Maintenance Organizations (HMOs)	p. 9
Characteristics of the Health Care System	p. 10
Professional Issues: The Nursing Shortage	p. 11
Health Care Priorities	p. 12
Forecast for Health Care	p. 14
Nursing Leadership's Heritage	p. 15
Challenge to Nursing	p. 16
Leadership Framework	p. 17
Differentiating Leadership and Management	p. 17
Case Studies	p. 18
Summary	p. 19
Learner Exercises	p. 20
References	p. 21
Leadership Theory	p. 23
Introduction	p. 23
Key Concepts	p. 23
Definition of Leadership	p. 24
Leadership Theory	p. 25
Great Man Theory of Leadership	p. 25
Trait Theory	p. 25
Behavioral School of Leadership	p. 26
Leadership Style	p. 26
Leadership Behaviors	p. 27
Situational Theory	p. 30
Contingency Model	p. 31
Situational Leadership Model	p. 32
A New Concept of Leadership	p. 32
Transformational Leadership	p. 34
Connective Leadership	p. 35
Seven Lessons of Leadership	p. 35
Process Model of Leadership	p. 37
Analysis and Problem Identification	p. 37
The Event	p. 38
The Participants	p. 38
Organizational Factors	p. 38
Interpersonal Processes between Participants	p. 38
Controlling Forces	p. 39
Determination of Action	p. 39
Action Plan	p. 39
Evaluation of Action	p. 39
Conclusions on Use of Process	p. 40
Case Studies	p. 40
Summary	p. 42
Learner Exercises	p. 42
References	p. 43
Appendices	p. 45
Interactive Processes of Leadership; Communication and Group Process	p. 50
Introduction	p. 50
Key Concepts	p. 51
Communication	p. 51
The Message	p. 51
Communication Process	p. 52
Ten Basics for Good Communication	p. 53
Blocks to Communication	p. 58
Culture and Gender	p. 59
Communication with the Health Team	p. 60
Preventing Communication Breakdown	p. 62
Communication with Difficult People	p. 63
Communication Networks	p. 65
Team Building	p. 66
Group Dynamics	p. 66
Interdisciplinary Teams	p. 67
Characteristics of a Group	p. 67
Group Processes	p. 67
Leaders Impact on a Group	p. 68
Insight	p. 68
The Group Approach	p. 69
Understanding	p. 70
Diagnose a Sick Group	p. 70
Flexibility	p. 70
Meetings: A Team Tool	p. 71
Evaluation of Group Effectiveness	p. 72
Case Studies	p. 72
Summary	p. 74
Learner Exercises	p. 74
References	p. 75
Appendix	p. 77
Decision Making and Conflict Management	p. 78
Introduction	p. 78
Key Concepts	p. 78
Decision Making	p. 79
Analysis	p. 79
Prediction of Outcomes	p. 81
Challenge to Nursing	p. 82
Impact of Decisions	p. 83
Systems of Decision Making	p. 84
The Decision Making Process	p. 85
Identify Participants	p. 85
Gather Pertinent Facts	p. 86
Generate Alternatives	p. 86
Predict Outcomes	p. 87
Select Best Alternative	p. 87
Plan for Managing Consequences	p. 87
Management of Conflict	p. 89
Nature of Conflict	p. 89
Basis of Conflict	p. 91
Examples of Common Conflicts in Nursing	p. 92
Approaches to Managing Conflict	p. 95
Process Model of Conflict Management	p. 96
Case Studies	p. 98
Summary	p. 99
Learner Exercises	p. 99
References	p. 100
The Ethical Responsibility of the Nurse Leader	p. 102
Introduction	p. 102
Key Concepts	p. 103
Ethics	p. 103
Ethical Theories	p. 105
Ethical Principles	p. 106
Barriers to Ethical Decision Making	p. 107
Strategies for Enhancing Ethical Decisions in Nursing Practice	p. 108
The Role of Institutional Ethics Committees	p. 109
The Employer-Employee Relationship	p. 109
Peer Relationships	p. 111
The Nurse--Patient Relationship	p. 113
Case Studies	p. 116
Summary	p. 116
Learner Exercises	p. 117
References	p. 118
Suggested Readings	p. 120
An Overview of Organizations and Management	p. 121
Organization and Management Theory	p. 123
Introduction	p. 123
Key Concepts	p. 123
Overview: Organizational Dynamics	p. 124
Classical Theory	p. 125
Scientific Management	p. 125
Administrative Management	p. 125
Organizational Principles	p. 126
The Bureaucratic Model	p. 128
Contribution of Classical Theory	p. 128
Modern Theory	p. 129
Behavioral Science	p. 129
General Systems/Social Systems Theory	p. 130
Modern Systems Theory Models	p. 132
The Modern Team Concept	p. 133
Interactional Phenomena	p. 134
Power	p. 134
Authority	p. 136
Responsibility	p. 136
Status	p. 136
Process of Delegation	p. 136
Organizational Concepts	p. 137
Organizational Chart	p. 137
Organization Structure	p. 137
Contingency Structure	p. 140
Integrated Health Care System	p. 141
Organizational Model	p. 142
Organization and Management Link	p. 144
Properties of an Organization	p. 144
Case Studies	p. 145
Summary	p. 146
Learner Exercises	p. 146
References	p. 147
Overview of Nursing Management	p. 149
Introduction	p. 149
Key Concepts	p. 150
Management Process	p. 150
Levels of Management	p. 151
Management Science	p. 151
Management in Nursing	p. 153
Evolution of Nursing's Management Role	p. 154
Objectives of Nursing Management	p. 155
Management Functions	p. 155
Planning	p. 155
Types of Planning	p. 156
Organizing	p. 157
Staffing	p. 158
Directing	p. 158
Coordinating	p. 159
Controlling	p. 159
Standards	p. 159
Policies	p. 161
Systems of Nursing Care Delivery	p. 161
Case Method	p. 161
Functional Method	p. 162
Team Nursing	p. 162
Restructuring Nursing Care Delivery Models	p. 163
Job Design	p. 163
Primary Nursing	p. 163
Total Patient Care	p. 164
Differentiated Practice	p. 164
Partners in Practice	p. 165
System Redesign	p. 165
Case Management	p. 166
Total Quality Management	p. 167
Transition to Manager	p. 167
Management Assessment Guide	p. 168
Case Studies	p. 169
Summary	p. 169
Learner Exercises	p. 170
References	p. 170
Delegation; The Manager's Tool	p. 172
Introduction	p. 172
Key Concepts	p. 172
Delegation	p. 173
Assignment of Work	p. 174
Scope of Practice	p. 174
Liability	p. 174
Scalar Chain	p. 175
Decentralization	p. 175
The Purpose of Delegation	p. 176
Cost Savings	p. 176
Time Savings	p. 177
Professional Growth for Employees	p. 177
Professional Growth of the Manager	p. 177
The Process of Delegation	p. 177
Guidelines for Effective Delegation	p. 178
Barriers to Delegation	p. 178
Case Studies	p. 180
Summary	p. 181
Learner Exercises	p. 181
References	p. 182
Suggested Readings	p. 182
Special Responsibilities of the Manager	p. 183
Maintaining Standards	p. 185
Introduction	p. 185
Key Concepts	p. 185
The Climate for Nursing Practice	p. 187
Professional Basis for Quality Assurance	p. 188
Practice Framework	p. 190
Legal Basis of Nursing	p. 192
Ethical and Societal Concerns	p. 192
Governmental Regulations	p. 193
Risk Management	p. 194
Model of Risk Management	p. 195
Financial Management	p. 195
Risk Identification	p. 195
Risk Analysis	p. 196
Risk Treatment	p. 196
Risk Evaluation	p. 196
Impact on Nursing Development	p. 196
Case Studies	p. 197
Summary	p. 197
Learner Exercises	p. 198
References	p. 198
Motivation in the Work Setting	p. 199
Introduction	p. 199
Key Concepts	p. 199
Definitions and Sources of Motivation	p. 200
Theories of Motivation	p. 201
Needs Theorists	p. 201
Personality Type and Motivation	p. 202
Motivation as Rational Decision Making	p. 203
Organizational Climate and Motivation	p. 204
Micromotivation and Macromotivation	p. 207
Motivational Problems	p. 208
A Situational Approach	p. 209
Issues Central to Nursing	p. 210
Case Studies	p. 210
Summary	p. 211
Learner Exercises	p. 212
References	p. 213
Monitoring and Improving Performance	p. 215
Introduction	p. 215
Key Concepts	p. 215
The Performance Appraisal System	p. 216
Design of a Performance Appraisal System	p. 217
Career Planning	p. 217
Criteria for Nursing Standards	p. 219
Active Participation in Performance Appraisal	p. 220
Essential Elements	p. 220
Philosophy, Mission, and Objectives	p. 221
Well-Defined Purpose	p. 221
Evaluation Tools that Produce Desired Information	p. 222
Performance Appraisal Process	p. 224
Planning for the Interview	p. 224
Participating in the Evaluation Interview	p. 225
Using Evaluation Results	p. 226
Rewards	p. 227
Obstacles to Performance Improvement	p. 229
Case Studies	p. 232
Summary	p. 233
Learner Exercises	p. 234
References	p. 234
Legal Issues in the Work Place	p. 236
Introduction	p. 236
Key Concepts	p. 237
Equal Employment Opportunity (EEO) Laws	p. 237
Title VII of the Civil Rights Act of 1964 (Amended in 1972)	p. 238
Civil Rights Act of 1991	p. 238
Civil Rights Act, Amended 1993	p. 238
Age Discrimination in Employment Act	p. 238
Pregnancy Discrimination Act	p. 238
Americans With Disabilities Act (ADA)	p. 239
Immigration Reform and Control Act	p. 239
Consolidated Omnibus Budget Reconciliation Act (COBRA)	p. 239
Occupational Safety and Health Act (OSHA)	p. 239
Sexual Harassment: A Special Case of Discrimination	p. 239
Hiring and Interviewing	p. 241
Family and Medical Leave Act (FMLA) of 1993	p. 241
Labor-Management Laws	p. 242
Unions and Collective Bargaining	p. 242
Strikes	p. 245
Case Studies	p. 246
Summary	p. 247
Learner Exercises	p. 247
References	p. 248
Managing Change	p. 251
Introduction	p. 251
Key Concepts	p. 251
A Theoretical Perspective	p. 252
Expanded Conceptual Framework	p. 252
Change and Stress	p. 254
Expanded Rate and Scope of Change	p. 255
Change Strategies	p. 255
Planned Change Theory	p. 255
Basis of Change in Nursing	p. 256
External Forces	p. 257
Internal Forces	p. 257
The Change Process	p. 260
Problem Identification	p. 260
Gaining Support for Change	p. 261
How Changes Are Made	p. 261
Planned Change	p. 262
Radical Intervention	p. 262
Change through Nonintervention	p. 263
An Example of Differing Adaptations to Change	p. 263
Stages of Change	p. 264
Unfreezing	p. 264
Moving	p. 264
Refreezing	p. 265
Change Agents	p. 265
Characteristics of Change Agents	p. 265
Responsibilities of Change Agents	p. 266
Strategies for Change Agents	p. 266
Response to Change	p. 266
Resistance to Change	p. 267
Evaluating Change	p. 269
Case Studies	p. 269
Summary	p. 271
Learner Exercises	p. 272
References	p. 272
Managing Resources	p. 275
Managing Resources; The Staff	p. 277
Introduction	p. 277
Key Concepts	p. 278
Staffing	p. 278
Process and Staffing Plan	p. 278
Workload Measures: Productivity Index	p. 280
Staffing Methodologies	p. 281
Scheduling Patterns	p. 283
Work Schedules	p. 284
Shared Staffing Help List	p. 285
Management's Role: Planning the Staffing Program	p. 286
Economic and Regulatory Issues	p. 286
Case Studies	p. 287
Summary	p. 288
Learner Exercises	p. 288
References	p. 289
Managing Resources; Time	p. 290
Introduction	p. 290
Key Concepts	p. 290
Time Management	p. 291
Principles of Time Management	p. 291
Communication	p. 291
Planning	p. 291
Delegation	p. 292
Prioritizing Goals	p. 292
Time Management Strategies	p. 293
Time Analysis	p. 293
Daily Planning	p. 293
Crisis Control	p. 294
Problem Analysis	p. 295
Task Analysis	p. 295
Time Control	p. 295
Time Evaluation	p. 295
Barriers to Effective Time Management	p. 296
Habit	p. 296
Work Expansion	p. 296
Oversupervision	p. 296
Underdelegation	p. 296
Losing Sight of Objectives	p. 296
Case Studies	p. 297
Summary	p. 298
Learner Exercises	p. 298
References	p. 298
Suggested Readings	p. 299
Managing Resources; The Budget	p. 300
Introduction	p. 300
Key Concepts	p. 300
Managing Financial Resources	p. 302
Financial Structure	p. 302
The Budgeting Proces	p. 303
A Policy Statement	p. 303
Goals and Financial Projections	p. 303
Related Budgeting Concepts	p. 304
Accounting	p. 304
Income Statements	p. 304
The Balance Sheet	p. 304
Cash-Flow Statements	p. 305
Cost Accounting	p. 305
Double-Entry Accounting	p. 306
Long-Range Financial Plans	p. 306
Types of Budgets	p. 307
Preparation of the Budget	p. 310
Review Past Performance	p. 310
Review the Organization's Goals and Projections	p. 311
Review the Variance	p. 311
Actual Preparation of the Budget	p. 311
Specific Responsibilities of the Nurse Manager	p. 311
Monitoring the Budget	p. 312
Case Studies	p. 315
Summary	p. 316
Learner Exercises	p. 317
Suggested Readings	p. 317
Informatics in Nursing	p. 318
Introduction	p. 318
Key Concepts	p. 318
Definition of Informatics	p. 319
Computers	p. 319
Components of Computers: Hardware and Software	p. 320
Hardware	p. 320
Software	p. 321
Nursing Informatics	p. 321
Significance of Nursing Informatics	p. 322
Nursing Informatics: Special Applications	p. 323
The Health Care Record	p. 325
Computerized Patient Record	p. 326
A Computerized Patient Record for Data Management	p. 326
Informatics Systems	p. 326
Challenge of Nursing Informatics	p. 327
Ethical Considerations	p. 327
Security	p. 327
Confidentiality	p. 327
Privacy	p. 328
The Internet: A Resource for Nursing	p. 328
Future Directions	p. 329
Case Studies	p. 329
Summary	p. 330
Learner Exercises	p. 330
References	p. 331
Index	p. 335
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