Sandra recently began questioning her decision to become a nurse and was considering leaving the profession after only six months of licensure. Orientation had left
* Sandra recently began questioning her decision to become a nurse and was considering leaving the profession after only six months of licensure. Orientation had left her in tears at least once per week, and she began questioning her ability to be a safe and competent nurse. Sandra felt belittled by her preceptor and unsupported by her co-workers, who all seemed too busy to help her. She frequently observed her preceptor roll her eyes and sigh loudly when Sandra asked a question; she observed the same thing from the preceptors of the other two new graduates.
1) As the nurse manager, what strategies can be implemented to reduce lateral violence on Sandra's part?2) How can Sandra and the other new graduates improve the work environment?
Leading and Managing in Nursing
SEVENTH EDITION
Patricia S. Yoder-Wise, RN, EdD, NEA-BC, ANEF, FAAN Professor and Dean Emerita, Texas Tech University Health Sciences Center, Lubbock, Texas
2
Table of Contents
Cover image
Title page
Copyright
Dedication
Contributors
Reviewers
Acknowledgments
Preface
Concept and practice combined
Diversity of perspectives
Audience
Organization
Design
Learning strategies
Complete teaching and learning package
Chapter overview Part 1: Overview
1: Leading, Managing, and Following
Introduction
Theory development in leading, managing, and following
Leading, managing, and following—different but related
Traditional and emerging leadership and management roles
Leading, managing, and following in a diverse organization
3
Conclusion
Reflections
The evidence
Tips for leading, managing, and following
2: Clinical Safety: The Core of Leading, Managing, and Following
Introduction
The classic reports and emerging supports
Other key agencies and endeavors
Meaning for leading and managing in nursing
Conclusion
Reflections
The evidence
Tips for clinical safety
3: Legal and Ethical Issues
Introduction
Professional nursing practice: nurse practice acts
Negligence and malpractice
Informed consent
Privacy and confidentiality
Policies and procedures
Employment laws
Professional nursing practice: ethics
Conclusion
Reflections
The evidence
Tips for incorporating legal and ethical issues in practice settings
4: Cultural Diversity and Inclusion in Health Care
Introduction
Concepts and principles
Theory
4
National and global directives
Special issues
Language
Meaning of diversity in the organization
Cultural relevance in the workplace
Individual and societal factors
Dealing effectively with cultural diversity
Implications in the workplace
Conclusion
Reflections
The evidence
Tips for incorporating cultural diversity in health care
Part 2: Know Yourself
5: Gaining Personal Insight: The Beginning of Being a Leader
Introduction
Informal and formal leadership
The core of learning to be a leader
Gaining insight into self
Becoming an authentic leader
Conclusion
Reflections
The evidence
Tips for Gaining Personal Insight
6: Being an Effective Follower
Introduction
Research on followership
Followership theories
Differences between leading and following
Leader–follower relationship
Conclusion
5
Reflections
The evidence
Tips on how to be an effective follower
7: Managing Self: Stress and Time
Introduction
Emotional intelligence
Understanding stress
Definition of stress
Sources of job stress
Dynamics of stress
Management of stress
Burnout
Resolution of stress
Management of time
Conclusion
Reflections
The evidence
Tips for self-management
8: Communication and Conflict
Introduction
Effective communication within healthcare settings
Types of conflict
Stages of conflict
Categories of conflict
Modes of conflict resolution
Differences of conflict-handling styles among nurses
The role of the leader
Managing incivility, lateral violence, and bullying
Conclusion
Reflections
The evidence
6
Tips for effective communication and addressing conflict
9: Power, Politics, and Influence
Introduction
History
Power
Empowerment
Sharing Power
Personal power strategies
Exercising Power and Influence in the Workplace and Other Organizations
Conclusion
Reflections
The evidence
Tips for using influence
Part 3: Know the Organization
10: Healthcare Organizations
Introduction
Characteristics and types of organizations
Integration
Acquisitions and mergers
Forces that influence healthcare organizations
Theoretical Perspectives
Nursing role and function changes
Conclusion
Reflections
The evidence
Tips for healthcare organizations
11: Organizational Structures
Introduction
Mission
Vision
7
Philosophy
Organizational culture
Factors influencing organizational development
Characteristics of organizational structures
Bureaucracy
Types of organizational structures
Emerging fluid relationships
Conclusion
Reflections
The evidence
Tips for understanding organizational structures
12: Care Delivery Strategies
Introduction
Historical methods of organizing nursing care
Leadership during implementation of a model of care
Organizational strategies influencing care delivery
Positive care delivery systems
Transitional care
Interprofessional education and collaboration
Conclusion
Reflections
The evidence
Tips for selecting a care delivery model
13: Staffing and Scheduling
Introduction
The staffing process
Evaluation of effective staffing
Factors in staffing that influence patient outcomes
Supplemental (agency or contract) staff and float pools
Organizational factors that affect staffing plans
Developing a staffing budget
8
Scheduling
Evaluating unit staffing and productivity
Conclusion
Reflections
The evidence
Tips for staffing and scheduling
14: Workforce Engagement Through Collective Action and Governance
Introduction
Nurses as knowledge workers
Professional practice responsibility
Workplace advocacy, engagement, and empowerment
Shared governance
Collective action, collective bargaining, and unionization in nursing
Healthy work environments
Conclusion
Reflections
The evidence
Tips for workforce engagement and collective action
Part 4: Use Your Skills
15: Making Decisions and Solving Problems
Introduction
Differentiation of decision making and problem solving
Decision making
Problem solving
Conclusion
Reflections
The evidence
Tips for decision making and problem solving
16: The Impact of Technology
Introduction
9
Types of technologies
Knowledge technology
Information systems
Informatics
Patient safety
Impact of clinical information systems
Safely implementing health information technology
Future trends and professional issues
Professional, ethical nursing practice and new technologies
Conclusion
Reflections
The evidence
Tips for managing information and technology
17: Delegating: Authority, Accountability, and Responsibility in Delegation Decisions
Introduction
Historical perspective
Definitions
Assignment versus delegation
NCSBN model: an organizational framework for delegation
Effective communication: an essential competency for successful delegation
Delegation and the decision-making process in nursing
Organizational and individual accountability
Legal authority to delegate
Learning how to delegate: different strategies for success
Conclusion
Reflections
The evidence
Implications for practice
Tips for delegating
18: Leading Change
Introduction
10
The nature of change
The change process
People and change
Context and change
Leadership and change
Conclusion
Reflections
The evidence
Tips for leading change
19: Building Effective Teams
Introduction
Groups and teams
Creating effective teams
Key concepts of teams
Issues that affect team functioning
Interprofessional teams
The value of team-building
The role of leadership
Conclusion
Reflections
The evidence
Tips for team building
20: Managing Costs and Budgets
Introduction
What escalates healthcare costs
How health care is financed
Healthcare reimbursement
The changing healthcare economic environment
Why profit is necessary
Cost-conscious nursing practices
Budgets
11
Conclusion
Reflections
The evidence
Tips for managing costs and budgets
21: Selecting, Developing, and Evaluating Staff
Introduction
Roles in an organization
Selection of staff
Developing staff
Performance appraisals
Coaching
Conclusion
Reflections
The evidence
Tips for selecting, developing, and evaluating staff
22: Person-Centered Care
Introduction
Person-centered care—why now?
Initiatives to deliver person-centered care
Challenges in the delivery of person-centered care
Patient engagement
Nurses in the delivery of person-centered care
Synthesis and application
Conclusion
Reflections
The evidence
Tips for competent person-centered care
23: Managing Quality and Risk
Introduction
Quality management in health care
12
Benefits of quality management
Planning for quality management
Evolution of quality management
Quality management principles
Customers
The quality improvement process
Quality assurance
Risk management
Conclusion
Reflections
The evidence
Tips for quality management
24: Translating Research Into Practice
Introduction
From using research to evidence-based practice
Development of evidence-based practice
Comparative effectiveness research
Practice-based evidence
Participatory action research
Quality improvement
Evaluating evidence
Organizational strategies to embed evidence-based practice into organizations
Issues for nurse leaders and managers
Conclusion
Reflections
The evidence
Tips for developing skill in using evidence and translating research into practice
25: Managing Personal and Personnel Problems
Introduction
Personal/personnel problems
Documentation
13
Progressive discipline
Termination
Conclusion
Reflections
The evidence
Tips in the documentation of problems
Part 5: Prepare for the Future
26: Role Transition
Introduction
Types of roles
Roles: The ABCs of understanding roles
Role transition process
Strategies to promote role transition
Conclusion
Reflections
The evidence
Tips for role transition
27: Managing Your Career
Introduction
A career framework
Career theory
Professional development
Contributing through scholarly activities and research
Career marketing strategies
Conclusion
Reflections
The evidence
Tips for a successful career
28: Developing the Role of Leader
Introduction
14
What is a leader?
The practice of leadership
Leadership development
Leadership development model
Surviving and thriving as a leader
The nurse as leader
Conclusion
Reflections
The evidence
Tips for becoming a leader
29: Developing the Role of Manager
Introduction
The definition of management
Nurse manager as change leader
Nurse manager role and the intergenerational workforce
The nurse manager and interprofessional collaboration
Building a positive work environment
Consuming research
Organizational culture
Mentoring
Day-to-day management challenges
Managing resources
Technology and informatics
Dashboards and decision support tools
Budgets and finance
Quality indicators
Professionalism
Conclusion
Reflections
The evidence
Tips for implementing the role of nurse manager
15
30: The Strategic Planning Process
Introduction
Strategic planning
Reasons for strategic planning
Phases of the strategic planning process
Conclusion
Reflections
The evidence
Tips for developing and executing a strategic plan for nursing
31: Thriving for the Future
Introduction
Leadership demands for the future
Leadership strengths for the future
Visioning, forecasting, and innovation
The wise forecast model©
Shared vision
Projections for the future
Conclusion
Reflections
Tips for the Thriving in the future
The evidence
Index
16
Copyright
3251 Riverport Lane St. Louis, Missouri 63043
LEADING AND MANAGING IN NURSING, SEVENTH EDITION ISBN: 978-0-323-44913-7
Copyright © 2019 by Elsevier Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
Notice Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
Previous editions copyrighted 2015, 2011, 2007, 2003, 1999, 1995. International Standard Book Number: 978-0-323-44913-7
Senior Content Strategist: Yvonne Alexopoulos Content Development Manager: Lisa P. Newton Senior Content Development Specialist: Tina Kaemmerer Publishing Services Manager: Julie Eddy Senior Project Manager: Jodi M. Willard Design Direction: Brian Salisbury
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Printed in Canada. Last digit is the print number: 9 8 7 6 5 4 3 2 1
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Dedication
This book is dedicated to the families and friends who supported all of us who created it, to the faculty who use this book to develop tomorrow’s emerging leaders and managers, and to the
learners who have the vision and insight to grasp today’s reality and mold it into the future of dynamic nursing leadership.
Lead on! ¡Adelante!
19
Contributors
Joan Benson, BSN, RN, CPN Manager, Clinical Informatics and Practice, Children's Mercy— Kansas City, Kansas City, Missouri
Kristin K. Benton, BS, BSN, MSN, DNP Director of Nursing, Nursing, Texas Board of Nursing, Austin, Texas
Amy Boothe, DNP, RN Instructor, Traditional Undergraduate Program, Texas Tech University Health Sciences Center, Lubbock, Texas
Elizabeth H. Boyd, MSN, BS Instructor/Site Coordinator, School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas
Myra A. Broadway, JD, MS, BSN Formerly, Executive Director, Maine State Board of Nursing, Past President, National Council of State Boards of Nursing, Maine Medical Professionals Health Program Advisory Committee USAFR Nurse Corps (Retired Colonel), Gardiner, Maine
M. Margaret Calacci, MS Director, Simulation and Learning Resources, Arizona State University College of Nursing and Health Innovation, Phoenix, Arizona
Mary Ellen Clyne, PhD President and Chief Executive Officer, Administration, Clara Maass Medical Center, Belleville, New Jersey
Jeannette T. Crenshaw, DNP, RN, LCCE, IBCLC, NEA-BC, FACCE, FAAN Associate Professor, School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas
Mary Ann T. Donohue-Ryan, PhD, RN, APN, APRN-MH, NEA-BC Vice President for Patient Care Services and Chief Nursing Officer, Administration, Englewood Hospital and Medical Center, Englewood, New Jersey
Michael L. Evans, PhD, MSN, BSN, BA Dean and Professor, School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas
Victoria N. Folse, PhD, APN, PMHCNS-BC, LCPC Director and Professor; Caroline F. Rupert Endowed Chair of Nursing, School of Nursing, Illinois Wesleyan University, Bloomington, Illinois
Jacqueline Gonzalez, DNP, MBA, MSN Senior Vice President/Chief Nursing Officer, Nicklaus Children’s Hospital, Miami, Florida
Debra Hagler, PhD, RN, ACNS-BC, CNE, CHSE, ANEF, FAAN Clinical Professor, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
Shari Kist, PhD, RN Missouri Quality Initiative (MOQI) Project Supervisor, Sinclair School of Nursing, University of Missouri—Columbia, Columbia, Missouri
Karren Kowalski, BSN, MSN, PhD President & CEO, Colorado Center for Nursing Excellence, Denver, Colorado Professor, Graduate Program, School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas
Mary E. Mancini, RN, MSN, PhD Senior Associate Dean for Education Innovation, Undergraduate Nursing, University of Texas at Arlington, Arlington, Texas
20
Maureen Murphy-Ruocco, APN-C, CSN, MSN, EdM, EdD, DPNAP Senior Fellow, National Academies of Practice, Nurse Consultant/Nurse Practitioner New York, New York Professor and Dean Emerita Felician University, Lodi and Rutherford, New Jersey
Karen A. Quintana, PhD, APRN, CPNP-PC Director of Pediatric Nurse Practitioner Studies, Graduate Program, School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas
Elaine S. Scott, BSN, MSN, PhD Chair, Nursing Science, East Carolina University, Greenville, North Carolina
Ashley Sediqzad, RN, BSN Manager, Clinical Informatics and Practice, Children's Mercy Kansas City, Kansas City, Missouri
Janis Bloedel Smith, DNP, MSN, BSN Senior Director, Clinical Informatics & Professional Practice, Patient Care Services, Children's Mercy Kansas City, Kansas City, Missouri
Susan Sportsman, PhD Nurse Consultant, Collaborative Momentum Consulting, LLC, St. Louis, Missouri
Sylvain Trepanier, DNP, MSN, BSN, RN, CENP Chief Clinical Executive, Administration, Providence St. Joseph Health, Torrance, California
Diane M. Twedell, DNP, MS Chief Nursing Officer, Mayo Clinic Health System, Southeast Minnesota Region, Austin, Minnesota
Jeffery Watson, DNP, RN-BC, NEA-BC, NE-BC, CRRN Assistant Professor, School of Nursing, Texas Tech University Health Sciences Center, Lubbock, Texas
Jana Wheeler, MSN, RN-BC, CPN Manager, Clinical Informatics & Practice, Children's Mercy Kansas City, Kansas City, Missouri
Crystal J. Wilkinson, DNP, RN, CNS-CH, CPHQ Associate Professor, School of Nursing, Texas Tech University Health Sciences Center, Austin, Texas
Patricia S. Yoder-Wise, RN, EdD, NEA-BC, ANEF, FAAN Professor and Dean Emerita, Texas Tech University Health Sciences Center, Lubbock, Texas
Margarete Lieb Zalon, PhD, RN, ACNS-BC, FAAN Professor, Nursing, University of Scranton, Scranton, Pennsylvania
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Reviewers
Karen E. Alexander, PhD, RN, CNOR Program Director RN-BSN, Assistant Professor, Clinical Heath and Applied Science—Nursing, University of Houston—Clear Lake, Houston, Texas
Vicki Bingham, PhD, RN, CPE Dean/Associate Professor of Nursing, Robert E. Smith School of Nursing, Delta State University, Cleveland, Mississippi
Deborah Birk, PhD, RN, MHA, NEA-BC Assistant Professor, Goldfarb School of Nursing, Barnes-Jewish College, St. Louis, Missouri
Barbara B. Blozen, EdD, MA, RN BC, CNL Associate Professor, New Jersey City University, Jersey City, New Jersey
Joseph Boney, MSN, RN, NEA-BC Director of Undergraduate Faculty Development/Instructor, Rutgers School of Nursing, Accelerated BS in Nursing Program, Newark, New Jersey
Mary T. Boylston, RN, MSN, EdD, AHN-BC Professor of Nursing, Nursing, Eastern University, St. Davids, Pennsylvania
Jane Campbell, DNP, RN, NE-BC Professor, School of Nursing, Northern Michigan University, Marquette, Michigan
Holly Johanna Diesel, RN, PhD Associate Professor, Academic Chair for Accelerated and RN to BSN Programs, Department of Nursing, Goldfarb School of Nursing at Barnes-Jewish College, St. Louis, Missouri
Jennifer B. Drexler, RN, MSN, PhDc, CCRN Clinical Faculty Educator, College of Nursing, University of New Mexico, Albuquerque, New Mexico
Lynn Renee Dykstra, MS, BSN, HPCN, RN Instructor, Adjunct Faculty, Northern Illinois University, College of Health and Human Sciences, Nursing, DeKalb, Illinois Oakton Community College, Division of Science and Health Careers, Nursing Des Plaines, Illinois
Julie A. Fitzgerald, PhD, RN, CNE Assistant Professor of Nursing, Ramapo College of New Jersey, Mahwah, New Jersey
Kay E. Gaehle, PhD, RN Associate Professor of Nursing, Department of Primary Care and Health Systems, Southern Illinois University—Edwardsville, Edwardsville, Illinois
Maria Gillespie, EdD, MSN, BSN, BS, CNE, RN Assistant Professor, Nursing, University of the Incarnate Word, San Antonio, Texas
Julia Henderson Gist, PhD, RN, CNE Dean, School of Health Sciences, Arkansas State University Mountain Home, Mountain Home, Arkansas
Stephanie A. Gustman, DNP, MSN, BSN, RN Assistant Professor, School of Nursing, Ferris State University, Big Rapids, Michigan
Cam A. Hamilton, PhD, MSN, RN, CNE Assistant Professor, School of Nursing, Auburn University at Montgomery, Montgomery, Alabama
Pamela Gibler Harrison, EdD, RN, CNE Professor of Nursing, Chair, Pre-Licensure Nursing,
22
Indiana Wesleyan University, Marion, Indiana
Karen L. Hoblet, PhD, MSN, RN, CNL Licensed RN, Clinical Nurse Leader, Interim Department Chairperson and Associate Professor, Interim Director Nurse Educator and Clinical Nurse Leader Programs, Advanced Population Care, The
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