Nclex PREP PPT Notes PDF

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NCLEX PREP PPT NOTES Leadership is one of the most important concepts in our lives. In the past, great leaders have helped move our society and our culture forward by accomplishing great visions. For example, President Kennedy stated, “ask not what your country can do for you, but what you can do for your country?” That was his vision. Dr. Martin Luther King, Jrs. Called his vision a “dream.” Mother Teresa called her vision a “calling.” What did Florence Nightingale call her vision? (nursing). So a leader is one who works with others to articulate a vision and then to develop a plan to make that vision happen. Therefore, the study of leadership is essentially the study of how to work with other people. Management process is universal – used in your personal life and professional life (bank account, family, school, social interactions) -And if you are working with people to carry out a vision, then the v ery essence of

leadership is the ability to influence other people. It is an interpersonal process involving influence and role modeling that inspires people to achieve personal and group goals. It is a process in which the learned and inherited characteristics of the individual are combined to mold the leader. And as Norman Swarzkoff says - do so with character. -We will look at the concepts of leadership and management, review the differences, and the qualities or behaviors that make an effective leader and/or manager. This saying claims that great leaders were once thought to be born with the qualities and skills that could not be acquired. It implies that if you are not a natural born leader, you will always follow into the rank of FOLLOWER. Contemporary leadership theory supports that leaders can develop the necessary skills. They claim that although leadership may come more easily to some than to others, every one can be a leader if one develops the necessary knowledge and skills. The relationship between leadership and management continues to prompt debate, although the literature demonstrates the need for both. But nursing management is not synonymous with nursing leadership. ALL LEADERS ARE NOT NECESSARILY MANAGERS AND ALL MANAGERS ARE NOT NECESSARILY LEADERS. Managers emphasize control – control of

hours, costs, salaries, overtime, supplies, etc. whereas leadership increases productivity by maximizing work force objectives. A Job title alone does not make a person a leader. Only the behavior determines if he or she is the leader. Effective managers usually possess good leadership skills; however, effective leaders are not always in a management position. Managers have formal positions of power and authority; leaders may have only the informal power afforded them by their peers. One cannot be a leader without followers. Think of leadership as being responsible for a ship sailing into waters where no one has ever sailed where unplanned obstacles are encountered. The leader uses knowledge and skills from previous journeys to develop new strategies to maneuver through the waters. E-mail Netiquette Principles: 1. Only use e-mail in the workplace for professional concerns. 2. Proofread your e-mail message before you send it. 3. Quote original messages properly in replies. 4. Avoid irony, sarcasm, and emotional tones. 5. Send plain text e-mails (no cutesy pictures, etc). 6. Avoid writing in all caps (shouting). 7. Ask before you send large attachments (may clog system). 8. Avoid emoticons (smileys, etc.) and other internet slang. 9. Make sure message is specific and complete. 1992 Stephen Covey, an author who is sought after internationally to teach seminars on leadership, identified eight characteristics of an effective leader. For people to be inspired and motivated, they should be positive about life, the situation at hand, the change facing them, etc. No one has told them “you are the leader.” If the followers will not follow, then the leader is ineffective An effective leader can influence other toward goal setting. When change occurs, they can be the one who rallies the troops, unofficially, and helps them move toward the new goals. They like new ideas, even change b/c they are risk takers, not reckless risk takers, but one willing to explore new ideas. They are personable and empathetic.

They are rewarded by their own personal achievements. Ex. Of Keitha’s statement re. Master’s degree. WHAT TO EXPECT WHEN WORKING WITH AN AUTOCRATIC LEADER: *Expect praise and criticism; both are quickly given; you know where you stand with this leader. *Instructions given by this leader are usually loud and clear, not subtle or with a hidden agenda. *Never get into a power struggle with this leader – you will lose! *Trust this leader in a crisis or emergency situation! *Do not expect to participate in any group decision making. *These leaders do not show the qualities of the science of human caring! *Achieving the goal is paramount. Example: Seal Team 6 taking down Bin Laden; in a code situation you need this type leader DISADVANTAGES: MAY RESULT IN HIGHER TURNOVER; INCREASES DISSATISFACTION A democratic leader uses the group process to make all major decisions. They are pleasant people to work with, but decision making is prolonged and time consuming. WHAT TO EXPECT WHEN WORKING WITH A DEMOCRATIC LEADER: *Your individual needs will be met *You will need to make a time commitment to the group *Emergencies within the group are stressful *This leader is devoted to the science of human caring framework Works when staff members can work independently and are committed to the job and the organization but group may flounder if no one emerges to give the group direction. People who work on a laissez-faire unit usually are out of synchrony with the rest of the organization because of the information that has not been passed on to them because the rest of the organization avoids this leader; thus, no flow of information and no synchrony. WHAT TO EXPECT WHEN WORKING WITH THIS LEADER: *Gives you no guidance, information, or individualized attention *This work environment does provide a great deal of autonomy *There is chaos in the system *You are usually out of sync with the rest of the organization *Feelings of resentment mount toward the leader

*This leader has probably never even heard of the science of human caring, much less tried to practice it! Managers emphasize organizing, coordinating, and controlling resources (e.g. space, supplies, equipment, people). They attend to short term goals and objectives according to those of the organization. In contrast leaders set a direction, develop a vision, and communicate the new direction to the staff. Managers address complexity whereas leaders address change. Managers must now address new challenges like workplace violence and lateral violence (explain nurse against nurse); must be proficient at informatics with the EMR emerging quickly even in rural hospitals; must understanding budgetary and financial skills; JCHAO standards, and on and on. Must know the following: 1. Level of care required by patient 2. Strengths and weaknesses of staff 3. Be able to match the above correctly UNDERDELEGATING: Manager may not trust his subordinates & believes he or she can do the job better or faster than anyone else. Sometime they underdelegate b/c they lack experience in the job or in delegation itself or because they have an excessive need to control. Some novice managers emerging from the clinical nurse role underdelegate b/c they find it difficult to assume the manager role. They have excellent clinical skills but have not yet gained the managerial skills but were probably promoted solely on their clinical expertise and excellence. OVERDELEGATING: Managers will overdelegate b/c they are poor managers of time; spending most of it just trying to get organized. Others overdelegate b/c they feel insecure in their ability to perform a task. Overdelegating to exceptionally competent employees will eventually decrease their productivity and make them resentful toward the manager. Conflict is present in ALL aspects of life and all organizations due to complexity and interactions of people. Brainstorming with group is helpful to stimulate ideas. Choose best solution for problem. When implementing solution, be sure to have a procedure and timeline in place.

Evaluation is important – if it is not working, go back to the table and brainstorm a new solution. Negotiation is a part of conflict resolution – interested parties bargain and pursue outcomes that benefit both group’s mutual interests. Most nurses negotiate on a daily basis. Focus should be on a win-win solution or a solution where each party wins something but is willing to give up something. Example: nurse A agrees to care for critically ill patient on Tuesday if nurse B will care for that same patient on Wednesday. Patient care delivery system: method used to deliver patient care. Multiple models and organization may choose a particular model based on things such as staffing capabilities, finances, number of patients, etc. Became popular during WW II when there was a severe shortage of nurses in the United States. Many nurses entered the military to care for the soldiers, so to provide for the patients here at home, the hospitals began to increase the number of LPNs and UAPs. FN is a method of providing patient care by which each licensed and unlicensed staff member performs specific tasks for a large group of patients. • Advantages -Efficiency at each task -Unskilled workers can be trained to perform 1-2 tasks very well -Financially beneficial Disadvantages: Fragmentation of care: charge nurse may be only one with total view of patient. Ineffective communication between care givers – leads ineffective evaluation of the patient’s response to care. Patient & family dissatisfaction; nurse dissatisfaction.

Teams composed of HCWs with diversity of skills, educations, and licensure. Oversight by charge nurse (RN) and each team has an RN team leader. Team leader may or may not have patients assigned for hands-on care. Strong communication is paramount in team nursing. Team members report directly to team leader, who then reports to the charge nurse or unit manager. There are several teams per unit, based on the size of the unit. Advantages: Facilitation and oversight of novice nurses Smaller groups of patients leading to higher quality of care Team leader has knowledge of patients needs and can coordinate care Increased patient satisfaction Disadvantages: Increased time from communication needs

Increased number of staff needed: increases financial needs Increased time for supervision, delegations, and coordination Can lead to omission of care Most educated staff are supervising and usually not delivering hands-on care In the 1960s a cultural revolution occurred in the US that also influenced nursing because nurses were becoming dissatisfied with their lack of autonomy and in the hierarchy in nursing. As a result Primary Nursing was developed by Marie Manthey – implemented in the 1970s as we know it now. In this delivery method, one RN functions autonomously as the patient’s primary nurse throughout the hospital stay. This nurse has 24 hour accountability and responsibility for the patient(s) under her care. She is held accountable for meeting outcome criteria and communicating with all other healthcare providers about the patient. She/he develops the written plan of care. The RN assumes 24-hour a day total patient care from admission through discharge. When the RN is not working, an associate nurse implements the plan. The Associate nurse is an RN who has been delegated to provide care to the patient according to the primary nurse’s specifications. If the patient develops additional complications, the associate nurse notifies the primary nurse, who has 24 hour accountability and responsibility. The associate nurse provide input to the patient’s plan of care, and the PN makes the appropriate alterations. ADVANTAGES: Increased quality of care and patient satisfaction Because RNs practicing PN must possess a broad knowledge base and have highly developed nursing skills, professionalism is promoted. Patients are satisfied because they have “their nurse.” Simplified communication. DISADVANTAGES: Is the RN ready to take on the 24 hour accountability? Increased costs for the organization due to increased number of RNs required. *Not as popular now due to once again shortage of RNs – research now shows patient satisfaction no greater than with Team Nursing when utilized correctly. The oldest mode of nursing. Here the nurses assume total responsibility for meeting all the needs of assigned patients during their time on duty. This method is still widely used in many hospitals and in home health. Very similar to primary nursing but does not extend beyond shift. DISADVANTAGES: May not be cost effective due to need for more RNs.

May not be preferred by RNs who feel that some tasks could be performed by less skilled individuals. ADVANTAGES: Provides nurses with high autonomy and responsibility. The patient theoretically receives holistic and unfragmented care during the nurse’s time on duty. Quality care by RN. High patient satisfaction. Decreases communication time between staff. Reduces need for supervision. Advantages: Provides professional practice model for nurses. Is cost effective Disadvantages: May lead to fragmented communication. Needs to be integrated into the care delivery model. The Nurse Licensure Compact (mutual recognition) allows a nurse to have one license (in his or her state of residency) and to practice (both physically and electronically) in other states which have enacted the nurse licensure compact, subject to each state’s practice laws and regulations. Under mutual recognition, a nurse may practice across state lines unless otherwise restricted (ASBN website). Primary state of residence: a. Driver’s license b. Voter registration c. Federal income tax Work in any compact state with an unencumbered license. One license (not multiple) Work 90 days after moving to another compact state. Graduate should license in the state that they are going to live in. Caution about moving to another state before taking NCLEX and licensing. Discuss handout (The Eight Steps of the NCLEX Examination Process) CAT: computerized adaptive testing means that the examination is created as the testtaker answers each question. The questions are categorized based on test-plan structure and level of difficulty. When you answer a question, the computer determines

your competency based on your answer. The more correct answers, the difficulty level increases. Incorrect answers: the computer selects an easier question. This process continues until the test plan requirements are met and a reliable pass-or-fail decision can be made. Professional behavior at all times is a MUST! We are seeing less and less evidence of professional behavior, especially in the healthcare field. You be the one to restore a good name of professionalism in the field of nursing. Strive to be a positive person that others will want to be around. Be a “balcony” person rather than a “basement” person! Finish your work and then look for ways to help others finish their work. Don’t ever let yourself say, “that is not my job; or; that is not my patient.” Work in healthcare is not always predictable. Strive to remain flexible in all situations. “Blessed are the flexible, for they shall not be bent out of shape!” Whether or not you return to school to advance your education, you will need to stay upto-date by attending educational workshops, reading professional journals, and staying current on evidence-based practice. Begin now to map out a career plan. Think about advancing to the next level of nursing. (use this time to talk about ARNEC). Pull it up on web. Briefly look at each subchapter of Nurse Practice Act to familiarize student with the Act and the layout. Also look briefly at the Rules and the position statements. Brenda Murphree, faculty member at SACC, is past president of ASBN. May be used during employment interviews to showcase education and career accomplishments. Should begin collecting documents at beginning of career and continually update portfolio....