Leadership Exam 4 Study Guide

Chapter 22Collective bargaining, unionization, and employment laws

Leadership Roles:

Is self aware regarding personal attitudes and vales regarding collective bargaining and employment
laws
Recognizes and accepts reasons why people seek unionization
Creates a work environment that is sensitive to employee needs, thereby reducing the need for
unionization
Maintains a cooperating/accommodating approach to dealing with unions
Ia a role model for fairness
Is nondiscriminatory in all personal and professional actions
Examines the work environment periodically to ensure that it is supportive for all members regardless
of gender, race, age, disability, or sexual orientation
Immediately confronts and addresses sexual harassment
Embraces the intent of laws barring discrimination and providing equal opportunities
Actively seeks a culturally and ethnically diverse workplace to meet the needs of the diverse client
population

Management Functions:

Understands and appropriately implements union contracts

Administers personnel policies fairly and consistently
Works cooperatively with the personnel department and top-level administration when dealing with
union activity
Promotes worker identification with management
Immediately and fully investigates all complaints regarding violations of the collective bargaining
contract
Create opportunities for subordinates to have input into organizational decision-making to discourage
unionization
Alert for discriminatory employment practices in the workplace and intervenes immediately
Ensures that the unit or department meets state licensing regulations
Understands and follows labor and employment laws that relate to the managers sphere of influence
Ensures that the work environment is safe
Works closely with human resource management when dealing with employment legislation issues

Collective bargaining: relations between employers acting through their management representation and
organized labor

Involves activities occurring between organized labor management that concerns employee
relations.
Includes negotiation of formal labor agreements and day-to day interactions between unions
and management
Agency Shopalso called an open shop, employees are not required to join the union
Arbitrationwhere a third party reviews the grievance, completes fact finding and reaches a
decision
Conciliation and mediationrefer to the activity of a third party to help disputes and reach
an agreement
Fact findingfrequently used in labor management disputes that involve government owned
companies

Free speechthe expressing of any views, argument, or dissemination thereof, written,

verbal, printed, etc. without threats or force or promise of benefit
Grievanceperception on the part of a union member that management has failed in
someway to meet the terms of the labor argument
Lockoutclosing a place of business by management in the course of labor dispute for the
purpose of forcing employees to accept management terms
National Labor Relations Boarddetermine who should be part of the official bargaining
unit when a new unit is formed and who should be in the unit and adjudicate unfair labor
charges
Professionalshave the right to be represented in the union
Union Shopclosed shop, employees are required to join and pay dues
union provides interest cards. Only 30% of the potential members have to sign the
interest card to have a vote. Sometimes nurses get handed or mailed an interest card, and
signing it counts as one of those counted toward the 30%. They can be sneaky about it, like
would you be interested in knowing what a union can do for you? and so you think, Yes; I
am always interested in learning more things, but it is actually an interest card that the
union will show your facility to prove that members want to vote in a union.
Nurses want unions:
- feel mistreated at work
-workplace is unsafe
-management has demonstrated that they will not listen or make improvements.
-It used to be that healthcare workers couldnt unionize, because a strike could put peoples
lives in danger.
psychological tactic managers use against nurses, so nurses are cautious about voting in a
union, because they dont want to endanger their patients with a strike.

Labor Legislation:
1.
2.
3.
4.
5.

National labor Act/Wagner Actgave unions many rights in organizing: resulted in

rapid union growth
Taft-Hartley AmendmentReturned some power to management, resulted in more
equal balance of power between unions and management
Kennedy Executive Order 1988Amended the 1935 Wagner act to allow public
employees to join unions
Amendments to the Labor Actallowed non-profit organizations to join unions
National Labor relations Board rulingallowed nurses to form their own separate
bargaining units

Reasons Why Nurses Join Unions:

1.
2.
3.
4.
5.
6.

To increase the power to the individual

To increase their input into organizational decision-making
To eliminate discrimination
Because of social need to be accepted
Because they are required to do so as a part of employment
Because they believe it will improve patient outcomes and quality of care

Reasons why Nurses dont want to join Unions:

1.
2.

A belief that unions promote the welfare state ad oppose the American system of free enterprise
A need to demonstrate individualism and promote social status

3.
4.
5.
6.

A belief that professionals should not unionize

An identification with managements viewpoints
Fear of employer reprisal
Fear of lost income associated with a strike or a walkout

Before the union comes:

Know and care about your employees

Establish fair and well-communicated personal policies
Use and effective upward and downward system of communication
Ensure that all managers are well-trained and effective
Establish a well-developed formal procedure for handling employee grievances
Have competitive compensation program of wages and benefits
Have an effective performance appraisal system in place
Use a fair and well-communicated system for promotions and transfers
Use organizational actions to indicate that job security is based on job performance, adherence to rules
and regulations and availability of work
Have an administrative policy on unionization

Union Organizing Strategies:

Meetings (both group and one-on-one)

Leaflets and brochures
Pressure on the hospital corporation through media and community contacts
Political pressure on legislators and local lawmakers
Corporate campaign strategies
Activism of local employees
Using lawsuits
Bringing pressure from financiers
Technology

Labor standards these laws establish minimum standards for working conditions regardless of the
presence or absence of a union contract- min. wage, health and safety, and equal law pay
Labor relationsthese laws relate to the rights and duties of unions and employers in heir relationship with
each other
Equal employmentthe laws that deal with employment discrimination were introduced in chapter 15
Civil and criminal lawsthese are statutory and judicial laws that proscribe certain kinds of conduct and
establish penalties
Other legislationnursing management has some legal responsibilities that do not generally apply to
industrial managers
Labor standardsregulations dealing with the conditions of the employees work, including physical
conditions, financial aspects, and the number of hours worked
Hours Workedincludes all the time that the employee is required to be on duty. Mandatory classes,
meetings, education etc. must be recorded as duty time
Equal Pay Act of 1963requires that men and women performing equal work receive equal compensation
and had a great impact on nursing management

Wagner act and prohibited unfair labor practices:

1.
2.
3.
4.
5.

To interfere with, restrain or coerce employees in a manner that interfered with their rights
outlined in the act.
To interfere with the formation of any labor organization or to give financial aid to the labor
organization
To discriminate with regard to hiring, tenure, etc. to discourage union membership
To discharge or discriminate against an employee who filed charges or testified before the NLRB
To refuse to bargain in good faith

Civil Rights Act of 1964laid the foundation for equal employment in the U.S. prohibit discrimination
based on factors unrelated to job qualifications and it promotes employment based on eligibility and merit
Age discrimination and employment actto promote the employment of older people based on their
ability rather then their age
Sexual harassmentunwelcome advances, requests for sexual favors, and other verbal and physical
conduct of implicit affects on the persons employment
Examining evidence 22.11/3 of nurses worldwide were exposed to physical violence and bullying, 1/3
reported injury, reported sexual harassment and 2/3 indicated nonphysical violence
Rehabilitation Act of 1973required all employers with government contracts of more that $25,000 to
take affirmative action to recruit, hire, and advance disabled people who are qualified
Veterans Readjustment Actprovides employment rights and privileges for veterans with regard to
positions that they held before they entered the armed forces
Occupational Safety and Health Actspeaks to employers requirements to provide a place of
employment that is free from recognized hazards that may cause physical harm

Chapter 23Quality Control

Quality control provides managers with the opportunity to evaluate organizational performance from
systematic, scientific, and objective viewpoint.
Managers must determine what standards will be used to measure quality care and develop and
implement quality control programs
Managers must assess and promote patient satisfaction whenever possible

Pay for performance/quality based purchasingcreated to align payment and quality incentives and to
reduce costs through improved quality and efficiency.

Hospital Consumer Assessment of Healthcare Providers and Systems Surveyspublicly reported a

survey of patients perspectives of the care they received that focuses on the how often and the critical
aspect of care not necessarily if they were satisfied
National Committee for Quality Assurancecompare the quality of care with patient outcomes, access
and availability, utilization, premiums and the plans financial stability and operating policies
Maryland Hospital Association Quality Indicator Projecta research project that focuses on the
performance measurement of the system most frequently selected for meeting requirements, used as a
benchmark for identification and measurement
Multistate Nursing Home Case Mix and Quality Demonstrationseeks to develop and implement both
a case mix classification system to serve as the basis for both Medicare and Medicaid payment and a
quality-monitoring system to assess the impact of the case-mix payment
Report cardsdesigned for objective measures of quality by using health plans, HCP, employer
purchasing groups, consumer information organizations and state governments however, there are different
performance measures used which can skew objective viewpoints
Patient safety and quality improvement actthe bill protects medical error information submitted to
new private organizations from being used in legal discovery and is treated as confidential
Leapfrog Groupa growing conglomeration of non-health-care fortune 500 companies leaders who are
committed to modernizing the current health care system
1.
2.
3.

4.

Computerized physician-provider order entryrequires primary providers to enter orders into a

computer instead of handwriting which helps to reduce serious prescribing errors
Evidence based hospital referralsuggests that patients with high-risk conditions should be
treated at hospitals with characteristics shown to be associated with better outcomes
Intensive care unit physician staffingexamines the level of training of ICU medical personnel
and suggests that the quality of care in hospital ICUs is strongly influenced by whether intensivists
are providing care and the staff organization of the ICU
Leapfrog safe practices scoresendorsement of safe practices to reduce the risk of harm in
certain processes, systems, or environments of care

Six Sigma Approachstatistical measurement that reflects how well a product or process is performing
the higher the values the higher the level of performance

1. What tasks are management functions of quality control?

A) Services to consumer- management will (5th step) :
- evaluate
-monitor
- regulate

Performance is measured against predetermined standards

correct discrepancies: between standards and actual performance

B) Controlling Function:

Periodic evaluation: unit philosophy, mission, goals, objectives

Measurement of individual/ group performance: against pre-established standards
Auditing of patient goals and outcomes

C) Steps of Quality Control:

1. The criterion or standard is determined
2. Information is collected: to determine whether the standard has been met
3. Educational or corrective action: if the criterion has not been met
2. What is benchmarking? Process of measuring products, practices, services against best-performing
organizations

Measure: products, practices, services angst best-performing organiz

Id desired standards of organiz performance
Determine how/why performance differs from exemplar orgnaiz= role model for improvement

3. Total Quality Management (TQI) or continuous quality improvement: individual( customer) is the
focal element production and service depend; customer-responsive environment; quest for quality is an
ongoing process.

Continuous purpose/ philosophy for improvement

Focus: improvement process/ not inspection
Do not reward for price alone; minimize total costs; work w single supplier
Constantly improve: planning, production, service
Job training/ retaining
Leadership organization
Stop fear- include employees to actively participate
Interdependent department; no barriers btwn departments
No slogans, exhortations, targets for workforce
Quality instead of quantity
Teamwork accomplishments
Educate/ train employees to max potential
Include all employees in TQm
Quality> profit improves product increases costumers overall creates more profits

4. What are clinical practice guidelines? standardized clinical guidelines

Provide diagnosis-based step-by-step interventions: for providers to follow in an effort to

promote quality care

Should reflect evidence-based practice (EBP)-based on cutting-edge research and best practices

5. Read about who should be involved in quality control on page 556.

Managers: research-based; accountability; inspire subordinates to high standards

Leaders: role models for high standards; max stand; vision: shape organizational goals; use limits
resources/ cost containment wisely
Subordinates: study direct cause-effect relationships modify performance
Consumer: sustained public interest; increased knowledge; address consumers disconnect btwn
perception of quality vs. actual care provided

Chapter 11from new graduate to retirement

-Individual RN: proff obligation to seek lifelong learning +maintain competencies
Goal setting in career planning help id how to exceed levels of competencies

Professional Specialty Certification: demonstrate advanced achievement; 5 years

Benefits:
-Rapid promotions
-opportunities management advancement
-personal/proff feelings of accomplishment
-earn more; salary incentives
-validation/ specialty knowledge competencies
- Credibility
-self-confidence
-greater autonomy

Patient Outcomes- based on certifications:

-assoc w/ better pt outcomes
-no impact on mortality
-nurses perception better\
-dec falls
-employers should invest in those of BSN

Reflective Practice: assessment of own practice; id learning opportunities;

-Professional Portfolio: reflect professional growth throughout career
Should contain:
-core competencies
-biographical info
-educational background
-certifications
-employment hex
-1-2 pg resumes
-checklist
-goals
-developmental experience
-presentations
-consultations
-publications
-proff activities
-honors
-thank u letters

2. Which activities demonstrate a commitment to career planning?

Self-assess: interests, skills, strengths, weaknesses, values

Determine goals:
Assess organization: for opportunities

Assess opportunities: outside

Develop strategies
Evaluate- plans
Reassess/ make new plans biannually

Accomplished by: self- assess; work environment assessment; job analysis; education; training;
job search and acquisition; work experience

Career Planning: evaluating strengths/ weaknesses; setting goals; examining career

opportunities; preparing for potential opportunities; using appropriate developmental activities

Leadership Roles:

Is self-aware of personal values influencing career development

Encourages employees to take responsibility for their own career planning
Identifies, encourages and develops future leaders
Shows genuine interest in the career planning/development of all employees
Encourages and supports developments of career paths within and outside the organizations
Supports employees personal careers decisions
Role model for continued professional development
Emphasizes the need for employees to develop skill set necessary for EBP
Supports new grad nurses and their transition into practice
Role models lifelong learning as a professional expectation and responsibility
Encourages others to continue their formal education as part of their career ladder and professional
journey

Management Functions:

Develops fair policies related to career development

Provides fiscal resources and release time for subordinate training and education
Uses a planed system of short and long term coaching for a career development
Disseminates career and job information
Works with employees to establish career goals that meet both needs
Works cooperatively with other departments in arranging for the release of employees
Views transitions to practice programs as an investment strategy to mitigate nurse turnover and
promote satisfaction
Coaches employees to create professional portfolios that demonstrate reflection as well as the
maintenance of continued competence
Attempts to match position openings with capable employees who seek new learning opportunities
Creates possibilities for career progression
Provides opportunities for legacy clinicians to reinvent themselves to renew their potential vale to the
organization and their coworkers

Career Stages:

Promise: typically reflects the first ten years of nursing employment. Individuals in this stage tend to
experience reality overload and making career choices is critical in this stage. Gaining experience,
identifying strengths and building confidence and positioning for the future occur in this stage
Momentum: typically reflects 11-29 years of nursing experience. These nurses have expert knowledge,
abilities, credentials, and education base. This is the time of accomplishment, challenge, and a sense of
purpose and often achieves enough expertise to be a role model. Career stagnation can occur in this stage
if opportunities are not taken and challenges faced head on.
Harvest: 30-40 years. Expert clinicians, the experimental value of nurses in the harvest phase may begin
to decline. These nurse-leaders must strive constantly for reinvention milestones can be conquered and
elevating their mastery while advancing their profession and positions as a professional statesperson occur
Justifications for career development:
1. Reduces employee attritioncareer development can increase nurse turnover rates due to a lack
of job advancement
2. Provides equal employment opportunityminorities and other underserved groups will have an
easier time moving up if they are recognized early on
3. Improves use of personnelwhen nurses are kept in positions that they have out grown,
productivity is reduced
4. Improves quality of work lifenurses increasingly want to control their own careers, less
willing to settle
5. Improves competitiveness of an organizationhighly educated professionals often prefer
organizations that have a good track record for career development
6. Avoids obsolescence and builds new skillsbecause of rapid changes in health care, some
employees believe that their skills have become obsolete
7. Promotes EBPEBP is not the gold standard for practice yet many nurses still lack the skill and
confidence in knowing how to research for best practice

Career planning:
Self assesses interests, skills, strengths, weaknesses and values
Determine goals
Assess the organization for opportunities outside
Develop strategies
Implement plans
Evaluate plans
Reassess and make new plans as necessary
Career Management
Integrate individual employee needs and organizational needs
Establish, design, communicate and implement career paths
Disseminate career information
Post and communication all jobs for the organizational openings
Assess employees career needs
Provide work experience for development
Give support and encouragement
Develop new personal policies as necessary
Provide training and education

Career Coaching:
1.
2.

3.

Gatheringby observing behavior one can see who has good communication, who is organized,
who uses effective negotiating, and who works collaboratively
Asking what is possiblethe manager should assess the department for possible changes in the
future, and potential challenges and opportunities. The manager should anticipate what kind of
changes are ahead, what projects will need planned, and what staffing and budget changes will
happen
Conducting the coaching sessionhelping employees increase their effectiveness, identifying
potential opportunities in the organization and advancing their knowledge, skills and experience.
Important not to intimidate employees when asking about future plans. This process allows for the
manager to identify future managers

Management developmenta planned system of training and developing people so that they acquire
skills, insight and attitudes towards managing people and their work effectively within the organization
Professional specialty certification:
Benefitsprovides a sense of accomplishment, validation of specialty knowledge and competence to peers
and patients, increased self confidence, promotes greater autonomy of practice, provides for increased
career opportunities and greater competitiveness in the job market, may result in salary incentives
Reflective practicea process for the assessment of ones own practice to identify and seek learning
opportunities to promote continued competence
Resume Structure:
Keep your writing clear and concise
Type the document in a single font format
Use bullet points or sentences
Include educational background, work history, awards/honors, scholarly achievements, and community
service activities
Do not include personal information about life
Maximize your strong points and minimize weaknesses
Never lie or outstretch info
Use good grammar, correct spelling and sentence structure
Use high-quality heavy weight paper
Include a cover letter addressed to a specific individual when possible and briefly highlight points of
the resume
Know what you want to do so you can plan accordingly
Know what recruiters are looking for
Highlight your accomplishments

Chapter 15Employee Recruitment, Selection, Placement and Indoctrination

B
Chapter 15
1. What is important about maintaining adequate staffing?

important phase of the management process

in health-care organizations because such organizations are usually

labor intensive (i.e., many employees are required to accomplish organizational goals)

2. What can be said about staffing turnover? How does the economy affect staffing?

economy improves= more staff turnover -nursing shortages occur=

economy declines= less staff turnover- nursing vacancy rates decline as well

Some turnover is normal and in fact desirable

It infuses the organization with fresh ideas and reduces the probability of groupthink

However, excessive or unnecessary turnover reduces the ability of the organization to produce its
end-product and is expensive

3. Understand the legal issues of interviewing

Illegal Questions are:

Age
Marital status
Children
Race
Sexual preference
Financial or credit status
National origin
Religion

4. Understand socialization and indoctrination:

A) Indoctrinationthe planned guided adjustment of an employment of an employee to the organization
and the work environment includes two phases:
1. Inductiontakes place after the employee has been selected but before performing the job role,
includes all the activities that educate the new employee about the organization
2. Orientationactivities that are more specific for that position and there may be a wide variety of
orientation programs

B) Socialization:

Learning of the behaviors that accompany each role by instruction, observation, and trial and error
Involves a sharing of the values and attitudes of the organization
Creates a fit between new staff members and the unit by introducing them to the norms of the
group
The first socialization to the nursing role occurs during nursing school and continues after
graduation

Sequential steps in staffing:

1. Determine the number and types of personnel needed to fulfill the philosophy, meet fiscal
planning responsibilities and carry out the chosen patient care delivery system selected by the
organization
2. Recruit, interview, select, and assign personnel based on established job description performance
3. Use organizational resources for induction and orientation
4. Ascertain that each employee is adequately socialized to organization values and unit norms
5. Use creative and flexible scheduling based on patient care needs to increase productivity and
retention
Leadership Roles:
1. Plans for future staffing needs proactively by being knowledgeable regarding current and
historical staffing variables
2. Identifies and recruits talented people to the organization
3. Encourages and seeks diversity in staffing
4. Is self aware regarding personal biases during the preempolyment process
5. Seeks to find the best possible fit between unique talents and organizational staffing needs
6. Periodically reviews induction and orientation programs to ascertain they are meeting unit goals
7. Ensures that each new employee understands appropriate organizational policies
8. Continually aspires work environment that promotes retention and worker satisfaction
9. Promotes hiring based on preferred criteria
Management Functions:
1. Ensures that there is an adequate skilled workforce to meet organizational goals
2. Shares the responsibility of the recruitment of staff
3. Plans and structures appropriate interview activity
4. Uses techniques that increase the validity and the reliability of interview process
5. Applies legal requirements of interviewing and selecting
6. Develops established criteria for employment selection
7. Uses knowledge of organizational needs and employee strengths to make placement decisions
8. Interprets info in employee handbook and provides info for revisions
9. Participate actively in employee orientation
Recruitmentprocess of actively seeking out or attracting applicants for existing positions and should be
an ongoing process
The nurse recruiter may be very involved or not involved depending on the size of the
institution, the existence of separate personnel department, the presence of a nurse recruiter
within the organization and the use of centralized or decentralized nursing management
Turnoverinfuses the workplace with new ideas and reduces the process of groupthink
where everyone shares similar thought processes, values and goals

Interviewa verbal interaction between individuals for a particular purpose-frequently accepted as the
foundation for hiring. 3 goals:
1. The interviewer seeks to obtain enough information to determine the applicants suitability for
the available position
2. The applicant obtains adequate info to make an intelligent decision about accepting the job if
offered
3. The interviewer seeks to conduct the interview in such a manner the regardless of the
interviewers result the applicant will continue to have respect for the goodwill towards the
organization
Validityoccurs when the interview measures what it is supposed to be measuredthe potential
for productivity as an employee (reliabilitymeasuring the same thing consistently)
Simple structured interviewmotivation, physical, education, professional, military experience, present
employer, previous positions, specific questions for registered nurses, personal characteristics, professional
goals, contributions to organizations, general questions
Evaluate the interviewby looking at the two largest aspectsthe requirements for the job and personal
bias (negative/positive feelings)
Legal aspects of Interviewing

Interviewing Tips:
1. Prepare in advance
2. Obtain copies of philosophy and organization chart of the organization
3. Schedule an appointment for an interview
4. Dress professionally and conservatively
5. Practice responses to potential questions
6. Arrive early on the day of the interview
7. Greet the interviewer formally and do not sit down before they do
8. Shake the interviewers hand upon entering the room
9. Sit quietly, be attentive and take notes only when necessary
10. Do not chew gum, fidget, slouch or play with things in your lap
11. Ask appropriate questions about the organizations
12. Avoid a what can you do for me? approach and focus
13. Answer interview questions as honestly and confidently as possible
14. Shake the interviewers hand at the close of the interview
15. Send a brief, typed thank you note to the interviewer within 24 hours

Chapter 16Socializing and Education staff for Team Building in a Learning Organization

The Learning Organization:

View learning as a key to the future for individuals as well as organizations
Promotes a shared vision and collective learning in order to create positive and needed
organizational change
Key characteristics
o Systems thinkingthe organization encourages staff to see themselves as connected
to the whole organization and work actives are seen as having an impact beyond the
individual
o Personal masteryeach member of the staff has a commitment to improve his or her
personal abilities
o Team learningthrough a collaboration of team members in order to reach their
goals
o Mental modelsto foster development through diverse thinking and promote the full
potential for the individual to learn
o Shared visionthose with a shared vision are more likely to put their personal goals
and needs aside and instead focus on teamwork and collaboration
Trainingan organized method of ensuring that people have knowledge and skills for a specific purpose
that they have acquired the necessary knowledge to perform the duties of the job
Educationmore formal and broader in scope. Recognizing educational needs and encouraging
educational pursuits are roles of the leader, the managers have to teach classes but are not formally
responsible for the employees education
Learning Theories:
Adult Learning theory(androgogy)are mature, self-directed people who have learned a great deal
from experience
Obstacles to learning:
Institutional barriers
Time
Self-confidence
Situational obstacles
Family reactions
Special individual obstacles
Assets for Learning
High self-motivation
Self-directed
A proven learner
Knowledge experience reservoir
Special individual assets
Social Learning theorysuggests we learn form our interactions with others in a social context and has
four separate processes:
1. People learn as a result of the direct experience for the effects of their actions
2. Knowledge is obtained through various experiences, such as observing others actions

3.
4.

People learn by judgments voiced by others, especially when vicarious experience is limited
People evaluate the soundness of new information by reasoning through inductive and deductive
logic

Other Learning theories:

Readiness to learnrefers to maturational and experimental factors in the learners background that
influence learning and is NOT the same as motivation to learn
Motivation to learnif learners are informed in advance about the benefits of learning specific content and
adopting new behaviors they are more likely to be motivated to attend a training session to learn
Reinforcementgood preceptors can reinforce desired behavior because once a behavior or skill is learned
it needs to be reinforced until it becomes internalized
Task Learningthe learning of complex task that is broken down into smaller parts, beginning with the
more simple tasks and then getting more complex
Transfer of learningthe goal of learning is to be able to transfer new learning into the work setting, there
needs to be as much similarity between the training content and the job
Span of memorythe effectiveness of staff development activities depends on some extent the ability of
the participants to retain information
Chunkingthis occurs when two independent items of information are presented and then grouped
together into one unit
Knowledge of resultspeople learn faster when they are informed of their progress and know how they are
measured against the expected outcomes
Sequence for developing an educational program:
1. Identify the desired knowledge or skills that the staff should have
2. Identify the present knowledge or skill
3. Determine the deficit of desired knowledge and skills
4. Identify the resources available to meet those needs
5. Make max. use of available resources
6. Evaluate and test outcomes after the use of resources
Evaluation of staff development needs:
Learners reactionhow did the learner perceive the orientation, the class the training or the
preceptor?
Behavior changewhat behavior occurs as a result? What was learned from the behavior?
Organizational impactassessing the quality of care, medication errors, accidents, etc
Cost effectivenessall staff activities should be quantified in some manner and this is often the most
neglected aspect of accountability and staff development

Chapter 17Staffing Needs and Scheduling Policies

1. What can be said about staffing policies and staffing ratios?

Employees are forced to work additional shifts, often under threat of patient abandonment

While mandatory overtime is neither efficient nor effective in the long term, it has an even more
devastating short-term impact in terms of staff perceptions of a lack of control and its subsequent
impact on mood, motivation, and productivity

2. What is true about travel nurses and other staffing alternatives?

travel or agency nurses can fill in during a scheduling emergency

their pay can be hard on the budget,
compromise care continuity
Get paid more; expensive for unit; envy for employees; dont know specialties; core
competencies; no benefits

3. What can be said about centralized and decentralized staffing?

Centralized and Decentralized Staffing:

Common staffing and scheduling options in health care organizations:

Chapter 18Creating a motivating climate

Maslowhierarchy of needs and theory of human motivation

Believed that people are motivated to satisfy certain needs starting with basic survival to complex
physiological needs
People seek a higher need only when the lower needs are met
Because of this managers began to realize that people are complex and are motivated by more than just
economic needs but have many needs motivating them all at once

Skinneroperant conditioning and behavior modification

People could be conditioned to behave in a certain manner through both reward and punishment

Chapter 16
1. What are mentorship and preceptorship?
A) Preceptor:

Active and purposeful

An experienced nurse who provides emotional support
Strong clinical skill role model
Close supervision
Nonjudgmental

B) Mentor:

An in-depth supportive and nurturing relationship between an expert and a novice

Formal relationship typically lasts 2 to 5 years, with mentor being one generation older than
mentee

Many nurses do not have the opportunity to have a true mentoring relationship in their lives

2. Know what education and training are:

A) Training: organized method of ensuring that people have:

training has an immediate use,

knowledge and skills for a specific purpose
have acquired the necessary knowledge to perform the duties of the job

B) Education:

more formal and broader in scope.

education is designed to develop individuals in a broader sense