Leadership (GLIC)

Guiding

Leading

Influencing

Commanding

FORIN

Formal- appointed individual (head nurse, charge nurse)

Informal- emerge and accepted by others/ accidental leaders (regular staff)

Leadership Characteristic

(GUPAIN)

Guiding vision- provides direction to the team

Passion- ability to inspire others

Integrity- honesty

Qualities

REUNEX

E-relationships with others

Unique personality

Exceptional clinical expertise

Define nurse leaders (CIMS)

Change

Influence

Motivates

Set direction
Skills

MoDeGreaT

Motivator-inspire to reach goal, use power

Delegator- task according to their standard scope of practice

Great and assertive communicator- listening

Team player- appreciate the works of others

Type of leadership style

ADELAI

Autocratic (nasusunod ang boss)

Democratic- consult manager to subordinates

Laissez-faire- no care

Management CPD

Coordinates PETISU (people, time, supply)

Problem Solving

Decision making

Manager Responsibilities

MODIHEN

Monitor

Disseminator

Handler

Entrepreneur

Nurse Manager has APO

Authority- formal right to direct others and power-ability to create and get resources to achieve goal
Power

CARE

Coercion-forcing ex. Use threat

Authority-we are commanding, making mandates to comply

Reward- incentives

Expertise-extensive experiences, degree of the managers

Levels of management FUMT

First Level – commonly managing daily activities ex. Primary nurse, charge nurse, team leader, case
manager

Unit level- 24-hour operation of the nursing unit ex. Staffing, nurse managers and assistant, supervision
to satff

Middle- number of unit manager supervising for unit level for over-all function ex. Nurse coordinator,
directors, assistant directors, supervisors, assistant directors for nursing

Top-level – executives ex. Vice pres, chief nurses, president, directors, to strategic plans and they refine
and change

Leadership theories

BeTRaSiQuan

Behavioral- what the leader does autocratic, demo, lasseiz

Transformational- communicator ex. Charismatic, courageous

Situational- require different types depends on the situation

Quantum- flexible to the environment

Theories of leadership and management

Functional leadership- focus on what the leaders to do, action centered

Narcissistic – they prioritize themselves, common leadership style, exhibits the holistic

Charismatic- you not to promote yourself because they see your worth

Motivational-
Change theory (Lewin)

RUM

Refreezing- change is integrated

Unfreezing- group of members are motivated

Moving- group members implement change

Management Theories ScHuRes

Scientific management-it focuses on the task of the subordinates

Human relations- theories x (ugly) and theory y (managers supports the members, make happy)

Responsibility-obligations to accomplish

The management process:

Planning (5M’s)

Man-power

Machine

Moment/time

Materials

Money

Organizing- identifies structure of the program, coordinates people

Staffing- recruits, hiring, training, scheduling on the ongoing staff development

Directing-communicating, delegating, motivating, managing conflict

Controlling- analyzing evaluating and monitoring

Planning Activities

FIRES

Feedback-to assess for improvement

Interview-obtain consent

Reading/research-solid basis
Education

Survey- to know if there would be conflicts

Organizing

Elements: SSD

Structuring

Staffing and Scheduling

Developing Job Description

Organizing Principles

USecPRiHo

Unity of command

Span of control

Exception principle

Chain of command/scalar principle

Principles of delegation or decentralization

Homogenous assignment or departmentation

Staffing

RHTSD

Recruiting

Hiring

Training

Scheduling

Developing Staff

Patient classification accrdg to service capability

HoSpePSY
Hospital

Level 1 – self care ex. Suturing, bp, bolus monitoring, first-aid, pharmacy, lab (1.5 hrs)

Level 2 – intermediate ex. Level 1 + operating room (3.0 hrs)

Level 3- highly specialized ex. Intubated, life vent + ICU (4.5hrs)

Level 4 critical (6.0 hrs) rehabilitation

Special Hospital

Psychiatric units

Nurse patient ratio

1:12 (nurse to patients)

1:20,000 (community)

RA 5901 forty hour week law

Date of effectively June 12, 1969

An act of prescribing forty hours a week of labor for government and private hospitals or clinical
personnel

100 bed capacity 0 40hrs per week at least 1 million population

<100 bed capacity 48 hrs/ week less than 1 million population

Civil service commission memorandum

Circular no.6 of 1996

Scheduling

Factors to consider

Different level of staff

Coverage for 24 hours

Staggered vacation, holidays, weekends

Shifting distribution
Mixing of NA and nurses

Types of scheduling

CDC

Centralized – chief nurse does schedule

Decentralized- middle managers or lower managements

Cyclical – covered a week

Developing job description

RDC duties, conditions, requirements

Contents of job description

Identifying data

Job summary

Qualifications/requirements

Job relationship

Specific/actual functions/activities

Salary

Nursing care delivery system

Fun Ca Talaga Pri

Functional

Case method (total care) icu 1:1

Team nursing- RN,NA,student

Primary- solo flight, you do all the job

Delegation keywords:

Transferring

Authority

Selected

Situation
Scope

NURSE – ACCOUNTABLE

15mins skin test for antibiotic

Late reaction- reassess, evaluation

4 rights of delegations (HANSTEN)

Tara Pre Co fee

Task

Person

Communication

Feedback

Phone call instruction – should have signature of the doctor for 24 hrs

Decision Making

SIPAD

Select solution

Implement

Problem Defining

Analyze

Develop solutions

Types of Decision Making

MUTSO

Muddling Through- may pake, remedy of the problem (but will not face the issue)

Satisfying- ano lang alam nya (failure)

Optimizing- no downside
Supervising

IGIE

Inspecting- know the strengths and weakness

Guiding (preceptor)

Improving Performance

Evaluation

Strategies for conflict resolution

1. Win lose strategy -dominance, majority wins

2. Lose lose strategy – need to compromise, bribe (unsuccessful)
3. Win win – both parties are happy

Conflict

A warning or indicator which tells something is wrong

How do we resolve conflict?

Clarification of objectives

Establishment of group norms

Determination of group boundaries

Measuring performance

Complete checklist

Hanecdotal recording

Essay or response report

Check rating scale

K quality assurance tool

Luhhh nursing audit

Insisted choice comparison

Scale rating

Tamang Ranking
Types of nursing audit

Patient care audit- patient interview and during rounds

Retrospective audit- reviewing of charts, interviews, quality assurance checklist

Performance appraisal

Reasons why conducted: CARB

Constructive feedback

Awareness of staff of their performance

Reviews concerns fair employment practice law

Basis of salary (Salary grade)

Nursing Ethics

VENTHIC

Veracity-truth

E-accountability-the nurse is responsible/liable

Non- maleficence- do no harm ex. Not assisting or performing abortion, to commit suicide

T-fidelity- keeping one’s promise

H-autonomy- freedom to choose a course of action ex. Respect the decision of pt

I-beneficence- doing good, acts of kindness ex. Holding the hands of the dying patient

C-justice- fairly and equally ex. Providing care across all ages

Profession

POET

Pride and honoric

Occupation or calling

Experience (body of knowledge)

Training (advance)
Professional nurse in Ph

1. Completed a 4-year bsn degree- baccalaureate degree

2. Successfully passed the Philippine licensure examination administered by the prc-bon (75%
rating)
3. Oath taking
4. Physical and mentally fit

PRC- professional regulation commission

What is license?

LIE- renew every 3 years

License is qualified by the authority

It’s a physical/legal document

Ellows to offer skills and knowledge

Continuing Professional education/development (cpe)

CPE

Choose training

Participate in seminars

Emphasize specialization

45-60 units of cpe change into

CPD

15 units

Effective march 1.2019 nurses only 15 cpd units in the 3 year renewal period

PRC started to require units for renewal

Patient’s bill of rights

PATIENTS

Providing respectful care

A-nderstandable information

Taking decision and care plans

Inform policies

Educate re Advance directives

No coercion to any procedure/research

Total privacy

Safe care

Nurse’s bill of rights

NURSES

Nurses promote health

U-lleviate suffering

Restore health

Services delivered

Entrust/protect care

Shine human dignity

Palliative care- alleviate the signs and symptoms of the patient

Patient’s Chart

CHARTS- a care not written; it is not considered not done

Communication

Health agency auditing

A legal documentation

Research purposes/Reimburse

To plan client care

Shared educational purposes

CBQ: what is the hallmark of a profession?

It is the ALTRUISM – selfless concern for the welfare of other people

Advance directives- advance healing direction

Living will- documents that the patient does not want to receive

Durable power of attorney (HC by proxy)

DNR order- under advance directives, bot type

Do not perform CPR

No defib

Refuse mech vent

Stop intubation

Can we revoke DNR?

Yes! According to Davis M. in 2022; HHH 2022)

An individual who is authorized in decision maker

Lawyer, immediate family member, physician

Nursing Jurisprudence

Code of ethics for nurses

Legal basis BON resolution No. 220

Who created: Board of Nursing

Who helped BON: PNA

Year of creation: 1982

Pattern: Code of good governance

Who revokes/suspends license: BON

RA 9173 new nursing law

An act providing for a more responsive nursing profession

Article: title of the law and its provision

2- declaration of the policies

RA 7305

The magna carta of public health workers was extracted to ensure that health workers are properly
compensated

Law

Rule of conduct that command what is right and prohibit what is wrong

Sources of law

1. Divine law- 10 commandments

2. Human law-man kind punishments

Nursing jurisprudence

Judicial- law making body ex. congress

Executive- interprets the law ex. Office of the pres and vice

Legislative- implement and execute the law ex. Bill

Civil case- bayad

Criminal case- bayad + kulong

Administrative case- suspension of license

BON – PRC – office of the president

Tort

A legal wrong, committed against a person or property independent of a contract which renders the
person who commits it liable for damages in a civil action

Keywords: harm and injury

Battery- is an actual carrying out of the threatened physical contact ex. tinusok

Assault – is an unjustifiable attempt to touch another person or even the threat of doing it Ex. Banta

Crimes, misdemeanor, felonies

Principal-it committed directly executed the act ex. Perform unnecessary surgery

Accomplice- assistant surgeon

Accessory- nurse

Misdemeanor

Less serious that felony

Punishable by no more than 1 year

Felony

Keywords: convicted, liable, sentenced to death, imprisonment, violence ex. Sexual harassment

Classes of Felonies

Consummated- all the elements of the crimes are present

Attempted- intend to kill but unsuccessful

Frustrated- all the elements of the crimes are present and executed but something happens to save the
patient

Defamation of character

Slander- oral defamation ex. Sinisiraan verbally

Libel- written words ex. Cyber libel

False Imprisonment

Making someone wrongfully feel that he or she cannot leave the place

Use of restraints- limit the movement, not restrict

REST

Requires physician’s order

Execute with caution

Should have right to move

Timely documentation

Veto power- power the president to recheck the bill

Dura lex sed lex- harsh but it is the law (the law is always the law)

Negligence

Failure to do something which a reasonable and prudent person should have done

Types of negligence

1. Commission - wrong doing

2. Omission total neglect of care – didn’t do anything

Malpractice

Acts or conducts that are not authorized or licensed or competent or skilled to perform, resulting to
injuries or non-injurious consequences

Legal Doctrines

Respondeat superior

“That the master must answer”

Employer is responsible

Force majeur

Inevitable, unseen

“Superior force”

Nobody is exempted

Res Ipsa Loquitor

“The thing speaks for itself”

Medical records
If it was not charted, it was not observed or done

Accurate charting

Consider sequencing of events

Include time

Informed Consent

CONSENT

Call the doctor to explain procedure

Obtained by the doctor

Nurse will secure

Signed by the patient or legal guardian

Evaluated patient’s condition prior

Notify patient of the alternatives

Time to call the witness