Kristine Emerald B.

Jazareno 10/11/2023
Francia Nicole Encinares BSN 4
Rose Jean De Luna

LEARNING EXERCISES (13)

Understanding Organizational, Political and Personal Power

❖ Learning Exercise 13.1

Research studies differ on how men and women view power and how others view men
and women in positions of authority. Do you think that there are gender differences in how
people are viewed as being powerful? Discuss this in a group, and then go to the library
or use other net sources to see if you can find recent studies that support your views.
ANSWER:
Many research studies suggest that there are perceived gender differences in how
individuals are viewed as powerful. It is very evident in our society the comparison of men
and women when it comes to power and positions of authority. The sad reality of this is
that gender divides power. Inequalities between men and women are one of the most
persistent patterns in the distribution of power. Societal expectations and stereotypes
about gender roles can influence how people perceive power. For instance, deeply held
ideas about women being more social and nurturing may influence people's perceptions
of their fitness for leadership roles. Studies have brought attention to the existence of
‘double standards’ when it comes to gender differences, in which an individual’s behavior
may be assessed differently depending on their gender. Men who display comparable
characteristics may be perceived as demonstrating strong leadership, while women in
leadership roles may face harsher criticism for their assertiveness.
It’s very crucial to approach this topic with sensitivity and acknowledge the diversity
of experiences among both men and women. People’s views and perceptions of power
can differ greatly depending on a various factor. Perceptions can change over time with
persistent efforts to dispel misconceptions and promote equality in leadership.
❖ Learning Exercise 13.2
Think back to your childhood. Who do you feel was most powerful in your family? Why do
ye think that person was powerful? Did you grow up with a very narrow authority-power
gap? Have your views regarding authority and power changed since you were a child?
Do you believe that children today have an authority-power gap similar to what you had
as a child? Support your answers with examples
ANSWER:
I think I would say that my father was the most powerful in our family, he was very
strict when I was a child and he has the control in our family not until they separated. I
can say that I did grow with a very narrow authority-power gap since my mom because
my sister and I was raised by our mother alone, she doesn't like to control us from what
we would want to do, she's always there to support us. Since I was a child my views
regarding authority power gap changed because there are times that my mom supports
us hence my father was the one who's not really supportive but now I can see that he's
giving us freedom specially me and that makes the authority power gap reduce the size.
❖ Learning Exercise 13.3
Do you think that cultural diversity might be a challenge when empowering nurses? Think
of ways that various cultures may view power and empowerment differently. If you know
people from other cultures, ask them how powerful people or those in authority positions
are viewed in their culture and compare that with your own culture.
ANSWER:
I think cultural diversity can present a challenge when trying to empower nurses,
especially in a globally where nurses come from different cultural backgrounds while still
working to ensure their empowerment and professional development. Cultural diversity
might present challenges such as communication, different culture background means
different communication style and language proficiency. To address this, organization can
implement communication training like language proficiency or provide interpreters when
necessary.
❖ Learning Exercise 13.4
You have been RN for 3 years. Six months ago, you left your position as a day charge
nurse at one of the local hospitals to accept a position at the public health agency. You
really miss your friends at the hospital and find most of the public health nurses older and
aloof. However, you love working with your patients and have decided that this is where
you want to build a lifetime career. Although you believe you have some good ideas, you
are aware that because you are new, you will probably not be able to act as change agent
yet. Eventually, you would like to be promoted to agency supervisor and become a
powerful force for stimulating growth within the agency. You decide that you can do a few
things to build a power base. You spend a weekend plotting your political design.
Make a power-building plan. Give six to ten specific examples of things you would do to
build a power base in the new organization. Provide rationale for each selection. It might
be helpful to consider your own community and personal strength when solving this
learning exercise.
ANSWER:
Establishing a power base in a new organization necessitates careful planning and
strategy, particularly in public health agencies. So, here are some power building plan
along with their strategies:
Power-building Plan Rationale
1. Build Strong Interpersonal Connections It is important to develop a trusting
relationship with coworkers, even if they
are distant or aloof. Engaging in casual
conversation, attending social
gatherings, and express a sincere
interest in their experiences. By doing
this, I will be able to build a supportive
network and gain a deeper
understanding of the corporate culture.
2. Seek for Mentoring Relationships Find well-respected people in the
company who can serve as mentors and
advisors. A mentor that can guide me
over obstacles and provide insights into
the organization’s politics as well as
career development recommendations.
Forming a mentorship connection will
help me gain more credibility and quickly

3. Engage in Team Activities Actively
4. Provide Creative Concepts
5. Remain Knowledgeable and Aware
6. Form Coalitions and Alliances
comprehend the dynamics of the
organization.
Participating in committees, group
activities, or cooperative initiatives as a
group volunteer shows that I am
dedicated to the organization’s
objectives. It gives me the chance to
highlight my abilities, work ethic, and
desire to help the team succeed.
I can offer insightful comments and
thoughts even as a novice. Innovation is
typically advantageous to public health
organizations. It tells us what we think
about enhancing procedures, introducing
new initiatives, or meting community
needs. I establish myself as someone
who cares about the company’s success
by demonstrating my dedication to its
goals.
The field of public health is dynamic, with
changing laws and procedures. Keep up
with the most recent findings, trends and
industry best practices. By possessing
knowledge establishes me as an expert,
earning the respect of my peers and
enhancing my reputation within the
company.
Determine who are the organization’s
significant decision-makers and
stakeholders. Then, actively look for
chances to work together on ideas and
projects. Forming alliances will increase
my impact and help me build a supportive
network. Working well with other helps
me to establish my credibility and project
an image of being a team player, which
is essential for building a power base.

We all aware that it takes time to establish a strong power foundation, and I should
always operate with ethics in mind. I will keep in mind the existing dynamics and culture
while concentrating on adding positive contributions to the organization.
❖ Learning Exercise 13.5
What danger, if any, is there for Sally Jones in Bob Blacks proposal? Explain two political
strategies that you believe Sally could use in the upcoming meeting, is it positive to
facilitate a win-win solution to this conflict? If so, how? If there is not a win-win solution,
how much can sally win?
ANSWER:
The two political strategies that Sally could use is first, become an expert handler
of information and communication, in every conflict communication is always vital for it to
have a win-win solution. Communicate well with Bob which technically wants to increase
his power and authority by proposing hiring new clerk and his department should do the
screening which the nursing department are responsible for it. Sally should discuss the
 facts thoroughly for it to not have a misunderstanding. Sally should be a proactive decision
maker, because being reactive is better than being passive.
❖ Learning Exercise 13.6
Devise a political strategy for successfully empowering the staff that report directly to you.
Consider the three elements necessary in the empowerment process, professional traits
of the staff, a supportive environment, and effective leadership. Of these things, what is
in your sphere of control? What change tactics can you use to increase the likelihood of
success?
ANSWER:
To successfully empower the staff reporting directly to me, a political strategy can be
including the three essential elements of empowerment such as enhancing professional
traits of the staff, fostering a supportive environment, and providing effective leadership.
To increase the likelihood of success, the change tactics that can be used for me is
Seeking feedback and making adjustment.
❖ Learning Exercise 13.7
You are a middle level manager in a public health department. One of your closest friends,
Janie, is an RN under your span of control. Today, Janie calls and tells you that she
injured her back yesterday during a home visit after she slipped on a wet front porch. She
said that the home owners were unaware that she fell and that no one witnessed the
accident. She has just returned from visiting her doctor, who advises 6 weeks of bed rest.
She requests that you initiate the paperwork for workers compensation and disability,
because she has no sick days left.
Shortly after your telephone conversation with Janie, you take a brief coffee break in the
lounge. You overhear a conversation between Jon and Lacey, two additional staff
members in your department. Jon says that he and Janie were water skiing last night,
and she took a terrible fall and hurt her back. He planned to call her to see how she was
feeling.
You initially feel hurt and betrayed by Janie because you believe that she has lied to you.
You want to call Janie and confront her. You plan to deny her request for workers
compensation and disability. You are angry that she has placed you in this position. You
also are aware that proving Janie’s injury is not work related may be difficult.
How would you proceed? What are the political ramifications if this incident is not handled
properly? How should you use your power and authority when dealing with this problem?
ANSWER:
Handling this kind of situation improperly could have significant political
ramification within the public health department as well as to your colleagues. To avoid
any future unfortunate circumstances or problems, I have to know first the true and
complete details about the story of Janie, conduct further investigation, review policies to
help me make informed decisions based on established procedures. Document the
details of my conversation with Janie, including her account of the incident, the doctor’s
advice and other relevant information. Most importantly I have to keep the information
confidential to the extent possible. Sharing details of the situation with others in the
department could lead to gossip and further complications. So, I would rather talk with
Janie privately about this matter to remain professional. Once I have a clearer picture of
the situation, I would address my personal feelings with her separately by emphasizing
the importance of trust in building good and strong foundation in the workplace. I will make
sure that I won’t let my emotions control me. I will base my decision on the available
evidence and adherence to company policies. If it turns out that Janie’s injury is not work-
related, I will handle the workers’ compensation request accordingly. However, if it is
work-related, I will follow the appropriate procedures.
Mishandling this kind of incident may cause havoc in the department. It may
damage trust and relationships among team members, affect morale, and potentially lead
to a negative work environment. Without proper investigations and procedures could lead
to legal repercussions. If Janie’s injury is work-related, denying her request unjustly may
violate employment laws, which may lead to potential legal action. The incident can
impact team dynamics negatively both external and internal. Effective teamwork may
suffer if there’s a sense of mistrust and division within the department.
Remember that misunderstandings and human error are possible. As an individual
that has power and authority I will use it wisely and judiciously. I’ll make certain choices
that are fair, transparent, and compliant with company guidelines. Avoid making decisions
based solely on personal emotions, and prioritize the well-being of my team. The key is
to approach the matter with fairness, professionalism and dedication to resolve issues
that fosters trust and productive workplace.
❖ Learning Exercise 13.8
ASSIGNMENT List the factors bearing on this decision. What (if any) Rower issues are
involved? Which choice will be the least damaging? Justify your decision
ANSWER:
Both has been a great help to the healthcare system and my decision would be nurse
Mikiou should go because working with someone who's been frequently absent from
work makes a workplace toxic, although he's competent but being absent from work is
not a good morale a nurse should have and also he is a health worker he should know
that The nurses' frequent absences from work ultimately have an impact on the hospitals'
ability to deliver high-quality treatment due to the workload placed on the other personnel.
❖ Learning Exercise 13.9
The power struggle in this scenario involves you, the unit clerk, the charge nurse. Does
the unit clerk in this scenario have informal or formal power? What alternative? What
action would you take?
ANSWER:
In this scenario, the power struggle involves myself as a leader, the unit clerk, and the
charge nurse. For me as a leader the action that I will use in addressing this scenario is
Relationship building, by demonstrating respect for their expertise, trust and cooperation
maybe fostered too.
❖ Learning Exercise 13.10
You are the day-shift charge nurse for the intensive care unit. One of your nurses, Carol,
has just requested a week off to attend a conference. She is willing to use her accrued
vacation time for this and to pay the expenses herself. The conference is in 1 month, and
you are a little irritated with her for not coming to you sooner. Carol’s request conflicts
with a vacation that you have given another nurse. This nurse requested her vacation 3
months ago.
You deny Carol’s request, explaining that you will need her to work that week. Carol
protests stating that the education conference will benefit the intensive care unit and
repeating that she will bear the cost. You are form but polite in your refusal. Later, Carol
goes to the supervisor of the unit to request the time. Although the supervisor upholds
your decision, you believe that Carol has gone over your head inappropriately in handling
this matter.
How are you going to deal with Carol? Decide on your approach and support it with
political rationale.
ANSWER:
In addressing the situation with Carol, it is significant to balance the needs of the
unit, fairness, and effective communication. First, I will schedule a private meeting with
Carol to discuss the issue. By handling the situation privately and tactfully, I will ensure
to maintain a good working relationship with Carol and helps prevent the situation from
escalating unnecessarily. Engaging in open communication with Carol, I’ll actively listen
to Carol’s perspective, allowing her to express her reasons for attending the conference
and so on. After that, I will politely explain the conflict situation. Telling that another nurse
had already been granted vacation for that week three months ago, and clarifying to her
the importance of maintaining appropriate staffing levels in the unit. By explaining the
conflicting situation and the need for fair treatment, I acknowledge the importance of
fairness in decision-making. Aside from that, I will not forget to recognize Carol’s initiative
and willingness to attend the conference and cover the expenses. However, I’ll also
emphasize and explain that adequate time for scheduling adjustments is also essential
to avoid any disruptions in the unit. I will just suggest to her an alternative solution such
as rescheduling the requested vacation for a different time that does not conflict with other
schedule to show to her that I am open in finding compromises that meet both the staff
member’s needs and the unit’s operational requirements. By adopting a calm and
diplomatic approach, I certify to address the issue with professionalism, preserve a
productive workplace, as well as preserving the values of justice and clear communication
within the team.

LEARNING EXERCISES (14)

Organizing Patient Care
❖ Learning Exercise 14.1
Most nursing students begin their clinical training by doing some form of functional nursing
care and then advancing to total patient care for a small number of patients. Reflect back
to your earliest clinical experiences as a student nurse. Which tasks were easiest for you
to learn? How din you gain mastery of those tasks? Was task mastery a time-consuming
process for you? Was it difficult to make the transition to total patient care? If so, why?
What skills were most difficult for you to learn in providing total patient care? Do you
anticipate having to learn additional skills t feel comfortable in the role of total care
provider as an RN? What higher level (nonfunctional) skills do you think will be the hardest
to learn and be confident with?
ANSWER:
The easiest task was taking vital signs of the patients, I gained mastery of this task
because we are exposed in doing it repeatedly because taking and checking vital signs
of the patient are necessary. It is a time-consuming process because it may be easy but
it doesn't mean that this does not require too much time to master it. It is difficult to
transition into total patient care because with total patient care, just one nurse takes care
of all the needs for each patient they're assigned to until the end of their shift.
Communication is what I find difficult to learn in providing total patient care because when
we were assigned in the ICU one patient is diagnosed with bipolar disorder and most of
the time he is irritable and when I'm checking his pulse rate and oxygen saturation he
sometimes try to pull the pulse oximeter so I have to put it again after telling him that I
have to take his vitals in a calm voice to avoid any misunderstanding situation given the
fact that he is irritable.
❖ Learning Exercise 14.3
Jimmy Jansen is a 44-year-old man with type 1 diabetes mellitus. He was recently
referred to your home health agency for case management follow-up at home. He is
experiencing multiple complications from his diabetes, including the recent onset of
blindness and peripheral neuropathy. His left leg was amputated below the knee last year
as a result of a gangrenous infection of his foot. He is unable to wear his prosthesis at
present because he has a small ulcer at the stump site. His chart states that he has been
only “intermittently compliant” with blood sugar testing or insulin administration in the past
despite the visit of a community health nurse on a weekly basis over the past year. His
renal function has become progressively worse over the past 6 months, and it is
anticipated that he will need to begin hemodialysis soon.
His social history reveals that he recently separated from his wife and had no contact with
an adult son who lives in another state. He has not worked for more than 10 years and
has no insurance other that Medicaid. The home he lives in is small, and he says that he
has not been able to keep it up with his wife gone. No formal safety assessment of his
home has been conducted. He also acknowledges that he is not eating right because he
now must do his own cooking. He cannot drive and states, “I don’t know how I’m going to
get to the clinic to have my blood cleaned by the kidney machine.”
Mr. Jansen has many problems that would likely benefit from case management
intervention.
ANSWER:
1. Make a list of five nursing diagnoses for Mr. Jansen that you would use to prioritize
your interventions.
• Imbalanced nutrition: less than body requirements related to insufficient
caloric intake to meet growth and development needs and the inability of
the body to use nutrients
• Risk for infection related to invasive procedures and skin damage
• Deficient knowledge related to misinterpretation of prognosis and treatment
need
• Ineffective tissue perfusion related to peripheral neuropathy as evidenced
by weak or absent peripheral pulses
• Visual problems related to elevated blood glucose level as evidence by
onset blindness
2. Then make a list of at least five goals that you would like to accomplish in planning
Mr. Jansen’s care. Make sure that these goals reflect realistic patient outcomes.
• Maintaining adequate nutrition
• Promoting skin integrity
• Preventing infection
• Regulating glucose levels
• Educating about the important of treatment and acknowledging feelings of
helplessness
3. What referrals would you make? What interventions would you implement
yourself? Would you involve other disciplines in his plan of care?
 In managing diabetes mellitus often involves a multidisciplinary approach, and
referrals to various healthcare professionals that can enhance the overall care and
well-being of individuals with diabetes. I would refer Mr. Jansen for the:
• Registered Dietitian/ Nutritionist, to ensure the guidance on meal planning,
carbohydrate counting and making healthy food choices to help manage
blood glucose levels.
• Ophthalmologist, to monitor for his vision problems.
• Nephrologist, since Mr. Jansen is at risk of kidney complications it is better
to monitor his kidney health on a regular basis.
• Social Worker to provide him support with navigating healthcare systems
and accessing resources.
• Neuropathologist, since Mr. Jansen is experiencing onset peripheral
neuropathy, it is best to ensure him to someone that can further examine
his tissues in the nervous system.
• Cardiologist, since diabetes is associated with an increased risk of
cardiovascular issues. A cardiologist may assess and manage him for any
cardiovascular risk factors.
• Mental Health Professionals, it was said that Mr. Jansen was recently
separated from his wife and living alone in a small house. Recommending
him to a mental health professional will provide him support for coping with
the emotional and mental aspects of diabetes.
4. What is your plan for follow-up and evaluation?
The management of Type 1 diabetes involves ongoing follow-up and evaluation to
ensure optimal glycemic control, prevent complications and address evolving
needs of the individual.
• Regular medical check-up
• Glycemic Monitoring
• Medication Adjustments
• Health Teaching
• Screening for complications
• Promoting psychosocial support
❖ Learning Exercise 14.5
In differentiating practice at the unit level. Will you use education, years of experience, or
skill level to differentiate your career ladder, or will you use some combination of the
three?
ANSWER:
For me, in differentiating the career ladder for nursing, it’s essential to consider a
combination of education, years of experience and skill level. In this approach it can
ensures that the career ladder acknowledge the diverse path through which nurses can
develop their expertise and contribute to patient care
❖ Learning Exercise 14.6
You work in an intensive care unit where there is an RN staff. The unit works 12-hour
shifts, and each nurse is assigned one or two patients, depending on the nursing needs
or the patient. The unit has always used total patient care delivery assignments. Recently,
your unit manager has informed the staff that all patients in the unit would be assigned a
case manager in an effort to maximize the use of resources and to reduce length of stay
in the unit. Many of the unit staff resent the case manager and believe that this had
reduced the RN’s autonomy and control of patient care. They are resistant to the need to
document variances to the care MAPs and are generally uncooperative but not to the
point that they are insubordinates.
Although you feel some loss of autonomy, you also think that the case manager has been
effective in coordinating care to speed patient discharge. You believe that at present, the
atmosphere in the unit is very stressful. The unit manager and case manager have come
to you and requested that you assist them in convincing the other staff to go along with
this change.
ASSIGNMENT: Using your knowledge of planned change and case management, outline
a plan for reducing resistance.
ANSWER:
Be up-front about the reason for the change. Tell the staff that for me, the case
manager has been effective in coordinating the speed patient discharge and I would tell
them that I know that it is normal to be resistant for the sudden change but come to think
of it, if you ever accept the changes and collaborate the staffs will definitely get used to
the change management. Demonstrate your enthusiasm for the change. I will not just tell
them how I would love the change but also show them. Action speaks louder than words,
it will be easier for me to convince them along with the unit and case manager. Lastly,
Over-communicate throughout the process. Share frequent updates about progress,
including what has been successful and what needs to be improved. This will gain the
trust and support of the staffs and make the process more smoothly by being open, honest
and sincere.