Chapter 1 1. Define decision making and problem-solving Decision making is a complex, cognitive process of choosing a particular course of action; the thought process of selecting a logical choice from available options. Problem solving is part of decision making; a systematic process focusing on analyzing a difficult situation involving higher order reasoning and evaluation 2. Define the qualities that define someone who is a good decision-maker Self-aware Courageous Sensitive Energetic Creative 3. Define clinical reasoning and critical thinking—compare and contrast Critical thinking is the mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach an answer or conclusion. Clinical reasoning is integrating and applying different types of knowledge to weigh evidence, critically think about arguments, and reflect on the process used to arrive at diagnosis 4. Define the characteristics of critical thinking 1. Insight 2. Intuition 3. Empathy 4. Willingness to take action 5. Identify a poor decision you made because of faulty data gathering? When we did group assignment on community assessment of Wicker Park in Community Health Nursing class. I interviewed two people locally about their drinking behavior. They all drank a lot, so I put drinking problem as the community problem in the assessment part of the project. I feel this is too arbitrary and need more evidence to make this assumption. 6. What are the frequent errors that are made in decision making? 1. No clear objective or goal for decision 2. Faulty data gathering 3. 4. 5. 6. 7. 8. 9. 10. 11. Failure to use science, logic, and empirical evidence in making decisions Not considering enough alternatives Faulty logic or “crooked thinking” Not assessing or ignoring the quality of the decision making that is required Lack of self-awareness Too much time spent identifying the problem Refusal to act Using outcome only for evaluation It is not enough to gather adequate information, think logically, select from among many alternatives, and be aware of the influence of one’s values. In the final analysis, one must act. 7. Evidence-based practice for nurses. What are the strategies for this to be successful? 1. Keep abreast of the evidence—subscribe to professional journals and read widely. 2. Use and encourage use of multiple sources of evidence. 3. Use evidence not only to support clinical interventions but also to support teaching strategies. 4. Find established sources of evidence in your specialty—do not reinvent the wheel. 5. Implement and evaluate nationally sanctioned clinical practice guidelines. 6. Question and challenge nursing traditions and promote a spirit of risk taking. 7. Dispel myths and traditions not supported by evidence. 8. Collaborate with other nurses locally and globally. 9. Interact with other disciplines to bring nursing evidence to the table. 8. Define the process for successful decision-making progress Step 1: Identify the decision You realize that you need to make a decision. Try to clearly dene the nature of the decision you must make. This rst step is very important. Step 2: Gather relevant information Collect some pertinent information before you make your decision: what information is needed, the best sources of information, and how to get it. This step involves both internal and external “work.” Some information is internal: you’ll seek it through a process of self-assessment. Other information is external: you’ll nd it online, in books, from other people, and from other sources. Step 3: Identify the alternatives As you collect information, you will probably identify several possible paths of action, or alternatives. You can also use your imagination and additional information to construct new alternatives. In this step, you will list all possible and desirable alternatives. 7 STEPS TO EFFECTIVE DECISION MAKING Decision making is the process of making choices by identifying a decision, gathering information, and assessing alternative resolutions. Using a step-by-step decision-making process can help you make more deliberate, thoughtful decisions by organizing relevant information and dening alternatives. This approach increases the chances that you will choose the most satisfying alternative possible. Step 4: Weigh the evidence Draw on your information and emotions to imagine what it would be like if you carried out each of the alternatives to the end. Evaluate whether the need identied in Step 1 would be met or resolved through the use of each alternative. As you go through this di-cult internal process, you’ll begin to favor certain alternatives: those that seem to have a higher potential for reaching your goal. Finally, place the alternatives in a priority order, based upon your own value system. Step 5: Choose among alternatives Once you have weighed all the evidence, you are ready to select the alternative that seems to be the best one for you. You may even choose a combination of alternatives. Your choice in Step 5 may very likely be the same or similar to the alternative you placed at the top of your list at the end of Step 4. Step 6: Take action You’re now ready to take some positive action by beginning to implement the alternative you chose in Step 5. Step 7: Review your decision & its consequences In this nal step, consider the results of your decision and evaluate whether or not it has resolved the need you identied in Step 1. If the decision has not met the identied need, you may want to repeat certain steps of the process to make a new decision. For example, you might want to gather more detailed or somewhat dierent information or explore additional alternatives. 9. Nursing process for problem-solving—define the steps Assessment, Diagnosis, planning, implementation and evaluation. Chapter 2 1. Define the components of the management process and provide an example of each. 1. Planning encompasses determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change. 2. Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals. Other functions involve working within the structure of the organization and understanding and using power and authority appropriately. 3. Staffing functions consist of recruiting, interviewing, hiring, and orienting staff. Scheduling, staff development, employee socialization, and team building are also often included as staffing functions. 4. Directing sometimes includes several staffing functions. However, this phase’s functions usually entail human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration. 5. Controlling functions include performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control. 2. Identify the similarities and differences between leadership and management. Why do we make these distinctions? Leadership is the art of getting work done through others willingly. Leaders are in the front, moving forward, taking risks, and challenging the status quo. A job title alone does not make a person a leader. Only a person’s behavior determines if he or she occupies a leadership position. Often do not have delegated authority but obtain their power through other means Have a wider variety of roles than managers and may have different personal goals Are frequently not part of the formal organization Focus on group process, information gathering, feedback, and empowering others Manager Are always assigned a position within an organization Have a legitimate source of power due to the delegated authority that accompanies their position Are expected to carry out specific functions. Emphasize control, decision making, decision analysis, and results Manipulate people, the environment, money, time, and other resources to achieve organizational goals Have a greater formal responsibility and accountability for rationality and control than leaders Direct willing and unwilling subordinates 3. Define: Autocratic style of leadership—when is this style useful in nursing? Makes decisions for the group. ● Motivates by coercion. ● Communication occurs down the chain of command, or from the highest management level downward through other managers to employees. ● Work output by staff is usually high: good for crisis situations and bureaucratic settings. ● Effective for employees with little or no formal education. 4. Define: Democratic style of leadership—when is this style best used in nursing? ● Includes the group when decisions are made. ● Motivates by supporting staff achievements. ● Communication occurs up and down the chain of command. ● Work output by staff is usually of good quality when cooperation and collaboration are necessary. 5. Define: Laissez-faire style of leadership—when is this style best utilized in nursing? ● Makes very few decisions, and does little planning. ● Motivation is largely the responsibility of individual staff members. ● Communication occurs up and down the chain of command and between group members. ● Work output is low unless an informal leader evolves from the group. ● Effective with professional employees. 6. Name 5 characteristics of leaders—why are these important to best functioning of nursing units? ● Initiative, good leaders help their teams and organisations to innovate, progress and overcome competition, and they spot and take advantage of opportunities that others pass by. ● Inspiration, you provide inspiration for team to improve constantly ● Energy, you need to provide good energy for the team ● Positive attitude, encourages building the strengths of employees and team members ● Communication skills, you need communication to explain tasks and goals clearly to their team 7. Define and differentiate between these different types of leaders: transformational, transactional, and authentic leadership Transformational Leader: Identifies common values Is a caretaker Inspires others with vision Has long-term vision Looks at effects Empowers others Transactional Leader: Focuses on management tasks Is directive and results oriented Uses trade-offs to meet goals Does not identify shared values Examines causes Uses contingency reward Authentic leaders inspire others to follow them by modeling a strong internal moral code.
