Running Head: NURSING LEADERSHIP AND MANAGEMENT
Nursing Leadership and Management
Tammy Fisher
Aspen University
N496
Module 6
Vanessa Kramasz, M.S.N., R.N.
February 2014
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Plan to Re-Motivate a New Employee
Motivation is an action people take to satisfy needs that have not been met, and put forth
effort to achieve goals (Marquis & Huston, 2012). Motivation can come from the person
themselves or from outside individuals such as fellow employees or supervisory staff.
Management desires to increase the drive of the employee and accomplishes the drive to succeed
by use of incentives and goals (Rahman, Mondol, & Ali, 2013). This paper will explore the
motivating factors for a graduate nurse that has begun to have a change in behavior.
Summary of Graduate Nurse Scenario
Sally Brown is a recent graduate who is working in a public health agency. Sally began as a
hard worker and was well liked but over a few months she had a med error, complaints from a
family, and the unexpected death of one of her patients. Sally has begun to appear de-motivated.
She is withdrawn, appears un-kept, and frequently absent from work.
Plan to Re-Motivate
Sally has a decrease in intrinsic motivation due to her series of misfortunes of a medication
error, conflict with a family member of one of her patients, and the death of one of her patients.
She is not meeting her own needs and needs someone to motivate her extrinsically. Internal
motivation such as feeling good about a job, successful completion of tasks, and receiving
feedback, as well as external motivation such as rewards and bonuses, are important to the
motivation of the employee (Skudiene & Auruskeviciene, 2012). Sally has to have these
motivational ideas instilled in her, so that she can succeed. The plan for the nurse leader for
Sally would include:
1. Face to face discussion with Sally about how she feels her job is progressing and the
situations that have occurred since she began her job. The nurse leader must discover the
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motivating factors for Sally and listen to find her unmet needs and plan to assist her with
meeting those needs. The nurse leader will gently speak to Sally about her changes in her
position, caregiving and appearance. She will assure Sally that the death of her patient
was not her fault and if Sally is not comfortable with discussion, have her mentor with
one of the other nurses that have been a successful and motivated employee. Sally may
have cultural differences in motivation and the nurse leader may need to discuss the
motivating factors.
2. While remaining a positive role model, the nurse leader must encourage Sally in her
nursing role and her skills and discuss with her how to avoid med errors and
confrontations with family members. Some training may be required in order to assist
her with the communication with family members.
3. The nurse leader should set up a schedule to follow up with Sally weekly to address her
accomplishments, her fears about her job and her assessment of how the nursing care is
successfully being implemented. Sally must be willing to meet and communicate at these
times. During the weekly meetings the nurse manager will clearly outline expectations
for the next week and set goals with bonus and reward opportunities clearly outlined.
4. The nurse leader may need to adjust Sally’s assignment and decrease her duties
temporarily so that she can concentrate on her care of her patients and feel better about
the care she is providing for her patients. Sally needs to understand that she has a mentor
in the nurse leader, and that she can address her concerns with her at any time.
5. After Sally has successfully re-adjusted to her nursing role, the nurse leader may decrease
the weekly meetings to monthly or quarterly, and slowly build her case load while
observing that she is able to complete her tasks successfully. Sally should be asked to
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step forward and mentor other new nurses when she is comfortable. This will give her
feeling of accomplishment and pride.
Sally was very accomplished and a flawless worker when she began her job. She lost
motivation when she had the shock of the daily employment, lack of accomplishment, conflicts
with family, and the death of her patient. Sally needs to be re-affirmed in her strength of
assessment and care of her patients, and needs to feel that she is an important part of the care
team. Her nurse leader should mentor her, meet with her to support and guide her, and give her
reasons and incentives to return to her previous status. Sally may need a nurse mentor to follow
and guide her on a daily basis and may need to be assigned to one of the other nurses on the staff.
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References
Marquis, B. L. & Huston, C. J. (2012). Leadership roles and management functions in nursing:
Theory and application (7th ed.). Philadelphia: Lippincott.
Rahman, M., Mondol, D. K., & Ali, A. (2013). Nexus of employee motivation with hrm and
workplace behaviour: An assessment of the dominant factors. Management Research
and Practice, 5(4), 49-57. Retrieved from
http://search.proquest.com/docview/1476274035?accountid=34574
Skudiene, V., & Auruskeviciene, V. (2012). The contribution of corporate social responsibility to
internal employee motivation. Baltic Journal of Management, 7(1), 49-67.
doi:http://dx.doi.org/10.1108/17465261211197421
NURSING LEADERSHIP AND MANAGEMENT
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Bringing a Group Together
The group process includes four stages in order to accomplish work: Forming, Storming,
Norming, and Performing, with a possible additional stage of Termination or Closure (Marquis
& Huston, 2012). Each group has task roles that the members of the group perform. The
purpose of this paper is to explore the scenario provided about a work group needs to be brought
together in order to accomplish their task.
Summary of the Group Scenario
The charge nurse on the evening shift of the medical unit has formed a group of staff
members in order to review the policy on requests for days off. The group was formed in
response to the employees displeasure in the way days off are granted. Each shift and each
discipline of Registered Nurses (RN), Licensed Vocational Nurses (LVN), and Certified Nursing
Assistants (CNA) are represented. The group has completed the initial stages of the group
process, and is now at a standstill.
Planning for the Group to Work Together
The group met and completed the initial step of Forming whereas they learned the boundaries
and behaviors, but there is no leader or secretary of the group identified so there is no clear
leader. Careful choice of the group members by the charge nurse will impact the outcome of the
committee, because hidden profiles or interests of group members may impact the thoughts and
outcome of the group process (Mojzisch & Schulz-Hardt, 2011). During the Storming step they
did polarize and the LVNs are now noting that there are more RNs on the group. The group is
stalled at the Storming step of the process. Group processes impact subconscious thoughts in the
group participants (Peled & Perel, 2012). Each of the group members has listened to the
information and formed their own subconscious opinions but now is not sharing their thoughts.
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It appears that during this step the group has initiators for information, information seekers and
givers, but no one to elaborate, coordinate or summarize the decisions that the group has
presented from their research. The group needs someone to stimulate decision making, and
facilitate the group actions by cohesive action. In order for this group to move forward, they
require someone to coordinate, keep them on track and stimulate them to verbalize their ideas.
The charge nurse needs to sit in on the meeting, learn the ideas and appoint a leader to
stimulate the group. She does not need to add more group members unless the ones in the group
refuse to participate, as this will slow the process. The group has to communicate and cannot
pout or argue among themselves, or the goal of the committee will be lost. The group needs
someone to raise the activity level and stimulate a response and a change. Once the group voices
their ideas for change, they can move on to the Norming stage with participant cohesion and the
Performing Stage with problem-solving and completion of the task to meet the goal of changing
the way that the requests for days off are handled.
NURSING LEADERSHIP AND MANAGEMENT
References
Marquis, B. L. & Huston, C. J. (2012). Leadership roles and management functions in nursing:
Theory and application (7th ed.). Philadelphia: Lippincott.
Mojzisch, A., & Schulz-Hardt, S. (2011). Process gains in group decision making. Journal of
Managerial Psychology, 26(3), 235-246.
doi:http://dx.doi.org/10.1108/02683941111112668
Peled, E., & Perel, G. (2012). Can a structured model for group intervention be responsive to
group process? A proposal. Clinical Social Work Journal, 40(4), 391-400.
doi:http://dx.doi.org/10.1007/s10615-010-0285-2
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How to Plan the Busy Morning
Delegation of work is the direction of others to assist with the tasks or workload (Marquis &
Huston, 2012). Delegation is a managerial process in which the manager takes responsibility for
the overall care, but directs others to assist with the tasks they are trained to perform. The
purpose of this paper is to explore the planning and delegation that a module leader completes on
a busy medical-surgical floor.
Summary of the Medical-Surgical Delegation Scenario
The module leader Registered Nurse (RN) is responsible for a 13 bed medical-surgical unit,
and has a Licensed Practical Nurse (LPN) and a Nursing Assistive Personnel (NAP) to assist her
in the management of the 13 patients. The patients vary in acuity and care levels, and one is
scheduled to go home today, two are having surgery or procedures and the other patients range
from good to poor condition.
Plan for Staffing the Medical-Surgical Module
Nursing assistants or NAPs are unlicensed yet they are important to the feeding, grooming
and toileting of the patients (Siegel et al., 2008). In this hospital, the job description states that
the NAP can complete simple wound care, personal care, feeding, and toileting of the patients on
the module. She will be in charge of personal care for all 13 patients and with Mrs. Dewey
going home and only 26 years old, she will need little care from the NAP. Mr. Vines and Mrs.
Brown will be off the floor part of the day due to surgical procedures and Mr. Vines wants to
move to a new room so he will probably not return to the module after his procedure. Mrs.
Smith will need feeding assist at meals and Mr. Arthur will need turned every two hours and
heavy personal care since he is bedbound and unable to care for himself.
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The RN and LPN will have their workloads split, with the RN in charge of all Intravenous
Piggybacks, Chemo infusions, and IV push medications with the LPN responsible to notify when
they will be due on her patients.
Assignments including medication pass (except IV piggyback and IV push medications) and
wound care and teaching to be as follows for the LPN:
1. 401-Jones, will require teaching on mastectomy and post-op care.
2. 402-Redford, back pain and good condition.
3. 403-Worley, will need frequent dressing changes by the LPN and NAP who has job
description that she can do simple dressings. LPN to complete the initial dressing of the
shift and the NAP to report to RN regarding dressing changes and drainage volume.
4. 404-1, Smith, will require NAP feeding assist for meals, LPN may need to assist NAP.
5. 404-2-Dewey, discharge today so will need discharge teaching and then will be off roster.
6. 405-2 –Vines, is pre-op today and then will move to a new room after the procedure so
will not return (he cannot go into 406 as that is a female room). LPN to cover until
surgery then the bed will be vacant and if a new patient comes, the RN will take bed
405-2 and care for that patient.
7. 406-1 is vacant and will be covered by the LPN with assist of RN if a patient arrives.
8. 406-2-Brown- will have planned surgery today so will be off floor most of shift.
Assignment for the RN includes all IV piggybacks and IV push medications on the floor and to
assist the LPN and the NAP to complete all procedures. RN assignment as follows:
1. 405-1 Arthur, chemo and declining condition
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2. 405-2 will be vacant when Vines goes to surgery and does not return so the RN will be
responsible if a new admit comes to bed 405-2. LPN is to assist the RN with new admit
if needed.
3. 407-1 West, critical type condition is only fair.
4. 408-1-Niles, Three days post-op and depressed, may require order for social work to
council or RN to listen to concerns, will have dry dressing changes on incision that the
NAP can complete.
5. 408-2-Ford, has an IV and nasogastric tube (NG) to be replaced today, is one day post op
from gastrectomy and will have dressing changes but RN to complete dressing changes.
6. 409-Land, Depression, may need a social work order to council, or RN time to talk about
fears, will be off floor some of day for barium enema procedure but will need prep for the
enema and frequent toileting.
The RN, LPN, and NAP will need to work together as a team to complete the patient care and
get all assignments finished by the end of the shift. Nursing teams have been created due to the
staff shortages and financial burden of providing adequate medical care (Walker, Doneghue, &
Mitten-Lewis, 2007). The RN, LPN, and NAP should assess the situation frequently to see if the
other workers are in need of assistance. When the LPN has extra time, she can assist the RN,
since the RN will have responsibility for the IV’s, the IV and NG replacement and the handling
of orders and charge responsibilities. The LPN or RN also can assist the NAP when she has
overload of responsibilities.
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References
Marquis, B. L. & Huston, C. J. (2012). Leadership roles and management functions in nursing:
Theory and application (7th ed.). Philadelphia: Lippincott.
Siegel, Elena, Young, Heather, Mitchell, Pamela, & Shannon, Sarah (2008). Nurse preparation
and organizational support for supervision of unlicensed assistive personnel in nursing
homes: A qualitative exploration. The Gerontologist, 48(4), 453-63. Retrieved from
http://search.proquest.com/docview/210985160?accountid=34574
Walker, K., Donoghue, J., & Mitten-Lewis, S. (2007). Measuring the impact of a team model of
nursing practice using work sampling. Australian Health Review, 31(1), 98-107.
Retrieved from http://search.proquest.com/docview/231724699?accountid=34574