Chapter 01: Leading, Managing, and Following

Yoder-Wise: Leading and Managing in Nursing, 7th Edition

MULTIPLE CHOICE

1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She

is asked to assess and adapt the unit to better meet the unique needs of the older adult patient.

Using complexity principles, what would be the best approach to take for implementation of

this change?

a. Leverage the hierarchical management position to get unit staff involved in

assessment and planning.

b. Engage involved staff at all levels in the decision-making process.

c. Focus the assessment on the unit and omit the hospital and community

environment.

d. Hire a geriatric specialist to oversee and control the project.

ANS: B

Complexity theory suggests that systems interact and adapt and that decision making occurs

throughout the systems, as opposed to being held in a hierarchy. In complexity theory, every

voice counts, and therefore, all levels of staff would be involved in decision making.

TOP: AONE competency: Communication and Relationship-Building

2. A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has

called in sick five times in the past month. He tells the manager that he very much wants to

come to work when scheduled but must often care for his wife, who is undergoing treatment

for breast cancer. According to Maslow’s need hierarchy theory, what would be the best

approach to satisfying the needs of this nurse, other staff, and patients?

a. Line up agency nurses who can be called in to work on short notice.

b. Place the nurse on unpaid leave for the remainder of his wife’s treatment.

c. Sympathize with the nurse’s dilemma and let the charge nurse know that this nurse

may be calling in frequently in the future.

d. Work with the nurse, staffing office, and other nurses to arrange his scheduled

days off around his wife’s treatments.

ANS: D

Placing the nurse on unpaid leave may threaten the nurse’s capacity to meet physiologic needs

and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect

patient care and threaten the needs of staff to feel competent. Arranging the schedule around

the wife’s needs meets the needs of the staff and of patients while satisfying the nurse’s need

for affiliation.

TOP: AONE competency: Communication and Relationship-Building

3. A grievance brought by a staff nurse against the unit manager requires mediation. At the first

mediation session, the staff nurse repeatedly calls the unit manager’s actions unfair, and the

unit manager continues to reiterate the reasons for the actions. What would be the best course

of action at this time?

a. Send the two disputants away to reach their own resolution.

b. Involve another staff nurse in the discussion for clarity issues.