Term
| Differentiated practice models |
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Definition
| models of clinical nursing practice that are defined or differentiated by level of education, expected clinical skills or competencies, job descriptions, pay scales, and participation in decision making. |
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Term
| associate degree nurse role |
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Definition
| functions primarily at the bedside in an institutional setting and is less-complex patient care situations. The time frame for care provided by the ADN is defined within a shift or limited period of time, based on activities that provide comfort, physiologic stabilization, or assistance to a peaceful death. Are called Associate Nurses. |
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Term
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Definition
| is conceptualized as operating across time from preadmission to post-discharge. The guiding principles of this role are found in the unusual and often unpredictable response of the patient that goes beyond needs addressed in the standards or pathways. The BSN intervenes to design and facilitate a comprehensive, well-prepared discharge based on unique needs of the patient and family. |
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Term
| Advanced Practice Registered Nurse |
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Definition
| role is based on the Master’s of science in nursing or doctorate of nursing practice (DNP). The APRN perspective is supported by in-depth education in physiology, physical assessment, pharmacology, and a broad healthcare systems perspective. The MSN/DNP role is not bound by setting but, instead, provides a continuum of care across all settings, working with the patient and family throughout wellness or illness or until death. |
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Term
| The carried educational backgrounds and philosophies of the Nurses’ implementing a model of practice |
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Definition
| have a significant impact on the success of the delivery system and the satisfaction of the nurse and the patients. |
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Term
| Case Method/ Total Patient Care |
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Definition
| is the oldest method of providing care to a patient. During an 8-12 hour shift, the patient receives consistent care from one nurse. The nurse, patient and family usually trust one another and can work together toward specific goals. Usually the care is patient-centered, comprehensive, continuous, and holistic. Because the nurse is with the patient during most of the shift, even subtle changes in the patient’s status are easily notices. |
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Term
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Definition
| is a method of providing patient care by which each licensed and unlicensed staff member performs specific tasks for a large group of patients. These tasks are in part determined by the scope of practice defined for each type of caregiver. |
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Term
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Definition
| Is an adaption of the case method, was developed by Marie Manthey as a method for organizing patient care delivery in which one RN functions autonomously as the patient’s primary nurse throughout the hospital stay. The primary nurse is accountable for the patient’s care 24 hours a day from admission through discharge. Conceptually, primary nursing care provides the patient and the family with coordinated comprehensive, continuous care. The primary nurse, preferable at least baccalaureate-prepared, is held accountable for meeting outcome criteria and communicating with all other healthcare providers about the patient. |
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Term
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Definition
| is the process of coordinating health care by planning, facilitating, and evaluating interventions across levels of care to achieve measurable cost and quality outcomes. Insurers began to use nursing case management as a strategy to manage the needs of complex patients who require coordination over the course of treatment. |
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Term
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Definition
| a. Because the RN is always accountable for assessment, diagnosis, planning, and evaluation, it is important that UNP’s understand what elements of implementation they may carry out and why the RN is responsible for analyzing data gathered. Thus RNs are accountable for an initial assessment and then intermittent evaluations. Both elements must be present to ensure effectiveness in entrusting an element of care to someone else. Delegators have lessened the amount of direct care work they will do. However, this practice has simultaneously increased their supervisory work. |
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Term
| communication as applied to delegation |
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Definition
| a. Although the UNP is performing tasks, the RN is monitoring care and outcomes. The RN should seek information, and the UNP should report information. This two-way-follow-through allows care to be altered in a timely manner. At times, especially as new skills are acquired or new relationships are forged, the RN will want to provide feedback during the care process. In all situations, the RN needs to provide feedback about performance at the end of such activity. In addition to making it known that the UNP was monitored and supported, the UNP knows how to perform better next time because feedback should be directed toward quality. |
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Term
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Definition
right task
right circumstances
a. right supervision
right direction/communication
right person |
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Term
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Definition
Is it appropriate to delegate (based on legal and institutional factors)?
Is the person able and willing to do this specific? |
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Term
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Definition
Would the delegation process suggest that the circumstances are right?
Is staffing such that the circumstances demand delegation strategies? |
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Term
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Definition
Is the prospective delegate a willing and able employee?
Are the patient needs a “fit” with the delegatee? |
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Term
| right direction/communication |
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Definition
Do you and the delegate have “common language”? (do words, such as time frames, needs, and critical, mean the same to both of you?).
Does the delegate know what and when to report? Is your communication based on a “fit“ with the situation and culture? |
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Term
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Definition
Do you know how and when you will interact about patient care with the delegate?
How often will you need to provide direct observation? |
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Term
| strategies to manage a potentially violent situation |
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Definition
Understand that an indivdual's perception of stress ie what precipitates escalation.
Take advantage of internal barriers that an escalated individual has which delay lashing out. This allows a way for the person to come back down without embarassment.
Train to identify subtle clues of behavior and establish communications that will de-escalate the situation.
Be aware of surroundings
Think ahead about potential problems and develop a plan to respond.
Speak with a calm professional tone and maintain self control.
Restate the feelings you hear and not the content of what is said. This validates the viloent person's feelings.
Use distance and neutral body language (dont fold arms or put hands on hips) |
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Term
| risk factors for potential violence or disruption |
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Definition
Working when understaffed, especially during visiting hours and meal times.
Transporting patients between areas in a facility
Long waits for patient care
Overcrowded, uncomfortable waiting areas
Working alone or in an area isolated from other staff
Solo work with patients in areas with no back-up or way to get assistance, such as communication devices or alarm systems
Poor environmental design
Inadequate security
Lack of staff training in handling potentially violent situations
Unrestricted movement of patients or visitors
Poorly lit corridors, rooms, parking lots, or other areas
Prevalence of handguns or other weapons among patients, their families,, or friends
Increasing presence of gang members, drug or alcohol abusers, trauma patients, or distraught family, or friends
Use of hospitals or healthcare facilities for holding criminals, violent individuals, and the acutely mentally disturbed
Serving chronically mentally ill patients being released without adequate resources for follow-up care.
Availability of money or drugs within the facility. |
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Term
| guidelines for preventing workplace violence and incivility |
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Definition
Surveying staff to identify problems
Implementing innovative interventions to rid the workplace of bullying
Ensuring non-retaliation for reporting of horizontal violence
Enforcing zero tolerance policies
Providing training on violence prevention
Promoting honest, open communication and an atmosphere of trust |
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Term
| Collective Bargaining Model – |
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Definition
| the performance of the mutual obligation of the employer and representative of the employees to meet at reasonable times and confer in good faith with respect to wages, hours, and other terms and conditions of employment or negotiation of any agreement or any question arising from those terms and conditions. The purpose of collective bargaining or unionization by nurses is to secure reasonable and satisfactory conditions of employment, including the right to participate in decisions regarding their practice. Is an effective, legal mechanism used by nurses to obtain the right to participate in decisions regarding their practice. |
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Term
| Traditional Trade Union Model – |
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Definition
| are increasingly seeking opportunities to represent nurses for the purpose of collective bargaining and to speak for nursing boards of nursing, regulatory agencies, and legislatures. They excluded employees of not-for –profit hospitals from coverage. |
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Term
| whistle blowing and whistle blowing protection |
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Definition
| a. “Refers to a warning issued by a current or former employee of an organization to the public about a serious wrongdoing or danger created or concealed within the organization”. The Whistleblower Protection Act only protects federal workers, and does not cover the private sector. Whistleblowers are called At-Will Employees and are in a vulnerable position. Managers of them have greater latitude in selecting disciplinary measures for specific infraction. An at-will employee may be terminated at any time for any reason except discrimination. In essence, they work at the will of the employer. It is critical for nurses to know their rights regarding discipline and termination. Union contract language requires management to follow “due process” for represented employees management is required to show sufficient evidence to prove their case against employee. This system isn’t perfect and this is one of it’s weaknesses. |
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Term
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Definition
| described as a democratic, egalitarian concept; it is a dynamic process resulting from shared decision making and accountability. Basic principals are partnerships, equity, accountability, and ownership |
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Term
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Definition
| an umbrella term encompassing activities within the practice setting. The choice of advocacy to reflect the framework in which nurses control the practice of nursing is consistent with the goals or professionalism. Includes an array of activities undertaken to address the challenges face by nurses in their practice settings. Including; focus on career development, employment opportunities, terms and conditions of employment, employment rights and protections, control of practice , labor-management relations, occupational health and safety , and employee assistance Advocacy occurs within a framework of mutuality, facilitation, protection, and coordination. |
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Term
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Definition
| the performance of the mutual obligation of the employer and representative of the employees to meet at reasonable times and confer in good faith with respect to wages, hours, and other terms and conditions of employment or negotiation of any agreement or any question arising from those terms and conditions. The purpose of collective bargaining or unionization by nurses is to secure reasonable and satisfactory conditions of employment, including the right to participate in decisions regarding their practice. Is an effective, legal mechanism used by nurses to obtain the right to participate in decisions regarding their practice. |
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Term
Steady State (career style)
Ex: Staff nurse – |
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Definition
| Constancy in position with increasing professional skill |
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Term
Linear –(career style)
Ex: Nursing service administrator – |
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Definition
| hierarchical orientation with steady climb |
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Term
Entrepreneurial and Transient – (career style)
Ex: Nurses in private practice; temporary assignments – |
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Definition
| desire to create new service; meeting own priorities |
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Term
Spiral – (Career style)
Ex: Nurse who returns after raising a family – |
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Definition
| Rational, independent responsibility for shaping career |
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Term
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Definition
| a. Signifies completion of requirements in a particular field beyond basic nursing educational preparation for licensure. Nurses can be certified in a number of different specialty areas. Is an expectation in employment settings for career advancement; in the field of advanced practice nursing, it is a requirement for practice and reimbursement. In many states, certification in advanced practice is the mechanism to achieve recognition as an advanced practice registered nurse from the board of nursing. Certification recognizes competence of the nurse in a specialized area. Nurses, managers, and administrators value certification. |
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Term
| critical elements of an interview |
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Definition
Check interviewing guides, such as What Color Is Your Parachute?
Check out the new organization
Review the organizations mission, vision, and values statements before the interview
Obtain statistics and facts
Ask about new program directions
Recheck your resume or curriculum vitae for the following:
Emphasis
New information
Practice using “action” words.
Decide about the following:
Appearance
Key points:
To make
To learn
Tool for quick check
Arrive on time and along
Make a memorable entrance;
Make eye contact
Shake hands
Smile
Say, “hello, I’m Kimberly”
Position yourself with the interviewer (e.g., decide to sit at an angle).
Appear interested – project competence, confidence, and energy
Accentuate the positive
Answer questions directly but know when not to
Ask for more information
Say only positive things about your present employer, but do not be untruthful
Secure a time frame for notification of a position offer.
Thank interviewer personally
Write a thank-you letter
Let interviewer know your decision
Put commitments in writing |
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Term
| 4. Describe a variety of professional development activities, including academic and continuing education programs |
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Definition
| Active involvement in education, service, and scholarship opportunities can help prepare you to deal with new roles and challenges in your employment setting and the larger scope of nursing and health care. Engaging in service activities and both sharing you r knowledge through research, writing, and speaking allow you to influence others in the profession and through the profession. |
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Term
| Academic education programs – |
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Definition
| Graduate education consists of either master’s-level or doctorate-level training. These degrees may open the door to numerous career opportunities. Some employment situations or career specialties require advanced education. As health care has become more complex, nurses recognized as independent practitioner need more education to meet healthcare demands. |
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Term
| Continuing education programs - |
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Definition
| also contributes to professional growth. Is defined as “systematic professional learning experiences designed to augment the knowledge, skill, and attitudes, of nurses and therefore enrich the nurses’ contributions to quality health care and their pursuit of professional career goals”. Opportunities exist at local, state, regional, and broader levels. In addition to increasing knowledge base, continuing education provides professional networking opportunities, contributes to meeting certification and licensure requirements, and documents additional pursuits in maintaining or developing clinical expertise. |
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Term
| contributions and benefits from active involvement in professional organizations. |
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Definition
| a. Belonging not only demonstrates leadership but also provides numerous opportunities to meet other leaders, participate in policy formation, continue specialized education, and shape the future of the profession. Are groups of people who share a set of professional values and who decide to join their colleagues to effect change. Many nursing associations set standards and objectives to guide the profession and specialty practice. |
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Term
| conflict management strategies/approaches |
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Definition
These approaches fall into two dimensions: assertiveness and cooperativeness.
Avoiding
Accomodating
Competing
Compromising
Collaborating |
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Term
Conflict management strategy
Avoiding: |
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Definition
| (unassertive and uncooperative) this is simply withdrawing from conflict which can either cause it to escalate or allow time to think about the situation. May be the approach of choice in no-win situations. |
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Term
Conflict management strategy
Accomodating: |
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Definition
| (unassertive and cooperative) This is self-sacrificing to serve other people. This is done when you place the needs of others over your own needs. This is an appropriate approach when you are fighting a losing argument, you are trying to build credit for later situations, you have made a mistake, other people have better solutions, letting others lean from mistakes, and when preserving harmonious relationships. |
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Term
Conflict management strategy
Competing: |
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Definition
| (assertive and uncooperative) When personal goals need to win out over those of other people. Useful when defending rights or principles. Appropriate use when quick decisive action is needed, when an important but unpopular action needs to be taken, when an individual or group is right about an issue that is vital to group welfare. Those who use this approach may act defensively, make cutting remarks, gossip or inuendo. |
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Term
Conflict management strategy
Compromising: |
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Definition
| (assertive and cooperative) This is a give and take approach involving negotiation skills. This is appropriate when neither side can have all the outcomes they want/need but a middle ground is created where there is a sense of energy which can build important relationships. (This is the most preferred resolution approach used in union degotiations) |
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Term
Conflict management strategy
Collaborating: |
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Definition
| (assertive and cooperative) This is the most time consuming but most creative approach. This approach involves analyzing situations and defining conflict at higher levels where shared goals are identified and commitment to working together is generated. When seeking creative, integrative solutions in which both sides needs/goals are important thus developing group commitment and consensual decision. When working through difficult emotional issuesthat interfere with morale, productivity, and growth |
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Term
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Definition
| a significant source of interpersonal conflict where aggressive and destructive behavior or psychological harassment of nurses against eachother. Ex: nonverbal inuendo, verbal confrontation, undermining activities, witholding information, sabotage, infighting, scapegoating, backstabbing, failure to respect privacy, and breaches of confidentiality |
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Term
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Definition
| Conflictual behaviors among individuals who consider themselves peers with equal power- but with little power within the system. |
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Term
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Definition
| closely related to lateral and horizontal violence but involves a real or percieved power differential between instigator and recipient. This involves psychological and physical stress, underperformance, professional disengagement, increased job trunover, and the potential for diminished quality of care. |
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Term
| factors that influence conflict resolution/management |
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Definition
The main styles used in conflict resolution/management between staff nurses are avoidance and accomodation.
Many factors cause these approaches to be more prevalent: 1. Fear of jeopardizing a nurses career may lead to their avoidance of conflict resolution 2. Nurses may feel that it is more advantageous to spend time with patients rather than engage in energy and time expendature on solving problems between staff resulting in avoidance or accomodation. 3. Perception of power of a physician (for example) over a nurse- lack of clarification between roles results in accomodation or avoidance. |
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Term
| documentation of disciplinary/performance problems |
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Definition
| is as critical as the documentation of patient care |
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Term
| absenteeism as a disciplinary issue |
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Definition
| has a deleterious effect on financial management, care delivery, and morale. Has also been linked to role stress, role strain and is an indicator of poor work satisfaction. It may be approached in a non punitive way: manager notices behavior, speaks with employee, if problem continues employee documents the action plan, if no change need to terminate employee is explored and executed if appropriate |
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Term
| strategies to support clinical competence |
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Definition
| Utilizing a skills checklist and competency evaluation program, employee self-assessment, remediation planning, critical thinking exercises, overall framework for evaluation. |
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Term
| procedures for improving performance |
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Definition
| are affected by motivation and ability. Motivation can be addressed by attempting to determine the cause of the problem and by working to provide an enviornment that is conducive to increased motivation. Lack of ability as evidenced by frequent error in judgement or technique, are indicators of lack of knowledge or skill and can be addressed by education and training. |
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Term
| procedure for termination. |
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Definition
Manager must beconfident that steps to help employee and to correct problem behaviors have been documented and exhausted.
Manager must recognize that if the employment continues, this employee will have a deleterious effect on overall organizational functioning and on care.
The employee must have been made fully aware of the problem performance and of the dact that all of the correct disciplinary steps have been followed.
The nurse manager should check with the HR and legal deptartments before proceeding to ensure that terminatio is justifyable legally and that proper steps have been followed |
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Term
| Stress buffering behaviors |
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Definition
| coping behaviors which reduce the detrimental effects of stress. The stressor-induced changes in the hormonal and immune systems can be modified by behavioral and coping responses. Examples include leisure activities, taking time for self, decreasing or d/c caffeine, positive social support, a strong belief in system, a sense of humor, developing realistic expectations, reframing events, regular aerobic exercise, meditation, and use of the relaxation response. |
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Term
| personal and professional stressors |
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Definition
External: workload, rotating shifts, high patient acuity, inadequate staffing, ethical conflicts, dealing with death and acute illness, role ambiguity, complexity compression, job security. Social stressors interpersonal relationships, change (travel nurse) overwork, role stress (incongruence between perceived role expectations and achievement) gender roles.
Internal: Personal triggers are events that have an effect on specific individuals: death of a loved one, auto accident, job loss, marriage/divorce. Job dissatisfaction, noisy work environment, difficult commute, negative self-talk, unrealistic expectations, exaggerated or rigid thinking, perfectionism, type A personality. These are buffered by psychological hardiness: cognitive appraisal and coping skills. |
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Term
| strategies to decrease stress |
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Definition
Physical: Accept limitations, modify nutrition, exercise, make physical health a priority, sleep, relax. Mental: learn to say no, cognitive restructureing and self talk, imagery, hobbies, vacation, learn about the system and handling problems, learn communication, conflict resolution, time management, continuing education.
Emotional/Spiritual: Meditation, prayer, counseling, support groups, networking, communicate feelings, acquire a mentor, ask for feedback |
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Term
| strategies to facilitate role transition |
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Definition
Strengthen internal resources, : recognize, use and strengthen ones own values and beliefs
Assess organizational resources, culture, and group dynamics: observe rituals, accepted practices, patterns of communication
Negotiate the role
Grow with a mentor
Develop management knowledge and skills
Mentors take on responsibility of guiding the development of another. Mentors bring experience and are characterized by 5 competencies: effective interpersonal communication, risk taking and creativity, self-knowledge, inspiring and leading change, and strategic vision. These competencies facilitate role transition in the mentee. Leadership education is needed to transition from clinical to front line supervisory positions. Experience and education provide a firm basis for seeking additional credentials which facilitate role transition. |
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Term
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Definition
| Roles such as leader, manager and follower require processes and shifts in responsibility. Staff nurse to nurse manager role changes from direct care to managing others who provide direct care. This requires active listening, encouragement, motivation organization, problem solving development and support skills whereas staff nurse role requires followership skills such as conforming, implementing, contributing, completing assignments, and alerting the manager. Movement between the extremes requires understanding of ROLES: Responsibilities, Opportunities, Lines of communication, Expectation and Support. For each role these aspects assist with the transition and understanding of the makeup of the given role. |
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Term
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Definition
| Responsibilities, Opportunities, Lines of communication, Expectation and Support. For each role these aspects assist with the transition and understanding of the makeup of the given role. |
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