Question

 Two new associate-degree graduates were hired for the pediatric unit. Both worked three 12-hour shifts a week, Jan in the day-to-evening shift and Ronnie at night. Whenever their shifts connected, they would compare notes on their experience. Jan felt she was learning rapidly, gaining clinical skills and beginning to feel at ease with her colleagues.

Ronnie, however, still felt unsure of herself and often isolated. "There have been times," she told Jan, "that I am the only registered nurse on the unit all night. The aides and LPNs are really experienced, but that's not enough. I wish I could work with an experienced nurse as you are doing."

 "Ronnie, you are not even finished with your 3-month orientation program," said Jan. "You should never be left alone with all these sick children. Neither of us is ready for that kind of responsibility. And how will you get the experience you need with no experienced nurses to help you? You must speak to our nurse manager about this."

 "I know I should, but she's so hard to reach. I've called several times, and she's never available. She leaves all the shift assignments to her assistant. I'm not sure she even reviews the schedule before it's posted."

 "You will have to try harder to reach her. Maybe you could stay past the end of your shift one morning and meet with her," suggested Jan. "If something happens when you are the only nurse on the unit, you will be held responsible."

1. In your own words, summarize the problem that Jan and Ronnie are discussing. To what extent is this   problem due to a failure to lead? Who has failed to act?

2. What style of leadership was displayed by Ronnie and the nurse manager? How effective was their leadership? Did Jan's leadership differ from that of Ronnie and the nurse manager? In what way?

3. In what ways has Ronnie been an effective follower? In what ways has Ronnie not been so effective as a follower?

4. If an emergency occurred and was not handled well while Ronnie was the only nurse on the unit, who would be responsible? Explain why this person or persons would be responsible. 

5. If you found yourself in Ronnie's situation, what steps would you take to resolve the problem? Show how the leader characteristics and behaviors found in this chapter support your solution to the problem.

Answer 1

If you found yourself in Ronnie's situation, what steps would you take to resolve the problem? Show how the leader characteristics and behaviors found in this chapter support your solution to the problem

Answer 2

1. The nurse manager has failed to act here. Rosemary is not confident and sure about how she has to work. This will lead to poor quality care for the patients. In some nights she is the only person in charge which leads to work overload and thus reduce the quality of care.
2. The leadership style of rosemary is transformational leadership and the nurse manager is laissez faire leadership.
3. They were not effective. Rosemary should take up responsibility and do things on her own when she has to.

Answer 3

         Question 1

    In this scenario, we can understand that this a communication between two staff nurses in a pediatric unit who are new degree graduates.

Jan and Ronnie are new degree graduates working on the Pediatric unit of a Hospital as staff nurses. Jan is working in the day to evening shift along with experienced staff while Ronnie was working alone in the night shift. They usually discuss each other regarding the experience during their shift and knowledge what they gained during the working period.

  Jan is gaining rapid knowledge and clinical skills as she is working with her experienced colleagues while Ronnie is not getting sufficient knowledge regarding the clinical practices as she was working alone in the night shift. Ronnie wish to work with an experienced staff to gain adequate knowledge. Jan also encourage Ronnie to work along with an experienced staff as she is new to the clinical environment and she will be the only responsible one if any problem occurred in the unit.

Jan encourages Ronnie to discuss the issue with the Nurse manager as she is very hard to reach. Ronnie also tried several times to reach the Nurse manager but she is not available. Again Jan is encouraging Ronnie to meet the Nurse Manager after her night shift to avoid clinical issues during her duty time.

Here the Nurse Manager failed to act. As a Nurse Manager , She has the responsible for taking care of the Staff and meeting goals .

Role of a Nurse Manager Includes:

· Staff management

· Case management

· Treatment planning

· Recruitment

· Budgeting

· Scheduling

· Discharge planning

· Mentoring

· Developing educational plans

· Records management

                 In this scenario , The Nurse Manger is not doing any responsibility what she should do. It is clearly mentioned that her assistant is assigning the duty schedules to the staff and she is not even checking before posting the duty routines.

               She is failed in the Staff management , Scheduling, Educational plans. As Ronnie is a new staff who not even finished the orientation classes, without providing proper orientation and education, assigning her to do duty alone in the night shift is a big failure from the side of Nurse Manager . This failure can leads to legal issues also.

Question 2

            As a Nurse Manager, She is responsible for creating safe, healthy environments that support the work of the health care team and contribute to patient engagement. Nurse managers need strong communication and leadership skills. They must be effective leaders who can strike a balance between working with the nursing staff and the healthcare facility administrators. The job requires management skills, budgeting and business acumen and leadership qualities. Communications and interpersonal skills are also vital.

             In this scenario, the leadership displayed by Ronnie and Nurse manager is very poor. Why because Ronnie is not even seeing her Nurse Manager to communicate regarding the clinical issues. There is no communication between them as the Nurse manager is not even attending the phone calls and she is very hard to available also.

              As a Nurse manager she has to assign the duty rosters and she should provide enough staff to work and she needs to give education to the new staffs also. Here the Nurse manager is not doing such responsibilities and she is assigning her duties to her assistant.

            Hence, Without failure, we can assume that as a Nurse manger she is a failure and there is no leadership quality within her.

             Here I think, Jan’s leadership is differ from that of Ronnie and Nurse Manager. Because Jan is doing a Day to evening shift where the Nurse Manger is available most of the time than night. So Jan can utilize the duty hours to discuss the clinical issues with the Nurse Manager and also she can learn new things by clearing doubts and can perform well. So without doubt, Jan's Leadership and Ronnie's Leadership is different to the Nurse manager.

Answer 4

The leadership styles are classified into three types, they are:

Authoritarian style :

Authoritarian leadership style provides clear procedures and policies. Leaders decide what goals are to be achieved, and they direct and control the decision-making ability of group members. Productivity in the team is generally high, but there is lack of creativity and innovation. In this style, the members are not involved in decision-making, so it is quick.

Democratic style :

Democratic leadership is suitable for a group who work together. It promotes autonomy, individual growth and sharing of decision-making abilities in the group members.

Laissez –faire style :

In the laissez –faire style, leaders indirectly participate in decision-making. All authority or control is given to the team and they determine goals, make decisions, and may create problem to organization. Leader does little planning and fails to encourage co-workers.

The following are leadership styles displayed by J, R, and the nurse manager:

J displayed autocratic leadership style because she is satisfactory in her work, suggesting decisions to solve the problem, provides strong motivation to co-workers.

R and the nurse manager displayed lassiez –faire leadership style , where R is confused and frustrated as there is no guidance, no goals, and no direction. Whereas nurse manager fails to encourage and motivate the new graduate nurses.

J’s autocratic leadership style makes quick decision as well as effective in work environment. R and nurse manager lassiez-faire leadership style is not an effective leadership as there are no goals and no guidance. This leadership style is often involved in work environment.

J’s leadership is differing from R and nurse manager leadership because the laissez-faire leadership decreases the efficiency of workers. However, the autocratic leadership of J is efficient in work and has more positive attitude in work environment.