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Jones & Bartlett Learning
Leadership In Nursing Practice / Edition 2

Leadership In Nursing Practice / Edition 2

by Tim Porter-O'Grady, Kathy Malloch


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Product Details

ISBN-13: 9781284075908
Publisher: Jones & Bartlett Learning
Publication date: 02/11/2015
Edition description: Older Edition
Pages: 598
Sales rank: 102,400
Product dimensions: 6.90(w) x 8.80(h) x 0.50(d)

About the Author

Senior Partner, Tim Porter-O'Grady Associates, Inc., Atlanta, Georgia, Professor of Practice, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, Clinical Professor, Leadership Scholar, Ohio State University College of Nursing, Columbus, Ohio

Professor of Practice, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, Clinical Professor, Ohio State University College of Nursing, Columbus, Ohio, Clinical Consultant, API Healthcare Inc., Hartford, Wisconsin

Table of Contents

Foreword xv

Preface xvii

Acknowledgments xx

Reviewers xxi

Chapter 1 Change and Innovation

Dynamics of Change and Innovation 6

Who, Why, When, and How of Change 7

Strategies to Minimize Risk in Change and Innovation Scenarios 24

Making Change and Innovation Happen 28

Caveat: Technology, Change, and the Human Element 30

Caveat: Measuring the Impact of Change and Innovation (What Problem Are You Fixing?) 31

Managing Resistance to Change 33

Course Correction 34

Leading and Managing 35

Appendix A Change Considerations: Scanning, Reflecting, and Integrating 41

Chapter 2 Becoming a Professional Nurse

The Elements of a Profession 44

The Ethical Foundations of a Profession 51

Shared Governance and Creation of a Professional Infrastructure 54

The Use of Language Characterizing Professional Dialogue 61

Personal Presentation of the Professional Self 62

Interactions with Other Disciplines 64

The Public and Policy Role of the Nursing Profession 68

Nursing and Trans disciplinary Partnership 72

I Am the Profession 73

Appendix A Extinguishing Childlike Behaviors in the Professional Nursing Staff 81

Appendix B The Professional Is a Cocreator 84

Chapter 3 Person of the Leader: The Capacity to Lead Self Knowledge 88

The Continuous Journey of Becoming 89

The Leadership Mirror 91

Leaders Versus Managers 93

The Personal Attributes of Leaders 96

Courage and Leadership 99

Leaders Engage Stakeholders 103

The Leader Stays in the Question 104

Recognizing Personal Needs for Self Development 107

Personal Transparency and Openness 112

Appendix A Old Versus New Leadership Skills 122

Appendix B Checking off Basic Leadership Attributes 122

Appendix C More Leader Core Behaviors 123

Appendix D What Staff Want from Their Leader 123

Appendix E Leadership 124

Chapter 4 Conflict Skills for Clinical Leaders The Early Engagement of Conflict 130

Looking for the Signs 131

Personal Comfort with Conflict 136

Trust: Creating a Safe Space for Positive Conflict 137

The Need for a Just Environment 137

Fully Sharing Information 138

Alienation Between Colleagues: What Happens When It Is Allowed to Flourish 139

Overcoming Personal Barriers to Engaging Conflict 140

Handling Conflict 143

The Norm of Conflict 155

Appendix A A Brief Conflict Skills Assessment 161

Chapter 5 Staffing, Scheduling, and Patient Care Assignments: Models, Components, and Measures of Effectiveness

The Foundation: Patient Care Delivery Model 165

Identifying Patient Care Needs 167

Measuring Human Work 172

Patient Classification Systems: Limitations and Challenges 175

Core Schedule 178

Evaluation of Workforce Management 187

Leading Versus Managing in Staffing and Scheduling: Concluding Thoughts 189

Appendix A Selected Staffing Effectiveness Research Evidence 196

Appendix B Perfect Staffing 199

Chapter 6 Principles of Ethical Decision Making The Basics 204

Ethical Issues and Challenges 209

Strategies to Address Ethical Issues 217

Concluding Thoughts 223

Ethics Discussion Scenarios 223

Appendix A Selected Healthcare Ethics Resources 234

Appendix B Common Barriers to Effective Relationships 235

Chapter 7 Leadership: The Foundation of Practice Partnership The Importance of Teams in Interdisciplinary Practice 238

Team Construction 241

Team Fables 248

Team Progress 255

When the Problem Is a Team Member 258

Collaboration 259

Decisions 260

Creating Equity: Overcoming the Uneven Table 261

Interdisciplinary Alignment 265

Focus on the Team Leader 266

Virtuality and Team Performance 268

Concluding Thoughts 270

Appendix A Sample Techniques for Team Decision Making 277

Appendix B Team-Based Decision-Making Process 278

Appendix C Keeping the Team Focused 278

Appendix D Some Dos and Don'ts of Team Leadership 279

Appendix E Creating Team Infrastructure 280

Appendix F Considerations for Team Effectiveness 280

Chapter 8 Resources for Healthcare Excellence

Basic Economics Are Not So Basic: Price, Demand, and Supply Complexities 284

Resource Categories: Human, Fiscal, Material, Technology, and Time 289

Value Measurement: Productivity, Quality and Volume 296

Basics of Budgeting 301

Dashboards and Measures 302

Variance Management 306

Concluding Thoughts: The Role of the Clinical Nurse Leader in Resource Management 310

Appendix A Common Financial Reports 316

Appendix B Staffing Effectiveness: Scorecard 317

Appendix C Evolving Metrics 318

Chapter 9 Navigating the Care Network: Creating the Context for Professional Practice

Complex Adaptive Systems 324

Placing Power Where the Action Is 327

Understanding How Clinical Work Changes 328

Transforming the Nature of Clinical Work 329

From a Medical Model to a Health Model 332

Ending Medical Separatism 332

Value-Driven Health Care 333

Elements of a New Kind of Structure 336

The Premises of Professional Shared Governance in Health Care 342

The Individual and the Organization 345

Appendix A Shared Decision-Making Requisites 357

Appendix B Shared Governance Staff Assessment Instrument 363

Appendix C Survey of Shared Leadership Practices 366

Chapter 10 Managing Your Career: A Lifetime of Opportunities and Obligations

Transition to Practice 378

Career Trajectories 380

Interviewing for New Roles 385

Continuing Competence 386

Course Correction: Life After Discipline 394

Excellence Versus Perfection 395

Personal Balance and Health 395

Exercise, Nutrition, and Role Modeling 397

Contributing to the Profession 397

Additional Thoughts 404

Appendix A Writing for Publication 410

Chapter 11 Policy, Legislation, Licensing, and Professional Nurse Roles

Key Concepts 415

The Policy Continuum: Local to National 416

Contemporary Healthcare Policy Issues and Initiatives 417

Professional Nursing Role and Policy 424

Final Thoughts on Policy 427

Appendix A Selected Resources for Healthcare Policy 432

Chapter 12 Delegation and Supervision: Essential Foundations for Practice

Delegatton: Definitions and Key Concepts 437

Steps of the Delegation Process: Roles of the Delegator and the Delegate 439

Protecting Your License: Nursing Liability for Delegation 444

The Challenges of Delegation 444

Strategies to Support Effective Delegation 447

Final Thoughts 448

Appendix A Joint Statement on Delegation: American Nurses Association and National Council of State Boards of Nursing 452

Appendix B Delegation Assessment: Why Don't I Willingly Delegate or Accept Delegated Tasks? 453

Appendix C Process of Delegation 453

Chapter 13 Overcoming the Uneven Table: Negotiating the White Waters of the Profession Principles and Basic Skills of Negotiating 456

Give and Take: The Principles of Exchange 458

Stages of Negotiation 459

The Clinical Leader and the Unique Characteristics of Collective Bargaining 475

Negotiating the Profession 480

Appendix A Negotiation Skills Assessment 487

Chapter 14 Accountability and Ownership: The Centerpiece of Professional Practice

The Professionalization of Nursing in the 20th Century: The Path to Accountability 492

Maturing the Profession: The Age of Accountability 494

Accountability and Ownership 496

The Cycle of Personal Accountability 501

Accountability in Action 502

Individual Role Accountability and Team Performance 504

Delineating Professional Work and Accountability 506

From Process to Outcome Focus 509

Accountability Is About Adding Value 513

The Individual, Creativity, and Accountability 514

Accountability and the Engagement of Risk 519

Accountability and Performance 523

Appendix A Individual Role Accountability and Team Performance 532

Appendix B Fitting Individual and Team Goals Together 533

Appendix C Creating a Culture of Accountability 534

Appendix D Revisiting Invitation and Expectation 534

Appendix E Responsibility Versus Accountability 535

Appendix F Accountability and Impact 536

Appendix G Role Clarity and Accountability Model 537

Appendix H Accountability and Locus of Control 538

Appendix I Ownership: The Center of Accountability 539

Appendix J Volume Versus Value 540

Appendix K Some Risk-Dealing Rules of Engagement 541

Chapter 15 Integrating Learning: Applying the Practices of Leadership

In the Era of Health Transformation 544

The Context of Healthcare Reform 544

The Management of Conflict 547

The Centrality of Accountability 548

Structure, Organizations, and Professionals: Creating the Context for Practice 550

Resource Management in Health Care 553

Ethical Behaviors 554

Staffing Effectiveness 554

Change and Innovation 555

Policy Making 556

Delegation 556

Career Management 556

Concluding Thoughts 557

Appendix A Exercise in Leadership: Advancing Evidence Based Practice 559

Appendix B Exercise in Leadership: Increasing Capacity 561

Appendix C Exercise m Leadership: Clinical Technology Management 562

Glossary 565

Index 571

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