A nurse manager is interested in supporting more involvement of ...

[madam-professor]

A nurse manager is interested in supporting more involvement of the staff nurses on the unit. What is one approach the nurse manager can take to facilitate this involvement?
 
  a. Inform the staff of decisions made.
  b. Use decentralized management.
  c. Avoid unit goals.
  d. Discourage input from other personnel.

Question 2

The nurse is caring for a 34-year-old woman, who was admitted to the hospital with multiple rib fractures. The patient states, I fell down the stairs. It was all my fault. I can be so stupid at times.
 
   The nurse notices healing bruises on the patient's back and buttocks. The patient's husband seems very caring, always holding her hand and often answering questions for her. The nurse should do which of the following? a. Direct her questions toward the husband because he answers most of them anyway.
  b. Accept the patient's report on how she received her broken ribs.
  c. Ask the husband to step into the waiting room while the patient is examined.
  d. Treat the patient's wounds and discharge her home.

[upturnedfurball]

Answer to Question 1

B
Decentralized management, in which decision making is made at the staff level, is very common within health care organizations. Advantages of decentralization include increased morale and improved interpersonal relationships among staff. Staff members feel more important and are more willing to contribute. The staff should be making the decisions, not being informed of decisions made. To make decentralized decision making work, managers need to move it down to the staff level. On a nursing unit it is important for all staff members (RNs, LPNs, and LVNs), nursing assistive personnel (NAP), and unit secretaries to feel involved, particularly with issues affecting their ability to care for patients. One of the responsibilities of a nurse manager is to help the staff establish annual goals for the unit. Avoiding unit goals will decrease involvement, not increase the participation.

Answer to Question 2

C
If you suspect abuse, interview the patient privately. A patient will probably not admit to problems of abuse with the abuser present. Sexual abuse, assault, and rape are also stressors that affect self-concept. Be alert to clues that suggest abuse. In addition, observe the interaction between the patient and partner for additional clues. Controlling behaviors such as speaking for the person or refusing to leave him or her alone with a caregiver are suggestive of emotional and perhaps physical or sexual abuse.