You walk into Mr. Smith's room and find him yelling at the LPN, ...

[clmills979]

You walk into Mr. Smith's room and find him yelling at the LPN, Miss Jones. He is obviously very upset and after you speak with him regarding his behavior, you determine that he has not slept for three nights because of unrelieved pain levels.
 
  The LPN is very upset with Mr. Smith and calls him an ugly, old man. You acknowledge her feelings and concerns and then suggest that Mr. Smith's behavior was aggressive but is related to lack of sleep and to pain. You say to Miss Jones, Can you both, together with Mr. Smith, determine triggers for the pain and effective approaches to controlling his pain? This approach demonstrates:
 
  a. Lack of empathy and understanding for Miss Jones.
  b. Concern with placating Mr. Smith.
  c. Leadership behavior.
  d. Management behavior.

Question 2

The chief nursing officer has asked the staff development coordinator to facilitate the development of a clinical competency program for the facility.
 
  While making rounds on the units, the staff development coordinator overhears RN staff complaining that they feel it is insulting to be required to participate in a competency program. Which behavior by the staff development coordinator is most appropriate in this situation?
 
  a. Disregard staff concerns and continue with development of the program.
  b. Inform the nurses that this program is a requirement for JCAHO accreditation.
  c. Schedule a meeting with the chief nurse executive to apprise her of the situation.
  d. Facilitate a meeting so nurses can articulate their values and concerns about a competency program.

[kthug]

Answer to Question 1

ANS: C
The situation between Mr. Smith and Miss Jones is a complex situation involving unrelieved patient symptoms and aggressiveness toward a staff member. Providing engaged, collaborative guidance and decision making in a complex situation where there is no standardized solution reflects leadership.

Answer to Question 2

ANS: D
The manager role involves guiding others through a set of derived practices that are evidence-based and known to satisfy preestablished outcomes such as participation in a competency program. This involves engagement of staff through sharing of concerns and ideas. A close analysis of the IOM report and the summary of the PPACA suggests that no health reform can unfold without active nursing engagement. Each document emphasizes that nurses must lead, manage, and behave as active collaborators with other members of the health team and with those being served.