HESI RN Leadership Exam

HESI RN Leadership Exam

VERSION 3

• #1 thing to remember

about negative feedback Unsatisfactory work must be acknowledged and discussed

• 2 biggest/worst actions

that lead to malpractice lawsuits Altering/falsifying a medical record, violation of an internal or external standard of practice

• 2 out of 3 people leave a

job because of this Ineffective/incompetent management

• 2 types of change Planned/Managed, Unplanned/Reactive
• 2 types of resistance to

change Active resistance and passive resistance

• 2 ways to be an

emotionally stable leader

• Recognize and understand your own emotions,

learn to manage them, stay calm and clear headed.

• Listen to others, perceive unspoken concerns,

acknowledge others perspectives, helpful

• 3 qualifications for RN

licensure in the USA Graduate from an approved RN program, english language proficiency, disclosure of criminal convictions

• 3 quality behaviors of

effective nurse managers?Interpersonal, decisional and informational behaviors along with leadership, business sense and clinical expertise

• 3 stages of lewins theory

of change Unfreeze(take out of comfort zone), Change(discomfort), Refreeze(new comfort zone)

• 3 types of liability Personal, vicarious, employer/corporate
• 4 stages of burnout 1. high expectations and idealism, 2. pessimism

and early job dissatisfaction, 3. withdrawal and isolation 4. irreversible detachment and loss of interest

• According to JCAHO

what is the reason for a large number of sentinel events that occur?Communication deficits among health care providers

• According to Rogers

what are typical innovators, early adapters, early majority, late majority, laggards and rejectors.

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responses to change?

• Advice for giving

feedback Give both negative and positive, give immediately, give frequently, give negative feedback in private, base it on observed behavior, include suggestions for change.

• AKA - Bottling emotions

(inappropriate way of dealing reality shock) Rutter

• These are activities that

an RN may NOT delegate Initial and follow up assessments, decisions and judgements about client plan of care, interventions that require professional RN knowledge or skills, decisions/judgements needed to evaluate care

• These are clinical

protocols involving all disciplines Critical pathways

• These are established

guidelines for the nursing profession to ensure quality of care Nursing Standards

• are

influenced by values Choices

• These are non life

essential values (things, people, ideas, kindness, and understanding) Extrinsic values

• These are offenses

committed against state laws Criminal acts

• These are organized

thoughts about why people exist in the universe Beliefs

• Behaviors at risk for

violence History of violent behavior, delusions paranoia suspicion, aggression, threats, rapid speech, anger, stiff posture, clenched fists, ETOH/drug use, male or youth, unrealistic policies/procedures 2 / 3

• Causes of reality shock Culture shock (expectations distorted with reality),

incongruent school values and work values, lack of support, lack of a mentor

• Choices to resolve

conflict Avoid it, accommodate, compete, compromise, collaborate

• Common actions

leading to malpractice lawsuits Fail to assess properly, fail to report changes in pt status, fail to document, fail to obtain informed consent, fail to report co-worker negligence, fail to provide adequate education * TWO BIGGEST* Altering/falsifying a medical record and Violation of an internal or external standard of practice

• Common causes of

negligence Client falls, equipment injuries, failure to monitor, failure to communicate, medication errors, medical errors

• Common mistakes

made during change implementation Failure to make need for change clear, unclear goals, too little time, poor leadership, insufficient coordination of the change process, insufficient education, dismissing complaints

• The CQI program

evaluates what 3 things?

1.Structure within which care is given, 2. the process of giving the care 3. the outcome of that care

• Describe the traditional

organizational structure Tall and narrow chain of command - Employees ranked top to bottom with the number on bottom greater than the top, authority is at the top only, power is distributed, communication is a challenge because of all of the layers of power

• Dont's of feedback Focus on negatives, let personalities intrude, be

vague, play favorites, correct people publicly

• Do's and Don'ts for

managing diversity Do - recognize it, value it and develop support for it, Ensure fairness, make all of the above part of your philosophy. Don't- pretend all are alike, expect everyone to conform, seek quick solutions, develop different performance standards, expect one workshop/meeting to solve it.

• Do's of feedback Include positive comments, be objective, be

specific, treat everyone the same, correct people privately

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