Download Caring for Older Adults Holistically, 4th Edition Chapter Eleven The

Caring for Older Adults Holistically, 4th Edition
Chapter Eleven
The Management Role of
the Licensed
Practical/Vocational
Nurse
Caring for Older Adults Holistically, 4th Edition
Management Roles
 Management role of LPNs changes constantly
 Work of LPN always involves leadership skills
 Always clarify the scope of responsibility and role
expected to be fulfilled
Caring for Older Adults Holistically, 4th Edition
Management Styles
 Everyone has a personal management style
 Determine an effective but flexible leadership
style
 Authoritarian
 High concern for tasks done
 Low concern for the people who perform those
tasks
 Make all decisions in work place
Caring for Older Adults Holistically, 4th Edition
Management Styles
 Authoritarian
 Does not allow for creative thinking or new ideas
 This management style is good in emergency
situations
 Permissive or laissez-faire
 Exact opposite of the authoritarian style
 Consists of an absence of leadership
 Does not require employee accountability
Caring for Older Adults Holistically, 4th Edition
Management Styles
 Democratic or participative
 Strong valuing of the people on the team
 Gathers information from other team members
 Identifies individual responsibilities
 Takes more time than other management styles
Caring for Older Adults Holistically, 4th Edition
Communication
 Important skill for a manager
 Verbal communication
 Change of ideas and understanding through
spoken words
 Nonverbal communication
 Ability to share messages without using words
 Body posture, facial and hand expressions
Caring for Older Adults Holistically, 4th Edition
Communication
 Communicating with clients
 Normal aging changes that affect communication
 Slower speech, presbycusis, presbyopia, slower
responses
 Successful communication with older adults must
be based on respect for them as people
Caring for Older Adults Holistically, 4th Edition
Communication
 Communicating with clients (cont.)
 Strategies
 Do not approach the person from the side
 Place yourself on eye level
 Reach out and touch the person if appropriate
 Speak at a normal rate
 Choose setting without disturbing or distracting
noises
Caring for Older Adults Holistically, 4th Edition
Communication
 Strategies (cont.)
 Repeat questions or comments
 Listen carefully
 Communicating with the families
 Recognize the emotional environment of the family
 Listen to them before you begin providing
information
 Spend time with family members
Caring for Older Adults Holistically, 4th Edition
Communication
 Communicating with the families (cont.)
 Find a quiet place to talk
 Facilitate the sharing of information from other
health-care providers
 Families are as important as the person
Caring for Older Adults Holistically, 4th Edition
Communication
 Interdisciplinary team communication
 Important to have effective communication between
team members
 Be prepared to discuss information with team
 Be ready to justify your concerns or requests
 Nurse is patient advocate
Caring for Older Adults Holistically, 4th Edition
Additional Communication Skills
 Assertive communication skills
 Assertive behavior is the most effective response
 Assertive response must not violate the rights of
another person
 Use statements “I feel,” “When you,” “We should”
Caring for Older Adults Holistically, 4th Edition
Additional Communication Skills
 Active listening
 Requires listening to what is being said
 Do not prepare a defense
 Show support for other person’s feelings
 Clarify the problem and negotiate a solution
Caring for Older Adults Holistically, 4th Edition
Planning Hoop
 Planning process never ends
 Planning is an intelligent process of thinking
based on facts and information
 Plan must always be re-evaluated
 Planning process consists of assessment, goal
setting, implementation, evaluation
Caring for Older Adults Holistically, 4th Edition
Planning Hoop
 Assessment
 Identify problem or potential problem that concerns
you
 Determine what knowledge is lacking
 Goal setting
 Preparing a plan to resolve a management problem
 Goals should be meaningful and carefully
thought out
Caring for Older Adults Holistically, 4th Edition
Planning Hoop
 Implementation
 Performance of plan
 Evaluation
 Plan must be evaluated for its effectiveness
 Crisis management
 Occurs when manager does not take the time
to plan
Caring for Older Adults Holistically, 4th Edition
Priority Setting
 Priority is determined after assessment of the situation
 Need to think of the entire organization when determining
priorities
 Two categories
 Concerns that relate to patient or resident care
 Concerns that relate to the process of running the
business of the institution
 Concerns need to be listed as a need or a want
Caring for Older Adults Holistically, 4th Edition
Managing Personnel
 Nurse manager is responsible for hiring and
evaluating employees
 Interview
 Exchange of information
 Determine applicants
 Dependability, skills, willingness to assume
responsibilities, adaptability, willingness and ability to
work with others
Caring for Older Adults Holistically, 4th Edition
Managing Personnel
 Interview (cont.)
 Be specific and direct in your comments
 Develop interview guide
 Employee evaluation
 All organizations have an established process for
evaluating employees
 First evaluation may come at 3 months,
6 months, or 12 months
Caring for Older Adults Holistically, 4th Edition
Managing Personnel
 Employee evaluation (cont.)
 Based on the five basic assumptions
 Assist employee to improve the management of
the workload
 Employee appraisal is a difficult process
 No one likes the current form; a perfect form does not
exist
 Information must be gathered on day-to-day
basis
 Appraisal made by supervisor
Caring for Older Adults Holistically, 4th Edition
Managing Personnel
 Employee evaluation (cont.)
 Should avoid
 Leniency error
 Recency error
 Halo error
 Evaluation process is critical to the growth and
stability of the organization
Caring for Older Adults Holistically, 4th Edition
Making Care Assignments
 Making effective assignments is critical to any
clinical area
 Successful care assignments match the worker
with the older person in a manner that allows for
the best nursing care to be administered and
received
 When making assignments, consider skills of
employees
Caring for Older Adults Holistically, 4th Edition
Making Care Assignments
 Use Benner’s From Novice to Expert theory to
assess CNAs’ skills
 Novice
 Advanced beginner
 Competent
 Proficient
 Expert
Caring for Older Adults Holistically, 4th Edition
Making Care Assignments
 The novice CNA also should be assigned to an
expert CNA who can assist with care when
needed
 Expert CNAs should be assigned to the most
challenging older adults
 More effective to assign the same employee to an
older person for several days in succession
Caring for Older Adults Holistically, 4th Edition
Making Care Assignments
 Delegation
 Goal is to delegate tasks while maintaining quality
patient and resident care
 Familiarize yourself with the Nurse Practice Act for
the state where you work
 Become familiar with the policy and procedures
and job descriptions for your facility
Caring for Older Adults Holistically, 4th Edition
Making Care Assignments
 Delegation (cont.)
 Five rights of delegation
 Right task
 Right circumstance
 Right person
 Right direction
 Right supervision
 Delegate routine work that can be done by
someone else
Caring for Older Adults Holistically, 4th Edition
Making Care Assignments
 Providing education to employees
 Assist with continuing education of employees
 Assist with increasing and maintaining the skills of
the employee
 Provide adequate orientation to new employees
 Provide mentoring program for new employees
Caring for Older Adults Holistically, 4th Edition
Managing Quality of Care
 Joint Commission on Accreditation of Hospitals
(JCAH)
 American Nurses Association
 National League of Nursing
 Total Quality Management (TQM)