NR 446 Edapt Week 1

Student Name

Chamberlain University

NR-446 Collaborative Healthcare

Prof. Name

Date

Collaborative – Week 1 Key Concepts

Differences Between Leaders and Managers

Leaders and managers often function in overlapping roles, but their approaches and primary focuses differ significantly. Leaders are typically visionaries who paint a compelling picture of the future, motivating others to work collectively toward that vision. They prioritize team collaboration and emphasize shared goals, inspiring members to contribute to a higher purpose. Leaders believe that united teams can achieve results beyond what individuals might accomplish alone.

In comparison, managers concentrate on executing organizational objectives through structured processes. Their role is more task-driven, focusing on efficiency, resource coordination, and accountability. Managers ensure that policies are followed, deadlines are met, and resources such as finances, staff, and time are optimized to achieve measurable goals. While leaders emphasize vision and innovation, managers ensure operational stability and consistency.

Varied Leadership Roles

Leadership in nursing encompasses multiple roles that go beyond directing others. Nurses who act as leaders may serve as counselors, mentors, or advocates, ensuring that patients and colleagues receive both guidance and support. They may also take on roles such as evaluators or facilitators, ensuring processes run smoothly while empowering others to participate.

Below is a list of common leadership roles:

Counselor
Teacher
Critical Thinker
Buffer
Advocate
Visionary
Director
Decision Maker
Communicator
Evaluator
Facilitator
Risk Taker
Mentor
Energizer
Priority Setter
Coach

Each of these roles enhances team performance and patient outcomes by addressing different dimensions of leadership.

Leadership Theories

Leadership theories provide frameworks for understanding how leaders influence and interact with teams. The three most recognized leadership styles are:

Authoritarian Leadership

This style involves leaders making decisions independently without considering staff input. It relies heavily on rules, commands, and sometimes negative reinforcement. Although often criticized for being rigid, it can be beneficial in emergency situations where swift decision-making is essential.

Democratic Leadership

Democratic leaders promote inclusivity by encouraging staff participation in decision-making. This style fosters accountability, shared responsibility, and collaborative problem-solving, which enhances team morale and trust.

Laissez-Faire Leadership

Leaders practicing this style adopt a hands-off approach, allowing staff to make most decisions. While it can foster independence, it may lead to disorganization, minimal innovation, and reactive rather than proactive changes in patient care.

Understanding Emotional Intelligence (EI)

What is Emotional Intelligence (EI)?
Emotional Intelligence refers to the ability to recognize, regulate, and manage one’s own emotions while understanding the emotions of others. In nursing, EI improves teamwork, communication, and conflict resolution. A nurse with strong EI can de-escalate stressful situations, build trust with patients, and contribute positively to a healthy work environment.

Delegation in Nursing

Delegation is a vital skill in nursing that ensures tasks are appropriately distributed among team members while maintaining accountability.

The Five Rights of Delegation

Right	Example
Task	Assigning the measurement of vital signs to a nursing assistant.
Circumstance	Avoid delegating critical care tasks, such as managing unstable patients.
Person	Delegating only to staff members competent for the specific task.
Direction	Giving clear, precise instructions (e.g., check vitals in Room 5 in 15 min).
Supervision	Monitoring performance and providing feedback (e.g., hand hygiene practice).

Delegating vs. Assigning

Delegating: Involves transferring the authority to perform specific nursing activities to a competent individual while the nurse retains accountability. For example, RNs and LPNs may delegate tasks to Unlicensed Assistive Personnel (UAP).
Assigning: Involves designating tasks to individuals who are already qualified to perform them. RNs may assign duties to other RNs or LPNs, while LPNs may assign to fellow LPNs.

Supervising and Accountability

Supervision: Directing, observing, and evaluating tasks performed by others.
Accountability: Accepting responsibility for one’s own actions. While nurses remain accountable for their delegations, staff members are responsible for carrying out assigned tasks correctly.

Seven Rights of Medication Administration

When administering medication, nurses must adhere to these rights:

Right Patient
Right Drug
Right Dose
Right Time
Right Route
Right Reason
Right Documentation
Right to Refuse

Managing Medication Errors

What should a nurse do first after a medication error?
The nurse’s immediate responsibility is to assess the patient for any injury or adverse reaction and provide urgent care if needed. Subsequent steps include notifying the provider, documenting the error, and completing an incident report to prevent future occurrences.

Minimum Requirements for a Medication Order

For safety and validity, a medication order must include:

Patient’s full name
Date and time of the order
Medication name
Dosage prescribed
Form of medication
Route of administration
Frequency or time of administration
Prescriber’s signature

Transcribing Orders

Verbal Orders: Used in emergencies when physicians cannot write themselves. Must be documented with date, time, physician’s name, and nurse’s signature.
Telephone Orders: Given when a physician cannot be present but immediate intervention is required. They must also include date, time, physician’s name, and transcriber’s signature.

Understanding the State Nurse Practice Act

The Nurse Practice Act defines the scope of nursing practice and varies by state but must comply with federal law. Violations can lead to disciplinary actions, including suspension or revocation of licensure.

Scope of Nursing Interventions

Exclusive to RNs

Initial assessments
Patient education
Developing care plans
Blood transfusions
Initiating IV fluids
Performing neurological scales (e.g., Glasgow Coma Scale)

Shared by RNs and LPNs

Tracheostomy care
Wound care
Suctioning
Urinary catheter insertion
Medication administration
Collecting sterile specimens

Delegated to UAP

Activities of daily living (ADLs)
Ambulation and transfers
Feeding stable patients
Taking non-sterile specimens
Recording intake/output
Bathing and positioning

Delegation Worksheet

Task	RN	LPN	UAP
Activities of daily living			✔
Transfers/ambulation	✔	✔	✔
Tracheostomy care	✔	✔
Suctioning	✔	✔
Feeding	✔	✔	✔
Vital signs	✔	✔	✔
Inserting urinary catheter	✔	✔
Administering medications	✔	✔

SBAR Communication

SBAR provides a structured method for delivering urgent information:

Situation: State your name, patient’s name, and the issue.
Background: Provide relevant medical history and context.
Assessment: Summarize the patient’s condition and problem.
Recommendation: Suggest next steps or treatment options.

Effective Change of Shift Reports

The most effective form is a bedside report, which allows patients to participate and fosters transparency between care providers.

Discharge Planning

Discharge planning starts at admission and ensures a smooth transition to home or another care setting.

Role of the Case Manager

Case managers coordinate resources, arrange referrals, and ensure patients’ long-term care needs are met.

Critical Pathways in Patient Care

Critical pathways are standardized care plans that outline expected recovery timelines for patients with similar diagnoses. They improve efficiency and promote consistency in care delivery.

Interdisciplinary Team Functions

Professional	Role
Registered Nurse (RN)	Direct care, assessments, coordination
Medical Doctor (MD)	Diagnosis and treatment planning
Speech Pathologist	Manages speech and swallowing disorders
Wound Care Nurse	Provides specialized wound care management
Dietitian	Assesses and develops nutrition plans
Occupational Therapist	Promotes independence in daily living activities
Physical Therapist	Improves physical mobility and musculoskeletal health
Chaplain	Provides spiritual and emotional support
Social Worker	Assists with access to care, housing, and community resources
Case Manager	Oversees continuity of care and resource management

Considerations as a Charge Nurse

Charge nurses must evaluate patient needs, acuity levels, and staffing availability. Factors include:

Patient status and monitoring requirements
Mental health or cognitive impairments
Specialized equipment needs
Infection control (e.g., isolation rooms)

When assigning float nurses, it is important to consider their background experience, familiarity with the unit, and ability to manage patient ratios effectively.

Priorities as a Float Nurse

Float nurses should:

Familiarize themselves with the unit’s specialty
Identify supply and medication areas
Learn patient ratios and protocols
Locate emergency equipment (e.g., crash cart)
Connect with the charge nurse for orientation

Conclusion

Nursing leadership and management, while distinct, are interdependent in creating a safe and efficient healthcare environment. By understanding leadership theories, emotional intelligence, effective delegation, and structured communication, nurses can enhance patient care outcomes and foster collaboration within interdisciplinary teams.

References

American Nurses Association. (n.d.). Nursing: Scope and standards of practice. Retrieved from https://www.nursingworld.org

Bishop, M. (2020). Leadership in nursing practice. Journal of Nursing Management, 28(5), 1050–1058. https://doi.org/10.1111/jonm.12838

NR 446 Edapt Week 1

Smith, L. (2019). Emotional intelligence and its impact on nursing leadership. Nursing Management, 50(8), 26–32. https://doi.org/10.1097/01.NUMA.0000553708.52239.02