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You are the team leader for 10 patients. An experienced LVN/LPN and nurse’s aide are also assigned to the team. It is an extremely busy day, and there is a great deal of work to be done. Several times today, you have found the LVN/LPN taking long breaks in the lounge or chatting socially at the front desk, despite the unmet needs of many patients. On those occasions, you have clearly delegated work tasks and time lines to her. Several hours later, you follow up on the delegated tasks and fi nd that they were not completed. When you seek out the LVN/LPN, you find that she went to lunch without telling you or the aide. You are furious at her apparent disregard for your authority. ASSIGNMENT: What are possible causes of the LVN/LPN’s failure to follow up on delegated tasks? How will you deal with this LVN/LPN? What goal serves as the basis for your actions? Justify your choice with rationale.

 

 
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You are one of a group of staff nurses who believe that part of your job dissatisfaction results from being assigned different patients every day. Your unit uses a system of total patient care, and the head nurse makes assignments. Two staff nurses have gone to the head nurse and requested that each nurse be allowed to pick his or her own patients based on the previous day’s assignment and the ability of the nurse. The head nurse believes that the staff nurses are being uncooperative because it is the head nurse’s responsibility to see that all the patients get assigned and receive adequate care. Although continuity of care is the goal, many part-time nurses are used on the unit, and not all the nurses are able to care for every type of patient. At the end of the conference, the two nurses are angry, and the head nurse is irritated. However, the next day, the head nurse indicates willingness to meet with the staff nurses. The other nurses believe this is a sign that the head nurse is willing to negotiate a compromise. They plan to get together tonight to plan the strategy for tomorrow’s meeting. ASSIGNMENT:  What are the goals for each party? What could be a possible hidden agenda for each party? What could happen if the conflict escalates? Devise a workable plan that would accomplish the goals of both parties, and develop strategies for implementation (see the Appendix for an analysis of these problems).

 

 
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You are a woman who is a unit manager with a master’s degree in health administration. You are about to present your proposed budget to the CEO, who is a man. You have thoroughly researched your budget and have adequate rationale to support your requests for increased funding. Because the CEO is often moody, predicting his response is difficult. You also are aware that the CEO has some very traditional views about women’s role in the workplace, and generally this does not include a major management role. Because he is fairly paternalistic, he is charmed and flattered when asked to assist “his” nurses with their jobs. Your predecessor, also a woman, was fi red because she was perceived as brash, bossy, and disrespectful by the CEO. In fact, the former unit manager was one of a series of nursing managers who had been replaced in the last several years because of these characteristics. From what you have been told, the nursing staff did not share these perceptions. You sit down and begin to plan your strategy for this meeting. You are aware that you are more likely to have your budgetary needs met if you dress conservatively, beseech the CEO’s assistance and support throughout the presentation, and are fairly passive in your approach. In other words, you will be required to assume a traditionally feminine, helpless role. If you appear capable and articulate, you may not achieve your budgetary goals and may not even keep your job. It would probably not be necessary for you to continue to act this way, except in your interactions with the CEO. ASSIGNMENT: Are such behavioral tactics appropriate if the outcome is desirable? Are such tactics simply smart negotiation, or are they destructively manipulative? What would you do in this situation? Outline your strategy for your budget presentation, and present rationale for your choices.

 

 
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You are the supervisor of a rehabilitation unit. Two of your youngest female nursing assistants come to your office today to report that a young male paraplegic patient has been making lewd sexual comments and gestures when they provide basic care. When you question them about their response to the actions of the patient, they maintain that they normally simply look away and try to ignore him, although they are offended by his actions. They are reluctant to confront the patient directly. Because it is anticipated that this patient may remain on your unit for at least a month, the nursing assistants have asked you to intervene in this conflict by either talking to the patient or by assigning other nurses’ responsibility for his care. ASSIGNMENT: How will you handle this staff–patient conflict? Is avoidance (assigning different staff to care for the patient) an appropriate conflict resolution strategy in this situation? Will you encourage the nursing assistants to confront the patient directly? What coaching or role playing might you use with them if you choose this approach? Will you confront the patient yourself? What might you say?

 

 
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