What has changed in health care that will make her work different now

Theories in Leadership

Theories in Leadership Case Study 1

approx 30 min

The study described in the Research Perspective (Hauck, Winsett, & Kuric, 2012) was about the introduction of evidence-based practice for a hospital. Rogers’s theory of diffusion of innovation served as the theoretical framework for that study. However, other theoretical perspectives are present. Based on situational-contingency theory, describe factors that the nurse researcher, as the leader of the implementation team, would need to consider. Consider the following:

Question 1

What considerations come into play that are outside of the group targeted for the change initiative? Are there any external stakeholders? What are the internal factors that would drive or limit change from being successful?

Question 2

How do people behave individually and in groups when it comes to adopting a practice-based change? Is there a difference between individual and group behaviors? If so, why does this occur?

 

Question 3

What should the nurse leader do to plan for and address potentially negative attitudes of staff regarding the implementation of evidence-based practice? How should the nurse leader use nurses with positive attitudes toward the implementation of evidence-based practice?

Question 4

How can previous interactions with the nurse leader impact the success or failure of implementing evidence-based practice?

Question 5

What are the resource requirements? What are the regulatory requirement

Influence and Diplomacy Case Study 2

approx 30 min

Ryan graduated from his BSN program about 18 months ago and has been working on a surgical unit in a large Magnet™ hospital. He belongs to his state nurses association and the Academy of Medical-Surgical Nurses (AMSN).

He recently moved to another town for graduate school and took a job in a small community hospital. The new chief nursing officer is trying to create a shared governance structure. The nursing staff seems disinterested in participating in such a governance structure. Some of them complain that they do not want to “think” about nursing beyond what they have to do at the bedside.

Ryan served on the practice council at the hospital where he worked after graduation. The nurses he works with now are discouraging him from volunteering to serve on one of the new councils being formed to implement shared governance. He is frustrated by his colleagues’ lack of interest in participating in decision making about nursing care. He wonders if this is the right place for him to work while in his graduate program. Although this hospital is closely affiliated with the school of nursing where he is a graduate student, the nurses on his unit openly challenge the wisdom of his decision to pursue a graduate degree.

Question 1

What resources should Ryan use to gain support for his desire to participate in the new shared governance structure?

Question 2

If Ryan wants to test the job market to find a position in a more positive nursing work environment, what resources can he use?

Question 3

Ryan has been subjected to a lot of questions and negative comments by some of the senior staff nurses about his graduate studies. They tend to negate the importance of advancing one’s nursing education. How can he redirect their comments?

Evolution of the Nurse Leader Case Study-3

approx 30 min

Margaret Compton, RN, is 52 years old and recently widowed. Her husband died a week after traumatic injuries from a serious fall on a hiking expedition.

Margaret has been out of the work force for 23 years, electing to stay at home and take care of her three children while her husband worked. Her youngest is in his third year of college, and Margaret has realized that she needs to return to the workforce.

During her husband’s hospitalization, Margaret realized that she missed nursing and eagerly looks forward to returning to active practice. She kept her license active all these years, but during her husband’s hospitalization, Margaret saw that much has changed since she left her last nursing position.

Question 1

What specific challenges does Margaret face in returning to the nursing workforce after 23 years?

Question 2

What has changed in health care that will make her work different now?

Question 3

What do you think is the same in nursing over time?

 

Professional Standards for Nursing Leadership Case Study 4

approx 30 min

You are the nurse manager of a busy operating room in a large metropolitan hospital, serving both adult and pediatric clients. A case is scheduled involving a child who will have a hip arthroplasty. The surgical technician usually scheduled for the pediatric cases is unavailable to assist with this case, so you schedule a surgical technician who has assisted with multiple hip arthroplasties but has never performed one on a younger child. After the procedure, the child has permanent damage to his sciatic nerve, and his parents have filed a lawsuit against the surgical technician, you as the nurse manager, and the hospital.

Question 1

How do you suspect that the court will react to such a case?

Question 2

What would their findings likely be in such an instance and why?

Question 3

What could you have done to prevent this outcome?

Professional Standards for Nursing Leadership Case Study 5

approx 30 min

Joe Rodriquez, 19, presents to the hospital Emergency Department with a diagnosis of West Nile virus. He has a fever of 102° F, chills, and generalized aching in all his muscles. He reports that he was recently hiking in a wooded portion of the state and was bitten repeatedly by mosquitoes, despite the fact that he used an insect repellent. He and his parents are informed about this condition, including the need for immediate hospitalization and the treatment plan. Joe refuses to be hospitalized, stating that he will follow all medical recommendations at home. He asks to be assigned a home healthcare nurse to assist with his medical treatment. His parents are totally torn between honoring their son’s wishes and forcing the admission of their son, so that he can receive the needed medical and nursing care.

Question 1

You are the nurse manager for the emergency department, and staff members approach you about this patient. How would you begin to resolve this dilemma?

Question 2

What type of direction would you give staff members to allow them to come to a satisfactory conclusion?

Question 3

How does the Code of Ethics for Nurses (ANA, 2001) provide guidance in reaching needed decisions?

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