Caring for Older Adults Holistically, 4th Edition Chapter Eleven The Management Role of the Licensed Practical/Vocational Nurse

Caring for Older Adults Holistically, 4th EditionCaring for Older Adults Holistically, 4th Edition

Chapter ElevenChapter Eleven

The Management Role of the Licensed

Practical/Vocational Nurse


Management RolesManagement 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


Management StylesManagement 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



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



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


CommunicationCommunication

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



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



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



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



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



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


Additional Communication SkillsAdditional 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”


Additional Communication SkillsAdditional 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


Planning HoopPlanning 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



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



Implementation Performance of plan

Evaluation Plan must be evaluated for its effectiveness

Crisis management Occurs when manager does not take the time

to plan


Priority SettingPriority 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


Managing PersonnelManaging 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



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



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



Employee evaluation (cont.) Should avoid

Leniency error Recency error Halo error

Evaluation process is critical to the growth and stability of the organization


Making Care AssignmentsMaking 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



Use Benner’s From Novice to Expert theory to assess CNAs’ skills Novice Advanced beginner Competent Proficient Expert



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



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



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



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


Managing Quality of CareManaging Quality of Care

Joint Commission on Accreditation of Hospitals (JCAH)

American Nurses Association National League of Nursing Total Quality Management (TQM)

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Caring for Older Adults Holistically, 4th Edition Chapter Eleven The Management Role of the Licensed Practical/Vocational Nurse