Time managemnet Time Management Assignment 1. What is the definition of time management and what is included in someone who optimizes their time m -

Time managemnet

Time Management Assignment

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Time managemnet Time Management Assignment 1. What is the definition of time management and what is included in someone who optimizes their time m

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1. What is the definition of time management and what is included in someone who optimizes their time management?
2. What are the major symptoms related to poor time management?
3. What are the three basic evaluation steps into planning so that reprioritization can occur?
4. Identify 5 relevant interventions that can be taken to mitigate internal/external time-wasting activities?
5. Identify daily planning actions that can be taken to maximize time management?
6. Describe the priority setting in clinical settings where decisions need to be made for patient care (As in ATI)
7. Name three ways nurses establish priorities in nursing practice (as in ATI)
8. Define and describe Time Management as a cyclic process Chapter 9

Time Management

Learning Objectives
1. Describe the importance of allowing adequate time for daily planning and priority setting (Text p 212)
2. Complete tasks according to the priority level they have been assigned whenever possible (Text p 212)
3. Build evaluation steps into planning so that reprioritization can occur (Text p 213)
4. Identify common internal and external time wasters as well as interventions that can be taken to reduce their impact (Text p 221-22)

Learning Objectives
*Time Management (ATI p 5) (Text p 219 & 221)
*Time Management Cyclic Process (ATI p 7) (Text p 220)

Time Management #1
Time management is making
optimal use of available time.

Time Management #2
There is a close relationship between time management and stress.

Time Management #3
There is a close relationship between time management and stress.

Symptoms of Poor Time Management #1
Constant rushing
Caught in crisis mode
Fatigue or listlessness, overwhelmed feeling
constantly missing deadlines
Insufficient time for rest or personal relationships
Sense of being overwhelmed by demands and details
Having to do what you dont want to, most of the time
Copyright 2021 Wolters Kluwer All Rights Reserved
7

Symptoms of Poor Time Management #2
Two mistakes common in planning are underestimating the importance of a daily plan and not allowing adequate time for planning.

Three Basic Steps in Time Management #1
Allow time for planning and establish priorities.
Complete the highest priority task whenever possible and finish one task before beginning another.
Reprioritize based on the remaining tasks and on new information that may have been received.

Three Basic Steps in Time Management #2
Priority setting is perhaps the most critical skill in good time management because all actions we take have some type of relative importance.

Three Basic Steps in Time Management #3
One simple means of prioritizing what needs to be accomplished is to divide all requests for our time into three categories:
dont do, do later, and do now.

Creating a Time-Efficient Work Environment
Gather all supplies needed before starting an activity.
Group activities that are in the same location.
Use time estimates.
Document nursing interventions as soon as possible after they are completed.
Always strive to end the work day on time.

Daily Planning Actions to Maximize Time Management #1
Identify key priorities to be accomplished that day.
Determine the expected level of achievement of a prioritized task.
Assess the staff assigned to work with you.

Daily Planning Actions to Maximize Time Management #2
Review the short- and long-term plans of the unit.
Plan ahead for meetings.
Allow time to assess progress of goal attainment.
Take regular breaks and use electronic calendars.

Personal Organization
Knowing and understanding how and why you use time or set priorities as you do
How do you waste time?
What types of work do you avoid?
What is the best time of day for you to work?
How long you can work before becoming nonproductive?

Making Lists #1
Remember that lists are planning tools and thus must be flexible!
Reexamine items that remain on the list! Perhaps they dont need to be done or they need to be broken down into smaller tasks.
Only put as many items on the daily list as can reasonably be accomplished in a day.

Making Lists #2
Being punctual implies that you value other peoples time and creates an imperative for them to value your time as well.

Internal Time Wasters
Procrastination
Poor planning
Failure to establish goals and objectives
Inability to delegate
Inability to say no
Management by crisis
Haste
Indecisiveness

External Time Wasters
Open-door policy
Telephone interruptions
Socializing
Meetings
Lack of information
Poor communication
Lack of feedback
Lack of adequately described policies and procedures
Incompetent coworkers
Poor filing system
Paperwork and reading

Procrastination #1
Means to put off something until a future time, to postpone, or to delay needlessly

Procrastination #2
Procrastination is not a character flaw but is a set of behaviors which were developed over a period of time; they are behaviors that can be changed.
The dread of doing a task uses more time and energy that doing the task itself.

Procrastination #3

Some projects are not accomplished because they are not broken down into manageable tasks.

Personal Time Management
Managing time is difficult if a person is unsure of his or her priorities for time management, including personal short-term, intermediate, and long-term goals.

The Time Inventory #1
Helps the individual determine how much time he or she spends on a particular task and what time of day he or she is most productive
Important to maintain the time inventory for several days or even weeks and to repeat it annually to see if long-term changes have been made

The Time Inventory #2
Taking regularly scheduled breaks from work is important as they allow the worker to refresh both physically and mentally.

Copyright 2021 Wolters Kluwer All Rights Reserved
25 Leadership Roles and
Management Functions
in Nursing
Theory and Application

Bessie L. Marquis, RN, MSN
Professor Emeritus of Nursing
California State University
Chico, California

Carol J. Huston, RN, MSN, DPA, FAAN
Director, School of Nursing
California State University
Chico, California

8th EditionEighth Edition

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Library of Congress Cataloging-in-Publication Data
Marquis, Bessie L., author.
Leadership roles and management functions in nursing: theory and application/Bessie L. Marquis, Carol
J. Huston.8th edition.

p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4511-9281-0 ISBN 1-4511-9281-9
I. Huston, Carol Jorgensen, author. II. Title.
[DNLM: 1. Leadership. 2. Nursing, Supervisory. 3. Nurse Administrators. 4. Nursingorganization
& administration. WY 105]

RT89
362.173068dc23

2013036678
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted
practices. However, the author(s), editors, and publisher are not responsible for errors or omissions or for any
consequences from application of the information in this book and make no warranty, expressed or implied,
with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this
information in a particular situation remains the professional responsibility of the practitioner; the clinical
treatments described and recommended may not be considered absolute and universal recommendations.

The author(s), editors, and publisher have exerted every effort to ensure that drug selection and dosage
set forth in this text are in accordance with the current recommendations and practice at the time of
publication. However, in view of ongoing research, changes in government regulations, and the constant
flow of information relating to drug therapy and drug reactions, the reader is urged to check the package
insert for each drug for any change in indications and dosage and for added warnings and precautions. This is
particularly important when the recommended agent is a new or infrequently employed drug.

Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA)
clearance for limited use in restricted research settings. It is the responsibility of the health-care provider to
ascertain the FDA status of each drug or device planned for use in his or her clinical practice.

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I dedicate this book to the two most important

partnerships in my life: my husband, Don Marquis,

and my colleague, Carol Huston.

BESSIE L. MARQUIS

I dedicate this book to my mother Marilyn Jorgensen.

You are one of the reasons

I have become the capable woman I am today.

CAROL JORGENSEN HUSTON

Reviewers
Carol Amann, MSN, RN-BC, CDP
Instructor
Gannon University
Erie, Pennsylvania

Joanne Casatelli, DNP
Molloy College
Rockville Centre, New York

Joanne Clements, MS, RN, ACNP
Assistant Professor of Clinical Nursing
University of Rochester
Rochester, New York

Margaret Decker, MS, RN, CNE
Clinical Assistant Professor
Binghamton University
Binghamton, New York

Hobie Feagai, EdD, MSN, FNP-BC, APRN-Rx
Chair
Department of Baccalaureate Nursing Program
Hawaii Pacific University
Kaneohe, Hawaii

Lisa Marie Greenwood, MSN, RN, APRN-BC, CWOCN, CNS
Nursing Instructor
Madison Area Technical College
Reedsburg, Wisconsin

Vonna Henry, BSN, MPH, RN
Assistant Professor
St. Cloud State University
St. Cloud, Minnesota

Debora Kirsch, RN, MS, CNS
Director of Undergraduate Nursing Studies
SUNY Upstate Medical University
Syracuse, New York

vi reviewers

Carole McCue, RN, MS, CNE
Instructor
Cochran School of Nursing
Yonkers, New York

Jennifer Douglas Pearce, MSN, RN, CNE
Professor and Chairperson
University of Cincinnati
Blue Ash, Ohio

Tawna Pounders, RN, MNSc
Coordinator and Medical-Surgical Theory Faculty
Baton Rouge Community College
Baton Rouge, Louisiana

Loretta Quigley, MSN
Academic Dean
St. Josephs College of Nursing
Syracuse, New York

Elaine Rose, RN, BN, MHS, DM(c)
Assistant Professor
Mount Royal University
Calgary, Alberta, Canada

Charlotte Sortedahl, DNP, MPH, MS, RN
Assistant Professor
University of Wisconsin
Eau Claire, Wisconsin

Patricia Varga, MSN, RN
Assistant Professor
Alverno College
Milwaukee, Wisconsin

Preface
This books philosophy has evolved over the past 30+ years of teaching leadership and
management. We entered academe from the acute care sector of the health-care industry,
where we held nursing management positions. In our first effort as authors, Management
Decision Making for Nurses: 101 Case Studies, published in 1987, we used an experiential
approach and emphasized management functions appropriate for first- and middle-level
managers. The primary audience for this text was undergraduate nursing students.

Our second book, Retention and Productivity Strategies for Nurse Managers, focused
on leadership skills necessary for managers to decrease attrition and increase productivity.
This book was directed at the nurse-manager rather than the student. The experience of
completing research for the second book, coupled with our clinical observations, compelled
us to incorporate more leadership content in our teaching and to write this book.

Leadership Roles and Management Functions in Nursing was also influenced by national
events in business and finance that led many to believe that a lack of leadership in management
was widespread. It became apparent that if managers are to function effectively in the rapidly
changing health-care industry, enhanced leadership and management skills are needed.

What we attempted to do, then, was to combine these two very necessary elements:
leadership and management. We do not see leadership as merely one role of management
nor management as only one role of leadership. We view the two as equally important and
necessarily integrated. We have attempted to show this interdependence by defining the
leadership components and management functions inherent in all phases of the management
process. Undoubtedly, a few readers will find fault with our divisions of management
functions and leadership roles; however, we felt it was necessary to first artificially separate
the two components for the reader, and then to reiterate the roles and functions. We do believe
strongly, however, that adoption of this integrated role is critical for success in management.

The second concept that shaped this book was our commitment to developing critical-
thinking skills through the use of experiential learning exercises and the promotion of whole-
brain thinking. We propose that integrating leadership and management and using whole-brain
thinking can be accomplished through the use of learning exercises. The majority of academic
instruction continues to be conducted in a teacher-lecturerstudent-listener format, which
is one of the least effective teaching strategies. Few individuals learn best using this style.
Instead, most people learn best by methods that utilize concrete, experiential, self-initiated,
and real-world learning experiences.

In nursing, theoretical teaching is almost always accompanied by concurrent clinical
practice that allows concrete and real-world learning experience. However, the exploration of
leadership and management theory may have only limited practicum experience, so learners
often have little first-hand opportunity to observe middle- and top-level managers in nursing
practice. As a result, novice managers frequently have little chance to practice their skills before
assuming their first management position, and their decision making thus reflects trial-and-
error methodologies. For us, then, there is little question that vicarious learning, or learning

vii

viii Preface

through mock experience, provides students the opportunity to make significant leadership and
management decisions in a safe environment and to learn from the decisions they make.

Having moved away from the lecturerlistener format in our classes, we lecture for only a small
portion of class time. A Socratic approach, case study debate, and problem solving are emphasized.
Our students, once resistant to the experiential approach, are now our most enthusiastic supporters.
We also find this enthusiasm for experiential learning apparent in the workshops and seminars we
provide for registered nurses. Experiential learning enables management and leadership theory to
be fun and exciting, but most important, it facilitates retention of didactic material. The research
we have completed on this teaching approach supports these findings.

Although many leadership and management texts are available, our book meets the need
for an emphasis on both leadership and management and the use of an experiential approach.
Two hundred and fifty-nine learning exercises, taken from various health-care settings and
a wide variety of learning modes, are included to give readers many opportunities to apply
theory, resulting in internalized learning. In Chapter 1, we provide guidelines for using the
experiential learning exercises. We strongly urge readers to use them to supplement the text.

We also provide guidelines for instructors on thePoint, Wolters Kluwer Healths
trademarked web-based course and content management system that is available to
instructors who adopt the text. We recommend its use. The Web site includes a test bank, an
image collection, suggestions for using the learning exercises, a glossary, and a large number
of PowerPoint slides with images.

TEXT ORGANIZATION
The first edition of Leadership Roles and Management Functions in Nursing presented the
symbiotic elements of leadership and management, with an emphasis on problem solving and
critical thinking. This eighth edition maintains this precedent with a balanced presentation
of a strong theory component along with a variety of real-world scenarios in the experiential
learning exercises. Nineteen new learning exercises have been added to this edition, further
strengthening the problem-based element of this text. Almost 200 displays, figures, and tables
(46 of which are new) help readers to visualize important concepts.

Responding to reviewer recommendations, we have added and deleted content. In
particular, we have attempted to strengthen the leadership component of the book while
maintaining a balance of management content. We have also added a chapter crosswalk
(pp. 1522) of content based on the American Association of Colleges of Nursing (AACN)
Essentials of Baccalaureate Education for Professional Nursing Practice (2008); the AACN
Essentials of Masters Education in Nursing (2011); the American Organization of Nurse
Executive (AONE) Competencies; and the Quality and Safety Education for Nurses (QSEN)
Competencies. This crosswalk shows how content in each chapter draws from or contributes
to content identified as essential for baccalaureate and graduate education, for practice as a
nurse administrator, and for safety and quality in clinical practice.

We have also retained the strengths of earlier editions, reflecting content and application
exercises appropriate to the issues faced by nurse-leader-managers as they practice in an era
increasingly characterized by limited resources and emerging technologies. The eighth edition
also includes contemporary research and theory to ensure accuracy of the didactic material.

Unit I provides a foundation for the decision-making, problem-solving, and critical-
thinking skills, as well as management and leadership skills needed to address the
managementleadership problems presented in the text. Unit II covers ethics, legal concepts,
and advocacy, which we see as core components of leadership and management decision
making. The remaining units are organized using the management processes of planning,
organizing, staffing, directing, and controlling.

Preface ix

LEARNING TOOLS
The eighth edition contains many pedagogical features designed to benefit both the student

and the instructor:
Examining the Evidence, appearing in each chapter, depicts new research findings,

evidence-based practice, and best practices in leadership and management.
Learning Exercises interspersed throughout each chapter foster readers critical-thinking

skills and promote interactive discussions. Additional learning exercises are also presented
at the end of each chapter for further study and discussion.

Breakout Comments are highlighted throughout each chapter, visually reinforcing key ideas.
Tables, displays, figures, and illustrations are liberally supplied throughout the text to

reinforce learning as well as to help clarify complex information.
Key Concepts summarize important information within every chapter.

NEW AND EXPANDED CONTENT
Additional content that has been added or expanded in this edition includes:
Increased focus on evidence-driven leadership and management decision making
New models for ethical problem solving and an increased emphasis on patient,

professional, and subordinate advocacy
Expanded discussion of full-range leadership theory, transformational leadership, and

leadership competency identification
Emerging leadership theories such as Strengths-Based Leadership and the Positive

Psychology Movement, Level 5 leadership, thought leadership, authentic leadership, and
servant leadership

Introduction to Affordable Care Act in 2010, and the new Patients Bill of Rights
Key components of the Patient Protection and Affordable Care Act (PPACA) as well as its

implementation plan between 2010 and 2014
Health-care reform and financing mechanisms, including bundled payments, accountable

care organizations, value-based purchasing, medical homes, and health insurance
marketplaces

The shifting in health-care reimbursement from volume to value
Reflective practice and the professional portfolio
Transition-to-practice programs/residencies for new graduate nurses
Civility, incivility, bullying, mobbing, and workplace violence
Visioning of health cares future
A broad discussion of social media as a communication tool and cause for work distraction

and the ethical issues encompassed in the topic
Continuing competence, lifelong learning, nurse residencies, reflective practice, and the

professional portfolio
Interprofessional collaboration including the Multidisciplinary Team Leader,

Interprofessional Primary Healthcare Teams, and Interprofessional Primary Health Care
Teams (PHCTs)

The unique needs of a culturally diverse workforce as well as a workforce representing up
to four generations at the same time

Nurse navigators
Patient- and family-centered care
Importance of self-care for nurses

x Preface

The use of ISBAR (Introduction, Situation, Background, Assessment, Recommendation) as
a tool to promote communication between care providers or between care providers and
patients/families

Social media and organizational communication
New mergers of collective bargaining agents to form super unions for nurses
Leapfrog initiatives including electronic health records, computerized provider order

entry, evidence-based hospital staffing, and ICU physician staffing
New Joint Commission core measures and National Patient Safety Goals
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)

survey
Patient safety and quality of care

thePoint (http://thepoint.lww.com), a trademark of Wolters Kluwer Health, is a web-based
course and content management system providing every resource that instructors and students
need in one easy-to-use site.

Instructor Resources
Advanced technology and superior content combine at thePoint to allow instructors to design
and deliver online and off-line courses, maintain grades and class rosters, and communicate
with students.

In addition, instructors will find the following content designed specifically for this
edition:
Test bank
Image bank
Instructors guide, including guidelines for using the experiential learning exercises in

the text
PowerPoint slides with images

Student Resources
Students can visit thePoint to access supplemental multimedia resources to enhance their
learning experience, download content, upload assignments, and join an online study group.
Students will also find a glossary that defines the italicized terms in the text.

THE CROSSWALK
New to this edition is a chapter crosswalk of content based on the AACN Essentials of
Baccalaureate Education for Professional Nursing Practice (2008); the AACN Essentials of
Masters Education in Nursing (2011); the AONE Competencies; and the QSEN Competencies.
A crosswalk is a table that shows elements from different databases or criteria that interface.
This edition then attempts to show how content in each chapter draws from or contributes
to content identified as essential for baccalaureate and graduate education, for practice as a
nurse administrator, and for safety and quality in clinical practice.

Without doubt, some readers will disagree with the authors determinations of which
Essential or Competency has been addressed in each chapter, and certainly, an argument
could be made that most chapters address many, if not all, of the Essentials or Competencies
in some way. The crosswalks in this book then are intended to note the primary content focus
in each chapter although additional Essentials or Competencies may well be a part of the
learning experience with each chapter.

The American Association of Colleges of Nursing Essentials of
Baccalaureate Education for Professional Nursing Practice
The AACN Essentials of Baccalaureate Education for Professional Nursing Practice
(commonly called the BSN Essentials) were released in 2008 and identified the following
nine outcomes expected of graduates of baccalaureate nursing programs (Table 1). Essential
IX describes generalist nursing practice at the completion of baccalaureate nursing education
and includes practice-focused outcomes that integrate the knowledge, skills, and attitudes
delineated in Essentials I to VIII. Achievement of the outcomes identified in the BSN
Essentials will enable graduates to practice within complex health-care systems and to
assume the roles of provider of care; designer/manager/coordinator of care; and member of
a profession (AACN, 2008) (Table 1).

TABLe 1 American Association of Colleges of Nursing Essentials of Baccalaureate Education for Professional Nursing Practice

Essential I: Liberal education for baccalaureate generalist nursing practice

A solid base in liberal education provides the cornerstone for the practice and education of nurses

Essential II: Basic organizational and systems leadership for quality care and patient safety

Knowledge and skills in leadership, quality improvement, and patient safety are necessary to provide high-quality health care.

Essential III: Scholarship for evidence-based practice

Professional nursing practice is grounded in the translation of current evidence into ones practice.

Essential IV: Information management and application of patient-care technology

Knowledge and skills in information management and patient-care technology are critical in the delivery of quality patient care

Essential V: Health-care policy, finance, and regulatory environments

Health-care policies, including financial and regulatory, directly and indirectly influence the nature and functioning of the
health-care system and thereby are important considerations in professional nursing practice.

Essential VI: Interprofessional communication and collaboration for improving patient health outcomes

Communication and collaboration among health-care professionals are critical to delivering high quality and safe patient care.

Essential VII: Clinical prevention and population health

Health promotion and disease prevention at the individual and population level are necessary to improve population health and
are important components of baccalaureate generalist nursing practice.

Essential VIII: Professionalism and professional values

Professionalism and the inherent values of altruism, autonomy, human dignity, integrity, and social justice are fundamental to
the discipline of nursing.

Essential IX: Baccalaureate generalist nursing practice

The baccalaureate graduate nurse is prepared to practice with patients, including individuals, families, groups, communities,
and populations across the lifespan and across the continuum of health-care environments.

The baccalaureate graduate understands and respects the variations of care, the increased complexity, and the increased use
of health-care resources inherent in caring for patients.

Preface xi

xii Preface

The American Association of Colleges of Nursing Essentials of Masters
Education in Nursing
The AACN Essentials of Masters Education in Nursing (commonly called the MSN
Essentials) were published in March 2011 and identified the following nine outcomes
expected of graduates of masters nursing programs, regardless of focus, major, or intended
practice setting (Table 2). Achievement of these outcomes will prepare graduate nurses to
lead change to improve quality outcomes, advance a culture of excellence through lifelong
learning, build and lead collaborative interprofessional care teams, navigate and integrate
care services across the health-care system, design innovative nursing practices, and translate
evidence into practice (AACN, 2011).

Essential I: Background for practice from sciences and humanities

Recognizes that the masters-prepared nurse integrates scientific findings from nursing, biopsychosocial fields, genetics, public
health, quality improvement, and organizational sciences for the continual improvement of nursing care across diverse settings.

Essential II: Organizational and systems leadership

Recognizes that organizational and systems leadership are critical to the promotion of high quality and safe patient care.
Leadership skills are needed that emphasize ethical and critical decision making, effective working relationships, and a
systems perspective.

Essential III: Quality improvement and safety

Recognizes that a masters-prepared nurse must be articulate in the methods, tools, performance measures, and standards
related to quality, as well as prepared to apply quality principles within an organization.

Essential IV: Translating and integrating scholarship into practice

Recognizes that the masters-prepared nurse applies research outcomes within the practice setting, resolves practice
problems, works as a change agent, and disseminates results.

Essential V: Informatics and health-care technologies

Recognizes that the masters-prepared nurse uses patient-care technologies to deliver and enhance care and uses
communication technologies to integrate and coordinate care

Essential VI: Health policy and advocacy

Recognizes that the masters-prepared nurse is able to intervene at the system level through the policy development
process and to employ advocacy strategies to influence health and health care.

Essential VII: Interprofessional collaboration for improving patient and population health outcomes

Recognizes that the masters-prepared nurse, as a member and leader of interprofessional teams, communicates,
collaborates, and consults with other health professionals to manage and coordinate care.

Essential VIII: Clinical prevention and population health for improving health

Recognizes that the masters-prepared nurse applies and integrates broad, organizational, client-centered, and culturally
appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and
popul

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