d.Self-evaluation skills: The nurse realizes she is
being effective in relieving Mr. Eng’s suffering
and vows to research techniques for pain man-
agement.
3.Sample answer:
Step 1. Identify problems with the old system and
specific processes that need to be changed.
Step 2. Analyze several potential solutions to the
problems, including a computerized system, and
discuss the advantages and disadvantages of each.
Step 3. Select a course of action to initiate change.
Step 4. Plan for changes by developing specific
objectives and a timetable to meet them and
identifying the people who will be involved in
the change process.
Step 5. Implement the change, evaluate its effects,
and revise accordingly to stabilize the new
system.
Resistance to change: Determine why resistance
exists and what technique will be most effective
in helping employees overcome it.- a.Threat to self: Loss of self-esteem: belief that
more work will be required and that social rela-
tionships will be disrupted. Explain the
proposed change to everyone affected in
simple, concise language so they know how
they will be affected by it.
b.Lack of understanding: The people who will be
affected by the change should be involved in
the change process. When they understand the
reason for and benefits of the change, they are
more likely to accept it.
c. Limited tolerance for change: Some people do
not like to function in a state of flux or disequi-
librium. Expedite the change so there is only a
short period of confusion, and explain this tac-
tic to the employees involved.
d.Disagreements about the benefits of the change:
Resistance may occur when the information
available to the change agent is different from
that received by individuals resisting the
change. If the information available to the
resisters is more accurate and relevant than the
information available to the change agent, then
resistance may be beneficial.
e.Fear of increased responsibility: People often
worry about having more complex responsibili-
ties placed on them, particularly if they are
unprepared for them. Since communication is
the key to understanding, opportunities should
be provided for open communication and feed-
back. Incentives may be helpful in obtaining a
commitment to change.
5.Nurses can change negative portrayals of nursing
in the media by organizing, monitoring the
media, reacting to the media, and fostering an
improved image.
6.Sample answers:
a.Planning: Identify the problem and establish
goals and a timeline for effecting change.
b.Organizing: Mobilize all available people and
resources to educate the students about the
dangers of binge drinking.
c. Motivating: Lead organized groups dedicated to
stop binge drinking on campus.
d.Controlling: Evaluate the plan of action and
degree of effectiveness.
7.Answers will vary with students’ experiences.- a.Identifying strengths: A nurse manager might
accomplish this through feedback analysis that
supports a focus on continually improving
those things that he/she does best; discovering
intellectual arrogance—being bright is no substi-
tute for knowledge; initiating work on acquiring
the skills and knowledge he/she needs to fully
realize strengths; remedying bad habits.
b.Evaluating work accomplishment: The manager
should ask: Am I a visual or auditory learner?
Do I learn best by reading or writing? Do I work
more productively in teams or alone? Am I more
productive as a decision maker or as an advisor?
c. Clarifying values: Working in an organization
or on a particular unit whose value system is
unacceptable or incompatible condemns a per-
son to frustration and poor performance. The
nurse manager should identify his/her own val-
ues and seek a work environment that is com-
plementary, not adversarial.
d.Determining where he/she belongs and what
he/she can contribute: In small or large organi-
zations, the nurse manager should prepare for
opportunities that emerge in response to these
queries; in this dynamic industry, he/she should
set reasonable short- to medium-range goals.
e.Assuming responsibility for relationships: The
nurse manager should cultivate them, nurture
them, and respect the differences they might
have. - a.What is amenable to change?
b.How does the group function as a unit?
c. Is the person or group ready for change and, if
so, at what rate can that change be expected to
be accepted?
d.Are the changes major or minor? - a.The patient’s condition
b.The complexity of the activity
c. The potential for harm
d.The degree of problem solving and innovation
necessary
e.The level of interaction required with the patient
f. The capabilities of the NAP
g.The availability of professional staff to accom-
plish the unit workload - a.The right task: The task should be one that can
be delegated.
b.The right circumstance: The patient setting
should be appropriate and resources and other
relevant factors considered.
c. The right person: The person should be
qualified to do the job.
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