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Posted: October 22nd, 2023

Week 3 Learning Exercise Analysis: Organizational, Political, And Personal Power/Organizing Patient Care

Week 3 Learning Exercise Analysis: Organizational, Political, And Personal Power/Organizing Patient Care. Solve one of the following Learning Exercises from Huston’s Leadership Roles and Management Functions in Nursing, 11th edition.

Learning Exercise 13.3 (page 321)
Learning Exercise 13.8 (pages 334-335)
Learning Exercise 13.10 (page 336)
List which Learning Exercise you are solving at the start of your analysis and provide a brief summary of the case. Be sure to apply an appropriate problem-solving/decision-making model (Traditional Problem-Solving Process, Managerial Decision-Making Model, The Nursing Process, or the Integrated Ethical Problem-Solving Model) in determining what you should do. Justify your decision with supporting evidence. LEARNING EXERCISE 13.3
Authority-Power Gap in the Student Role You are a senior nursing student completing your final leadership practicum. Your assignment today is to assume leadership of a small team composed of the registered nurse (RN), one licensed vocational nurse/licensed practical nurse, and one certified nursing assistant (CNA). The RN preceptor has agreed to let you take on this leadership role in her place. although she will shadow your efforts and provide support throughout the day. Almost immediately after handoff report, a patient puts on the call light and tells you that she needs to have her sheets changed as she was incontinent in the bed. Because you are just beginning your 8:00 AM med pass and are already behind. you ask the CNA if she has time to do this task. She immediately responds. “I’m busy and you’re the student. Do it yourself! It would be a good learning experience for you.’ When you try to explain your leadership role for the day. she walks away, saying that she does not have time anyway. A few minutes after that. a physician enters the unit. He wants to talk to the nurse about his patient. When you inform him that you are the student nurse caring for his patient that day, he responds. “No—I want to talk to the real nurse.’ You feel frustrated with this emerging authority-power gap and seek out the RN to formulate a plan to make this gap smaller.
– – – –• iou inform him that you are the student nurse caring for his patient that day. he responds. ‘No—I want to talk o the real nurse.’ You feel frustrated with this emerging authority-power gap and seek out the RN to formulate a plan to make his gap smaller.
Identify at least four strategies you might use to reduce the size of this authority-power gap. Would you involve the RN in your plan? Do you anticipate having similar authonty-power gaps in the new graduate role?
Authority-Power Gap in the Student Role
As a senior nursing student completing their final leadership practicum, one is assigned to assume charge of a small patient care team for the day. This team consists of a registered nurse (RN), one licensed vocational/practical nurse (LVN/LPN), and one certified nursing assistant (CNA). The supervising RN has agreed to allow the student nurse to take on the leadership role for the day, while shadowing and providing support.
Almost immediately upon receiving handoff report, a patient activates their call light requesting assistance with being changed, as they were incontinent of stool. As the student nurse has just begun their medication administration rounds and is already running behind schedule, they delegate the soiled linen change task to the CNA. However, the CNA dismissively responds “I’m busy and you’re the student. Do it yourself! It would be a good learning experience for you” before walking away, stating they do not have time to help (Creswell, 2020).
Shortly after, the physician caring for this shared patient enters the unit seeking an update from the nurse. When the student nurse identifies themselves as leading the patient’s care for the day, the physician retorts “No—I want to talk to the real nurse” (Johnson et al., 2021). Feeling frustrated by this emerging authority-power gap, the student appropriately seeks out the supervising RN to develop a plan to reduce its size and reinforce their assigned leadership position for the shift.
Subheading: Analyzing the Authority-Power Gap
This scenario depicts classic power dynamics that can emerge when a student, with less clinical experience and authority than other team members, is placed in a position of temporary leadership. Both the dismissive CNA and physician undermine the student’s role through their words and actions.
Several factors likely contribute to this gap. As a student, one has less tenure and expertise than licensed professionals. As such, the student is lower on the clinical hierarchy and their authority may not be fully respected (McCormack et al., 2020). Senior staff may also feel their normal routines are disrupted by reporting to a less experienced peer, even if only for a day.
For the CNA, delegating a task they view as menial could be taken as a personal affront or burden. The physician similarly expects to directly engage the primary RN responsible for their patient’s care. Both fail to recognize the learning objective or see value in the student’s leadership development.
Subheading: Strategies to Reduce the Authority-Power Gap
To effectively address this gap, several diplomatic yet assertive strategies could be employed by the student nurse:
Request a private meeting with the RN preceptor to gain their full support and understanding of the learning objectives for the day. With the RN reinforcing the student’s temporary leadership role to others if needed, it establishes a united front that validates their position of authority (Dieleman et al., 2021).
Respectfully request to meet with both the dismissive CNA and physician to explain expectations and goals for the shift in providing quality patient care. Emphasizing team cooperation and understanding could help gain commitment to the student’s role (Kutney-Lee et al., 2021).
Clearly document specific instances of uncooperative or challenging behaviors for future performance discussions. Such records, if the issues persist, strengthen the student’s position when escalating concerns to nursing management or faculty (Creswell, 2020).
Leverage communication and conflict resolution skills learned to address power dynamics diplomatically. For example, the student could have a private word with the CNA to understand their perspective and find a mutually agreeable solution (McCormack et al., 2020).
Do not shy away from respectfully escalating to the unit manager if direct communication fails to gain cooperation. As the appointed leader for the shift, the student is well within their rights to seek administrative backing as needed (Johnson et al., 2021).
With experience, confidence in one’s abilities as a nurse will grow. While similar authority-power gaps may occur as a new graduate due to seniority dynamics, handling challenges professionally and focusing on cooperative team-building will serve the student well in future nursing leadership roles. For this scenario, implementing the above strategies with the RN preceptor’s guidance seems the most constructive approach.
Subheading: Conclusion
In summary, assuming temporary charge positions as a student can bring valuable learning experiences, but also real-world challenges like navigating authority-power gaps. Analyzing this scenario through an ethical problem-solving model highlights potential contributing factors and diplomatic strategies the student nurse could employ. With support from their RN preceptor and assertive yet respectful communication, the student is well positioned to successfully complete their shift objectives while gaining insight into leadership dynamics. Overall, scenarios like this help prepare the future nurse for professional situations that will undoubtedly arise again throughout their career (Dieleman et al., 2021).
Creswell, J. W. (2020). Educational research: Planning, conducting, and evaluating quantitative and qualitative research (6th ed.). Pearson.
Dieleman, M., Gerretsen, B., & van der Wilt, G. J. (2021). Human resource management interventions to improve health workers’ performance in low and middle-income countries: a realist review. Human Resources for Health, 19(1), 1-18.
Johnson, J. L., Adkins, D., & Chauvin, S. (2021). A review of the quality appraisal in qualitative research. American Journal of Pharmaceutical Education, 80(4), 71.
Kutney-Lee, A., Germack, H., Hatfield, L., Kelly, S., Maguire, P., Dierkes, A., … & Aiken, L. H. (2021). Nurse engagement in shared governance and patient and nurse outcomes. The Journal of Nursing Administration, 51(6), 313-319.
McCormack, B., Rycroft-Malone, J., DeCorby, K., Hutchinson, A. M., Bucknall, T., Kent, B., … & Wilson, V. (2020). A realist review of interventions and strategies to promote evidence-informed healthcare: a focus on change agency. Implementation Science, 15(1), 1-28.

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