Deck 20: Collective Nursing Advocacy

Question 1

Which of the following is a common belief related to the relationship between supervisory and nonsupervisory nursing positions?

A) Nonsupervisory nurses have no decision-making power.
B) Supervisory nurses have an adversarial relationship with nonsupervisory nurses.
C) Nonsupervisory nurses are rarely empowered on an individual basis.
D) Supervisory nurses have total accountability for patient care on the unit.

Answer 1

Nonsupervisory nurses have no decision-making power.

Question 2

A group of staff nurses and a nurse manager represent a subculture in their facility.Subcultures differ in regard to

A) organizational mission.
B) approaches to conflict.
C) quality patient care.
D) union membership.

Answer 2

approaches to conflict.

Question 3

Government has indicated to provincial health departments that the budget will be decreased in the coming year by 7%.After the funding announcements,senior officials at the hospital meet and make decisions regarding cost containment of new revenue streams.This action is consistent with

A) the practice of leaving financial decisions with senior officials who understand the total context of funding.
B) a tendency to concentrate decision making during economic downturns at the top administrative level.
C) a need to make expedient decisions that are likely to be poorly received by staff.
D) ensuring that decisions with regard to cost are made equitably across all departments.

Answer 3

a tendency to concentrate decision making during economic downturns at the top administrative level.

Question 4

A Magnet™ hospital surveys the staff about job satisfaction.This type of environment,in which nurses have authority and autonomy,is linked with

A) patient satisfaction with the health care organization.
B) organizations with a limited number of nurse managers.
C) private specialty organizations in urban areas.
D) sophisticated academic health sciences universities.

Question 5

In a nurse managers' meeting,strategies for ways to help retain staff are discussed.One strategy for assisting nurses in developing collective action skills is

A) accepting the practice of "going along to get along."
B) attending as many workshops as is practical.
C) spending as much time as possible in clinical settings.
D) taking the opportunity to work with a mentor.

Question 6

In accomplishing the goal of providing breakfast for children in elementary school,Leanne is particularly effective in approaching businesses with the needs that the group has determined and articulating the ways that the group has found for businesses to participate.Recently,Leanne has been taking a new graduate nurse with her and encouraging her to lead the conversations with businesses.Leanne is demonstrating

A) empowerment.
B) followership.
C) professionalism.
D) knowledge of context.

Question 7

The emergency department staff members are concerned that working long hours without rest puts patient safety at risk.One staff member decides that she will risk her job and become a whistle-blower.Whistle-blowing is an appropriate recourse when management

A) disregards due process when disciplining a nurse.
B) delays responding to repeated efforts to provide safe care.
C) hires nurses who are not a part of the union during a strike.
D) refuses to bargain in good faith with the elected bargaining agent.

Question 8

Martin,the unit manager,receives complaints from community agencies that patients who have been discharged from his unit seem to lack understanding about their disorder and immediate strategies for managing elements of their care.Martin checks the patient teaching sheets and notes that the sheets are initialled by staff.He calls the agencies and indicates that teaching has been done.Martin's follow-up to complaints from the community is

A) appropriate and indicates that he has assumed accountability for the actions of his staff.
B) indicative that he does not clearly understand the concept of accountability.
C) indicative of strong support for his staff and their autonomy.
D) important in clarifying the difference between his accountability and that of the community in patient care.

Question 9

Collective action is effective in

A) ensuring that needs of nurses are placed ahead of those of other disciplines.
B) defining nursing as a profession.
C) advising patients of the needs of nurses.
D) amplifying the influence of individuals.

Question 10

The emergency department staff decides to use a collective bargaining model for negotiation.This model is characterized by

A) an adversarial relationship.
B) management decision-making.
C) a spirit of trust to negotiate in good faith.
D) an inability to resolve complaints.

Question 11

In Hospital STV,senior administration is strongly oriented toward fiscal and social conservatism.The nursing department is deeply concerned with the provision of quality to the community,which includes a high number of poor and unemployed residents.To accomplish the goals of the nursing department,resources need to be allocated that administration is not able to allocate.Nursing and administration

A) are engaged in shared governance.
B) are involved in an irreconcilable conflict of interests.
C) represent separate subcultures in the institution.
D) represent union and nonunion conflict.

Question 12

Health care inequities frequently arise from

A) failure of organizational structures to adhere to shared governance.
B) social determinants of health.
C) lack of commitment to health.
D) inability to pay for health services.

Question 13

The emergency department nurses' decision to organize for the purpose of collective bargaining is being driven by a desire to

A) establish the staffing pattern that will be used.
B) determine the hours that one is willing to work.
C) create a professional practice environment.
D) protect against arbitrary discipline and termination.

Question 14

In an inner-city area,a group of nurses meet and develop a plan to negotiate with local businesses to support a breakfast program for young elementary school-age children.This is an example of

A) community development.
B) collective bargaining.
C) collective action.
D) shared governance.

Question 15

In looking at an organizational chart for her institution,Marie notes that the nursing staff is led at the senior level by a non-nurse executive.Marie expresses concern that this is a reflection of how nursing is viewed within the organization.Marie's comments reflect

A) a concern that resource allocation will be made on a business and not a professional model.
B) the dissatisfaction that occurs when lack of autonomy is given to nurses.
C) concern with the nonadvancement of nursing practice in the institution.
D) an awareness of how organizational culture is reflected in organizational structure.

Question 16

Work environment factors have a direct effect on nurses' job satisfaction and the ability to influence patient care and are mainly influenced by the

A) negotiated employment contract.
B) relationship between nurses and administration.
C) nurse-to-patient ratio.
D) organizational mission statement.

Question 17

The chief nursing officer uses the hospital's workplace advocacy to help the overwhelmed emergency department staff.Workplace advocacy is designed to assist nurses by

A) creating professional practice climates in their institutions.
B) equipping them to practice in a rapidly changing environment.
C) negotiating employment contracts.
D) representing them in labour-management disputes.

Question 18

Nurses on the dialysis unit notice that changes in labelling of fluids have caused several alarming instances in which fluids were almost administered incorrectly.They take this concern to the unit manager.As an advocate of nurse autonomy,the most appropriate response in this situation would be which of the following?

A) Ensure that the nurses are aware of the reasons for the change and how the decision was made about the new labels.
B) Discuss concerns about the labels and develop potential solutions that take into account changes that can be made at the local level and those that need system intervention.
C) Suggest that the staff wait until they have become more familiar with the labels before taking further action.
D) Tell the staff that you will notify the pharmacy about these concerns and leave it up to the pharmacy to decide what should be done.

Question 19

The staff members in a local emergency department are experiencing stress and burnout as the result of excessive overtime.The staff decides to unionize to negotiate for better working conditions.Approximately what percentage of nurses in Canada are members of a union?

A) 60%
B) 70%
C) 80%
D) 90%

Question 20

You are a new nurse manager who has "inherited" a unit with high nurse turnover and complaints of patient dissatisfaction.What would be your first course of action?

A) Conduct an assessment of the unit resources and nursing practice.
B) Review the personnel files of nurses who have resigned.
C) Interview upper management about their vision for the unit.
D) Meet with your staff to clarify your vision for the unit.

Question 21

Sandra,a registered nurse on the surgery unit,is assisting with a procedure in the patient examination room.The physician orders a medication to be given intravenously.Sandra questions the order,on the basis of her knowledge of the patient's history and of other medications that the patient has been given.The physician reiterates the order and Sandra refuses to give it.In this instance,Sandra is demonstrating

A) autonomy.
B) accountability.
C) authority.
D) best practice.

Question 22

In an inner-city neighbourhood characterized by high levels of violence,nurses in an emergency department are concerned with low levels of security presence in their department.Security levels have recently been decreased.An appropriate action would be which of the following?

A) Provide information about the decision related to recent changes in staffing.
B) Refer the matter to the head of security and let her deal with it.
C) Provide mentors who can help nurses diffuse aggressiveness.
D) Accept the security levels as a consequence of funding realities.

Question 23

In an inner-city neighbourhood characterized by high levels of violence,the nurses in the emergency department continue to be concerned about safety levels.As the manager,you ask the nurses to

A) register their concerns with senior management.
B) take their concerns to the local newspaper.
C) provide accurate, clear, concise data of incidents involving safety.
D) contact their union to discuss their concerns.

Question 24

Evidence-informed practices (EIPs)are a key strategy for enhancing learning and increasing nurse capacity,as well as for contributing to

A) morale on the unit.
B) a decline in participatory decision-making.
C) professional autonomy.
D) ethical practice.

Question 25

After changes in health care funding and the community's expressed concerns about care that is being delivered at Hospital A,senior executives at the hospital determine that the hospital will engage in a strategic planning process.The senior executives decide on a participatory process in which staff are widely consulted regarding input about the organization and the external environment and are actively invited to be part of decisions related to mission statement,goals,and objectives.For true shared governance to be seen as part of this approach,which of the following conditions is necessary?

A) It must be evident in the outcomes of the process that staff and senior executives have partnered on the decisions.
B) Stakeholders must be assured of the value of their input even though final decisions rest with senior executives.
C) Publications must clearly outline how staff input was solicited and obtained.
D) Staff must be reassured that significant concerns will be kept in mind even if they have not been addressed in planning documents.

Question 26

On Unit 62,the nurses and the unit manager have been involved in shared decision-making about the model of nursing care delivery that the unit will adopt.All individuals have participated and been involved in decision-making and implementation of changes.When issues arise during implementation,it is expected that

A) accountability resides entirely with the unit manager.
B) individual expertise will be used to provide solutions, but that responsibility for the change is shared.
C) no one really has any accountability or responsibility for the changes.
D) all of the staff will participate in the evaluation of the changes.