Releted Lit

8/8/2019 Releted Lit

1/48


2/48

Bottom of Form

Renesis Likert: PowerPoint on Likert

Dr Renesis Likert has studied human behaviour within many organisations.After extensiveresearch, Dr. Rensis Likert concluded that there are four systems of management. According toLikert, the efficiency of an organisation or its departments is influenced by their system ofmanagement. Likert categorised his four management systems as follows;

Exploitive authoritative system (1)

In this type of management system the job of employees/subordinates is to abide by the decisionsmade by managers and those with a higher status than them in the organisation. The subordinatesdo not participate in the decision making. The organisation is concerned simply aboutcompleting the work. The organisation will use fear and threats to make sure employeescomplete the work set. There is no teamwork involved.

Benevolent authoritative system (2)

Just as in an exploitive authoritative system, decisions are made by those at the top of theorganisation and management. However employees are motivated through rewards (for theircontribution) rather than fear and threats. Information may flow from subordinates to managersbut it is restricted to what management want to hear.

Consultative system (3)

In this type of management system, subordinates are motivated by rewards and a degree ofinvolvement in the decision making process. Management will constructively use theirsubordinates ideas and opinions. However involvement is incomplete and major decisions arestill made by senior management. There is a greater flow of information (than in a benevolentauthoritative system) from subordinates to management. Although the information fromsubordinate to manager is incomplete and euphemistic.

Participative (group) system (4)

Management have complete confidence in their subordinates/employees. There is lots ofcommunication and subordinates are fully involved in the decision making process. Subordinatescomfortably express opinions and there is lots of teamwork. Teams are linked together bypeople, who are members of more than one team. Likert calls people in more than one grouplinking pins. Employees throughout the organisation feel responsible for achieving theorganisations objectives. This responsibility is motivational especially as subordinates areoffered economic rewards for achieving organisational goals which they have participated insetting.

Likerts Ideal System

Likert believes that if an organisation is to achieve optimum effectiveness then the idealsystem to adopt is Participative (system 4).

Nursing management is performing leadership functions of governance and decision-makingwithin organizations employing nurses. It includes processes common to all management likeplanning, organizing, staffing, directing and controlling. A good nurse manager should be open
http://www.learnmanagement2.com/likertpowerpoint.htmhttp://en.wikipedia.org/wiki/Nursehttp://en.wikipedia.org/wiki/Nursehttp://www.learnmanagement2.com/likertpowerpoint.htmhttp://en.wikipedia.org/wiki/Nurse


3/48

to anything in the environment and be sensitive to the needs of the staff under her/hismanagement.

It is common for RNs to seek additional education to earn a Master of Science in Nursing orDoctor of Nursing Scienceto prepare for leadership roles within nursing. Management positionsincreasingly require candidates to hold an advanced degree in nursing.

Nurse managerA nurse manager is a specialist in human resource management and information management.

Select from the list on the right to view more nursing profile.

What does a nurse manager do?A nurse manager usually supports the clinical unit by providing information, assisting withpersonnel management, recruitment, and business planning/budget management. Nurse

managers contribute to the strategic direction of the organisation, through unit business planning,and incorporates innovative management planning. Nurse managers develop services to enhancecore business and respond to changing organisational needs.

What career opportunities are available for nurse managers?Nurse managers' careers usually extend into information management/project type roles, orproceed to higher level management positions.

Where can I get more information on becoming a nurse manager?You should access information on becoming a nurse manager through a hospital and arrange tomeet with a Nurse Manager. For more information on postgraduate course availability in thisarea, click here to go to the further education section.
http://en.wikipedia.org/wiki/Master_of_Science_in_Nursinghttp://en.wikipedia.org/wiki/Doctor_of_Nursing_Sciencehttp://en.wikipedia.org/wiki/Doctor_of_Nursing_Sciencehttp://en.wikipedia.org/wiki/Master_of_Science_in_Nursinghttp://en.wikipedia.org/wiki/Doctor_of_Nursing_Science


4/48


5/48


6/48

Leadership styles in nursing management: preferred

and perceived.

Sellgren S, Ekvall G, Tomson G.

Department of Nursing, Karolinska University Hospital, Stockholm, [email protected]

Abstract

AIM: The aim was to explore nursing leadership regarding what nurse managers andsubordinates see as important and to explore subordinates' opinions of their nurse manager's
http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sellgren%20S%22[Author]http://www.ncbi.nlm.nih.gov/pubmed?term=%22Ekvall%20G%22[Author]http://www.ncbi.nlm.nih.gov/pubmed?term=%22Tomson%20G%22[Author]http://www.ncbi.nlm.nih.gov/pubmed?term=%22Sellgren%20S%22[Author]http://www.ncbi.nlm.nih.gov/pubmed?term=%22Ekvall%20G%22[Author]http://www.ncbi.nlm.nih.gov/pubmed?term=%22Tomson%20G%22[Author]


7/48

performance in reality. Background The manager's style can be fundamental for subordinates'acceptance of change and in motivating them to achieve stated visions and goals and high qualityof care.

METHODS: Nurse managers (n=77) and 10 of each included nurse manager's subordinatesreceived a questionnaire to assess 'preferred' leadership behaviour in three dimensions: change,

production and employee/relation orientations. The same questionnaire was used to assesssubordinates' opinions of their manager's leadership behaviour.

RESULTS: There are statistically significant differences in opinions of preferred leadershipbetween managers and subordinates, especially related to production and relation orientation.The subordinates' perception of real leadership behaviour has lower mean values than theirpreferred leadership behaviour in all three dimensions.

CONCLUSIONS: Subordinates prefer managers with more clearly expressed leadershipbehaviour than managers themselves prefer and demonstrate.

PMID: 16787469 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms

hip Styles in NursingLeadership styles in nursing management play a very significant role in the

management of a nursing facility. This article throws light on management and

leadership styles in nursing.

Ads by Google

1000 training ideas Best-selling training tips & much more for trainers and coaches

www.koganpage.com

Organic Church Leadership Jesus - Alive Today! His Body Must Be Alive, Organic &

Relational, too OrganicChurchLife.com
http://www.ncbi.nlm.nih.gov/pubmed/16787469http://www.google.com/url?ct=abg&q=https://www.google.com/adsense/support/bin/request.py?contact=abg_afc&url=http://www.buzzle.com/articles/leadership-styles-in-nursing.html&hl=en&client=ca-pub-9037304895410090&adU=www.koganpage.com&adT=1000+training+ideas&adU=OrganicChurchLife.com&adT=Organic+Church+Leadership&adU=www.planleadexcel.com&adT=RLM+Planning+%26amp%3B+Leadership&adU=www.apihealthcare.com&adT=Automate+nurse+schedules&adU=international.mq.edu.au/distance&adT=Improve+Teaching+Skills&adU=Leader3training.com&adT=Leadership+Training&adU=CoachedtoSuccess.com&adT=Your+Leadership+Style%3F&adU=www.lifeskills-enrichment.com.sg/&adT=LifeSkills+Enrichment&adU=Youtube.com/insidedukenus&adT=Duke-NUS+Medical+School&adU=graduateinstitute.ch/executive/&adT=Decision+Making&adU=www.ich-international.ca&adT=ICH+International&adU=www.SunBuggy.com&adT=Real+Team+Building+Events&adU=www.21stCenturyjob.com&adT=Nursing+Overseas&adU=www.JobStreet.com&adT=POEA+Approved+Job+Orders&gl=PH&usg=AFQjCNHeSH3bvkL6z-BgWaFt4DhPv0Nglwhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BdHBRGvC3TJ7VAoXOcN6blagN0vbozwHmotHBCMCNtwHQ9wcQARgBIJ-OggIoDjgAUPiP65H6_____wFg4aS6hZAaoAGvjfz-A7IBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCQOq3NmLbuj6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=1&sig=AGiWqtxMuU-0WaDInM6oD29Ium6qRNfoFQ&client=ca-pub-9037304895410090&adurl=http://www.koganpage.com/products/HumanResources/H/TrainingandCoaching/H004/http://googleads.g.doubleclick.net/aclk?sa=l&ai=BdHBRGvC3TJ7VAoXOcN6blagN0vbozwHmotHBCMCNtwHQ9wcQARgBIJ-OggIoDjgAUPiP65H6_____wFg4aS6hZAaoAGvjfz-A7IBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCQOq3NmLbuj6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=1&sig=AGiWqtxMuU-0WaDInM6oD29Ium6qRNfoFQ&client=ca-pub-9037304895410090&adurl=http://www.koganpage.com/products/HumanResources/H/TrainingandCoaching/H004/http://googleads.g.doubleclick.net/aclk?sa=l&ai=Bp9EYGvC3TJ7VAoXOcN6blagNkvq90QG6lZGRF8CNtwHwhA4QAhgCIJ-OggIoDjgAUOP6s5r8_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=2&sig=AGiWqtw4nQBTY1mHSVq27LaFucJI26InQQ&client=ca-pub-9037304895410090&adurl=http://www.OrganicChurchLife.com/Organic-Leadershiphttp://googleads.g.doubleclick.net/aclk?sa=l&ai=Bp9EYGvC3TJ7VAoXOcN6blagNkvq90QG6lZGRF8CNtwHwhA4QAhgCIJ-OggIoDjgAUOP6s5r8_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=2&sig=AGiWqtw4nQBTY1mHSVq27LaFucJI26InQQ&client=ca-pub-9037304895410090&adurl=http://www.OrganicChurchLife.com/Organic-Leadershiphttp://www.ncbi.nlm.nih.gov/pubmed/16787469http://www.google.com/url?ct=abg&q=https://www.google.com/adsense/support/bin/request.py?contact=abg_afc&url=http://www.buzzle.com/articles/leadership-styles-in-nursing.html&hl=en&client=ca-pub-9037304895410090&adU=www.koganpage.com&adT=1000+training+ideas&adU=OrganicChurchLife.com&adT=Organic+Church+Leadership&adU=www.planleadexcel.com&adT=RLM+Planning+%26amp%3B+Leadership&adU=www.apihealthcare.com&adT=Automate+nurse+schedules&adU=international.mq.edu.au/distance&adT=Improve+Teaching+Skills&adU=Leader3training.com&adT=Leadership+Training&adU=CoachedtoSuccess.com&adT=Your+Leadership+Style%3F&adU=www.lifeskills-enrichment.com.sg/&adT=LifeSkills+Enrichment&adU=Youtube.com/insidedukenus&adT=Duke-NUS+Medical+School&adU=graduateinstitute.ch/executive/&adT=Decision+Making&adU=www.ich-international.ca&adT=ICH+International&adU=www.SunBuggy.com&adT=Real+Team+Building+Events&adU=www.21stCenturyjob.com&adT=Nursing+Overseas&adU=www.JobStreet.com&adT=POEA+Approved+Job+Orders&gl=PH&usg=AFQjCNHeSH3bvkL6z-BgWaFt4DhPv0Nglwhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BdHBRGvC3TJ7VAoXOcN6blagN0vbozwHmotHBCMCNtwHQ9wcQARgBIJ-OggIoDjgAUPiP65H6_____wFg4aS6hZAaoAGvjfz-A7IBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCQOq3NmLbuj6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=1&sig=AGiWqtxMuU-0WaDInM6oD29Ium6qRNfoFQ&client=ca-pub-9037304895410090&adurl=http://www.koganpage.com/products/HumanResources/H/TrainingandCoaching/H004/http://googleads.g.doubleclick.net/aclk?sa=l&ai=BdHBRGvC3TJ7VAoXOcN6blagN0vbozwHmotHBCMCNtwHQ9wcQARgBIJ-OggIoDjgAUPiP65H6_____wFg4aS6hZAaoAGvjfz-A7IBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCQOq3NmLbuj6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=1&sig=AGiWqtxMuU-0WaDInM6oD29Ium6qRNfoFQ&client=ca-pub-9037304895410090&adurl=http://www.koganpage.com/products/HumanResources/H/TrainingandCoaching/H004/http://googleads.g.doubleclick.net/aclk?sa=l&ai=Bp9EYGvC3TJ7VAoXOcN6blagNkvq90QG6lZGRF8CNtwHwhA4QAhgCIJ-OggIoDjgAUOP6s5r8_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=2&sig=AGiWqtw4nQBTY1mHSVq27LaFucJI26InQQ&client=ca-pub-9037304895410090&adurl=http://www.OrganicChurchLife.com/Organic-Leadershiphttp://googleads.g.doubleclick.net/aclk?sa=l&ai=Bp9EYGvC3TJ7VAoXOcN6blagNkvq90QG6lZGRF8CNtwHwhA4QAhgCIJ-OggIoDjgAUOP6s5r8_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=2&sig=AGiWqtw4nQBTY1mHSVq27LaFucJI26InQQ&client=ca-pub-9037304895410090&adurl=http://www.OrganicChurchLife.com/Organic-Leadership


8/48

RLM Planning & Leadership Train managers to be leaders Learn how to improve

your leaders www.planleadexcel.com

A nursing leader might either be a nurse manager who is assigned the obligation of

handling one unit or a nurse executive who is responsible for the operations of all

in-patient nursing units. Usually, a successful or effective nurse leader, typically hasa repertoire ofleadership skills that she employs according to the situations that are

being faced.

Leadership Skills in Nursing

After a nurse graduates from a nursing school and gets her Registered Nurse (RN)

license, she normally possesses some fundamental leadership skills to apply to

direct patient care. As she gets more experienced and advances in her post, she

would be required to learn more on leadership. There are many leadership courses

that are available in colleges and universities, professional education facilities, and

even large public and private hospitals. It is truly crucial for a nurse to seek advice,

mentoring, and coaching from a senior nurse leader who would render honestfeedback regarding her leadership style.

Types of Leadership Styles in Nursing

Broadly speaking, there are two types of fundamental leadership styles, democratic

and autocratic. These styles are further divided into subcategories. For instance, a

nurse leader who is democratically inclined, would engage his nurses in decision-

making and let them carry out their work in an independent manner. Whereas, a

directive autocrat would provide instructions without looking for inputs and

superintend his nurses in an close manner. More on leadership.

A nurse leader who has a considerable amount of work experience would select a

leadership and management style that would work best in any circumstance. For

instance, he might play a democratic kind of a role when it is time to purchase new

equipment for his nursing section. He can arrange to buy the equipment that is

required by nurses, and then allow them to utilize it individually as needed. But

from the other point of view, he might act as a directive autocrat when dealing with

less experienced nurses, giving only one-sided instructions, while he closely

oversees their work. Nurse leaders most importantly need to be very stress and

tension-free while managing things, as they work in a critical life and death situation

where every moment counts. and where temperamental or emotional behavior is

not accepted. They need to be able to fully concentrate on what they do, as it may

be a question of someones life and health.

Some Considerations of Leadership Styles in Nursing

A nurse leader might change his leadership style according to the age and expertise

of the nurses working under his supervision. There can be many cases where

veterans would like to share their hard-earned expertise with new recruits who are
http://googleads.g.doubleclick.net/aclk?sa=l&ai=BM9ZVGvC3TJ7VAoXOcN6blagN6Li_3AGgiOb3FsCNtwHgxQgQAxgDIJ-OggIoDjgAUIvqsPj7_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=3&sig=AGiWqtyiEe4cDqsBEavdR96dnn_52OOIig&client=ca-pub-9037304895410090&adurl=http://www.planleadexcel.com/leadinghttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BM9ZVGvC3TJ7VAoXOcN6blagN6Li_3AGgiOb3FsCNtwHgxQgQAxgDIJ-OggIoDjgAUIvqsPj7_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=3&sig=AGiWqtyiEe4cDqsBEavdR96dnn_52OOIig&client=ca-pub-9037304895410090&adurl=http://www.planleadexcel.com/leadinghttp://www.buzzle.com/articles/leadership-skills/http://www.buzzle.com/articles/nursing-schools/http://www.buzzle.com/articles/patient-care/http://www.buzzle.com/articles/leadership-courses/http://www.buzzle.com/articles/coaching/http://www.buzzle.com/articles/leadership-styles/http://www.buzzle.com/articles/leadership/http://www.buzzle.com/articles/leadership-and-management/http://googleads.g.doubleclick.net/aclk?sa=l&ai=BM9ZVGvC3TJ7VAoXOcN6blagN6Li_3AGgiOb3FsCNtwHgxQgQAxgDIJ-OggIoDjgAUIvqsPj7_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=3&sig=AGiWqtyiEe4cDqsBEavdR96dnn_52OOIig&client=ca-pub-9037304895410090&adurl=http://www.planleadexcel.com/leadinghttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BM9ZVGvC3TJ7VAoXOcN6blagN6Li_3AGgiOb3FsCNtwHgxQgQAxgDIJ-OggIoDjgAUIvqsPj7_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=3&sig=AGiWqtyiEe4cDqsBEavdR96dnn_52OOIig&client=ca-pub-9037304895410090&adurl=http://www.planleadexcel.com/leadinghttp://www.buzzle.com/articles/leadership-skills/http://www.buzzle.com/articles/nursing-schools/http://www.buzzle.com/articles/patient-care/http://www.buzzle.com/articles/leadership-courses/http://www.buzzle.com/articles/coaching/http://www.buzzle.com/articles/leadership-styles/http://www.buzzle.com/articles/leadership/http://www.buzzle.com/articles/leadership-and-management/


9/48

in responsible positions. Whereas, younger and less-experienced nurses might

benefit from close supervision along with sufficient guidance and feedback. Nursing

has veered towards a shared model of management which involves nurses in

decision-making. In this leadership model, a nurse leader employs a democratic

style of leadership, encouraging nurses to actively get involved in medical decision-

making activities along with monitoring their patient results. You may want to knowmore on:

Ethics in Nursing Jobs and Profession

Communication Techniques in Nursing

This is in essence about the leadership styles in nursing, however, a nurse manager

may change his style according to situation and the way nurses respond to his

instructions. His/her style may also change according to situational demands of the

medical facility. Effective leadership would certainly make the nursing professionals

work in the best possible manner.

By Stephen Rampur

Ads by Google

Automate nurse schedules Creative & flexible schedules lead to a healthy & safe

environment. www.apihealthcare.com

Improve Teaching Skills Earn a Degree or Masters in Education Leadership online

international.mq.edu.au/distance

Leadership Training Become an exceptional leader Study online - anywhere,

anytime! Leader3training.com

Your Leadership Style? Build effective leadership skills to achieve success in life

and work CoachedtoSuccess.com

LifeSkills Enrichment Master Training & Certfication Centre for DISC (IML)

www.lifeskills-enrichment.com.sg/

Duke-NUS Medical School Join our Online Community and Get our Free Updates &

News ! Youtube.com/insidedukenus

Decision Making Short course in Geneva on decision-making and diplomacy.

graduateinstitute.ch/executive/

ICH International Facilitation, Mediation, Training Coaching, Leadership, Speaking

www.ich-international.ca

Discuss Email Article
http://www.buzzle.com/articles/leadership-models/http://www.buzzle.com/articles/decision-making/http://www.buzzle.com/articles/decision-making/http://www.buzzle.com/articles/ethics-in-nursing-jobs-and-profession.htmlhttp://www.buzzle.com/articles/communication-techniques-in-nursing.htmlhttp://www.buzzle.com/articles/nursing/http://www.buzzle.com/articles/effective-leadership/http://www.buzzle.com/authors.asp?author=26525http://www.google.com/url?ct=abg&q=https://www.google.com/adsense/support/bin/request.py?contact=abg_afc&url=http://www.buzzle.com/articles/leadership-styles-in-nursing.html&hl=en&client=ca-pub-9037304895410090&adU=www.koganpage.com&adT=1000+training+ideas&adU=OrganicChurchLife.com&adT=Organic+Church+Leadership&adU=www.planleadexcel.com&adT=RLM+Planning+%26amp%3B+Leadership&adU=www.apihealthcare.com&adT=Automate+nurse+schedules&adU=international.mq.edu.au/distance&adT=Improve+Teaching+Skills&adU=Leader3training.com&adT=Leadership+Training&adU=CoachedtoSuccess.com&adT=Your+Leadership+Style%3F&adU=www.lifeskills-enrichment.com.sg/&adT=LifeSkills+Enrichment&adU=Youtube.com/insidedukenus&adT=Duke-NUS+Medical+School&adU=graduateinstitute.ch/executive/&adT=Decision+Making&adU=www.ich-international.ca&adT=ICH+International&adU=www.SunBuggy.com&adT=Real+Team+Building+Events&adU=www.21stCenturyjob.com&adT=Nursing+Overseas&adU=www.JobStreet.com&adT=POEA+Approved+Job+Orders&gl=PH&usg=AFQjCNHeSH3bvkL6z-BgWaFt4DhPv0Nglwhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BWileGvC3TJ7VAoXOcN6blagNrKGiwwGkx9WoFMCNtwHwhA4QBBgEIJ-OggIoDjgAUILEsVpg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=4&sig=AGiWqtxi7_f3WDzf0RGFUtWxnHPF0OjGwA&client=ca-pub-9037304895410090&adurl=http://www.apihealthcare.com/solutions_for_healthcare_providershttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BWileGvC3TJ7VAoXOcN6blagNrKGiwwGkx9WoFMCNtwHwhA4QBBgEIJ-OggIoDjgAUILEsVpg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=4&sig=AGiWqtxi7_f3WDzf0RGFUtWxnHPF0OjGwA&client=ca-pub-9037304895410090&adurl=http://www.apihealthcare.com/solutions_for_healthcare_providershttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BbjWUGvC3TJ7VAoXOcN6blagN_orE3QHeoIjWFcCNtwGw2wYQBRgFIJ-OggIoDjgAUJSHtsn-_____wFg4aS6hZAaoAGS7cvgA7IBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCU3je8sKpsD6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=5&sig=AGiWqtw-XwM6rxdI2Yz3eqG-9M9JPyIU9w&client=ca-pub-9037304895410090&adurl=http://www.international.mq.edu.au/study/distanceeducation/distance/educationhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BbjWUGvC3TJ7VAoXOcN6blagN_orE3QHeoIjWFcCNtwGw2wYQBRgFIJ-OggIoDjgAUJSHtsn-_____wFg4aS6hZAaoAGS7cvgA7IBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCU3je8sKpsD6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=5&sig=AGiWqtw-XwM6rxdI2Yz3eqG-9M9JPyIU9w&client=ca-pub-9037304895410090&adurl=http://www.international.mq.edu.au/study/distanceeducation/distance/educationhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BfwwpGvC3TJ7VAoXOcN6blagNj_j50wHH4cyQF8CNtwGQvwUQBhgGIJ-OggIoDjgAUM2o82Ng4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQJTeN7ywqmwPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=6&sig=AGiWqtyhbXQhM1aYTKVZwUUabuYkgVObdg&client=ca-pub-9037304895410090&adurl=http://Leader3training.comhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BfwwpGvC3TJ7VAoXOcN6blagNj_j50wHH4cyQF8CNtwGQvwUQBhgGIJ-OggIoDjgAUM2o82Ng4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQJTeN7ywqmwPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=6&sig=AGiWqtyhbXQhM1aYTKVZwUUabuYkgVObdg&client=ca-pub-9037304895410090&adurl=http://Leader3training.comhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BC64ZGvC3TJ7VAoXOcN6blagNhJ3XEJjQ7ocXwI23AYDxBBAHGAcgn46CAigOOABQtJiEmAZg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=7&sig=AGiWqtxNzfNDU61O5mvRQFondDaQwN4DEg&client=ca-pub-9037304895410090&adurl=http://CoachedtoSuccess.com/personalassessments/online_assessments/leadershipmanagement.htmlhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BC64ZGvC3TJ7VAoXOcN6blagNhJ3XEJjQ7ocXwI23AYDxBBAHGAcgn46CAigOOABQtJiEmAZg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=7&sig=AGiWqtxNzfNDU61O5mvRQFondDaQwN4DEg&client=ca-pub-9037304895410090&adurl=http://CoachedtoSuccess.com/personalassessments/online_assessments/leadershipmanagement.htmlhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=Br8fNGvC3TJ7VAoXOcN6blagNqs3E0gGC2r6VF8CNtwHgpxIQCBgIIJ-OggIoDjgAUPz7r6v5_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQIVVA80CeSpPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=8&sig=AGiWqtwxML6siTnn9TMU5RIhqGJzL0A-SQ&client=ca-pub-9037304895410090&adurl=http://www.lifeskills-enrichment.com.sg/http://googleads.g.doubleclick.net/aclk?sa=l&ai=Br8fNGvC3TJ7VAoXOcN6blagNqs3E0gGC2r6VF8CNtwHgpxIQCBgIIJ-OggIoDjgAUPz7r6v5_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQIVVA80CeSpPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=8&sig=AGiWqtwxML6siTnn9TMU5RIhqGJzL0A-SQ&client=ca-pub-9037304895410090&adurl=http://www.lifeskills-enrichment.com.sg/http://googleads.g.doubleclick.net/aclk?sa=l&ai=BKFMYGvC3TJ7VAoXOcN6blagNlMC73gGUlOfZFs6u6MQEoOFnEAkYCSCfjoICKA44AFD-ttzi______8BYOGkuoWQGqABiKiS-AOyAQ53d3cuYnV6emxlLmNvbcgBAdoBQGh0dHA6Ly93d3cuYnV6emxlLmNvbS9hcnRpY2xlcy9sZWFkZXJzaGlwLXN0eWxlcy1pbi1udXJzaW5nLmh0bWyAAgGpAhVUDzQJ5Kk-wAIByALM9r0EqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=9&sig=AGiWqtw10Fxff6JEiIMGm673m7UpjMowwg&client=ca-pub-9037304895410090&adurl=http://www.youtube.com/insidedukenushttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BKFMYGvC3TJ7VAoXOcN6blagNlMC73gGUlOfZFs6u6MQEoOFnEAkYCSCfjoICKA44AFD-ttzi______8BYOGkuoWQGqABiKiS-AOyAQ53d3cuYnV6emxlLmNvbcgBAdoBQGh0dHA6Ly93d3cuYnV6emxlLmNvbS9hcnRpY2xlcy9sZWFkZXJzaGlwLXN0eWxlcy1pbi1udXJzaW5nLmh0bWyAAgGpAhVUDzQJ5Kk-wAIByALM9r0EqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=9&sig=AGiWqtw10Fxff6JEiIMGm673m7UpjMowwg&client=ca-pub-9037304895410090&adurl=http://www.youtube.com/insidedukenushttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BW5VaGvC3TJ7VAoXOcN6blagNrZOO1wHFnKfzE8CNtwGA8QQQChgKIJ-OggIoDjgAUOK6jewBYOGkuoWQGrIBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCD_-ZOlCasT6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=10&sig=AGiWqtzOPueb4XX_1r8bbgVPQ2Y5JjhM_A&client=ca-pub-9037304895410090&adurl=http://graduateinstitute.ch/corporate/_thematic.htmlhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BW5VaGvC3TJ7VAoXOcN6blagNrZOO1wHFnKfzE8CNtwGA8QQQChgKIJ-OggIoDjgAUOK6jewBYOGkuoWQGrIBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCD_-ZOlCasT6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=10&sig=AGiWqtzOPueb4XX_1r8bbgVPQ2Y5JjhM_A&client=ca-pub-9037304895410090&adurl=http://graduateinstitute.ch/corporate/_thematic.htmlhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BAMwOGvC3TJ7VAoXOcN6blagN2MWq3gGQorb8FMCNtwHw9RIQCxgLIJ-OggIoDjgAUIz79LL4_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQKv50v4JrSwPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=11&sig=AGiWqtwy2fZIP3Cy_ucNhqgNqmIksZcHEg&client=ca-pub-9037304895410090&adurl=http://www.ich-international.cahttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BAMwOGvC3TJ7VAoXOcN6blagN2MWq3gGQorb8FMCNtwHw9RIQCxgLIJ-OggIoDjgAUIz79LL4_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQKv50v4JrSwPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=11&sig=AGiWqtwy2fZIP3Cy_ucNhqgNqmIksZcHEg&client=ca-pub-9037304895410090&adurl=http://www.ich-international.cahttp://tmp/svd7d.tmp/javascript:switchid('comments','DiscussTab',2,0);http://tmp/svd7d.tmp/javascript:switchid('email','EmailTab',3,0);http://www.buzzle.com/articles/leadership-models/http://www.buzzle.com/articles/decision-making/http://www.buzzle.com/articles/decision-making/http://www.buzzle.com/articles/ethics-in-nursing-jobs-and-profession.htmlhttp://www.buzzle.com/articles/communication-techniques-in-nursing.htmlhttp://www.buzzle.com/articles/nursing/http://www.buzzle.com/articles/effective-leadership/http://www.buzzle.com/authors.asp?author=26525http://www.google.com/url?ct=abg&q=https://www.google.com/adsense/support/bin/request.py?contact=abg_afc&url=http://www.buzzle.com/articles/leadership-styles-in-nursing.html&hl=en&client=ca-pub-9037304895410090&adU=www.koganpage.com&adT=1000+training+ideas&adU=OrganicChurchLife.com&adT=Organic+Church+Leadership&adU=www.planleadexcel.com&adT=RLM+Planning+%26amp%3B+Leadership&adU=www.apihealthcare.com&adT=Automate+nurse+schedules&adU=international.mq.edu.au/distance&adT=Improve+Teaching+Skills&adU=Leader3training.com&adT=Leadership+Training&adU=CoachedtoSuccess.com&adT=Your+Leadership+Style%3F&adU=www.lifeskills-enrichment.com.sg/&adT=LifeSkills+Enrichment&adU=Youtube.com/insidedukenus&adT=Duke-NUS+Medical+School&adU=graduateinstitute.ch/executive/&adT=Decision+Making&adU=www.ich-international.ca&adT=ICH+International&adU=www.SunBuggy.com&adT=Real+Team+Building+Events&adU=www.21stCenturyjob.com&adT=Nursing+Overseas&adU=www.JobStreet.com&adT=POEA+Approved+Job+Orders&gl=PH&usg=AFQjCNHeSH3bvkL6z-BgWaFt4DhPv0Nglwhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BWileGvC3TJ7VAoXOcN6blagNrKGiwwGkx9WoFMCNtwHwhA4QBBgEIJ-OggIoDjgAUILEsVpg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=4&sig=AGiWqtxi7_f3WDzf0RGFUtWxnHPF0OjGwA&client=ca-pub-9037304895410090&adurl=http://www.apihealthcare.com/solutions_for_healthcare_providershttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BWileGvC3TJ7VAoXOcN6blagNrKGiwwGkx9WoFMCNtwHwhA4QBBgEIJ-OggIoDjgAUILEsVpg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=4&sig=AGiWqtxi7_f3WDzf0RGFUtWxnHPF0OjGwA&client=ca-pub-9037304895410090&adurl=http://www.apihealthcare.com/solutions_for_healthcare_providershttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BbjWUGvC3TJ7VAoXOcN6blagN_orE3QHeoIjWFcCNtwGw2wYQBRgFIJ-OggIoDjgAUJSHtsn-_____wFg4aS6hZAaoAGS7cvgA7IBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCU3je8sKpsD6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=5&sig=AGiWqtw-XwM6rxdI2Yz3eqG-9M9JPyIU9w&client=ca-pub-9037304895410090&adurl=http://www.international.mq.edu.au/study/distanceeducation/distance/educationhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BbjWUGvC3TJ7VAoXOcN6blagN_orE3QHeoIjWFcCNtwGw2wYQBRgFIJ-OggIoDjgAUJSHtsn-_____wFg4aS6hZAaoAGS7cvgA7IBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCU3je8sKpsD6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=5&sig=AGiWqtw-XwM6rxdI2Yz3eqG-9M9JPyIU9w&client=ca-pub-9037304895410090&adurl=http://www.international.mq.edu.au/study/distanceeducation/distance/educationhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BfwwpGvC3TJ7VAoXOcN6blagNj_j50wHH4cyQF8CNtwGQvwUQBhgGIJ-OggIoDjgAUM2o82Ng4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQJTeN7ywqmwPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=6&sig=AGiWqtyhbXQhM1aYTKVZwUUabuYkgVObdg&client=ca-pub-9037304895410090&adurl=http://Leader3training.comhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BfwwpGvC3TJ7VAoXOcN6blagNj_j50wHH4cyQF8CNtwGQvwUQBhgGIJ-OggIoDjgAUM2o82Ng4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQJTeN7ywqmwPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=6&sig=AGiWqtyhbXQhM1aYTKVZwUUabuYkgVObdg&client=ca-pub-9037304895410090&adurl=http://Leader3training.comhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BC64ZGvC3TJ7VAoXOcN6blagNhJ3XEJjQ7ocXwI23AYDxBBAHGAcgn46CAigOOABQtJiEmAZg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=7&sig=AGiWqtxNzfNDU61O5mvRQFondDaQwN4DEg&client=ca-pub-9037304895410090&adurl=http://CoachedtoSuccess.com/personalassessments/online_assessments/leadershipmanagement.htmlhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BC64ZGvC3TJ7VAoXOcN6blagNhJ3XEJjQ7ocXwI23AYDxBBAHGAcgn46CAigOOABQtJiEmAZg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sgAIBqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=7&sig=AGiWqtxNzfNDU61O5mvRQFondDaQwN4DEg&client=ca-pub-9037304895410090&adurl=http://CoachedtoSuccess.com/personalassessments/online_assessments/leadershipmanagement.htmlhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=Br8fNGvC3TJ7VAoXOcN6blagNqs3E0gGC2r6VF8CNtwHgpxIQCBgIIJ-OggIoDjgAUPz7r6v5_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQIVVA80CeSpPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=8&sig=AGiWqtwxML6siTnn9TMU5RIhqGJzL0A-SQ&client=ca-pub-9037304895410090&adurl=http://www.lifeskills-enrichment.com.sg/http://googleads.g.doubleclick.net/aclk?sa=l&ai=Br8fNGvC3TJ7VAoXOcN6blagNqs3E0gGC2r6VF8CNtwHgpxIQCBgIIJ-OggIoDjgAUPz7r6v5_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQIVVA80CeSpPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=8&sig=AGiWqtwxML6siTnn9TMU5RIhqGJzL0A-SQ&client=ca-pub-9037304895410090&adurl=http://www.lifeskills-enrichment.com.sg/http://googleads.g.doubleclick.net/aclk?sa=l&ai=BKFMYGvC3TJ7VAoXOcN6blagNlMC73gGUlOfZFs6u6MQEoOFnEAkYCSCfjoICKA44AFD-ttzi______8BYOGkuoWQGqABiKiS-AOyAQ53d3cuYnV6emxlLmNvbcgBAdoBQGh0dHA6Ly93d3cuYnV6emxlLmNvbS9hcnRpY2xlcy9sZWFkZXJzaGlwLXN0eWxlcy1pbi1udXJzaW5nLmh0bWyAAgGpAhVUDzQJ5Kk-wAIByALM9r0EqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=9&sig=AGiWqtw10Fxff6JEiIMGm673m7UpjMowwg&client=ca-pub-9037304895410090&adurl=http://www.youtube.com/insidedukenushttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BKFMYGvC3TJ7VAoXOcN6blagNlMC73gGUlOfZFs6u6MQEoOFnEAkYCSCfjoICKA44AFD-ttzi______8BYOGkuoWQGqABiKiS-AOyAQ53d3cuYnV6emxlLmNvbcgBAdoBQGh0dHA6Ly93d3cuYnV6emxlLmNvbS9hcnRpY2xlcy9sZWFkZXJzaGlwLXN0eWxlcy1pbi1udXJzaW5nLmh0bWyAAgGpAhVUDzQJ5Kk-wAIByALM9r0EqAMB6AOiA-gD_gHoA_0D6APLAvUDAgAABA&num=9&sig=AGiWqtw10Fxff6JEiIMGm673m7UpjMowwg&client=ca-pub-9037304895410090&adurl=http://www.youtube.com/insidedukenushttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BW5VaGvC3TJ7VAoXOcN6blagNrZOO1wHFnKfzE8CNtwGA8QQQChgKIJ-OggIoDjgAUOK6jewBYOGkuoWQGrIBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCD_-ZOlCasT6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=10&sig=AGiWqtzOPueb4XX_1r8bbgVPQ2Y5JjhM_A&client=ca-pub-9037304895410090&adurl=http://graduateinstitute.ch/corporate/_thematic.htmlhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BW5VaGvC3TJ7VAoXOcN6blagNrZOO1wHFnKfzE8CNtwGA8QQQChgKIJ-OggIoDjgAUOK6jewBYOGkuoWQGrIBDnd3dy5idXp6bGUuY29tyAEB2gFAaHR0cDovL3d3dy5idXp6bGUuY29tL2FydGljbGVzL2xlYWRlcnNoaXAtc3R5bGVzLWluLW51cnNpbmcuaHRtbIACAakCD_-ZOlCasT6oAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=10&sig=AGiWqtzOPueb4XX_1r8bbgVPQ2Y5JjhM_A&client=ca-pub-9037304895410090&adurl=http://graduateinstitute.ch/corporate/_thematic.htmlhttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BAMwOGvC3TJ7VAoXOcN6blagN2MWq3gGQorb8FMCNtwHw9RIQCxgLIJ-OggIoDjgAUIz79LL4_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQKv50v4JrSwPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=11&sig=AGiWqtwy2fZIP3Cy_ucNhqgNqmIksZcHEg&client=ca-pub-9037304895410090&adurl=http://www.ich-international.cahttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BAMwOGvC3TJ7VAoXOcN6blagN2MWq3gGQorb8FMCNtwHw9RIQCxgLIJ-OggIoDjgAUIz79LL4_____wFg4aS6hZAasgEOd3d3LmJ1enpsZS5jb23IAQHaAUBodHRwOi8vd3d3LmJ1enpsZS5jb20vYXJ0aWNsZXMvbGVhZGVyc2hpcC1zdHlsZXMtaW4tbnVyc2luZy5odG1sqQKv50v4JrSwPqgDAegDogPoA_4B6AP9A-gDywL1AwIAAAQ&num=11&sig=AGiWqtwy2fZIP3Cy_ucNhqgNqmIksZcHEg&client=ca-pub-9037304895410090&adurl=http://www.ich-international.cahttp://tmp/svd7d.tmp/javascript:switchid('comments','DiscussTab',2,0);http://tmp/svd7d.tmp/javascript:switchid('email','EmailTab',3,0);


10/48

Use the feedback form below to submit your comments.

Top of Form

323387 1.470774

Your

Comments:

Your Name:

Bottom of Form

Use the form below to email this article to your friends.

Top of Form

Recipient Email

Address:

Separate multiple email addresses

by ;

Your Name:

Your Email Address:

Bottom of Form


11/48

Leadership Styles in Management

Leadership Roles in Nursing

Nursing Leadership Qualities

Participative Leadership

Types of Leadership Styles

Participative Leadership Style

Leadership Theories and Styles

Leadership Styles and Examples

Different Leadership Styles

Leadership Types and Styles

Different Styles of Leadership - Six Leadership Styles

Autocratic Leadership Style

Types of Leadership Styles in Education

Leadership Styles in Education

Nurse Practitioner Salary

Pediatric Nurse Salary Range

Neonatal Nurse Salary Range

Nurse Practitioner Vs Physician Assistant

Neonatal Nurse Job Description

Interview Questions for Nurses Vocational Nurse Salary

Nurse Responsibilities

Salary of a Nurse

Nurse Practitioner Salary Range

School Nurse Salary

School Nurse Job Description

Psychiatric Nurse Practitioner Salary

Pediatric Nurse Practitioner Salary

Acute Care Nurse Practitioner Salary

Neonatal Nurse Practitioner Salary

Nurse Salary

Registered Nurse Requirements

Registered Nurse Job Description

Nursing: Prerequisites for Nursing
http://www.buzzle.com/articles/leadership-styles-in-management.htmlhttp://www.buzzle.com/articles/leadership-roles-in-nursing.htmlhttp://www.buzzle.com/articles/nursing-leadership-qualities.htmlhttp://www.buzzle.com/articles/participative-leadership.htmlhttp://www.buzzle.com/articles/types-of-leadership-styles.htmlhttp://www.buzzle.com/articles/participative-leadership-style.htmlhttp://www.buzzle.com/articles/leadership-theories-and-styles.htmlhttp://www.buzzle.com/articles/leadership-styles-and-examples.htmlhttp://www.buzzle.com/articles/different-leadership-styles.htmlhttp://www.buzzle.com/articles/leadership-types-and-styles.htmlhttp://www.buzzle.com/articles/different-styles-of-leadership-six-leadership-styles.htmlhttp://www.buzzle.com/articles/autocratic-leadership-style.htmlhttp://www.buzzle.com/articles/types-of-leadership-styles-in-education.htmlhttp://www.buzzle.com/articles/leadership-styles-in-education.htmlhttp://www.buzzle.com/articles/nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/pediatric-nurse-salary-range.htmlhttp://www.buzzle.com/articles/neonatal-nurse-salary-range.htmlhttp://www.buzzle.com/articles/nurse-practitioner-vs-physician-assistant.htmlhttp://www.buzzle.com/articles/neonatal-nurse-job-description.htmlhttp://www.buzzle.com/articles/interview-questions-for-nurses.htmlhttp://www.buzzle.com/articles/vocational-nurse-salary.htmlhttp://www.buzzle.com/articles/nurse-responsibilities.htmlhttp://www.buzzle.com/articles/salary-of-a-nurse.htmlhttp://www.buzzle.com/articles/nurse-practitioner-salary-range.htmlhttp://www.buzzle.com/articles/school-nurse-salary.htmlhttp://www.buzzle.com/articles/school-nurse-job-description.htmlhttp://www.buzzle.com/articles/psychiatric-nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/pediatric-nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/acute-care-nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/neonatal-nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/nurse-salary.htmlhttp://www.buzzle.com/articles/registered-nurse-requirements.htmlhttp://www.buzzle.com/articles/registered-nurse-job-description.htmlhttp://www.buzzle.com/articles/nursing-prerequisites-for-nursing.htmlhttp://www.buzzle.com/articles/leadership-styles-in-management.htmlhttp://www.buzzle.com/articles/leadership-roles-in-nursing.htmlhttp://www.buzzle.com/articles/nursing-leadership-qualities.htmlhttp://www.buzzle.com/articles/participative-leadership.htmlhttp://www.buzzle.com/articles/types-of-leadership-styles.htmlhttp://www.buzzle.com/articles/participative-leadership-style.htmlhttp://www.buzzle.com/articles/leadership-theories-and-styles.htmlhttp://www.buzzle.com/articles/leadership-styles-and-examples.htmlhttp://www.buzzle.com/articles/different-leadership-styles.htmlhttp://www.buzzle.com/articles/leadership-types-and-styles.htmlhttp://www.buzzle.com/articles/different-styles-of-leadership-six-leadership-styles.htmlhttp://www.buzzle.com/articles/autocratic-leadership-style.htmlhttp://www.buzzle.com/articles/types-of-leadership-styles-in-education.htmlhttp://www.buzzle.com/articles/leadership-styles-in-education.htmlhttp://www.buzzle.com/articles/nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/pediatric-nurse-salary-range.htmlhttp://www.buzzle.com/articles/neonatal-nurse-salary-range.htmlhttp://www.buzzle.com/articles/nurse-practitioner-vs-physician-assistant.htmlhttp://www.buzzle.com/articles/neonatal-nurse-job-description.htmlhttp://www.buzzle.com/articles/interview-questions-for-nurses.htmlhttp://www.buzzle.com/articles/vocational-nurse-salary.htmlhttp://www.buzzle.com/articles/nurse-responsibilities.htmlhttp://www.buzzle.com/articles/salary-of-a-nurse.htmlhttp://www.buzzle.com/articles/nurse-practitioner-salary-range.htmlhttp://www.buzzle.com/articles/school-nurse-salary.htmlhttp://www.buzzle.com/articles/school-nurse-job-description.htmlhttp://www.buzzle.com/articles/psychiatric-nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/pediatric-nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/acute-care-nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/neonatal-nurse-practitioner-salary.htmlhttp://www.buzzle.com/articles/nurse-salary.htmlhttp://www.buzzle.com/articles/registered-nurse-requirements.htmlhttp://www.buzzle.com/articles/registered-nurse-job-description.htmlhttp://www.buzzle.com/articles/nursing-prerequisites-for-nursing.html


12/48

Qualities of a Good Nurse

LPN Job Description

Nurse Anesthetist Salary

Traveling Nurse Salary

Average LPN SalaryBusiness & Finance Business Articles

Top of Form

partner-pub-9037 FORID:10 ISO-8859-1

Search

REFLECTIVE MANAGEMENT LEARNING PRACTICE MODELTunc Medeni, JAIST,Japanese Advanced Institution of Science and Technology,8-1 Asahidai, Tatsunokuchi, Nomigun, Ishikawaken, [email protected] ABSTRACTIn discussions of the interrelations of Management, Development, Knowledge,Practice, and Learning, the concepts of Reflection and Transfer of Knowledge hold animportant place. While transfer of knowledge can be described as how we transferwhat we have learned in one place or time to another place or time, when we need tomake use of this learned knowledge; reflection has several interpretations, likereflection-on-action and critical reflection, in addition to various basic definitions thatenable us make use of the concept to understand learning, knowing and acting.

Using Peter Checkland`s Appreciative System and Soft Systems Methodology we canalso conceptualize reflection as a systematic approach to the process of inquiry intoproblematic situations, approaching the issues in a soft, purposeful way (instead of ahard, goal-oriented one), in appreciation of the important concerns of a given situation(like maintenance of existing relationships). We can also use natural sciencephenomena to explain reflection in a more systematic way. It seems that many issuesabout reflection have their origins in the natural sciences, and we can use these asmetaphors to explain and make use of the term as a psychological and social concept.For example, when we discuss reflection, inevitably we must also consider refraction.This is the natural phenomenon we observe in prisms; when light passes through theprism it is refracted and split into the colors of the rainbow. The effect of the prismon the sun ray passing through it can be interpreted as an individual dimension ofreflection: As the prism turns white light into different colors with refraction andthen again into white light with reflection, individual can freely and creatively think invarious enriching ways, and then come up with a single refined plan of action. Inaddition, psychoanalytic a reflecting mirror can help an individual reflecthimself/herself. This can be done individually or in front of another person, whichalso helps the other person reflect him/herself, and highlights the interpersonaldimension of the reflection. Moreover, the freethinking associated with reflectioncoincides with the emancipatory nature of the term, as an important social dimension.
http://www.buzzle.com/articles/qualities-of-a-good-nurse.htmlhttp://www.buzzle.com/articles/lpn-job-description.htmlhttp://www.buzzle.com/articles/nurse-anesthetist-salary.htmlhttp://www.buzzle.com/articles/traveling-nurse-salary.htmlhttp://www.buzzle.com/articles/average-lpn-salary.htmlhttp://www.buzzle.com/chapters/business-and-finance.asphttp://www.buzzle.com/chapters/archives-223.asphttp://www.buzzle.com/articles/qualities-of-a-good-nurse.htmlhttp://www.buzzle.com/articles/lpn-job-description.htmlhttp://www.buzzle.com/articles/nurse-anesthetist-salary.htmlhttp://www.buzzle.com/articles/traveling-nurse-salary.htmlhttp://www.buzzle.com/articles/average-lpn-salary.htmlhttp://www.buzzle.com/chapters/business-and-finance.asphttp://www.buzzle.com/chapters/archives-223.asp


13/48

This stresses being critical and evaluative towards an outcome that is liberating, ineffect, for society.BAI 2004 (International Workshop on Business and Information)

-2

We have come a long way from ancient discoveries about how to reflect or refractlights and images using mirrors to our current use of similar principles in the transfer

of data and information. This transferability can also be applied to knowledge for ourfuture. Here temporal and spatial concerns are very important, relating to theinter-social dimension of reflection. For example, light passes through variouscontexts, but our minds have a tendency to simply perceive the course of light in alinear fashion. Thus, we mistakenly see a break in the handle of a teaspoon in a glassof water. That simple misperception of the eye and mind can be explained accordingto the laws and rules of classical physics. This linearity can also be observed in otherhuman activities. In thinking and decision-making processes, we can question themisperception caused by the refraction in our mental processes. There are manyother important natural phenomena that we cannot yet explain completely; as newdiscoveries, like those in quantum mechanics, are made, they can be used tounderstand these natural occurrences and also as analogies to increase ourunderstanding in the social sciences.Finally, using the mathematical features of the ellipse, and conceptualizing the practiceof management and learning, both as a product and process, we can develop thefollowing illustration for a reflective management-learning model:The model I have developed in this work has important implications like equallysignifying the importance of learning in action and action in learning in a visible wayfor maybe a very first time.Other than its highlighting some special points, I think its value as a general systematicframe was limited among the receivers of my work. Even if bound to be limited theuse of natural sciences phenomena in this way in social sciences was an interestingattempt, where even the exchange among similar, closest fields are uncommon because

of the isolating expertise of the individual fields.BAI 2004 (International Workshop on Business and Information)

-2

This is somewhat related to discussions of soft and hard systems methodology, inwhich, simplistically, the former stresses the process and the latter signifies the product.Initially desired, the ideal is to be able to obtain both the process and product.Second, if we place learning, and management (or) practice as he two loci in an ellipse,the resulting figure provides a useful expression for the attainment of process andproduct. This elliptical diagram is recognition of the equal importance of bothlearning and management or practice, moving beyond the perception of previouscircular models like learning cycles, etc. Moving along the ellipse, one can obtain theprocess, then process and product together, and finally the product by itself, which is

transferred to the other side with a reflective object passing through the middle of thewhole figure. In this way we can visualize both the spatial and temporal meanings ofthe possible transfer of the rich experience and knowledge gained from learning andmanagement practice.REFERENCESCheckland, P. 1999. Systems thinking, systems practice. Chichester: John Wiley &Sons. References...


14/48

Argyris, C., & Schn, D. A. (1974). Theory in practice: Increasing professional

effectiveness. San Francisco, CA: Jossey-Bass.

Bolman, L., & Deal, T. (2003). Reframing organizations: Artistry, choice, and

leadership (3rd edition). San Francisco, CA: Jossey-Bass.

McWhinney, W. (1992). Paths of change: Strategic choices for organizations

and society. Newbury Park, CA: Sage Publications.

Schn, D. A. (1991). Educating the reflective practitioner. San Francisco,

CA: Jossey-Bass.

Sergiovanni, T. J. (1989). Informing professional practice in educational

administration. Journal of Educational Administration, 27(2), p. 186.

Bottom of Form

Custom Search

Topics

Perceptions of Nurse Managers' Leadership Style by Nurse Managers and RN Staff: JobSatisfaction as Perceived by RN StaffRichard McElhaney, DNS, RN, Nursing, University of Mobile, Mobile, AL, USA

Learning Objective #1: Describe, compare, and explore the nurse managers' perceptions of theirleadership styles versus RN staff members' perceptions of the nurse manager' leadership style.

Learning Objective #2: Ascertain if leadership effectiveness and leadership flexibility on nursemanagers are predictive of job satisfaction.

ABSTRACT The nursing profession is changing rapidly due to changes in healthcaresuch as: shifting social values, downsizing, and federal regulations. Most nurse managers are ill

prepared for changes associated with their role today. Effective nursing leadership is essential to


15/48

meet the challenges that these complex changes present to the healthcare profession. Thisdescriptive, comparative, study was conducted to compare perceptions of leadership style of

nurse managers as perceived by the nurse managers and their RN staff using Hersey andBlanchards (1991) Situational Leadership Model. A convenience sample of 11 nurse managers

and 79 Registered Nurse staff from one hospital setting was used to compare perceptions ofnurse managers leadership styles. A second purpose of the study was to determine RN staff

perceptions of leadership style effectiveness and leadership flexibility of their nurse managerswere predictive of job satisfaction using Stamps (1997) Index of Work Satisfaction.

Nnurse manager respondents were female, average age of thirty-one. Majority had amasters degree in nursing, had between 6-10 years of experience in their position and in their

assigned unit for more than five years. Majority of the RN staff were female, average age of RNstaff was 36,had a Bachelor of Science degree in nursing and worked in their unit for 1-5 years.

RN staff perceived the leadership style effectiveness of the nurse manage as beingsignificantly less effective than did the nurse managers. The leadership effectiveness styles of

nurse managers as perceived by RN staff were predictive of two components of job satisfaction:nurse-nurse interaction and total interaction. Comparing perceptions of the nurse

managers with those of RN staff will help nurse managers identify areas that may improve their

leadership ability in various situations.See more ofStrategies in Nursing AdministrationSee more ofThe 17th International Nursing Research Congress Focusing on Evidence-BasedPractice (19-22 July 2006)

Abstract

Objective: The purpose of this study was to look at manager and staff perceptions of themanager's leadership style and to determine what effect transformational leadership style has onjob satisfaction.

Background: Nursing job satisfaction is a critical element in addressing the nursing shortage.Literature supports that job satisfaction is related to nurse manager leadership style. This fact hascaused nurse managers to carefully consider their leadership style and the impact it has on thenurses they manage.

Methods: A descriptive correlational, comparative design was used in a convenience sample ofnurse managers and their direct report nursing staff (n = 92).

Results: A correlation was found between nurse manager transformational leadership style andnurse job satisfaction (r= 0.348,P< .05).

Conclusion: Transformational leadership style was associated with higher levels of jobsatisfaction. The findings added to the knowledge about variables that are correlated with jobsatisfaction, which is a critical issue to nursing.

With a 20% deficit of nurses predicted by 2010,1every nurse executive in the nation is strivingto recruit and retain nurses and identify what the nursing workforce really wants in theirleaders.2 Although the evidence indicates that nurse managers with transformational leadershipstyles have a positive effect on nursing staff job satisfaction,3-6 organizational commitment,7and retention,8 not all nurse leaders have adopted this style of management. Many nurse leadersaspire to this style of management and often assume that they demonstrate transformationalleadership behaviors, but what do their subordinates say about their manager's leadership style?
http://stti.confex.com/stti/congrs06/techprogram/session_7389.htmhttp://stti.confex.com/stti/congrs06/techprogram/meeting_congrs06.htmhttp://stti.confex.com/stti/congrs06/techprogram/meeting_congrs06.htmhttp://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://stti.confex.com/stti/congrs06/techprogram/session_7389.htmhttp://stti.confex.com/stti/congrs06/techprogram/meeting_congrs06.htmhttp://stti.confex.com/stti/congrs06/techprogram/meeting_congrs06.htmhttp://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617


16/48

How does the manager's leadership style affect the subordinates' job satisfaction? This studyexamined managers' leadership styles from their perspective and from that of their subordinatesand the association between their leadership styles and their subordinates' job satisfaction. It wasexpected that nurse leaders who demonstrated transformational leadership styles would havemore satisfied subordinates as compared with managers with transactional or laissez-faire styles.

Conceptual Framework

The transformational and transactional leadership theory suggests that that there is a relationshipbetween the manager's leadership style and the followers' motivation and satisfaction levels asindicated in the Augmentation Model of Transactional and Transformational Leadershipconceptual model.3 Bass and Avolio3indicated that transformational leaders influence thefollowers' perceptions of what is important through 5 critical strategies: (1) idealized influence orinstilling employee pride in the leader's vision and mission,9 (2) idealized or behavioralinfluence or using leader behaviors to demonstrate his/her values and mission to employees, (3)inspirational motivation by increasing staff's awareness and acceptance of the desired mission,(4) intellectual stimulation by influencing followers to think in new ways, and (5) individualizedconsideration by mentoring followers or expressing appreciation when the mission and related

goals are accomplished.

In contrast, transactional leaders use exchange transactions to reward staff performance3,10using 2 major strategies: (1) contingent rewards by giving constructive recognition for theemployees accomplishing the leader's vision and (2) active management by exception by givingcorrective feedback to ensure that specific delegated tasks are accomplished.

A third style of leadership, "passive/avoidant behavior," or a laissez-faire style is the absence ofeither transformational or transactional leadership and is considered to be a nontransaction ornonleadership style10,11 and is thought to be ineffective resulting in negative outcomes.

When leaders augment transactional with transformational leadership, "a greater amount ofExtra Effort, Effectiveness, and Satisfaction is possible from employees."3(p22) Therefore,

successful leaders must use a mix of both transformational and transactional styles and caninfluence staff by demonstrating behaviors that meet subordinates' needs through interactionalencounters that motivate them to achieve outcomes beyond what they would ordinarilyaccomplish in any other style.

Leadership is "one of the most observed and least understood phenomena on earth"12(p2)

because it is complex and multidimensional.13 Kouzes and Posner14 described leadershipas the "relationship between those who aspire to lead and those who choose tofollow."14(p20) Leaders do not exist without followers, and the 2 separate roles arecomplementary.13 Leadership style affects the work environment,7 job satisfaction,15 andretention.16

Transformational leadership has been associated with strong subordinate emotional

affiliation with the leader influencing the subordinates' behavior and their perceptions ofthe leaders' effectiveness. The transformational leader creates an environment thatstimulates individual growth among his/her subordinates8 and energizes his/hersubordinates to perform beyond their expectations, because the subordinates haveinternally adopted their leader's vision and mission.12,17

Bass18 described differences in how subordinates perceive the transformational andtransactional leaders' effectiveness. Transformational leadership and subordinates' view ofleaders' effectiveness were reported to be significant and highly correlated as compared
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617


17/48

with transactional leadership and perceptions of a leader's effectiveness.18 Similarly,McGuire and Kennerly7 reported significant and moderate correlations betweentransformational leadership and organizational commitment (r= 0.39,P< .01) ascompared with a significant and negative association between a laissez-faire style andsubordinate's organizational commitment (r= -0.20,P< .01). Organizational commitmentis often viewed as a result of a satisfied workforce.

Job satisfaction is a multidimensional construct that describes workers' feelings ofenjoyment, fulfillment, and appreciation for their work at a level they believe it shouldbe.15,19,20 Bratt et al19 reported significant and strong associations betweenorganizational work satisfaction and nursing leadership behaviors (r= 0.56,P< .001). Radand Yarmohammadian15 indicated a relationship between a hospital manager's years ofexperience and 2 leadership dimensions of employee-oriented leadership (r= 0.736,P= .024) and task-oriented leadership (r= 0.706,P= .023), which are likely the result ofexperience and confidence in the manager role. Job satisfaction has also been associatedwith staff empowerment5; magnet designation with participatory management styles6;patient-centered care and staff opportunities for independent thinking, input into theorganization, and professional growth21; and transformational leadership andprofessionalism among the staff.22 Job dissatisfaction has also been studied in associationwith leadership styles and organizational attributes. Job satisfaction was related more topatient care, professionalism, autonomy, and opportunities for learning and growth.21 Jobdissatisfaction was related to organizational factors such as threats to personal safety, lackof fairness, organizational politics, and threats of possible layoffs.21,23

The importance of nurse job satisfaction cannot be overstated because it impacts manyvariables including patient satisfaction, quality of patient care, intent to stay or leave,satisfaction and trust in management, and the overall work environment.16,19,21,23,24Furthermore, the reported studies indicated that if nurse managers desire to positivelyinfluence nurse job satisfaction, the managers must identify strategies that will empowernurses by adopting and implementing transformational leadership styles.5,15 This study is

important because being a transformational leader is a highly desired trait, and manynurse managers aspire to be and perceive themselves to be transformational leaders, butthis self-reported perception may not be validated by subordinates' perceptions of theirmanager's leadership style.

Methodology

This study used a cross-sectional, descriptive correlational and comparative design withself-administered questionnaires. Approval to conduct this study was obtained from theinstitutional review boards of the authors' hospital and university. The convenience sample(n = 92) included 15 nurse managers and their respective nursing staff drawn from apopulation of nurse managers and nurses in a not-for-profit metropolitan hospital campus

consisting of an acute care hospital, a women's hospital, an outpatient pavilion, and apsychiatric hospital located in southern California. Managers were included if they hadbeen in their current position for at least 6 months, had 24-hour accountability for 1 ormore patient care areas, and had at least 3 direct-report staff nurses who also agreed toparticipate.3 A significance level ofa = .05 was set, and a power analysis was done withmethodology described by Polit and Beck.25 It was determined that a sample size of 88would be sufficient to obtain a power of .80 and a medium effect size of .30 to prevent typesI and II errors. Of the 155 research packets distributed, a total of 92 were returned (59%
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617


18/48

response rate), with 14 nurse managers matched with 76 staff nurses submitting usablesurveys.

Data were collected by distributing self-administered questionnaire(s) to nurse managersand to their direct-report nursing staff during staff meetings. Each study participantreceived a cover letter explaining the study's purpose, methods to ensure anonymity and

confidentiality of the participants' responses, and the process to participate in or opt out ofthe study. The return of completed research packets by participants indicated consent toparticipate.

Instruments with known psychometric properties were used with the authors' permissionsto operationalize the study's variables of interest.

Bass and Avolio's Multifactor Leadership Questionnaire (MLQ)26 was used to measure theleadership characteristics of nurse managers. The questionnaire contains 12 subscales and45 items that identify and measure leadership effectiveness behaviors shown to be stronglyassociated with both individual and organizational success.3 Five subscales measureelements of transformational leadership; 2 subscales measure transactional leadership; 2subscales measure laissez-faire/passive avoidant leadership; and the last 3 subscales

measure leadership outcomes. Confirmatory factor analysis was used to confirm theconstruct validity and to identify subscales. Construct validity was further determined bycorrelating the MLQ with the Gordon Personal Profile and the Thinking Scale of theMyers-Briggs Type Indicator.26 The instrument has been used in multiple studies and hasdemonstrated stable psychometric properties.27

The MLQ uses Likert-like scoring ranging from 0 (not at all) to 4 (frequently, if notalways). When scored, the resulting values indicate the leadership characteristics mostfrequently used and the predominant leadership style of the leader. Two versions of theinstrument were used: the self-assessment Leader Form (5x-Short) completed by nursemanagers and the Rater Form (5x-Short) completed by staff nurses to record theirperceptions of their managers' leadership characteristics. Both forms have demonstrated

acceptable psychometric properties in multiple studies with Cronbach [alpha]'s on theLeader Form subscales ranging from .60 to .78 and Cronbach [alpha]'s on the Rater Formsubscales ranging from .70 to .84. For this study, Cronbach [alpha]'s for the Leader Formranged from .39 to .84 and on the Rater Form from .61 to .84. The lower Cronbach[alpha]'s in this study are likely the result of a small sample size of nurse managers.

The concept of job satisfaction was operationalized using the Stamps28 Index of WorkSatisfaction Questionnaire-Part B (IWS-B), measuring staff nurses' job satisfactionthrough an attitudinal scale with total scores reflecting the level of job satisfaction. TheIWS-B is a 44-item questionnaire with 6 subscales measuring the following dimensions: (1)pay, (2) autonomy, (3) task requirements, (4) interaction, (5) professional status, and (6)organizational policies. The instrument uses a 7-point Likert scale ranging from 1

(agreement) to 7 (disagreement) yielding interval-level data, with higher scores indicatinghigher levels of job satisfaction. Previously reported studies reported high internalreliability with Cronbach [alpha]'s ranging from .69 to .83 for the entire scale.28 Contentvalidity was reported to be CVI = .87, and the test-retest reliability to be r= 0.83.29 In thisstudy, the Cronbach [alpha]'s for the subscales ranged from .56 to .88.

Two separate demographic forms were developed for nurse managers and staff nurses todescribe the samples and to control for possible confounding variables such as sex, age,race, marital status, highest nursing and nonnursing degree attained, years in the nursing
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617


19/48

profession, years of experience as a line manager, years of experience as a manager incurrent unit(s), and the average hours worked per week. The clinical staff nurse formincluded similar items but included additional items such as current position, work shift,and work status.

Data were analyzed using the SSPS, version 15.0.1,30 with descriptive statistics used to

describe the sample; Pearson product-moment correlation coefficients were used toevaluate the relationships among study variables and demographic variables; and a 1-wayanalysis of variance was used to test differences between the nurse managers' perceptionsof their leadership style as compared with the subordinates' perceptions of their leader'sstyle. Each individual nurse manager's data were compared with his/her aggregated unitdata obtained from his/her subordinate nurses.

Results

The nurse managers in the sample ranged in age from 29 to 66 years (mean, 49.1 years),with a mean of 24.9 years of experience in nursing and 3.3 years in their current position.Years in a line-management position ranged from 1 to 17 years (mean, 7.5 years). The

nurse managers were mainly women (92.9%), white (85.7%), and divorced (50.0%). Thenurse managers in the sample were educationally prepared as follows: diploma (7.1%),associate (14.3%), baccalaureate (64.3%), or master's prepared (14.3%). All worked fulltime, and respondents claimed they worked nearly 50 hours weekly (mean, 48.07 hours).

The staff nurse sample was slightly younger than the managers and ranged in age from 45to 71 years (mean, 43.4 years) and had a mean of 17.2 years' experience in nursing. Thestaff nurses were mainly women (88.2%), white (73.7%), and married (59.2%). Most staffnurses in the sample were educationally prepared at either the associate (26.3%) orbaccalaureate (53.9%) level, with the remainder being diploma (15.8%), master's (1.3%),or doctoral prepared (1.3%) nurses. The majority worked full time (86.8%). Most staffnurses worked either 12-hour day shift (43.4%) or 12-hour night shift (32.9%). In addition,some held degrees in fields other than nursing including associate degrees (16%),baccalaureate degrees (13%), and master's degrees (3%). None of the demographicvariables were significantly correlated with leadership style or job satisfaction.

The following research questions were generated:

Nurse managers as transformational and transactional

leaders

Nursing Economics, July-August, 2006 by Elaine McGuire,Susan M. KennedyThe effective leader achieves a balance between transformational and transactional behaviors,thus creating a leadership style that matches the needs of followers. The leader can then helpfollowers to realize greater individual and organizational achievements (Bass, 1998). Followerswho feel more self-confident and involved, have a sense of belonging, and share a common
http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://findarticles.com/p/articles/mi_m0FSW/http://findarticles.com/p/articles/mi_m0FSW/is_4_24/http://findarticles.com/p/search/?qa=Elaine%20McGuirehttp://findarticles.com/p/search/?qa=Susan%20M.%20Kennedyhttp://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=825617http://findarticles.com/p/articles/mi_m0FSW/http://findarticles.com/p/articles/mi_m0FSW/is_4_24/http://findarticles.com/p/search/?qa=Elaine%20McGuirehttp://findarticles.com/p/search/?qa=Susan%20M.%20Kennedy


20/48

sense of direction tend to emerge as committed and loyal employees of the organization. Thestrength or degree of this commitment is reflected by a strong value in and acceptance of theorganization's goals and values. There is a readiness to expend considerable effort on behalf ofthe organization and a strong desire to remain a member of the organization.

Purpose

The purpose of this study was to explore the transformational and transactional leadershipcharacteristics of nurse managers in relation to the organizational commitment of RNs workingon their respective unit(s). Each manager's predominant leadership style was self-identified andthen re-examined in contrast to staff's perceptions of the leadership style used.

Research questions

1. What is the relationship between the nurse manager's self-assessment and the RNs' assessmentof the manager as it relates to transformational and transactional leadership characteristics?

2. What is the relationship between the RNs' perception of the nurse manager's transformationaland transactional leadership characteristics and the degree of organizational commitmentdemonstrated by the same RNs?

3. What is the relationship between the self-assessed transformational and transactionalleadership characteristics of the nurse manager and the degree of organizational commitmentdemonstrated by the RNs reporting to that nurse manager?

Methodology

This descriptive correlational study examined the relationship between two key variables: theleadership style of nurse managers and the organizational commitment of staff nurses.Similarities and differences in nurse manager and staff nurse perceptions of leadershipcharacteristics were also explored.

Sample

The chief nursing officers of 21 not-for-profit hospitals with greater than 150 beds located in theMidwest region of the country were contacted to obtain permission to include nurse managers oftheir respective acute care nursing units in the study. Eleven of the 21 eligible hospitals agreed toparticipate. A convenience sample comprised 63 nurse managers who had been in their currentposition for at least 6 months. Each manager had 24-hour accountability and directed, planned,coordinated, and controlled the operational activities and personnel for one or more patient careareas. For a nurse manager to be a participant in this research, at least 5 of their 15 or moredirect-report RN staff also had to agree to participate.

The nurse manager sample's demographic characteristics reflected the general nursing

population. The sample was predominantly female (94%) and between the ages of 36 and 55.The managerial experience of the group showed a wider variation ranging from as few as 6months to as long as 33 years. The majority of nurse managers (76%) held either a baccalaureateor master's degree in nursing. Over half (59%) of the nurse managers had operationalresponsibility for more than one nursing unit and supervised an average of 64 employees. Thenurse managers often managed multiple specialty areas and multiple cost centers.
http://www.jenonline.org/issues?Vol=34http://www.jenonline.org/issues/contents?issue_key=S0099-1767(08)X0005-4


21/48

Volume 34, Issue 5, Pages 403-409(October 2008) 9 of 40

ABSTRACT

FULL TEXT

FULL-TEXT PDF(139 KB)

GET FULL TEXTELSEWHERE

Top of Form

S0099-1767(07)0

CITATION ALERT

CITED BY

RELATEDARTICLES

EXPORT CITATION

EMAIL TO ACOLLEAGUE

DOWNLOADIMAGES

NEED REPRINTS?

BOOKMARKARTICLE

Bottom of Form

The Impact of ED Nurse Manager Leadership Style on StaffNurse Turnover and Patient Satisfaction in Academic

Health Center HospitalsTop of Form
http://download.journals.elsevierhealth.com/ppt/journals/0099-1767/PIIS0099176707004680.pptmailto:[email protected]://www.jenonline.org/article/S0099-1767(07)00468-0/abstract#cor1http://tmp/svd7d.tmp/javascript:openPopupWin('/imagesinfo','',400,200,200,200);http://www.jenonline.org/article/S0099-1767(08)00053-6/abstracthttp://www.jenonline.org/article/S0099-1767(07)00519-3/abstracthttp://download.journals.elsevierhealth.com/ppt/journals/0099-1767/PIIS0099176707004680.ppthttp://download.journals.elsevierhealth.com/ppt/journals/0099-1767/PIIS0099176707004680.ppthttp://www.jenonline.org/article/S0099-1767(07)00468-0/abstracthttp://www.jenonline.org/article/S0099-1767(07)00468-0/abstract


22/48

yes platform+medline author author

Glenn

H. Raup, PhD, MSN, RN, CNA-BC

Bottom of Form

published online 13 June 2008.

Introduction

Nurse managers with effective leadership skills are an essential component to the solution forending the nursing shortage. Empirical studies of existing ED nurse manager leadership stylesand their impact on key nurse management outcomes sush as staff nurse turnover and patientsatisfaction have not been performed. The specific aims of this study were to determine whattypes of leadership styles were used by ED nurse managers in academic health center hospitalsand examine their influence on staff nurse turnover and patient satisfaction.

Method

ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completedsurveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academichealth centers were obtained.

Results

Fishers exact test with 95% confidence intervals were used to analyze the data. The samplepercentage of managers who exhibited Transformational leadership styles and demographicfindings of nurse manager age, total years experience and length of time in current positionmatched current reports in the literature. A trend of lower staff nurse turnover with

Transformational leadership style compared to non-Trasformational leadership styles wasidentified. However, the type of leadership style did not appear to have an effect on patientsatisfaction.

Discussion

The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nursemanager leadership strategies are vital to maintaining the standards of professional emergencynursing practice to create an environment that can produce management outcomes of decreasedstaff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patientsatisfaction.

Perceptions of Nurse Managers' Leadership Style by Nurse Managers and RN Staff:

Job Satisfaction as Perceived by RN Staff

Richard McElhaney, DNS, RN, Nursing, University of Mobile, Mobile, AL, USA

Learning Objective #1: Describe, compare, and explore the nurse managers'

perceptions of their leadership styles versus RN staff members' perceptions of the

nurse manager' leadership style.

Learning Objective #2: Ascertain if leadership effectiveness and leadership flexibility


23/48

on nurse managers are predictive of job satisfaction.

ABSTRACT The nursing profession is changing rapidly due to changes in healthcaresuch as: shifting social values, downsizing, and federal regulations. Most nurse managers are ill

prepared for changes associated with their role today. Effective nursing leadership is essential tomeet the challenges that these complex changes present to the healthcare profession. This

descriptive, comparative, study was conducted to compare perceptions of leadership style ofnurse managers as perceived by the nurse managers and their RN staff using Hersey and

Blanchards (1991) Situational Leadership Model. A convenience sample of 11 nurse managersand 79 Registered Nurse staff from one hospital setting was used to compare perceptions ofnurse managers leadership styles. A second purpose of the study was to determine RN staff

perceptions of leadership style effectiveness and leadership flexibility of their nurse managerswere predictive of job satisfaction using Stamps (1997) Index of Work Satisfaction.

Nnurse manager respondents were female, average age of thirty-one. Majority had amasters degree in nursing, had between 6-10 years of experience in their position and in their

assigned unit for more than five years. Majority of the RN staff were female, average age of RNstaff was 36,had a Bachelor of Science degree in nursing and worked in their unit for 1-5 years.RN staff perceived the leadership style effectiveness of the nurse manage as being

significantly less effective than did the nurse managers. The leadership effectiveness styles ofnurse managers as perceived by RN staff were predictive of two components of job satisfaction:

nurse-nurse interaction and total interaction. Comparing perceptions of the nursemanagers with those of RN staff will help nurse managers identify areas that may improve their

leadership ability in various situations.

See more ofStrategies in Nursing AdministrationSee more ofThe 17th International Nursing Research Congress Focusing on Evidence-BasedPractice (19-22 July 2006)

Leadership Styles in NursingLeadership styles in nursing management play a very significant role in the

management of a nursing facility. This article throws light on management and

leadership styles in nursing.
http://stti.confex.com/stti/congrs06/techprogram/session_7389.htmhttp://stti.confex.com/stti/congrs06/techprogram/session_7389.htmhttp://stti.confex.com/stti/congrs06/techprogram/meeting_congrs06.htmhttp://stti.confex.com/stti/congrs06/techprogram/meeting_congrs06.htmhttp://stti.confex.com/stti/congrs06/techprogram/session_7389.htmhttp://stti.confex.com/stti/congrs06/techprogram/meeting_congrs06.htmhttp://stti.confex.com/stti/congrs06/techprogram/meeting_congrs06.htmhttp://www.google.com/url?ct=abg&q=https://www.google.com/adsense/support/bin/request.py?contact=abg_afc&url=http://www.buzzle.com/articles/leadership-styles-in-nursing.html&hl=en&client=ca-pub-9037304895410090&adU=www.immigration.ca&adT=Immigrate+as+a+Nurse&adU=www.iomba.ch&adT=Intl+Organizations+MBA&adU=www.callidussoftware.com/coaching&adT=Callidus+Sales+Training&adU=CoachedtoSuccess.com&adT=Your+Leadership+Style%3F&adU=Leader3training.com&adT=Leadership+Course+Online&adU=www.voyedge.net&adT=IT+Personal+Development&adU=OrganicChurchLife.com&adT=Organic+Church+Leadership&adU=international.mq.edu.au/distance&adT=Improve+Teaching+Skills&adU=www.lifeskills-enrichment.com.sg/&adT=LifeSkills+Enrichment&adU=www.veritas-pi.com&adT=Restructuring-Leadership&adU=Youtube.com/insidedukenus&adT=Duke-NUS+Medical+School&adU=www.JobStreet.com&adT=Top+POEA+Agencies+Hiring&adU=www.apihealthcare.com&adT=Patient+Classification&adU=www.AyosDito.ph&adT=Part+Time+Job&gl=PH&usg=AFQjCNHBzsRagxJNKgtbICwQAirZVHoJ1Q


24/48

Ads by Google

Immigrate as a Nurse Want to Live & Work in Canada? Free evaluation of yourcreditials www.immigration.ca

Intl Organizations MBA An MBA with a Soul with a unique focus on Social

Entrepreneurship www.iomba.ch

Callidus Sales Training Boost sales by up to 20% with sales training from Callidus.

Learn how. www.callidussoftware.com/coaching

A nursing leader might either be a nurse manager who is assigned the obligation of

handling one unit or a nurse executive who is responsible for the operations of all

in-patient nursing units. Usually, a successful or effective nurse leader, typically has

a repertoire ofleadership skills that she employs according to the situations that are

being faced.

Leadership Skills in Nursing

After a nurse graduates from a nursing school and gets her Registered Nurse (RN)

license, she normally possesses some fundamental leadership skills to apply to

direct patient care. As she gets more experienced and advances in her post, she

would be required to learn more on leadership. There are many leadership courses

that are available in colleges and universities, professional education facilities, and

even large public and private hospitals. It is truly crucial for a nurse to seek advice,

mentoring, and coaching from a senior nurse leader who would render honestfeedback regarding her leadership style.

Types of Leadership Styles in Nursing

Broadly speaking, there are two types of fundamental leadership styles, democratic

and autocratic. These styles are further divided into subcategories. For instance, a

nurse leader who is democratically inclined, would engage his nurses in decision-

making and let them carry out their work in an independent manner. Whereas, a
http://www.buzzle.com/articles/nursing-schools/http://www.buzzle.com/articles/leadership-courses/http://www.buzzle.com/articles/coaching/http://www.buzzle.com/articles/coaching/http://www.buzzle.com/articles/leadership-styles/http://www.buzzle.com/articles/leadership/http://www.buzzle.com/articles/leadership-and-management/http://googleads.g.doubleclick.net/aclk?sa=l&ai=BprC9Mhy6TKvpLIGPcNai0MIEqo3ZwQHiwuioFcCNtwGg7w8QARgBIJ-OggIoDjgAUKiOz6AHYOGkuoWQGqAB7IuJ_wOyAQ53d3cuYnV6emxlLmNvbcgBAdoBQGh0dHA6Ly93d3cuYnV6emxlLmNvbS9hcnRpY2xlcy9sZWFkZXJzaGlwLXN0eWxlcy1pbi1udXJzaW5nLmh0bWyAAgHIAvTe1QWoAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=1&sig=AGiWqtw1ygFo3KvOFm6RWyQmP3clMSTGlw&client=ca-pub-9037304895410090&adurl=https://www.immigration.ca/assess2.asphttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BprC9Mhy6TKvpLIGPcNai0MIEqo3ZwQHiwuioFcCNtwGg7w8QARgBIJ-OggIoDjgAUKiOz6AHYOGkuoWQGqAB7IuJ_wOyAQ53d3cuYnV6emxlLmNvbcgBAdoBQGh0dHA6Ly93d3cuYnV6emxlLmNvbS9hcnRpY2xlcy9sZWFkZXJzaGlwLXN0eWxlcy1pbi1udXJzaW5nLmh0bWyAAgHIAvTe1QWoAwHoA6ID6AP-AegD_QPoA8sC9QMCAAAE&num=1&sig=AGiWqtw1ygFo3KvOFm6RWyQmP3clMSTGlw&client=ca-pub-9037304895410090&adurl=https://www.immigration.ca/assess2.asphttp://googleads.g.doubleclick.net/aclk?sa=l&ai=BtxptMhy6TKvpLIGPcNai0MIEp7_hcbn_w6IDwI23AbDFNxACGAIgn46CAigOOABQ-ZvxPWDhpLqFkBqyAQ53

Releted Lit

Documents

Transcript of Releted Lit