1 postsRe: Topic 1 DQ 2

This paper compares and contrasts two leadership theories: transformational and authentic leadership. In addition to this, the paper takes a look at the strengths and weaknesses of each of these two theories in relation to the nursing profession. To begin with, Sfantou et al. (2017) note in their article that the leadership style that is pursued by the leader is highly important, since it determines the nature of the relationship between an individual who is at the top of the organization (or heads the team) and his/her subordinates/followers. When it comes to transformational leaders, they are able to create strong relationships among team members, as well as motivation in the team (in general). Also, transformational leaders are known for improving worker commitment to goal attainment, as well as boosting overall performance on the institutional level (Asif et al., 2019).

What about authentic leaders? They align values with actions and are known for building transparent relationships with their followers (Carvalho et al., 2016). Also, authentic leaders create an environment where everybody feels respected and appreciated for his/her contribution, no matter how small or big (Nelson et al., 2014). If the two leadership styles were compared and the “best” one was chosen for addressing nursing issues, I would point to authentic leadership. Establishing trustful relationships is one of the pillars of a well-functioning nursing team. An authentic leader knows how to do this. Transformational leaders, on the other hand, are really result-oriented. However, in a nursing environment this can actually hinder the working process. For nurses, it is important to be transparent, trustful of their leader, and empathic. In my opinion, authentic leaders help to foster these qualities in their followers to a great extent. While both leadership styles are worthy of consideration, authentic leadership is the “better” version of the two.

References

Sfantou, D., et al. (2017). Importance of leadership style towards quality of care measures in healthcare settings. Retrieved from Healthcare, 5(4).

Asif, M., et al. (2019). Linking transformational leadership with nurse-assessed adverse patient outcomes and the quality of care. Retrieved from International Journal of Environmental Research and Public Health, 16(13).

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3 postsRe: Topic 1 DQ 2

Servant leadership is a type of leadership in which the main goal of the leader is to serve and place the needs and interests of their followers and organization over their own self-interest and needs (Greenleaf Center for Servant Leadership, 2016). “Servant leadership is a philosophy and set of practices that enriches the lives of individuals, builds better organizations, and ultimately creates a more just and caring world,” states the Greenleaf Institute for Servant Leadership. The phrase “servant leadership” was coined by Robert K. Greenleaf in The Servant as Leader and in his thesis he makes several strong statements including the philosophy that, “caring for persons, the more able and the less able serving each other, is the rock upon which a good society is built” (Greenleaf Center for Servant Leadership, 2016). This type of leadership style is set up to serve each member in the group. In a diverse workplace, this type of leadership would be beneficial in that it allows for personalized management and can help to establish cohesiveness in a team environment (Root, 2007). In other forms of management styles, the needs and visions of the company are often put ahead of the needs of the staff. In the servant leadership setting, all input and opinions are taken into consideration which helps to build loyalty from staff, can improve feelings of teamwork, and increase staff morale (Root, 2007). When employees are satisfied with their jobs and their company, workplace productivity tend to rise.

Transformational leaders work with their employees to implement change. This type of leadership involves creating a vision for followers and guiding changes through inspiration and motivation. This theory was developed by James Burins in the 1970s with the basic assumptions that, “Both leaders and followers have the ability to “raise each other to the highest levels of motivation and morality” (Marquis & Huston, 2017, p. 50).” (Grand Canyon University, 2018). “In Burns’ view, transformational leadership has the potential to motivate followers to satisfy higher-level needs, such as self-esteem and self-actualization. Those influenced by transformational leaders find meaning and value in their work, make significant contributions to the success of their employing organization, and become leaders’ themselves” (Rose O. Sherman, 2019). Transformational leaders use the following four elements when leading others; idealized influence, inspirational motivation, intellectual stimulation, and individual consideration. “Transformational leadership focuses on empowerment, viewing errors as learning opportunities, and valuing innovation which means staff members have a means of continually providing input about how to improve care. As a result, transformational leadership can revitalize healthcare from the point of patient care and more” (Rose O. Sherman, 2019). This can be a very powerful approach, but the visionary, big-picture aspect can distract the leader from the day-to-day tasks. It works best when the leader has a detail-oriented subordinate to keep him things grounded.

Grand Canyon University (Ed). (2018). Nursing leadership & management: Leading and serving. Retrieved from https://lc.gcumedia.com/nrs451vn/nursing-leadership-and-management-leading-and-serving/v1.1/

Greenleaf Center for Servant Leadership. (2016). The Servant as a Leader. Retrieved from What is Servant Leadership: https://www.greenleaf.org/what-is-servant-leadership/

Root, G. N. (2007). The Advantages of the Servant Leadership Style. Retrieved from Leadership: https://smallbusiness.chron.com/advantages-servant-leadership-style-11693.html

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I need a response for these 2 peers

Peer 1 

Societal justice and critical reflection are the fundamental concepts underlying community activism. The former refers to the unbiased distribution of resources for a prolific and fulfilling lifestyle (Reichlin et al., 2019). For instance, through campaigns and demonstrations, nurses, practitioners and the general community would be able to advocate the cause of providing adequate medical amenities.  

Critical reflection boosts one’s understanding of the resident community’s issues (such as inadequate staffing) as well as those of others across the globe. Through this approach, the management and staff members would be able to devise long-term resolutions that ensure adequate staffing in the present and future (Reichlin et al., 2019). For example, pursuing suitable programs at academic institutions can steer students in the direction of the healthcare industry.  

Paying attention and keeping up with the trends in the tobacco industry is vital. This effort helps the advanced practice nurses to engage in community activism for preventing the negative health impacts associated with Big Tobacco in their respective societies (Salmond & Echevarria, 2017). As a result, the nurses would be in a position to enlighten the community members on addictiveness and diseases (such as lung cancer) associated with the increased consumption of tobacco products.  

Organizing programs to campaign against smoking is an essential stratagem that would aid nurses in educating the public on why tobacco control policy measures such as higher taxes are needed to ensure reduced consumption. With this tactic, nurses could participate in community activism to curb any further ill effects arising from the use of Big Tobacco (Salmond & Echevarria, 2017). Moreover, holding seminars that counsel smokers and non-smokers, especially the youth, to remain vigilant against industry-instigated efforts would be essential in discouraging the consumption of tobacco products. 

Peer 2 

Through schooling, training, and knowledge learned along the way, Advanced Registered Nurse Practitioners (ARNPs) are equipped with the necessary skillset and tools to assist members of the community have improvement in their health outcomes. As key players in patient, ARNPs play a vital role in community activism to bridge the gap in healthcare disparities across different population groups and to improve the community. Maryland & Gonzalez (2012) asserts that the vast “amount of interactions that nurses have with patients leads to them personally witnessing the positives and negatives of the current healthcare system and consequently enable them to identify the needs of their patients by the care or the lack of it they receive.” Due to their first-hand interaction, nurses can advocate for their patients and their families and convey their experiences to the public and policymakers to bring about change in current health care policies (Maryland & Gonzalez, 2012).  

According to Messias (2019), community activism entails the key concepts of “community, social justice, raising consciousness, critical reflection, praxis, and empowerment of members of the community.” With each key concept comes certain actions on the part of the activist and subsequent delineations of certain orders of events. Nurse Practitioners can embody all the characteristics of community activism Messias asserts to promote the overall health status of the community. According to Messias (2019), community activism starts with an understanding of the community, in which individuals must realize that they are part of a larger group and share common interests in order to catalyze change. Praxis entails the process of ideas and theories being made and actualized, which consequently brings about unification—or division—of members of the community. Praxis affects the practices and customs of members of the community and affect the interaction of these individuals. With social justice, the way individuals perceive justice and what is right or wrong, affects the justice system and what behaviors are viewed as deviant in the community.  

Raising consciousness and empowerment of members of the community are vital to altering the status quo hopefully for the better but negative impacts can ensue. Teaching members of the community that they have rights can empower them to develop or defend them against lawmakers. Shining light on certain issues, such as through protest and petition with local or federal elected officials can bring about necessary changes in the management of certain disease plaguing the community (Mason, Gardner, Outlaw, & O’Grady, 2016). Empowerment is the ultimate goal (Mason et al., 2016) as by doing so individuals in the community will do what is necessary to improve their health on a holistic level.  

Maryland & Gonzalez (2012) argues that nurses can make significant influence in community activism on a multilevel approach. Maryland & Gonzalez (2012) asserts that school nurses can attend school board meetings to voice their personal viewpoint of the ramifications of inadequate staffing to monitor the health of school children. They are only equipped with the knowledge to voice this opinion because of their personal experience with performing their duties of providing basic healthcare to their patients (in this case, school children). My daughter is a third grader at a local elementary school. In a school of more than 800 students, there is only one nurse. Imagine how difficult it is to provide care to these students during the cold and flu season or any ordinary day for that matter. This stresses the importance of community activism by nurses and advanced practice nurses. The level of care they provide to their patient population is affected by factors in the community so who is best to make the issues known and advocate for and against them but nurses? Nurses, through their inimitable experience with their patients, can bring to the forefront issues that affect their patient and the community. Policymakers should hold the voice of nurses in high-esteem prior to making any changes that will affect individuals of a community.  

From a community activism approach, ARNPS can mitigate further negative health impacts from Big Tobacco by bringing social awareness and consciousness to the issue. Letting members of the community become aware or reminded of the ramifications of smoking cigarettes or consuming other tobacco products will greatly decrease the number of individuals in the community that smoke or will smoke. Health fairs broadcasting posters of individuals with lung cancer or tracheostomies from cigarette smoking or oral cancers from chewing tobacco are one of the ways that ARNPS can use community activism to help manage the negative impact of Big Tobacco. On each healthcare visits, ARNPs need to assess if their patients smoke and make them aware of the ramifications in addition to offer smoking cessation counseling and education. Empowerment is necessary to help individuals in the community to stop because many of them have been smoking since childhood. Smoking is also a way that many of these individuals cope and manage stress. Offering them alternative coping measures is crucial to getting them to stop smoking. Educating the community of the long-term risk of smoking, the consumption, and second-hand smoking, is vital to deterring the use of tobacco and promoting the overall health of the community. Mason et al. (2016) states that tobacco usage and exposure is the foremost cause of preventable death in the nation. This statement alone will serve to remind individuals of the negative consequences of smoking and will lead to many of them quitting. 

To conclude, advanced practice nurses play a rather significant role in patient advocacy to improve the health outcomes of their patients. Nurses can employ various teaching methodologies to assist their patients improve their overall health. Tackling issues at the community level can help nurses being awareness to issues that directly and indirectly affect patients. Bringing awareness to certain issues, such as the negative influence of Big Tobacco on the overall health of individuals in a community, are one of the many ways that ARNPS can help ameliorate the health status of the community. The ARNP can collaborate with other members of the interdisciplinary team and elected officials to maximize the impact of decreasing negative health issues in the community. 

Response posts must be minimum 100 words each. Word document, double space. APA (6th) 

This the original work if you needed 

Describe the key concepts underlying community activism and give examples of how each of these concepts applies to a specific context. Examine how advanced practice nurses can engage in community activism to limit further negative health impacts from Big Tobacco in their respective health communities. 

Attached below is an additional resource, an article, that details various ways by which nursing professionals can engage in community activism. 

Patient Advocacy and in the Community and Legislative Arena: http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No1-Jan-2012/Advocacy-in-Community-and-Legislative-Arena.html?css=print 

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Discussion Assignment:

Respond to the following Case study:

Explain how you might apply knowledge gained from the Response case studies to your own practice in clinical settings.

· Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

·  

· Suggest additional health-related risks that might be considered.

·  

· Validate an idea with your own experience and additional research.

·  

· Explain your reasoning using at least TWO different references from current evidence-based literature in APA Format.

Case Study: Knee Pain

Patients Initial:  JD       Age: 15    Genders:  Male

S.
CC: “Knee pain”.
HPI: A 15 year old male who presents with dull pain started about 2 months in his both knees. Sometimes one or both knees click, and he also describes a catching sensation under the patella.  He is young soccer player.

· Location: One or both knees bilaterally

· Onset: Pain and other symptoms goes and comes back for about 2 months

· Character: Dull pain

· Associated signs and symptoms: Click and catching sensation under patella

· Timings: comes and goes

· Relieving factors: Rest

· Severity: 8/10 pain scale

Current Medications:  One Tylenol over the counter, 325 mg 6 hours for pain control

Allergies: No known allergies of medications, food or latex materials.

PMHx: JP has received all of the vaccines recommended to protect him from life-threatening diseases, meningococcal and papillomavirus vaccines per pediatrician’s recommendation. No major illnesses and surgeries in the past. His major issue is knee pain which bother him during soccer ball practice.

KNEE PAIN                                                                                                                                                                               3

Soc Hx:  JP is 9th grade first year of high school. He plays soccer when knee pain permits; does not smoke, no alcohol, lives with parents no siblings. He uses school bus to and from school. He uses seat belt while rides motor vehicles, does not use cell phone while driving. They have working smoke detectors in the house, help parent with house chores.

Fam Hx. JP’s mother (40 years old), father (46 years old), paternal grandfather (70 years old), PGM (66 yrs old), MGM (64 yrs old) MGF (71 yrs old). They all are healthy but little overweight.  MGF has minor joints pain; he takes extra strength 1 Tylenol at night so he can sleep well. JP is the only child (Ball et al., 2019).

ROS:

GENERAL: No fever, chills, weakness or fatigue

Musculoskeletal: Bilateral knee pain, click, and catching sensation under the patella. 

Skin: Intact around the knees bilaterally

Objective

Physical exam:

• Vital signs: BP 140/80, P      72, RR 16, temp  36.9C, O2 sat 100,  Wt 134.5 lbs, Ht       70”  BMI: 24.4
• General: Patient is      AA&Ox4, moderately appears ill because of knee pain otherwise appears      strong and healthy, genital are at adult size with pubic hair and spread      to the inner thigh’s, has deeper voice, weighs 170 lbs, ht. 70”, no fever,      no chills, no weakness, was happy to give information (Coguen, 2019).
• HEENT: Normocephalic, no      visual loss, pupils are normal in size and reactive to light, no ocular      discharge noted. No hearing loss. N o sneezing, congestion, no runny nose.      No sore throat (Ball et al., 2019).

KNEE PAIN                                                                                                                                                                          4

• Mouth: He has all teeth      without evidence of carries. There are no lesions present in the oral      cavity (Hui, 2015).
• Neck: On auscultation no      carotid bruits. No tracheal deviation noted. No masses palpated.  His      neck is supple and able to move all directions without resistant. There is      no erythema or tenderness of the nodes (Ball et al., 2019).
• Skin: JP’s skin is clear      of rash and lesions, it is warm to touch. There is no cyanosis of his      skin, lips, blond thin hair combed; he has good skin turgor on examination      (Ball et al., 2019).
• Nails: Pink, smooth, flat      with smooth edges and rounded (Ball et al., 2019).
• Cardiovascular: Regular      heart rate and rhythm, no murmur, gallops or rubs (Balls et al., 2019).
• Respiration:  Breath      sounds clear to auscultation in all lung fields. Diaphragmatic excursion      is symmetrical. No increased AP diameter (Ball et al., 2019).
• Abdomen: Soft, nontender.      No masses or organomegaly. Bowel sounds physiological in all four      quadrants. No guarding or rebound noted (Ball et al., 2019).
• Rectal/GU: Normal male      genitalia with full puberty. No burning on urination (Ball et al., 2019).
• Neurological: CN 11-X11      grossly intact. No focal neurological deficit noted (Ball et al., 2019).
• Musculoskeletal: No      clubbing, cyanosis, or edema, muscles are too tight below knees      bilaterally; upper extremities have good muscle bilaterally tone in all      extremities. Has full range of motion of all extremities without pain      except knees (Ball et al., 2019).
• Hematologic: No complaint      of bleeding, no bruises noted on the body (Ball et al., 2019).
• Lymphatic: There is no      erythema or tenderness of the nodes (Ball et al., 2019).
• Psychiatric: Appears      happy, no sign of depression, anxiety, nor autism (Ball et al., 2019).

KNEE PAIN                                                                                                                                                                          5

• Endocrinologic: HE denies      of sweating, cold or heat intolerance, polyuria or polydipsia (Ball et      al., 2019).
• Allergies: Not known of      any medication, food, and environmental allergies at this time (Ball et      al., 2019).

Assessment:

           JP’s complaint pain in front of knee pain bilaterally with squat, kneel, going down stairs. He feels of popping, grinding, slipping, or catching in knee cap when he bends or straighten his legs.  His thigh muscles bilaterally are slightly weak. His muscles are too tight, have a trace of edema bilaterally and he is overweight. JP’s knee cap are slightly misaligned; with palpitation femoral pulses are 2+ regular normal bilaterally with knee flexion, at the middle of posterior knee at popliteal fossa with tight hand (Sullivan, 2019).  

Diagnostic Results: MRI, Labs, x-rays might not show soft tissues of the knees, CT scan (black, 2016).

Treatment:  Often begins with simple measures. Rest the knees as much as possible. Avoid or modify activities that increase the pain, such as climbing stairs, kneeling or squatting.   Physical therapies will be ordered by physician upon diagnostic findings (Black, 2016).

Differential diagnoses
1. Patellar tracking disorder (PTD): PTD means that the knee cap (patella) shifts out of the leg bends of straightens. The knee cap sits in a groove at the end of the thigh bone. The thigh weak muscle, tendons, ligaments, or muscles in the legs that are too tight. The activities that stress the knee again and again, especially those with twisting motions (Black, 2015)

KNEE PAIN                                                                                                                                                   6

2. Patellar tendonitis (PT): PT is a common overuse injury, caused by repeated stress on your patellar leading to injury to the tendon connecting your knee cap to your shinbone and pain is found in between that area. It is most common in athletes whose sports involve frequently jumping such as basketball and volleyball. At first be present only as you begin physical activity or just after an intense workout (Black, 2015).
3. Patellofemoral joint syndrome: It is one of the most common knee complaints of both the young active sports athlete and the elderly. It can be caused by overuse of the knee joints, physically trauma, or misalignment of the knee cap.  Patients may report a painful catching sensation and a painful giving way of the knee and is mainly due to overuse or a change in exercise intensity (Black, 2015).
4. Osteoarthritis: Obesity in children and adolescents has been linked to   musculoskeletal disorders, loss of flexibility, bone spurs, swelling, grating sensation. High-impact, high-intensity, and repetitive athletics have a strong association with the occurrence of osteoarthritis in teenagers (Black, 2015).
5. Bursitis:  Sudden inability to move a joint, excessive swelling, redness, bruising or rash in the affected area, sharp  or shooting pain, especially on exert. Bursa reduces friction and cushion pressure between your bones, tendons, muscles, and skin near your joints and inflamed pain is felt with activity or rest (Black, 2016).

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