Introduction In recent years, the practice of nursing has evolved substantially both in the United States and at an international level. In America, the introduction of the 2010 Affordable Care Act (ACA) served to herald a new frontier of growth for the nursing practice, particularly at the level of the...
Introduction Healthcare providers should maintain quality and minimize risk in service delivery. Patients expect to get the best healthcare services. Therefore, healthcare risk and change management are important aspects in service delivery. Nurses play a key role in risk and quality management as explained in this presentation. The Role of...
In a substantial number of countries all over the world, population may be currently regarded as culturally and ethnically diverse. It goes without saying that cultural competence of health care providers is immeasurably essential and imperative for successful health care delivery as it is established on the common principles of...
Theoretical foundation plays a significant role in any occupation field, and nursing is not an exception. A nursing theory can be defined as an “organized and systematic articulation of a set of statements related to questions in the discipline of nursing” (Application of Theory in Nursing Process, 2012). Sustainable theoretical...
Introduction Benner, P. (1982). From novice to expert. The American Journal of Nursing. 82(3), 402-407. The quality of health care intervention is built on nursing skills and experience (Benner, 1982). Thus, nurses develop skills to ensure patient’s safety. In the article “From Novice to expert”, Benner Patricia described the development...
The personal decision of terminally ill patients to commit suicide because of the unbearable suffering and pain is a challenge for the medical staff, including physicians and nurses. Thus, the decision to commit suicide is connected with a lot of ethical, moral, and legal dilemmas and issues, and the main...
Viewpoint and purpose of the assignment This paper analyses the possible health problems that the patient could be suffering from in the provided case. The paper will also explore the interventions that can be used and the outcomes of these actions. Preliminary Problem List of Ms. N The patient could...
This study aimed at establishing the enablers and barriers of guideline implementation in a primary healthcare setting. The Promoting Action on Research Implementation in Health Services (PARIHS) framework acted as “a template for data analysis and interpretation” (McKillop, Crisp and Walsh, 2012). The researchers intended to undertake a qualitative study...
General differences between the Associate Degree/Diploma nurse and the Baccalaureate prepared nurse about the nurse as a Member of the Health Care Team/Coordinator of Care Though one might think that every member of the staff providing nursing services performs the same work, i.e., taking care of the people with health...
Introduction In an increasingly evolving and complex health care sector, Advanced Practice Nurses (APN) has become inevitable. Advanced practice for nurses is a multifaceted terminology explaining a precocious level of nursing practice that optimizes the utilization of tertiary training, extensive nursing competence, and skill in handling the health care demands...
Introduction Reforms are necessary for the improvement of the healthcare system. They affect all the stakeholders in the system, including patients, hospital management, and various medical professionals. The drastic changes in the healthcare system can have beneficial and detrimental effects on all the parties involved. Nurses can be significantly affected...
Introduction A successful nurse manager should have developed leadership skills to perform effectively in the modern working environment. “Nurse Manager Skills Inventory” can be discussed as an effective tool to conduct self-evaluation in relation to such areas of leadership as personal and professional accountability; career planning; personal journey disciplines; and...
Evaluation Methods Evaluation is a critical process because it provides valuable information about the performance of health programs and changes in the clinical processes (Oman, Duran, & Fink, 2008). According to Polit and Beck (2008), this process begins at the planning phase and continues throughout the lifespan of the project....
The abstract section of the journal article does not have a research question being addressed even though a clear purpose of the study has been pointed out. The study explores various aspects that enhance the degree of risk that older Hispanic women are exposed to when it comes to HIV...
Political History and Development of Nursing Education: Comparison of Kenya and Ireland Kenya is one of the African countries where Europeans settled at during the colonial era (Mule, 1986). Although it is believed that missionaries and explorers introduced the nursing profession in the country, the natives had their own traditional...
Nurses are always at frontline as far as prevention of healthcare- associated infections are concerned. This can be facilitated by their closeness to the patients and also their application of practices meant to control infections and transmission of diseases and organisms to the patients. Nurses prevent infection directly by providing...
Abstract Rape is one of the most despicable crimes against human dignity imaginable and, unfortunately, a major concern of contemporary society. Despite the attempts of nurses and therapists to enhance awareness on the subject matter, a range of people remain criminally unaware of what rape is, how it should be...
Introduction Acute care is the most common sought service in healthcare facilities. The aging generation presents the health industry with increased demand for immediate and effective healthcare services. Elder people deserve continuous care to enhance the function ability of their weak body systems. The rise in demand for improved care...
Ethical and legal issues resolution requires exemplary level of professionalism and theoretic preparedness on the part of nursing professionals (Hamric, Hanson, Tracy, & O’Grady, 2013). Not only the situation is complex because the nursing practice is regulated by a large scope of legislative norms but the main influential factor is...
The feeling of powerlessness among nurses has been documented in various studies. This trend prioritizes the need to empower nurses. The nurses working under Nancy express their feeling of powerlessness through resignation. Nurses who feel powerless experience dissatisfaction and depersonalization. Retaining nurses entails improving the working conditions that are relevant...
In the article “A randomized controlled trial to reduce delay in older adults seeking help for symptoms of acute myocardial infarction,” the authors examine and talk about how aged adults (over 65 years) with signs of Acute Myocardial Infarction (AMI) have prolonged pretreatment time lag than the young adults (Tullman,...
Abstract Awareness of faculty members with regards to evidence-based practice (EBP) in the teaching of baccalaureate nursing is yet to be conclusively determined. It is a fact that EBP is not a new concept in teaching and practice in the nursing field. However, its implementation is characterized by a number...
Introduction This essay is a critique of a quantitative nursing research study. It examines the effectiveness or otherwise of research conducted by Josephine M. Mancuso to study the impacts of health literacy and patient trust on glycemic control in a semi-urban American population. The researcher wanted to identify variables that...
Nursing Autobiography I graduated as a Licensed Practical Nurse (LPN) in 2009. I used to work as a technician in a pharmacy. I also worked as a Hemodialysis Nurse (HN) after graduating in 2009. I took extra classes a year later to become a registered nurse (RN). I also earned...
Background The change project relates to the prevention of respiratory complications on patients undergoing interventional radiological procedures under conscious sedation at Kendall Regional Hospital. In interventional radiology contexts, nursing professionals are required to have core competencies and skills in pre-procedure patient evaluation and the management of post-procedure side effects (Perez-Rojas,...
Introduction: Martha Rogers Metaparadigm Martha Rogers presents one of the best nursing theories. Rogers’ Unitary Human Beings Theory makes it easier for nurses to provide quality support to their patients. Nurses should always “support the health expectations for every patient” (Meleis, 2011, p. 36). This grand theory “is applicable in...
My Philosophy In theory, nursing does not impress upon one as a field that is particularly concerned with philosophy or introspection. The scientific and technical aspects of a nurse’s job make it appear to be a decidedly systematic discipline, well removed from the philosophical underpinnings that characterize the social sciences....
Introduction Available nursing scholarship demonstrates that nursing models and theoretical frameworks began to be identified in the 1950s, and provided a wide spectrum of opportunities for the nursing profession to progress from a constricted focus on illness to a broader concern with human needs and individualized care (McCrae, 2012). Ernestine...
‘Aesthetics’ is the study of art and beauty with a goal of ascertaining the validity of aesthetic judgments, emotions, and artistic merit (properties) of art forms (Brilowski, 2005). People experience art differently due to distinctive individual tastes and perceptions. Chinn and Kramer (2014) define art as the “process of creating...
Purpose The objective of the reviewed study is clear. The research attempts to determine the influence of the services delivered by the nursing practitioners on such aspects of health care quality as cost, patient experience, and satisfaction (Jennings, Clifford, Fox, O’Connell, & Gardner, 2015). The study is significant as it...
The evaluation of whether nursing is a science, an art, or both has been at the centre of discussions of the nursing theories. For instance, one perspective considers nursing to be a basic science that consists of the nursing knowledge, which nurses practice to better human life (Barrett, 2002). A...
Nurse practitioners are majorly concerned with ensuring that there is proper implementation and a rendering of helpful and professional nursing care. This requires the application of various nursing practice theories depending on the level of care the patient needs. Florence Nightngale’s theories of nursing help nurses to plan and deliver...
What Motivates Me in my Practice? I am a migrant nurse practitioner from Cuba and derive utmost motivation from the results of my work. Away from my home, I have come face to face with dire illnesses in the places I have served. Some nursing cases I have handled have...
Similarities and Differences in Assessing Children among Different Age Groups According to Laberde (2011), toddlers, unlike school-aged children, are ignorant of their health and have to look up to their parents to keep away from dangerous conditions, such as pools. In terms of nutritional patterns, school-aged children have an increased...
This article covers impairment caused by drug and substance abuse in nurses. The article was authored by two nursing assistant professors from Ball State University in Muncie Indiana. According to the authors of this article, drug and substance abuse in nurses is a complicated matter. This is because nurses have...
Nursing philosophy plays a crucial role for every healthcare professional. According to the University of St. Augustine (2020), this term denotes “a statement that outlines a nurse’s values, ethics, and beliefs” (para. 3). Even though many nursing students claim that it is challenging for them to create such a philosophy,...
Leadership Styles and Traits A majority of the leaders in healthcare institutions should have trust. Patients and other healthcare professionals should trust that a particular healthcare expert can be trusted to advocate for their rights. Such trust results to empowerment, the courage to engage in innovative ideas, taking risks, and...
Introduction Organized labor has an enormous influence in most of the industries. Nurse unions are worth mentioning because they are quite active and influential. They are determined to ensure that rights of trained professionals are respected, and they are not discriminated in the workplace. Such specialists are often reluctant to...
Political History and Development of Nursing Education: Comparison of Poland and Kenya Kenya education underwent a continuous development process. It began with the introduction of nursing curricula by Christian missionaries from western countries. The colonial government then embraced the mandate and became the leading authority for managing nurse education in...
Introduction Any professional discipline is theory-driven and evidence-based including nursing practice. Thus, a theoretical framework is designed to explain the phenomena observed in nursing practice and organize knowledge about them. The nursing theory uses concepts, propositions, and assumptions to describe, explain, and predict the phenomena observed in practice and prescribe...
Professional nursing is a complex field, which requires a certain level of agility in terms of procedure choice. Each case is unique, and a personalized approach can provide a range of benefits while being challenging for some specialists. A nurse is the cornerstone of an effective healthcare system, enabling quality...
Introduction Evidence based practice (EBP) refers to the inclusion of the best international research evidence in health care (Ubbink, Guyatt & Verneulen, 2009). In the recent past, EBP has gained popularity due to the need to cut the costs of health, provide better quality medical care, and improve patient outcomes....
Introduction The ever-increasing number of patients suffering from dementia-related conditions has amplified the ethical issues in nursing practice. Currently, patients with Alzheimer’s infection suffer at the hands of health practitioners due to a need for constant care and decisions that are made without the support of the stipulated ethical nursing...
Introduction The skin plays a crucial role in protecting the inner tissues of the body from external harm. Consequently, the skin undergoes a fascinating self-healing process whenever it is bruised or wounded. The process is a complex course that entails a harmonious effort from various cells, including those on the...
Gap between Theory and Practical in Nursing According to Simmons, Lanuza, Fonteyn, Hicks, & Holm (2003), encountering conditions and situations related to patient health does not require experience; rather, experience help nurses reflect quickly in the moment of decision-making. As a result, in the nursing field, there exists gap between...
The role of a professional nursing organization is to “generate energy, create a flow of ideas, and maintain a healthy profession that advocates for the needs of its clients and nurses” (Merton, 2011, p. 50). The main goal of the nursing professionals is to care for the individuals who cannot...
Health care is a crucial event for the well-being of all humans in every country. Nurses are agents of morality and attention who attend to the calling needs of health through acting on their professional skills for the wellbeing of the community, (Ellis et al. 2012). Community health is also...
Summary “Is satisfaction a direct predictor of nursing turnover? Modeling the relationship between satisfaction expressed intention and behavior in a longitudinal cohort study” is the article written by Murrells, Robinson, and Griffiths for Human Resources for Health in 2008. In this work, job satisfaction and nurses’ intentions are identified as...
The culturally appropriate nursing care is important in order to address the needs of diverse patients, provide them with much attention, and demonstrate the understanding of their expectations. The aspect of culture can influence the quality and delivery of the nursing care significantly because people belonging to various cultures are...
Leadership Traits & Styles in Modern Health Care Organizations In the context of leadership traits, Whitehead, Weiss and Tappen (2010) employ the trait theories to show that effective nursing leaders must demonstrate management of attention (capacity to communicate to followers a sense of goal or direction), management of meaning (capacity...
Introduction Patient care and monitoring systems have been the focus of different clinical disciplines. In this case, they involve a lot of aspects like measuring important signs and bedside monitoring. It should be known that patient care and monitoring systems measure and monitor other bodily functions. This is done using...
Introduction Nowadays, nurses are one of the largest groups of professionals who deal with health issues. The modern perception of nursing was shaped by such prominent figures as Florence Nightingale. She was not only a health care specialist; she was also a social and political activist. In this paper, I...
Being a nurse is, probably, one of the most interesting and responsible jobs in the whole world. It aims at helping people and being a connection link between professional doctors and ordinary people when the latter is in need of medical help and explanations. Educating nurses is an important aspect...
Discussion Questions According to Feldman and Alexander (2012), writing an effective summary can be very because one has to provide detailed information about the entire work using as a limited number of words as possible. The executive summary must provide a mirror about the contents of a report to help...
Nursing practices are based on nursing theories, evidence and knowledge gathered from other fields to guide professional nursing care. Nurses, therefore, are required to integrate emerging evidence from nursing and other fields into their practice. Evidence-based nursing practice requires nurses to integrate new findings and review study implications within the...
Risk models are useful in guiding nurses in their work processes and application of knowledge in practice. Some researchers, however, have noted serious challenges in the way many guidelines are developed (Kerr, Meisner, Thiessen-Philbrook, Coca, & Parikh, 2015). Further, Kerr et al. (2015) have observed that some guidelines may not...
The Chapter 464 of 2015 Florida Statutes is devoted to nursing and may be alternatively cited as Nurse Practice Act (NPA). It is aimed at eliminating the danger of incompetent nurses practicing in Florida. Therefore, the minimal requirements for Florida nurses are determined by NPA. Authority According to the regulation...
Introduction The objectives stipulated in the Affordable Care Act of 2010 concerning the Medicare and Medicaid programs reveal that nursing has become the most advanced segment that provides healthcare in the United States of America (USA). In the recent past, nursing has been facing several challenges that delayed progress of...
Introduction With the increased cost of operation and dwindling funds, health care organizations are currently pressured to efficiently utilize their cost of medical care (Cook & Gaynor, 2012). The organizations are expected to effectively manage their cost of medical care without compromising on the quality of health care offered in...
Purpose of the study The purpose of this research is to explain the nurses’ perception using evidence-based practice, identify their attitudes, use, and understanding of their skills and knowledge associated with the evidence-based practice. The study also intends to find out the application of learned skills, attitudes, and knowledge of...
Introduction There is no organization that been known to ever exist without a leader. Leadership is an integral part of any organization. It is only through a steward that any organization can thrive and be able to meet its goals. True leaders have been known to put interests of the...
Introduction Although not indicated in the article, it is clear that the researchers wanted to answer the question “what are the barriers and enablers to implementation of a New Zealand‐wide guideline for assessment and management of cardiovascular risk in primary health care?” (McKillop, Crisp & Walsh, 2012). Who participated in...
The significance of human resource (HR) management cannot be underestimated because it is the key to improving performance by motivating people to self-development and organizing them. However, what does it take to create an effective HR management system? First of all, the most significant skill in human resource management is...
Article Selection Many nurses are tasked with caring for bed-ridden patients both at home and in the hospitals. In the process of giving the care, it is important to ensure that the patients do not develop other problems such as pressure ulcers. Pressure ulcers present a significant problem in healthcare....
Nurse practitioners (NPs) are registered nurses who offer primary health care services for patients based on their needs. Generally, they ensure health and well-being of patients through various approaches. NPs must acquire advanced training and education in order to be accredited and registered. Consequently, most NPs have master’s degree qualifications...
A simple definition of nursing philosophy is that it is an “attitude towards life and reality that evolves from each nurse’s beliefs” (June, 2008). This definition grants nurses the freedom to choose their own path when it comes to nursing philosophy. Notable figures in the nursing discipline have added their...
Abstract Barbara Resnick is among the theorists whom people acknowledge based on their significant contributions to the nursing field. Resnick’s middle-range hypothesis of self-efficacy, which forms the basis of this paper, determines the extent to which people believe in their capacity to realize certain goals in their life. This paper...
This paper is aimed at discussing the fatigue experienced by nurses who work a 12-hour shift three days per week. It results in burnout and job dissatisfaction. Moreover, this issue can considerably impair the quality of care. Very often, medical workers may not pay due attention to the needs of...
Introduction An article critique is a reader’s response to the article by evaluating its layout and conformity to a research article. An article critique gives a reader/critic the chance to explore his or her thought processes, and research and analysis skills, so that he or she can engage with the...
Background of the LHC program This program was initiated in order to address the issue of providing high quality and safe patients’ care in healthcare organizations. The Louisiana Health Care Group (LHC) in conjunction with the Department of Nursing (DON) at the University of Louisiana in Lafayette collaborated to evaluate...
Conflicts arise when two or more people or rival groups disagree upon the needs of the challenging person or party (Moreland and Apker 1-9). In such a case, the parties cannot agree on the suggestions and recommendations of either party for the benefit of one of them. Conflict management is...
Introduction Conceptual Explanation of Each Core Value There are different reasons why different individual make a choice of taking up nursing as a lifetime career. These reasons may range from financial gains, personal, love for people, professional, or even for job security. Nevertheless, every individual who make that choice of...
Introduction Falls are a common phenomenon amongst the elderly. In most cases, fall victims end up dying, immobilized, or institutionalized in a clinical facility. Therefore, key players in the health care sector have to come up with ways of preventing this occurrence. This paper is a literature review on the...
Introduction A patient’s individual experiences of disease are essential in designing an appropriate treatment plan. Whereas a medical diagnosis or prognosis can reveal an illness, only a persistent investigation of the patient’s experiences can help the health care team understand the disease. In a patient-centered (PCC) model, a physician considers...
Personal Philosophy Philosophy can be defined as a search for truth that delves into an examination of current issues surrounding reasoning, logic and social issues. From the perspective of a nursing practitioner, the application of a philosophical approach focuses on how the act of providing medical care is perceived and...
Introduction Leadership is a major factor that determines the progress of any institution. Transformational leadership encourages the integration of determination, character, and passion in goal attainment. In the health care system, transformational leadership is a basic requirement, especially in modern societies where the system experiences various challenges. Nurse leaders and...
The two authors talk about high rates of physical inactivity among young Taiwanese residents and how this situation affects the status of their health. Adolescents in Taiwan observe sedentary lifestyles and they continue to do so even when they become adults. The article’s arguments are based on a health promotion...
Although the nurse practitioner (NP) roles are yet to be fully understood in many care settings around the world due to lack of clarity and a better definition, it is largely documented in the nursing scholarship that such roles can be of immense importance in improving healthcare delivery and increasing...
Enhancing practice environments and creating a workplace atmosphere pleasurable for the productive day, a nurse administrator builds a safer health system. As patient care is the main objective of nursing, the ultimate goal of a nurse administrator is to create patient safety culture by means of managing people and resources....
Introduction As nurses mull over their tasks in the direction of complementary modalities, in addition to integrative care, it is vital that they assess the values of the performance of the American Holistic Nurses Association (AHNA). The present Standards of Holistic Nursing are anchored in 5 Core Values of performance...
The epidemiological approach Application of the epidemiological approach to the analysis of health care systems works with several dimensions. It involves four subsystems, which are the individual, the institutional, the societal, and the larger system. The societal subsystem covers the political, socio-cultural, demographic, and economic elements. This dimensional analysis assigns...
Research Proposal Title of the study: Relationship between levels of fatigue, loneliness, and self-care among patients Undergoing Hemodialysis Problem/Background Hemodialysis plays a significant role in improving the quality of life in patients with end-stage renal disease. In most cases, patients encounter challenges during the procedure. These challenges include bodily changes,...
Health care is a critical aspect of the well-being and health of every nation. It is important to understand the necessary morality and ethics for both the client and the service provider on behalf of successful service delivery. Ethics and morality create such circumstances as a nurse – penitent relationship,...
In general, reflective accounts play a highly significant role in the practice of any nurse or midwife as they help to analyze incidents, identify necessary improvements or changes, and summarize obtained knowledge. For this account, the reflection on Standard 9.4 of the Health & Care Professions Council with the use...
Abstract Evidence-based practice (EBP) has facilitated transformation of nursing practice from tradition-oriented to science-oriented. It has enhanced data collection, judgment, and enabled nurses to acquire essential skills. This paper will have three primary parts. The first part will discuss the importance of evidence-based practices in the nursing career. The second...
Introduction There has been a growing shortage of nurses worldwide. This shortage has caused a migration tendency of qualified nurses, usually from less well-off countries to more ‘economically advantaged’ countries to fill these vacancies (Ea et al, 2010). The difference in cultural background has proved a challenge to these immigrant...
Political History and Development of Nursing education A comparative study of the political history and development of nursing education in China and Kenya shows that the Western missionaries positively influenced the development of the nursing education systems under the different political systems of both countries. In Kenya, nursing education was...
Introduction Laws are laid-down rules that clearly stipulate what should be done and what should not be done. When such rules are not adhered to (any form of deviation), it may lead to punishment. Ethics, on the other hand, may not be likened to law since they are not measurable....
The quality of health care services is a very important issue in the world nowadays. Today the health care industry is experiencing a significant shortage of registered nurses. This means that not as many people choose this profession and work in this career. Unfortunately, such shortages are not very easy...
Introduction According to Masters (2013), burnout is a syndrome of emotional exhaustion, depersonalization, and decreased personal accomplishment. Unlike physicians, nurses work under exceptional conditions that expose them to stressful conditions. Ordinarily, nursing practitioners are expected to deal with life and death issues on a daily basis and there is no...
Introduction In the United States, the introduction of the ‘meaningful use’ law is revolutionizing the health care sector. As an important policy, this law plans to change the current use, payment, and health care delivery systems. The described policy aims at making the American health care system efficient, better and...
The present description is concerned with highlighting about a nurse association of a country which is a member of International Council of Nurses (ICN). ICN represents nearly 130 national nurse associations that cover 16 million nurses globally (International council of Nurses,2013). Here, Kenya is one among the listed ICN member...
Introduction The introductory paragraph introduces the significance of the report to the target population before discussing the background information about the theory and the theorist. The subsequent section provides an in depth analysis of the theory while explaining its application in different contexts. After providing its relevance, the paper presents...
Introduction The nurses have the responsibility to provide the appropriate care necessary to improve the patient’s physical, psychological and emotional conditions. The 33-year-old patient has been regularly visiting Sabatia Health Center. Although he had been diagnosed with malaria at first, the patient had shown other conditions such as high blood...
This paper gives a detailed analysis of fifteen research articles. The targeted articles focus on nurse-to-patient ratios in different healthcare institutions. Koetting, M. (2010). Safety in numbers: nurse-to-patient ratios and the future of healthcare./Hospital: man, woman, birth, death, infinity, plus red tape, bad behavior, money, god, and diversity on steroids....
In the recent past, one may observe active debates regarding the nurse-patient ratio, which have resulted in the fact that various states enact laws and policies to oversee this ratio achieved. In this regard, your assistance in achieving such a state in order to improve the health care system will...
Introduction The U.S. national population has been growing steadily, yet there have not been a sufficient number of nurses being recruited to provide services adequately. Furthermore, many of the practicing nurses are retiring at an early age because of work stress they have to endure on the job. Other groups...
Patient Initials: PK Age: 60 years Sex: Male Subjective Data Client Complaints: Patient reported to clinic complaining of decreased urinary flow, nocturia and dysuria. Patient has been experiencing these symptoms for two years but they have worsened in the past two weeks. He has not experienced any form of radiating...
Healthcare provision needs to be equal and fair to all the patients, despite their cultural backgrounds. The following schemes are critical in a culturally diverse society. Nurses and medical care organizations should employ them to ensure superior health quality to multicultural populations. According to Douglas et al. (2009), healthcare institutions...
Introduction The profession of nursing presents the largest proportion of the health human workforce in the national healthcare system. Therefore, it applies that these practitioners play a fundamental role in achieving the overall goals of public health. However, the achievement of nursing profession has been prevented partially by the variations...
Abstract Recognizing a patient’s need for privacy is very important in the practice of nursing. The concept of privacy pertains to all areas of human activity in society and appears in the literature of several different disciplines. In the nursing profession, privacy is equally recognized as a very critical issue...
Introduction For effective functioning of an organization, good leadership is essential. Leadership is a way of life, a concept, and an aspect of continuous evolution of different professions. Leadership is the ability to establish goals and visions, and the ability to achieve those goals while maintaining competence, commitment, and teamwork...