Introduction Healthcare is one of the most important topics of discussion in the 21st century. Part of the reason is that a great percentage of the population – especially in the Western world – is aging. There are now many elderly people needing care. On top of that, breakthroughs in...
The value and life of disabled in the community is no difference from the rest of the population. The problems that affect the disabled most are the socio cultural factors that cause the most discomforts. This is due to the fact that the disabled community is seen as an ‘outcast’....
Plan In the introduction part, I will point out that this study is a critique of a journal article written by the above-mentioned authors and was subsequently submitted for publication to the American Journal of Nursing. The said article was published in time for the September 2006 issue of the...
Aseptic technique is a general term that involves the practice of procedures and processes in the care and treatment of patients, by reducing the introduction of micro-organisms to the patients. Asepsis is of two kinds, general asepsis, and surgical asepsis. General asepsis concerns the procedure and processes involved in the...
During a person’s lifetime, he is called upon to make decisions and choices that will have a direct effect on who he is as an individual and how he will interact with people in his daily life. Sometimes, these decisions take us down one path that finds the person leading...
The paper is an analysis of several findings which highlight the issues regarding ESL students in regard to the Nursing Programme. A background has been provided regarding the issues and the rationale behind such issues. At the same time, a relationship has been drawn between that of ESL in nursing...
Abstract This paper investigates the models and standards used by a particular healthcare agency for quality improvements. The findings indicate that the agency has implemented already established options for standards of care, care delivery models, quality improvement, leadership, and evidence-based care. The paper demonstrates that an agency can adopt such...
High-quality community nursing implies caring for people from highly diverse backgrounds who live in many different settings, including prisons, jails, and similar facilities. Healthcare excellence is particularly important in the latter environments because incarcerated individuals often face an extensive list of health risks and have multiple complex health problems. The...
The field of nursing is growing at a fast pace, which means that more consideration and understanding of the given health care sector are needed. Assessment of the patient’s attitude to health requires considerable and specific knowledge in the field of psychology and sociology. A number of issues in nursing...
The availability of affordable health insurance is a major prerequisite for maintaining an adequate level of healthcare access across various populations. The United States does not have a universal healthcare insurance system, whereas private and employer-sponsored forms of insurance dominate the market. Nevertheless, the country has two effective federal programs...
Artistic Representation of My Perception of Caring Why nursing? Why medicine? Why me, after all? Why choose the profession so daring? Because helping people is something I love, Because every person needs caring. For me, definition of caring is The help, the support, the attention; We patiently tend to the...
Introduction I am a master’s student, and I will be glad to expand your horizons about issues with financing nursing education while paying vehement attention to the Nursing Workforce Reauthorization Act of 2017 and its revision. Nowadays, being a nurse implies not only providing high-quality care but also being a...
Connection between Professional and Academic integrity Maintaining academic integrity is one of the characteristics that distinguishes a professional nurse. The philosophy that enables a nurse to be honest and transparent in their learning is a crucial component of the nursing ethics that serves as a guide for addressing professional dilemmas....
The Modeling and Role Modeling Theory was introduced and developed by Helen Erickson, Evelyn M. Tomlin, and Mary Anne P. Swain and borrowed its basic concepts from a large variety of sources (among which are Maslow’s Theory of Hierarchy of Needs, Piaget’s Theory of Cognitive Development, and Seyle and Lazarus’s...
Ear tugging, fever, copious discharge and cerumen, difficulty sleeping, as well as TM erythema are the major symptoms of AOM (McCormick et al., 2016). The redness of a TM is the local AOM symptom that may lead to hyperemia – as a result, the TM becomes red, and it can...
Introduction: Lydia Hall’s Nursing Theory Various conceptualized theories provide an efficient framework for improving and enhancing the quality of caregiving. It is critical to mention that contemporary nursing practice is vastly based on the early conceptualizations of nursing theory, which were suggested in the middle of the 20th century (Meleis,...
Introduction Nurses have to deal with many different varieties of conflicts constantly in care settings. Patients can be aggressive due to various factors such as pain, and other medical professionals can enter into disagreements over matters such as treatment. Such incidents are unavoidable, as conflict is an essential part of...
Examples of work stressors Working as a nurse in a hospital is a stressful experience mostly because this position puts a practitioner in a high-stakes environment. One of the biggest causes of stress in my experience has to do with the amount of time I spend trying to acquire authorization...
Abstract This paper presents an analysis of a particular clinical agency’s approach to treating depression. Specifically, its population health and case management processes are described. An evidence-based clinical pathway by the National Institute of Healthcare and Excellence of the United Kingdom is then applied to a case from the agency....
Barriers Encountered When I got a letter confirming that I had been offered a position to pursue a career in nursing in my preferred college, I was very pleased. However, I was not fully prepared for the challenges that lay ahead. Most of my friends pursued a career in social...
The problem of patient safety has received a lot of deserved attention recently. Numerous studies addressing the physical well-being of inpatients have concluded that patient falls pose an immediate threat to patients’ health (Reuben et al., 2017). In their articles, Sujan (2015), Hill et al. (2016), Roman et al. (2016),...
My Personal/Professional Strategies to Increase My Power As a registered nurse (RN), I am aware of the inadequate nurse staffing in healthcare facilities, resulting in a detriment for both nurses and patients. High workload and insufficient nurse-patient ratios put at severe risk the health of nurses and increase the likelihood...
While the development of medical technology provides opportunities for better patient outcomes, it also raises ethical and legal concerns that deal with patient integrity and autonomy (Park, 2009). This research discovers the ethical issues faced by nurses in hospitals. The reported ethical issues fall into three categories such as “end-of-life...
Comprehensive History and Physical Examination Name: Jessica Age: 32 Complaint: The patient’s vision has been dropping significantly in her left eye, with significant pain accompanying the problem. History of the illness: The patient claims that she has been experiencing a drop in her left eye vision since morning. Jessica has...
The success of the healthcare sector depends on its ability to acquire and implement emerging technologies. Such systems have the potential to improve the quality of medical available to the targeted patients. When implemented and supported efficiently, any patient care technology will guide decision-making processes and solve emerging problems. The...
The given CALS standards are partially used by my peers and me. In my nursing practice, I always strive to remove any communication barriers, such as language variations. Therefore, I undertake a nursing action of language assistance, where I deliberately focus on assisting people regardless of their English proficiency or...
Introduction Environmental health is becoming a relevant topic for discussion as man-made and natural hazards are beginning to affect human well-being severely. The environment and surrounding that we live in can have a profound impact on health, both positively and negatively. This paper will discuss the basics of environmental health,...
Personal Nursing Autobiography I have a strong academic background that supports my healthcare practice. I completed my Master’s degree in microbiology several years ago in Cuba. I currently work as a registered nurse (RN) in Florida where I offer evidence-based services to my clients. My employer is the Florida Health...
Introduction Nursing requires an understanding of components that affect an individual’s health and excellent professional skills. A nurse should be aware of personal values, which contribute to his or her work and can be reflected in a philosophy statement. This paper aims to identify my nursing philosophy, explain the four...
Pediatric obesity caused by fast-food consumption is a significant issue in nursing practice. Comprehensive family lifestyle interventions proved to be effective in reducing unhealthy eating behaviors and body mass in pediatric patients (Janicke et al., 2014). The nursing-focused plan is to design a lifestyle intervention that would reduce fast-food consumption...
Role Description A nurse practitioner (NP) in a primary care setting carries out the responsibilities of providing primary healthcare services to adults. The core responsibilities include direct patient assessment, diagnoses of illnesses, and treatment. NP’s role also incorporates adherence to a plan of care, provision of “a full range of...
Introduction Advocacy in nursing practice requires a well-informed perspective on ethical and legal contexts as well as ethical authority. The role of nurse advocates is to be the voice of patients in order to navigate the challenges of complex health systems and empower them in making informed decisions. In daily...
Introduction Among the variety of nursing theories and approaches to helping patients, it is sometimes difficult to choose those that can best match personal priorities and help to provide qualified assistance. In this regard, the need to develop and maintain a personal model may be needed, which will reflect the...
One can hardly doubt the immense importance of the discussion of abusive relationships in contemporary society. It is apparent that people who survived such relationships are in need of qualified caregiving since such experiences impose various mental health problems, such as depression, anxiety, and trust issues (Albina, 2016). However, it...
Introduction The given paper’s purpose is to reflect on the key concepts acquired in the class as well as its real-world application. Previously, I have stated my opinion on the matters, such as bioethics and trust between legislators and patients. In addition, I emphasized the importance of patient-centered care, which...
Background: APN, Licensing, and the Associated Challenges Licensure, Accreditation, Certification, and Education (LACE) Considerations LACE for APN Clinical Roles in California LACE for APN Clinical Roles in Illinois and Comparison to California LACE for APN Clinical Roles in Washington and Comparison to California and Illinois Evidence-Based Strategies (EBS): Continuity between...
Problem Statement One of the current problems in health care in the United States is understaffing in nursing. It does not only make nurses feel under pressure and overloaded with work but is also dangerous for patients. Understaffing is caused by the shortage of registered nurses. Nurse shortage, in its...
Despite technological progress and the intentions to underline the worth of rights and freedoms, contemporary nursing has hardly gone far away from the offered nursing theories, the Nightingale’s model, and the hierarchy of human needs. The concept of caring undergoes certain contributions and improvement, and patient safety is promoted through...
The world in the twenty-first century presents a variety of advances in multiple fields of human activity. With those advancements, higher requirements and increased standards appear, encouraging people of all professions to incorporate all available knowledge, skill, and attitude to become better in professional performance (Palos, 2014). Nursing, as a...
Nursing Issue Medication errors comprise a major nursing care issue that affects many patients each year. The World Health Organization (WHO, 2016) defines medication errors as the disruption to the process of “prescribing, transcribing, dispensing, administration or monitoring” of medication (p. 4). Such definition suggests that medical errors are highly...
Conflict resolution is a vital aspect in healthcare systems due to the strong interpersonal and complex professional relationships that occur within all areas of care, ranging from treatment to administrative tasks. Medical professionals are called upon to understand and practice conflict resolution techniques to resolve any situations that may arise...
Assignment Criteria Your Answers: (NOTE: See Milestone 1 Grading Rubric for details required in each area.) Nursing Care Issue and Outcome Nursing Care Issue: Medication Error Outcome:Improving the control over the intake of medications in medical institutions of different profiles will help to make the treatment process more perfect. Errors...
Introduction Jean Watson’s philosophy of nursing provides a general framework for nursing care that can be applied to various healthcare settings. This paper will give an overview of this theory and list the main assumptions of Watson’s theory of human caring. Further, it will outline Jean Watson’s 10 carative factors...
Nurses possess adequate competencies that empower them to meet their patients’ needs. Unfortunately, certain gaps and obstacles make it impossible for many practitioners in the United States to achieve their potential. Consequently, they have been unable to transform the health outcomes of different citizens. These issues informed the report “The...
Introduction The modern healthcare system of the US can be characterized by numerous attempts to improve treatment outcomes and increase the efficiency of care delivery. For this reason, there are multiple innovations, including better training for health workers, the extensive use of technologies, and the reconsideration of outdated practices. Under...
Introduction Conflicts in a healthcare setting are dangerous because they may affect patient outcomes adversely. Due to this reason, hospital management should ensure that executives and staff members have proper conflict resolution skills. Additionally, policies of a healthcare establishment should address issues that occurred in the past and may affect...
The Hospice and Palliative Nurses Association (HPNA) is a professional organization that promotes excellence in hospice and palliative nursing care. The HPNA provides education, resources, and support for nurses to ensure they have the skills and knowledge to give high-quality care to patients and their families. The organization also works...
Introduction Nursing theories are important tools for nurse practitioners, researchers, and educators. They provide guiding frameworks supported by theoretical and empirical knowledge, enabling nurses to create a plethora of supporting frameworks centered around patient care. Modern nursing theories have a variety of approaches to patient care. Henderson’s theory focuses on...
The turnover rate for new nurses often reaches as high as one in five individuals. It is a costly and impactful factor in the healthcare workforce. A nurse’s ability to fulfill responsibilities and meet patient needs is strongly dependent on emotional and psychological health. Adverse working conditions and high-pressure healthcare...
Nursing Theory A large body of nursing research has identified a correlation between staffing aspects and patient outcomes. Managing the quality of care and patient safety is important as failure to do so may result in significant expenses. On average, the cost of an individual central line-associated bloodstream infection (CLABSI)...
Assignment Revision There are different types of diseases, especially chronic conditions that require self-care. This is true for elderly patients suffering from chronic pain. However, a range of factors affects their ability to provide self-care in an appropriate manner, the most essential of which include social, environmental, and genetic ones....
Introduction Student Introduction and Statement of Purpose Student: I am a student at Chamberlain College of Nursing. This interview will be conducted as a part of the series of tasks aimed at understanding the job of a nurse better by getting insights from a professional nurse’s firsthand experience. Nurse Introduction...
Introduction The quality of patient care is a primary concern of contemporary health care. The quality of the provided care depends on some interrelated factors which include professionalism of the staff, technical equipment of a facility, etc. Still, one of the significant factors is a nursing care delivery model adopted...
Introduction Today we could observe significant shifts in people’s mentalities and value systems. These alterations are stipulated by the rapid development of human thought, science, and humanistic values. In such a way, the human being is considered the greatest treasure and his/her life should be protected. This belief triggered numerous...
Healthcare remains one of the most critical sectors in any community or country. Different professionals in this field possess adequate skills that guide and empower them to deliver timely and exemplary services to their patients. The selected community setting for this discussion will revolve around hospice care. Community health nurses...
Introduction The process of formulating a nursing philosophy revolves around reflection and self-discovery. Understanding oneself guides a nurse on the path to self-improvement. In my opinion, the purpose of a nurse is to construct a proper environment for a patient in order to facilitate the process of physical and mental...
University Every nurse develops a set of practices and values as he or she works and learns. In addition to the expansion of knowledge that happens as experience is accumulated, the process leads to the formation of a personal nursing philosophy. To create a unified set of standards and set...
As for health care providers, it is essential for nurses to nurture and maintain the professional culture through constant development by joining specific professional organizations. The professional development is a vital obligation to pursue competence stability, the advancement of professional nursing practice, as well as uphold successful attainment of career...
Introduction: Malpractice in Nursing Examples Regarding malpractice in nursing, examples that one can come up with are numerous, ranging from medication errors and misdiagnosis to childbirth injuries and injuring patients with equipment. This paper will focus on one type of nursing malpractice: missed care, which is a problem that concerns...
My name is (name), and I am a registered nursing practitioner in (state). Today, I am writing to request your assistance in the introduction of the new legislation, aimed at improving the working conditions of shift nurses. Current bills on the matter do not provide evidence of sufficient support and...
Introduction Nurses frequently fulfill leadership roles in their practice. In such leadership positions, the importance of delegation in nursing is hard to underestimate. Moreover, nursing leaders should master the art of conflict management to establish a healthy workplace. There are several conflict resolution styles in the nursing profession, for example,...
There are many cases when the personal experience of the specialist can help him or her to provide the clients with proper assistance and prevent them from getting depressed. I am strongly convinced that such a situation will be especially beneficial for the client if we talk about the fields...
Abstract Horizontal violence among nurses is an issue that leads to high rates of turnover, mental health problems for impacted individuals, lowered quality of healthcare, and significant financial losses for the healthcare industry research considers two views points, scientific, and mathematical, and each of them poses two research questions. The...
Key Concepts of My philosophy My philosophy of nursing is based on core beliefs that include professionalism, accountability, compassion, and education. Nurses have the responsibility to promote and protect health and overall human wellbeing. In that regard, they should be accountable for self-regulation, professional development, and the quality of their...
Introduction Healthcare-associated infections (HCAIs), including hospital-acquired infections (HAIs) and surgical site infections (SSIs), are a considerable bother for healthcare worldwide. One of the most efficient preventative measures for HCAIs is promoting adherence to hand hygiene standards by both patients and care providers. The present project aims at promoting nursing teamwork...
Abstract American Association of Colleges of Nursing (AACN) identifies nine crucial aspects of master’s education in nursing (MEN). Essentials I and IV recognize that master’s-prepared nurses should have an adequate background in related sciences and humanities to acquire the latest evidence, interpret the findings, and use them in practice. Essentials...
A low rate of qualified nurses’ retention in the healthcare sector is a significant issue of concern because the lack of professionals negatively affects workgroup processes. There are a plethora of different factors that may contribute to practitioners’ decisions to leave their jobs or quit the profession. They include dissatisfaction...
Introduction – Nursing Curriculum Framework The organizing framework is created to direct the nursing curriculum and contribute to the optimal learning process of students. It is traditionally developed in agreement with the mission and philosophy proclaimed by Nursing University. Thus, it involves the learning community that empowers evidence-based decisions and...
Nursing practicum examples usually include activities that involve student nurses’ participation in patient evaluation and treatment. Later, students are expected to reflect on their professional experiences, as well as knowledge and skills obtained during the practicum. If you wonder how to write a reflection in nursing, examples on our website...
Abstract The essentials of master’s education in nursing focuses on redefining the basic concepts that should be embraced by nursing colleges when developing the course content of their master’s students. The content should emphasize the need to enable nurses to appreciate the relevance of change in their respective workplaces. They...
Introduction The description of a nursing conceptual framework. The framework components correlate with one another. A nursing model based on teamwork. Teamwork is one of the main elements of success. Orem’s nursing theory about self-care deficit. The ability to address personal needs on one’s own. Conceptual Framework Feedback on nursing...
Introduction The article was written by Araújo, Araújo, and Caetano (2011) “Comparison of risk assessment scales for pressure ulcers in critically ill patients” which discusses whether nurses can improve their performance and benefit consumers when using not only clinical judgment but also scales to predict pressure ulcers. This paper perfectly...
Individuals exposed to domestic violence usually experience a wide range of short-term and long-term adverse effects, including health problems, impaired social functioning, and so on. It is considered that nurses play an essential role in the timely detection of family violence through patient screening. However, it may be difficult to...
Nurse leaders contribute optimally in health facilities, especially when they are well equipped with nurse manager and/or leader inventory tools, for instance, personal and professional accountability and career planning among others. Such tools spell the behaviors that are necessary for any successful nursing manager. Nevertheless, as this paper reveals, as...
Recommendations As a student who pursues BSN in nursing, I fit perfectly into the IOM Future of Nursing recommendation 4 that states that the number of nurses with a baccalaureate degree should increase to 80% by 2020. If I finish my study successfully, I will be able to meet this...
Training Diverse Volunteers The differences in the individuals who want to acquire the needed skill presuppose the extreme diversity in learning styles and approaches that should be used to attain the desired result and attain success. This diversity is associated with developmental psychology theories stating that every individual has a...
Ethical Dimensions of Organizational and Leadership Behavior in Advanced Nursing Practice Ethical conduct is a major element of advanced nursing practice, and, among other things, it is pertinent to organizational and leadership behavior. From the perspective of organizational behavior, the interdisciplinary and intradisciplinary interactions of nurses are of primary importance....
Introduction For this assignment, I have chosen to watch and reflect on the video about Hildegard Peplau and her theory of interpersonal relations in nursing. I selected this video because I believe that a healthy, positive relationship between the patient and the nurse is vital to successful recovery. At the...
The healthcare system in the U.S. is in the process of reform, and nursing is the central part of the matter. Contemporary nurses are expected to apply their knowledge and skill to provide competent, patient-centered, and evidence-based care. At the same time, patients and their families require nurses to be...
Efficient interprofessional collaboration is one of the trends that shows positive results in the healthcare system today. The team consisting of members with different professional skills enables to provide patients with the best care in clinical settings. The outcomes of this collaboration in the case of a successful team are...
Introduction The United States health care delivery system undergoes multiple changes regularly. Nowadays, many researchers and journalists call it sick and unreliable due to high costs and the lack of control (Anderlini, 2018). Recent steps to recover healthcare quality and delivery cannot be neglected. During the last two years, Trumpcare...
Introduction: Nursing Diagnosis for Vision Impairment This paper discusses a case of a patient who presented to the emergency department with complaints of significant vision impairment in one eye. After discussing the patient’s subjective symptoms and objective examination findings, this report will provide an impaired vision nursing diagnosis. Finally, the...
The group consisting of individuals with diverse characteristics of their age, occupation, and cognitive abilities should be trained in a specific way that presupposes the utilization of all the learning theories. For instance, adult learning theory becomes critical for the provision of materials to the elderly as they have their...
Discovery: topic and practice issue The topic and the nursing practice issue related to this topic Reducing the risk of surgical site infections (SSIs) has been chosen as the topic for this task. Nurses play a critical role in the care of patients after surgery, and thus they contribute significantly...
Fast Facts on the nursing workforce collected by the American Nurses Association (2014) relate to the key determinants that characterize the United States’ nursing profession. Such determinants included job growth rates, median salaries, occupations with the most annual openings, the highest concentration of registered nurses (RNs) per 100,000 population, age,...
Nursing Care Issue The problem of nursing care violence has been in existence for a while, yet it has only recently started receiving attention. In the realm of contemporary nursing, violent behaviors displayed by patients are shockingly common (Speroni, Fitch, Dawson, Dugan, & Atherton, 2014). The effects of the identified...
Article Title This article is jointly authored by various nursing scholars and it focuses on the experiences of newly registered nurses (RNs). The article has a lengthy title although it serves the purpose of informing the readers what the study entails. For instance, the title mentions the study’s main test...
Nursing Theory Henderson’s nursing need theory implies that a nurse should follow a treatment plan prescribed by a doctor, but everything that relates to personalized care is creatively planned by herself or himself. Henderson believes that the nurse should set only long-term goals in restoring patient independence while meeting 14...
The article by Galbraith & Brown (2011) is titled “Assessing intervention effectiveness for reducing stress in student nurses: A quantitative systematic review”, and it reflects the contents. The abstract that is provided is well-written, and all the necessary information is provided. Moreover, it is possible to state that it can...
Obtaining Necessary Approval and Securing Support The change implementation should start with targeting the key stakeholders and obtaining the necessary support and approval. First and foremost, it is essential to communicate the need for change to the senior management. The proposed plan implies involving several parties: HR members, team managers,...
Nurses have a significant role in affecting the legislative process. They can contact the committees and state officials personally or through a professional organization to discuss their professional experiences and address existing problems. This paper discusses the parts of the lawmaking process that care providers can influence, lists the way...
Introduction Nurses constitute the largest group of clinical personnel who interact with patients and deliver direct care. Therefore, they play an essential role in the quality of care and patient safety. The level of nurse staffing significantly affects patient outcomes. The previous research findings suggest that improved patient-to-nurse staffing ratios...
Anxiety Nursing Care Plan Jessica is diagnosed with anxiety, as she revealed the feeling of uneasiness and discomfort connected with her loss of vision. The patient anticipates danger, as she is likely to be afraid of the possibility of further complications, total loss of vision, and inability to live a...
When we are speaking of a nurse that went through abusive relationships, we have to understand that the damage done by the latter cannot be perceived either subjectively or one-sidedly. Therefore, it is safe to say that there are both positive and negative effects that can impact one’s practice. First,...
National Nurses United (NNU) is one of the largest healthcare interest groups that strive to improve people’s health quality. The key issues with which the group is concerned include the increased quality and access to education for nurses and the promotion of a safe workplace for them (“About National Nurses...
Previous experience of intimate partner violence (IPV) or abuse can lead to different adverse outcomes in nursing professional’s practice. Connor, Nouer, Speck, Mackey, and Tipton (2013) point out that if a person was in abusive relationships and encounters experiences similar to theirs at work, they might have various responses to...
Self-assessment is one of the elements of cultural competence, so each healthcare professional should conduct such tasks regularly (Purnell, 2014). The assessment of cultural and linguistic competence of my healthcare facility sheds light on quite significant gaps in this area. Although some policies and guidelines related to cultural and linguistic...
Introduction It is apparent that the continuous development of the nursing profession in general, as well as the personal progress of every particular nursing professional, is of considerably high importance. The knowledge, which is obtained from scientific research, usually serves to translate into evidence-based practice. One of the better examples...
Introduction This paper aims to define and explain my beliefs and thoughts about the four nursing metaparadigms and their correlation with the 21 Nursing Problems Theory proposed by Faye Glenn Abdellah. The primary factor that has influenced the development of my nursing philosophy is the study of existing approaches to...
Nursing theories are crucial in nursing education because they provide a foundation for future practice. Ideas and concepts expressed by nursing theorists can help nurses to define their personal philosophies of nursing, thus ensuring a more holistic approach to patient care. Dorothea Orem’s nursing theory is one of the most...
The title accurately describes the study type and method but does not give an accurate understanding of the subject in question. This is acceptable given the highly specific topic of the research. The abstract, on the other hand, is representative of the article, thoroughly describing the reason for conducting the...
Introduction The issue of nurse staffing has always been challenging for healthcare settings because providers are often put in extreme workload conditions that they cannot manage. The problem becomes even more complex when Nursing Managers use their authority to assign overtime and additional shifts, failing to consult with their subordinates....