To Mr. Medes:

We appreciate your shared information regarding Jesus Christ as a servant-leader. Sr. Agravante set Jesus an example because as we all know Jesus is a good servant-leader of GOD. By knowing this, we nurses will have an understanding and a background what a servant-leader is all about.

Question:
If you will become a nurse administrator, transformational leadership can be a daunting prospect because of different criticism like abuse of power. How will you become more confident and better equipped to stop abuse of power?

Klarisse Esteban wrote:
In the nursing academe, most of the students taking up nursing nowadays are the ones who do not have the passion for the profession but they perceive it as opportunity to have a good future. With the utilization of the CASAGRA Transformational Leadership Model, these kind of students will be able to have a deeper view on what nursing is all about and thus, they may be able to be good nurses. Students who are less interested in the course that they are taking tend to be less motivated; thus, they tend to give low quality output in terms of academic performance and professionalism.

TO KLARISSE ESTEBAN:

I think it is great that such a great number of people want to go into nursing in the Philippines. Shows that they are a caring society. I would suggest that before taking up NUrsing, the students must understand the situation that graduating as a nurse is not a ticket to USA. And must realize the true meaning of nursing.

casagramoderators wrote:To Mr. Prado:

It is good that you have experienced one sample of a good leader through your undergraduate school. You mentioned fear to instructors and dean. It seemed that because of fear the students were forced to do the tasks because of some consequences thereafter.

Question:

Through your experience, are the students became a good leader in different ways?

Our current dean has been holding the position for about a decade now and so far most of the alumni are successful in their field of practice. Her type of leadership is unusual for this generation's nursing education but her ways proved to be more effective on the type of students in the school. She makes unpopular decisions but with good results. Like what I said on my previous post, educators adjust their rules based on their perceived needs of the students. Like what Mr. Enrile said, nursing schools should be governed with iron fists. I think it would be better if all nursing schools adapt the way of teaching of the older generations. Theirs was a less complex type but their discipline and dedication were impeccable. What we need are more strict clinical instructors. What I want to advocate is a more stringent and unified screening for prospective nursing students besides a college entrance exam.

To Mr. Prado:

It is good that you have experienced one sample of a good leader through your undergraduate school. You mentioned fear to instructors and dean. It seemed that because of fear the students were forced to do the tasks because of some consequences thereafter.

Question:

Through your experience, are the students became a good leader in different ways?

TO MS. CEE MENDOZA:


i agree that the measurement on how a leader is transformational is in terms of his influence on the followers. The followers of such a leader feel trust, admiration, loyalty and respect for the leader and because of the qualities of the transformational leader are more willing to work harder than originally expected.

A key criticism is that within it transformational leadership has potential for the abuse of power (Hall, Johnson, Wysocki & Kepner, 2002)

If you will become a nurse administrator in the future, what will you do to prevent this potential abuse of power?

When I googled the compound word "servant leader" in the google images, this picture was among the results:



Agravante used the Servant Leader Model on the leadership behavior, revolving around the care complex, and Jesus Christ as the core.

I don't want to focus about the weakness/limitation of Agravante's theory in the context of religion, but may I take a further step in explaining why she used Jesus Christ as a model for servant-leadership. These explanations might give us a deeper understanding to know the proponent's background and ideals that can lead to a different perspective of the theory.

1. In Jesus Christ we see the marks of the LEADER.

Jesus led by example

Jesus set the standard by which all future leadership is to be assessed. He was the natural leader. He did not have to raise His voice to be heard. He didn't need to strike the synagogue pulpit to be heard. When He entered the room, a hush fell over the people. He was a born leader.

Pilate wanted Jesus to accept the designation of King of the Jews. Jesus would have none of that. He needed no human title to establish his leadership. His leadership was inherent within Him. He sets an example of strong, sensitive leadership for all who presume to a leadership position.

Jesus led by action

When decisive action was needed, Jesus acted. When the Temple was despoiled by manipulative, unscrupulous commercial interests, Jesus overturned the money changers' tables (Matthew 21:12) When the howling wind and raging sea threatened to overturn the boat, Jesus cried out, "Peace be still" (Mark 4:39) and a great calm came upon the sea.

Jesus was a strong man, a decisive leader. He confronted what was wrong or harmful and led by action.

Jesus led by the quality of His life

Jesus grew in favor with God and with men and women (Luke 2:52). He went around doing good (Acts 10:38). The common people heard Him gladly. He spoke with authority, not like the Scribes and the Pharisees (Matthew 7:29). The apostle Paul often wrote about the "grace of our Lord Jesus Christ" (2 Corinthians 8:9). Jesus was loved by-and loved and prayed for-his friends (John 17). He was such an attractive person that people were drawn to Him like iron filings to a magnet (Luke 4:15).

Jesus led by the depth of His compassion

Jesus wept over the city of Jerusalem (Luke 13:34). When his friend Lazarus was declared dead, the Scriptures tell us that his strong leader, Jesus, wept for His friend (John 11:35). When the sister of Lazarus was under pressure from her activist sister, Martha, Jesus came to her defense (Luke 10:42). Leadership without compassion is arid and sterile. Jesus, a strong, bold leader, revealed a sensitivity and compassion that enhanced and balanced His strength of character and dynamic leadership.

Jesus led by making the ultimate sacrifice

Only a person of immense strength could look death squarely in the face and walk serenely towards it. Only a person of absolute conviction could have endured the lashes, the nails, the thorns and the spear and accept the loneliness and agony of the Cross of Calvary. Many followers of Jesus have carried their cross to Golgotha and accepted martyrdom in the name of Jesus Christ. They followed the slap of His sandals to the Cross-following the example He set.

Jesus was a born leader. Within His human experience, Jesus sets the example for leadership and calls us to follow.

2. In Jesus Christ we see the marks of the SERVANT.

Jesus was a servant because:

a) The prophets predicted that a servant would come and suffer.

"He was despised and rejected by men, a man of suffering and acquainted with grief" (Isaiah 53:3).
"Like a lamb led to the slaughter and like a sheep silent before its shearers, He did not open his mouth" (Isaiah 53:7).
The New Testament takes up this theme, quoting Isaiah, "Here is my servant whom I have chosen, my beloved in whom my soul delights" (Matthew 12:18).

b) He offered us a powerful model of servanthood.

When not one of His disciples was prepared to wash the accumulated dust off the feet of the disciples (even of Jesus), it was Jesus, the Lord of glory, who took up the basin and towel and washed the feet of his friends (John 13:5).

c) He understood the blessing that accompanies meekness.

In Matthew 5, when Jesus taught from a mountain, he set down for posterity the demeanor of the servant.
"How blest are the poor in spirit because the Kingdom of heaven is theirs" (5:3).
"How blest are the gentle because they will inherit the earth" (5:5).
"How blest are the merciful because they will obtain mercy" (5:7).
"How blest are the peacemakers because they will be called the children of God" (5:9).

d) Jesus taught the obligation of servanthood.

In the most radical way Jesus continued this theme in Matthew 5.
"Don't resist an evil-doer.if anyone slaps you on the right cheek, turn the other to him also (5:39). if anyone forces you to go one mile with him, go an extra mile" (5:41).
"Love your enemies and pray for those who persecute you" (5:44).

e) Jesus exhibited humility.

When well-meaning but misguided disciples tried to protect Jesus from children pressing to be near Him, Jesus said, "Let the children come to me. The Kingdom of God is made up of children like these" (Matt. 19:14). He was the good shepherd caring for the sheep (Hebrews 13:20).

f) Jesus went to his death at Calvary as the "suffering servant."

Jesus was the Lamb of God who laid down His life for His sheep (John 1:29, 36). He submitted to the shame and ignominy of a very humiliating death on a rough wooden cross. He died, the just for the unjust. He served God and God's people right to the end.

Let us all accept the opportunities of LEADERSHIP that the Lord and His people offer us. However, guided by the Holy Spirit, let us lead with the spirit of the servant and in so doing we will walk in the steps of Jesus the Christ.

This is actually an excerpt from an article I found online about Jesus as a servant leader. I was somewhat inspired to share the article so that we may have a deeper understanding and realization about the essence of this specific transformational leadership.

I feel that Agravante's theory instills unto us that transformational leadership is about a deep sense of caring, and a deeper sense of selflessly helping others because true leadership emerges from those whose primary motivation is a deep desire to help others (Spears, 2004).

I might be wrong, but I think Jesus Christ was used not as a representative of any religion (Roman Catholicism or Christianity) but rather, as a separate and independent entity and was just used because He is worthy of emulation. I strongly agree with the moderators that this might pose conflict/resistance among the members of other religions since they have their own set of beliefs.

Jesus Christ's character has already set the example of a real transformational leader, as the focal point of Agravante's theory. My one-liner reflection is that, emulating Jesus Christ will lead us to be better transformational nurse leaders, which will effectively and consequently transform nursing education and practice to a higher, more realized and meaningful level.

To Ms. Liongson:

We would like to commend you about the factors that you believe may contribute to the development of a nurse leader. Having a good self esteem can be a good contributing factor for a person to be good leader. Once a nurse is very dedicated to his profession, he will not have a difficult time to lead others in the profession because he loves what he’s doing. By this, he will be effective as a leader to his co-workers. A leader should also be minded of establishing a good relationship to others for him to be effective and respected. And most importantly, a good leader must have an understanding of leadership. We have a saying that “a good leader must be a good follower”, this entails within an organization a leader should also be open minded. He listens to the concerns of the member and have a collaboration for as the organization will be strong.

Question:

Using these additional factors, what will be the effect of these to the nursing profession?

The CASAGRA Transformational Leadership Model is an excellent approach to the teaching strategy not only in the nursing academe but also in other academic fields as well. It is a good approach in teaching since not only do the students learn the ways of the profession itself but also they tend learn to utilize it in their own lives.


In the nursing academe, most of the students taking up nursing nowadays are the ones who do not have the passion for the profession but they perceive it as opportunity to have a good future. With the utilization of the CASAGRA Transformational Leadership Model, these kind of students will be able to have a deeper view on what nursing is all about and thus, they may be able to be good nurses. Students who are less interested in the course that they are taking tend to be less motivated; thus, they tend to give low quality output in terms of academic performance and professionalism. If the teachers would be able to provide proper motivation and encouragement, scenarios like this will be avoided (Bengtsson M and Ohlsson, 2010). With the CASAGRA Transformational Leadership Model, the students see a concrete example of what they are supposed to do. This method of teachoing, is very beneficial since they are able to see the type of people they are likely to become in the future and they would be motivated to do what it takes for them to achieve that goal.


I agree with this model since it provides significant improvement in the strategies of teaching. This will make learning easy while providing an efficient way for the student to increase his passion and competence in the field of nursing.

Reference:
Bengtsson M, Ohlsson B; The nursing and medical students motivation to attain knowledge; Nurse Education Today (NURSE EDUC TODAY), 2010 Feb; 30(2): 150-6 (37 ref)

Being a nurse educator, or simply a teacher, is a very noble and transformative job. Educators shape the future of their students. Educators are a big influence in decisions that students make. They play a role that no other profession can do so well, cultivation of knowledge. They are the prime movers in future building. If not for good acedemic professionals, there will never be a good president or good nurses. Educators are also our second parents. They play a vital role in morality. They nurture us and provides us with a sense of security. They are indispensible to our lives.

Nurse educators are not so different from basic teachers. The only difference between the two is the level of knowledge on their field of expertise. Nurse educators are, of course, more inclined in allied health teachings specifically nursing concepts. They also differ in strategies on doing their jobs. Nurse educators have a difficult and tedious task of instilling the basic and complex knowledge, skills and attitude to nursing students in 4 years. They have to imbibe a more “real life” approach to teaching.

Different styles of learning and teaching are also implemented by different schools. My undergraduate school for instance has a very strict and semi-autocratic style of teaching. We are trained to be submissive and to be good subordinates while being assertive at the same time. The culture that we were accustomed to was a high degree of respect and fear to our instructors most especially the dean. It was her way of maintaining discipline and compliance to the strict training that she imposes. If you look at it, it would seem like its hard to cope with very stringent rules but after graduating, we were glad that we were trained that way. Nurse educators adjust to the perceived needs of the students that they are teaching.

In CASAGRA, the servant leadership role for me is the core of the thoery. It encompasses the whole aspect of nursing education by pointing out important characteristcs of an education that will lead to a more caring, skilled and refined nurses. Nurse educators can shape the future of nursing by empowering its students (Kalb, 2008). Nurses become what their mentors envisioned them to be by training them with what they think is the best for them. I think that the one factor that educators must posses is the most basic trait of a nurse, caring.

It is time to train our students be aware of their identity as nurses. Nurses' primary role is to care by means of intimate bodily contact and with different degrees of involvement by physicians and social work (Hall, 1963).

In clinical practice, CASAGRA can be applied to novice nurses. They can be what their hospitals' vision of how a nurse should be given the proper education and training. But the issue of understaffing still lingers. Senior nurses cannot mentor their juniors because of the high demand of tasks that they have to accomplish because of understaffing (Canadian Nurses Association, 2009). CASAGRA can be applied by instilling a servant leadership role through mentoring. Nursing Education and Training departments should set a goal for novice nurses so that they can plant a good seed that will bear fruits of a more caring and compassionate nurse.

To the moderators. Thank you for commending my perception about the theory. In response to your question:
"Would it be possible nowadays when the CASAGRA transformative leadership model apply to other study group with different religious views would be effective?"

I believe that religion should not be a barrier in improving leadership behaviors using CASAGRA theory. As I mentioned earlier, the very foundation of this model is based from caring behavior. And that value encompasses any religion especially in nursing profession. As Jean Watson's theory of human caring explains that it is the very essence of nursing. It should be something innate to us and that is not exclusive to catholic religion alone.

About using Jesus Christ as an example, this may be a sensitive topic to nurses with different beliefs. So I agree with Ms. Mendoza that using "supreme being" will be more appropriate.

I acknowledge that there's a possiblity of bias in the study since it was used in one faculty only. Thus, further research should be done to test its effectiveness.

Raphael_Desoyo wrote:Nurses now are too consumed with themselves and forgot the real essence of nursing, most of them are bluntly going on with their lives as a nurse. No one’s there to lead them and inspire them to be better nurses thus providing better care and live a better experience as a nurse.

Most of the nurses today have less opportunity to enhance their leadership qualities due to the poor employment status of the profession today. There is a surplus of nurses everywhere, so enhancing their leadership qualities thru the clinical setting is very hard. For the nurses who are fortunate enough to get to the clinical setting, they the opportunity be led by nurse manager. The factors that can influence the growth of nurses basically is their environment, experiences and their personal beliefs and ideals. For the nurses who aren’t employed as a nurse, mainly their influence for nursing growth would be the fire in their heart to pursue nursing.

There's been a lot of forums about the over abundance of nurses in the Philippines. Most countries look at the Philippines to ease THEIR nursing shortage. Nevertheless, because hospitals in the Philippines aren't able to hire all the new grads, there were a lot of new graduates who can’t obtain the experience they need. The surplus of nurses in the Philippines is a reality. A lot of nurses were unemployed. Many are depressed and disappointed why they took nursing which led them to take up other jobs such as call center agents and medical representatives.
Sometime during a nurse conference, a nurse asked a question: why you took up nursing degree? Some will say “I wanted to serve humanity!” Some would not hesitate to say, “ I wanted to earn $$$!”

Funny, but there's a reality in it. The Philippine schools of nursing modified its perspective now days but for some who retains their mission and vision.


If you will be given a chance to become a nurse educator, how will you re-define the role of nurses in our society's current trends and how will you imply this to your students?

To Mr. Desoyo:

We appreciate your understanding about the CASAGRA transformative leadership model. Through experiences we nurses can be a good leader. You focus on the spiritual side of the study which is effective to the Roman Catholic based on the result of Sr. Carolina Agravante’s findings.

Question:

In your opinion, is the leadership behavior of the nurses will improve when spiritual aspects is not present?

casagramoderators wrote:TO MR. MARK PAOLO ENRILE

When I read about the special techniques you mentioned on how nursing educators should be, I wish sister Carolina Agravante included those. You also mentioned the quality of the nurses’ graduates has declined as the passing rate slowly goes down. What effective means would you suggest to the nursing association that will address the concerns of repeaters and avoid waste of resources of the graduates and their parents?

Thank you so much for the comments fellow scholars. In terms of securing an more effective measure against low passing rate, I would go back to my earlier statement regarding quality education. Quality education would provide a very strong framework from which students would base their answers on the board examination and even when they are practicing nurses. Resources of both the school, the government and the students with their parents will not be in vain given that quality education is assured.

A more stringent and anal perusal of qualified clinical instructors, lectures and of course passing rates of the different nursing schools we have will definitely contribute to the renaissance of our nursing education system.

A leader for me is like a horse driven carriage. The passengers and the chauffer symbolize the members of the group or a team and the horse is the leader. The horse carries a big responsibility since it leads the way to the right path and following the chauffer to the right way going to a particular destination. The horse at the same time serves the passengers since it is carrying the carriage where the passengers are. Like a horse, a leader carries big responsibilities for a team or a group, and at the same time serving the members of the group. It is important for a leader to be a servant-leader for him/her to know the feelings and opinions of the members and at the same time value their opinion for the task to be accomplished. A leader should influence a group of individuals to finish a certain task. A leader is defined by Northhouse as a process whereby an individual influences a group of individuals to achieve a common goal. (Cummings et al., 2008)


According to a study conducted to examine the factors that contribute to nursing leadership and the effectiveness of educational interventions in developing behaviors among nurses, twenty leadership factors were examined and categorized into four groups: behaviors and practices of individual leaders, traits and characteristics of individual leaders, influences of context and practice settings and leader participation in educational activities. (Cummings et al., 2008) Among these factors I believe that behaviors and practice is the most significant. Experience or practice particularly influences the development of leadership since through it leaders are molded and enhanced. I also agree to what Mr. Enrile and Mr. Mosquera regarding the importance of education and experience into developing leadership. With education, a leader or a teacher may gain more knowledge and at the same time will be able to share their skills to others.


CASAGRA transformative leadership model is all about molding leaders, educators and staff nurses, to become a competent and committed individual through the three concepts identified which is focused on the psycho-spiritual view. CASAGRA transformative leadership model can be applied to different settings. As a staff nurse in a hospital setting, the CASAGRA leadership can mold them into becoming a better and more efficient in delivering health care to patients. It is the same way to nursing educators to their student nurses through delivering the concepts of nursing in a way that the students will understand them easily and put them into practice.


The theory of Sister Carolina Agravante focuses mainly on the psycho-spiritual aspect of leadership. I agree and commend with what Mr. Desoyo said that Jesus Christ is a great leader and a great nurse in the history. To be able to develop the skills and characteristics of being a leader, we should center our reflection and analysis on the teachings and practices Jesus Christ, our Creator had done. Through the retreat workshop concept formed by Sister Carolina, nurses, nurse educators and other nurse managers and administrators can reflect and have time to build and mold their values as an individual and through this they will be able to share and live it up to their students and colleagues as well. It is also a good analysis that leaders can only be leaders if they are able to influence others.


In Conclusion, I truly advocate the theory of Sister Carolina because through this theory health care team will yield to a successful collaboration thus delivering an effective health care and health education. I also believe as a Paulinian in the quote, “MAKE A DIFFERENCE”. I believe that in your own little way we can already change and make a difference in our life. This difference maybe the start of something we can develop or build today. Through this theory made by Sister Carolina Agravante, the health care organization will be able to create not only good educators but also good nurses thus making a difference in delivering health care to patients.


Reference:
Cummings, G., Lee, H., Macgregor, T., Davey, M., Wong, C., Paul, L., et al. (2008). Factors contributing to nursing leadership: A systematic review. Journal of Health Services Research and Policy. 13, 240-248.

I appreciate how Mr. Enrile painted us a picture of the current status of nursing education and the “substandard” graduates that it produces. This can be attributed to the fact that nowadays Nursing is hardly ever viewed as a noble vocation, but merely a ticket to greener pastures. Nursing schools have sprouted even from Computer Science schools because of this demand. I do believe that the quality of education given to Nursing education is no longer rooted on the very values of a caring profession since the goal is to produce board passers. The attempts to meet the goal are centred on knowledge and procedures. This is problematic since nursing care is supposed to be holistic and not merely physical.

It is given that a good education, training and life experiences regarding care are basic requirements for the development of leadership characteristics, skills and expertise among nurses. But there are other factors that I believe may contribute to the development of a nurse leader.
1. ORGANIZATION-BASED SELF ESTEEM (OBSE). OBSE refers to a person’s assessment of his adequacy and worth in his place in his institution of employment. A high OBSE is characterized by a person’s view of himself as significant, effective and a contributing member of the work force. This attitude elicits support from supervisors and colleagues. (Schultz,2002)
2. PERSONAL VALUE FOR THE PROFESSION. A nurse who genuinely enjoys Nursing, is genuinely interested in patients and has confidence in his professional know-how has high potentials as a leader and teacher (DeYoung, 2003). He strives for excellence by expanding his knowledge and polishing his skills throughout his career path. This can be done not just by continuing education, but also by up trainings, continuously reading and doing research. In this way, he serves as a role model.
3. WILLINGNESS AND APPRECIATION FOR SELF-GIVING. Henderson posited that Nursing is different from other professions because it entails going beyond one’s self (Tomey, Alligood, 2002). This does not only apply to nurse-patient relationships. It also trickles down to nurse-colleague relationships. Simply being responsive to one’s colleagues and the readiness to give assistance is leadership. It also shows confidence in one’s competence.
4. UNDERSTANDING MEANING OF LEADERSHIP AND MANAGEMENT AND SUPPORTING THEORIES. Becoming a leader needs basic understanding of the essence of leadership and how leadership skills are developed and practiced. Leadership is focused on empowering people and groups to achieve the common organizational goals. Management is the coordination of activities and people to meet organizational desired outcomes. Leadership and Management theories give guidance on how to be an effective leader. An example is the behavioural leadership theory of White and Lippitt which identified three leadership styles: authoritarian, democratic and laissez-faire. All of which are models for leading.(Masters, 2005)

Agravente’s transformative leadership model, focussing of psycho-spiritual change in leadership behaviours, can be applied to the staff nurses, nursing administrators and to patients. To begin with, Filipinos are generally spiritual and religious, regardless of religion and practice. We are also service-oriented, traced back from the old days of “bayanihan”. Spirituality is one’s belief in a higher power that exists in all things (Bastable, Trese). As human beings, we are able to open up to more effective communication and possibilities of choice in changing what is not right through critical spirituality or awareness of one’s internal being (Burke). Nurses and Nurse Administrators are also educators who bank on communication to alter what is wrong in our patients’ health. We do health teaching for our patients and their families. It is also our advocacy to disseminate health information to the public in all ways possible. More important than imparting knowledge is to reflect on the reason why we are doing it. Reflection increases the nurse’s self awareness which is the first step in establishing a therapeutic relationship. It also paves way to collaboration among staff members (Vessey, DeMarco, et, al, 2009). On the other hand, patients’ spiritual and religious beliefs have been found to influence healh beliefs and improve health status (Bastable, 2008). The spiritual exercise of contemplating on Jesus Christ’s suffering as a servant leader gives hope and renewed strength to endure.


CASAGRA may positively affect nurses’ job satisfaction and performance. Agravante proposes that a person’s psycho-spiritual dynamics affects a nurse’s leadership behaviours. Spirituality allows a nurse to open himself to people more easily, widening channels or communication (Burke). This improves performing caring tasks since interacting with patients is our means of determining their needs, as Travelbee suggested, and allowing them to gain insight of their condition, as proposed by Peplau (Tomey, Alligood, 2002). With this positive performance, a nurse may gain satisfaction with his work. According to Herzberg, job satisfaction is gained when a person completes his job satisfactorily and gains recognition for it (Masters, 2005).


Nurse educators should respond to the changing times with different approaches. Primarily, with preservation of good character, values and ethics because it leads to enhanced competency (Vessey, DeMarco, et, al, 2009). Competency allows an educator to be committed to others (Vanaki, Memarian, 2009). It is also important for and educator to be constantly socially aware to determine the emerging problems of the times. Nurse educators should be innovative, creative and stimulating to gain the confidence of their learners as they integrate nursing principles with nursing knowledge.


Being a good Nurse educator and leader does not happen just by imitating former educators and leaders, even though it may be helpful. It involves knowledge, educational theory and research, openness to continuous development and reflection. Leading and teaching qualities may be inherent, but they may also be developed through time. There is always room for growth for everyone.


SOURCES:
-DeYoung, Sandra (2003). Teaching Strategies for Nurse Educators. Upper Saddle River, NJ: Prentice Hall.
-Bastable, Susan B. (2008). Nurse as Educator. Sudbury, MA: Jones & Bartlett Publisher, Inc.
-Trese, Leo J. (1965). The Faith Explained (3rd ed). Manila: Sinag-tala Publishers, Inc.
-Tomey, A.M. & Alligood, M.R. (2002). Mosby, Inc.
-Masters, K. (2005). Role Development in Professional Nursing Practice. Sudbury, MA: Jones & Bartlett Publisher, Inc
-Burke, Robert. Leadership and Spirituality..http://www.metafuture.org/articlesbycolleagues/RobertBurke/Leadership%20RBurke2.pdf
-Vanaki, Z. & Memarian, R. (2009). Professional Ethics: Beyond the Clinical Competency. Journal of Professional Nursing (Vol. 25)
-Vessey, J. & Demarco, R. Et. Al (2009). Bullying of Staff Registered Nurses in the Workplace: A Preliminary Study for Developing Personal and Organizational Strategies for the Transformation of Hostile to Healthy Workplace Environments. Journal of Professional Nursing (Vol. 25)