Abstract

Good leadership is essential for the success of a business organization. Modern business has been diversified and new practices have been introduced. Even the most effective leadership techniques can end up being obsolete as far as new business models are concerned. Leaders should be flexible. They should strategize their leadership models in such a way that they can quickly adopt to change soon as the need arises. In order for business leaders to remain relevant as time goes by, they should be able to outline their main areas of organizational leadership that they intend to put their major focus on. This study will focus on three elements of leadership; team leadership, innovation and people development. These three were chosen based on the realization that they bring together all the other elements of organizational leadership. A discussion of how the three should be employed by business leaders will form the bulk of this study.

Leadership Competency Improvement Focus Proposal

Introduction

In my life, I have always believed in the power of transformational leadership as the key to success in business. There are different scales of business that exist today. In my case, I consider a business that employs many people as being more viable than a sole proprietorship. This is based on my belief on the essence of profit maximization, customer satisfaction and creating employment opportunities. In order to bring the significance of the above mentioned objectives into practice, realized that effective transformational leadership is a component that will have to be embedded in my life for as long as I wish to practice business. Transformational leadership is not just applicable in the business sector. It is applicable in my everyday life as well. My interactions with friends and family are made more efficient whenever I apply the ideologies of transformational leadership, values and ethics.  Personally, this trait has garnered me a large amount of success and I intend to continue holding on to it.

Leadership Competencies

Innovation, team leadership and people development are the leadership competencies that will be addressed in this study. People development involves coming up with strategies to enhance the quality of employee output. Identifying the best people development strategies is one of the greatest challenges facing business leaders. Learning and development programs is one way by which leaders can practice people development. Many business organizations spend a lot of money on these programs.

Innovation constitutes coming up with new ways of doing things. Anyone can innovate. Employees have for a long time now been embedded in the misconception that business innovation is something that should be left to the executives. This is not the case. One way in which this mindset can be reversed is by implementing people development programs. Innovation brings numerous advantages to a business organization. For instance, it gives a firm the competitive advantage of growing and adapting the firm’s business in the marketplace. Organizations that employ innovation are likely to save time and money in their operations.

The success or failure of a business team is determined by the effectiveness of the team leaders’ strategies. A good leader will lead his or her team to success while a bad one will lead his or her team to failure. Team leadership is characterized by the size of the organization one is dealing with. Being the manager of a small company is not the same as heading a large organization. The two bring diverse challenges on the table. As such, it is advisable to view the two in the context of leadership in general.

Effective team leadership depends on the characteristics of the leaders. A good team leader is supposed to be flexible. The modern business environment keeps changing from time to time. An effective leader should be able to quickly adopt to these changes and unite the team around new and reversed goals. By so doing the leader ensures that the team does not get glued to old practices in a changing business environment. A team leader is tasked with the responsibility of developing the organization’s operational strategies. A good leader should not take on this responsibility independently. He or she should take advice from the organization’s funders, trustees, staff, service users and partner agencies.

Innovation, team leadership and people development are some of the main factors that define an organization’s success or failure. The success of a business is dependent on a number of factors. The core competencies of a firm are based on its leadership model. Innovation, team leadership and people development are three most crucial components of a leadership model. They encompass all the other factors that lead to organizational success. An organization that is able to come up with an effective strategy that will include these three is guaranteed to succeed even in the most unfavorable business environment. This formed the rationale for choosing these three.

Leadership competencies proposal

People development can be done in different ways. Managers play a crucial role in influencing employees. One way in which people development can be executed is by igniting the managers’ passion to coach their employees. Managers pass important skills, insights and knowledge to the employees through coaching and mentoring. Modern business has been globalized and as such, it has become more competitive and complex (Tipu, Ryan and Fantazy, 2012). This has led to managers being overburdened by new responsibilities. This has made it difficult for them to handle what they were originally tasked to do let alone offer coaching and mentoring.

The business world is changing. Knowledge and skills can be become obsolete in just a few months. Leaders should ensure that managers and their employees learn rapidly and regularly. Currently in most organizations, learning and people development is a once in a while occasion. This should be transformed to be a more continuous, ongoing campaign. Adopting new strategies of conducting people development can consequentially lead to information overload. This can be risky to an organization.

Enacting leadership strategies that will ensure that tech employees own their own career development is good way of performing people development. The organization cannot control the learning futures of the employees. It is the responsibility of every individual to own, self-direct and control his or her learning futures (Freeborough, 2012). Individual’s talent development is crucial for overall productivity. It is not only essential for the general organizational success but it is also important for self-development and one’s ability to innovate.

Most employees do not have trust in the leadership systems that guide them in their respective organizations. This study suggests building trust in organizational leadership as a people development strategy. Employees crave transparency, honesty and openness from their leaders. Research conducted by the American Psychological Association postulates that only half of the employees in the U.S. are certain that their leaders are being upfront and open with them (Green, Miller and Aarons, 2015). Leaders are supposed to share their ongoing learning journeys with their employees. They should conform to the old adage, “lead by example.”

Through research and planning, an organizational can be able to identify the respective areas that need innovation. One way in which this can be done is through conducting a market study.  Business market environment keeps changing. New trends keep coming up with the wake of every new working day. In order to stay up to date with these trends, an organization should be able to analyze these new trends and relate them to customers’ wants and needs and those of the competitors. Doing so will enable the firm to stay ahead of its competitors or at least stay in the same level.

Leaders should be open to new ideas. They should be adoptive to change. In order for them to do this, they should be able to seek advice. A good organization should have advisors, grants and assistance. These are essential in driving innovation. Learning everything there is to know about local and international collaboration can help the leaders head their employees through efficient and reliable innovative techniques. There is need to protect the organization’s ideas (Salem, 2015). Seeking Intellectual Property protection can aid the organization in commercializing its ideas.

Team leadership is the foundation on which innovation and people development are practiced. In this case, what matters is the characteristics that make an individual a good leader. A good leader should be confident, respectful, fair, influential, delegate, should have integrity, and should be a facilitator and a negotiator.

References

Freeborough, R. E. (2012). Exploring the affect of transformational leadership on nonprofit

leader engagement and commitment (Order No. 3498733). Available from ABI/INFORM Collection. (928140246).

Green, A. E., Miller, E. A., & Aarons, G. A. (2013). Transformational leadership moderates the

relationship between emotional exhaustion and turnover intention among community mental health providers. Community Mental Health Journal, 49(4), 373-9.

Salem, I. E. (2015). Transformational leadership: Relationship to job stress and job burnout in

five-star hotels. Tourism and Hospitality Research, 15(4), 240-253.

Tipu, S. A. A., Ryan, J. C., & Fantazy, K. A. (2012). Transformational leadership in pakistan:

An examination of the relationship of transformational leadership to organizational culture and innovation propensity. Journal of Management and Organization, 18(4), 461-480.

Decreasing CNA Turnover Rates

Abstract

The primary rationale for the selection of this project is the need to reduce the turnover rates of Certified Nursing Assistants in my home health agency. The turnover rates of CNAs remain a long-term care issue affecting the delivery of quality care. The current turnover rates range from 56% to 75% for the CNA’s. This research study seeks to probe whether CNA’s empowerment procedures are associated with the retention of CNAs. In an effort to gather an evidence-based knowledge for this study, data from nursing homes and home health agencies will be used.  After an adjustment for the covariates, an efficient staff empowerment initiative score was established to be positively associated with the higher levels of retention. In comparison with the low empowerment section, nursing institutions with scores that were perceived to be medium had a 45% chance of having higher CNA retention rate; while those with higher empowerment scores were considered to have a 65% likelihood of having a higher CNA retention rate. Greater opportunities for nursing institutions in regard to CNA empowerment are therefore associated with long-term CNA retention. This research reveals that staffing empowerment measures are worthwhile from a CNA staffing retention point of view.

Decreasing CNA turnover rates

The U.S. will have over 88.5 million people aged over 65 years by 2050, double the 2010’s 40.2 million estimates (Hummel, 2017), with an estimated increase in the demand for CNAs in the range of 5.7-6.5 million (Meyer, Raffle & Ware 2014). The need for nursing homes is also expected to rise. Such postulates, compounded by the cost of training a CNA, and beliefs that CNA stability positively impacts the quality of care afforded to nursing home residents have ignited long-standing interest in CNAs turnover and retention in long-term care facilities (Institute of Medicine, 2008; Squillace et al., 2008). As Bowers and Nolet, (2011) note, the correlation between CNA staff stability and care quality is premised on the idea notions that staff staying for more extended periods at a facility establish a relationship with both colleagues and residents thus are familiar with the residents’ needs (Donoghue, 2010). Importantly then, appraising whether CNA’s empowerment procedures result in this correlation cannot be overstated.

Systematic Problem Identification

Adequately skilled CNAs are highly required to meet the increasing demands of the aging population in long-term nursing homes that are unable to provide basic geriatric services (Lerner et al., 2014; Ammons & Kelly, 2015). CNAs account for 66% of the total healthcare workforce segment in long-term health care (Hummel, 2017). CNAs who characteristically spend 6-8hours in contact with residents, function in one of the most core and influential capacities in nursing homes (Hummel, 2017)

By 2020, the need for CNAs will increase by 20% and 39% by 2024 (Hummel, 2017). Such amplification in demand for these staff and the facilities in which they operate is paired with the opposing realities of them having one of the highest turnover rates for any long-term care work-related position (Ammons & Kelly, 2015). This is compounded by the cost of recruiting, orienting and training a new CNA into a nursing facility, which is estimated to be $30,000 (Squillace et al., 2008). Such facts are a recipe for crisis and prerequisites for approaches for nursing facilities to retain their CNAs, including staff empowerment measures.

Assessment of Researching the Existing Knowledge-Base

The stability of staff in literature is measured as staff turnover (the % of quitting staff in specified periods (usually a year)) and staff retentions (the % of remnant staff within the same period) (Bowers & Nolet, 2011; Donoghue, 2010). As Hummel, (2017) reports, the estimated annual CNAs turnover rates range between 23.8% to 74.5%; in 2012, the turnover rate was 52%, with 47,000 vacant positions for skilled labor being reported in nursing facilities. In Castle and Engberg’s (2005) research in four states, a yearly 85.8% turnover rate was realized in 354 facilities while the 2010 CNA turnover rates as reported by AHCA (2014) was 42.6%. National CNA retention rates as estimated by Donoghue (2010) were 62.5%.

Employment practices that are empowerment focused have been proposed as one of the means of enhancing CNA job stability and satisfaction (Hummel, 2017). The approaches have been linked to staying intent, higher job satisfaction, and lower turnover rates. These include developing more supportive facility culture and the development of greater CNA opportunities (Bowers & Nolet, 2011). Best exemplifying this includes offering educational and training opportunities, practice implementation reflecting staff valuing, staff involvement in the planning of care and participation of staff in day to day and managerial decision making (Koren 2010).

Probst, Baek, and Laditka, (2010) research postulate positive associations between organizational climate, sufficient time for tasks, good hourly earnings, good supervisor behavior and staff valuation with job satisfaction. Approaches implementing team empowerment gave CNAs authority to make decisions on their work, leading to modest positive effects on CNA job satisfaction, performance, improved procedures, cooperation, coordination and better resident care (Yeatts & Cready, 2007). The study also revealed a minimal likelihood of CNAs exposed to empowerment for getting fired or quitting.

The clinical significance of CNAs is enormous. CNAs are considered paraprofessional performing multiple tasks with and for residents. Most of the work of CNAs is associated with the physical care of residents (Squillace et al., 2008). CNAs are also trained to provide non-physical support, including the ability to recognize changes in behavior and social interaction decrements among residents (Hummel, 2017). Additionally, they also offer support to resident family members, making their retention in a nursing home important.

Adaptation of Existing Practice

In practice, the implementation of cultural changes within organizations is one of the leading fronts changing staff empowerment (Banaszak-Holl et al., 2013). Movements advocating for cultural change are expansive and mainly focus on the improvement care and life quality for residents in nursing facilities (Zimmerman, Shier & Saliba, 2014). CNA empowerment presents residents with a homelike atmosphere, direction, close contact, decision making based on collaboration and processes aimed at improving quality of care (Koren, 2010). Implementation of the principles of staff empowerment follows the postulates of being organized to support the empowerment of all staff responding to the needs and desires of residents (Hummel, 2017).

Conduct a Clinical Trial and Evaluation

Evaluation of the effectiveness of this approaches will employ the postulates of (Berridge, Tyler & Miller, 2018) and (Banaszak-Holl et al., 2013).  A culture change survey of nursing home directors and administrators at similar nursing homes will be conducted via mail, phone and online at a sample of nursing homes implementing the approach. The survey will use a stratified sampling design. The survey will examine two culture change domains: staff empowerment practices (choices and decisions) and the physical environment. Survey questions will be designed to be on the area of interest, that is, the domains of staff empowerment practices and retention rates. Analysis of data obtained will follow the postulates of Tyler et al., (2013).

That, as Berridge, Tyler & Miller, (2018) postulates, nursing homes which identify themselves as adopters of change implemented strategies such as the cross-training of staff, provided leadership training opportunities, and engaged nurse assistants in decision making on assignment residents. Then for the sample of facilities implementing staff empowerment practices, the evaluation will be based on CNA tracking information as provided by participating facilities, pre and post job satisfaction surveys and CNA exit interviews. Qualitative measures will be undertaken through valuations; observations made on project variables will be detailed.

Decision: Adoption, Modification, Rejection

Relationships between organizational cultural changes and the stability and satisfaction of CNAs is complex (Bowers & Nolet, 2011). Implementations of changes may be hard in the face of more permanent staff with long institutional relationships and memory as they tend to be attached to a familiar, different model (Donoghue, 2010). An uphill task would be the achievement of staff buy-ins (Tyler et al., 2013). Strategies (below) to involve CNAs and assure buy-ins require extensive training and strong communication (Hummel, 2017). Modification: going beyond the federally recommended staff-residence rations in the face of looming large workload issues, residence dissatisfaction, and CNA turnover. More realistic ratios have to be established in the face of growing CNA pools due to improved wages and better training.

Plan for Diffusion of Innovation to Other Areas

Findings from the research will be diffused to training institutions to offer adequate training (Hummel, 2017). The development of highly specific and meaningful training programs for CNAs can help address turnover problems. Such training has to be imperatively accompanied by between hourly pay. The acquisition of better trained CNAs only reasonably requires more than minimum wage to guarantee long-term stay. Financially constrained nursing facilities can strongly argue their case for additional resources for wages (Hagerty & Buelow, 2017).

Maintenance Mechanisms

Strategies to overcome resistance to change in part will entail the use of change agents with characteristics similar to the targets of change which has been postulated to improve the reception of change (Berridge, Tyler & Miller, 2018). A second option involves the use of dramatic symbols and ceremonies signaling disengagement from the past (Parkin, 2009). Organizations have been known to burn old policies and tear down buildings to demonstrate their disengagement from the past and the embracement of the future. The approach best works when fundamentally supported by widespread communication about the change and ensuring that staff and administrators understand the rationale (Hagerty & Buelow, 2017).

The critical importance of involving persons affected by the change cannot be overstressed. If CNAs feel involved in the planning and implementation of the change are invited to participate and voice their views in the process, they will be much more likely to commit to the changes and engage colleagues to do the same (Hummel, 2017). Similarly, it is critical to get a person on board who have substantial credibility or leadership in the organization. They are likely to be influential by creating by-ins particularly among CNAs resisting change (Parkin, 2009). Finally, change is likely to be far less successful when an organization fails to commit sufficient resources to see it through. Whether these resources are new training for the new process or finances, failure to invest in what it takes for success readily invites resistance.

Evaluation and Dissemination Plan

A culture change survey of nursing homes implementing the approach will be conducted to examine staff empowerment practices to appraise the post-implementation retention rates, as based on the postulates of Berridge, Tyler, and Miller, (2018). Targeted dissemination and diffusion of research findings will employ multifaceted dissemination strategies, emphasizing on media and channels that are most effective for stakeholders – nursing home administrators and directors, funding organizations, CNAs training institutions and CNAS. Based on the postulates of knowledge uptake, theoretically-informed frameworks will be used to guide research finding dissemination through presentations at conferences, posters, institutional websites, and podcasts.

In conclusion, CNA empowerment practices implemented by new-culture-adopting nursing homes are positively associated with retention cannot be ignored, more so as they are indicative of how they may be used to enhance staff stability. This new and vital knowledge on changing the culture of an organization can confer benefits to both nursing facilities and the care afforded to residents. It is expected that the findings of the research will benefit nursing facilities that seek the achievement of higher retention rates of CNAs.

References

American Health Care Association. (2014). American health care association 2012 staffing report. American Health Care Association Department of Research. Washington, DC. Author.

Ammons, S. K., & Kelly, E. L. (2015). Work and family in the new economy. Bingley, U.K: Emerald.

Banaszak-Holl, J., Castle, N. G., Lin, M., & Spreitzer, G. (2013). An assessment of cultural values and resident-centered culture change in US nursing facilities. Health care management review, 38(4), 295.

Berridge, C., Tyler, D. A., & Miller, S. C. (2018). Staff empowerment practices and CNA retention: findings from a nationally representative nursing home culture change survey. Journal of Applied Gerontology, 37(4), 419-434.

Bowers, B., & Nolet, K. (2011). Empowering direct care workers: lessons learned from the GREENHOUSE Model. Seniors Housing & Care Journal, 19(1), 109-20.

Bowers, B., Roberts, T., Nolet, K., Ryther, B., THRIVE Research Collaborative, Brown, P., Cohen, L., Grabowski, D., Horn, S., Hudak, S. & Reed, D., 2016. Inside the Green House “black box”: Opportunities for high‐quality clinical decision making. Health services research, 51, pp.378-397.

Castle, N. G., & Anderson, R. A. (2011). Caregiver staffing in nursing homes and their influence on the quality of care: Using dynamic panel estimation methods. Medical care, 545-552.

Castle, N. G., & Engberg, J. (2005). Staff turnover and quality of care in nursing homes. Medical care, 616-626.

Donoghue, C. (2010). Nursing home staff turnover and retention: An analysis of national-level data. Journal of Applied Gerontology, 29(1), 89-106.

Hagerty, D., & Buelow, J. R. (2017). Certified Nursing Assistants’ Perceptions and Generational Differences. American Journal of Health Sciences, 8(1), 1-6.

Hummel, R. (2017). CNA Turnover and Retention in nursing homes (Doctoral dissertation, University of Pittsburgh).

Institute of Medicine (U.S.). (2008). Retooling for an aging America: Building the health care workforce. Washington, D.C: National Academies Press.

Koren, M. J. (2010). Person-centered care for nursing home residents: The culture-change movement. Health Affairs, 29(2), 312-317.

Kulik, C. T., Ryan, S., Harper, S., & George, G. (2014). Aging Populations and Management. Academy of Management Journal, 57(4), 929-935.

Lerner, N. B., Johantgen, M., Trinkoff, A. M., Storr, C. L., & Han, K. (2014). Are nursing home survey deficiencies higher in facilities with greater staff turnover? Journal of the American Medical Directors Association, 15(2), 102-107.

Meyer, D., Raffle, H., & Ware, L. J. (2014). The first year: employment patterns and job perceptions of nursing assistants in a rural setting. Journal of nursing management, 22(6), 769-778.

Parkin, P. (2009). Managing change in healthcare: Using action research. Los Angeles: SAGE.

Probst, J. C., Baek, J. D., & Laditka, S. B. (2010). The relationship between workplace environment and job satisfaction among nursing assistants: Findings from a national survey. Journal of the American Medical Directors Association, 11(4), 246-252.

Squillace, M. R., Bercovitz, A., Rosenoff, E., & Remsburg, R. (2008). An exploratory study of certified nursing assistants’ intent to leave. US Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy.

Tyler, D. A., Feng, Z., Leland, N. E., Gozalo, P., Intrator, O., & Mor, V. (2013). Trends in post-acute care and staffing in US nursing homes, 2001–2010. Journal of the American Medical Directors Association, 14(11), 817-820.

Yeatts, D. E., & Cready, C. M. (2007). Consequences of empowered CNA teams in nursing home settings: A longitudinal assessment. The Gerontologist, 47(3), 323-339.

Zimmerman, S., Shier, V., & Saliba, D. (2014). Transforming nursing home culture: Evidence for practice and policy. The Gerontologist, 54(Suppl_1), S1-S5.

Be an Organ Donor

For many people, it can be disconcerting to think about what might happen at the end of their lives. The prospect of death is daunting, and many people prefer not to think about the details. However, an important end-of-life decision to address is whether or not to become an organ donor. Any person over the age of 18 can register to be become an organ donor, and there are a wide range of circumstances under which organs may be donated (US Department of Health and Human Services [HHS], 2018). It is possible for older people to donate their organs, depending on the way they die, or the organs may be donated when a person suffers from an unexpected accident that leaves them brain dead (Girlanda, 2016). When a patient is declared brain dead, it means that there is an “irreversible cessation of brain stem activity” (Girlanda, 2016), but in some cases, they may still have functioning organs and tissues that are suitable for donation (Yousefi, Roshani, & Nazari, 2014). If the person is registered as an organ donor, the useable organs may be removed by medical staff and transplanted into one or more needy patients (HHS, 2018). Aside from brain death, there are also several other types of death that are conducive to organ donation, such as cardiac death, but brain death accounts for between eighty and ninety percent of all organ donations each year (Girlanda, 2016). It is important to distinguish these types of organ donation—that is, donation by a registered donor who has reached the end of their life—and living donation, which is sometimes coerced and goes beyond the scope of this paper. When it comes to the question of whether or not to register to become an organ donor, the issue is limited in scope to end of life circumstances.  There are a wide range of benefits to organ donation at the end of life, more people should make the decision to register to become organ donors.

In the United States, there has long been a high demand for organ donation.  In 2017 alone, a total of 34,770 organ transplants were made as a result of organ donation (HHS, 2018). However, there are still far fewer organ donors than are needed within the healthcare system.  In April 2018, there were over 114,000 people on the national transplant waiting list. Moreover, this number has increased significantly in recent years: in 1991, there were only about 24,000 people on the list (HHS, 2018). While it is true that the number of registered donors has also gone up in the last three decades, the rate of the increase in the number of donors has been outstripped by the increase in the demand. As of 1991, there were about 7000 instances of successful organ donation in the United States, but by 2017, that number only risen to about 16,400 successful instances of organization, which is still far fewer than the number of donations that were needed by patients on the waiting list (HHS, 2018). The discrepancy in the rate of increase between organ donation demand and actual organ donation stems directly from the fact that too few people in the United States are registered organ donors.

Perhaps the most compelling reason why more people should register to become organ donors is that organ donation can have a truly positive impact on the lives of others. A single organ donor has the potential to save the lives of eight different people (HHS, 2018). Moreover, organ donation also positively affects the people who love and support the receiver, including their family, friends, colleagues, and even their casual perspectives (Moritsugu, 2013). Therefore, from an ethical perspective, organ donation is a highly altruistic gesture (Dalal, 2015). When a person chooses to become an organ donor, it is a decision that inherently benefits others, without regard to the self (Dalal, 2015). While the end of a person’s life may be a tragedy—especially if it is cut short by an unexpected accident that leaves them brain dead—organ donation makes it possible for them to improve the world through one last act of kindness toward others. No matter what the cause of a person’s death, registering to become an organ donor ensures that their final act will be to do something that benefits others.

For more practical thinkers, another reason to make the choice to become an organ donor is that organ donors are needed, and potential donors are in a position to fulfill that need. This argument rests on the ethical principle of utilitarianism (Dalal, 2015). Given the long length of the organ donor waiting list, there is no doubt about the need for people to register to become organ donors. Every day, about 20 people on the waiting list die waiting for an organ transplant (HHS, 2018), so organ donation has a clear utility for society as a whole. Unfortunately, only about 3 in 1000 people die in a manner that is conducive to organ donation (HHS, 2018). Comparing these statistics, it is clear that the only way to ensure that the number of available organs can catch up with the number of needed organs is to increase the number of registered donors who have agreed to donate their organs. Utilitarianism necessitates that the people with the available resources—organs that are in functional condition at the time of death—should make those resources available to the others in society who desperately need them.

Another reason to become an organ donor is that it can relieve the burden on a person’s own family in the event of an unexpected accident in which they are rendered brain dead, but their organs are suitable for donation to needy patients.  If a person is not a registered organ donor at the time of the accident, but the doctors determine that the organs are suitable for donation, the decision about organ donation falls to the family. This can be extremely challenging for family members during the initial period of grief. Not only does the family have to deal with the shock of the loss of a loved one, but they are suddenly faced with the question of what the person would have wanted (Yousefi et al., 2014). In addition, families who are making decisions while they are overcome with grief may be less likely to choose organ donation because they hope the patient will recover, even when the doctors have clearly specified that the patient is brain dead (Yousefi et al., 2014). Families may also have trouble understanding the process of organ donation, and there may be conflicting opinions within the family about what the person wanted (Yousefi et al., 2014). Clearly, when a person decides not to register to become an organ donor, they place their family members in a challenging decision-making position at what is likely to be one of the hardest moments of their lives—when they are stricken by grief and trying to recover from an unexpected loss. Out of consideration for their families, more people should take responsibility for their own decisions and register in advance for organ donation.

Finally, more people should register to become organ donors in order to advance the science of organ transplant.  Although improvements in surgical techniques and immunosuppression strategies have reduced the failure rates of organ transplants in recent years, the success of an organ transplant is still far from guaranteed (Girlanda, 2016).  In 2017, over 34,700 organ transplants were attempted, but only about 16,400 succeeded (HHS, 2018). However, every time an organ transplant succeeds, it contributes to clinicians’ understandings of the factors that play into a successful transplant. Therefore, by registering to become an organ donor, a person can contribute to advances in medical science that have long-term implications for improvements in organ donation efficacy in the future.

Critics of the argument point out that organ transplant is cost-inefficient, so it can place an unnecessary financial burden on the healthcare system (Axelrod, 2013). Organ transplant is highly resource-intensive, and for patients receiving organs like kidneys, the costs of long-term dialysis may be lower than the cost of transplantation (Axelrod, 2013). In cases where the transplant fails anyway, the transplant attempt is ultimately nothing but an economic loss. Therefore, opponents may argue that instead of encouraging organ donor registration, it is more important to focus on improving medical technology and finding alternatives to cost-inefficient organ transplant.

While it is true that the process of organ donation and transplant is not cost-efficient, there may be ways to reduce cost inefficiencies in the future, even for high-risk transplants patients (Axelrod, 2013). Also, clinicians can learn from every transplant attempt, ultimately leading to better outcomes for future patients. Therefore, regardless of the resource-intensive nature of the process and the potential strain on the healthcare system, it is worthwhile to encourage more people to register to become organ donors and thereby increase the number of transplant attempts each year.

In conclusion, more people should make the decision to register to become organ donors in the event that their organs are suitable for donation when they die. The ethical support for this argument is underpinned by both altruism and utilitarianism. People should also choose to donate their organs because it means that their family will not have to make the challenging decision for them, and it can contribute to further advancement in the medical field. Although there is a credible economic argument against increasing the number of transplant attempts, the costs of transplantation are outweighed by the potential benefits. Therefore, all US adults who are currently unregistered should take the opportunity to register to become organ donors today.

References

Axelrod, D.A. (2013). Economic and financial outcomes in transplantation: Whose dime is it anyway? Current Opinion in Organ Transplantation, 18(2), 222-8.

Dalal, A.R. (2015). Philosophy of organ donation: Review of ethical facets. World Journal of Transplantation, 54(2), 44-51.

Girlanda, R. (2016). Decreased organ donation for transplantation: Challenges and opportunities. World Journal of Transplantation, 6(3), 451-9.

Moritsugu, K.P. (2013). The power of organ donation to save lives through transplantation. Public Health Reports, 18(2), 245-6.

Organ donation statistics. (2018). US Department of Health and Human Services.

Yousefi, H., Roshani, A., & Nazari, F. (2014). Experiences of the families concerning organ donation of a family member with brain death. Iranian Journal of Nursing and Midwifery Research, 19(3), 323-30.

Taking a Stand

This should be a 4 to 5-page paper. Page count does not include a title page or reference pages. In this paragraph, you will introduce the conceptual frameworks of the constructs of ethics, moral, or legal standards. Use a support to help define it here. Should have a minimum of three to four sentences for this topic. Then you will add the purpose of this paper in the last sentence of this paragraph. Be explicit what you will be discussing.

Ethical, Moral, or Legal Dilemma

Consider an ethical, moral, or legal dilemma that you have encountered in your work environment and describe it. Mentally survey your work environment, or one with which you are familiar, and identify a timely issue/dilemma that requires you to perform the leadership role of moral agent or advocate to improve a situation (e.g., speaking or acting on behalf of a vulnerable patient, the need for appropriate staffing, a colleague being treated unfairly). Then I would expect you to use your APA resources from the Walden Writing Center to correctly cite and reference your work. The Walden Library is an excellent place to find your evidenced-based support.

Analysis of the Moral, Ethical, and Legal Implications of Situation

Discuss the moral, ethical, and legal implications of this situation. Each new topic will have a new paragraph. Support your perspectives with literature to support and cite correctly. What ethical, moral, or legal skills, dispositions, and strategies would help you resolve this dilemma? Define the differences between ethical, moral, and legal leadership.

Role as Moral Agent or Advocate for this Specific Issue

Discuss and describe your role as the moral agent or advocate for this specific problem for the Situation discussed in the previous heading level. Finally, consider the values and principles that guide the nursing profession; the organization’s mission, vision, and values; the leadership and management competencies addressed in this course; and your values and reasons for entering the profession. What motivation do you see for taking a stand on an important issue even when it is hard to do so? Be sure to support your perspectives and view with literature. Use current literature – that is within five years to support your work. Use correctly cited material. Do not use contractions or use too many directly quoted material. Use more paraphrasing here.

Self-Assessment and Leadership Styles

Consider your leadership styles identified by your self-assessment in this section.  Under resources, for week 1 you will find the link to the Keirsey self-assessment. Use the week one Keirsey Temperament Sorter self-assessment results to discuss in this area. Again keep the paragraphs with one topic and not too long. Cite the Keirsey Temperament Sorter (n.d.) like this when sharing the source outside the parenthesis. Then if you cite your results (Keirsey Temperament Sorter, n.d.) like this, when citing within the parenthesis. Be sure to reference correctly also. I included the correct way to reference the Keirsey Sorter in the References.

Also, include if the leadership styles acted as a barrier or facilitation during this dilemma. Describe this here. Cite appropriately. The link to the Keirsey Temperament Sorter is at Keirsey Temperament Sorter (KTS-II). (n.d.).

Conclusion

Wrap the paper up here. Be sure you do not add any new information in the conclusion.

References

Cianci, A. M., Hannah, S. T., Roberts, R. P., & Tsakumis, G. T. (2014). The effects of authentic leadership on followers’ ethical decision-making in the face of temptation: An experimental study. The Leadership Quarterly, 25(3), 581–594.

Keirsey Temperament Sorter (KTS-II). (n.d.).

Laureate Education (Producer). (2012a). Ethical, moral, and legal leadership.Baltimore, MD: Author.

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management in nursing: Theory and application (9^th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins.