NKU- DNP Peers’ Posts Needing Responses DISCUSSION QUESTIONS Instructions: 1. Choose 2 of the following topical areas to address in this week's discussion board: 1. How do you integrate theory and science into EBP? 2. What are effective leadership characteristics? 3. What is Systems Thinking and how does it relate to Leadership in Advanced Practice? 4. In  Zaccagnini, the reader is presented with brief summaries of 18 theories of nursing.  Choose one that may underpin your nursing practice and describe why that theory supports your practice or choose another theory/model that you currently use or would like to implement in your setting. 5. Does theory  relate or contribute anything to daily practice?  In what ways might you use theory in practice? 6. In what ways might you use theory in practice? 7. Discuss the benefits, concerns, and challenges of the systems approach as it relates to the multiple dimensions of a health care system. Please share an example of systems thinking or transformational leadership that you have seen in practice. 8. What leadership styles do you think you will most likely adopt as a DNP graduate, when engaged in a leadership role? Why? 9. Do you face conflict or avoid it?  How do you gain experience in feeling comfortable addressing conflict in the workplace? PEER RESPONSES Michelle Grise MondayJan 16 at 12:13pm Hi Everyone, 1. What are effective leadership characteristics? Before I delve into effective leadership characteristics, I believe it would be helpful to explain how I learned effective leadership and came to appreciate what a good leader is. I came to the US permanently in 1994 (became a US citizen in 2009) and I was able to join the US Army with my green card. I was young and did not know what a leader was. Boy did the Army teach me! Throughout an almost 21-year career, as you know, the military rotates personnel frequently, sometimes every 3-4 years and during my career and three deployments, I definitely experienced leaders that taught me how NOT to be and took away from the great leaders that nurtured me. By learning ineffective leadership characteristics, I believe effective leadership can be born from that information. Familiar words that define ineffective leadership include, but are not limited to, passive; aggressive; or avoidant (Fosse et al., 2019). Understanding these concepts may allow the DNP to adopt successful strategies that promote effective leadership. There are various leadership models available, which includes approaches such as Directive; Autocrat; Permissive; and Democrat (Muczyk, 2020). A combination of these leadership characteristics is appropriate depending on the individual or situation being addressed. Leadership is a process that can be modified to fit the audience and environment for the DNP. 2. Do you face conflict or avoid it?  How do you gain experience in feeling comfortable addressing conflict in the workplace? Early in my career I leaned towards avoiding conflict.

1. NKU- DNP Peers’ Posts Needing Responses
DISCUSSION QUESTIONS
Instructions:
1. Choose 2 of the following topical areas to address in this week's discussion board:
1. How do you integrate theory and science into EBP?
2. What are effective leadership characteristics?
3. What is Systems Thinking and how does it relate to Leadership in Advanced Practice?
4. In Zaccagnini, the reader is presented with brief summaries of 18 theories of
nursing. Choose one that may underpin your nursing practice and describe why that
theory supports your practice or choose another theory/model that you currently use or
would like to implement in your setting.
5. Does theory relate or contribute anything to daily practice? In what ways might you
use theory in practice?
6. In what ways might you use theory in practice?
7. Discuss the benefits, concerns, and challenges of the systems approach as it relates to the
multiple dimensions of a health care system. Please share an example of systems thinking
or transformational leadership that you have seen in practice.
8. What leadership styles do you think you will most likely adopt as a DNP graduate, when
engaged in a leadership role? Why?
9. Do you face conflict or avoid it? How do you gain experience in feeling comfortable
addressing conflict in the workplace?
PEER RESPONSES
Michelle Grise
MondayJan 16 at 12:13pm
Hi Everyone,
1. What are effective leadership characteristics?
Before I delve into effective leadership characteristics, I believe it would be helpful to explain
how I learned effective leadership and came to appreciate what a good leader is. I came to the

2. US permanently in 1994 (became a US citizen in 2009) and I was able to join the US Army with
my green card. I was young and did not know what a leader was. Boy did the Army teach me!
Throughout an almost 21-year career, as you know, the military rotates personnel frequently,
sometimes every 3-4 years and during my career and three deployments, I definitely experienced
leaders that taught me how NOT to be and took away from the great leaders that nurtured me.
By learning ineffective leadership characteristics, I believe effective leadership can be born from
that information. Familiar words that define ineffective leadership include, but are not limited to,
passive; aggressive; or avoidant (Fosse et al., 2019). Understanding these concepts may allow the
DNP to adopt successful strategies that promote effective leadership. There are various
leadership models available, which includes approaches such as Directive; Autocrat; Permissive;
and Democrat (Muczyk, 2020). A combination of these leadership characteristics is appropriate
depending on the individual or situation being addressed. Leadership is a process that can be
modified to fit the audience and environment for the DNP.
2. Do you face conflict or avoid it? How do you gain experience in feeling comfortable
addressing conflict in the workplace?
Early in my career I leaned towards avoiding conflict and I believe that was due to being raised
in a culturally subservient home. The Army helped me gain confidence, insight and taught me to
face conflict and promote a healthy working environment. Confrontation tends to have a negative
stigma and many people will avoid confrontation to avoid uncomfortable conversations. During
our officer leadership course, we had to read books such as Crucial Conversations: Tools for
talking when stakes are high and The Anatomy of Peace: Resolving the Heart of Conflict to
name a few. At the time, I read those books begrudgingly however twelve years later, I still use
and refer to many of those concepts to maintain healthy working relationships and a pleasant
working environment. I strongly believe in ‘good’ confrontation when it is well placed.
For example, we work on bias in the ED. ED providers work 24 hr shifts and it is common for all
ED staff to be judgmental when a frequent flyer comes in, a patient ‘faking’ symptoms, or
a patient coming in with a non-emergent complaint. We’ve had many healthy conversations
where I’ve been able to explain to staff that sometimes it can be difficult for providers to
walk into a patients room unbiased or objective. This is especially difficult when it is 0200 in
the morning and you have to assess a non-emergent patient. Hearing negative comments or
tunnel vision type statements about a patient can lead to poor decisions. I asked the staff to try
and minimize negative or biased comments which would help decrease negativity and toxicity in
the department. So in response to my request, the staff now make the exact opposite statements
sarcastically and jokingly to create a positive workspace. And some of the statements are quite
hilarious when you get woken up in the middle of the night. I am absolutely grateful that the staff
have been receptive and took a ‘confrontational’ conversation and made it into a positive
situation.
If you do a climate survey, the staff will quickly tell you that I set high standards and
expectations and it is a running joke that they tell all the new staff “you just have to get to
know her just don’t be lazy―. The staff will also tell you that when there is a problem
whether it is personal or professional, they feel comfortable coming to me for guidance. The two
attributes that I continue to struggle with to this day is tact and not having the ability to ‘sugar

3. coat’ statements. There are many times that I cannot catch the words coming out of my
mouth fast enough before rephrasing a statement. In those instances, I will hold myself
accountable and apologize or tell my boss of my misstep. I try to work on this every shift I work,
there are many times I fail and I wake up and try again the next day.
References
Fosse, T., Skogstad, A., Einarsen, S., & Martinussen, M. (2019). Active and passive forms of
destructive leadership in a military context: A systematic review and meta-analysis. European
Journal of Work and Organizational Psychology , 28 (5), 708–722.
https://doi.org/10.1080/1359432x.2019.1634550
Muczyk, J. P. (2020). The secret of successful leadership—the critical match between the
characteristics of leaders, the attributes of subordinates, and the circumstances of the situation.
Articles , 23 (1), 27–34. https://doi.org/10.7202/1071507ar
Edith Gyan
MondayJan 16 at 1:29pm
What are effective leadership characteristics?
There are many right ways to lead a team effectively. Undoubtedly, ineffective leadership can
cost companies more than just morale. An effective leader must balance productivity with quality
of care and possess practical leadership qualities. According to research from Gallup, 24 percent
of employees are actively disengaged because of poor management and leadership
characteristics, leading to less productive teams, less profitability, and a turnover. Turnover is
nearly twice the annual salary of every employee who quits. Hence, effective leadership is vital
in retaining employees, satisfying customers, and improving company productivity. Leaders
must communicate the company's vision effectively to guide teams and influence change.
In every field, there is a need for effective leadership. However, nurses need leadership skills to
help team members function better to improve patient care as healthcare advances. An effective
leader must be proficient in quality improvement strategies to create and sustain changes at
organizational and policy levels (Zaccagnini & Pechacek, 2021). Successful leaders demonstrate
leadership qualities such as effective communication, motivation, accountability, delegation, and
constructive feedback (Landry, 2018). Effective leadership characteristics consist of the
following:
Ability to Influence Others
A leader must influence others and get followers for the needed change. Before a leader can be
effective, one must understand oneself and the leadership's impact by evaluating cost-
effectiveness using the principles of economics and finance to lead and redesign realistic care
delivery strategies effectively. As a leader, influencing others can empower employee
development, accelerate quality improvement, and create a safer and better

4. working environment for the team (Landry, 2018). By so doing, a leader could influence others
by building trust with colleagues and stakeholders. As such, the leader focuses on understanding
ways to motivate and encourages others to share their opinions and suggestions for improvement.
Hence, making colleagues and customers know that change emanates from them based on their
opinions and shared ideas.
Transparency
Another characteristic of a leader is transparency. Transparency results in
employees understanding the company's vision and focusing on their efforts to help achieve
company-wide goals. As a result, the team will become more proactive, improve decision-
making, and fill their calendar with items that will lead to achieving the set goals. Also,
transparency leads to trust building and reveals clear goals. The more open a leader becomes
about the organizational goals, challenges, vision, and mission make it easier for employees to
understand their role and contribute to organizational success. Hence, having a sense of value
and purpose translates into higher employee engagement levels (Landry, 2018).
Encourage Risk-Taking and Innovation
Risk-taking is a critical skill for an effective leader to possess. Leaders who take risks inspire
their employees to be more creative and endorse organizational change. In risk-taking and
innovation, the higher the risks, the higher the returns. Hence, a leader with experimentation
skills is critical to establishing and maintaining the company's competitive advantage. As such,
great leaders recognize this and encourage risk-taking and innovation within their organizations
(Landry, 2018). Overall, creating a culture that embraces innovative ideas makes employees
more emboldened to propose new ideas because their creativity is valued. Breakthroughs do not
happen when companies play it safe (Landry, 2018).
Value Ethics and Integrity
Integrity and having high moral standards are essential attributes a leader must possess.  High
ethical standards enable a leader to be fair, instilling employee confidence. Employees want to
feel safe in their environment and know that the leader will advocate for them, treat them
fairly, and do what is right for them and the business. As a leader, it is essential to act with
integrity, build trust within the team, and model behavior for others (Landry, 2018).
Act Decisively
Another characteristic a leader must possess is to act in the fastest way possible due to the fast-
changing pace of the healthcare system. Influential leaders need to make strategic decisions
quickly to gain a competitive advantage. It allows them to balance emerging opportunities with
long-term goals and objectives. A leader should be bold when making decisions, as the goal of a
leader is to move the organization forward (Landry, 2018). Overall, influential leaders need to
avoid hard truths. They take responsibility for their decisions, maintain optimism, and focus on
charting a new course of action. They also help others cope with organizational change and
address issues quickly to avoid festering and escalation.

5. What leadership styles will you most likely adopt as a DNP graduate when engaged in a
leadership role? Why?
The leadership styles include authoritarian, democratic, transformational, transactional, and
visionary leadership. The authoritarian leader exercises total decision-making power and
absolute control over the subordinates. This leadership style may be necessary during
emergencies but may leave the leader dissatisfied. Such leaders are autocratic and refrain from
involving other staff in decision-making. The leader does not focus on relationship building and
development.
Transactional Leadership style
The transactional leadership style emphasizes hierarchy and responsibility within the
organization. The leaders serve and take comfort in knowing that every person holds a clear role.
Transformational leadership style
Transformational leadership has a dedicated structure in which specific protocols are closely
adhered to maintaining a high degree of control.
Visionary leadership style
The visionary leader seeks to transform nursing using evidenced based practice and innovation in
today's rapidly changing healthcare.
Democratic leadership style
Democratic leaders allow group discussion when there is a problem and select an acceptable
solution. Such a leadership style promotes shared responsibility and allows for greater
involvement in change. In nursing, dialogue is essential in delivering patient-centered care,
teamwork, collaboration, and quality improvement strategies to improve patient, staff, and
stakeholders outcomes (Zaccagnini & Pechacek, 2021).
Among the listed leadership styles, I will mainly adopt democratic leadership as a DNP graduate.
Such leadership style allows the participation of members in decision-making. It allows
employees to play a more significant role in making important decisions through extensive
discussions and brainstorming. Also, the Magnet Certification Program encourages more
decision-making control by the staff through this leadership style (Zaccagnini & Pechacek,
2021).
Nowadays, having democratic leadership helps establish effective healthcare organizations with
high productivity and quality of care. Democratic leadership helps direct and coordinate a team's
activities toward a common goal. Democratic leaders possess an outstanding strength leading to
quality and integration of care (Sfantou et al., 2017). Being a democratic leader will enable me to
have practical strategies to balance productivity with quality care, safety, affordability, and
accessibility of care based on surveys from employees and customers, leading to

6. transformation. Adopting the democratic leadership style means I must be easy to follow and
nurture the followers so that more people will jump in and bring transformation. Such a leader
enhances teamwork, collaboration, quality improvement strategies, and participation. Based on
consensus, the best solution for the underlining problem will be selected so that most employees
will support any change through their participation.
Also, I want staff members to openly share their ideas and concerns and offer opinions to resolve
problems. By so doing, it empowers staff members towards greater personal engagement and
professional satisfaction. In addition, adopting a democratic leadership style will enhance the
adoption of change and its assimilation (Zaccagnini & Pechacek, 2021). Hence, engaging
employees can bring about the desired transformation and outcomes. The overall leadership of
the democratic style is to improve patient health outcomes and satisfaction. When employees are
happy, the patient satisfaction rate increases.
References
Landry, L., (2018). 6 characteristics of an effective leader. Retrieved from
https://online.hbs.edu/blog/post/characteristics-of-an-effective-lead.
Sfantou et al., (2017). Importance of Leadership Style towards Quality-of-Care Measures in
Healthcare Settings: A Systematic Review. Retrieved fromÂ
https://pubmed.ncbi.nlm.nih.gov/29036901/
Zaccagnini, M. & Pechacek, J. (2021). The Doctor of Nursing practice essentials . (4th ed.).
Jones & Barlett Learning.
Katherine Cram
YesterdayJan 18 at 8:01pm
What leadership styles do you think you will most likely adopt as a DNP graduate, when
engaged in a leadership role? Why?
The authors in chapter 9 of “National Academies of Science, Engineering, and Medicine―
(2021) discuss the future of nursing and what is needed to achieve health equity. While the
chapter focuses on what is needed for health equity it also brings up general points, discussions
regarding nursing leadership, and suggestions to be a successful nursing leader. Nurses at every
level are leaders in some form, whether formal or informal. The authors cite the Crossing the
Quality Chasm report stating that leaders have roles including expressing the vision and goals of
the organization, providing direction, listening to the frontline workers, integrating improvement
efforts, and creating a supportive environment and culture. These characteristics are not
necessary just in formal leadership roles but should be evident to frontline colleagues (National
Academies of Science, Engineering, and Medicine, 2021).
These are all leadership qualities and styles I hope I already am near possessing and if not, I hope
to possess in the future as I acquire more experience. I am a firm believer in the first step to

7. achieving these goals is to lead by example. If I am not showing the organization's vision and
goals, I cannot expect my colleagues or staff to emulate them. As the authors state in
“National Academies of Science, Engineering, and Medicine― (2021) leadership is needed
at many levels to provide sustained direction and a coherent set of values and incentives to guide
group and individual actions. The authors also state “nurses as a professional group manifest
many of the characteristics of strong leadership- including courage, humility, caring,
compassion, intelligence, empathy, awareness, and accountability...― (National Acadamies of
Science, Engineering, and Medicine, 2021, p. 277). These are all leadership qualities I hope to
continue to work towards. When discussing with my nurse leader colleagues, I always am a big
proponent of transparency and accountability in leadership. If you do not hold people
accountable to your expectations, then the rest of the styles fall to the wayside. I hope to continue
to have the expectations of courage, intelligence, empathy, humility, and caring. I continue to
work to fulfill these expectations by leading by my own example and then in turn hold others
accountable when these are not exhibited. I also believe in leading by example in constantly
sharing knowledge and cultivating a culture of constant learning. Sharing the “why―
behind change always seems to get buy in much quicker than just instructing on what to do with
no reason.
Do you face conflict or avoid it? How do you gain experience in feeling comfortable
addressing conflict in the workplace?
This is a remarkably interesting question to me as I feel like I am in the middle of the two
options. As Zaccagnini and Pecacek (2021) state “experience is the best teacher―. Learning
takes place through action and observing of an action. Once observed, we then adjust and take
new action accordingly. Further, learning is entwined through life and thus successful healthcare
organizations. These statements ring extremely true regarding my experience with handling
conflict. Over my four years in leadership, I feel as if I have grown with how I deal with conflict.
I vividly remember my first crucial conversation and how nervous I was and how much I
avoided it until the last minute possible. I also remember the first time I needed to have a
difficult conversation with the leader I reported to. I was, again, so nervous and procrastinated as
long as possible in having the conversation. Now, four years later I find myself still getting
nervous at times (and even having the physiological response of stomachache, hives, etc.) but to
a much lesser degree. I also find myself, as recent as last week, conquering conflict head on
immediately to get it behind me. With experience I have realized I prefer to not have it lingering
and wondering “what could happen― with the conversation rather than just getting it done
and having it behind me. I believe experience with dealing with conflict in the workplace comes
with time. I also believe it is important to have a confidant to discuss matters of conflict with and
seek advice to act as somewhat of a mentor when unsure of how to face conflict.
References:
National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-
2030: Charting a Path to Achieve Health Equity . Washington, DC: The National Academies
Press. https://doi.org/10.17226/25982Â Links to an external site.

8. Zaccagnini, M., & Pechacek, J. (2021). The doctor of nursing practice essentials . (4th Ed.).
Burlington, MA: Jones & Bartlett Learning.
Edited by Katherine Cram on Jan 18 at 8:07pm
Garry Thompson
YesterdayJan 18 at 8:41pm
What are effective leadership characteristics?
To be an effective leader one needs to have not only good quality individual characteristics but
also need to master the environment and fully understand the culture of the organization in which
they work. Individual leadership skills including their education, work experience, efficiency,
and other intellectual competencies help the leader to establish validate position respect.
However, combining those competences with the interpersonal skills for building a great work
environment is truly the only way the unit/department/organization can progress. Those
intangible attributes are mastering listening and effective communication. Each of these allows
for the development of strong relationships amongst leaders and staff. Within any connection,
one cannot understate a leader’s honesty, respect, caring, approachability as each of these
attributes create strengthen the trust that relationships are built on and those relationship will help
support staff motivation and engagement. Even with these personal characteristics it is vital to
combine them with organizational/environmental considerations for the leader to truly prosper.
The environmental factors need to include support from their leader including mentorship. It is
also vital for leaders to develop relationships with their colleagues to support their continued
development which will allow them to thrive in their role (Frangieh & Jones, 2022).
What leadership styles do you think you will most likely adopt as a DNP graduate, when
engaged in a leadership role? Why?
For me to truly drive a healthcare organization's change in our current healthcare delivery
system, one needs to have a leader who is transformational. Transformational leadership is all
about the empowerment of team members to collaborate and achieve success. Being a
transformational leader does not require a formal leadership role, however, nurses and
particularly DNP graduates should understand their profession at the foundation is based on
being a leader whether at a formal position or providing care at bedside. Attributes like
coaching, inspiration, and mentoring to transform others and organizations are the core concept
of being a transformational leader and is the best approach to providing direction for the
organization of the future (Zaccagnini & White, 2017). Given the opportunity to embrace the
concepts of transformational leadership will truly improve the outcomes of great organizations.
Frangieh, J., & Jones, T. (2022). Factors facilitating or inhibiting the capacity for effective
leadership among front―line nurse managers: A scoping review. Journal of Nursing
Management (John Wiley & Sons, Inc.), 30(7), 2653–2669.
https://doi.org/10.1111/jonm.13776Links to an external site.

9. Zaccagnini, M. E., & White, K. W. (2017). The doctor of nursing practice essentials: a new
model for advanced practice nursing (Third edition.). Jones & Bartlett Learning.