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Developing effective leadership skills within healthcare may be one of the most critical abilities for nurses. Nurses are often the glue that holds the interdisciplinary team together; without influential leaders, the team can fall apart. There are many different leadership theories and styles available to review and model. The purpose of this discussion post is to review two key insights gained through the review of scholarly resources on leadership and to describe real-life situations in which these leadership styles were exemplified, their effectiveness, and their impact on the workplace.
During my scholarly research on the topic of leadership theories and styles, there were a couple of different things I learned. I am already familiar with the transformational leadership style through previous classes at Walden University. Transformational leadership focuses on the encouragement of individuals, leading by example, and sharing goals and successes (Ferreira et al., 2022). Through my research this week, I learned more about alternative leadership styles. First, I learned about the servant leadership style (Malak et al., 2022). Servant leadership is a common style of leadership found in healthcare organizations (Malak et al., 2022). It focuses on the leader’s responsibility to serve those they lead and put the needs of others before themselves (Malak et al., 2022). Another insight gained through my research was the leadership style of transactional leadership (Poels et al., 2020). Transactional leadership focuses on rewarding or penalizing individuals based on the completion of tasks (Poels et al., 2020).
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Throughout my nursing career, I have seen many examples of leadership styles from various nursing managers and facility administrators. One example is my current administrator, who leads with a transactional leadership style. She is very task-oriented and bases rewards and disciplines of individuals on completing duties in a competent, timely manner (Poels et al., 2020). Although this is effective in getting employees to do their jobs, it does not inspire loyalty or shared goals. Employees do not feel they are valued as individuals and get the feeling that they are replaceable. Another example of leadership I have seen in person at my workplace is transformational leadership by my current director of nursing. She encourages individuals to perform at their best and pushes everyone to succeed. She pushes everyone to see themselves as part of a larger team and work towards shared goals but ensures that individuals know they are valued as people and employees. This leadership style effectively gets people to work together as a team and inspires more loyalty than any other form of leadership I have seen.
Overall, finding a leadership style that feels right for each person is essential to being a nurse leader. Although some take to leadership more naturally and eagerly than others, one can learn to be a leader. One can contribute to their team’s success if one can lead effectively and are confident in their particular leadership style.
References
Ferreira, T. D. M., de Mesquita, G. R., de Melo, G. C., de Oliveira, M. S., Bucci, A. F., Porcari,
T. A., Teles, M. G., Altafini, J., Dias, F. C. P., & Gasparino, R. C. (2022). The influence
of nursing leadership styles on the outcomes of patients, professionals and institutions:
An integrative review. Journal of Nursing Management, 30( 4), 936– 953.
https://doi.org/10.1111/jonm.13592Links to an external site.
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NURS-6053N LEADERSHIP THEORIES IN NURSING PRACTICE DISCUSSION ESSAY
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Malak, H. M., Lorman, W., Rundio, A., Simion, D., & Simion, M. G. (2022). Predominantly
practiced leadership styles of Chief Nursing Officers in healthcare organizations. Journal
of Interprofessional Education & Practice, 28.
https://doi.org/10.1016/j.xjep.2022.100517Links to an external site.
Poels, J., Verschueren, M., Milisen, K., & Vlaeyen, E. (2020). Leadership styles and leadership
outcomes in nursing homes: a cross-sectional analysis. BMC Health Services Research,
20(1), 1–10. https://doi.org/10.1186/s12913-020-05854-7Links to an external site.
LEADERSHIP THEORIES IN PRACTICE
A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.
However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations.
Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review the Resources and examine the leadership theories and behaviors introduced.
Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
Reflect on the leadership behaviors presented in the three resources that you selected for review.
BY DAY 3 OF WEEK 4
Post two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.
BY DAY 6 OF WEEK 4
Respond to at least two of your colleagues on two different days by explaining how the leadership skills they described may impact your organization or your personal leadership, or by identifying challenges you see in applying the skills described.
Hello
I appreciate your insight on leadership styles. I think when it comes to nursing, transformational leadership model should be adopted instead of transactional. I find leaders who use transformational leadership style boost my moral as a nurse even when other working conditions such as staffing ratios and increasing workload are unfavorable. As a person, I feel valued when a leader recognizes me for me and appreciates and supports what I bring to the table. Kiwanuka and associates (2021) guarantee that the use of transformational leadership style by nurse managers guarantees a higher quality of nursing care.
A systematic review done by Speechia and associates (2021) also showed a positive correlation between nurse managers using transformational leadership and increased job satisfaction by nurses existed. While transactional leadership styles work in some settings, I believe people need compassion and support to excel in the health sector.
References
Kiwanuka, F., Nanyonga, R. C., Sak-Dankosky, N., Muwanguzi, P. A., & Kvist, T. (2021). Nursing leadership styles and their impact on intensive care unit quality measures: An integrative review. Journal of nursing management, 29(2), 133–142. https://doi.org/10.1111/jonm.13151Links to an external site.
Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership Styles and Nurses’ Job Satisfaction. Results of a Systematic Review. International journal of environmental research and public health, 18(4), 1552. https://doi.org/10.3390/ijerph18041552Links to an external site.
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organ,
Collapse SubdiscussionAudrey Okofo-Mensah
Audrey Okofo-Mensah (She/Her)
Dec 21, 2022Dec 21, 2022 at 4:46pm
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Leadership Behaviors That Create a Healthy Working Environment
Leadership is an essential part of healthcare and dictates the type of culture present in any organization. There are several leadership theories, but three that are mostly observed and used in nursing are the behavioral leadership theory, transactional leadership, and transformational leadership theory. Gifford and associates (2018) reason that, behavioral leadership theory suggests that effective leadership may result in change-oriented, relation-oriented, and task-oriented behaviors; transformational leadership is the degree to which a leader inspires and motivates others to follow an ideal or a particular course of action while transactional leadership involves the provision of incentives, rewards, and monitoring to meet quality.
Gifford and associates (2018) also observed that dimensions of transformational and transactional leadership align with the leadership behaviors in relation-oriented and change-oriented conceptual categories. For example, in transformational leadership, attitudes are influenced through relations, and the team focuses on change through collective learning, support and recognition. The writers concluded that, whether in transformation or leadership behaviors, managers effected a positive influence because good communication skills, encouragement and support towards change and learning activities were exhibited.
Harris and Mayo (2018) assessed the transformational leadership model and used a study to determine how effective the transformational leaders model encourages and supports innovation, enhances patient-centered care, encourages excellence, and has ethical integrity.
Two key insights that are evident in both articles are the supportive role the transformational leaders give to their teammates in a particular goal and the encouragement in pursuing excellence. Such leaders form such unique relationships with their teammates that, they feel supported in their role and give excellence work. One of such leaders I met was a manager I encountered for a couple of weeks on a travel assignment. This manager supported all her staff, defended her staff and the staff felt she was a bridge between them and the administration. She allowed access from all and was always in the loop of unit affairs and encounters. I met CNAs that worked with her and picked up extra shifts to accommodate staffing needs because she would work with their schedule in going to school. She supported those that had family challenges that affected their work such as allowing some to only work weekends or part time to accommodate family challenges. The way she managed the unit, she was fair and just. She joined in during day shift and would work as a nurse to help when the unit was tough. This leader had very little resistance when she implemented new policies on the unit. As a matter of fact, her unit was one of the first in the hospital to embark on evidence-based staff project. She had staff that had transitioned from CNA to RN. They feel supported and genuinely enjoyed working for her and with her. As a travel nurse I extended my contract for as long as I could because the environment was healthy the leader was transformational.
Based on her transformative leadership, she also had staff within the hospital transferring to her unit. She also had the lowest scores in fall reductions, CAUTIs and CLABSIs during the annual assessment. She is always receiving an applause for her exceptional leadership skills, and I think the hospital is very impressed with her.
Under transformational leadership, the importance of supporting and encouraging staff leads to compliance and commitment in achieving a desired goal was evident (Duggan et al., 2015; Gifford et al., 2018; Harris & Mayo, 2018). This type of environment is healthy because people thrive and can become better teammates.
References
Duggan, K., Aisaka, K., Tabak, R. G., Smith, C., Erwin, P., & Brownson, R. C. (2015). Implementing administrative evidence based practices: Lessons from the field in six local health departments across the United States. BMC Health Services Research, 15(1). https://doi.org/10.1186/s12913-015-0891-3Links to an external site.
Gifford, W. A., Squires, J. E., Angus, D. E., Ashley, L. A., Brosseau, L., Craik, J. M., Domecq, M.-C., Egan, M., Holyoke, P., Juergensen, L., Wallin, L., Wazni, L., & Graham, I. D. (2018). Managerial leadership for research use in nursing and Allied Health Care Professions: A systematic review. Implementation Science, 13(1). https://doi.org/10.1186/s13012-018-0817-7Links to an external site.
Harris, J., & Mayo, P. (2018). Taking a case study approach to assessing alternative leadership models in health care. British Journal of Nursing, 27(11), 608–613. https://doi.org/10.12968/bjon.2018.27.11.608Links to an external site.
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Collapse SubdiscussionMorgan Alicia Smith
Morgan Alicia Smith
Dec 22, 2022Dec 22, 2022 at 6:43pm
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First Response
Audrey, great post this week! I enjoyed reading about your experiences regarding transformational leadership. Transformational leaders inspire others to achieve common goals (Broome & Marshall, 2021). It indeed sounds as though the manager you worked under on your travel assignment exemplified the traits of a transformational leader. She inspired loyalty in the same way that transformational leaders do and led by example. One of the most important qualities of transformational leaders is that they are willing to jump in and help the individuals they lead and never ask anyone to work harder than they are willing to do. The fact that she understood that her employees had lives and responsibilities outside of work and made them feel as though she cared about those responsibilities again makes me feel that she truly represented the best attributes of a transformational leader. Transformational leaders never make the people they lead feel as though they are replaceable, but instead that they are valued as individuals and cared about in an authentic way (Ferreira et al., 2022). This allows people to give their best and reach common goals. It certainly sounds like the unit benefitted greatly from the manager’s excellent leadership qualities. Well done!
Morgan Smith
References
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert
clinician to influential leader (3rd ed.). New York, NY: Springer.
Ferreira, T. D. M., de Mesquita, G. R., de Melo, G. C., de Oliveira, M. S., Bucci, A. F., Porcari,
T. A., Teles, M. G., Altafini, J., Dias, F. C. P., & Gasparino, R. C. (2022). The influence
of nursing leadership styles on the outcomes of patients, professionals and institutions:
An integrative review. Journal of Nursing Management, 30( 4), 936– 953.
https://doi.org/10.1111/jonm.13592 Links to an external site.
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Collapse SubdiscussionPauline Atianjoh
Pauline Atianjoh
Dec 23, 2022Dec 23, 2022 at 3:42pm
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Audrey,
In addition, I have also learned that healthcare leadership is essential in playing roles of organizing, planning, controlling, implementing, budgeting, and analysis. It establishes means to utilize and achieve the organizational goals professionally. Therefore, effective leadership is an essential element for implementing reforms and shaping the corporate culture in the healthcare sector (Restivo et al., 2022). Several healthcare organizations entrust leadership roles to specified people who are certain of accomplishing the vision of the organization. The leaders are important in providing an understanding of the hospital’s goals which is to reach the potential of quality care and safety. These leaders collaborate with other healthcare team members to help in achieving the organizational goals. The achievable visions are refined by the communication skills which should be present in a leader to implement useful strategies within the healthcare organization (Gannotta, 2022). The leaders are also important in determining the potential of different employees who can be delegated to perform a specific function.
References
Gannotta R. J. (2022). Changes in the Healthcare Environment Prompt Leaders to Think Digitally. Frontiers of health services management, 38(3), 24–30. https://doi.org/10.1097/HAP.0000000000000131
Restivo, V., Minutolo, G., Battaglini, A., Carli, A., Capraro, M., Gaeta, M., Odone, A., Trucchi, C., Favaretti, C., Vitale, F., & Casuccio, A. (2022). Leadership Effectiveness in Healthcare Settings: A Systematic Review and Meta-Analysis of Cross-Sectional and Before-After Studies. International journal of environmental research and public health, 19(17), 10995. https://doi.org/10.3390/ijerph191710995
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Collapse SubdiscussionLeslie Sandoval
Leslie Sandoval
Dec 21, 2022Dec 21, 2022 at 5:28pm
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Les Sandoval
Discussion Post Week 4
The first principle for leadership is that leaders must be grounded in ethical principles that guide human behavior and actions. No matter how brilliant the strategy or how productive the steps are, if leaders do not hold the trust and act in the best interests of those they serve, they are not competent. (Marshall & Broome, 2021). Marshall & Broom (2021) define leadership as the discipline and art of guiding, directing, motivating, and inspiring a group or organization toward common goals. It includes the engagement and management of people, information, and resources. The authors define transformational leadership as a process through which leaders influence others by changing their understanding of others of what is essential. Transformational leaders inspire others to achieve what might be considered extraordinary results. (Id.)
Transformational leadership is viewed as the most effective model of leadership because, while it recognizes the importance of rewards, it goes further to satisfy the higher needs of the follower by engaging this person emotionally and intellectually. (Doody & Doody, 2013). This type of leadership is needed in the nursing profession, which is facing unprecedented levels of burnout. Circumstances such as inadequate support or leadership within the workplace can aggravate burnout even more. The World Health Organization (WHO) recognizes nurse burnout as an “occupational phenomenon.” The WHO defines nurse burnout as “resulting from chronic workplace stress that has not been successfully managed.” (World Health Organization, 2019).
Our text describes transformational nursing leaders such as Florence Nightingale, Clara Barton, and Dorothea Dix. (Marshall & Broome, 2021). There is a rich history of transformational nursing leaders to reflect upon. However, transformational leadership is still needed in the nursing profession. Leaders who involve staff, encourage teamwork and motivation, and reward good work performance can improve job satisfaction and impact the quality of work life. A transformational leadership presence is vital, especially in clinical areas where new graduate nurses are present. Transformational leadership qualities promote a healthy environment for employees and staff, producing improved staff satisfaction, retention, and patient satisfaction. (Smith, 2011).
In my nursing career, I have seen one transformational leader that tried to make a difference by involving staff and encouraging teamwork and motivation. This leader was a traveling acute care nurse practitioner whose specialty was cardiology. The regular leadership at the hospital I worked for did not care about educating or encouraging staff nurses. The standard practice was to let the more experienced nurses eat their young and treat them however they wanted to. This leader would travel to and from Houston, Texas, every week. His motivational talents made me look forward to the days I would work with him, and one could feel his absence during the days he would go home to Houston. He was a wealth of knowledge and always did his best to teach staff nurses how to do things and why we do things. He never made staff feel stupid and had the patience level to tolerate staff nurses me asking questions until they fully understood the concepts. His demeanor promoted a healthy environment and improved our willingness to stay late or help out whenever he asked. As a result of his leadership skills, the younger staff nurses’ attitudes improved, improving patient satisfaction and care.
References
In-text citation: (What Is Nurse Burnout? | Nursejournal.org, 2021)
What is Nurse Burnout? /Nursejournal.org. (2021, September 29). Nursejournal. org/https://nursejournal.org/resources/nurse-burnout/#. :text=Circumstances%20such%20as%20not%20having%20effective%20support%20or.
Giltinance. (2013). Leadership styles and theories. Nursing Standard, 27(41).
World Health Organization. (2019, May 28). Burn-out-an “occupational phenomenon”: International classification of diseases. World Health Organization. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases Links to an external site..
Doody, O., & Doody, C.M. (2013). Transformational leadership in nursing practice. British Journal of Nursing, 21(20), 1212-1218. https://www.magonlinelibrary.com/doi/full/10.12968/bjon.2012.21.20.1212.
Smith, M. A. (2011). Are you a transformational leader? Nursing Management (Springhouse), 42(9), 44-50. https://doi.org/10.109701.numa.0000403279.04379.6a Links to an external site..
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Collapse SubdiscussionPauline Atianjoh
Pauline Atianjoh
Dec 21, 2022Dec 21, 2022 at 5:41pm
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Impact of Leadership Behaviors
The nurses must work in a healthy working environment that is satisfying, empowering and it is safe to provide quality patient care. Leadership behaviors have a direct impact on creating a healthy working environment for nurses. the two main insights I heard from the article are that leaders should play an important role in creating work environments that influence the experience of the employees and the subsequent health and job-related outcomes (Vidman & Stromberg, 2020). A positive leader should be typified by honesty, self-awareness, integrity, and empathy for the employees to create a positive working environment where nurses feel empowered.
Positive leadership behaviors reduce the possibility of burnout and dissatisfaction. Therefore, leadership behaviors should empower the nurses to utilize the acquired skills and knowledge to control their work and in increasing job satisfaction, with a commitment to work and high-quality care (Suratno et al., 2018). Additionally, the leadership theories help to empower the behaviors by enlightening and showing concern for caring for nurses’ feelings hence minimizing exhaustion. For instance, the transformational leadership style promotes a healthy working environment where nurses feel committed to work.
The leadership styles are capable of helping employees to develop their potential and empowering individuals to make changes. Leaders that advocate for teamwork usually involve their staff in decision-making, rewarding excellence, encouraging motivation ad increasing the satisfaction of employees hence impacting their work-life (Nilsson & Nilsson, 2021). For instance, a transformational leader inspires followers through motivation to maintain loyalty.
Application of Leadership Behaviors and Skills
The situation where I have encountered the leadership skills and behaviors that create a healthy working environment is how a nurse in-charge of the medical-surgical unit dealt with a nurse who constantly slept during duty. The manager talked to the nurse and convinced him to be serious about the job. During the conversation, the manager did not criticize the nurse but reassured him that he trusted and respected him and reminded him also that he was neglecting his duties which could affect the nurse’s outcome. The leader supported the nurse to improve their commitment to care. Thereafter, the nurse became more committed to work and stopped sleeping during shifts hence the goals of the organization were achieved.
Effectiveness of the Skill
In this case, the skill used by the manager was effective in enabling the nurse to recognize his mistakes and in helping him to change his behavior. The nurse leader had the skills of open communication and active listening which inspired and motivated the nurse hence promoting behavior change (Broome & Marshall, 2021). Therefore, by listening to the concerns and needs of the nurse without criticism, the leader built a trusting relationship with the nurse. The relationship helped the nurse to be, to be honest, and fair which enabled him to decide on the behavior change. Leadership skills generate a positive workplace environment that motivates the employees to be part of the organization’s vision. Additionally, the skill makes nurses feel appreciated and improves their satisfaction.
References
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springerhttps://dl.uswr.ac.ir/bitstream/Hannan/138756/1/9780826105288.pdf
Nilsson, K., & Nilsson, E. (2021). Organizational Measures and Strategies for a Healthy and Sustainable Extended Working Life and Employability-A Deductive Content Analysis with Data Including Employees, First Line Managers, Trade Union Representatives, and HR-Practitioners. International journal of environmental research and public health, 18(11), 5626. https://doi.org/10.3390/ijerph18115626
Suratno, K., Kusrini, K., & Ariyanti, S. (2018). The Relationship between Transformational Leadership and Quality of Nursing Work Life in Hospital. International Journal of Caring Sciences, 11(3), 1416-1420
Vidman, Å., & Strömberg, A. (2020). Leadership for a healthy work environment – a question about who, what, and how. Leadership in health services (Bradford, England), 34(1), 1–15. https://doi.org/10.1108/LHS-06-2020-0041
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Collapse SubdiscussionAshtyn Mcquaid
Ashtyn Mcquaid
Dec 22, 2022Dec 22, 2022 at 9:15am
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Pauline,
I agree the environment on the unit is influenced by relationships with leadership. I am a float nurse and have been on many units. An initiative in our hospital right now is barcode scanning percentages. On one unit, the manager hands out gift cards each month to the highest scanner and reminds her staff to keep scanning. On another unit we get emails showing everyone’s percentage and reminding us of the rules. Another unit emailed us warning this could lead to disciplinary action. “Transformational leadership is an approach that focuses on the attributes and behaviors of the leader required to empower and motivate team members” (Collins et al., 2020). Three different approaches by three different managers. Having a good manager is so important for job satisfaction. Elaine Marshall, RN, PhD (2021) states in her book, Transformational Leadership in Nursing, “Evidence is mounting that links the influence of transformational leaders to both improved nursing practice at the bedside, and positive patient outcomes in the aggregate” (p. 9).
References
Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nursing standard (Royal College of Nursing (Great Britain) : 1987), 35(5), 59–66. https://doi.org/10.7748/ns.2019.e11408
Marshall, E. S., RN, PhD (2021). Transformational Leadership in Nursing, (p. 9). Springer Publishing Company. https://dl.uswr.ac.ir/bitstream/Hannan/138756/1/9780826105288.pdfLinks to an external site.
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Collapse SubdiscussionTyesha L Sullivan
Tyesha L Sullivan
Dec 23, 2022Dec 23, 2022 at 10:45am
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Pauline,
In order to become a great leader, one must master a demanding and complex role in order to navigate ensuring success for the company and delivering results that count. This is accomplished by leading in a way that creates a positive and encouraging atmosphere for all staff. As you stated, with transformational leadership staff’s satisfaction is met and burnout is minimized to create a safe and effective work environment. Transformational leaders develop the patient’s care quality and citizenship behaviors by providing an appropriate practicing atmosphere. These studies show the significance of TL to make a work atmosphere that helps and promotes a better practicing environment for nurses to be professional and enhance the desired outcomes for both the nurses and the patients (Asif et al., 2019).
Reference
Asif, M., Jameel, A., Hussain, A., Hwang, J., & Sahito, N. (2019). Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment. International journal of environmental research and public health, 16(13), 2381. https://doi.org/10.3390/ijerph16132381Links to an external site.
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Collapse SubdiscussionAudrey Okofo-Mensah
Audrey Okofo-Mensah (She/Her)
Dec 23, 2022Dec 23, 2022 at 11:33pm
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Peer Response #2
Hello Pauline,
Thank you for giving a different perspective to leadership styles. I truly believe that a positive leader makes a lot of difference. You are right in saying leadership behaviors on nurses should be that of empowerment to acquire skills, increase job satisfaction and commitment towards high quality care. It will take a transformational and an authentic leader to inspire others and encourage them. Transformational leaders focus on building relationships with people and creating change by emphasizing values (Giddens, 2018) which is exactly what the manager did in your discussion post.
In a systemic review by Speechia and associates (2021), there was a positive correlation between transformational leadership style and nurse’s job satisfaction. The group advocated for leaders to promote technical and professional competencies while improving staff satisfaction and morale.
References
Giddens J. (2018). Transformational leadership: What every nursing dean should know. Journal of professional nursing : official journal of the American Association of Colleges of Nursing, 34(2), 117–121. https://doi.org/10.1016/j.profnurs.2017.10.004Links to an external site.
Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership Styles and Nurses’ Job Satisfaction. Results of a Systematic Review. International journal of environmental research and public health, 18(4), 1552. https://doi.org/10.3390/ijerph18041552Links to an external site.
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Collapse SubdiscussionCarolyn Hart
Carolyn Hart
Dec 24, 2022Dec 24, 2022 at 11:33am
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Pauline,
Excellent
