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Brief Contents
Acknowledgments
Foreword
About the Editors
Contributors
CHAPTER 1 Conceptual Foundations for Nursing

Professional Governance: Professional
Governance, Accountability, and Ownership of
Nursing’s Social Contract
CHAPTER 2 Principles of Professional Governance in

Organizations of Excellence
CHAPTER 3 Nursing Leadership Behaviors as Foundational

to Professional Governance
CHAPTER 4 Professional Governance in a Healthcare

System and the Role of the Chief Nurse
Executive
CHAPTER 5 The Role of the Clinical Care Nurse in Nursing
Professional Governance
CHAPTER 6 The Role of the Nurse Manager in Professional

Governance
CHAPTER 7 Peer Accountability and Relationships in a

Professional Governance Structure
CHAPTER 8 The Functional Framework, Bylaws, and

Structural Mandates for Nursing Professional
Governance
CHAPTER 9 Application of Professional Governance

Structures Across the Continuum
CHAPTER 10 The Measurement of the Effectiveness of

Nursing Professional Governance
CHAPTER 11 Transforming Outcomes—The Impact of

CHAPTER 12 Assuring Sustainability of Professional

Governance
CHAPTER 13 Fostering Professionalism from the Academy

to the Practice Setting
CHAPTER 14 Value-Informed Nursing Practice and

Leadership in Modern Health Care
CHAPTER 15 Beyond the Organization―Governing Our

Practice as a Profession in the Greater Nursing
Community
Appendices
Postscript
Index
Contents
Acknowledgments
Foreword
About the Editors
Contributors
CHAPTER 1 Conceptual Foundations for Nursing Professional

Governance: Professional Governance, Accountability, and
Ownership of Nursing’s Social Contract
Tim Porter-O’Grady, Rachel E. Start, and Joanne T. Clavelle
Introduction
Nursing Professional Identity
Professional Nursing Governance and the Journey to Equity and
Value
Principles Underlying Professions
Professional Self-Governance
Professional Accountabilities
Practice
Professional Governance and Collective Bargaining
Translation of Professional Governance Principles into the
Foundations of Nursing Practice
Trust
Accountability
Parity
Inclusivity and Structure
Conclusion
Chapter Questions
References
CHAPTER 2 Principles of Professional Governance in

Organizations of Excellence
Marla J. Weston
Introduction
Professional Governance Empowers Nurses
Principle #1: Professionals Are Knowledge Workers with a Realm of
Practice Expertise and Authority
Principle #2: Professional Governance Is Decision Making Within the
Realm of Knowledge Authority
Principle #3: Professionals Have Both Autonomy Within Their
Practice and Control Over Their Practice
Principle #4: Accountability Is Owned by the Professional
Principle #5: Equitable Collateral Relationships Undergird
Principle #6: The Accountabilities of the Clinical Nurse Are Different
from the Nurse Manager
Principle #7: Professional Governance Is Different From Participative
Decision Making
Principle #8: Organizational Leaders Create an Environment for
Conclusion
Chapter Questions
References
CHAPTER 3 Nursing Leadership Behaviors as Foundational

to Professional Governance
Beverly J. Hancock and Kevin K. McEwan
Introduction
Positional Versus Role Leadership
Model for Leadership Competencies
Leadership Behaviors, Knowledge, and Skills That Support Professional
Accountability
Leadership to Establish Professional Governance Vision and Structures
Leadership Participation to Guide Success
Leadership Skills Needed to Effectively Navigate Governance Structures
Leaders to Disseminate Professional Governance Utility
Leaders to Sustain Professional Governance
Common Governance Leadership Challenges
Leadership Development
Council Chairs and Presidents
Impact of Leadership Development and Future Leadership Roles
Conclusion
Chapter Questions
References
CHAPTER 4 Professional Governance in a Healthcare System

and the Role of the Chief Nurse Executive
Sharon H. Pappas and Tim Cunningham
Introduction
It Starts Here
Why Systems?
What Is a System?
Holding Company or Operating Company?
So How Does That Impact Professional Nurses?
Why Are Networks Important to a System?
Nurses Leading Life at the Intersection of Networks and Systems—CNE as
Catalyst
Joining the Ranks of the Integrated
Back to Decision Making
Nurses as Advisers or Decision Makers?
Decision-Making Model
Conclusion
Chapter Questions
References
CHAPTER 5 The Role of the Clinical Care Nurse in Nursing

Judith M. Hahn, Kate Baron, and Ena M. Williams
Introduction
Licensure and Responsibility to the Public That We Serve
A “New” Profession With Historical Hierarchy
Ownership
Oversight of Practice
Individual Nurses Engaging in Professional Organizations to Support Practice
Nursing Professional Governance and the Professional Nurse
Applying Evidence-Based Practice
Interprofessional Partners
The Magic of Making Change
Utilizing Resources
Practice Change Process
Accountability for Autonomous Evidence-Based Practice Through Outcome
Measures
Conclusion
Chapter Questions
References
CHAPTER 6 The Role of the Nurse Manager in Professional

Governance
Robert E. Boesch, Brandon “Kit” Bredimus, and Beverly J. Hancock
Introduction
Culture and Professional Governance
The Manager’s Role in Professional Governance
Shift in Leadership Roles
Developing and Supporting the Council Chair
Role of the Nurse Manager in Council Meetings
Beyond the Meetings
Managers and Leaders as Advocates
Diplomacy Versus Activism
Advocacy’s Effect on Culture
Leading Change on the Unit
Encouraging Tests of Change
Sustaining Engagement and Empowering Change
Tools of Sustainability
Conclusion
Chapter Questions
References
CHAPTER 7 Peer Accountability and Relationships in a

Professional Governance Structure
Amy Steinbinder and Barb Haag-Heitman
Introduction
Peer Review
Defining Terms
Alignment with Professional Governance Councils
Organizing Peer Review by Domains and Roles
Domains
Guidelines for Nurses in All Roles Organized by Domain
Peer Review for All Nurses
Individual Responsibilities
The Quality and Safety Domain
Incident-Based Peer Review
Organizational Level
Unit/Divisional Level
Prospective Peer Review
Nurse Leaders
Role Actualization Domain
Organizational Level
Unit/Division
Peer Competency Validation
Practice Advancement Domain
The Research or Practice/Evidence-Based Practice Council Provides Leadership
for Practice Advancement
Conclusion
Chapter Questions
References
CHAPTER 8 The Functional Framework, Bylaws, and

Structural Mandates for Nursing Professional Governance
Victoria George
Introduction
Self-Regulation of a Discipline
The Journey Continues
The Structure of Governance Builds Organization-Wide Autonomy
and Accountability
A New Leadership Vision of the Future of Work
Successful Models of Partnership in Health Care
Equity-Based Models in Health Care
Nursing Self-Regulation
Role of the CNE/CNO
Next Step in the Journey
A Call to Action
Conclusion
Chapter Questions
References
CHAPTER 9 Application of Professional Governance

Structures Across the Continuum
Jessica Polk, Elizabeth Carreira, Deena Gilland, Rebecca Dellafave,
Bonnie Proulx, Nancy May, and Rachel Start
Introduction
Understanding the Operationalization of Structure in Professional
Governance
Industry Trends in Nursing Professional Governance Structures
Assessing, Creating, Standing Up, and Sustaining Professional
Governance Structures
Emory Healthcare
Background and Structure Creation and Assessment
Unit Practice Councils Roles and Voting
Professional Governance Structures That Mobilize Advanced Practice
Nurses
Metrics That Show Progress and Impact
Ensuring Structure That Encompasses the Continuum as Well as the
System
Considering Collateral Relationships and the Interprofessional Team
in the Work of Professional Governance
Administrative Management Structures That Empower Professional
Governance Principles
Rochester Regional Health Primary Care and Ambulatory Specialty
Institute (RRH PCASI)
Background and Structure Creation and Assessment
Metrics That Show Progress and Impact
Considering Collateral Relationships and the Interprofessional Team in the
Work of Professional Governance
Ensuring Structure That Encompasses the Continuum as Well as the System
Conclusion
Chapter Questions
References
CHAPTER 10 The Measurement of the Effectiveness of

Nursing Professional Governance
Lindsey M. Tarasenko and Paula M. Meek
Introduction
Basic Measurement Principles and Assessments
Reliability
Representativeness
Responsiveness
Professional Governance Instruments
The Index of Professional Nursing Governance
Reliability of the IPNG
Representativeness of the IPNG
Responsiveness of the IPNG
Summary of the Psychometric Properties of the IPNG
The Verran Professional Governance Scale
Representativeness of the VPGS
Reliability of the VPGS
Next Steps in Testing of the VPGS
Scale Selection
Conclusion
Chapter Questions
References
CHAPTER 11 Transforming Outcomes―The Impact of

Elizabeth Carreira, Jessica Polk, Rebecca Dellafave, Deena Gilland,
Angela Moss, Nancy May, Angelique Richard, Rebecca Love, and
Rachel Start
Introduction
History of Healthcare Quality and Practice Oversight of Performance
in Nursing
Tracking Impact Through Meaningful Quality Improvement Built on Reliable
Correlations
Understanding Quality, Payment, and Accountability Structures in the
U.S. Healthcare System
Professional Governance and Other Organizational Structures That
Guide Quality and Performance Improvement
Fulfilling the Professional Mandate to Improve Outcomes: The
Business Case for Professional Governance
Nursing Demographic Measurement as an Outcome
Patient Health Outcome Impact
Tactics to Track Progress and Impact
NSIs and Tracking Mechanisms: An Exemplar
Nurse Billing: The Future of Nurse Contribution Measurement
Care Coordination and Transition Care Management: Leveraging the
Discipline-Specific Strength of Nursing in the Complex
Management of Patients and Populations
Nurse-Led Care Coordination Teams
Nurse Care Coordination: An Exemplar of Autonomous Nursing
High-Risk Patient Populations
TCM
Screenings for SDoH Barriers and Increasing Health Equity
Impact on Health Equity and Access to Health Care: An Exemplar
Emerging Trends in Performance Improvement: Tools to Achieve
Improved Nursing Practice
Conclusion
Chapter Questions
References
CHAPTER 12 Assuring Sustainability of Professional

Governance
Joanne T. Clavelle and Tim Porter-O’Grady
Introduction
Outcomes
Nursing Outcomes
Patient and Organizational Outcomes
Professional Practice Models
Alignment with Magnet® Recognition
Sustainable Structures
Structures of Governance
Structure and Language
New Language Leads to New Thinking and Acting
Laying the Foundations of Professional Practice With the Position Charter
Privileging for Practice
The End of Performance Evaluations
Clinical Advancement as a Replacement for Performance Evaluation
The Clinical Advancement Program and the Demonstration of Contribution
Role of the Nurse Manager in Sustaining Nursing Professional
Governance
What Professional Workers Need from Managers
Collateral Leader Behaviors That Support Professional Practice
Conclusion
Chapter Questions
References
CHAPTER 13 Fostering Professionalism from the Academy to

the Practice Setting
Cynthia McCurren, Janet Stifter, Karen M. Mayer, and Cathy
Catrambone
Introduction
Nursing Professional Governance: Academic/Practice Partnerships
Integration of Professional Development and Governance in the
Academic Stage
Student Acclimation to Professional Governance and Community
AACN Competencies in Academic Curricula
Professionalizing the Emergent Leadership Role Within Nursing
Leadership Trajectory
Nursing Peer Review
The Novice Nurse
Peer Interviews
Onboarding and Transition to Practice Programs
Preceptors
Residencies, Internships, and Externships
Mentorship Programs
Leadership Measurement Tools
Outcome Measures
Patient Outcome Measures
Nurse Professional Development Measures
The CNO/Transformational Leader in Professional Governance
Mentoring for Positional Leadership Roles Within Professional
Governance
Every Nurse to Be a Leader
Conclusion
Chapter Questions
References
CHAPTER 14 Value-Informed Nursing Practice and
Leadership in Modern Health Care
Olga Yakusheva, Hannah Ratliff, and Deena K. Costa
Introduction
Implications of Value-Based Health Care for Nurses
The Ethical Imperative of Value-Informed Nursing
The Economic Value of Nursing
The Economic Value of Healthcare Delivery
Value-Informed Nursing
Value-Informed Nursing Practice
Value-Informed Nursing Leadership
Quantifying the Organizational Economic Value of Nursing
How to Make Value-Informed Nursing a Reality
Change in Professional Norms, Attitudes, and Behaviors
Value-Informed Nursing Education
Value-Informed Nursing Innovation
Conclusion
Chapter Questions
References
CHAPTER 15 Beyond the Organization―Governing Our

Practice as a Profession in the Greater Nursing Community
Beverly J. Hancock, Rachel Start, Robyn Begley, Aney Abraham,
Lydia H. Albuquerque, Kathy Malloch, and MT Meadows
Introduction
National Governance Through Professional Organizations
National Association of Indian Nurses of America: The Power of a Unified
Voice and Focus
AAACN
Unchartered Territory: Defining the Role of the Ambulatory Nurse
and Measuring Contribution
AAACN/CALNOC Collaboration
AONL: Defining Practice Competency
Nurse Executive Competencies
Nurse Manager Competencies
Professional Accountability
Tri-Council for Nursing: Addressing National Issues Through
Professional Partnerships
Influence at the National Level
Conclusion
Chapter Questions
References
Appendices
Postscript
Index
Acknowledgments
The editors and authors would like to acknowledge the support,

encouragement, partnership, and contribution of the American
Organization of Nurse Leaders. This partnership has served as a
catalyst for this book and establishes the foundation for future
exploration and applications of the role that nursing professional
governance plays in the accountability of the leader and as a
framework for governing the professional practice of nursing in all
settings where nurses practice.
Foreword
Professional governance is a lifestyle. It’s an identity. Professional

governance exists as a form of leadership behavior within the
individual as well as within the greater nursing community.
Professional governance is the fulfillment of trust given, of power
given, of reliance for livelihood expected. Professional governance
cannot be shirked. Both individuals and communities of nurses must
return health back to those who trust in them. Both individuals and
communities must return well-being, continuity, and access back
through expert and discipline-specific autonomous management of
practice as if the stakes were so high, people’s lives depended on it.
With power given, as an established and validated profession,
based on discipline-specific research and reliable scientific
knowledge, for decades now, nurses must rise to a more complete
understanding of the impact that they can and must make for
patients, populations, and society. Professional governance can no
longer be relegated unilaterally to a council or committee structure
that supports the attainment of specialty designations or improved
engagement scores. Professional governance must be focused on
the serious and sobering gaps that exist where health equity,
promotion, disease prevention, coordinated progression of care, and
improved value are concerned for patients and populations.
Nurses want to do serious work. They entered this profession to
take on real problems. When structures encourage patriarchal calls
for nurses to “have a voice,” our profession does not rise to the level
that is required to fully engage their service to society. Authentic
ownership and the power that supports it must be given to the
expertise that the nursing profession offers for transformation of the
serious issues that burden those that gave us that power.
Newer generations want mission, are hungry for mobilization
toward a shared purpose and higher calling. They see through
inauthentic leadership; they disengage quickly out of “shell”
structures that ask only that they choose the next pizza party or
nurses’ week gift. They want to fix BMI for their populations. They
want to create clean air for their patients with asthma. They want to
ready the environment for zero pressure ulcers gained to their most
vulnerable of patients. Nurses today navigated a world through
COVID-19, arguably the greatest modern healthcare crisis of a
century. They did this by flexing; adapting; basing interventions on
what they knew in their discipline-specific knowledge; and building
upon it validated new interventions to study, test, and disseminate.
Engagement of nurses now requires a serious commitment to relying
upon their expertise, their leadership to transform outcomes, and
their autonomous management of practice.
Nursing has, for decades now, established itself as a profession,
built upon a reliable, valid body of knowledge unique to nurses. As a
profession, then, it is accountable, just as other professions are, to
society, to utilize the recognition of reliance that society gives to
those disciplined groups so that health, livelihood, and well-being
are realized. The ownership of accountability inherent in any
individual or community of professionals demands that governance
of that professional service be closely attended to and progressively
acted upon. One profession cannot speak for another profession
because the discipline-specific education and scientifically validated
knowledge embedded in that profession is wholly different from the
other. No other discipline or profession can govern nursing, and the
converse is also true: nursing cannot govern or discipline another.
Professions engage in governance through structures that enable
quality service and practice. Structures can define the frame in which
the behavior of professional nursing governance is expressed.
Professions partner with the organizations in which they practice to
advance the work that they each share as important. All nurses who
embody and fully embrace ownership of professional governance are
leaders. All nurses, engaging in this work, come from different
backgrounds and possess specialty niche knowledge within the
discipline of nursing. As such, structures that would seek to support
professional governance within nursing should be inclusive of every
specialty perspective within the discipline, fully reflective of the
populations served, and conducted within a horizontal structure
rather than a hierarchical approach. However, as nurses have often
designed their practice governance within the organizations in which
they practice, they are often structured vertically, industrially, and
within an employee-based format intended to advance effectiveness
of work. These two structures can come into conflict if not fully
understood from a complexity systems perspective. From a
complexity systems perspective, the administrative manager holds a
positional role that intersects with the vertical structures and
elements of an organization, and should manage resources, time,
and development assets to ensure a supporting infrastructure for
professional governance within the healthcare organization. As
members of the nursing profession, with a specialty as an
administrative nurse, however, in the horizontal structure delineated
in nursing professional governance, they sit in the “role leader
position” (a managerial expert at the table), often where the clinical
nurse chairs the council and where the manager supports, advises,
and guides, as positional leader. This balance between vertical and
horizontal intersections requires a constant, detailed commitment to
professional governance autonomy while collateral partnership
between the two structures is addressed.
Nurses have a well-established body of qualitative and quantitative
research that substantiates and validates its position of value to
patients and populations. Decades of research have shown the
correlation of nursing discipline-specific intervention on quantifiable
positive patient outcomes. Nurses are at every point in the
healthcare system, and yet the fact that reimbursement structures
do not reflect this financial and social value has burdened the
profession significantly. Interprofessional decision making related to
clinical and financial outcomes must include nurses for sustainable
transformation of health care for the foreseeable future. Parity of the
disciplines at all points in the continuum of care and within the
vertical organizational structures of our health system must be fully
addressed; empowerment and the supporting infrastructures and
leadership must enable autonomous discipline-specific practice
management to occur in all services of any health system. Nurses
practice across all settings in the healthcare system. It is imperative
that they be included in strategy formation and decision-making
efforts for maximal impact to those served. Rather than being
viewed solely as a “cost” on any given health system’s ledger,
because of their explicit value, nurses must be reflected in the
contribution margins of every health system. These efforts will only
further mobilize the important mandate that nursing transform the
gaps that are currently burdening patients and populations with lack
of access, affordability, and health. All disciplines contribute in an
integrated community of practice. Together they create and live the
agenda of effective health service. Nursing professional governance
sets the frame for equity and partnership with nurses and raises
individual and collective expectations of membership in this
community of practice and of being active participants in the life of
the profession.
This book serves as a contemporary guide for advancing nursing
professional governance and the life and work of nurses. We
encourage our colleagues to use it to lay the foundations of
professional practice beginning in nursing school; to onboard with
expectations that each nurse will engage in ownership of practice;
and to create cultures where every nurse becomes rooted in their
professional community at their individual, organizational, and
specialty associations. Inside this text are the essential principles,
processes, and expectations for creating, advancing, and validating
nursing professional governance for the future of nursing and health
care. This work enables nurses to fulfill the promise of nursing, have
a positive impact on the health of individuals, and advance the
quality of life for all persons and communities.
Rachel E. Start, MSN, RN, NEA-BC, FAAN

Tim Porter-O’Grady, DM, EdD, APRN, FAAN, FACCWS
Beverly J. Hancock, DNP, RN, NPD-BC
About the Editors
Rachel E. Start, MSN, RN, NEA-BC, FAAN

Rachel Start is a champion for professional governance as well as
the evolution of nursing practice in the ambulatory environment. Her
engagement and leadership of initiatives within state, national, and
international organizations has been driven by a desire to see
nursing realize its full contribution across settings. She has
significantly advanced the field of ambulatory care nurse sensitive
measurement, having led the national development of nurse
sensitive indicators (NSIs). Rachel was co-chair of the American
Academy of Ambulatory Care Nursing (AAACN) Nurse Sensitive
Indicator Task Force and the lead editor on the Ambulatory Care
Nurse-Sensitive Indicator Industry Report: Meaningful Measurement
of Nursing in the Ambulatory Patient Care Environment (May, 2016).
As this work continued, she was on the steering committee for
AAACN/CALNOC to test for feasibility the NSIs proposed in 150
organizations across the country, with subsequent development of a
benchmarking database for ambulatory nurses. This database was
acquired by Press Ganey and is now housed in the NDNQI platform.
She was an adviser on a Military Health Services study for
ambulatory measurement and was recognized with team members
by the National Institutes of Health Clinical Center for this work.
She has represented AAACN as an advocate for advancing nursing
practice in ambulatory at the ANA Ambulatory Summit on Nursing
Measurement, the ANCC Magnet® Commission, the National Alliance
for Quality Care, American Organization for Nursing Leadership
(AONL), Vizient, Press Ganey, and AACN and as a consultant to
numerous other organizations. Rachel founded the Illinois
Ambulatory Nurse Practice Consortium (IANPC) in 2013, giving
ambulatory nurses voice for legislation and advocacy. Through this
she actively advocated to lawmakers in Illinois for strengthening of
the Nurse Practice Act. She advocated for IANPC to be recognized as
a chapter of the AAACN. She has served on the AONL Care
Continuum Committee, AAACN Nurse Executive Task Force, and
AACN Nursing Essentials Task Force as a practice partner. Most
recently (2021) she was elected to the AAACN Board of Directors
and, in May 2023, will start a term as president of AAACN. Rachel
has been on the faculty of the Dynamic Leadership for Professional
Governance Program offered regularly through the American
Organization of Nurse Leaders.
She has published and presented extensively on the imperative for
meaningful measurement and nursing practice advancement as
related to the shifting healthcare landscape at numerous national
venues. She has consulted with numerous organizations related to
nursing practice, professional governance, Magnet® principles, and
innovative care delivery models and emergent roles within nursing.
Rachel is also currently working on her PhD at Loyola University,
researching the role of the ambulatory nurse through a study
entitled, “Assessment of Relationships Between Quality and Staffing
in the Ambulatory Environment,” which is a descriptive, correlational
study of structure process and outcome indicators in the primary
care setting. Rachel is also currently the Associate Vice President of
Medicine, Behavioral, and Emergency Services at Rush University
Medical Center.
Rachel is blessed to be the wife of Michael Edward; the mother of
Christiaan Jonker; daughter to Don and Carole Williams; sibling to
Andy, Katie, Michael, and Elizabeth; and aunt to many dear nieces
and nephews. And she is thankful always for Grandma Joanne
Butterfield Wagner.
Beverly J. Hancock, DNP, RN, NPD-BC
Dr. Beverly J. Hancock is the Senior Director for Leadership
Development for the American Organization for Nursing Leadership
(AONL), leading a team of staff and expert faculty in developing
AONL’s educational and leadership development resources,
programs, and online learning for nurse leaders. She is part of the
core team responsible for planning and executing the AONL Annual
Conference and leads the annual AONL Professional Governance
Leadership Conference. Her focus is on developing the leadership
abilities of all nurses relevant to their positions and scope of
influence to further the mission of AONL to transform nursing
through expert and influential leadership.
Dr. Hancock has presented widely and published on the topics of
leadership development, professional governance, and environments
of excellence. Prior to AONL she worked at Rush University Medical
Center in Chicago, Illinois, where she held a variety of clinical and
administrative roles and was involved in shared governance for more
than 25 years, beginning in her first year as a clinical nurse on the
unit council. She also served as Magnet Program Director for Rush’s
initial designation and two re-designations and in this role worked
closely with the presidents and council chairs of the Professional
Nursing Staff at Rush. She has extensive experience with the Magnet
Recognition® program, having coached many aspiring Magnet®
organizations and worked as an educator and consultant for the
ANCC Magnet Recognition® Program. She is an American Journal of
Nursing (AJN) peer reviewer and has served as an AJN book-of-the-
year reviewer. She has also served on several Boards including as
Chair of the LaSalle Senior Center, which served multiethnic low-
income seniors in the Cabrini Green neighborhood of Chicago and
most recently as President of the Wheaton College (IL) Alumni
Association. Dr. Hancock has her certification in Professional
Development through the American Nurses Credentialing Center and
is a certified Clifton Strengths Coach. She has flourished with the
support of her husband Jonathan and has delighted in watching her
daughters, Elizabeth and Abigail, in their own leadership journeys.
Tim Porter-O’Grady, DM, EdD, APRN, FAAN, FACCWS
Dr. Tim Porter-O’Grady has been a nurse for 50 years. He is currently
senior partner-health systems for TPOG Associates LLC, an
international health consulting practice in Atlanta, Georgia, and
Tucson, Arizona. Tim is an advanced practice nurse, board-certified
in geriatrics and wound specialties, and holds two earned
doctorates, one in learning behavior and another in complex systems
leadership.
He has been Clinical Professor, Leadership Scholar at The Ohio
State University, College of Nursing, and Professor and Innovations
Scholar at Arizona State University College of Nursing and Health
Innovation, and is currently a Clinical Professor at Emory University,
School of Nursing. He is nationally and internationally recognized as
an expert and futurist in clinical health systems, nursing leadership,
nursing professional governance, and health systems innovation.
Dr. Porter-O’Grady has consulted with over 300 clinical systems
worldwide and has lectured at over 500 settings globally. He has
authored or co-authored 26 books and over 225 journal publications,
and is a 10-time winner of the AJN “Book of the Year Award.”
Tim is an elected fellow of the American Academy of Nursing and
a clinical fellow in the American College of Clinical Wound Specialists.
Tim is immediate past Chair of the Board of the American Nurses
Foundation, and has served on the Board of Catholic Community
Services, a community health system for the underserved in Tucson.
He has also served on the editorial boards of five proctored
healthcare journals.
Tim has received numerous awards, including the American
Organization of Nurse Leaders Lifetime Achievement Award,
American Nurses Association Luther Christman Health Leadership
Award, the American Association of Critical Care Nurses Healthcare
Pioneer Award, the American Academy of Nursing’s President’s
Award, and is a 2020 inductee into the ANA Nursing Hall of Fame
and a 2022 inaugural inductee into the Georgia Nurses Hall of Fame.
He lives with his husband of 46 years between Tucson and Atlanta
where they love to hike, read, and spend time with colleagues and
friends.
Contributors
Aney Abraham, DNP, RN, NE-BC

Dr. Aney Abraham currently serves as the Vice President, Patient
Care Services at Rush University Medical Center, Chicago, Illinois. Dr.
Abraham has over three decades of leadership experience, in
hospital operations, regulatory standards, practice, and safety
accountability in both inpatient and outpatient settings.
She has served as the president of the Indian Nurses Association
of Illinois, Chair of the election committee at the national level and is
currently serving as a member of the Bylaws Committee of the
American Nurses Association of Illinois.
Lydia H. Albuquerque, DNP, RN, ACNP-BC, CCRN, FNAP, FAAN
Dr. Lydia Albuquerque currently serves as an Assistant Professor at
William Paterson University and an acute care Nurse Practitioner at
Robert Wood Johnson University Hospital, Barnabas Health, New
Jersey.
Dr. Albuquerque brings over three decades of experience in
nursing education, research, and administration. At William Paterson,
she teaches Doctoral of Nursing Practice students the importance of
leadership and collaboration.
Kate Baron, APRN, ACNP-BC, MAIOP
Kate Baron is Nursing Professional Governance Coordinating Council
Chair Emeritus Yale New Haven Hospital. Kate is currently practicing
in the role of Acute Care Nurse Practitioner at Yale New Haven
Hospital.
Robyn Begley, DNP, RN, FAAN
Robyn Begley is Chief Executive Officer of the American Organization
for Nursing Leadership (AONL) and is Chief Nursing Officer and
Senior Vice President of workforce for the American Hospital
Association (AHA). In her role at AONL, she leads a membership
organization of more than 12,000 nurse leaders whose strategic
focus is excellence in nursing leadership.
Robert E. Boesch, DNP, RN, NEA-BC, CPHQ, CNML
Dr. Robert Boesch is a millennial nurse leader with over 15 years of
nursing leadership experience. Rob currently serves as the Chief
Nursing Officer within the Centra Health system, which he joined in
December 2020. Prior to serving in this role, Rob worked as a Vice
President of Nursing—Acute Care Services and Vice President of
Surgical Services within the Penn State Health Milton S. Hershey
Medical Center. During his time at Penn State, he earned a Master’s
Degree in Nursing Administration and Leadership (MSN), as well as
his Doctorate of Nursing Practice (DNP) through Penn State
University. As a member of American Organization for Nursing
Leadership (AONL), Rob completed the AONL Nurse Manager
Fellowship in 2017 and served stints on the Certified Nurse Manager
Leader (CNML) Steering Committee, Membership Committee, as well
as the Conference Planning Committee. Rob currently serves as a
faculty member for AONL, teaching in the Certified Nurse Manager
and Leader certification program. At the state level, Rob currently
serves on the Virginia Organization of Nurse Leaders Board of
Directors. A dynamic and passionate nurse leader, Rob believes in
the principles of authentic leadership. His LEAD (Love,
Empowerment, Acceptance, and Delegation) approach continues to
drive his staff centered leadership mentality. When leaders place
their teams at the center, he believes that staff are empowered and
supported to be patient centered in their care delivery. It is through
this leadership approach that Rob connects his personal mission in
health care with our nursing professional values.
Brandon “Kit” Bredimus, DNP, RN, CPEN, CNML, NE-BC, CENP, NEA-BC,
FACHE, FAONL, FNAP
Dr. Kit Bredimus is the Chief Nursing Officer at Midland Health in
Midland, Texas. Dr. Bredimus is a nationally recognized leader, being
named as a Modern Healthcare Rising Star in Nursing, AONL Early
Careerist Award, Nursing Management’s Visionary Leader Award
Finalist, and Texas Nurses Association Year of the Nurse Award. Kit
holds multiple Board certifications in leadership and is a Fellow of
the American College of Healthcare Executives, American
Organization for Nursing Leadership, and the National Academies of
Practice. Dr. Bredimus presents on the national level through various
speaking events, podium presentations, podcasts, and publications
on today’s important leadership topics.
Elizabeth Carreira, MSBA, BSN, RN, NE-BC, CPPS, AMB-BC
Elizabeth Carreira is currently a Director of Nursing at Rochester
Regional Health in ambulatory care and serves as the Magnet®
Program Director. As a registered professional nurse, Liz’s clinical
expertise is in the fields of oncology and ambulatory care, with a
focus on nursing professional development and regulatory
preparedness. Liz is a graduate of the University of Rochester,
receiving her baccalaureate degree in nursing in 2000, and her
master’s degree in business administration in 2014, and is a member
of Beta Gamma Sigma.
Cathy Catrambone, PhD, RN, FAAN
Cathy Catrambone is an Associate Professor and Associate Chair at
Rush University College of Nursing, Adult Health and Gerontological
Nursing. She received her BSN from Loyola University in Chicago and
her MSN and PhD from Rush University. She is a Past President of
Rush University Medical Center Professional Nursing Practice (PNS)
and founder of the PNS Past Presidents Council. She is deeply
committed to nursing professional governance and mentoring future
nurse leaders. She served as chair of the American Academy of
Nursing, Global Nursing and Health Expert Panel. Dr. Catrambone is
a former President of the Sigma Theta Tau International (Sigma) and
leader on the Global Advisory Panel for the Future of Nursing and
Midwifery.
Joanne T. Clavelle, DNP, RN, NEA-BC, FACHE, FAAN
Joanne Clavelle is Chief Executive Officer of Clavelle Consulting,
based in Arvada, Colorado, and is Assistant Professor at the
University of Colorado College of Nursing DNP Program. Her 45-year
nursing career has spanned several senior level nurse executive roles
within U.S. hospitals and health systems, most recently as Regional
Vice President/Chief Nursing Officer–West for GetWellNetwork;
System Senior Vice President and Chief Clinical Officer for Scottsdale
Healthcare, and later HonorHealth; and Vice President of Patient
Care Services and Chief Nursing Officer for St. Luke’s Health System
in Boise, Idaho. Dr. Clavelle has a Doctorate in Nursing Practice from
Case Western Reserve University, Frances Payne Bolton School of
Nursing. Her most recent professional engagements include serving
as director-at-large of Sigma Theta Tau International Honor Society
of Nursing, Chair of its Clinical Advisory Committee, and editorial
boards for the Journal of Nursing Administration and Healthcare
Executive. Dr. Clavelle is a well-known writer, presenter, and
researcher on transformational leadership, structural empowerment,
professional governance, nurse practitioner/physician collaborative
practice, patient experience, and the impact of technology on
transforming nursing practice. For the past 8 years, she has
facilitated a nationally recognized research team in developing a
conceptual model on professional governance in organizations and
corollary measurement instrument: the Verran Professional
Governance Scale.
Deena K. Costa, PhD, RN, FAAN
Deena Kelly Costa PhD, RN, FAAN is an Associate Professor at Yale
School of Nursing and Yale School of Medicine in the Section of
Pulmonary, Critical Care and Sleep Medicine. She is also Co-Director
of the National Clinician Scholars Program at Yale University. Dr.
Costa has more than a decade of adult critical care nursing
experience. She is a trained health services researcher who studies
how to optimize critical care delivery, with a specific emphasis on
improving ICU teams and patient outcomes. A key part of her
research and advocacy has focused on supporting nursing through
policy and practice development, at all levels. Her work has been
published in leading journals such as New England Journal of
Medicine, JAMA, and American Journal of Respiratory and Critical
Care Medicine. She is a long-standing collaborator of Dr. Olga
Yakusheva.
Tim Cunningham, RN, DrPH, FAAN
Tim Cunningham is Co-Chief Well-Being Officer at Emory Healthcare
and the Woodruff Health Sciences Center at Emory University. He
holds a joint appointment as adjunct associate professor at the Nell
Hodgson Woodruff School of Nursing at Emory, and serves as Vice
President of Practice and Innovation for Emory Healthcare. He
collaborates with interprofessional teams to support structural and
systemic well-being change for healthcare teams and professionals,
university staff and faculty, researchers, learners, and community
members. Before becoming an executive leader, Cunningham
worked as a performing artist and humanitarian clown with
organizations such as Clowns Without Borders and the Big Apple
Circus. He then became an emergency/trauma nurse and practiced
clinically for 7 years before completing his doctorate in public health,
focusing on resilience, well-being, and compassion. His publications,
including two books on self-care and a children’s book on resilience,
center around ideas of well-being, compassion, and fostering
creativity.
Rebecca Dellafave, MS, BSN, RN
Rebecca DelleFave has been in the practice of nursing for 18 years.
She obtained her undergraduate degree from Nazareth College of
Rochester (2005) and her Masters of Science, Leading Healthcare
Systems, from the University of Rochester (2011). She has held
numerous nursing and nursing leadership positions, and she is
currently serving as the Vice President and Chief Nursing Officer for
Ambulatory Services at Rochester Regional Health. In this role she
oversees clinical practice for more than 1,600 licensed and
unlicensed clinical support roles. She has been awarded Rochester
Business Journal’s Health Care Hero award in the area of Health
Care Staff (2017) and Nurse (2021) and published articles on
innovative nurse leadership models and ambulatory nurse sensitive
indictors. Currently Rebecca is co-leading the American Academy of
Ambulatory Care Nursing (AAACN) task force on Ambulatory Nurse
Sensitive Indicators (NSIs), which has a focus of publishing an
updated industry report. In 2022, Rebecca’s ambulatory organization
obtained its initial Magnet® Designation from ANCC. Rebecca has
previously served as the Chair of the Board of Directors for March of
Dimes, Finger Lakes, and is an active Girl Scout leader in her
community. She currently resides with her husband and two
daughters and has lived in the Rochester community for 34 years.
Victoria George, RN, PhD, FAAN
Dr. Victoria George is an international speaker and researcher who
has published extensively on creating professional practice
environments through shared leadership education, governance, and
peer review practices that lead to increased nurse autonomy.
Dr. George has been a Chief Nurse (CNE) Executive for over 30
years. In the CNE role for Aurora Health Care, Dr. George led the
first hospital system to Magnet® Designation in 1999. Before her
current role as Chief Executive Officer and Managing Partner of
Nursing Consulting Partners, LLC, she was the first SVP/CNO for a
68-hospital health system where she facilitated the design and
implementation of their first systemwide nursing governance mode.
Deena Gilland, DNP, RN, NEA-BC, FAAN
Deena Gilland has devoted the last 16 years of her career to building
structure, processes and sequential outcomes to enhance nursing
excellence in ambulatory care environments. As a result of her work
within her own health system, she helped lead the Emory Clinic, a
solely outpatient setting made up of more than 200 clinics,
ambulatory surgery centers, infusion centers, and other ambulatory
care areas, to one of the first ambulatory Magnet® Designations in
2022. An important part of that success was developing the
foundation and mechanisms to support professional governance in a
geographically dispersed outpatient setting. Gilland also worked with
the Emory School of Nursing to develop ambulatory nursing specific
required curriculum and clinical rotations for all BSN students. This
pipeline includes an ambulatory residency program for new
graduates to successfully begin their professional nursing career in
ambulatory care. From this work the first edition of the textbook,
Perspectives in Ambulatory Care, was written. This text is being used
by schools of nursing and practice settings to build foundations for
ambulatory nursing practice and improved patient care across the
continuum.
Gilland has presented her work nationally at multiple conferences
and webinars, including the American Academy of Ambulatory Care
Nursing (AAACN), the national Press Ganey conference, the Georgia
Association of Healthcare Executives, and with leaders from ANCC.
She currently serves on the American Organization for Nursing
Leadership (AONL) workforce committee bringing ambulatory
nursing and nursing leadership expertise into the ongoing work. She
was elected to the AAACN Board of Directors in 2018 and served as
the organization’s president from 2022 to 2023. The work she
developed and later published in the first edition of Perspectives in
Ambulatory Care, contributed to her election as a Fellow in the
American Academy of Nursing. She currently serves as Vice
President of Patient Care Services and Chief Nursing Officer of
Ambulatory Care at Emory Healthcare in Atlanta, Georgia.
Gilland attributes her ability to lead this work to the support of her
wonderful husband Dan, children Alison and Alex, son-in-law Josh,
and now beautiful grandchildren Luke and Violet.
Barb Haag-Heitman, PhD, RN
Barb Haag-Heitman has been consulting on peer review for over a
decade. She has written several books, publications, and research
works focused on advancing peer review for all nurses. Barb also
specializes in creating professional nursing practice environments
that foster high performance and sustained quality outcomes for
patients and nurses. Barb was a founding member of Nursing
Consulting Partners and consults on Magnet®, Pathway to
Excellene®, professional governance, and peer review nationally and
internationally.
Judith M. Hahn, PhD, RN, NEA-BC, CPHQ
Judith M. Hahn is Executive Director of Nursing Professional Practice,
Yale New Haven Hospital. Judi is the executive sponsor for Nursing
Professional Governance at Yale New Haven Hospital. She is
passionate about organizational structures and processes and how
they contribute to an environment where nurses thrive and find joy
and meaning in their work.
Rebecca Love, RN, BS, MSN, FIEL
Rebecca Love is an experienced nurse executive and first nurse
featured on Ted.com, and is one of LinkedIn’s Top Voices. Rebecca
was the first Director of Nurse Innovation and Entrepreneurship in
the United States at Northeastern School of Nursing—the founding
initiative in the country designed to empower nurses as innovators
and entrepreneurs, where she founded the Nurse Hackathon. This
movement has led to transformational change in the nursing
profession. In early 2019, Rebecca, along with a group of leading
nurses in the world, founded and is President of SONSIEL: The
Society of Nurse Scientists, Innovators, Entrepreneurs & Leaders, a
nonprofit that quickly attained recognition by the United Nations as
an Affiliate Member to the UN. Rebecca is an experienced Nurse
Entrepreneur, founding HireNurses.com in 2013, which was acquired
in 2018 by Ryalto, LTD UK, where she served as the Managing
Director of U.S. Markets, until its acquisition in 2019. Currently,
Rebecca serves as the Chief Clinical Officer of IntelyCare, Inc.
Rebecca is passionate about empowering nurses and creating
communities to help nurses innovate, create, and collaborate to start
businesses and inventions to transform health care.
Rebecca holds an MS in Nursing from Northeastern University, a
BA in International Relations/Spanish from Boston University, and
sits on the Board of NextGen Ventures, Health Science
Entrepreneurs at Northeastern University and the Host Committee
for the Massachusetts ACLU. She currently lives in Marblehead,
Massachusetts, with her husband and three children.
Kathy Malloch, PhD, MBA, RN, FAAN
Kathy Malloch is a leadership consultant and educator residing in
Glendale, Arizona. She is currently President of KMLS, LLC and
Associate Director for Education and Evidence-Based Regulation at
Arizona Board of Nursing, and she is Past President of the Arizona
Board of Nursing and Clinical Professor, The Ohio State University,
College of Nursing.
Nancy May, DNP, RN, AMB-BC, NEA-BC, FAAN
Dr. May began working at the University of Michigan in 2015 as the
Chief Nursing Officer for ambulatory care and in 2019 was appointed
as the Chief Nurse Executive (CNE) for the University of Michigan
Health System. As CNE she is responsible for regulatory standards
and nursing practice across the health system. She has held
leadership roles at Cleveland Clinic and served as a Chief Nursing
Officer at Baylor Scott and White in Texas Health System.
Nancy became involved with nursing associations in the 1990s and
has served on many boards, including an appointment on the
American Organization of Nurse Leaders (AONL) representing
ambulatory care nursing since 2019. In addition, she has served on
the American Academy of Ambulatory Care Nursing’s (AAACN) Board
advocating for the RN and the impact that nurses play in quality and
safety, along with the development of tools for care coordination and
transition management, and a transition to practice compendium for
the RN into ambulatory care. Later she was appointed president of
AAACN and was the Board liaison that drove the agenda for
development of Nurse Sensitive Indicators (NSIs) by partnering with
CALNOC to pilot indicators at over 150 sites. An industry report on
NSIs was published, and now the NSIs are used by Magnet®
organizations around the globe.
Continuing to advocate for outcomes that nursing impacts, Dr. May
is a Magnet® Commissioner for the American Nurse Credentialing
Center. She has also participated on task forces with the Institute of
Health Improvement, Joint Commission Nursing Advisory Board, and
American Medical Group Association CNO Council and chaired a task
force for the AONL on value-based payment models.
Dr. May is Board-certified by the ANCC in Nurse Executive
Advanced, Ambulatory Care and is a Fellow in the Academy of
Nursing.
Karen M. Mayer, PhD, MHA, RN, NEA-BC, FACHE
Karen M. Mayer is Assistant Professor, Rush College of Nursing, Rush
University, and Nursing Excellence Liaison, Rush University Medical
Center, with 14 years of experience as Vice President/Chief Nursing
Officer at Rush Oak Park Hospital. Karen serves as a board member
for the Forum for Shared Governance, a consultant for the quality
committee at Lewis University, and as a guest speaker for the Illinois
Organization of Nurse Leaders (IONL) Fellowship Program and many
area colleges of nursing on the topic of professional governance as
well as finding fit after graduation.
Cynthia McCurren, PhD, RN, FNAP
Cynthia McCurren is the Dean of Nursing at the University of
Michigan–Flint and the 2022–2024 Chair, Board of Directors of the
American Association of Colleges of Nursing. She was Co-Chair of
the Essentials Task Force (AACN, 2021), and a member of the Task
Force on AACN’s Vision for Nursing Education. She is committed to
intentional academic/practice partnerships to ensure a shared vision
for the transformation of nursing education and practice.
Kevin K. McEwan, DNP, RN, NEA-BC
Dr. Kevin McEwan is a Chief Nursing Officer at Madisonhealth,
President of Nurse Leaders of Idaho, ANCC Magnet® Appraiser, and
former Board member for American Organization for Nursing
Leadership (AONL). He has led multiple organizations to Magnet®
and Pathway to Excellence® Designation. He has a passion for
promoting emerging nurse leaders through professional development
and governance.
Mary Theresa (MT) Meadows, DNP, MBA, RN
MT Meadows is a nursing leadership development consultant. She is
currently President of Meadows Consulting Group, LLC, Lake Bluff,
Illinois, and is Retired Director Professional Practice, American
Organization for Nursing Leadership (AONL).
Paula M. Meek, PhD, FAAN, ATSF
Dr. Meek is the Assistant Dean for the PhD program at the University
of Utah and is committed to supporting and promoting the next
generation of nurse scientists. Dr. Meek has investigated symptom
appraisal, treatment, and management for over 20 years and
specializes in longitudinal measurement used to evaluate symptoms
in both chronic and acute phases of illnesses. She helped develop
and test several questionnaires that capture symptom intensity and
burden and helped test the psychometric properties of the Verran
Professional Governance Scale. Dr. Meek is a Fellow of the American
Thoracic Society and has been a member of five expert panels of the
American Thoracic Society and a systematic review panel. Dr. Meek
is a Fellow of the American Academy of Nursing and serves on the
fellow selection committee.
Angela Moss, PhD, RN, APN-BC, FAAN
Dr. Moss is an expert in academic-practice partnerships—whereby
universities partner with community-based organizations to improve
population health, students are afforded community-based learning
opportunities, and faculty expertise is leveraged to disseminate
population health best practice evidence based on broad scales. For
the past 17 years, she has maintained an active community-based
nursing practice as an adult nurse practitioner and, as a faculty
member, has studied, participated in, and contributed to the
development of the Rush College of Nursing (CON) Academic
Practice program. In her administrative role as assistant dean of
faculty practice, Dr. Moss supervises over 25 teams of over 100
community-based nurse and NP faculty clinicians, students, and
interdisciplinary professionals including community health workers.
Collectively, her work represents a philosophical shift in nursing
education and community-based nursing clinical practice with a
refreshed focus on population health and health equity. Dr. Moss will
create a national nursing workforce prepared to meet and lead
health initiatives addressing our nation’s public health crises such as
poverty, gun violence, opioid misuse, obesity, social isolation, and
high infant-maternal mortality.
Sharon H. Pappas, RN, PhD, NEA-BC, FAAN
Sharon H. Pappas is the Chief Nurse Executive for Emory Healthcare.
She is a member of Emory Healthcare and the Woodruff Health
Science Center’s senior leadership teams and is responsible for
nursing practice across Emory’s hospitals, ambulatory care, and
post-acute agencies. With five Emory Healthcare operating units
designated as Magnet®, she works to establish this same nursing
excellence as a distinctive competency throughout Emory
Healthcare.
Dr. Pappas has focused her scholarship on the role nurses and the
nursing environment play in patient safety and hospital costs. She is
a faculty member for the Nell Hodgson Woodruff School of Nursing.
Sharon is a member of the American Organization for Nursing
Leadership (AONL) where she served as a Board member and
currently represents AONL on the Commission on Magnet® for the
American Nurses Credentialing Center. She currently chairs the
Commission on Magnet (COM). Sharon is a Fellow in the American
Academy of Nursing, where she is past Chair of the Expert Panel on
Building Health System Excellence. Dr. Pappas served on the
National Academy of Science, Engineering, & Medicine Committee on
Systems Approaches to Improve Patient Care by Supporting Clinician
Well-being.
Sharon is married to Greg Pappas and has two daughters, Kristen
and Ruth.
Jessica Lorre Polk, DrPH, MPH, BSN, RN
Jessica Polk has a diverse and comprehensive background in the
healthcare field, with experience in various inpatient, ambulatory,
and public health settings. She is passionate about improving the
health of vulnerable patient populations and having an impact on
health outcomes by advocating for health equity and bridging the
gaps in the fragmented U.S. healthcare system.
Jessica was awarded the prestigious Gates Millennium Scholarship
funded by the Bill & Melinda Gates Foundation. This scholarship
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Mat tikar dŭmpas
Box peti kaban
Road jalan malakau
Bridge jambātan
Bow panah
Arrow anak panah
Spear tombak bangkau
Sword pedang
Chopping-knife parang puduk
Boat prahu awang
Canoe sampan
Spirit hantu
Man lakilaki mama
Woman perampuan babai
Husband laki karūma
Wife bini karūma
Father bapa ama
Mother ma ina
Grandfather nenek
Child anak wata
Son anak lakilaki wata mama
Daughter anak perampuan wata babai
Brother sudara lakilaki pegari mama
Sister sudara perampuan pegari babai
Old tuah lukus
Young muda meñguda
Boy budak wata
Girl anak dara raga
THE END.
London: Printed by Smith, Elder & Co., Little Green Arbour Court, Old Bailey, E.C.
FOOTNOTES:
[1] Trusan, means a passage connecting one stream with
another, or a short cut joining two reaches of the same stream.
[2] I may remark here that the map I had with me had been
constructed during my former journeys, and I verified it as I
proceeded.
[3] The Murut tribe, who formerly inhabited the Madalam
branch of the Limbang, and occupied the country round the base
of the mountain of Molu.
[4] A pikul is 133⅓ lb.
[5] A gantang is six pints.
[6] Gray shirtings.
[7] There are two ranges, which explain why I was so puzzled
by the different appearances presented by these mountains. In
fact, it was only afterwards I discovered that in ascending the
Trunan we had got under the “child of Molu” as it is called by the
Malays; had we continued ascending the Madalam, we should
have found ourselves under the great peak.
[8] The best kinds are Timbaran and Damuan.
[9] Journal of the Indian Archipelago, vol. vi. page 562.
[10] I think it very probable that he meant that Andrew was the
name of the captain, and that he was one of the crew of Maria
Frederica, whose capture is referred to farther on.
[11] This horrible story was originally told us by Mr. Wyndham,
but I made many subsequent inquiries, and had every particular
of the story confirmed by trustworthy native authority. A man
named Si Bungkul, who was a captive at Tungku at the time, told
me he saw an English captain buried up to his waist, and that an
elderly Lanun chief, called Rajah Muda, who was famous for his
long beard, walked up to him, and with one blow cleft him from
the shoulder to the side with his kempilan or heavy Lanun sword.
[12] I may notice that many of the under estimates of the
population of this city arise from reckoning the houses at two
thousand, and multiplying that number by five, as the average of
a family. But in Brunei this system will not apply, as to test it, we
have made above a hundred inquiries of different men, as to the
amount of inhabitants in each of their houses, and the highest
was the sultan, with seventy in his palace, while the lowest was
seven in a small fisherman’s hut. I think in placing the average at
fifteen, and reducing the number of houses, I am understating the
population, which is considered by many to exceed forty
thousand.
Transcriber’s Notes:
1. Obvious printers’, punctuation and spelling errors have been corrected

silently.
2. Where hyphenation is in doubt, it has been retained as in the original.
3. Some hyphenated and non-hyphenated versions of the same words have

been retained as in the original.
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Professional Governance for Nursing:

The Framework for Accountability,

Cambridge IGCSE and O Level History Workbook 2C - Depth

Business and Professional Communication: KEYS for

Scope and Standards of Practice for Professional

Professional Nursing Concepts: Competencies for Quality

The Doctor of Nursing Practice Project: A Framework for

Scope and Standards of Practice for Professional

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CHAPTER 1 Conceptual Foundations for Nursing

CHAPTER 2 Principles of Professional Governance in

CHAPTER 3 Nursing Leadership Behaviors as Foundational

CHAPTER 4 Professional Governance in a Healthcare

CHAPTER 6 The Role of the Nurse Manager in Professional

CHAPTER 7 Peer Accountability and Relationships in a

CHAPTER 8 The Functional Framework, Bylaws, and

CHAPTER 9 Application of Professional Governance

CHAPTER 10 The Measurement of the Effectiveness of

CHAPTER 11 Transforming Outcomes—The Impact of

CHAPTER 12 Assuring Sustainability of Professional

CHAPTER 13 Fostering Professionalism from the Academy

CHAPTER 14 Value-Informed Nursing Practice and

CHAPTER 15 Beyond the Organization―Governing Our

CHAPTER 1 Conceptual Foundations for Nursing Professional

CHAPTER 2 Principles of Professional Governance in

CHAPTER 3 Nursing Leadership Behaviors as Foundational

CHAPTER 4 Professional Governance in a Healthcare System

CHAPTER 5 The Role of the Clinical Care Nurse in Nursing

CHAPTER 6 The Role of the Nurse Manager in Professional

CHAPTER 7 Peer Accountability and Relationships in a

CHAPTER 8 The Functional Framework, Bylaws, and

CHAPTER 9 Application of Professional Governance

CHAPTER 10 The Measurement of the Effectiveness of

CHAPTER 11 Transforming Outcomes―The Impact of

CHAPTER 12 Assuring Sustainability of Professional

CHAPTER 13 Fostering Professionalism from the Academy to

CHAPTER 15 Beyond the Organization―Governing Our

The editors and authors would like to acknowledge the support,

Professional governance is a lifestyle. It’s an identity. Professional

Rachel E. Start, MSN, RN, NEA-BC, FAAN

About the Editors

Rachel E. Start, MSN, RN, NEA-BC, FAAN

Aney Abraham, DNP, RN, NE-BC

1. Obvious printers’, punctuation and spelling errors have been corrected

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