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Leadership Style And Nursing Retention, Brenae J. Reason Dec 2023

Leadership Style And Nursing Retention, Brenae J. Reason

MSN Capstone Projects

Nursing is the heart of healthcare, for decades we have been the drivers of innovation and have contributed to so many advancements in the profession. Even with nursing being a sincere passion amongst many nurses, there is an alarming trend of nurses who are faced with burnout (Brusie, C., n.d.). It has been reported that 1 in 5 nurses left their position in one particular health system (Andreyeva et al., 2023). It is also noted that turnover can be costly for organizations (Zuniga et al., 2019). While there are a multitude of reasons nurses could be leaving their companies, one …


The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins Dec 2023

The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins

MSN Capstone Projects

In 2023, the National Council of State Boards of Nursing revealed that 100,000 nurses left the workforce during the COVID-19 pandemic and another 900,000 plan to leave by 2027 due to stress, burnout, and retirement. Identifying and implementing practical strategies to reduce voluntary turnover as a result of stress and burnout is a top priority for nursing leaders across the country. Work engagement and job satisfaction have well been documented in the literature as antidotes to occupational stress and burnout in the nursing profession (Schaufeli & Bakker, 2004; Pressley & Garside, 2022). Evidence suggests that implementing shared governance is a …


The Cancer Nursing Workforce In Australia: A National Survey Exploring Determinants Of Job Satisfaction, Natalie Bradford, Elizabeth Moore, Karen Taylor, Olivia Cook, Lucy Gent, Theresa Beane, Natalie Williams, Kimberly Alexander, Erin Pitt, Jemma Still, Cameron Wellard, Gemma Mcerlean, Deborah Kirk, Leanne Monterosso, Alexandra Mccarthy, Zerina Lokmic-Tomkins, Jessica Balson, Priscilla Gates Dec 2023

The Cancer Nursing Workforce In Australia: A National Survey Exploring Determinants Of Job Satisfaction, Natalie Bradford, Elizabeth Moore, Karen Taylor, Olivia Cook, Lucy Gent, Theresa Beane, Natalie Williams, Kimberly Alexander, Erin Pitt, Jemma Still, Cameron Wellard, Gemma Mcerlean, Deborah Kirk, Leanne Monterosso, Alexandra Mccarthy, Zerina Lokmic-Tomkins, Jessica Balson, Priscilla Gates

Research outputs 2022 to 2026

Background: To maintain and improve the quality of the cancer nursing workforce, it is crucial to understand the factors that influence retention and job satisfaction. We aimed to investigate the characteristics of cancer nurses in Australia and identify predictors of job satisfaction. Methods: We analysed data from an anonymous cross-sectional survey distributed through the Cancer Nurses Society Australia membership and social media platforms from October 2021 to February 2022. The survey was compared to national nursing registration data. Data were analysed with non-parametric tests, and a stepwise, linear regression model was developed to best predict job satisfaction. Results: Responses were …


Transformational Leadership Training For Leaders, Kristie Gilliland Dec 2023

Transformational Leadership Training For Leaders, Kristie Gilliland

Electronic Theses and Dissertations

The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …


Breaking The Transactional Mindset: A New Path For Healthcare Leadership Built On A Commitment To Human Experience, Kirsten Krull, Jerry Mansfield, Jennifer Gentry, Karen Grimley, Barbara Jacobs, Jason Wolf Nov 2023

Breaking The Transactional Mindset: A New Path For Healthcare Leadership Built On A Commitment To Human Experience, Kirsten Krull, Jerry Mansfield, Jennifer Gentry, Karen Grimley, Barbara Jacobs, Jason Wolf

Patient Experience Journal

Numerous health care publications have focused on the compelling need to improve patient experience and the associated improvements necessary to address workforce well-being. The COVID-19 pandemic exacerbated and illuminated long-standing problems in health care including workforce shortages, inequity in health care delivery outcomes, care provider burnout, and overall societal structural racism.1,2 The Beryl Institute’s Nursing Executive Council (NEC) manuscript Rebuilding a Foundation of Trust: A Call to Action in Creating a Safe Environment for Everyone3 focused on actions and behaviours to heal relationships and build trust between care providers and leaders with commitments to safety, empathy, shared decision …


Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster Sep 2023

Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster

Electronic Theses and Dissertations

Nurse turnover is prevalent among new graduate nurses. Many new graduate nurses feel unsupported by their peers, lack self-confidence, or feel overburdened due to the workload assigned to them. New graduate nurses with support systems are more likely to stay with an organization. Research suggests the creation of a supportive environment for new graduate nurses to help increase nurse retention in this demographic. A unit-based transition onboarding program was launched to create a supportive environment to help retain new graduate nurses on a medical-surgical unit. New graduate nurses with at least 1 to 3 years of experience completed a Likert-type …


From Crisis Management To Multi-Level Interinstitutional Partnerships: Development Of The Southeastern Conference Deans Nursing Coalition, Jeannette O. Andrews, Victoria Niederhauser, Julie Sanford, Suzanne Prevost, Demetrius Porche, Janie Heath, Pamela Jeffries, Nancy Fahrenwald Jun 2023

From Crisis Management To Multi-Level Interinstitutional Partnerships: Development Of The Southeastern Conference Deans Nursing Coalition, Jeannette O. Andrews, Victoria Niederhauser, Julie Sanford, Suzanne Prevost, Demetrius Porche, Janie Heath, Pamela Jeffries, Nancy Fahrenwald

School of Nursing Faculty Publications

The Southeastern Conference (SEC) Nursing Dean's Coalition is a purposeful alliance organized to collaboratively address several challenges that arose during the COVID-19 pandemic. Over the last three years, this strategic team of academic leaders has evolved from a crisis response team to a multidimensional support team, leveraging both individual and collective strengths, to provide several benefits to the dean members, as well as other SEC nursing faculty members, students, and institutions. Participation has grown from the original 12 deans to engage a broader team of associate deans and nurse leaders in faculty development, research, service, and diversity, equity, and inclusion. …


Implementing Ethics Education For Nurse Managers, Mona L. Lateyice, Rachel E. Marzec May 2023

Implementing Ethics Education For Nurse Managers, Mona L. Lateyice, Rachel E. Marzec

Doctor of Nursing Practice Scholarly Projects

Background: Every day, nurses are faced with making decisions for patient care and may come across complicated ethical decisions. Ethical practice is essential in every health care organization in providing care and how they conduct themselves (ANA, 2015). Nurse managers are responsible for ensuring ethical standards are met by nursing staff.

Problem: Nurse managers are faced with ethical problems more than fifty percent of their work time (Aitamaa, 2019). There are studies that show nurse managers and nurses have difficulty solving ethical problems because they lack understanding of ethical principles (Huang, et al., 2020). Evidence shows nurses are deficient in …


Go Forth With Wisdom & Leadership, Kristen Montgomery Apr 2023

Go Forth With Wisdom & Leadership, Kristen Montgomery

Epsilon Sigma at-Large Research Conference

see attached pp


Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment Jan 2023

Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment

Faculty Publications

The purpose of this article is to guide nurse executives in building learning capacity within their organizations. The Organizational Learning Road Map provided is grounded in the American Organization for Nursing Leadership’s Nurse Leader Core Competencies. Key steps include: developing one’s self as a learning leader, sharing a learning-focused vision for the organization, establishing a culture of learning, charting a course toward becoming a learning organization, developing a leadership team to support learning throughout the organization, measuring progress toward the vision, and sustaining momentum.


Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney Jan 2023

Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney

Walden Dissertations and Doctoral Studies

Nursing leadership is the cornerstone of the ever-changing landscape of healthcare. Minimal courses are included in nursing curriculums to prepare nurses to become proficient and develop knowledge of nursing leadership styles. There is a direct correlation of evidence-based leadership styles that impact effective communication, improved patient outcomes, succession planning, nursing retention, and relationship management. In an effort to bridge the gap of knowledge, an educational face-to-face training was developed and presented to new nursing staff in an orientation setting. The project practice question focused on commitment from nursing staff to implement increased knowledge of nursing leadership styles into their practice. …


Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney Jan 2023

Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney

Walden Dissertations and Doctoral Studies

Nursing leadership is the cornerstone of the ever-changing landscape of healthcare. Minimal courses are included in nursing curriculums to prepare nurses to become proficient and develop knowledge of nursing leadership styles. There is a direct correlation of evidence-based leadership styles that impact effective communication, improved patient outcomes, succession planning, nursing retention, and relationship management. In an effort to bridge the gap of knowledge, an educational face-to-face training was developed and presented to new nursing staff in an orientation setting. The project practice question focused on commitment from nursing staff to implement increased knowledge of nursing leadership styles into their practice. …


The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter Dec 2022

The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter

Master's Projects and Capstones

Problem: The assistant nurse manager (ANM) role is considered an entry-level management position and is not intended as a permanent career role. The unintended consequence is that there is a high rate of organizational turnover, making it challenging to build and retain a solid, cohesive, and productive team.

Context: A new manager of a float pool team in a 166-bed community hospital found that with little financial investment, a significant impact is made by holding a safe space for listening to the ANM team and designing education and training around what is most important to frontline managers.

Interventions: A baseline …


Leading With Emotional Intelligence In Perioperative Nursing: An Integrative Review, Elise Rhodes, Paula Foran Dec 2022

Leading With Emotional Intelligence In Perioperative Nursing: An Integrative Review, Elise Rhodes, Paula Foran

Journal of Perioperative Nursing

Background: Emotional intelligence has increasingly become synonymous with effective leaders within successful organisations. The perioperative environment is a complex setting within an organisation that requires nurse leaders to possess self-awareness that allows them to understand and control their emotions while using this insight to benefit others. Perioperative nurse leaders can use their emotional intelligence to manage conflict, negotiate between multidisciplinary team members, motivate staff to provide high level safe patient care and promote a positive work culture that can increase staff retention.

Review methods: A literature search of databases of CINAHL, Pubmed, Medline and Scopus was conducted to extract qualitative, …


Teamwork That Affects Outcomes: A Method To Enhance Team Ownership, Brian Carlson, Richelle Graham, Brad Stinson, Jordan Larocca Aug 2022

Teamwork That Affects Outcomes: A Method To Enhance Team Ownership, Brian Carlson, Richelle Graham, Brad Stinson, Jordan Larocca

Patient Experience Journal

Healthcare is the ultimate team sport, and this case study explores how to build teamwork across teams. The ability for nursing, environmental services and food and nutrition services to work collaboratively to benefit patients is paramount to a patients experience and outcomes. The case study describes how the work was done to build teams and then improved outcomes in both patient and employee experiences. The learnings are applicable to any team setting not just those described in this case study.

Experience Framework

This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework ( …


Hidden Relationships: Perspectives On Leadership And Management In Afghan Maternity Services - An Ethnographic Exploration, Rachel Arnold, Edwin Van Teijlingen, Kath Ryan, Immy Holloway Jun 2022

Hidden Relationships: Perspectives On Leadership And Management In Afghan Maternity Services - An Ethnographic Exploration, Rachel Arnold, Edwin Van Teijlingen, Kath Ryan, Immy Holloway

Journal of Asian Midwives (JAM)

Introduction: Health system leaders have a vital role to play in ensuring the delivery of high-quality care. Improving the quality of healthcare, particularly in low-income countries often focuses on the performance of healthcare providers and the availability, acceptability, and uptake of services. The role that health service leaders play in facilitating effective care has received less attention in the literature. This study explored the perspectives of Afghan maternity care providers, managers and other stakeholders on leadership and the provision of quality maternity care.
Methods: This ethnographic study used semi-structured interviews, participant observation, and background interviews for data collection. …


The Development Of Evidence-Based Practice Mentors Through A Competency-Based Educational Program: A Leadership Perspective, Laura C. Moore, Tracy L. Brewer, Pamela Hardesty, Diana Burdick May 2022

The Development Of Evidence-Based Practice Mentors Through A Competency-Based Educational Program: A Leadership Perspective, Laura C. Moore, Tracy L. Brewer, Pamela Hardesty, Diana Burdick

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

One of the most productive strategies to achieving the safest, high-quality patient care is promoting the widespread use of evidence-based practice (EBP) in clinical settings. Despite the considerable emphasis and support for EBP, many clinicians still fail to translate current research into clinical practice. To address the pervasive lack of EBP among clinicians, an EBP project was developed at an acute care pediatric facility to increase EBP utilization via the implementation of a virtual EBP educational program. The findings from this project describe the establishment of an EBP educational program with the intent to create a critical mass of EBP …


The Impact Of Covid-19 On Nurse Leadership Characteristics, Karen Fowler, Leslie K. Robbins May 2022

The Impact Of Covid-19 On Nurse Leadership Characteristics, Karen Fowler, Leslie K. Robbins

Nursing Faculty Publications

Background: Nurse leaders are vital for improving nursing efficiencies and the quality of care that they provide during a crisis and its aftermath. The value of positive leadership characteristics has never been more critical than during the COVID-19 pandemic. Functioning in a crisis mode required nurse leaders to demonstrate the necessary skills for clear communication and solid leadership. Therefore, nursing leadership, especially in emergencies such as the COVID-19 pandemic, needs to be transformative in the sense that leaders are informational, motivating, and able to advance the organization, notwithstanding a global pandemic. Timely leadership research during and after COVID-19 is crucial …


Factors Contributing To Nurse Burnout In Oncology, Caroline Withers May 2022

Factors Contributing To Nurse Burnout In Oncology, Caroline Withers

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Nurse burnout is a pressing concern for healthcare with significant implications for all areas of nursing and patient outcomes. However, the specialty of oncology experiences burnout differently than other specialties for a multitude of reasons. This literature review aims to determine factors that contribute to nurse burnout within oncology, and identify evidence-based prevention strategies. The twenty studies included in the review underscore the crucial role of management and leadership in the prevention of nurse burnout. Further education and research are needed to better understand causes of burnout, as well as proper interventions. Interventions need to be established on a hospital …


The Effects Of A Formal Organizational Program On Nursing Supervisor Self-Perception Of Leadership, Jonathan Allen Judy-Del Rosario Apr 2022

The Effects Of A Formal Organizational Program On Nursing Supervisor Self-Perception Of Leadership, Jonathan Allen Judy-Del Rosario

Doctor of Nursing Practice Scholarly Projects

Nursing house supervisors oversee hospital operations during evenings, nights, weekends, and holidays, yet many feel disconnected from others in the nursing leadership team. These individuals work as the sole leader on duty, having limited interaction with the daytime leaders and often lack formal leadership development. This quantitative, quasi-experimental study explored the effects of implementing a formal educational and team building program on the perception of the supervisor’s leadership skills as well as collaboration with the leadership team. The Leadership Practices Inventory and the Collaborative Behavior Scale – Shortened were the two surveys administered to assess the effects of this program. …


When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores Apr 2022

When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores

Dissertations

In healthcare, workgroup mistreatment is a pervasive problem that begins during medical education (medical and nursing school) and becomes embedded in the “hidden curriculum of professionalism,” which dissuades and even punishes learners for talking about abuse they witness. Furthermore, the mistreatment of healthcare providers (HCPs) pervades all disciplines in the healthcare delivery chain due to a combination of cultural factors, systemic pressures, dysfunctional hierarchies, and leadership’s tolerance of intimidating and disruptive behaviors. Not surprisingly, 18% of U.S. HCPs have left the medical field since the start of the COVID-19 pandemic, and burnout, stress, anxiety, and increased workloads have been identified …


The Impact Of A Formal Leadership Development Program On Charge Nurse Leadership Competencies: An Integrative Review, Ellen Mae Hudson Feb 2022

The Impact Of A Formal Leadership Development Program On Charge Nurse Leadership Competencies: An Integrative Review, Ellen Mae Hudson

Doctoral Dissertations and Projects

This integrative review focuses on the current body of evidence for charge nurse leadership development (CNLD). It identifies common skills and competencies, provides a synthesis of existing training practices, and identifies gaps in the evidence. A thorough literature search of electronic databases and reference lists was completed, resulting in the identification of 22 studies published between 2011 and 2020. Data from the selected studies were evaluated and categorized into common themes; virtually all reported positive outcomes for the charge nurse development program implemented. Two of the studies reviewed were integrative reviews that compared identified themes and methodologies. Four studies were …


Impact Of Emotional Intelligence On Interprofessional Teamwork, Interprofessional Communication, And Interprofessional Leadership, Kathleen M. Cox Jan 2022

Impact Of Emotional Intelligence On Interprofessional Teamwork, Interprofessional Communication, And Interprofessional Leadership, Kathleen M. Cox

Nursing Theses and Dissertations

Objective: The purpose of this body of work was to explore relationships among emotional intelligence (EI) and interprofessional (IP) competency domains to enhance IP team dynamics and communication.

Background: Decentralization of healthcare delivery may hinder effective handoffs creating opportunity for miscommunication of vital information and subsequent medical errors. Fostering effective communication is paramount for IP teams; however, differing communication styles can promote misunderstanding and conflict. Behavioral aspects of team dynamics and communication that comprise EI may be a solution but are rarely addressed in educational and safety programs.

Methods: Included in this portfolio are three manuscripts that help elucidate …


Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed Jan 2022

Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed

Walden Dissertations and Doctoral Studies

AbstractThe National Academy of Medicine (NAM) has called for more leadership, more accountability, and increased education and training of health care leaders. The NAM has demanded that nurses participate in health care policy making, increase their knowledge of research and data collection, advise leaders across the business world, train and educate seamlessly, and practice to the full extent of their licensure. The purpose of this qualitative phenomenological study was to explore the lived experiences of 12 influential nurse leaders from the state of Arizona. Transformational leadership theory provided the framework for the study. Semi-structured interview data were transcribed, coded, and …


Leadership Styles And Rn Turnover Intentions In Long-Term Care Facilities, Kelli M. Casey Jan 2022

Leadership Styles And Rn Turnover Intentions In Long-Term Care Facilities, Kelli M. Casey

Walden Dissertations and Doctoral Studies

Employee turnover is a concern for leaders in the nursing home industry because employees with turnover intentions may negatively impact the continuity of operations and strategic plans, resulting in poor quality of care for residents. Grounded in House's path-goal theory, the purpose of this quantitative, correlational study was to examine the relationship among idealized attributes, idealized behaviors, inspirational motivation, intellectual stimulation, individualized consideration, contingent reward, management by exception-active management by exception-passive, and turnover intentions in RNs. The independent variables were the subcategories of transformational and transactional leadership. The dependent variable was turnover intentions. Participants included 110 nonmanagement RNs working in …


Relationship Between Ethnic Diversity Of Nursing Leadership And Bedside Nursing Engagement, Neneh Iyesha Kamara Jan 2022

Relationship Between Ethnic Diversity Of Nursing Leadership And Bedside Nursing Engagement, Neneh Iyesha Kamara

Walden Dissertations and Doctoral Studies

Ethnic diversity in the U.S. nursing workforce had not been well researched. This aspect of nursing is important to the advancement of the profession because ethnic diversity of nursing helps reduce health care disparities. The purpose of this quantitative correlational study was to examine the possible relationship between the perceived ethnicity of nurse leaders and the engagement of bedside nurses. Culture of care theory was the theoretical foundation for this study. The Utrecht Work Engagement Scale with additional demographic questions was used to survey 53 bedside nurses with 2 or more years of experience. Simple regression was used to analyze …


Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky Jan 2022

Age And Experience As Factors For Predicting Emotional Intelligence In Nurse Managers, Patricia Gursky

Walden Dissertations and Doctoral Studies

Emotional intelligence (EI) is defined as the capacity to recognize and manage emotions and feelings to guide behaviors which is an ability that is crucial for nurse mangers to possess. Understanding the key factors for predicting emotional intelligence in nurse managers may influence hiring practices and the appointment of managers who will influence job satisfaction, employee engagement, retention, and turnover. The purpose of this quantitative predictive correlational study, guided by King’s theory of goal attainment and Mayer and Salovey’s four-branch ability model of EI, was to determine whether age, years of experience as a nurse, and years of experience as …


Tackling Burnout: Investing In Nurse Managers To Secure The Future Of Nursing, Enhance Manager Effectiveness, And Support High Quality Patient Care, Corey French Jan 2022

Tackling Burnout: Investing In Nurse Managers To Secure The Future Of Nursing, Enhance Manager Effectiveness, And Support High Quality Patient Care, Corey French

DNP Scholarly Projects

Background: Burnout is a widespread, pervasive issue the healthcare industry. Many efforts related to burnout reduction have been focused on front line caregivers but there is continued opportunity to address burnout in leadership. The global aim of this quality improvement project was to reduce burnout among the nursing leadership team at a large, academic medical center in the greater Boston area.

Problem Description: A preliminary survey was completed to assess for the presence of burnout within the leadership team. Results revealed that more than half of the nurse leaders surveyed were experiencing burnout at least 50% of the time. This …


Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson Jan 2022

Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson

Walden Dissertations and Doctoral Studies

This project was an evaluation of a quality improvement (QI) initiative conducted in a large medical enterprise to address the problem of poor performance of their hospitals in accreditation surveys. The desired outcome was to evaluate whether an innovative plan of correction process was impactful in reducing the negative outcomes of regulatory and accreditation surveys. The practice-focused question guiding this project addressed the effect of the pre-accreditation evaluation and a plan of correction process in this QI initiative on reducing requirements for improvement (RFI) and condition-level deficiencies (CLD) cited in a recent The Joint Commission survey review. This project was …


Leadership Rounding To Improve Patient Satisfaction In Pediatric Ambulatory Care, Tara J. Haskell Nov 2021

Leadership Rounding To Improve Patient Satisfaction In Pediatric Ambulatory Care, Tara J. Haskell

Student Scholarly Projects

Practice Problem: Low patient satisfaction has been linked to poor treatment compliance, patients leaving the practice, staff decreased job satisfaction, and high staff turnover (Haskard Zolnierek & DiMatteo, 2009; Prakash, 2010). Magnet reporting has identified wide discrepancies in ambulatory clinics, with some clinics reporting below benchmark patient satisfaction ratings.

PICOT: In pediatric ambulatory and primary care services, how will the implementation of leader-led customer service rounding, compared to current practice, increase family and/or patient satisfaction over 4 weeks?

Evidence: Key findings are that the rounding needs to be population-specific, intentional, and swiftly followed up when problems are identified. The body …