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N4685 Capstone

Capstone Reflective Journal Submit by 2359 CST Saturday of each module specified in Course Calendar. Name:

Sinidu Hailu

Date:

7 November 2020

Overview: Capstone Reflective Journal Each module you will make an entry into your Journal. You are asked to reflect on 3 of the key points for each module. Each entry should reflect on your understanding of the topic, your experiences and observations in your work environment or general nursing environment regarding the module topic. This is a cumulative document. You will save it to your own computer desktop or memory device and update it each week. You may choose to record more than one entry each week, especially if you have an “aha!” moment as a result of your reading, discussions, or experience. You will upload and submit the latest version of your Capstone Reflective Journal to Blackboard by 2359 the Saturday following each of the first six modules of this course. It is not necessary that your entries be formatted or written in any particular way because it is for your benefit. Your entries will only be reviewed to ensure that you are making sufficient progress and thinking deeply about the requirements in the course.

2020

N4685 Capstone Rubrics Use this rubric to guide your Journal entries. There will be total of 6 Journal entries for Modules 1-6. Each module you are expected to address 3 key points from the Module content, discuss how each point applies to your practice as a nurse, and, finally, how will your practice change in the future because of this information. In Module 7 your Journal entries will be used as you write the last paper for the program, the Synthesis Paper.

Journal Rubric for each Module T a r ge t

Criteria Address 3 Key Points from Module for each Journal entry

Una c c e pt a bl e

Di s c u s st h e3k e yp o i n t ss e l e c t e da n d Do e sn o t s u ffic i e n t l yr e c o r dc o n n e c t i o n s wh yt h e ya r ei mp o r t a n t o rme mo r a b l e . o rr e fl e c t i o n s ( 5 0p o i n t s )

( 0Po i n t s )

Co n n e c t RNBSNe x p e r i e n c e sf r o m e a c hk e yp o i n t t oc a r e e r g o a l s , p r i o r n u r s i n gp r a c t i c e , ap r e v i o u sRNBSN c o u r s e , n u r s i n gt h e o r i e so r r e s e a r c h . Ci t ea n dr e f e r e n c ea sn e c e s s a r y .

F a i l st oc o n n e c t RNBSNe x p e r i e n c e st o g o a l s , p r i o r n u r s i n gp r a c t i c e , c o u r s e wo r k , t h e o r i e so r r e s e a r c ht ok e ya r e a s a d d r e s s e do r n or e f e r e n c e s .

(50 points)

Relevance and Evidence Based Practice (25 points)

( 0p o i n t s ) ( 2 5p o i n t s )

Future (25 points)

De s c r i b e sh o wp e r s o n a l p r a c t i c ewi l l b e F a i l st od e s c r i b e sh o wp e r s o n a l p r a c t i c e d i ff e r e n t i nt h ef u t u r eb a s e do nRNBSNwi l l b ed i ff e r e n t i nt h ef u t u r eb a s e do n p r o g r a ma sar e s u l t o f t h e3k e ya r e a s RNBSNp r o g r a m a d d r e s s e d . ( 0p o i n t s ) ( 2 5p o i n t s )

Late submissions will be penalized 5% per day unless prior arrangements have been made with your Academic Coach to complete the assignment at a later time.

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N4585 Capstone

Instructions Each week, record your experiences, connections to your course goals, and reflections as they relate to the given prompts and/or your course project. You must record one entry each week, but may record more (insert rows as needed). You may find it helpful and rewarding to record one entry at the beginning of the week, think about the prompt during the week, then record another at the end of the week. For privacy, refer to patients, online colleagues, and/or coworkers with initials instead of names. Save this document to your own computer desktop or storage device after each entry to create a cumulative journal. You will upload the document and submit it each week by 2359 Saturday night. No Reflective Journal entry is made on Module 7. Remember that the more thoughtfully and intentionally you record your immediate reflections, the easier it will be for you to pull all your experiences and thoughts together for your Synthesis Paper in Module 7. Module Journal Entries A separate Journal entry is required for Modules 1-6 by 2359 Saturday of each indicated module. Provide details of your thinking, including insights, challenges, paradigm shifts, and goals. Identify previous course topics, readings, or research that relate to the prompt. Journal Entry

Module 1: Identify 3 key points form this module. Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Ke yPo i n t 1 Re s t r a i n t u s eo np a t i e n t st h a t a r ep u l l i n go u t n e c e s s a r yme d i c a l e q u i p me n t . T h i si si mp o r t a n t b e c a u s et h ep a t i e n t ma yb ea l e r t a n do r i e n t e da t b a s e l i n ea n di sc u r r e n t l yc o n f u s e da n dma yh a v ea l t e r e dme n t a l s t a t u sd u et oa n i n f e c t i o ns u c ha sau r i n a r yt r a c t i n f e c t i o n . I n t r a v e n o u sa n t i b i o t i c sma yb en e c e s s a r yf o r t h ep a t i e n t t og e t we l l a n d b a c kt ob a s e l i n e . Wi t ht h ef a mi l yi na g r e e me n t , r e s t r a i n t sma yb ee s s e n t i a l t ok e e pt h o s el i n e si nt h ep a t i e n t . Ad e q u a t es t a ffin g , h o we v e r , c a na l s op r e v e n t t h eu s eo f c o n d i t i o n sb ys t a y i n gwi t ht h ep a t i e n t a n do b s e r v i n g . I h a v es e e nav e r yc o n f u s e dp a t i e n t , a n dg e n e r a l l y , t h ep a t i e n t i sn o t c o n f u s e da t h o me . Th ep a t i e n t h a da na c u t e i l l n e s sa n dn e e d e dme d i c a t i o n s . Ho we v e r , t h ep a t i e n t c o n t i n u o u s l yr e mo v e dt h eI Va c c e s sa n da t t e mp t e dt og e t o u t o f b e d , a l t h o u g ht h ep a t i e n t wa saf a l l r i s k . Re s t r a i n t swe r en e c e s s a r yb e c a u s et h eo n e t o o n eo b s e r v a t i o n wa si n e ff e c t i v e . “ Us eo f s u c hd e v i c e sh a sc o meu n d e r i n t e n s es c r u t i n y , a sp h y s i c a l r e s t r a i n t c a nr e s u l t i na g i t a t i o n , c o n f u s i o n , d e c o n d i t i o n i n g , p r e s s u r eu l c e r s , s t r a n g u l a t i o n , d e a t h , a n da d v e r s ep s y c h o l o g i c a l e ff e c t s ”( s t a g se t a l . , 2 0 1 7 ) . T h eu s eo f r e s t r a i n t sh a st ob eu s e dc a r e f u l l y , a n dag r e a t d e a l o f e d u c a t i o nn e e d st oc o mewi t ht h eh e l po f l i mi t a t i o n st op r e v e n t t h eh a r m, a sme n t i o n e da b o v e . Re f e r e n c e s St a g g s , V . , Ol d s , D. , Cr a me r , E. , Sh o r r , R. , St a g g s , V . S. , Ol d s , D. M. , &Sh o r r , R. I . ( 2 0 1 7 ) . Nu r s i n gSk i l l Mi x , Nu r s eSt a ffin gL e v e l , a n dPh y s i c a l Re s t r a i n t Us ei nUSHo s p i t a l s : aL o n g i t u d i n a l St u d y . J GI M: J o u r n a l Of Ge n e r a l I n t e r n a l Me d i c i n e , 3 2 ( 1 ) , 3 5 4 1 . d o i : 1 0 . 1 0 0 7 / s 1 1 6 0 6 0 1 6 3 8 3 0 z Ke yPo i n t 2 Nu r s ePr a c t i t i o n e r s( NP)i nt h ea c u t ec a r es e t t i n g . Th eNPh a sc l i n i c a l e x p e r i e n c ewi t hp a t i e n t sa n di sf a mi l i a r wi t h c o n v e r s i n gwi t hme d i c a l s t a ffa n da n c i l l a r ys t a ffa t t h ec r i t i c a l f a c i l i t y . I wo r ki nas ma l l h o s p i t a l wi t hah o s p i t a l i s t a n dn u r s ep r a c t i t i o n e rt h a t wo r k so nt h eme d i c a l s u r g i c a l fl o o r a n dI CU. T h ep a t i e n t sa r es e e nb ye i t h e rt h e p h y s i c i a no r t h eNP . I h a v ef o u n dt h a t t h eNPi sab i t e a s i e rt ot a l kt oa n dd i s c u s sp a t i e n t c a r e , a st h e yh a v ea t o n e t i meh a v eb e e nan u r s ei nmys h o e s . I h o p et ob e c o mea nNPi nt h ef u t u r ea n de x p e c t t ob ea swe l c o mi n ga st h e NPI c u r r e n t l ywo r kwi t h . “ Ad v a n c e dn u r s i n gp r a c t i c ei sa s s o c i a t e dwi t hn u r s e swh oh a v ea ne x p e r t k n o wl e d g e

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b a s e , c o mp l e xd e c i s i o n ma k i n gs k i l l s , a n de x p e r t c l i n i c a l j u d g me n t ” ( Ha l l i d a ye t a l . , 2 0 1 8 ) . Re f e r e n c e s Ha l l i d a y , S. , Hu n t e r , D. J . , &Mc Mi l l a n , L . ( 2 0 1 8 ) . Wa r ds t a ffp e r c e p t i o n so f t h ea d v a n c e dn u r s ep r a c t i t i o n e r ’ sr o l e i na‘ h o s p i t a l a t d a y ’ s e t t i n g . Br i t i s hJ o u r n a l Of Nu r s i n g , 2 7 ( 2 ) , 9 2 9 7 . d o i : 1 0 . 1 2 9 6 8 / b j o n . 2 0 1 8 . 2 7 . 2 . 9 2 Ke yPo i n t 3 Pr e v e n t i n gHa r m. T h eg o a l o f p a t i e n t c a r ei st op r e v e n t h a r m. “ Th eJ o i n t Co mmi s s i o no nt h eAc c r e d i t a t i o no f He a l t h c a r eOr g a n i z a t i o n s( 2 0 0 2 ) i s s u e das e n t i n e l e v e n t a l e r t h i g h l i g h t i n gd o c u me n t e di n j u r i e sa s s o c i a t e dwi t h s i d er a i l ”( Wa g n e r e t a l . , 2 0 0 7 ) . Al t h o u g ht h ema i nt o p i cf o r t h i swe e ki sr e s t r a i n t u s e , s i d er a i l sh a v eb e c o me c o mmo ni nt h eh o s p i t a l . T h e r ea r et e r me dr e s t r a i n t swh e nt h ep a t i e n t c a n n o t mo v ef r e e l yd u et ot h eu p r i g h t p o s i t i o n ’ ss i d er a i l s . I h a v es e e np a t i e n t sa t t e mp t t oh u r r yo v e r t h es i d er a i l a n de v e nt o s st h e i r b o d i e so v e r t h e r a i l i n g s . Th a n k f u l l ya l l h a v eb e e nu n s u c c e s s f u l . I f n o t , t h e ywo u l dh a v ef a l l e na n dh a da ni n j u r y . Af t e r r e a d i n ga f e wa r t i c l e sa b o u t r e s t r a i n t u s ei np r e v e n t i n gh a r m, I k n o wI wi l l u s et h i si n f o r ma t i o ni nt h ec l i n i c a l s e t t i n gb yn o t p u t t i n ga l l s i d er a i l su pa n dc o n t i n u o u s l ya s s e s s i n gmyp a t i e n t st oa v o i da n yd a ma g e . Re f e r e n c e s Wa g n e r , L . , Ca p e z u t i , E. , Br u s h , B. , Bo l t z , M. , Re n z , S. , &T a l e r i c o , K. ( 2 0 0 7 ) . De s c r i p t i o no f a na d v a n c e dp r a c t i c e n u r s i n gc o n s u l t a t i v emo d e l t or e d u c er e s t r i c t i v es i d er a i l u s ei nn u r s i n gh o me s . Re s e a r c hI nNu r s i n g&He a l t h , 3 0 ( 2 ) , 1 3 1 1 4 0 .

Module 2: Identify 3 key points from this module. Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Ke yPo i n t 1 Nu r s ep r a c t i t i o n e r ’ so r d e rf o rr e s t r a i n t u s e . Re s t r a i n t u s ei sb e n e fi c i a l f o rp a t i e n t s , “ p a r t i c u l a r l ya mo n gp a t i e n t sa t r i s kf o r s e l f t e r mi n a t i n gn e c e s s a r yt r e a t me n t i n t e r v e n t i o n s , i n c l u d i n ge n d o t r a c h e a l t u b e sa n di n v a s i v ec a t h e t e r s ”( Do l a n , 2 0 1 7 ) . I nt h e s ec a s e s , t h eu s eo f r e s t r a i n t si sn e c e s s a r ys ot h a t t h ep a t i e n t c a nr e c e i v ea p p r o p r i a t et r e a t me n t . T h i sa ff e c t smywo r ka san u r s e s i n c eI mo n i t o rt h ep a t i e n t t oa s s e s st h en e e df o rr e s t r i c t i o n sa n dp r o v i d en u r s i n gc a r e .I wo r kwi t han u r s e p r a c t i t i o n e r wh owo r k sc l o s e l ywi t ht h eh o s p i t a l i s t s e r v i c e . At n i g h t t h eNPi su s u a l l yo nc a l l wh e nwen e e do r d e r s . I nt h eI CU, weh a v eh a ds o mer a r eo c c a s i o n swh e nwen e e dt op l a c eap a t i e n t o nr e s t r a i n t s , s ot h e yd o n ’ t p u l l o u t i n v a s i v el i n e s . Re f e r e n c e s Do l a n , J . ( 2 0 1 7 ) . DET ERMI NANT SOFNURSES’ USEOFPHY SI CALREST RAI NT SI NSURGI CALI NT ENSI VE CAREUNI TP A T I ENT S. Ame r i c a nJ o u r n a l Of Cr i t i c a l Ca r e , 2 6 ( 5 ) , 3 7 3 3 7 9 . d o i : 1 0 . 4 0 3 7 / a j c c 2 0 1 7 2 4 4 Ke yPo i n t 2 SMARTl e a r n i n go b j e c t i v e s T h i swe e kI l e a r n e dab i t mo r ea b o u t SMARTg o a l sa n dh o wt op r e p a r ef o rt h e m. I nt h eBSNp r e p a r e dn u r s e , al o t o f r e s e a r c ha n de v i d e n c e b a s e dp r a c t i c ei si mp l e me n t e d . SMARTg o a l sa ff e c t myn u r s i n gp r a c t i c e , a sI a ma c h a r g en u r s eo nt h eme d i c a l s u r g i c a l fl o o r a t n i g h t . Weh a v es t r o n gt e a mwo r ka n dh a v el a t e l yb e e ng o i n go v e r d i s e a s ep r o c e s s e st h a t wed o n ’ t s e et o omu c h . I h a v es t a r t e di mp l e me n t i n gSMARTg o a l ss ot h a t a sag r o u pa t n i g h t , wec a nl e a r nas k i l l t o g e t h e r a n ds e t at i me f r a mei nwh i c hwec a na l l a c h i e v et h a t g o a l . Re c e n t l ywewe n t o v e r NGt u b ei n s e r t i o n . Th e ya r eu s u a l l yp l a c e di nt h eEDb e f o r eb e i n ga d mi t t e dt ot h efl o o r . Weh a v ewo r k e dwi t h t h eERc h a r g en u r s et og i v eu sah e a d su ps owec a ns e n dn u r s e sd o wnt oo b s e r v e , a n du l t i ma t e l yb ea b l et o i n s e r t a nNGt u b eo nt h e i ro wn . Ke yPo i n t 3 St a ffe d u c a t i o n : No wt h a t I a ms t a r t i n gt or e s e a r c hmo r eo nr e s t r a i n t u s e , I h a v et h o u g h t o f s t a ffi n s e r v i c e . Re s t r a i n t u s ec a nb eb e n e fi c i a l t ot h ep a t i e n t ; h o we v e r , t h e i r“ u s eh a sb e e ni mp l i c a t e di ni n c r e a s e dp h y s i c a l a n d p s y c h o l o g i c a l i n j u r i e s , a n dr e s t r a i n t b a n d sh a v eb e e ni mp l i c a t e di ns e v e r a l p a t i e n t d e a t h s ” ( Yi n Yi ne t a l . , 2 0 1 6 ) . Ha v i n ga ni n s e r v i c et os t a ffme mb e r sb r i n g sf o r t hk n o wl e d g ea n dar e mi n d e rt on u r s e so nt h er e a s o n i n g , mo n i t o r i n g , a n de v a l u a t i o no f t h eu s e .“ Nu r s i n gs t a ffwh ol a c k e ds u ffic i e n t r e s t r a i n t k n o wl e d g et e n d e dt ou s e r e s t r a i n t smo r eo f t e nt h a nt h e i r mo r ek n o wl e d g e a b l ep e e r s ” ( Yi n Yi ne t a l . , 2 0 1 6 ) . I wi l l b ep r e s e n t i n gmyp r o j e c t

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o nr e s t r a i n t st omyf e l l o ws t a ffme mb e r st or a i s ea wa r e n e s sa n dp r o v i d ee d u c a t i o no nt h eu s eo f c o n d i t i o n s . Re f e r e n c e s Yi n Yi n , C. , Hs i u Hu i , Y . , El Wu i , L . , &L i Yi n , C. ( 2 0 1 6 ) . T h eEffic a c yo f a nI n Se r v i c eEd u c a t i o nPr o g r a m De s i g n e dt oEn h a n c et h eEff e c t i v e n e s so f Ph y s i c a l Re s t r a i n t s . J o u r n a l Of Nu r s i n gRe s e a r c h( L i p p i n c o t t Wi l l i a ms &Wi l k i n s ) , 2 4 ( 1 ) , 7 9 8 6 . d o i : 1 0 . 1 0 9 7 / j n r . 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 2

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N4585 Capstone

Module 3: Identify 3 key points form this module. Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Ke yPo i n t 1

Di s c u s s i o n b a s e dp r e s e n t a t i o n : Al a r g ep o r t i o no f myp r e s e n t a t i o nwi l l b eb yd i s c u s s i o n . Ma t h i a ss t a t e st h a t “ d i s c u s s i o n b a s e de n v i r o n me n t s i g n i fi c a n t l ye n h a n c e di n t e r e s t i nt h et o p i ca n do v e r a l l p e r f o r ma n c ei nt h ec o u r s e ” ( 2 0 1 5p p . 1 ) . I l e a r nwe l l b y d i s c u s s i n gt h eo b j e c t i v e sa n db e i n ga b l et oa s kq u e s t i o n s , a n dg e t t i n gf e e d b a c k . Re f e r e n c e s Ma t h i a s , C. ( 2 0 1 5 ) . AL e a r n e r l e d , Di s c u s s i o n b a s e dEl e c t i v eo nEme r g i n gI n f e c t i o u sDi s e a s e . Ame r i c a nJ o u r n a l Of Ph a r ma c e u t i c a l Ed u c a t i o n , 7 9 ( 6 ) , 1 1 0 .

Ke yPo i n t 2

Ho s p i t a l p o l i c i e sa n dp r o c e d u r e s : Re s t r a i n t u s es h o u l db eu p d a t e dwi t he v i d e n c e b a s e dp r a c t i c ea n dwo r k e do n f r e q u e n t l yt oe n s u r ep a t i e n t s a f e t ya n di n f o r ms t a ffo f a n yc h a n g e s . “ Ho s p i t a l ss h o u l dr e v i s i t wh e na n dh o wo f t e n t h e yt r a i ns t a ffi nr e s t r a i n t a n ds e c l u s i o np o l i c i e sa n dp r o c e d u r e s . T h e ys h o u l da l s oc o n s i d e ra d d i n go ri n c r e a s i n g d e e s c a l a t i o nt r a i n i n gt oa v o i dc i t a t i o n sf o rs e r i o u sd e fi c i e n c i e s ” ( Ri g h t sa n dRe s t r a i n t s , 2 0 1 8 , p . 3 ) . Re f e r e n c e s Ri g h t sa n dr e s t r a i n t s : Th en e e df o rr e a s o n a b l er e s t r a i n t a n ds e c l u s i o np o l i c i e s . ( , 2 0 1 8 ) . Pa t i e n t Sa f e t yMo n i t o r J o u r n a l , 1 9 ( 2 ) , 1 3 1 6 .

Ke yPo i n t 3

Pr o p e r k n o wl e d g e : Ac c o r d i n gt oas t u d yd o n eb yF a r i ñ ae t a l . , “ Al mo s t a l l ( 9 8 %)h a du s e dp h y s i c a l r e s t r a i n t , a n d 8 2 %t h o u g h t t h e i rt r a i n i n gi nt h eu s eo f p h y s i c a l r e s t r a i n t wa si n s u ffic i e n t ”( 2 0 1 8 , p p . 1 ) . T h i si ss ot r u ei nn e w n u r s e sc o mi n gi nt owo r k . T h e r ema yn o t b eap a t i e n t wh owi l l b ei nr e s t r a i n t s ; h o we v e r , t h ep o l i c yi st a u g h t t o t h e s en e wn u r s e s . Al o n gwi t ht h es y s t e ma n dp r o c e d u r e s , ap r e s e n t a t i o nwi l l h e l pt h en u r s ea n do t h e r s t a ff me mb e r sk n o wo f r e s t r a i n t u s e . Re f e r e n c e s F a r i ñ a L ó p e z , E. , Es t é v e z Gu e r r a , G. J . , Po l o L u q u e , M. L . , Po g r á n y i v á , A. H. , &Pe n e l o , E. ( 2 0 1 8 ) . Ph y s i c a l Re s t r a i n t Us eWi t hEl d e r l yPa t i e n t s : Pe r c e p t i o n so f Nu r s e sa n dNu r s i n gAs s i s t a n t si nSp a n i s hAc u t eCa r e Ho s p i t a l s . Nu r s i n gRe s e a r c h , 6 7 ( 1 ) , 5 5 5 9 . d o i : 1 0 . 1 0 9 7 / NNR. 0 0 0 0 0 0 0 0 0 0 0 0 0 2 5 2

Module 4: Identify 3 key points from this module. Reflect on how why each point is important, how it impacts on your work experience or nursing practice, and how will you change your practice in the future based on each key area. Ke yPo i n t 1

CVCu r r i c u l u mVi t a e : I h a v eo n l ye v e r wr i t t e nar e s u mea n dh a v en e v e rh e a r do f aCVu n t i l t h i sc o u r s e . Ch r i s t e n b e r r ys t a t e st h a t aCVi sd i ff e r e n t f r o mr e s u me sa sa“ CVi sa ne x t e n s i v ed e s c r i p t i o no f t h ea p p l i c a n t ’ s t e a c h i n ga n dr e s e a r c he x p e r i e n c e , p u b l i c a t i o n s , p r e s e n t a t i o n s , a wa r d s , h o n o r s , s e r v i c e , a n dp r o f e s s i o n a l a ffil i a t i o n s ”( p p . 3 , 2 0 1 4 ) . Af t e rI g r a d u a t ewi t hmyBSN, I p l a nt owr i t eaCVa n da d dt oi t wi t he v e r yd e g r e eI a c h i e v ea n dwo r ke x p e r i e n c e s . Re f e r e n c e Ch r i s t e n b e r y , T . L . ( 2 0 1 4 ) . F a c u l t yDe v e l o p me n t . T h eCu r r i c u l u mVi t a e . Nu r s eEd u c a t o r , 3 9 ( 6 ) , 2 6 7 2 6 8 . d o i : 1 0 . 1 0 9 7 / NNE. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 3

Ke yPo i n t 2

2020

Pr o f e s s i o n a l Or g a n i z a t i o n s : J o i n i n gap r o f e s s i o n a l o r g a n i z a t i o ns h o wst h a t y o ua r ea c t i v ei nt h eo r g a n i z a t i o na n d i n t e r e s t e di ny o u r wo r k p l a c e . J i l ks t a t e s , “ c o n s i d e r j o i n i n go n et od e mo n s t r a t ep r o f e s s i o n a l e n g a g e me n t ”( p p . 7 , 2 0 1 8 ) . I h a v ej o i n e dt h r e eo r g a n i z a t i o n swi t h i nmywo r k p l a c eb e c a u s eI l i k...