The core of leadership is awareness. The text by Don Miguel, The Four Agreements, presents a set of agreements to enhance p awareness. What is NOT one of the four agreements?

A. Increased mortality rates are not an outcome of quality stamina. In fact, quality stamina aims to improve overall care quality and patient outcomes, which should ideally lead to decreased mortality rates. High-quality care and sustained attention to standards generally contribute to better patient outcomes and lower mortality rates.
B. Quality stamina does not typically result in decreased patient volume. In fact, maintaining high-quality care can lead to increased patient satisfaction and potentially attract more patients. Decreased patient volume might be a result of other factors, such as poor service or lack of resources, rather than quality stamina.
C. Improved job satisfaction is a positive outcome of quality stamina. When healthcare staff work in an environment where high standards are maintained, they often experience greater job satisfaction due to better working conditions, support, and recognition of their efforts.
D. Optimal workload distribution is another positive outcome associated with quality stamina. Effective quality management practices can lead to more efficient processes and better distribution of tasks, which helps in reducing burnout and maintaining a sustainable work environment.
E. Enhanced nurse retention is also a likely outcome of quality stamina. When healthcare organizations prioritize quality and maintain high standards, it often leads to a better work environment and job satisfaction, which can contribute to higher nurse retention rates. Retaining experienced staff helps in maintaining consistent, high-quality care.

A. In a decentralized scheduling system, the responsibility for creating and managing schedules lies primarily with the individual units. Therefore, after developing a draft schedule, the nurse manager or designated scheduler would need to negotiate it with the unit staff to ensure it meets their needs and is feasible.
B. Budgetary approval is typically handled at a higher organizational level and is not typically part of the decentralized scheduling process.
C. This would be the case in a centralized scheduling system, not a decentralized one.
D. Balancing personal schedules with institutional needs is important but it's not a specific step in the decentralized scheduling process after creating a draft schedule. This is an ongoing consideration for all schedulers.