Reply 1

During this episode of saving Sara, Paula represented herself as the “out group”. Paula expressed that she was not like the younger nurses who are Technology savvy. Paula is feeling less valuable as a nurse due to her making a error of not understanding/ using the new E.H.R system could have killed a patient due to negligence of not knowing being trained on the new software. Throughout the episode of Saving Sara, Sara feels she is guilty of the situation that happened and wants to help Paula (2022). During this episode of saving Sara, Paula represented herself as the “out group”. She displayed hardship is not about liking a person but coaching Paula about entering data in the system. Sara decided to coach and support Paula and talk to her about the terminal consequences that could have happened. According to Decuypere et al, leaders that are intrinsically motivated are more inclined to invest in the well-being and psychological growth of their employees; they will invest more in the (exchange) relationships with their employees when their own basic psychological needs are met (2022). As a Leader and taking ownership when your staff is not fully educated on an application, Sara must teach Paula how to use the new software. Due to the lack of initiative to learn the new software, Paula actions could’ve caused harm to a patient. Sara must know initiate a write-up and give it to Paula. Sara leads a constrictive conversation that promotes inspiration and dedication in Paula to master the EHR system (Saving Sara, 2022). During this episode Sara displayed transformation leadership when she asks her nurses to come up with a new system for patients who have behavioral issues. This tactic shows that Sara is using her staff more inclusively.



Decuypere, A., Bauwens, R., & Audenaert, M. (2022). Leader Psychological Need Satisfaction Trickles Down: The Role of Leader-Member Exchange. Frontiers in psychology, 13, 799921.

(Saving Sara, 2022). Using the video from episode 1 on Toni, Assignment Drift. (2022, January 27). Retrieved September 14, 2022,


Reply 2

Based on the social exchange theory, the leader-member exchange (LMX) theory discusses the pleasant psychological experiences that nurses experience (Saeka Kawaguchi, 2021). In this scenarios and previous ones Paula is exhibiting “out-group” characteristics because she refuses to learn the new HER system that is in place now, she blames the system for the error that occurred. By Paula administering a medication but putting in the old system she could’ve caused the patients life. When Sarah had a conversation with Paula and coached her she had a supportive conversation, she explained she understands this was a mistake but she had to write her up.

Sarah demonstrated transformational leadership qualities not just with Paula but also with the other members of her team by collaborating with them and asking them to brainstorm ideas to make their job easier. A transformational leadership approach motivates staff to go above and beyond the call of duty to advance a common goal, we see this at the end when Dr. Acharya is leaving the room complaining that they’re going to get sued because of the violent patient, Sarah then asks two members of the staff to come up with ideas for putting a caution sign for aggressive patients. Sarah is willing to accept offers from the members of her team and listen to what they have to say.


Saeka Kawaguchi, M. R. (2021).  Relationship Between Teams’ Leader–Member Exchange Characteristics and Psychological Outcomes for Nurses and Nurse Managers: A Cross-Sectional Study in Japan. Retrieved from