Perioperative nursing

Perioperative nurses take the responsibility of safeguarding the rights of surgical patients before, during and after his surgery. The nurse’s decisions during this period of the patient’s institutionalization are based on universal moral principles. As the patient’s advocate or representative during this crucial period, the nurse ensures the quality and continuity of care that a surgical patient needs.This is simply based on the premise that patients during this period cannot functionally and actively participate, decide and monitor the regimen of care that best suits them particularly during and after sedation. Often, Perioperative nurses are faced with decisions necessary when caring for surgical patients. They are therefore necessarily prepared to recognize that soon ethical dilemmas will occur and the nurse must take appropriate courses of action through responsible nursing decisions. Not only are they expected to make clinical and technical decisions but al so ethically and morally sound decisions suitable for the treatment of their patient.In a daily encounter and exchange with the patient, nurses often have the potential to develop relationships with their patients based on trust. Patient’s trust that nurses will support and follow through with any concerns or issues that have been discussed ((Seifert, 2002: 306). At the same time nurses provide a listening ear  Ã‚   to their patient while providing encouragement and support.Likewise, nurses are provided with the opportunity to learn and gather information essential to the health concerns of their patients including fears and apprehensions. This provides an ample opportunity for nurses to exact information that could be relayed to physicians and other family members pertinent to the regimen of treatment acceptable to the patient. Base on the parameter of therapeutic use of self, nurses are encouraged to maintain a professional and therapeutic relationship between nurses and patients and their family members (Rushton et al, 1996: 186).The Nurses’ RoleWithin the framework of the nursing process, nurses’ work in collaboration with the other health team members in order to achieve desirable patient outcomes (AORN, 2004:16). They are enjoined to use the tools of the nursing process to meet the needs of the patient undergoing invasive procedures. Although much of the practice involves technicalities, the patient is still the main focus of the perioperative nurse rather than on her technical functions. The goal is still to provide care and support for the patient and for their families (Spry, 2005:3).As the perioperative nurse, one is likewise expected to assist the patient and their families in making sound decisions to meet the overall desired outcome of wellness after surgery and a healthy return to normal life. Along the lines of perioperative nursing, care is provided in various settings based on three major aspects of providing direct care ; coordinating comprehensive care and educating patient and their families (Spry:3).The impact of illness particularly when invasive procedures are due usually limits the patients’ individual autonomy and ability to make decisions, thereby placing the perioperative nurse in a powerful position.   Patients and family members often feel helpless in a health care setting; how much more when a love one is scheduled for operation? The patient is therefore vulnerable at this stage so the role of the nurse as an advocate for the patient is stressed as vital to patient care.It would most likely help the patient and his family t know that the nurse during a perioperative setting and procedure ensure a continuous assessment of care for the patient while in the OR, thereby providing ample assurance that the patient’s needs are being met. The nurse, as a moral agent of the patient, must therefore be ready and be able to act and advocate for the patient’s needs whenever ne cessary while providing perioperative care.In addition, the nurse’s role includes informing patients of their rights and to ensure that patients are given all the necessary information necessary to make/participate in the decision making and likewise support them in whatever decision they undertake. Although the nurse has a responsibility in safeguarding the patient from the incompetence of other health care professionals her main ethical duty is the prevention of a potential injury to the patient and to third parties (Kohnke, 1980: 2039).Nurses in general and in particular perioperative nurses must act as an advocate for the patient, co-worker, family members and students (Seifert, 2002: 307). By virtue of her relationship with the patient, her obligation is to provide a safe, professional and ethical care particularly during the perioperative phase when the patient and family members are most vulnerable. Likewise, technically, the patient and the family member are not equip ped to understand the aspect of perioperative invasive procedures which is why the nurse should come as an advocate for the rights of the patient and their families. Thus it is in principle the duty of the nurse to provide patients with ethical care they ought to receive during this particular phase of their treatment.Promoting perioperative nurses’ safetyIt is therefore another vital job of a perioperative nurse to ensure and create an environment that fosters ethical behavior. As a duty to herself, the nurse must engage in a life-long learning experience, maintaining competence, and promoting personal and professional values, supports the establishment and maintenance of an ethical workplace (Seifert, 2002:306).Nurses must be able to establish, maintain, and improve the work environment and maintain an ability to preserve their integrity and moral self respect. Other virtues and excellence of character like loyalty and honesty further promote nurses’ abilities to ful fill moral obligations and cited as exemplary qualities of the moral person to behave in an ethical manner (ANA, Sec.20). The environment strongly influences in the acquisition of virtues and excellence that may support or impedeethical behavior. Certain policies, procedures and position often help in influencing behavior that can affect the delivery of care. Certain intolerable policies that become inconsistent with a nurse job like mandatory overtime can greatly become an impediment to an employee’s ethical performance.When nurses are exposed under a strong foundation of ethical practice, standards can positively guide in her performance in the surgical setting. Not only will she be able to identify activities and interventions that help her achieve specific patient outcome but also link her actions t ethical behavior. Most set standards are often based on clinical mandates with virtues of wisdom, honesty, loyalty and courage that are the same qualities of the moral person (AORN, 2002: 492). Nurses who are exposed to this professional standard are likely to employ these standards and view them as a normal practice essential to improve unethical and unsafe practices within her responsibility.Providing a therapeutic work setting or enhancing a safe environment will likewise be a concern to all perioperative nurses. Potential hazards, risks, and unsafe conditions abound in the surgical arena where constant distractions, excessive noise, hasty reviews of patient records, and frequent interruptions can produce situations where the likelihood of error increases. It is always right to alert physicians and others within the health team of any unsafe or deteriorating patient condition that can lead to an active error like sending the wrong patient for surgery; patient morbidity and perhaps mortality. An enlightened approach to this error is to replace blame and punishment with learning and improving (Reeder, 2001:117).Facing Ethical DilemmasA nurse, for exampl e, has a statutory duty to report suspected cases of abuse or potential for injury, and this situation may arise when a coworker demonstrates incompetent practice. This is an ethical dilemma facing nurses and it seems that nurses are no closer to a solution of how they can be effective advocates for patients without compromising their working identity or facing conflicts of loyalty (Martin, 1998:156). In essence, the nurse would exercise moral alignment with the patient rather than with the physician or the hospital.The nurse will not do any injustice if she takes on the role as the patient’s advocate in all aspects of health care (Seifert, 2002:309). In truth, all health care providers should function as patient advocates (Kohnke, 1980:2040). In instances such as clarifying consent issues, perioperative nurses may act as advocates in a potential ethical conflict (Spry, 2005:3). It may be that all cases in which nurses advocate involve ethical action, but not all cases may ne cessarily involve ethical conflict (Seifert, 2002:309).The nurse’s role in perioperative practice has two components which implies supporting the patient’s autonomy or his right to choose freely, regardless of whether the nurse is in agreement with the patient’s decision. One of the fundamental duties of nursing is to promote and defend patients’ rights (Segesten and Fagring, 1996:142). The act of suppressing an individual’s rights serves as the catalyst response of the nurse to act as the patient’s advocate which is her second role.If advocacy implies speaking up for someone, then it is her duty to speak up for the welfare and benefit of the patient. Again, this could be an identifiable problem because not all nurses are comfortable with conflict situations. Others may not recognize any rights violations; the nurse may not have a level of experience or communication skills that will facilitate advocacy; they may not be empowered as related to a restrictive care environment; or they just may not have a level of understanding about advocacy in general (Seifert, 2002:308).During an error occurrence during the perioperative phase communication and interdisciplinary relationships is the common cause coupled with disruptive physician behavior; institutional responses to such behavior; and the effects of such behavior on nurse satisfaction, morale, and retention (Rosenstein, 2002: 34).When errors or mistakes do occur, it is imperative that nurses learn what occurred, identify systems gaps that represent latent conditions that can lead to errors, collectively review the causes of the error, and share lessons learned.(Reeder, 2001 118). Unfair, illegal, or unethical practices challenge the creation of a moral environment thus collaboration, fairness, and respect for patients and all members of the health care team are more likely to support fulfillment of ethical obligations(Reeder, 2001:118).Conclusion:As an ethical practice, the nurse acts in behalf of the patient, the institution and for herself. This creates confusion particularly when the nurse is faced with a dilemma that conflicts between her personal values and professional obligations (Segesten and Fagring:144). Nurses must therefore act in accordance with the practice standards and code of ethics in coordination with her own values. Speaking up in behalf f the perioperative patient suggest that she is favorably acting as the patient’s advocate particularly during the perioperative phase.This should be viewed as her essential role as a professional and should base her actions according to ethical principle and values. She should speak up when an injustice occurs although in some cases, she would face danger for her actions such as loosing her job. Insofar as ethical practice is concern, an individual must be able to choose whether to sacrifice oneself for her patient and follow a principle of justice. Otherwise if a nurse has any problems with this, she can choose a field that may not compromise her personal beliefs, values or ethics when challenged.The advocacy training for nurses starts within the confines of the nursing education and working environment for the nurse. The philosophy of nursing in which nursing practice stems from supports an individual to promote his/her well-being which is the ethics f practice (Gaylord, 1995:18). In the nursing school, one must be prepared to identify the ethical issues in patient care and understand the ethical principles and philosophies found in the daily practice and be trained to recognize the patient’s rights, wishes and care issues (Seifert, 2002:312). The knowledge of such ethical principles allows the nurse to stand as an advocate for the patient and speak in his behalf using effective communication skills. Related essay: â€Å"Ati RN Community Health Online Practice 2016 B†Works CitedSpry, Cynthia. (2005). Essentials of Perioperative Nursing (3rd ed.) Aspen: Jones and Barlett.Rushton, C., Armstrong, L., McEnhill, E.(1996,June).Establishing therapeutic boundaries as patient advocates. Pediatric Nursing 22, 185-189.Seifert, P.C. and American Nurses Association. (2002, August). Ethics in perioperative practice: Duty to self. AORN Journal 76, 306-313.United States. American Nurses Association. Code of Ethics for Nurses with Interpretive Statements, 20.Segesten, K. and Fagring, A. (1996, October). Patient advocacy: An essential part of quality nursing care. International Nursing Review 43, 142-144.Gaylord,N. and Grace, P.(1995,March). Nursing advocacy: An ethic of practice. Nursing Ethics 2, 11-18.Martin, G. (1998, March). Communication breakdown or ideal speech situation: The problem of nurse advocacy. Nursing Ethics 5, 147-157.Rosenstein, A. (2002, June). Original research: Nurse-p hysician relationships: Impact on nurse satisfaction and retention. American Journal of Nursing 10, 26-34.Reeder, J. (2001,April). Patient Safety, Errors and mistakes, and perioperative Nursing. Seminars in Perioperative Nursing 10, 115-118.Kohnke, M.(1980, November). The nurse as advocate. American Journal of Nursing 80,2038-2040. Perioperative nursing Perioperative nurses take the responsibility of safeguarding the rights of surgical patients before, during and after his surgery. The nurse’s decisions during this period of the patient’s institutionalization are based on universal moral principles. As the patient’s advocate or representative during this crucial period, the nurse ensures the quality and continuity of care that a surgical patient needs.This is simply based on the premise that patients during this period cannot functionally and actively participate, decide and monitor the regimen of care that best suits them particularly during and after sedation. Often, Perioperative nurses are faced with decisions necessary when caring for surgical patients. They are therefore necessarily prepared to recognize that soon ethical dilemmas will occur and the nurse must take appropriate courses of action through responsible nursing decisions. Not only are they expected to make clinical and technical decisions but al so ethically and morally sound decisions suitable for the treatment of their patient.In a daily encounter and exchange with the patient, nurses often have the potential to develop relationships with their patients based on trust. Patient’s trust that nurses will support and follow through with any concerns or issues that have been discussed ((Seifert, 2002: 306). At the same time nurses provide a listening ear  Ã‚   to their patient while providing encouragement and support. Likewise, nurses are provided with the opportunity to learn and gather information essential to the health concerns of their patients including fears and apprehensions. This provides an ample opportunity for nurses to exact information that could be relayed to physicians and other family members pertinent to the regimen of treatment acceptable to the patient. Base on the parameter of therapeutic use of self, nurses are encouraged to maintain a professional and therapeutic relationship between nurses and patients and their family members (Rushton et al, 1996: 186).The Nurses’ RoleWithin the framework of the nursing process, nurses’ work in collaboration with the other health team members in order to achieve desirable patient outcomes (AORN, 2004:16). They are enjoined to use the tools of the nursing process to meet the needs of the patient undergoing invasive procedures. Although much of the practice involves technicalities, the patient is still the main focus of the perioperative nurse rather than on her technical functions. The goal is still to provide care and support for the patient and for their families (Spry, 2005:3). As the perioperative nurse, one is likewise expected to assist the patient and their families in making sound decisions to meet the overall desired outcome of wellness after surgery and a healthy return to normal life. Along the lines of perioperative nursing, care is provided in various settings based on three major aspects of providing direct ca re; coordinating comprehensive care and educating patient and their families (Spry:3).The impact of illness particularly when invasive procedures are due usually limits the patients’ individual autonomy and ability to make decisions, thereby placing the perioperative nurse in a powerful position.   Patients and family members often feel helpless in a health care setting; how much more when a love one is scheduled for operation? The patient is therefore vulnerable at this stage so the role of the nurse as an advocate for the patient is stressed as vital to patient care. It would most likely help the patient and his family t know that the nurse during a perioperative setting and procedure ensure a continuous assessment of care for the patient while in the OR, thereby providing ample assurance that the patient’s needs are being met. The nurse, as a moral agent of the patient, must therefore be ready and be able to act and advocate for the patient’s needs whenever necessary while providing perioperative care.In addition, the nurse’s role includes informing patients of their rights and to ensure that patients are given all the necessary information necessary to make/participate in the decision making and likewise support them in whatever decision they undertake. Although the nurse has a responsibility in safeguarding the patient from the incompetence of other health care professionals her main ethical duty is the prevention of a potential injury to the patient and to third parties (Kohnke, 1980: 2039).Nurses in general and in particular perioperative nurses must act as an advocate for the patient, co-worker, family members and students (Seifert, 2002: 307). By virtue of her relationship with the patient, her obligation is to provide a safe, professional and ethical care particularly during the perioperative phase when the patient and family members are most vulnerable. Likewise, technically, the patient and the family member are not eq uipped to understand the aspect of perioperative invasive procedures which is why the nurse should come as an advocate for the rights of the patient and their families. Thus it is in principle the duty of the nurse to provide patients with ethical care they ought to receive during this particular phase of their treatment.Promoting perioperative nurses’ safetyIt is therefore another vital job of a perioperative nurse to ensure and create an environment that fosters ethical behavior. As a duty to herself, the nurse must engage in a life-long learning experience, maintaining competence, and promoting personal and professional values, supports the establishment and maintenance of an ethical workplace (Seifert, 2002:306). Nurses must be able to establish, maintain, and improve the work environment and maintain an ability to preserve their integrity and moral self respect.Other virtues and excellence of character like loyalty and honesty further promote nurses’ abilities to fulfill moral obligations and cited as exemplary qualities of the moral person to behave in an ethical manner (ANA, Sec.20). The environment strongly influences in the acquisition of virtues and excellence that may support or impede  ethical behavior. Certain policies, procedures and position often help in influencing behavior that can affect the delivery of care. Certain intolerable policies that become inconsistent with a nurse job like mandatory overtime can greatly become an impediment to an employee’s ethical performance.When nurses are exposed under a strong foundation of ethical practice, standards can positively guide in her performance in the surgical setting. Not only will she be able to identify activities and interventions that help her achieve specific patient outcome but also link her actions t ethical behavior. Most set standards are often based on clinical mandates with virtues of wisdom, honesty, loyalty and courage that are the same qualities of the moral person (AORN, 2002: 492). Nurses who are exposed to this professional standard are likely to employ these standards and view them as a normal practice essential to improve unethical and unsafe practices within her responsibility.Providing a therapeutic work setting or enhancing a safe environment will likewise be a concern to all perioperative nurses. Potential hazards, risks, and unsafe conditions abound in the surgical arena where constant distractions, excessive noise, hasty reviews of patient records, and frequent interruptions can produce situations where the likelihood of error increases. It is always right to alert physicians and others within the health team of any unsafe or deteriorating patient condition that can lead to an active error like sending the wrong patient for surgery; patient morbidity and perhaps mortality. An enlightened approach to this error is to replace blame and punishment with learning and improving (Reeder, 2001:117).Facing Ethical DilemmasA nurse, for example, has a statutory duty to report suspected cases of abuse or potential for injury, and this situation may arise when a coworker demonstrates incompetent practice. This is an ethical dilemma facing nurses and it seems that nurses are no closer to a solution of how they can be effective advocates for patients without compromising their working identity or facing conflicts of loyalty (Martin, 1998:156). In essence, the nurse would exercise moral alignment with the patient rather than with the physician or the hospital. The nurse will not do any injustice if she takes on the role as the patient’s advocate in all aspects of health care (Seifert, 2002:309). In truth, all health care providers should function as patient advocates (Kohnke, 1980:2040). In instances such as clarifying consent issues, perioperative nurses may act as advocates in a potential ethical conflict (Spry, 2005:3). It may be that all cases in which nurses advocate involve ethical action, but not all case s may necessarily involve ethical conflict (Seifert, 2002:309).The nurse’s role in perioperative practice has two components which implies supporting the patient’s autonomy or his right to choose freely, regardless of whether the nurse is in agreement with the patient’s decision. One of the fundamental duties of nursing is to promote and defend patients’ rights (Segesten and Fagring, 1996:142). The act of suppressing an individual’s rights serves as the catalyst response of the nurse to act as the patient’s advocate which is her second role. If advocacy implies speaking up for someone, then it is her duty to speak up for the welfare and benefit of the patient. Again, this could be an identifiable problem because not all nurses are comfortable with conflict situations. Others may not recognize any rights violations; the nurse may not have a level of experience or communication skills that will facilitate advocacy; they may not be empowered as related to a restrictive care environment; or they just may not have a level of understanding about advocacy in general (Seifert, 2002:308).During an error occurrence during the perioperative phase communication and interdisciplinary relationships is the common cause coupled with disruptive physician behavior; institutional responses to such behavior; and the effects of such behavior on nurse satisfaction, morale, and retention (Rosenstein, 2002: 34). When errors or mistakes do occur, it is imperative that nurses learn what occurred, identify systems gaps that represent latent conditions that can lead to errors, collectively review the causes of the error, and share lessons learned.(Reeder, 2001 118). Unfair, illegal, or unethical practices challenge the creation of a moral environment thus collaboration, fairness, and respect for patients and all members of the health care team are more likely to support fulfillment of ethical obligations(Reeder, 2001:118).Conclusion:As an ethical practice, the nurse acts in behalf of the patient, the institution and for herself. This creates confusion particularly when the nurse is faced with a dilemma that conflicts between her personal values and professional obligations (Segesten and Fagring:144). Nurses must therefore act in accordance with the practice standards and code of ethics in coordination with her own values. Speaking up in behalf f the perioperative patient suggest that she is favorably acting as the patient’s advocate particularly during the perioperative phase. This should be viewed as her essential role as a professional and should base her actions according to ethical principle and values. She should speak up when an injustice occurs although in some cases, she would face danger for her actions such as loosing her job. Insofar as ethical practice is concern, an individual must be able to choose whether to sacrifice oneself for her patient and follow a principle of justice. Otherwise if a nurse has a ny problems with this, she can choose a field that may not compromise her personal beliefs, values or ethics when challenged.The advocacy training for nurses starts within the confines of the nursing education and working environment for the nurse. The philosophy of nursing in which nursing practice stems from supports an individual to promote his/her well-being which is the ethics f practice (Gaylord, 1995:18). In the nursing school, one must be prepared to identify the ethical issues in patient care and understand the ethical principles and philosophies found in the daily practice and be trained to recognize the patient’s rights, wishes and care issues (Seifert, 2002:312). The knowledge of such ethical principles allows the nurse to stand as an advocate for the patient and speak in his behalf using effective communication skills.Works CitedSpry, Cynthia. (2005). Essentials of Perioperative Nursing (3rd ed.) Aspen: Jones and Barlett.Rushton, C., Armstrong, L., McEnhill, E.(1 996,June).Establishing therapeutic boundaries as patient advocates. Pediatric Nursing 22, 185-189.Seifert, P.C. and American Nurses Association. (2002, August). Ethics in perioperative practice: Duty to self. AORN Journal 76, 306-313.United States. American Nurses Association. Code of Ethics for Nurses with Interpretive Statements, 20.Segesten, K. and Fagring, A. (1996, October). Patient advocacy: An essential part of quality nursing care. International Nursing Review 43, 142-144.Gaylord,N. and Grace, P.(1995,March). Nursing advocacy: An ethic of practice. Nursing Ethics 2, 11-18.Martin, G. (1998, March). Communication breakdown or ideal speech situation: The problem of nurse advocacy. Nursing Ethics 5, 147-157.Rosenstein, A. (2002, June). Original research: Nurse-physician relationships: Impact on nurse satisfaction and retention. American Journal of Nursing 10, 26-34.Reeder, J. (2001,April). Patient Safety, Errors and mistakes, and perioperative Nursing. Seminars in Perioperative Nursing 10, 115-118.Kohnke, M.(1980, November). The nurse as advocate. American Journal of Nursing 80,2038-2040. Perioperative nursing Perioperative nurses take the responsibility of safeguarding the rights of surgical patients before, during and after his surgery. The nurse’s decisions during this period of the patient’s institutionalization are based on universal moral principles. As the patient’s advocate or representative during this crucial period, the nurse ensures the quality and continuity of care that a surgical patient needs.This is simply based on the premise that patients during this period cannot functionally and actively participate, decide and monitor the regimen of care that best suits them particularly during and after sedation. Often, Perioperative nurses are faced with decisions necessary when caring for surgical patients. They are therefore necessarily prepared to recognize that soon ethical dilemmas will occur and the nurse must take appropriate courses of action through responsible nursing decisions. Not only are they expected to make clinical and technical decisions but al so ethically and morally sound decisions suitable for the treatment of their patient.In a daily encounter and exchange with the patient, nurses often have the potential to develop relationships with their patients based on trust. Patient’s trust that nurses will support and follow through with any concerns or issues that have been discussed ((Seifert, 2002: 306). At the same time nurses provide a listening ear  Ã‚   to their patient while providing encouragement and support. Likewise, nurses are provided with the opportunity to learn and gather information essential to the health concerns of their patients including fears and apprehensions. This provides an ample opportunity for nurses to exact information that could be relayed to physicians and other family members pertinent to the regimen of treatment acceptable to the patient. Base on the parameter of therapeutic use of self, nurses are encouraged to maintain a professional and therapeutic relationship between nurses and patients and their family members (Rushton et al, 1996: 186).The Nurses’ RoleWithin the framework of the nursing process, nurses’ work in collaboration with the other health team members in order to achieve desirable patient outcomes (AORN, 2004:16). They are enjoined to use the tools of the nursing process to meet the needs of the patient undergoing invasive procedures. Although much of the practice involves technicalities, the patient is still the main focus of the perioperative nurse rather than on her technical functions. The goal is still to provide care and support for the patient and for their families (Spry, 2005:3). As the perioperative nurse, one is likewise expected to assist the patient and their families in making sound decisions to meet the overall desired outcome of wellness after surgery and a healthy return to normal life. Along the lines of perioperative nursing, care is provided in various settings based on three major aspects of providing direct ca re; coordinating comprehensive care and educating patient and their families (Spry:3).The impact of illness particularly when invasive procedures are due usually limits the patients’ individual autonomy and ability to make decisions, thereby placing the perioperative nurse in a powerful position.   Patients and family members often feel helpless in a health care setting; how much more when a love one is scheduled for operation? The patient is therefore vulnerable at this stage so the role of the nurse as an advocate for the patient is stressed as vital to patient care. It would most likely help the patient and his family t know that the nurse during a perioperative setting and procedure ensure a continuous assessment of care for the patient while in the OR, thereby providing ample assurance that the patient’s needs are being met. The nurse, as a moral agent of the patient, must therefore be ready and be able to act and advocate for the patient’s needs whenever necessary while providing perioperative care.In addition, the nurse’s role includes informing patients of their rights and to ensure that patients are given all the necessary information necessary to make/participate in the decision making and likewise support them in whatever decision they undertake. Although the nurse has a responsibility in safeguarding the patient from the incompetence of other health care professionals her main ethical duty is the prevention of a potential injury to the patient and to third parties (Kohnke, 1980: 2039).Nurses in general and in particular perioperative nurses must act as an advocate for the patient, co-worker, family members and students (Seifert, 2002: 307). By virtue of her relationship with the patient, her obligation is to provide a safe, professional and ethical care particularly during the perioperative phase when the patient and family members are most vulnerable. Likewise, technically, the patient and the family member are not eq uipped to understand the aspect of perioperative invasive procedures which is why the nurse should come as an advocate for the rights of the patient and their families. Thus it is in principle the duty of the nurse to provide patients with ethical care they ought to receive during this particular phase of their treatment.Promoting perioperative nurses’ safetyIt is therefore another vital job of a perioperative nurse to ensure and create an environment that fosters ethical behavior. As a duty to herself, the nurse must engage in a life-long learning experience, maintaining competence, and promoting personal and professional values, supports the establishment and maintenance of an ethical workplace (Seifert, 2002:306). Nurses must be able to establish, maintain, and improve the work environment and maintain an ability to preserve their integrity and moral self respect.Other virtues and excellence of character like loyalty and honesty further promote nurses’ abilities to fulfill moral obligations and cited as exemplary qualities of the moral person to behave in an ethical manner (ANA, Sec.20). The environment strongly influences in the acquisition of virtues and excellence that may support or impede  ethical behavior. Certain policies, procedures and position often help in influencing behavior that can affect the delivery of care. Certain intolerable policies that become inconsistent with a nurse job like mandatory overtime can greatly become an impediment to an employee’s ethical performance.When nurses are exposed under a strong foundation of ethical practice, standards can positively guide in her performance in the surgical setting. Not only will she be able to identify activities and interventions that help her achieve specific patient outcome but also link her actions t ethical behavior. Most set standards are often based on clinical mandates with virtues of wisdom, honesty, loyalty and courage that are the same qualities of the moral person (AORN, 2002: 492). Nurses who are exposed to this professional standard are likely to employ these standards and view them as a normal practice essential to improve unethical and unsafe practices within her responsibility.Providing a therapeutic work setting or enhancing a safe environment will likewise be a concern to all perioperative nurses. Potential hazards, risks, and unsafe conditions abound in the surgical arena where constant distractions, excessive noise, hasty reviews of patient records, and frequent interruptions can produce situations where the likelihood of error increases. It is always right to alert physicians and others within the health team of any unsafe or deteriorating patient condition that can lead to an active error like sending the wrong patient for surgery; patient morbidity and perhaps mortality. An enlightened approach to this error is to replace blame and punishment with learning and improving (Reeder, 2001:117).Facing Ethical DilemmasA nurse, for example, has a statutory duty to report suspected cases of abuse or potential for injury, and this situation may arise when a coworker demonstrates incompetent practice. This is an ethical dilemma facing nurses and it seems that nurses are no closer to a solution of how they can be effective advocates for patients without compromising their working identity or facing conflicts of loyalty (Martin, 1998:156). In essence, the nurse would exercise moral alignment with the patient rather than with the physician or the hospital. The nurse will not do any injustice if she takes on the role as the patient’s advocate in all aspects of health care (Seifert, 2002:309). In truth, all health care providers should function as patient advocates (Kohnke, 1980:2040). In instances such as clarifying consent issues, perioperative nurses may act as advocates in a potential ethical conflict (Spry, 2005:3). It may be that all cases in which nurses advocate involve ethical action, but not all case s may necessarily involve ethical conflict (Seifert, 2002:309).The nurse’s role in perioperative practice has two components which implies supporting the patient’s autonomy or his right to choose freely, regardless of whether the nurse is in agreement with the patient’s decision. One of the fundamental duties of nursing is to promote and defend patients’ rights (Segesten and Fagring, 1996:142). The act of suppressing an individual’s rights serves as the catalyst response of the nurse to act as the patient’s advocate which is her second role. If advocacy implies speaking up for someone, then it is her duty to speak up for the welfare and benefit of the patient. Again, this could be an identifiable problem because not all nurses are comfortable with conflict situations. Others may not recognize any rights violations; the nurse may not have a level of experience or communication skills that will facilitate advocacy; they may not be empowered as related to a restrictive care environment; or they just may not have a level of understanding about advocacy in general (Seifert, 2002:308).During an error occurrence during the perioperative phase communication and interdisciplinary relationships is the common cause coupled with disruptive physician behavior; institutional responses to such behavior; and the effects of such behavior on nurse satisfaction, morale, and retention (Rosenstein, 2002: 34). When errors or mistakes do occur, it is imperative that nurses learn what occurred, identify systems gaps that represent latent conditions that can lead to errors, collectively review the causes of the error, and share lessons learned.(Reeder, 2001 118). Unfair, illegal, or unethical practices challenge the creation of a moral environment thus collaboration, fairness, and respect for patients and all members of the health care team are more likely to support fulfillment of ethical obligations(Reeder, 2001:118).Conclusion:As an ethical practice, the nurse acts in behalf of the patient, the institution and for herself. This creates confusion particularly when the nurse is faced with a dilemma that conflicts between her personal values and professional obligations (Segesten and Fagring:144). Nurses must therefore act in accordance with the practice standards and code of ethics in coordination with her own values. Speaking up in behalf f the perioperative patient suggest that she is favorably acting as the patient’s advocate particularly during the perioperative phase. This should be viewed as her essential role as a professional and should base her actions according to ethical principle and values. She should speak up when an injustice occurs although in some cases, she would face danger for her actions such as loosing her job. Insofar as ethical practice is concern, an individual must be able to choose whether to sacrifice oneself for her patient and follow a principle of justice. Otherwise if a nurse has a ny problems with this, she can choose a field that may not compromise her personal beliefs, values or ethics when challenged.The advocacy training for nurses starts within the confines of the nursing education and working environment for the nurse. The philosophy of nursing in which nursing practice stems from supports an individual to promote his/her well-being which is the ethics f practice (Gaylord, 1995:18). In the nursing school, one must be prepared to identify the ethical issues in patient care and understand the ethical principles and philosophies found in the daily practice and be trained to recognize the patient’s rights, wishes and care issues (Seifert, 2002:312). The knowledge of such ethical principles allows the nurse to stand as an advocate for the patient and speak in his behalf using effective communication skills.Works CitedSpry, Cynthia. (2005). Essentials of Perioperative Nursing (3rd ed.) Aspen: Jones and Barlett.Rushton, C., Armstrong, L., McEnhill, E.(1 996,June).Establishing therapeutic boundaries as patient advocates. Pediatric Nursing 22, 185-189.Seifert, P.C. and American Nurses Association. (2002, August). Ethics in perioperative practice: Duty to self. AORN Journal 76, 306-313.United States. American Nurses Association. Code of Ethics for Nurses with Interpretive Statements, 20.Segesten, K. and Fagring, A. (1996, October). Patient advocacy: An essential part of quality nursing care. International Nursing Review 43, 142-144.Gaylord,N. and Grace, P.(1995,March). Nursing advocacy: An ethic of practice. Nursing Ethics 2, 11-18.Martin, G. (1998, March). Communication breakdown or ideal speech situation: The problem of nurse advocacy. Nursing Ethics 5, 147-157.Rosenstein, A. (2002, June). Original research: Nurse-physician relationships: Impact on nurse satisfaction and retention. American Journal of Nursing 10, 26-34.Reeder, J. (2001,April). Patient Safety, Errors and mistakes, and perioperative Nursing. Seminars in Perioperative Nursing 10, 115-118.Kohnke, M.(1980, November). The nurse as advocate. American Journal of Nursing 80,2038-2040.

Improve Maternal Health Essay

The World Health Organization defines maternal health as â€Å"the health condition of women during pregnancy, childbirth and the postpartum period that needs to be safeguarded to prevent death† (http://www. who. int/topics/maternal_health/en/). Improving maternal health is one of the concerns of the Millennium Development Goals with focus on reducing maternal mortality and achieving universal access to reproductive health care by the year 2015. In 2008, sixty-eight (68) developing countries account for the majority of the maternal and child mortality. In the same year, the World Health Organization reported that some of the countries where maternal health is of prime importance and is given high importance include Norway, Australia, Netherlands, Sweden, Denmark and other developed countries. On the other hand, many developing countries are left behind in terms of giving importance or even appreciation to maternal health such as Afghanistan, Yemen, Niger, Chad, Sudan, Congo and other Southeast Asian countries. Poor maternal health adversely affects women. The World Health Organization reported that almost 500,000 women die of childbirth and pregnancy every year due to complications brought about by childbearing. Most of these women die due to unavailability of maternal health services and emergency assistance. It is the woman and her child that is always at risk when maternal health is not of top priority of a government. A woman and her child will always be exposed to infection and other forms of diseases when they are not given proper knowledge and skills in maternal health.

The Welsh Health Survey Health And Social Care Essay

The study was based on a representative sample of local people populating in private families in Wales. A random sample of references from the Postcode Address File ( PAF ) was selected and the sample was stratified by local authorization. Data was collected at two degrees: family ( through a short interview with respondents ) and single ( through self-completion questionnaire ) . The consequences reflect people & A ; acirc ; ˆâ„ ¢s ain apprehension of their wellness instead than a clinical appraisal of their medical status, and their ain reading of the wellness services they have used.Major Highlights of the information is given below: –Socio-economic and personal information about respondents: –Researcher has done statistical analysis of the information and has calculated mean, standard divergence of individual consecutive figure and family consecutive figure every bit good. In the lodging term of office 75.6 % respondents belong to the class of proprietor resident, 14.7 % are on societal leasing whereas merely 9.7 % are on private rental. In the above study employment informations of respondents besides taken as bulk 41.3 % are engaged in everyday and manual businesss, 35.7 % have their managerial and professional business where as 20.4 % respondents have their intermediate business and minority 2.6 % have ne'er worked and they are in long term unemployment. Among the respondents the ratio of female was high as it was 53.6 where as the ratio for male respondent was merely 46.4 % . As it was the study for grownups so 75+ old ages old respondents was being merged. The information depicts that the age group start from 16 old ages old and covers the respondents age of 75+ it covers the every age group of grownups. There was no biasness with the age. The study was non stick to the peculiar age group. Data depicts the economic position of respondents which reflects that 47.8 % are in employment, 2.2 % are unemployed and half of the entire figure i. e 50 % respondents are economically inactive. Data sing the making of respondents shows that 17.6 % are degree qualified. 54.8 % have other makings apart from degree classs whereas 27.6 % are disqualified.Health position, unwellnesss and other conditions:41.6 % reported that they are non suffered from corpulence and fleshiness where as 58.4 % which is more than half they suffered from it. Merely 2.7 % respondents reported that they had of all time stroke, 22.3 % answered that they presently being treated for high blood force per unit area, 10.7 % for asthma, 14.4 % for a respiratory unwellness, 11.4 % for other chronic unwellness, 14.8 % for arthritis, 5.5 % for seeing job, 10.7 % for a mental unwellness, 9.5 % for a bosom status, and 6.9 % for diabetes. 29.1 % of respondents reported that they are holding a restricting long-run unwellness.Health-related life style:21.9 % respondents reported that they are presently smoked. 19.9.0 % of respondents non-smokers reported being on a regular basis exposed to other people ‘s baccy smoke indoors. 8.2 % answered that they drink about every twenty-four hours. 35.4 % of grownups reported eating five or more parts of fruit and vegetables the old twenty-four hours. 29.3 % reported run intoing the guidelines for physical activity in the past hebdomad.Health service usage:17.62 % of respondents reported that they had talked to a GP about their ain wellness in the past two hebdomads where as 82.4 % respondents did non talked to a GP in past two hebdomads. 83.8 % of grownups reported that they have non attended casualty in the last 12 months whereas 16.2 % respondents have attended the same. 33.6 % of grownups reported go toing a hospital outpatient section in the past 12 months, and 9.9 % respondents answered that they have stayed in infirmary as an inmate ( nightlong or longer ) . 69.9 % of grownups reported that they have used a tooth doctor in the past 12 months, 70.1 % a druggist and 49.9 % an optician. 55.1 % respondents reported that they are taking regular prescribed medicine.Strengths of informations: –The information was really elaborate information to cognize the wellness position of people populating in Waless because it was based on holistic attack which was related to other wellness issues as good. The gathered information was unbiased. The study involves people irrespective of their age groups, local life country and gender. The study was done successful as it is utile in many ways which highlights the existent state of affairs of wellness related issues of local people. Through this findings policy shapers, research workers and other stakeholders can reexamine and supervise bing wellness policies and do new schemes and can develop new policies for their improvement. This information provides a direct engagement and demand of NHS to supply wellness attention installations to the people in their countries. The study provides an chance to do an effectual coaction among different stakeholders in civil society and local authorization so that authorities can do new schemes to filtrating the policies for people wellness well- being.Failing of informations: –Information which was collected sing restricting long term unwellness, non stipulating whether or non the unwellness was treated or non. Adult respondents were classified as holding any bosom status if they reported of all time holding been treated for a bosom onslaught or presently being treated for angina, bosom failure or ‘another bosom status ‘ . Consequences for high blood force per unit area ( high blood pressure ) are besides shown, but are normally shown individually from bosom conditions because high blood force per unit area is a hazard factor for bosom disease instead than an existent bosom status. Adult respondents were asked whether they were presently being treated for diabetes, doing no differentiation between type 1 and type 2 diabetes. If they responded positively, they were asked how their diabetes was controlled ( by injection, tablets or diet ) . Respondents were asked whether they had any trouble with their hearing, without a hearing assistance if they normally wore one. If they answered yes, they were asked about the usage and effectivity of hearing AIDSs.Analysis and reading of Datas: –The information shows that 5.5 % of grownups reported holding trouble with their seeing. Table 1.1 shows that were droop addition in the per centum who reported that they holding trouble with their seeing and these respondents are belongs to peculiarly age group of 75 old ages or over this. Besides the job of eyesight exists in particularly older adult females which could be because of age factor. Data depicts that 14.4 % of grownups reported being treated for any respiratory unwellness. Around 10.7 % of respondents reported that they are presently being treated for asthma. Table 1.2 shows that the per centum of job of respiratory unwellness is increasing by age. We can see that of entire answering adult females respondents are more being treated for a respiratory unwellness in comparing to male respondents. We can analyse from the informations that 10.7 % of grownups are being treated for mental unwellness. Among them maximal respondents are being treated for depression. If we do compare the mental unwellness from age than we can state that harmonizing to the informations mental unwellness is increasing among respondents towards the in-between age before come ining in the retirement age. Besides per centum of mental unwellness is higher among female as compared to male respondents. Data shows that figure of per centum of respondents who reported that they of all time holding been treated for a shot. We can analyse that the jobs of shot is increasing with age. In this variable besides we have found that overall Numberss of female respondents are higher in comparing to male respondents. As per the information job of arthritis is quickly turning with the age. We have analyzed that 5.5 % of grownups reported holding trouble with their hearing. Table 1.3 shows that the job of hearing exists to those who are aged 65 old ages. Besides the ratio of male respondents who have reported trouble in hearing i.e. higher than the females. Decision: – After analysis the whole information we can state that there is demand to carry on farther research studies in the same field. As this was the study based on the foregrounding the cardinal wellness issues of people in Waless. Though the study has been conducted successfully nevertheless there is demand to analyze or research the wellness facet with deepness research based on one to one detailed interviews besides the ratio and figure of instances of diseases can be compared in the last few old ages. So that the reappraisal of bing policies can be done and new schemes can border or develop for supplying the better wellness attention installations to the people.

Perception and communication Article Example | Topics and Well Written Essays - 250 words

Perception and communication - Article Example The main aim is to conduct this study focusing on South African organizations. The research was conducted in an exploratory manner. For the purpose of achieving its aim, the research was conducted by interviewing a sample of professional accountants. The views on the concept of interpersonal communication varied significantly from other professions as accountants take interpersonal communication as a tool to aid their professional goals, rather than creating unofficial relationships and bonds with fellow colleagues. The study also reveals that organizational communication is perceived as an official channel for accountants to collaborate their efforts; however, communication barriers may hinder the success of communication due to lack of relationships and knowledge about colleagues, their lives and views on issues. The perception about interpersonal communication of accountants, as per the research, seems flawed as they perceive it to be an official means of communication rather than a way to establish social groups and social status for their group. The main weakness of the article is its primary focus on qualitative rather than quantitative methodology. The article is primarily designed to observe South African organizations and accountants; hence, the applicability of the results and findings on other regions and groups may be questioned. The article provides a thoughtful start to a research; however, it lacks coherence, direction and sufficient supporting evidence. Considering the strengths of this article, one may conclude that the article is written in simple and easily understandable language. The article follows a logical flow of information starting from the definition of the key terms like perception, interpersonal communication and organizational communication to the conclusion where it achieves its

EASY JET (ONE BUDGET AIRLINE) Essay Example | Topics and Well Written Essays - 2500 words

EASY JET (ONE BUDGET AIRLINE) - Essay Example Porter's Generic Value Chain can be applied to examine the firm's ability to connect primary value chain activities with support services (Porter, 1998). Easy Jet has made use of both strategies to better advantage in marketing its products. Supplier power refers to the degree of freedom that suppliers have over the firm which buys supplies from them. Easy Jet in particular and the budget airline industry in general have to procure supplies from suppliers in the open market where rules of competition might threaten Easy Jet's own strategic objectives as well as others. For example customer care practices require a host of supplier networks to coordinate every aspect of the marketing process from the time of inquiry to the end of the journey. How Easy Jet would respond and how would the rest of the industry respond to all this, depend on a number of other variables such as the concentration ratios in the supplier industries, the availability of and the degree of dependency on credit, macro-economic variables, e.g. interest and business tax rates and a host of other factors. In the airline industry it's an unwritten rule that the aggregation of strategic supplier networks across a range of ancillary services - e.g. handli ng customers' inquiries to the seat allocation process - would benefit only those airlines which place their products in strategic sub-segments appropriately and immediately. Buyer poweBuyer power is perhaps the most effective force with far reaching consequences for the business that the company has to face. For instance customers of short haul budget airlines carry such weight in the decision making process of the individual airline to such an extent that they can drive prices down if they happen to boycott a certain airline or airlines on the ground that their services are below their expectations. Buyer power has also been studied in the budget airline market segment with reference to price and income elasticities of demand. The European no-frills low cost airline market segment is ruled by the same economic principles but its qualitative shift has brought about a highly articulate population of consumers whose demand for the product at a given time is determined not only by the price and

Strategic management Research Proposal Example | Topics and Well Written Essays - 1500 words

Strategic management - Research Proposal Example This is because Saudi Arabia encompasses the geographical scope of the area that was inhabited by the Prophet of Islam and the various activities he was involved in, during his life and the founding of Islam. Due to this, the King of Saudi Arabia has the title â€Å"Custodian of the Two Holy Mosques† (Ramady, 2010). This is primarily because Saudi Arabia controls the two holiest sites of Islam: Mecca and Medina. Saudi Arabia is an absolute monarchy that is controlled by the core principles of the Islamic faith (Niblock, 2006). The King of Saudi Arabia has an absolute power over activities in the kingdom and his decrees are obeyed without question (Bowen, 2008). This is necessary to preserve his authority as a major figurehead in the world of Islam. Also, the king has the right and power to appoint authorities to run the various public institutions of the kingdom (Roberts, 2007). Until the 1930s when oil was discovered in Saudi Arabia, education was mainly steeped in Islamic study and Islamic law (Roberts, 2007). By the 1940s, the need to acquire higher education institutions in Saudi Arabia was recognized by the King of Saudi Arabia (Abiur, 1988). This is because Saudi Arabia had two main options: to either rely on foreigners who had the skills or send their nationals to Europe, America or other nations with modern institutions of higher learning to get educated. This was seen as undesirable because it exposed Saudis to lifestyles that were not seen as complementary. In 1949, the King of Saudi Arabia commissioned the first college in Mecca but it was to operate a religious curriculum (Abir, 1988). A teacher training college was established in 1952 but the Ulama or religious elites controlled these institutions. Finally, in 1957, the King commissioned the University of Riyadh. Several universities and institutions of higher learning were opened after this. As Saudi public institutions, the universities are ran by authorities that are appointed by

Research paper on Milton's Paradise Lost Example | Topics and Well Written Essays - 1500 words

On Milton's Paradise Lost - Research Paper Example In this sense, the book and the author direct that freewill is not free at all, as it should be interpreted in a literal sense, but is instead a will that remains arbitral based on who you ask. This is shown clearly with illustrations from then authority of the king in puritan times, as well as the application of freewill in following God’s will. The section that draws up the arbitral sense of freewill is drawn and illustrated by the use of strong words that go to the extent to show then following freewill in the sense of being godly is not all free. This is because it is imposition of God’s will upon man, which in the first place is meant for to occur and is part of a design by God to be in power. As a result, there is no way that man exercises freewill in any way as all aspects of will are manipulated by God by design and by default, from the moment that one commences exercising it (Barfoot 176). In addition, the book stats that man’s exertion of freewill is by no means free as it is an act of obedience to God begging the question how freewill is meant to be freewill and how it is independent of God and His power, as well as how it should be defined. The definition of the term freewill in the book remains wanting in that it does not show a distinct definition that can be applied for the purpose of identification of the action that man engages out of sheer freewill. Instead, the whole ordeal of defining what freewill is turned into a means of showing how God works to exert freewill and how freewill is supposed to manifest itself for the glory of God. This is because the book shows that almost every aspect of freewill, including its practice, is for the glory of God, as none of it remains directly under the control of man at any given time. With this in mind, the book describes the application of freewill in antics used to ensure obedience and devotion to a high authority. It is in this case that freewill is brought out at as a challenge to God’s authority as it requires a clear definition and distinction between the ways to obedience and devotion without the use of the above-mentioned default and manipulation by God. This is not clarified in the book, but instead shows the Adam and Eve scene in separation, where there are the words saying that God towards thee has done his part do thine (Bizik 70). This part is a clear illustration of freewill at work, where God gives man freewill, by creating it in the first place and allowing the two to choose between the choices, they were given. The above illustrates that there is no way that freewill is existent, and that it is merely a convenience for human rights forums. The translation of the above statement, therefore, is that God is the master of all, and that there is no way that man has freewill as even the choices given to Adam and Eve are only bound by the will of God and His need for devotion and obedience by man towards Him. It is because of this that manâ€⠄¢s will is not free as man’s will is subjected to God’s direction thus the mental faculties of man are not independent or free of the influence. Instead, man’s freewill is subordinate to God’s will and command, as well as system of beliefs and institutions

The Law Essay Example | Topics and Well Written Essays - 1500 words

The Law - Essay Example When Arthur is discharged from hospital he discovers that the landlord of his flat, which he was occupying before the accident, has let the flat to another tenant. Arthur applies to the Local Authority for alternative accommodation but is told that he fails to come within the statutory definition of homlessness. In the above there are several issues that need to be discussed on order to be able to discuss the legal actions that might result from the scenario. The issues that require examination are unfair dismissal with regard to the dismissal from work and dangerous driving on the part of Barry. With regard to the injuries of Arthur caused in the accident there needs to be a discussion on the chain of causation to determine whether Barry should be held liable for the suffering caused or whether Arthur has a claim against the doctor for the negligent treatment. In respect of the flat there needs to be a discussion on breach of contract and unlawful eviction as the landlord has let the flat to someone else in breach of the tenancy agreement. In respect of the homelessness there needs to be an examination of the Housing Act 1996 to determine why Arthur is not regarded as legally homeless. Unfair dismissal as is suggested is when an employer dismisses an employee without good reason. In some instances unfair dismissal can be regarded as automatically unfair. This might be the case in situations where the employer has not followed a proper dismissal procedure before dismissing the employee1. In some claims for unfair dismissal the employee has to have worked for the employer for at least a year whereas in other case the year rule does not apply. In recent times the law has been changed by placing statutory requirements on the employer before the employee can be dismissed. Previous legislation used to regard the employee more as a servant to the employer than a contributing member of the workforce2. Section 94 of the Employment Rights Act

There is a large discrepancy in wealth distribution in the PRC. In Essay

There is a large discrepancy in wealth distribution in the PRC. In fact it has amongst the most unequal levels of distribution o - Essay Example This paper examines the implication of wealth inequalities in the PRC, particularly regarding individual’s way of living, education, housing, transportation, employment, and human rights for a citizen in the PRC; in relation to that, the paper will address whether people who are deprived access to these things can even be considered citizens. The paper will also highlight the effect of sexual, racial, and class discriminations on the patterns of consumption in the PRC and the manner in which the different social groups in China define and promote popular culture in the consumption patterns. As already mentioned, wealth inequalities have a very profound impact on individual’s way of living; generally, the large disparities between the rich and the poor in the PRC results to social inequalities since they deprive the poor access to most of the very basic yet fundamental social opportunities and services in life. For instance, the huge gaps between the rich and the poor in the PRC implies that the poor have been deprived access to decent lives with since basic needs such as food and shelter will almost always remain an elusive dream beyond their reach. Poor households in the PRC cannot afford daily provision, leave alone healthy dietary, and nutrition and they have to struggle for bare survival to see another day; apart from that, poor housing or lack of housing altogether predisposes the poor to harsh environmental conditions, which further aggravate their already worse condition. Housing projects in the PRC have been monopolized by the affluent and well-educated group that has the financial flexibility to live in those rich neighborhoods (Doray Demers 297). This implies that those without financial flexibility cannot access decent housing in decent neighborhoods like around Beijing (Tomba 1). Additionally, the poor cannot afford quality medical and healthcare, and are more likely to suffer even from simplest of all common treatable diseases. Poor n eighborhoods in the PRC have a disparity of healthcare facilities, and the least that are available do not even offer quality healthcare services either; Lack of quality healthcare and housing coupled with poor nutrition inevitably results to despicable living conditions. Apart from that, wealth disparities also deprive the poor access to quality education since it leads to unequal access to educational opportunities; whereas the rich can afford quality education for their children, the poor lag behind simply because of limited educational opportunities and high cost of education. Uneven wealth distribution also implies that some areas of the PRC are more developed thus have more education facilities that offer quality education than others, which are underprivileged due to disparities in wealth distribution. The rich neighborhoods in the PRC have enough schools, which provide enough opportunities for children from socially affluent families to access to education, unlike poor neigh borhoods that lag behind in development, thus have few congested schools that offer low quality education. In this respect, the limited access to educatio

Democratic Society Essay Example for Free

Democratic Society Essay The conducted study revealed that both external and internal factors are of great importance for facilitation democratic changes in developing countries. Some observers argue that democratic outcomes are strongly related to the extent to which power holders have been encouraged by pressure from various external and domestic sources – for example, internationally, from foreign governments granting financial aid and, at home, from civil and political society to allow citizens greater participation in the political arena. Others suggest that democratic progress is primarily associated with an array of domestic factors affecting political outcomes, including level of economic development, quality of political leadership and political culture. It seems that truth, as usual, lies somewhere in between. Without a doubt, globalization of democratization encourages developing countries to keep up to date and join the process of internationalization of economic growth and get profit from widening of free markets, reinforced by new means of international communication. But our study proves that to promote democratization the developing nation has to maintain multiple domestic conditions such as adherence to sustainable economic development and willingness to allocate public resources in equitable manner, strong middle class, powerful and soundly structured civil society, effectively functioning multi-party system, and liberal political culture. Thus, economic development proved to be the most important predictor of democratization. It seems that, once a country achieves a certain degree of economic development, additional economic growth is an important ingredient for the developing country’s continued progress toward further democratization. Our study demonstrated that continued democratization of developing countries depends heavily on their economic liberalization, supported by the increased purchasing power of the people. The empirical findings cited in our study clearly showed that the ‘unique’ Confucian or Islamic political culture/civilization does not prevent the internationalization of national economies from affecting the degree of democracy. It seems, therefore, that states may be able to delay, but not negate, the process of political liberalization induced by economic liberalization. As the economic opportunities increase for individuals and private businesses, their awareness of the potential for improving their civil liberties also increases. Subsequently, they will begin to demand more freedom. It seems, therefore, that the improvement of the standard of living and the popular involvement in the economic and political decision-making are critical for long-term democratization in developing countries. References Arblaster, A. (1999). Democratic Society and Its Enemies. In P. Burnell P. Calvert, (Eds. ), The Resilience of Democracy: Persistent Practice, Durable Idea, special issue of Democratization, 6(1), 33-49.

Cystic Fibrosis Newborn Screening

Cystic Fibrosis Newborn Screening Cystic fibrosis is a common autosomal recessive genetic disorder1. This means that to have cystic fibrosis, a person must have inherited a defective gene from each of his or her parents2. This gene is located on chromosome seven2. Absence or mutation in this particular gene results in worse performance or absence of the Cystic Fibrosis Transmembrane Conductance Regulator2. This is most commonly found in Europe, North America, and Australia1. This gene manages anion transport and mucociliary clearance in the airways1. With the failure of this function, the results are mucus retention and chronic infection in the lungs1. Nowadays, modern technology provides aid for patients with their diseases and gives them a longer and more active life. Newborn screening for cystic fibrosis is a modern technological advance which is designed to detect early signs of cystic fibrosis. Several methods under the name of the Newborn Screening are used to detect whether a newborn has cystic fibrosis or not1. These methods include immunoreactive trypsinogen (IRT) testing combined with DNA mutation analysis and the sweat chloride test1. IRT stands for Immunoreactive Trypsinogen Test. The procedure of this test is a chemical reaction. Trypsinogen is made from the pancreas, and it normally transmits to the intestines where it is activated to a form of an enzyme called trypsin. In a patient who has cystic fibrosis, the thick mucus covers the pancreatic ducts1. Therefore, trypsinogen wont reach the intestines, and the amount of trypsinogen goes up. This test runs with a blood sample, and if the results come out with a normal level of trypsinogen, then this test is reliable, but if there is a high level of trypsinogen, then more tests need to be run to find out whether the patient has cystic fibrosis or not. A sweat chloride test is the amount of chloride in patients sweat. In a patient that has Cystic Fibrosis, the sweat chloride test will result in significantly higher levels of chloride in sweat than a person that does not have cystic fibrosis due to the restricted movement of chloride. The gene mutation test is a DNA sequencing test to locate a defective gene in the chromosome. There are many different types of mutations that can cause a deficiency in the production of the CFTR protein. More than 2000 CFTR variants have been discovered1. About 15% of the identified gene variants are not associated with CF1. CFTR mutations can be classified into six classes according to their effects on protein function1. Classification is helpful because it relates to the molecular and cellular processes in gene translation and protein processing and has some useful clinical relations1. Class I, II, and III mutations are associated with no residual CFTR function and patients with these mutations on average have a severe phenotype, whereas individuals with class IV, V, and VI mutations have some residual function of CFTR protein and have a mild lung phenotype and pancreatic deficiency1. Today, different laboratories use a wide variety of panels depending on the patients need, like t he twenty-three panel or panel of seventy. The following is an example of a molecular CF test. Lab Corporation of America published a procedure for a Cystic Fibrosis molecular diagnostic3; The coding sequence of CFTR is amplified by polymerase chain reaction and each PCR product (amplicon) then sequenced bi-directionally, using Sanger sequencing methodology. CFTR Chr7(q31,2) Nucleotide Change Amino Acid Change Consequencing Zygosity Relation to Cystic Fibrosis c.1327G>T p.Asp443Tyr missense mutation homozygous recessive, associated 1. Prof J Stuart Elbom, Cystic Fibrosis, Lancet, 19-25 November 2016, Volume 388, Issue 10059, page 2519-2531 2. The Clinical and Functional Translation of CFTR(CFTR2) at Copyright 2011 US CF Foundation, John Hopkins University The Hospital for Sick Children; available at https://cftr2.org. 3. Corporation of America Published Documents   2014   available @ http://oneworld.labcorp.com/Billing/TestMaster/Resource Center/Sample Reports/C-4/Cystic Fibrosis (CF) CFTR 252763.pdf

Types of Analysis for Strategic Planning

Types of Analysis for Strategic Planning Task 1 Internal Assessment Sometimes, it is something inside the organization that demands a major change. It can be technological change forcing new methods of carrying out its work, Cost efficiency/Performance, Assets condition/Productivity, Organizational culture and image, Organizational structure, Key staff, Operational efficiency, Operational capacity, Brand awareness, Market share and financial resources. External Assessment Sometimes the outside world forces such decisions on the organization. Such forces may include major shifts in the market, big changes in government policy, market competition, distribution methods, and the geography in which you will compete to get result Assumptions We can assume certain alternative that can be true in forming strategy and from which conclusion can be drawn, as the strategy is based on assumptions Priority issues We must address our priority issues. It can be cost of production, service level and delivery, organization and material effectiveness, customer service and friendliness, new product/service innovation and quality RESULT REQUIRED The second step to identify where do we want to be? We must set our mission and objective to reach our goals. Mission/ Vision It can be defined as what the company is to become over set period of time. To be effective the vision must be simple. It must be something that the people within the business can identify easily and it must have tangible impact on the business. Objectives Objectives are concrete goals that the organization seeks to reach, for example, an earnings growth target. The objectives should be challenging but achievable. They also should be measurable so that the company can monitor its progress and make corrections as needed. HOW The third step to find out how will we get there? We should make some strategy and proper programs to reach our goals. Strategic development process is dynamic and continuous. A change in one component can necessitate a change in the entire strategy. As such, the process must be repeated frequently in order to adapt the strategy to environmental changes. Throughout the process the firm may need to cycle back to a previous stage and make adjustments. IMPLEMENTATION The fourth step to define who must do what. Once a strategy is developed it is most important how to implement it and for effective implementation, it needs to be translated into more detailed policies that can be understood at the functional level of the organization. As strategy forms at corporate level, it should be translated into specific policies for functional areas such as marketing, R D, production, Human resources, Information Systems. REVIEWS The final step is to review once implemented, the results of the strategy need to be measured and evaluated, with changes made as required to keep the plan on track. Control systems should be developed and implemented to facilitate this monitoring. Standards of performance are set, the actual performance measured, and appropriate action taken to ensure success. Example: In my previous organization in Dubai, having two divisions, dealing in waterproofing and insulation materials and both were doing well. The management realized scope of further expansion into interior business. The Chairman has three sons. Two of them looking after two divisions and the third just returned from abroad after completing his studies. The company had enough resources, financial, premise etc. to start the new business. The chairman utilized all of the available resources efficiently and started a new interior business. Now I realized that they had followed above strategic planning process to be success and still they are doing well. Task 2 How does one involve stakeholders in the strategic planning process and give examples of what tools you might use to review strategic options. As an organization grows, it becomes more important that all those involved are clear about what the organization is looking to achieve and how it is planning to do it. Each organization should identify those with a legitimate interest in its work (stakeholders) and ensure that there is regular and effective communication with them about the organization. It is therefore worthwhile reviewing who the stakeholders are in the organization because they help to get job done more effectively. Stakeholders may vary according to the nature of the organization but most common can be explained in following diagram. Suppliers Government Customers Organization Bank / Financial Institution Employees Competitors How to engage stakeholders while developing strategy Personal Interviews It can provide quite detailed and rich data on individual behavior and attitudes. Data gathered with this process can help to develop strategy more effectively. Focus Groups Under this method people are selected and invited to meet together to discuss some aspect of a particular product or services which is helpful in making strategic decision. Advertising: It is a form of communication that helps to persuade potential customer to purchase or to consume more of a particular brand of product or service. If the strategy is to develop for a new product then view of prospective customer can be obtained by this means. Newspaper inserts: It enables advertiser to target their advertisement to specific geographic market. Mostly it covers local area and strategy planner can get the feedback from relevant stakeholders. Web/Online Surveys One of the most sophisticated and modern method to involve stakeholders in strategy planning process. It’s quick and more accurate and solves the distribution and result collection problems. Conferences: Company can arrange conferences where views can be exchange which will help the planner to form the strategy accordingly. Stakeholders are invited to discuss on a particular topic. Workshop / problem solving meetings: It is like a meeting emphasizing interactions and exchange of information among a usually small number of participants. Newsletters: A newsletter is a regularly distributed publication, generally about one main topic that is of interest to its subscribers. For example Company send newsletter to their employees to update their market position and any future development. Annual report: It is a complete report of an organization’s activities throughout the preceding year. It is normally sent to Shareholders and other interested stakeholders informing about the company’s activities and financial performance. It has been observed that individual stakeholders usually may have their own interests which they will ensure are protected and valued. It means that stakeholders can influence negatively or positively the performance of an organization. It is therefore important for an organization to determine which stakeholders can have a positive or negative impact on their organization so that the positive effects are promoted and the negative effects are managed so as to minimize damage. For example employees of an organization will be concerned about their job security and salaries and other benefits and while planning the strategy if they are not involved in planning process they may resist due to some risk, which they don’t want to take but if they are better educated they will help to achieve strategic goal. There are three important tools that can be used to review strategic options. †¢ Suitability †¢ Feasibility †¢ Acceptability Suitability: This is one of the important tools while developing a strategic plan. The planner must ensure that the strategy he is planning, will it be adjusted with the current environment and are we competent enough to face the challenges. Suitability is a decisive factor for assessing the extent to which a proposed strategy fits the situation identified in the strategic analysis, and how it would sustain or improve the competitive position of the organization. Some authors have referred to this as ‘consistency’. Suitability is therefore a useful tool for screening strategies. For example, if a strategy is likely to improve the organization’s competitive standing then we should find out, can we able to resolve the company’s liquidity problems, or decrease dependence on a particular supplier? Feasibility: Whether it can be implemented successfully. The organization must evaluate their resources and at the evaluation stage there are a number of fundamental questions which need to be asked when assessing feasibility. For example: Can the strategy be funded? Are we capable of performing to the required level (e.g., quality level, service level)? Can the necessary market position be achieved, and will the necessary marketing skills be available? Will the required skills at both managerial and operative level are available? Will the technology (both product and process) be available to compete effectively? Can the necessary materials and services be obtained? It is also important to consider all of these questions with respect to the timing of the required changes. Acceptability: Alongside suitability and feasibility, it is the third factor to review strategic options. This can be a difficult area, since acceptability is strongly related to peoples expectations, and therefore the issue of acceptable to whom? Following essential questions need to be asked when assessing Acceptability. Return What will be the effect on capital structure? Profitability analyses (return on capital employed, payback period, discounted cash flow, market valuation, etc.) Risk Will the function of any department, group or individual change significantly? Financial ratio projections; Sensitivity analysis; Decision matrices Stakeholder Expectations Will the organization’s relationship with outside stakeholders (e.g., suppliers, government, unions, and customers) need to change? Needs, power, interest, and predictability of stakeholders. Task 3 Prepare an example SWOT analysis of an organization you know or have studied listing the 4 key (SWOT) elements in a table. Explain how strategic planner will use the analysis in developing the strategy using some of the example elements you have listed. SWOT stands for strengths, weaknesses, opportunities and threats. Strengths and weaknesses are internal factors, which relates with resources. Opportunities and threats are external factors which relates with environment. SWOT analysis is a tool for auditing an organization and its environment and is often used to highlight where a business or organization is and where it could be in the future. It is the first stage of planning and helps marketers to focus on key issues. The following SWOT analysis looks at PRIMARK which is an Irish clothing retailer. The SWOT analysis will give a clear picture of the business environment PRIMARK is operating in at the present time. Strengths: The strengths of a business or organization are positive elements, something they do well and are under their control. The following section will outline main strengths of PRIMARK. A strong brand is an essential strength of PRIMARK as it is recognized and respected. Competitive pricing is a vital element of their overall success, as this keeps them in line with their rivals, if not above them. The lucrative location. mostly on high street adds up PRIMARK strengths due to its accessibility Keeping costs lower than their competitors and keeping the cost advantages helps PRIMARK pass on some of the benefits to consumers. There distribution chain is one of their strengths and links to success. Supplier relationships are strong at PRIMARK, which strengthens their overall performance. Weaknesses: Weaknesses of an organization is things that need to be improved or perform better, which are under their control. Weaknesses are also things that place you behind competitors. This section will present main weaknesses of PRIMARK. They don’t have good advertising technique to tell customers about their business. There limited product line is a major weakness. PRIMARK does not functions wider international market, which has an effect on success, as they do not reach consumers in more `overseas markets. Due to lower price more customer visit in their store but they don’t have enough checkout counters to avoid long queue. Opportunities: Opportunities are external changes, trends or needs that could enhance the business or organization’s strategic position, or which could be of a benefit to them. This section will outline opportunities that PRIMARK is currently facing. Decrease in taxation is an opportunity for them to reduce prices or increase profits. New market opportunities are a way to push them forward. PRIMARK has the opportunity to enter a niche market, gain leading position and therefore boost financial performance. Expanding the product lines by PRIMARK could help them raise sales and increase their product portfolio. They can enjoy benefits from reduction in interest rates so that business costs would come down. Expanding into other markets could be a possibility for them. Threats: Threats are factors which may restrict, damage or put areas of the business or organization at risk. They are the factors which are outside of the companys control. Being aware of the threats and being able to prepare for them makes this section valuable when considering contingency plans and strategies. This section will outline main threats PRIMARK is currently facing. Consumer lifestyle changes could lead to less of a demand for its products. Changes in the way consumers shop and spend and other changing consumer patterns could be a threat to their performance. Being undercut by low-cost imports is a major threat for them. Slow growth and decline of the retail market is a threat to them. Increased competition from overseas is another threat to them as it could lead to lack of interest in their product. The actions of a competitor could be a major threat against PRIMARK, for instance, if they bring in new technology or increase their workforce to meet demand. Price wars between competitors, price cuts and so on could damage profits for them. A slow economy or financial slowdown could have a major impact on their business and profits. PRIMARK could be threatened by the growing power customers have to set the price of their products. Conclusion Given this analysis we come to realize that each organization has its own external and internal problems to handle. The process in which we enable to identify and analyze such problems is by using proper management method of analysis like SWOT. The SWOT analysis is useful in a difficult strategic situation. The strengths are analyzed to reach opportunities and to avoid threats. The search of weaknesses is of importance as it allows the manager to minimize them. It also explains what unique resources you have and what you can offer that makes you stand from the rest. Task 4 Explain the differences between balanced scorecard, scenario planning, cost benefit analysis and sensitivity analysis giving at least one example of where each technique would be most appropriately applied Balance Scorecard The balance scorecard is a performance management tool to measuring whether the smaller-scale operational activities of a company are aligned with its larger- scale objectives in terms of vision and strategy. By focusing not only on financial outcomes but also on the operational, marketing and developments inputs to these, the balance scorecard helps provide a more comprehensive view of a business, which in turn helps organization act in their best long-term interests. It was proposed by Robert Kaplan and David Norton in 1996 In the balance scorecard we refer to the several different kinds of balance. For example -The balance between short and the long term. -The balance between four perspectives. The Balance scorecard approach generally has four perspectives: Finance: Return on Investment, Cash flow, Return on capital employed Financial results (quarterly/Yearly) Internal business processes: Process alignment (is the right process in the right department?) Learning and growth Is there the correct level of expertise for the job? Employee turnover Source Businessball.com Job satisfaction Training learning opportunity Customer: Delivery performance to customer Quality performance for customer Customer satisfaction rate Customer percentage of market Customer retention rate Scenario Planning Scenario planning is a method for learning about the future by understanding the nature and impact of the most uncertain and important driving forces affecting our world. It is a group process which encourages knowledge exchange and development of mutual deeper understanding of central issues important to the future of the business. It is a process of visualizing What future conditions or events are probable? What their consequences or effects would be like and how to respond to, or benefit from them. Four aspect should taken into consideration in scenario planning Future scientific capabilities Technological developments The role of business and government Social attitudes The transport for London is having scenario planning about future development like air conditioning in Tube. Cost benefits Analysis The process involves, weighting the total expected costs against the total expected benefits in order to choose the best or most profitable option. It is typically used by governments to evaluate the desirability of a given intervention. It is an analysis of the cost effectiveness of different alternatives in order to see whether the benefits are greater than costs. The costs and benefits of the impacts of an intervention are evaluated in terms of the public’s willingness to pay for them (benefits) or willingness to pay to avoid them (cost) inputs are typically measured in terms of opportunity costs the value in their best alternative use. The guiding principle is to list all parties affected by an intervention and place a monetary value of the effect it has on their welfare as it would be valued by them. Sensitivity Analysis It is a technique for determining the outcome of a decision if a key prediction turns out to be wrong. ‘The Study of how the uncertainty in the output of a model (numerical or otherwise) can be apportioned to different sources of uncertainty in the model input’ Suppose that the manager of an organization just completed a linear programming solution which will have a major impact on the company, such as determining how much to increase the overall production capacity and are about the present the results to the board of directors. How confident are you in the results? How much will the results change if your basic data (e.g. profit per item produced, or availability of a component) is slightly wrong? Will that have a minor impact on your results? Will it give a completely different outcome, or change the outcome only slightly? Bibliography: Primark.co.uk Thompson John L . Strategic Management . 4th Ed Team-based strategic planning By C. Davis Fogg 1994 http://www.netmba.com/strategy/process/ JOHNSON, G., and SCHOLES, K. (1997). Exploring Corporate Strategy, Fourth Edition, Prentice Hall, New York. [Chapter 8] Business dictionary.com Cases in public policy analysis by George M. Guess, Paul G. Farnham Wikipedia.org Practical Optimization: a gentle Introduction – John W. Chinneck, 2000 A Practical guide to using the Balanced scorecard By Nils-Gà ¶ran Olve, Anna Sjà ¶strand, Carl-Johan Petri Businessball.com http://www.well.com/~mb/scenario_planning/ dft.gov.uk Sensitivity analysis in practice by Andrea Saltelli, Stefano Tarantola, Francesca Campolongo

Lawn Pesticides and Chemicals Essay -- Health Toxic Substances Essays

Lawn Pesticides and Chemicals Recently, the use of lawn pesticides and chemicals has grown enormously with home owners and golf course management in hope of attaining "the perfect turf." However, the negative effects that are associated with attaining ones "dream turf" is primarily caused by the direct use of pesticides and chemicals. The chemical pesticide industry fails to address these issues and has made every effort to keep this information from the public. Herbicides and pesticides are not a natural way to achieve a beautiful lawn, contrary to what lawn care companies would like people to believe. They are broad-spectrum biocides, and by their very nature can harm organisms other than the targeted species (Dieglman, 1996). Pesticide industries make false claims by stating that their chemicals are heavily diluted, failing to mention that toxins are still extremely dangerous in small amounts. Other false claims include companies like ChemLawn which state that a child would have to ingest ten cups of treated grass clippings to equal the toxicity of one aspirin. In fact, the real danger is not from grazing the lawn. Most poisonings come from inhaling pesticide residues or absorbing them through the skin (Begley, 1988). These chemicals include wartime defoliants such as Agent Orange, nerve-gas type pesticides, and artificial hormones (Dieglman, 1996). In some instances, pesticides like DDT, which remain active for many years, accumulate in our bodies and are released at potentially toxic levels. In women, lifetime exposures to such chemicals are released in the breast milk of her firstborn child (International Joint Commission, 1990). Pesticides drift and settle during application where they can easily reach houses and p... ...l and human health risks that outweigh its intended results. Alternative strategies must be developed which will bring about better results on the environment. Long lasting solutions, which require less time, are definitely the best place to start. References N. Diegelman. Poison in the Grass. 1996. Begley, Sharon, and Hager. "Please Don’t Eat the Daises." Newsweek 16 May 1988. International Joint Commission on the Great Lakes. "Selected Persistent Toxic Substances in Human Breast Milk in the Great Lakes Basin." March 1990. American Defender Network. "Lawn Chemical Dangers." 1989. American Cancer Society, Erie County Branch. "Warning: The Use of Pesticides May Be Hazardous To Your Health." 1991. G. Davidson. "Pesticides: The Killing Fields." Woman’s Day. 1994. N. Polk. "The Perfect Lawn Isn’t Always Green." The New York Times, Oct. 17, 1990.

The Differences between Hypertext and the Printed Page :: Art Painting Language Essays

The Differences between Hypertext and the Printed Page Two painters, alone in the night, fervently work on their objets d’art. One, concerned with borders and lines, and the obviousness of it all, creates on her canvas a network of lines, circles, and primary colors. The other, thinking more about the medium (or rather the way she can master the colors and images), whimsically lets her hands wander on the surface, combining hues and smudging shapes. As the sun peaks its head over the hillside, each artist will have created her own oeuvre. Networks of lines and shapes, blurred lines and indistinguishable endings, like the paintings, hypertext has achieved that same structure. The goal of hypertext, it would seem, is to create works of increasing abstraction so that the way in which we relate to a written work gradually moves away from its informational content to the object, in and of itself. The transition is, by far, not an easy one. The academy is fraught with controversy over the obscurity of the hypertext medium. Lando w, in his section of Hyper/Text/Theory entitled â€Å"What’s a Critic to Do?,† attempts to reconcile the differences between hypertext and the printed page—differences that are as blatant, yet as subtle, as those between an abstract painting and an impressionist painting. The blurred edges of hypertext are represented by the concept of seemingly indistinguishable authorship. The author function becomes less significant as hypertext modes of textuality allow for a cacophony of voices to be included in each work. In contrast to the read-only versions of hypertext (those which cannot be annotated or amended), networked textuality allows for greater flexibility. The particular importance of networked textuality—that is, textuality written, stored, and read on a computer network—appears when technology transforms readers into reader-authors or â€Å"wreaders,† because any contribution, any change in the web created by one reader, quickly becomes available to other readers. This ability to write within a particular web in turn transforms comments from private notes, such as one takes in margins of ones’ own copy of a text, into public statements than, especially within educational settings, have powerfully democratizing effects (Landow 14). Hypertextual liberation comes from the shift from an expressive author who bears his or her soul in writing, to a community of voices who individually shape the text.