Thursday, October 31, 2019

Health for community and people across lifespan Essay

Health for community and people across lifespan - Essay Example People are influenced by a variety of life issues and circumstances. It was highlighted that some are predictable or might be chosen at the same time some are unpredictable. In a situation where life became suddenly changed there will be consequences that might be out of control and an individual becomes stressed. Both ideas involve broad view, for an instance issues like redundancy or divorce may be predictable while other people are not expecting to lose their job or divorced. Nevertheless, life changing events frequently involves positive learning also risk of stress (Aldworth et. al2010). Page: 159, This assignment deals with health needs in the community in order to meet the provision across lifespan, the perspective of people regarding inclusion, access to choice, and disengagement of services. Also, factors affecting access to health care of an individual from the perspectives of social, health and behavioural science theory. Also the role of a nurse within the multi-disciplinary team will be explored in the delivery of holistic care. And it relates to an individual in decision making. In the scenario, it is very evident that social exclusion is present and it will reflect on this assignment. However, a recommendation and advice will be made for the individual on how to promote health, wellbeing and lifestyle (University of Bedford). The main focus of this essay is Gladys a 51 year old lady. She parted from her husband soon after the delivery of Joshua and presently divorced. At present, she lives with her two sons, her granddaughter and her father in-law in a 4 bed roomed house through the housing association. Presently, she is a full time carer for her granddaughter and her father in-law. She does smoke roll-ups, but unable to afford a car (University of Bedford). She was separated from her husband right after the birth of Joshua, which shows her tendency towards the postnatal depression. Postnatal depression

Monday, October 28, 2019

How working environment can impact on motivation Essay Example for Free

How working environment can impact on motivation Essay (A) Describe, with examples, how working environment can impact on motivation and contribute to an effective workplace in travel and tourism, covering:- * Job location In travel and tourism, the holiday atmosphere at resort contributes to a sense of well-being. Customers are happy to be on holiday and it is relatively easy to have a positive attitude to work. Whereas if you were working in a call centre where you are office bound and have to spend most of the talking to customer on the telephone. The organisation has to consider how this poorer environment can be improved so that staff remains motivated. * Working conditions and Hours of work Hours of work vary tremendously throughout the industry- some people are happy to work unsocial hours because it fits in with their lifestyle or they wish to have time off when everyone else is working. However, the overall number of hours per week should not exceed 40. * Health and safety Safety and security factors must be considered in the workplace, and legislation such as the Health and Safety at Work Act 1974 must be adhered to. Specific regulations also apply where food is served or where the chemical hazards, for example in a swimming pool. All these requirements are important. For some organisations a lapse in safety procedures can mean the collapse of the business and even a prosecution. Companies that organise activity holidays for children, for example must make health and safety a priority. Health and safety is important for both customers and employees. Employees need to know that they can go about their work in a safe environment and work together to ensure their customers are safe. * Equipment and Resources Sate-of-the-art equipment and a pleasant environment are important to motivate staff. * Social event Most companies have a Christmas party or social outgoing for staff. These are useful events to create camaraderie amongst staff and build teams. * Theories of motivation The motivation and commitment of employees is key to success of a team and therefore to the company. Several theorists have come up with models of motivation. The two of that we will look at are Maslow and Herzberg. 1. Maslow Abraham Maslow was an American who in the 1940s developed a theory of motivation. The theory is valid still for understanding how people are motivated in the workplace. Employers can use it to provide conditions that fulfil peoples needs at the different levels. Maslow theory is displayed as a pyramid because employees can only move up the levels once the lower levels are fulfilled. So, an employee cant achieve level 4 at work if they are having problems in their personal life or working with colleagues (level 3). Similarly, if they have just been made homeless (level 1) their concern will be finding shelter not performing at work. 2. Herzberg Herzbergs theory is also known as the hygiene theory. Herzberg identified characteristics which make people satisfied with their jobs and those which make them dissatisfied: satisfiers and dissatisfiers. The satisfiers are factors which give people long-term motivation and enable them to enjoy their work: * The type of work * Promotion prospects * Having responsibilities * Sense of achievement * Personal development * Gaining recognition This dissatisfiers or hygiene factors need to be operating well in an organisation but according to Herzberg do not ultimately motivate people. These are: * Salary * Working conditions * Relationships with others- colleagues and managers * Company policy (B) Describe, with examples, how working relationships can impact on motivation and contribute to an effective workplace in travel and tourism, covering:- * Management style Management is about motivating people to act in certain ways so that the team can achieve its common goal. A good manager must inform, motivate and develop the team. The four types of manager/management I will be talking about are:- 1. An autocratic manager An autocratic manager makes all the decisions and announces them to the team. This person is the boss and so has full control. The main advantage of this kind of leadership is that decisions are made quickly, as no consultation is involved. Its other advantages include:- * Where there is a need for urgent action the autocrat will take control * Some team members gain security from being told what to do. Disadvantages include:- * Team members may become frustrated at their lack of control * There may not be room for the team to express creativity * There may be over-dependence on the leaders Autocratic management belongs in a traditional hierarchical structure. 2. Consultative management With consultative management, the leader still makes the decisions but discusses them with the team. The advantages include:- * The team is informed of what is going on * Open discussion is encouraged * The manager spends time with the team The disadvantages are that the team feel involved but frustrated by having no real power. 3. Democratic management With democratic management, the decision-making is shared among the team. The advantages include:- * Ideas are encouraged from everyone * There is greater involvement and commitment from team members * The team is likely to be supportive of the leader * The team is fully informed The disadvantages include:- * Some team members may not be able to cope with being involved in decision-making * The democratic process can take too long * The leader may not agree with the decisions of the team * Powerful team members may take over 4. Laissez-faire management With laissez-faire management the team is left to sort itself out and get on with its work. The manager does not get involved and therefore is not leading the team. The advantages include:- * Highly motivated and skilled people are able to get on with their tasks * The team is empowered The disadvantages include:- * New team members will be uninformed * The team may be left with little or no direction * Teamwork Teamwork skills are essential in the workplace. You must be able to work with other people in a team even if you dont happen to like them. A team is a group of people who are working together to achieve common objectives. Even when you are not physically with other members of your team, you can work together by contributing to a sequence of activities with a common aim. If you were working as a resort representative in Spain, you would still be working in a team with colleagues in head office in the UK. 1. Team roles Good teams achieve synergy; that is, together they can achieve more than the members could individually. More ideas, energy and resources are generated as a group because:- * The team solves problems and makes decisions together * The team focuses on the priorities, with everyone working towards the same aim * The team provides a sense of belonging and a sense of status * The team provides a support network Not everyone in a team is the same- each person has their own strengths and weaknesses. If each person had the same weaknesses, the team could not work; there needs to be a balance of skills. A method of recognising individuals strengths and weaknesses is needed in order to build an effective team. The management expert R.Meredith Belbin has outlined nine team roles necessary for a successful team. One person can represent more than one role, as most people have strengths in more than one area. Belbins roles:- Chairperson/ co-ordinator = The group leader, likely to be relaxed and extrovert, also likely to be a good communicator. They will build on the strengths of team members and give them encouragement. Plant = The ideas person in the team, a person who is creative in looking for solution to problems, but not always good at details, and so may make careless mistakes. Shaper = The task leader, who unites ideas and effort. Needs to be dominated and extrovert in order to make things happen. Monitor/ evaluator = The team analyst, who is not so good at ideas but pays attention to details, thus keeping the team directed towards its target. Implementer = The organiser of the team, who is able to make the ideas of the plant and shaper and turn them into manageable and realistic tasks. A practical, stable and disciplined person. Resources investigator = The person who is outgoing and will explore and report on ideas and developments outside the group; is sociable and enthusiastic and good under pressure. Team worker = A very people-oriented person, sensitive to others needs. The team worker has good communication skills and will be good at motivating other. A natural mediator, who will deal with any conflict within the team, this person is very good to have around in a crisis. Finisher = A person who sticks to deadlines and likes to get on with things. Will probably be irritated by the more relaxed members of the team. Specialist = This person is single-minded and a self-starter and provides knowledge and skills in specialist areas each of Belbins roles acquires a different level of important according to the objectives of the team and the stage in the teams life. 2. team development Formal teams are part of the structure of an organisation and are planned in order to meet that organisations objectives. The formal team will follow rules and regulations and may meet on a pre-arranged schedule and complete administrative procedures. Examples in travel and tourism includes sales teams and marketing teams Informal teams work within or outside formal teams. They are sometimes based on personal relationships between members rather than on work roles. When you complete group work for assignments, you often choose the colleagues you wish. You choose to work with people you like and ones you know will be as committed as you are to the work. This is an informal team. There are several theories of team structure and development, which will help you to understand the effectiveness of teams. Bruce Tuckman (1965) identified four main stages of team development:- * Forming at this stage, team members form their first impressions of each other and establish identities. They are sounding each other out and finding out what is expected of them. * Storming- the team members have, by now, become more used to each other. Members are prepared to put forward their ideas forcibly and openly; they are also prepared to disagree and so there may be some conflict and hostility. * Norming the team now begins to establish co-operation. Conflict is controlled, views are exchanged and new standards introduced. * Performing the team is now working together; it begins to arrive at solutions and achieve objectives. There can also be a fifth stage, called adjourning or mourning, where the team has disbanded and the members miss being part of the team. * Job roles and lines of responsibility An organisation chart shows the structure of the company and how the work is divided into different areas. It also shows the lines of responsibility between staff, so that it is apparent who is responsible to whom. An employee studying a chart will find the possible promotions routes. The chart may show a hierarchical structure or line relationship. This is a very traditional structure and shows a chain of command with each person responsible to the person above them. It is sometimes referred to as a pyramid structure. Many organisations today would be depicted in a chart with a flatter structure. There are fewer layers of management, and each manager has a broader span of control. Restructuring of organisations often involves getting rid of middle managers, hence the flattened structure. * Channels of communication Open communication must be encouraged and ideas should be freely expressed in the workplace. There should be trust and support between team members. An effective leader can encourage good communication and shape the way the team works. * Verbal Verbal communication is the process of sending and receiving messages with words, including writing and there are different ways a person can do verbal communication 1. Telephone 2. Word of mouth 3. Video conference 4. Face to face 5. Presentation 6. Walkie-talkie 7. Meetings 8. Bluetooth/ headset (mobile phone) 9. Radio 10. Sign language * Written Written communication guarantees that everyone concerned has the same information and it provides a long-lasting record of communication for future such as 1. Books 2. Brochures/ leaflets, newspaper 3. E-mail 4. Text (written + electronic + verbal) 5. Fax (written + electronic) 6. Notice boards 7. Minutes of meetings * Electronic Electronic communication means any method used to convey a message that has been transmitted via electronic means such as e-mail, video conferencing, radio, TV, mobile phone, internet, fax etc. * Equal opportunities Legislation exists to ensure that personal receive equal opportunities and that there is no discrimination. The arts of parliament that you should be aware of are:- * Race relations Act 1976 This act makes discrimination on racial grounds unlawful in employment, training, education and the provision of goods, facilities and services. The two main type of discrimination involved in this Act are:- 1. direct discrimination:- discrimination against colour disability, citizenship 2. indirect discrimination:- discriminating a racial group * Sex discrimination Act 1975 This act makes it unlawful to discriminating against someone on the ground of gender, marital status, Gender reassignment or sexual orientation. The act was updated in 1986 to remove restrictions on womens hours of work and then it allowed women to take h=jobs with flexible hours. This act not only covers discriminations in the workplace but in job advertisements and interviews. * Disability discrimination act 1995 This act makes discrimination against people with disabilities unlawful in respect of employment, education and access to goods, facilities, services, and premises. Employers are required to make reasonable adjustments to accommodate people with disabilities. Examples include providing specially adapted keyboards for arthritis sufferers, facilitating wheelchair access and relocating people with limited mobility to the ground floor. * Equal pay act 1970 This act was introduced to address the problem of women being paid less than men for the same work. It allows employees to claim equal value in terms of demands made on them, such as effort, skills and decisions made. There is also an EU Directive that state that for the same work or work of equal value, sex discrimination must be eliminated in all aspects of pay. * Other forms of discrimination Discrimination at work is a very serious issue and can result in large amounts of compensation being awarded following successful tribunals, not to set up policies to ensure that the workplace is free from discrimination. Measures to be taken include:- 1. Setting up a comprehensive equal opportunities policy covering all aspects of discrimination 2. Training staff in discrimination legislation and on how to implement the equal opportunities policy 3. Setting up complaints procedures for instances of discrimination * Employment rights act 1996 When someone gets a job they can aspect to receive a contract of employment. This is a legally binding agreement between the employer and the employee. Under the Employment Rights Act, the employer must give the employee a written document including the following information, in writing within 2 months of starting work:- 1. Name of employer and employee 2. Date employment began 3. Rate of pay and interval of pay 4. Hours of work 5. Holiday entitlement and pay 6. Job title and brief description of duties 7. Place of work 8. Notice entitlement and requirements 9. Sick leave entitlement and sick pay 10. Pension and pension scheme 11. Disciplinary procedures and grievance producers 12. Date of end of employment it fixed term 13. Additional details about working aboard if appropriate. * Notice board After one month of continues employment an employee is entitle to one week of notice if the employment ends. After 2 years employment they are entitle to 2 weeks notice, after 3 years, 3 weeks notice and so on. After 12 years the legal maximum 12 weeks notice is reached. A employee must also give notice of leaving to an employer. After one month of continuous employment, an employee must give a minimum of one weeks notice. Employees are entitled to normal pay during notice periods as long as they are working or available for work. * Redundancy Redundancy pay is calculated according to the employees age, length of service and salary. Employees can claim for unfair dismissal if they suspect: 1. There is no real redundancy 2. They were unfairly selected for redundancy Dismissal is treated as redundancy if the whole business is closing or a particular job disappears or requires fewer employees. An employer may offer alternative employment. If the employee unreasonably refuses it they are not entitled to redundancy pay. * EU Directives on hours and pay The European Working Time Directive was enacted in the UK through the Working Time Regulations 1998. This lays down the following: 1. A maximum 48-hours week, averaged over 17 weeks 2. at least 4 weeks paid annual leave 3. a weekly rest period of at least 24 hours in each 7-day period 4. a daily rest period of at least 11 consecutive hours between each working day 5. an in-work rest break of 20 minutes for those working hours or more per day Some sectors are excluded from the regulations; one of theses is transport. * National Minimum Wage Act 1998 This Act provides workers with a minimum hourly rate below which their wages will not fall. Those who work part time benefit most, because they are often badly paid. The Low Pay Commission advises the Secretary of State on the value of the minimum rate. A special lower rate applies to 18-to 21years-olds. * Maternity and paternity leave The Employment Relations Act 1999 provides for basic rights for maternity leave. There are three periods of maternity leave. Ordinary maternity leave is for a period of 18 weeks which coincides with the period for statutory maternity pay. This applies to all employees. Compulsory maternity leave extends to a period of 2 weeks after the birth; the employer must not permit the woman to return to work during this period. Additional maternity leave follows immediately after the original 18-weekperiod and must end within 29 weeks of the birth. Employees with at least one years service with an employer are eligible for the additional maternity leave. Under the same Act there are provisions to allow parents 3 months leave in order to care for a child. This is intended to be taken before the child is five. It is intended to be available to men and to women, in addition to maternity leave. Paternity leave is available to men to: 1. Have or expect to have responsibility for the childs upbringing 2. Are the biological father of the child, or the mothers husband or partner 3. Have worked continuously for their employer for 26 weeks ending with the fifteenth week before the baby is due. Eligible employees can choose take either 1 week or 2 consecutive weeks paternity leave (not odd days) * Statutory sickness pay An employer must pay Statutory Sick Pay to employees who become sick and who normally earn at least à ¯Ã‚ ¿Ã‚ ½79 per week. After 28 weeks, Incapacity Benefit or Income Support must be claimed instead. * Grievance and disciplinary procedures These must be included in the employees written statement or contract, or at least there must be a reference to where they can be found. Disciplinary producers deal with such maters as warnings to be given before dismissal. Warnings might arise from the following:- 1. Lack of capability or qualifications-although the employer has a responsibility to give training 2. Misconduct-which includes habitual lateness 3. Gross misconduct (for example, assault or theft) leads to instant or summary dismissal. Grievance procedures deal with complaints by employees who are not satisfied with aspects of their employment. Employees must be given the name of a person to whom a complaint can b made and should be informed of right of appeal. * Investors in people Investors in people is a UK quality standard development in 1990. Those companies who gain the award have proved that they invest in the training and development of their staff. This is beneficial to employees and also to customers and suppliers. The standard for Investors in people is based on four key principals: 1. Commitment from the top to develop all employees 2. Regular review of training and development needs 3. Taking relevant action to meet those needs throughout peoples careers 4. Evaluating training and development outcomes for individuals and the organisation in order to continuously improve These principals are subdivided into 24 indicators of effective practise, and the organisation provides evidence for assessment against the indicators. Once the organisation gets the award it is entitled to display the Investors in People logo on company literature. * Buddies and mentoring Mentoring schemes are growing in popularity. They offer employees a one-to one relationship with a mentor, someone with greater experience and a willingness to listen and advice. The mentor and the mentee meet regularly and discuss aspects of the mentees job, such as career development. The mentor does not act as a line manager or superior and is never judgemental, but acts as a sounding board and is able to offer ideas and a different outlook on work issues. The Hilton hotel chain runs a mentoring scheme for its staff at all levels. Its purpose is to support staff in their career development. Mentors at the Hilton chain are often colleagues of the mentees doing similar jobs, which departs from the traditional model. All of the mentors have had mentoring training. Some companies have similar, but sometimes less formal, schemes where a new member of staff is given a buddy as a source of information and help. * Job security Many contracts today are fixed term, especially in areas such as visitor attractions. This means that the period of employment is not indefinite but lasts for a period of months or a year or two. The reason for such contracts is flexibility for employers- they can lose staff on fixed contracts at the end of the period without penalty. However, such contracts are demotivating for staff as they worry about their future income and job prospects. C) Describe with examples, how incentives can impact on motivation and contribute to an effective workplace in travel and tourism including: * Remuneration Remuneration means how much you get paid. You would imagine that this is very important as a motivator. In fact, it is an important factor in attracting people to a company but research shows that it is not the most important incentive. * Performance related pay Bonuses are often based on overall profits and awarded to all employees- usually performance related. * Incentive scheme An example of an incentive scheme could be a competition that staff are invited to enter. The competitions may be based on generating new ideas within the company, or how to boost sales, customer satisfaction or commissions on sales. * Discounts Discounts may be given on holidays or travel for those working in the industry. Many who work in travel and tourism receive cheap travel, perhaps by going on standby if they work for an airline or by going on fact-finding trips to a destination if they work for a travel agent. * Holiday entitlement In the UK employees can expect around 4 weeks paid holiday per year. In the public sector more holiday is often given, but this may be balanced against lower pay. * Pension schemes A good pension scheme can act as an incentive for many people who are concerned about security in retirement. * Perks As a perk, employees in the travel and tourism industry are often provided with a uniform. They may get to travel or live aboard and be paid to live there. They may be provided with a company car. * Opportunities for promotion and progression Many employees need a challenge and if they are in the same position, doing a job they find easy, they may become bored and less efficient. Thus, opportunities to move on and face new challenges are an important incentive. Opportunities may arise within an organisation and good people are quickly promoted. You may wish to let it be known that you are interested in progression and ask to be sent on relevant training courses and conferences. D) Described, with examples, how training can impact on motivation and contribute to an effective workplace in travel and tourism including: * Training Those employers who wish o ensure an effective workplace will offer ongoing training and development to staff. There are several benefits to organisations add to their workforces. Training can: * Improve individual performance * Improve team performance * Allow staff to be better informal * Equip staff to deal with change and emergencies * Make for a more flexible workforce * Improve morale * Allow managers more time to manage through delegation of other tasks. * Induction training Employers have to provide instruction and training to ensure health and safety, and this is usually a part of induction training. The induction is the first stage of training and is given to new employees; it is important as new employees need to be made welcome and become effective in their work as quickly as possible. Induction covers: * The nature of the job * Introduction to the workplace and to staff * The lines of responsibility * Facilities such as toilets, lockers, canteen * Health and safety basics * Training opportunities * In-house training Large companies offer their own in-house training and may even write their own materials. These training courses are very beneficial as they are tailor- made to meet the needs of the company. * External courses Thousands of external courses are available. These may be specific to travel and tourism or other professional qualifications in areas such as marketing or human resource management. They may be offered by colleges, by travel associations or by private companies. Companies may allow individuals or groups to attend such courses. Some may be long term, leading to advanced qualifications, so a great deal of commitment is required on behalf of the individual.

Saturday, October 26, 2019

Study on the use of reflection in nursing

Study on the use of reflection in nursing In recent years, reflection has undoubtedly become an important concept in nursing, stimulating debate and influencing nursing practice and education around the world. Much has been written about the theory of reflection, the majority of which has been applied to the educational setting (Price 2004). However, the process of reflecting has been described as a transferable skill which may be incorporated into clinical practice, enabling practitioners to better understand themselves and others, and solve problems (Mantzoukas Jasper 2004). Indeed, the capability to reflect consciously upon ones professional practice is generally considered important for the development of education and, hence, for clinical expertise (Mamede Schmidt 2004). Reid (1993) defines reflection as a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice (Reid 1993, p. 305). The nursing profession seems to advocate the need for nurses to be educated and practice in ways that develop their critical thinking, autonomy and sensitivity to others (Reed Ground 1997). Bulman (2004) contends that reflective practice may provide a means of achieving this. Within an intensive care setting, some evidence exists to suggest a strong relationship between lived experience and learning, with most critical care practitioners learning from previous experience (Hendricks et al 1996). More recently, reflection has been closely associated with the concepts of critical thinking and deconstruction. It is argued that a combination of these principles create a retrospective and prospective dimension, giving the practitioner the ability to deconstruct events, to reason the origins of situations, and to consider what has gone before and what may happen yet (Rolfe 2005). In order to be effective in practice there is a requirement to be purposeful and goal directed. It is suggested therefore that reflection cannot just be concerned with understanding, but must also focus on locating practice within its social structures, and on changing practice (Bolton 2001). This suggests that a structured approach to reflection is of benefit to the practitioner. Indeed the use of a model or framework of reflection is advocated as a tool which can aid and facilitate the practitioner in reflection, promoting a process of continuous development (Bulman 2004). Reflection is seen as a dynamic process and not a static one (Duke 2004), and thus the use of a framework which adopts a cyclic approach to reflective practice seems appropriate. One such framework is Gibbs (1988) Reflective Cycle, which is adapted form a framework of experiential learning, and uses a series of questions to guide, and provide structure for the practitioner when reflecting on an experience. Gibbs (1988) highlights 6 important areas of consideration when reflecting on a specific situation, encouraging the practitioner to consider what happened, why it happened and what could be done differently in the future. The 6 components of the Reflective Cycle are outlined below: Description What happened? Feelings What were you thinking and feeling? Evaluation What was good and bad about the situation? Analysis What sense can you make of the situation? Conclusion What else could you have done? Action Plan If the situation arose again, what would you do? It is clear that the idea of reflective practice has come to have a considerable impact on the nursing profession. This paper will focus on 2 clinical scenarios occurring within an intensive care setting. The issues raised will be discussed within the context of Gibbs (1988) Reflective Cycle. The aim in doing so is to highlight the benefits of a structured reflective process, and to identify ways in which clinical practice may be improved in the future. Scenario 1 Description The first scenario concerns the care of an elderly, critically ill patient, who was being treated in a surgical intensive care unit. At the time of this scenario the patient had been in intensive care for almost 3 weeks, having been admitted with respiratory failure requiring intubation, and displaying clinical symptoms consistent with sepsis. The patient had many other underlying medical problems, was morbidly obese, and despite antibiotic therapy was requiring high levels of inotropic and ventilatory support. Despite the patients symptoms, no definite source of sepsis had been identified. The above patient was being cared for by the author on a 12 hour day shift and at the morning ward round it was noted that the patients condition had deteriorated significantly over the previous 2 days, with increased inotrope dependence and worsening renal function. With few treatment options left to try, the consultant anaesthetist decided that the patient should have a CT scan to identify or rule out an abdominal problem as a source of the sepsis. The patient was reviewed by a consultant surgeon who felt that in view of the patients co-morbidity, surgery of any kind would not be appropriate, despite potential positive findings on CT. Knowing that a CT scan had been carried out 1 week previously with no significant findings, the author raised concerns about the benefit of such a procedure, and suggested that at the very least the patients family should be informed or consulted about the planned investigation. The patients son had been spoken to the previous day and informed that the prognosis was very poor. Withdrawal of treatment had been mentioned as a possibility in the event of no improvement in the patients condition. The son however was not informed about the scan which went ahead the same day. Transferring the patient to the radiology department for scan proved difficult. The patient was sedated for transfer resulting in a need for increased inotropes due to further hypotension caused by the sedation. The patients large size also created a problem in finding an appropriate transfer trolley to take the patients weight. Again the author voiced concerns, stating that perhaps transfer was inadvisable in view of the patients unstable cardiovascular status. The anaesthetist decided that we should proceed with the scan. The patient remained unstable throughout the transfer, requiring a further increase in inotropes on arrival at scan. Whilst on the CT table, the patient became dangerously hypotensive and bradycardic, and it seemed that cardiac arrest was imminent. Adrenaline boluses were administered, and large fluid boluses of gelofusine were also given. In view of this, the CT scan was abandoned midway, and the patient was quickly transferred back to ICU. Further adrenaline boluses were needed during transfer. On arrival back to ICU, the author was met by the patients son, who was not aware that the patient was being scanned. He was made aware of the patients poor condition. Back in ICU it was decided that further resuscitation was not appropriate. The son was present when the patient died a few minutes later. Feelings On the day these events took place, the predominant thoughts and feelings of the author were ones of guilt and inadequacy. Having considered the multiple health problems faced by the patient at this time, the author felt that the process of transferring the patient to CT scan and carrying out the scan itself may cause the patient stress, discomfort and potential danger, and ultimately be of little or no benefit. During the transfer and scanning process, the author became increasingly anxious about the immediate safety of the patient, and the potential for deterioration in the patients condition. When the patient became dangerously bradycardic and hypotensive, the authors thoughts were concentrated on trying to prevent cardiac arrest. On returning to ICU and meeting the patients son, it seemed that neither the dignity of the patient or the concerns of the family had been respected. The author felt an inadequacy and felt that the interests of the patient had not been properly advocated. The patient passed away in a distressing and undignified manner, and the son did not have the opportunity to spend personal time with the patient prior to this happening. The author felt guilty, as it seemed that the CT scan should not have happened and that the undignified circumstances surrounding the patients death need not have occurred. Evaluation Looking back on the events of scenario 1, it seems that there were both positive and negative aspects to the experience. During transfer to CT scan and the emergency situation which followed, the author felt that there was good teamwork between the different professionals involved in the care of the patient. Because of this, prompt action was taken, preventing cardiac arrest. However, it seems that this situation may have been avoided, which in turn raises many questions relating to the care of the patient. Ethically, one must question how appropriate it was to scan a severely septic, unstable patient, especially when corrective treatments would have been inappropriate in the event of an abnormality being discovered. Should the author have advocated the interests of the patient and family more forcefully? Was there a lack of communication and consensus between the critical care team? The events of this incident culminated in a clinical emergency situation which led to the patients death. Thus, the author feels that the patients clinical condition and the ethical issues and dilemmas surrounding the patients care must be examined and discussed, in the hope that lessons can be learned through the reflective process. Analysis Sepsis Most illness and death in patients in intensive care is caused by the consequences of sepsis and systemic inflammation. Indeed, sepsis affects 18 million people worldwide each year (Slade et al 2003), with severe sepsis remaining the highest cause of death in patients admitted to non-coronary intensive care units (Edbrooke et al 1999). Sepsis is a complex condition that results from an infectious process, and is the bodys response to infection. It involves systemic inflammatory and cellular events that result in altered circulation and coagulation, endothelial dysfunction, and impaired tissue perfusion (Kleinpell 2004). Dellinger et al (2004) define sepsis as the systemic response to infection manifested by 2 or more of the following: High or low temperature (>38 °C or Heart rate > 90 beats per minute Respiratory rate > 20 breaths per minute or PaCO2 High or low white blood cell count (> 12,000 or In severe sepsis impaired tissue perfusion along with micro vascular coagulation can lead to multiple organ system dysfunction, which is a major cause of sepsis-related mortality (Robson Newell 2005). While all organs are prone to failure in sepsis, pulmonary, cardiovascular, and renal dysfunction occur most commonly (Hotchkiss Karl 2003). When multiple organ system dysfunction occurs, Dolan (2003) promotes evidence-based sepsis treatment whereby patients should receive targeted organ support. This includes mechanical ventilation, renal replacement therapy, fluids, vasopressor or inotropic administration, and blood product administration, to maximize perfusion and oxygenation. In recent years new therapies have emerged which have been shown, in some cases, to increase the chance of survival from severe sepsis. Recombinant human activated protein C has been shown to have anti-inflammatory, anti-thrombotic and pro-fibrinolytic properties (Dolan 2003). In a randomised controlled trial, Bernard et al (2001) found a significant reduction in the mortality of septic patients who had been treated with activated protein C. The National Institute for clinical excellence (2004) now recommends this treatment for adult patients who have severe sepsis resulting in multiple organ failure, and who are being provided with optimal ICU support. Steroids, the use of which in ICU has long been debated, have also been shown, in low doses, to reduce the risk of death in some patients in septic shock (Annane 2000). Despite the development of specific treatments to interrupt or control the inflammatory and procoagulant process associated with sepsis, its management remains a major challenge in healthcare (Kleinpell 2004). The patient in scenario 1 was clearly in a state of severe sepsis, with respiratory, cardiac and renal failure, and receiving some of the supportive treatments mentioned above. Indeed it seems that the severity of this condition should not have been underestimated. In view of this, the ethical issues surrounding the decision to take this patient to CT scan must now be considered. Ethical Dilemmas and Consensus Ethical issues have emerged in recent years as a major component of health care for critically ill patients (Friedman 2001). Thus, caring for these patients in an intensive care setting necessitates that difficult ethical problems must be faced and resolved (Fisher 2004). Traditionally, much of the literature in biomedical ethics comes from theoretical perspectives that include principled ethics, caring ethics and virtue ethics (Bunch 2002). Although these perspectives provide an ethical awareness, which can be helpful, they do not of necessity give much direction for clinical practice. Melia (2001) supports this notion, suggesting that many discussions of ethical issues in health care are presented from a moral philosophical viewpoint, which as a consequence leaves out the clinical and social context in which decisions are taken and carried through. Beauchamp Childress (1994) identify 5 principles pertinent to decision making in intensive care. These are: salvageability, life preservation, non-maleficence, beneficence, and justice. Ethical dilemmas occur when two or more of the above principles come into conflict. The principles of beneficence (doing good), non-maleficence (doing no harm) and justice (fair treatment) are well established within the field of bioethics. Within a critical care context however, the dilemma between salvageability and life preservation becomes an important focus for health care professionals. Indeed, Prien Van Aken (1999) raise the question of whether all medical means to preserve life have to be employed under all circumstances, or are there situations in which we should not do everything that it is possible to do. This question becomes particularly relevant when a patients condition does not improve but rather deteriorates progressively. Curtin (2005) suggests that at some point in the course of t reatment, the line between treating a curable disease and protracting an unpreventable death can be crossed. In such incidences Prien Van Aken (1999) identify a transitional zone between the attempt to treat the patient, and the prolongation of dying, in which a conflict between the principles of life preservation and non-maleficence develops. These concepts seem particularly relevant to scenario 1 where the interests of the patient may have been neglected in favour of further attempts to treat the patients condition. This, in turn created a conflict between the principles of salvageability and life preservation. The decision to perform a CT scan on a patient with such cardiovascular instability and a very poor prognosis, meant that the patient was subjected to dangers and harms when there were few, if any benefits to justify this. Hence, the conflict between the ethical principles was not resolved, and the professional duty of non-maleficence toward the patient was not respected. Such conflicts and dilemmas in intensive care can be made all the harder by the availability of advanced technologies. Callahan (2003) writes that one of the most seductive powers of medical technology is to confuse the use of technology with a respect for the sanctity of life. In addition, Fisher (2004) contends that it has become all too easy to think that if one respects the value of life, and technology has the power to extend life, then a failure to use it is a failure to respect that value. This is particularly true of diagnostic technologies (such as CT scanning) which must be used with caution, especially in cases where the diagnostic information will make little or no difference to the treatment of the patient, but can create or heighten anxiety and discomfort for the patient (Callahan 2003). Medical technology is a two-edged sword, capable of saving and improving life but also of ending and harming life (Curtin 2005). Good critical care medicine carries the responsibility o f preserving life, on the one hand, and making possible a peaceful death, on the other. Callahan (2003) concludes by warning that any automatic bias in favour of using technology will threaten that latter possibility. Consensus between members of the intensive care team is also highlighted as an important issue in ethical decision making. Effective communication and collaboration among medical and nursing staff are essential for high quality health care (Woodrow 2000). Collaboration can be seen as working together, sharing responsibility for solving problems, and making decisions to formulate and execute plans for patient care (Gedney 2000 p.41). In intensive care units where ethical problems are faced frequently, care has to be a team effort (Fisher 2004). In a qualitative study, Melia (2001) found that there was a strong desire within the intensive care team that ethical and moral consensus should be achieved in the interests of good patient care, even though it was recognised that there is no legal requirement for nurses to agree with ICU decisions. Cobaoglu Algier (2004) however, found that the same ethical dilemma was perceived differently by medics and nurses with the differences being related to the hospitals hierarchical structure and the traditional distinctions between the two professions. Similarly, it has been observed that differences between doctors and nurses in ethical dilemmas were a function of the professional role played by each, rather than differences in ethical reasoning or moral motivation (Oberle Hughes 2001). It seems therefore that while the medical and nursing professions share the same aims for patient outcomes, the ideas surrounding how these outcomes should be achieved may differ (Fisher 2004). These differences have contributed to the development of the concept of the nurse as patient advocate, which sees advocacy as a fundamental and integral role in the caring relationship, and not simply as a single component of care (Snowball 1996). The role of the nurse advocate should be that of mediator and facilitator, negotiating between the different health and illness perspectives of patient, doctor, and other health care professionals on the patients behalf (Mallik 1998). Empirical evidence is sparse and philosophical arguments seem to predominate in the field of patient advocacy. There is some evidence to suggest that nurse advocacy has had beneficial outcomes for the patient and family in critical care areas (Washington 2001). Hewitt (2002) however found that humanistic arguments that promote advocacy as a moral imperative are compelling. Benner (1984) writes of advocacy within the context of being with a patient in such a way that acknowledges your shared humanity, which is the base of nursing as a caring practice (Benner 1984, p. 28). It has been argued that advocacy, at least in a philosophical sense, is the foundation of nursing itself and as such should be regarded as an issue of great importance by all practitioners (Snowball 1996). Conclusion It can be concluded that sepsis in a critical care environment is a complex condition with a high mortality rate, requiring highly specialised treatments. As such, the ethical issues and dilemmas faced by health care staff caring for a septic patient can be both complex and far reaching. It must be noted, that there can be no general solutions for such ethical conflicts; each clinical case must be evaluated individually with all its associated circumstances. A study of ethical principles would suggest that it is important that the benefits of a specific treatment or procedure are established prior to implementation, and that these benefits outweigh any potential harms or risks to the patient. The ultimate decision maker in the scenario under discussion was the consultant anaesthetist, who should have provided a clearer rationale for performing a CT scan on such an unstable patient. As the nurse caring for the patient, the author recognises that the final decision regarding treatment rested with the anaesthetist. However, the author could have challenged the anaesthetists decision further, advocating the patients interests, with the aim of reaching a moral consensus within the team. Perhaps then the outcome would have been more favourable for all concerned. Action Plan By reflecting on this scenario, the author has gained an understanding of sepsis and the potential ethical problems which may be encountered when caring for a septic or critically ill patient. As a result, the author feels more confident to challenge those decisions made relating to treatment, which do not seem to be in the best interest of the patient, or which have the potential to cause more harm than good. The author now has a greater understanding of the professional responsibility to advocate on a patients behalf, with the aim of safeguarding against possible dangers. It is hoped that this will result in improved outcomes for patients in the authors care. Scenario 2 Description This incident occurred in a surgical intensive care unit while the author was looking after a ventilated patient who had undergone a laparotomy and right sided hemi-colectomy 2 days previously. Around 10.30am the patient was reviewed by medical staff and was found to be awake and alert with good arterial blood gases, and requiring minimal ventilatory support. In view of this, it was decided that the patients support should be reduced further, and providing this reduction was tolerated, that the patient should be extubated later in the morning. In the intensive care unit in which the author works an intensive insulin infusion protocol is used (see Appendix A). This is a research based protocol which aims to normalize blood glucose levels and thus improve clinical outcomes for critically ill patients. All patients on this protocol require either to be absorbing enteral feed at à ¢Ã¢â‚¬ °Ã‚ ¥30ml/hr, on TPN or on 5% dextrose at 100ml/hr (Appendix A, note 2). The patient involved in this incident was receiving enteral feed via a naso-gastric tube, and was on an insulin infusion which was running at 4 U/hr. When it was decided that the patient was to be extubated, the author stopped the enteral feed as a precaution, to prevent possible aspiration during or after extubation. The author however did not stop the insulin infusion which breached the protocol guidelines. About 12 noon the patients blood gases showed that the reduction in support had been tolerated, and so the patient was extubated. Shortly after this the author was asked to go for lunch break and so passed on to a colleague that the patient had recently been extubated but was managing well on face mask oxygen. Returning from lunch 45 minutes later, the author found the patient to be disorientated and slightly confused. With good oxygen saturations, the author doubted that the confusion had resulted from hypoxia or worsening blood gases. The author then realised that the insulin infusion had not been stopped with the enteral feed earlier. A check of the patients blood glucose level showed that it was 1.2mmol/L. The author immediately stopped the insulin infusion, administered 20mls of 50% dextrose intravenously, as per protocol, and recommenced the enteral feed. Twenty minutes later, the patients blood glucose level had risen to 3.7mmol/L. The patient continued on the insulin protocol maintaining blood glucose levels within an adequate range. There were no lasting adverse effects resulting from the hypoglycaemic episode. Feelings When it was realised that the insulin infusion had not been stopped, the author felt a sense of panic, anticipating correctly that the patients blood glucose level would be dangerously low. Thoughts then became concentrated on raising the blood glucose level, to ensure that no further harm would come to the patient as a result of the authors mistake. Following the incident, when the patients glucose levels had risen, feelings of guilt were prominent. At this point the author realised how much worse the outcome could have been for the patient. The author felt incompetent, knowing that the patient could have been much more severely affected, or could even have died as the result of such a simple mistake. Evaluation The events of scenario 2 highlight the fact that clinical errors, while easily made, can have potentially disastrous consequences. This is especially true of those errors which involve the administration of drugs intravenously. In the interest of patient safety, it is important that all such errors are avoided. The clinical error outlined above could easily have been avoided. It seems that there was not sufficient awareness, on the authors part, of the insulin infusion protocol and the guidelines concerning the administration of insulin. As a result, the insulin protocol was not adhered to. The following analysis therefore will focus on the importance of insulin therapy in critical care areas, and will consider the safety issues surrounding intravenous drug administration. Analysis Blood Glucose Control in Intensive Care It is well documented that critically ill patients who require prolonged intensive care treatment are at high risk of multiple organ failure and death (Diringer 2005). Extensive research over the last decade has focused on strategies to prevent or reverse multiple organ failure, only a few of which have revealed positive results. One of these strategies is tight blood glucose control with insulin (Khoury et al 2004). It is well known that any type of acute illness or injury results in insulin resistance, glucose intolerance and hyperglycaemia, a constellation which has been termed the diabetes of stress (McCowen et al 2001). In critically ill patients, the severity of this condition has been shown to reflect the risk of death (Laird et al 2004). Much has been learned recently about the negative prognostic effects of hyperglycemia in critically ill patients. Hyperglycaemia adversely affects fluid balance, predisposition to infection, morbidity following acute cardiovascular events, and can increase the risk of renal failure, neuropathy and mortality in ICU patients (DiNardo et al 2004). Research suggests that there are distinct benefits of insulin therapy in improving clinical outcomes. Such benefits have been seen in patients following acute myocardial infarction, and in the healing of sternal wounds in patients who have had cardiac surgery (Malmberg 1997; Furnary et al 1999). More recently Van den Berghe et al (2001) conducted a large, randomized, controlled study involving adults admitted to a surgical intensive care unit who were receiving mechanical ventilation. The study demonstrated that normalisation of blood glucose levels using an intensive insulin infusion protocol improved clinical outcomes in critically ill patients. In particular, intensive insulin therapy was shown to reduce ICU mortality by 42%, and significantly reduce the incidences of septicaemia, acute renal failure, prolonged ventilatory support, and critical illness polyneuropathy. The length of stay in intensive care was also significantly shorter for patients on the protocol. It is unclear as to why improved glycaemic control has been associated with improved outcomes in several clinical settings. Coursin and Murray (2003) have summarized several leading hypotheses including maintenance of macrophage and neutrophil function, enhancement of erythropoiesis, and the direct anabolic effect of insulin on respiratory muscles. The potential anti-inflammatory effects of insulin have also been evaluated (Das 2001). There is also uncertainty over whether it is the actual insulin dose received per se, or the degree of normoglycaemia achieved that is responsible for the beneficial effects of intensive glycaemic management. Van den Berghe (2003) analysed the data derived from their 2001 study and have concluded that the degree of glycaemic control, rather the quantity of insulin administered was associated with the decrease in mortality and organ system dysfunction. In a follow up to Van den Berghe et als 2001 study, Langouche et al (2005) found that a significant part of the improved patient outcomes were explained by the effects of intensive insulin on vascular endothelium. The vascular endothelium controls vasomotor tone and micro-vascular flow, and regulates trafficking of nutrients and several biologically active molecules (Aird 2003). Langouche et al (2005) conclude that maintaining normoglycaemia with intensive insulin therapy during critical illness protects the vascular endothelium and thereby contributes to the prevention of organ failure and death. Whatever the reasons for improved patient outcomes, the study by Van den Burghe et al (2001) has prompted much research in this field, all of which has yielded similar results. In a similar study, Krinsley (2004) found that the use of an insulin protocol resulted in significantly improved glycaemic control and was associated with decreased mortality, organ dysfunction, and length of stay in the ICU in a heterogeneous population of critically ill adult patients. Thus it seems that with the strength of the emerging data in support of a more intensive approach to glycaemic management, insulin infusions are being utilised with increasing frequency, and are considered by many to be the standard of care for critically ill patients (DiNardo et al 2004). It is important to note that a well recognised risk of intensive glucose management is hypoglycaemia. Indeed Goldberg et al (2004) emphasise that in the ICU setting where patients often cannot report or respond to symptoms, the potential for hypoglycaemia is of particular concern. The events of scenario 2 highlight the authors error in the administration of insulin resulting in hypoglycaemia. For this reason some issues surrounding intravenous drug therapy will now be discussed. Intravenous Drug Therapy There is an increasing recognition that medication errors are causing a substantial global public health problem. Many of these errors result in harm to patients and increased costs to health providers (Wheeler Wheeler 2005). In the intensive care unit, patients commonly receive multiple drug therapies that are prescribed either for prophylactic indications or for treatment of established disease (Dougherty 2002). Practitioners caring for these patients find themselves in the challenging position of having to monitor these therapies, with the goal of maximizing a beneficial therapeutic response, as well as minimizing the occurrence of any adverse drug-related outcome (Cuddy 2000). The Nursing and Midwifery Council (NMC) (2004) identifies the preparation and administration of medicines as an important aspect of professional practice, stressing that it is not merely a mechanistic task performed in strict compliance with a written prescription, but rather a task that requires thought and professional judgement. Heatlie (2003) found that the introduction of new insulin protocols and regimes could give rise to problems, espe

Thursday, October 24, 2019

Essay example --

†¢ Establish topic and connection with audience. †¢ Establish credibility on the topic and then preview the main points. †¢ Preview the key points in the body of the outline (at least 3 main points). †¢ Summarize and conclude with a closure device. †¢ Include at least 1 peer reviewed source with proper citations. My Favorite Moment Speech – 3 minutes †¢ Describe a favorite moment. †¢ Demonstrate your comprehension of basic tools of an address. †¢ Imagine you are asked by your boss to present this Favorite Moment to a group (general group at your employment). Your boss asks you: Can you make that speech tomorrow? You say â€Å"Yes, of course.† †¢ Decide on a moment in your life which best exemplifies who you are and/or wish to be and then use â€Å"the moment† as evidence. †¢ Present clearly and follow your outline. Demonstration Speech Outline †¢ Two (2) pages that describe what you are going to demonstrate. †¢ You are researching a topic unfamiliar to you and gaining a general understanding and passing it along to the audience. †¢ Imagine you are asked to make a demonstration speech but there is no classroom or ballroom. †¢ Approximately 25 people are called together and you are asked immediately to make this demonstration speech. Where do you go? How do you pull them together? What is your course of action? †¢ Identify greeting and attention getting device. †¢ Establish topic and connection with audience. †¢ Establish credibility on the topic and then preview the main points. †¢ Preview the key points in the body of the outline (at least 3 main points). †¢ Summarize and conclude with a closure device. †¢ Include at least 2 peer reviewed sources with proper citations. Demonstration Speech – 5 minutes †¢ Decide on a topic that you wan... ...estion. The paper must be a minimum of 5 pages in length (double-spaced and with a type font no larger than 12 pts.) and must include at least 3 sources, each of which must be cited within the text of the document using the MLA style. The paper must use at least 2 primary sources, including no less than 1 source from an academically recognized journal or book located in the database of the college’s Learning Resource System. The paper may use no more than 1 secondary source. A properly formatted Works Cited page must also be provided. The value of the paper is 50 points. Assessment of the paper will be based on the points and rubric described in the syllabus. Once graded, the number of points earned will be added to the student’s cumulative total for the course. 1. Paper 1- Choose a speech in Chapter 3 of the Glover book, which focus on knowing your audience.

Wednesday, October 23, 2019

Challenges of Hr

Challenges of HR The future success of any organizations relies on the ability to manage a diverse body of talent that can bring innovative ideas, perspectives and views to their work. The challenge and problems faced of workplace diversity can be turned into a strategic organizational asset if an organization is able to capitalize on this melting pot of diverse talents.With the mixture of talents of diverse cultural backgrounds, genders, ages and lifestyles, an organization can respond to business opportunities more rapidly and creatively, especially in the global arena, which must be one of the important organizational goals to be attained. More importantly, if the organizational environment does not support diversity broadly, one risks losing talent to competitors. The role of HR has changed from a primarily administrative position to one that is more strategic.Times certainly have change from those days when the HR department was called the â€Å"smile and file† department since in that era the primary qualifications for HR were simply a friendly disposition and an ability to file. The emerging trends in HR call for HR Professionals to take the lead in planning for the future and becoming strategic business partners in their organizations. The key to HR planning for the future begins with one simple question that HR Professionals have to ask themselves: If we are successful in the years to come, what will our customers and competitors are saying about us?With the answers to this question, HR Professionals can formulate a clear, shared vision and a sense of direction for the organization. The role of the HR Professional is evolving with the change in competitive market environment and the realization that Human Resource Management must play a more strategic role in the success of an organization. Organizations that do not put their emphasis on attracting and retaining talents may find themselves in dire consequences, as their competitors may be outpla ying them in the strategic employment of their human resources.With the increase in competition, locally or globally, organizations must become more adaptable, resilient, agile, and customer-focused to succeed. And within this change in environment, the HR Professional has to evolve to become a strategic partner, an employee sponsor or advocate, and a change mentor within the organization. In order to succeed, HR must be a business driven function with a thorough understanding of the organization's big picture and be able to influence key decisions and policies.In general, the focus of today's HR Professional is on strategic personnel retention and talents development. HR Professionals will be coaches, counselors, mentors, and succession planners to help motivate organization's members and their loyalty. The HR Professional will also promote and fight for values, ethics, beliefs, and spirituality within their organizations, especially in the management of workplace diversity. The ro le of the HR Professional must parallel the needs of the changing organization.Successful organizations are becoming more adaptable, resilient, quick to change directions, and customer-centered. Within this environment, the HR Professional must learn how to manage effectively through planning, organizing, leading and controlling the human resource and be knowledgeable of emerging trends in training and employee development. The Twenty-first century recognizes the importance of HR Professionals in their contribution to supplying the best manpower supply in a thriving industry.Organizations in the business world rely on Human Resources management teams in overseeing business functions such as hiring, training, conducting interviews, relaying of company-related business trends and issues and employees' benefits and the like. Individuals who work inside this type of industry are tasked to making sure that the provided workforce are adept in their respective business roles and are able t o function optimally under any condition.Companies are increasingly seeking technological solutions to streamline the basics of HR administration, manage competencies, deal with performance and boost learning. Making them work in concert remains a huge challenge. The HR function has an opportunity to deliver on the promise of becoming a strategic department within your organization. Lately, technology has been enabling HR departments to reinvent themselves as a strategic business partner, providing opportunities for HR to play a greater role in aligning the workforce with business objectives.The end result can be improved organizational performance. HR Professionals keep the company they are working with able to stay on top despite of existing competition against companies who compete with the same product or services a certain company caters to. The most successful HR Professionals add value and make a difference with their organizations. They do this by treating their departments as business partners, anticipating their needs and providing HR solutions just-in-time. About the Author Syed Imtiaz Hussain is Head of HR & Administration in one of the leading multinational Company.As a member of top management team; he develops a highly professional A-Class HR environment in the organization by utilizing his vast practical and visionary experience of HRM and HRD. He believes organizations that invest in people can face the global economic and technological challenges in better way. His numerous of articles were Published in leading Newspapers and practitioner journals. He is also the author of â€Å"HR Global Challenges†. If you have questions or comments about this article, you can contact Imtiaz at (www. whrppk. com) [email  protected] com

Tuesday, October 22, 2019

Is citizenship in Australia an individuals legal status

Is citizenship in Australia an individuals legal status Citizenship in Australia has been considered as a new concept in spite of the prevailing politics that has existed for many years. The political factors often raise questions on the relationship between the state and its citizens. In addition, the validity of Australian citizenship has also been argued out on the perspective of whether it acts to safeguard an individual’s legal status or that of the state.Advertising We will write a custom essay sample on Is citizenship in Australia an individual’s legal status? specifically for you for only $16.05 $11/page Learn More Short and Mutch (2001, p. 114) point out in their publication that while citizenship in Australia is an important component that draws individuals and institutions together in order to share aspirations and values as well as to exercise social responsibilities, issues of individuals’ legal status, ability to perform duties and enjoy certain rights in Australia have been of concern for some duration of time now. Citizenship has been described as a legal entity which should create a balance between individuals and state while allowing equal access to rights and protection by existing laws. In addition, citizenship in Australia has in the past decade been affected by conflicts both in terms of its practical meaning and in relationship to an individual’s legal status. It is against this background that this paper critically examines the citizenship in Australia and its legal role among Australians in general. A brief overview of citizenship in Australia The history of the creation of the current Australian citizenship can be traced way back in 1949 when it took effect after it was formed through the Nationality and Citizenship Act (1948). Studies reveal that earlier on, before its formation, Australians did not have any form of well recognized legal status in their own country which could be granted to them as proof of citizenship. As a result, the y mainly relied on the one which was being offered to the British nationals. However, with an increase in immigration practices that became common after the federation, migration programs were developed which saw the rise of citizenship laws that were addressing immigration policies. The trend of migration in Australia has over the years risen significantly with 153, 648 in 1949. The latter was the number that was granted citizenship at that time. This figure rose to 22 million individuals in 2009 (Dutton 2000, p. 333).Advertising Looking for essay on government? Let's see if we can help you! Get your first paper with 15% OFF Learn More According to Chauchat and Cogliati-Bantz (2008, p. 193), citizenship in Australia may be obtained in several ways. Some of the key ways include grant, adoption, descent as well as birth. It is important to mention that many permanent citizens in Australia today have attained their status through grants. However, obtaining citi zenship by grant saw the introduction of new rules that made acquisition of citizenship in Australia harder than it was some 30 years ago. Today, over thirty amendments have been made on the Australian citizenship legislation. This has led to less regard of the Australian citizenship status since it is being regarded as an important component of identifying oneself with the country. In other words, it is a way of showing commitment and loyalty to the country. Boreham, Stokes and Hall (2004, p. 100) argue that even with the rise in provision of citizenship to individuals in Australia, its practical impact on legal rights and material situation has very little effect on individuals. This is attributed to the manner in which it impacts negatively on the legal status of individuals and poses the threat of its ability to grant individuals their rights and protection. This has been worsened by myriad of amendments that have been done in the past. Patriotism versus preceduralism The amendm ents carried out in the Australian citizenship legislation have been subject of great debate in legal and academic circles bearing in mind that its symbolic and legal changes have impacted on individuals’ legal status. The amendments have also made the cost of acquiring citizenship to be a lot easier. This has made its expected impact on provision of support and legal protection to be less felt and robbed Australians the sign and status of feeling like distinct people with a unique culture, evolved memories, history and a common future.Advertising We will write a custom essay sample on Is citizenship in Australia an individual’s legal status? specifically for you for only $16.05 $11/page Learn More The citizenship has ceased being associated with loyalty and patriotism, rather it demands adherence to procedures and laws. Dutton (2000, p. 333) argues that proceduralism has replaced the aspect of an individual’s legal status. Its call for obedience to laws and tolerance seems to be the only value which it demands from citizens. While proceduralism has received much credit from many analysts who feel it fits well with multiculturalism, others feel that citizenship ought to be light and prescriptive and not complex and oppressive. As Cook, Walsh and Harwood (2009, p. 45) indicate, Australia has a highly diverse population similar to other countries. Unlike other countries that highly restrict their growth and development only to their people, Australia is open to all who have basic history of the country and English understanding, good moral characteristics, no criminal record and readiness to swear allegiance to the country’s constitution. Among individual Australians, their belonging in Australia is based on legal status and patriotism and not tolerance in living as a community or side by side as this does not just rob them of some of their rights, it also allows newcomers to interfere with their cultures. Pe rmanent residence versus citizenship McGregor (1997, p. 64) argues that the introduction of permanent residents in Australian citizenship impacts on the legal rights that an Australian individual reserves on its provisions. Being largely symbolic, the Australian citizenship and its material benefit like education, welfare gains and access to Medicare which were legally enjoyed by Australian citizens have now been opened to permanent citizens. Another area of change is full access to employment and old age pension. These have made citizenship and its legal rights not to be fully enjoyed by Australian citizens. Jaensch (1997, p. 90) argues that there are a few legal barriers that prevent full participation of migrants with or without citizenship in the Australian society.Advertising Looking for essay on government? Let's see if we can help you! Get your first paper with 15% OFF Learn More The problem of citizenship on an individual’s legal status as put forward by Dutton (2002, p. 86) is that it has not been thoroughly debated in terms of how Australians are supposed to benefit. Rather, it is about commitment and levels of loyalty to the nation. Citizens in Australia confer the right to a passport, service on juries and right to vote and work. Besides, citizens and non-citizens alike may work in public offices and have immunity from deportation. The problem posed by these provisions on the legal status of Australian citizens is the slightness in their practical difference with permanent residents. The element fostered by the Australian citizenship legislation is one that strongly supports proceduralism over individuals’ legal status. This has drawn sharp arguments from different supporters and opponents with the former seeing citizenship as more inclusive and a component that grants everyone full community and political membership. While critically eval uating the problem of citizenship and individuals’ legal status, Sifa, (2000, p. 154) argues that addressing it should largely be considered from an economic outset. The very reference of minority groups invokes a sense of poor social economic overtone that restricts their ability to move up the social economic hierarchy towards the top. Therefore, the manifestation and outlay of citizenship and its effects is a paradox in the sense that demanding people at the top to reflect their own cultures and those of the minority groups is indeed cumbersome. Donoghue and Tranter (2010, p. 493) posit that through economic empowerment, the minority groups and their representative cultures become easily represented in important developments and societal demands. The numerous amendments in the Australian citizenship laws largely sought to protect possible bias towards people of a given group or culture in Australia in terms of enjoyment of basic rights and protection by the law. Such amend ments are critical because they reduce possible sense of inferiority for the minority groups and their cultures. Though some analysts indicate that such laws may present possible crashes between the dominant and the minority groups, the same consideration is not always true. Chesterman and Galligan (1999, p. 64) indicate that the Australian local administration creates effective checks and balances that require strict adherence and sets up major penalties if faulted. Though it often takes place involuntarily, the resulting orientation depicts key tolerance and eventual acceptance based on mutual respect. Conclusions To sum up, the arguments above were based on the thesis statement that citizenship in Australia has been considered as a new concept for many years in spite of its political theories that have been advanced by the political class. This factor has elicited more questions especially in regards to the relationship between the state and its people. In addition, an individual ’s legal status has also been inquired on whether it is an integral component that affects the acquisition of Australian citizenship. From the discussion, it is clear that citizenship may be obtained in several ways such as grant, adoption, by descent and birth. It is also evident that the Australian citizenship law has gone through many amendments, a consideration that has seen citizens in Australia and other residents, permanent and non-citizens, receive equal treatment. As noted in the essay, while this has received a considerable support from multiculturalists, it is without doubt that it has impacted on individual legal rights of Australians raising questions on whether Australians should continue existing as a community besides immigrants or as individuals who have full legal status. References Boreham, P., Stokes, G., Hall, R 2004, The Politics of Australian Society: Political  Issues for the New Century, Pearson Longman, Sydney. Chauchat, M., Cogliati-Bantz, V 200 8, Nationality and Citizenship in a Devolution Context: Australian and New Caledonian Experiences, University of Queensland Law Journal, vol. 27, no. 2, pp. 193-220. Chesterman, J., Galligan, B1999, Defining Australian Citizenship: Selected Documents, Melbourne University Press, Melbourne. Cook, I., Walsh, M., Harwood, J 2009, Government and Democracy in Australia, Oxford University Press, Melbourne. Donoghue, J., Tranter, B 2010, Citizenship, Civic Engagement and Property Ownership, Australian Journal of Social Issues, vol. 45, no. 4, pp. 493-508. Dutton, D 2000, Defining Australian Citizenship: Selected Documents, Australian Journal of Political Science, vol. 35, no. 2, pp. 333-333. Dutton, D 2002, One of Us? A Century of Australian Citizenship, University of New South Wales Press, Sydney. Jaensch, D 1997, The Politics of Australia, Macmillan Education Australia, Melbourne. Short, P.M., Mutch, A 2001, Exchange, reciprocity, and citizenshipprinciples of access and the challenge to human rights in the third sector: An Australian perspective, Social Justice, vol. 28, no. 4, pp. 114-127. Sifa, S 2000, Citizenship and Indigenous Australians: Changing Conceptions and Possibilities, Pacific Affairs, vol. 73, no. 1, pp. 154-155.

Monday, October 21, 2019

Understanding and Using Record Data Types in Delphi

Understanding and Using Record Data Types in Delphi Sets are ok, arrays are great. Suppose we want to create three one-dimensional arrays for 50 members in our programming community. The first array is for names, the second for e-mails, and the third for number of uploads (components or applications) to our community. Each array (list) would have matching indexes and plenty of code to maintain all three lists in parallel. Of course, we could try with one three-dimensional array, but what about its type? We need string for names and e-mails, but an integer for the number of uploads. The way to work with such a data structure is to use Delphis record structure. TMember Record ... For example, the following declaration creates a record type called TMember, the one we could use in our case. Essentially, a record data structure can mix any of Delphis built-in types including any types you have created. Record types define fixed collections of items of different types. Each item, or field, is like a variable, consisting of a name and a type. TMember type contains three fields: a string value called Name (to hold the name of a member), a value of a string type called eMail (for one e-mail), and an integer (Cardinal) called Posts (to hold the number of submissions to our community). Once we have set up the record type, we can declare a variable to be of type TMember. TMember is now just as good variable type for variables as any of Delphis built-in types like String or Integer. Note: the TMember type declaration, does not allocate any memory for the Name, eMail, and Posts fields; To actually create an instance of TMember record we have to declare a variable of TMember type, as in the following code: Now, when we have a record, we use a dot to isolate the fields of DelphiGuide. Note: the above piece of code could be rewritten with the use of with keyword. We can now copy the values of DelphiGuide’s fields to AMember. Record Scope and Visibility Record type declared within the declaration of a form (implementation section), function, or procedure has a scope limited to the block in which it is declared. If the record is declared in the interface section of a unit it has a scope that includes any other units or programs that use the unit where the declaration occurs. An Array of Records Since TMember acts like any other Object Pascal type, we can declare an array of record variables: Note: Heres how to declare and initialize a constant array of records in Delphi. Records as Record Fields Since a record type is legitimate as any other Delphi type, we can have a field of a record be a record itself. For example, we could create ExpandedMember to keep track of what the member is submitting along with the member information. Filling out all the information needed for a single record is now somehow harder. More periods (dots) are required to access the fields of TExpandedMember. Record With Unknown Fields A record type can have a variant part (not to be confused with Variant type variable). Variant records are used, for example, when we want to create a record type that has fields for different kinds of data, but we know that we will never need to use all of the fields in a single record instance. To learn more about Variant parts in Records take a look at Delphis help files. The use of a variant record type is not type-safe and is not a recommended programming practice, particularly for beginners. However, variant records can be quite useful, if you ever find yourself in a situation to use them.

Sunday, October 20, 2019

Pablo Picasso Changed the Way We Look at Art essays

Pablo Picasso Changed the Way We Look at Art essays Picasso Changed the Way We Look at Art "There is no abstract art. You must always start with something. Afterwards you can remove all traces of reality." -Pablo Picasso Picasso had not always been so enlightened with the fact that there was more to art than the eye could see. During the course of his ninety-one year life, Picasso encountered many ideas and people that helped form the wonderfully talented and brilliant artist in history. Picasso was born Pablo Ruiz on October 25th 1881, in Malaga, Spain. His father was a inspiring artist while his mother took care of the house. Picasso had shown a great artistic talent in his early childhood years. At 14 years old, Picasso adopted his mother's less common name. Changing Ruiz to Picasso. Shortly after this event, Picasso had finished his one month qualification exam into the Acadamy of the Arts in Barcelona. The only exceptional thing about this was that Picasso had done this in one day. Picasso stayed with the acadamy for three years, before deciding to move to San Fernando where he would then attend the Acadamy of San Fernando until the turn of the century. Picasso then joined up with the group of aspiring artists. Pablo Picasso was probably the most famous artist of the twentieth century. During his artistic career, which lasted more than 75 years, he created thousands of works, not only paintings but also sculptures, prints, and ceramics, using all kinds of materials. He almost single-handedly created modern art. He changed art more profoundly than any other artist of this century. First famous for his pioneering role in Cubism, Picasso continued to develop his art with a pace and vitality comparable to the accelerated technological and cultural changes of the twentieth century. Each change embodied a radical new idea, and it might be said that Picasso lived several artistic lifetimes. Picasso was born on October 25, 1881, in Malaga, Spain, son ...

Saturday, October 19, 2019

Electrical circuits Lab Report Example | Topics and Well Written Essays - 3750 words

Electrical circuits - Lab Report Example The report looks deeper into the literature review of electrical circuits and electronic components. The focus shifts to the analysis of electrical component analysis of their behavior and responses. Electronic components in electrical circuits include semiconductor devices diode, op amp and transistors. The electronic component features are explained in developed electrical networks. Performing signal processing in the semiconductor devices is meant to get information about input signal like RMS, peak value, the relative phase and the amplitude envelope. Nonlinear components are used in the feedback loop in examining the performance of diodes and op amp devices. Transistors have the capabilities of working with small-signal and large-signal characteristics exhibited by the bipolar junction transistor. Electrical circuit resonance behavior is imperative. The design research focuses on factors leading to vibration and resonant circuit components. Analysis of both parallel and series c ircuit have been reported vividly. Their performance in terms of the quality factor, bandwidth and power, are important factors determined. The transistors are used because they boost current components of the circuit. Black box is examined for various components to determine their values and responses to varying inputs of current and voltages. The report outline drifts into determining the values by elaborating on the procedures followed in the methodology. Results of the values of component rating have been documented and analyzed. The discussion and analysis section gives view about the results. RLC response characteristics in different connection conditions have been put out expounding on the effects of loading and use of active and passive devices in electrical circuits. They achieve application in designing of filters and communication equipment. Signal systems make use of electronic

Friday, October 18, 2019

Research proposal Dissertation Example | Topics and Well Written Essays - 3250 words

Research proposal - Dissertation Example The advancements in digital communications technology and the further strengthening of multilateral trade ties have created an environment in the 21st century more receptive than that which characterised international business a few decades ago. A greater understanding and familiarity with other countries’ cultures, laws, and social institutions has greatly diminished the uncertainty and distrust that held countries back from openly participating in international trade and business. Furthermore, the faster pace of technology transfer and development of productive capacity in less developed economies have created new markets that provide added impetus for cross-border trade. The United Kingdom is one such developed economy that may itself benefit from, as it may benefit others through, increased participation in other markets. A country which presents attractive opportunities for expanded trade relations is Ecuador. The prospects have to be examined further, however, and a basi s for the formulation of a viable marketing strategy has to be established before concrete plans could be drawn. 1.2 Research aim This study aims to examine implications and directions for strategic marketing that U.K firms may explore in their effort to establish a presence in the Ecuadorean market. Existing macroeconomic and industrial data for Ecuador, industry information on U.K. firms, and the use of established strategic theory in a competitive environment shall provide the context and constraints within which the aim is to be attained. 1.3 Objectives In order to satisfactorily accomplish the above-stated aim, the proposed study seeks to attain the following objectives: 1.3.1. To describe the social, political, economic, technological, ecological, and legal situations in Ecuador that may impact upon the business opportunities of foreign firms wishing to enter the market, using the PESTLE country analysis framework; 1.3.2. To identify industries in Ecuador where U.K. firms may successfully enter and create a significant impact, citing particular advantages and disadvantages, through use of Porter’s Diamond Framework. 1.3.3. To suggest strategic directions that U.K. firms may take for the industry or industries identified, in order to initially effect entry, and thereafter to sustain competitive performance in the Ecuadorean market, through the three fundamental marketing strategy paradigms, namely (a) standardization-adaptation, (b) concentration-dispersion, and (c) integration-independence. 1.4 Research questions The study shall strive to achieve the aforestated objectives, guided by the following research questions to which it shall provide relevant answers: 1.4.1 What are the social, economic, political, technological, ecological, and legal conditions existing in Ecuador that may influence the business environment? 1.4.2 On the basis of the results of the environmental scan on Ecuador, what possible industries may be engaged in by U.K. firms see king to enter the market in this country? 1.4.3 In relation to the industries identified, what possible strategic marketing directions may U.K. firms adopt in entering into and sustaining performance in these markets? 2. Literature review 2.1 International marketing strategy In deciding upon entering a foreign market, a firm takes on considerable risks, but foresees that there is an opportunity to earn considerable returns as

I don't have any topic, you have to choose the topic and write it Essay

I don't have any topic, you have to choose the topic and write it please - Essay Example Many students are feeling lots of prospects from their family and school to achieve the best position and marks. Students are afraid by feeling pessimistic during exams, such condition draw them into the exam stress and then nervous breakdown. Exam stress is a genuine problem for many students. The signs of stress can be exposed in various ways.  Ã‚  Common signs of exam stress include Nausea, headaches, continuous sleepiness, violence, depression, excess drinking, eating or smoking and some time chest pains also (Crystal).  The exam seasons always bearing lots of stress clouds for the students which frightens them every time. Mainly the exam stress acquired by the students, who are anxious of not being able to revise entire syllabus earlier than the exam time and worried to get good result in the exams. Many research studies have done by various scientist and institutions each year to identified the ratio of nervous breakdown among children. According to the children’s commissioner, half of 8 to 17 year aged students are anxious about their educational performances (Loveys). Freshly a study from the University and College Counsellors Association came which developed a worrying conclusion that the psychological fitness of students has considered to be inferior to the general population.  Ã‚  The research revealed that, â€Å"30% to 50% of students experience shifting phases of anxiety and depression.† Manchester University  estimated the result of a survey that 53% of students had anxiety at a pathological level.  Ã‚  Exam stress thought to be the main cause which linked with the today’s fashion, moved towards perfectionism culture (Crystal). Dr Maggie Atkinson said that the youngsters acquired great pressure to attained good marks and exam ranks by their ambitious parents as well as schools (Loveys). Vicki Abeles commented on the issue of educational stress that today’s educational system is not generating independent thinkers which will

As Project Management evolves a new set of issues is demanding Essay - 1

As Project Management evolves a new set of issues is demanding attention - Essay Example Consequently, complexity and drastic change build a high-risk environment wherein decision makers have little faith about the future. They view experiences through dense perspectives and base their decisions on guesswork and small measures of certainty (Lewis 2007). Making things more difficult is the aggressively competitive environment that has emerged with the introduction of the Internet and the spread of globalisation. This competitive environment has motivated a fascination with winning customers’ hearts and minds. In the contemporary business environment, customer satisfaction rests at the core of most business endeavour (Lewis 2007). This paper will explore the new business climate and their implications for project management. The traditional saying â€Å"the only constant is change† (Frame 2002: 26) ceases to be a witty oxymoron and is now a prevailing reality in contemporary business life. Untapped change is a primary determinant of project failure. Changes in markets, technology, regulations, budgets, and personnel motivate changes in project requirements and demands. Project personnel discover themselves operating in ‘rubber baselines’ (Frame 2002: 26). The abundance of alternatives is obvious in project management. For instance, there are several workable ‘scheduling software packages’ (Howes 2001: 13) being recommended by suppliers. How does an individual choose from such diversity? A great deal of the complexity of present projects is linked to the diversity of alternatives confronting all project actors, from customers to team members to project managers. These alternatives cover all project features. For instance, consider the alternatives related to the buying of a product or service (Howes 2001). Practically any product or service to be used on a project has a variety of suppliers or providers, each with its distinct qualities (Frame 2003). In

Thursday, October 17, 2019

The Suffrage of women through the 1800s-1900s Research Paper

The Suffrage of women through the 1800s-1900s - Research Paper Example The delicacy of women was overemphasized and their abilities to play a significant role in the development and progress of the society were underestimated. Since they were considered to be in need of help, support and care, they were not offered a chance to work and support their family. They had been mistreated in a number of ways for a long period of time. They were suppressed to the extent that they were not allowed to cast their vote to represent their opinion in the political elections. Circumstances continued to remain like this until the 20th century when the women’s rights to cast their vote were finally recognized in different parts of the world after a series of events of struggle made by the women of that period. (www.wic.org, 1995). Not only that, the 20th century brought a large number of other opportunities for the women which they had been longing for so long over the past centuries, which included and were not limited to educational and work related opportuniti es. This paper aims at analyzing the history of efforts women have made to get their rights acknowledged world wide in the 19th and the 20th century with special reference to the American Suffrage Movement. â€Å"Women of the 19th and 20th century are pioneers in the international recognition of gender equality and women’s rights†. In ancient periods, women were considered as the fundamental cause of various evils that existed in the ancient societies. Women were largely recognized as inferior to men, both physically and emotionally. And this concept was not confined to any particular country. Instead, women were looked down at nearly all over the world. This is evident from the Greek myth, according to which a woman named Pandora opened a box that brought sadness and diseases for the men. (Gupta, 2010). In India, women were burnt alive together with the dead-body of their husbands as per the Hindu customs. If left alive, they were

The Blame game, an interesting perspective Essay

The Blame game, an interesting perspective - Essay Example † provides another reflection on the key causes of child obesity which consist of factors beyond the fast food industry. Child obesity is caused by many elements that consist of nutrition, genetics, and society. Obesity, like other health- related behaviors is one of the chief causes for disability. It is associated with heart disease, heart stroke, high blood pressure, and even cancer. Undoubtedly, childhood obesity is in rise throughout the United States as approximately 9 million of children in the US are obese or overweight. Children in this current generation have a shorter life expectancy due to high rates of obesity as opposed to children 2 decades ago. . Obesity much like other diseases is associated with important risk factors such as heart disease, heart stroke, and even cancer. Many elements contribute to obesity, which is why it is important to address these issues. This paper will seek to address the problem and seek the remedies that could be implemented in order to eliminate this problem. According to Siegal, , fast-food restaurant around schools is a huge public concern that can serve as detrimental for kids in Chicago as the availability and the price of greasy food is extremely low. He further argues that obese children experience peer pressure for not having that perfect body shown on TV as the body to have both psychologically and emotionally. According to his perception, it is ironic how society wants people to have the perfect body but at the same time promotes unhealthy food to children. Consequently, children are faced with emotional distress because there are confused. He justifies his opinion by portraying his recent study shows that those obese children are more likely to have low self-esteem, depression, higher rates of anxiety disorders, and psychopathology Since they are often discriminated and isolated in society, obese children are prone to fail academically. He further on goes to suggest that obese children scored lower an d math and reading test because they lack self-esteem that is so vital towards their academic success. One of the key elements that lacked from Seigal’s argument is the fact that Siegal’s research lacked was the actual eating habits of the students. Since nutrition is not our schools system priority, children have unlimited access to unhealthy foods (Siegal).. In some schools physical education programs have been cut due to lack of funds to support while the contract to vendors with high calories and low quality foods are encouraged within the schools settings. Many of the competitive foods now sold in school cafeterias, vending machines, school stores, and school fundraisers are typically high in calories and low in nutritional value (Siegal).. Indeed, Schools can be viewed as a factor for child obesity. . Since Siegal fails to observe the eating patterns of young children, Miranda Cox argues that other elements as well as fast food industries should also be accounted for. Undoubtedly, the rise of obesity can be blamed for lack of parent’s cooperation, poor nutrition from schools, and the availability of fast food (Siegal).. It would not be fair also to blame the food industry for the poor quality of food being supplied to the children. The lack of regulation from the FDA in the food industry is also the key cause of obesity. Seigal is clear that he wants a clear distinction of buffer zones between fast food chains and schools. However, Miranda Cox ultimately states in her argument that even with