A Report On The Emergency Department - 926 Words

S (situation): Hi, my name Kelsey and I am a nurse in the emergency department. I am calling about Shannon O’Reilly’s most recent laboratory results. B (background): Ms. O’Reilly is 24 years old who came to the emergency in a DKA crisis earlier this morning and has been DM1 since she was 3 years old. A (assessment): Ms. O’Reilly’s vital signs are temperature of 37.5 C, pulse of 112, blood pressure of 102/52, and respirations of 24. Her respirations are still deep but have a regular rhythm. She has a CBS of 8.1 and regular insulin running as per orders. The lab work shows uncompensated metabolic acidosis with no hypoxia. Ms. O’Reilly’s neurological status has improved with a GSC of 13. Her dehydration is being treated with NS containing 40mEQ KCL/L running at 200ml/hr and potassium levels maintained at 4. R (recommendation): Do you want to continue with the current care plan continued with frequent CBS and potassium monitoring? Describe your rationale for the recommendations made. Shannon’s glucose levels are still high (above 6.1 mmol/L) thus still needs the insulin drip (Robbins et al., 2010). Administration of insulin and efforts made to correct metabolic acidosis forces potassium into the cells causing hypokalemia (Bopp, 2010). Thus, even though the potassium is within therapeutic levels (3.5-5 mmol/L) there is a high chance that Shannon may experience hypokalemia and the administration of NS with potassium is necessary (Bopp, 2010). More Clinical Reasoning:Show MoreRelatedPaper661 Words   |  3 Pages1. The roles of the nurses in the Emergency Department: The nurses receive brief report from the paramedics and sign the report. Because the patients normally have multiple signs and symptoms, the ER nurses need to perform a focused assessment and head to toe assessment. They find out the causes of the chief complains and conduct several tests. The nurses ask pertinent questions in regard to additional signs and symptoms. In trauma, they perform immediate treatment and to prevent respiratoryRead MoreA Brief Note On Collaboration And Teamwork Among Health Care1121 Words   |  5 PagesIn this paper I will discuss various health care interdisciplinary relationships, including radiology, working in the emergency room, and working with the pharmaceutical company that market department needs to foster effective collaboration with the development department. Also, I discuss ways to avoid and resolve conflict, how to work as a team and collaborate with other departments, and ways to improve the process. Furthermore, how interdisciplinary relationships affect my organization and the patientsRead MoreEmergency Response Plan For A Disaster Involving Best Sanitizers, Inc. Essay1032 Words   |  5 Pagespurpose of this document is to define the emergency response plan, personnel, training, procedures and support agencies in preparation for a disaster involving Best Sanitizers, Inc.. 2.0 Scope 2.1 This document provides a total facility response program applicable to emergency situations. 2.2 The procedure details emergency reporting, evacuation, and post emergency response. 2.3 Detailed responses have also been outlined for specific types of emergencies including but not limited to: fire, chemicalRead MoreEmergency Responders Face The Difficult Task Of Ensuring The Safety And Wellbeing Of The Citizens1645 Words   |  7 PagesEmergency responders face the difficult task of ensuring the safety and wellbeing of the citizens they serve. Natural and man-made disasters augment the daily threats that responders face. The threat of disaster poses an especially large risk due to their massive sizes and therefore, additional susceptibility to hazards. The Kansas City government created an Emergency Operations Plan (EOP) to combat the most likely dangers they are likely to face based off of their Threats, Hazards IdentificationRead MoreCollaboration And Teamwork Among Health Care1514 Words   |  7 Pagessustaining human medicine and patient care overlap diverse fields. The reality of protecting, improving and providing care to patients in any the health ca re facility and or emergency room includes an effective relationship with an innovative radiology division (Columbia University Medical Center. (CUMC), (2015). Routinely, the emergency room works in direct partnership with the radiology, putting patient first in providing care. A patient admitted to the health care facility is typically under the careRead MoreViolence Against Nurses in the Emergency Department782 Words   |  4 PagesViolence Against Nurses in the Emergency Department Kimberly L. Kirk Professional Nursing Practice of the Baccalaureate Nurse August 8, 2014 Violence against Nurses in the Emergency Department According to the National Institute for Occupational Safety and Health, workplace violence is defined as â€Å"an act of aggression directed toward persons at work or on duty, ranging from offensive or threatening language to homicide† (Wolf, Delao Perhats, 2014, p.305). Workplace violenceRead MoreEmergency Management Plan Chemical Spill/Release1388 Words   |  6 PagesUniversity | Emergency Management Plan | Chemical Spill/Release | | Erik Gohl | 11/7/2011 | | Purpose Events which interfere with the normal operations of Hennepin Technical College (HTC) are unavoidable. The purpose of this document is to explain the actions, roles, and responsibilities that are to be taken by individuals and departments in the event of a spill or release of a hazardous chemical or waste. (Homeland Security, 2011) Emergency Management Team The Emergency ManagementRead MoreThe Us of Emergency Room as a Primary Care Provider1047 Words   |  5 PagesThe Use of Emergency Room as a Primary Care Provider There are Emergency rooms all over the United States that are being utilized as primary care provider., by patients covered by private insurance, Medicaid, Medicare as well as the uninsured.(Baker, August 13, 2008) Some patients call their primary care provider and are told, they cannot be worked in for several days or weeks. The option given is to go to the Emergency room for treatment. Other reasons are people who do not have a primaryRead MoreAn Article By Meaghan Craig From Global News1640 Words   |  7 PagesSaskatoon Health Region confirmed that â€Å"601 people left emergency departs in December without being seen† but I was unable to find any reports stating this number (Craig, 2015). Overall, this article from Global News contains trustworthy information about the concerns for challenges older adults are facing when it comes to receiving medical care in a timely matter. To fully understand the need to reduce wait times in emergency departments, we must first understand why wait times have been increasingRead MoreWhat Is Allegan County Health Department1057 Words   |  5 PagesThe Allegan County Health Department has adopted the model shown in Figure 2 as the definition of phases of awareness for All-Hazard emergencies except pandemic influenza. The ACHO or designee is responsible for establishing operations. Upon the designation of the Activate Phase, the ICS process goes into effect and the Time-Based Operational Phases will be applied. Figure 2. Alert, Standby, Activate Phases III-2.6 Continuity of Operations’ Initial Actions †¢ The Allegan County Health Officer

A Film On The Melting Ice Caps Essay - 1601 Words

Reina of Antarctica I propose a film on the melting ice caps, using the character Reina as the reason that they are melting. She will be the reason for melting the ice caps due to humans came to her home and drill for oil where she lives. I chose to have both Greek and Japanese mythology because I thought it would be a great idea to see how the two cultures will come together. Since both countries are known by many people all around the world and because they are surrounded by the sea these two countries would be the first to be swallowed by the sea that surrounds then due to the melted ice caps. The ending is supposed to represent the ice caps still melting now. The government that is going to sponsor the drilling company will be the English because the English are newer at drilling than the United States, since they are new at drilling they were exploited by the company. Antarctica, extremely cold and the home of penguins, and huge icebergs. The home of the princess of the cold, Reina. She wears what a normal teenager may wear during the summer. Yet, it is during the winter and she doesn’t mind it. It is during the third quarter of year, so it is extremely cold and -72 degrees Fahrenheit. She is friends with all the animals near her home. She is a beautiful young woman who transforms into a monster when she is upset. Reina is always confused with a Greek goddess due to how beautiful she is, yet she was made into a monster by Hera, wife of Zeus and the goddess of childShow MoreRelatedA Film On The Melting Ice Caps1588 Words   |  7 PagesI propose a film on the melting ice caps, using the character Reina as the reason that they are melting. She will be the reason for melting the ice caps due to humans came to her home and drill for oil where she lives. I chose to have both Greek and Japanese mythology because I thought it would be a great idea to see how the two cultures will come together. Since both countries are known by many people all around the world and because they are surrounded by the sea these two countries would be theRead MoreReflection On Al Gore s An Inconvenient Truth1470 Words   |  6 PagesTruth† Al Gore begins his film â€Å"An Inconvenient Truth† by defining global warming and how it affects our planet. He states that most people believe, â€Å"[t]he earth is so big that we can’t possibly have a lasting impact on the earths environment.† Gore then briefly explains the science behind global warming. Next, he brings in examples of people and places that are being affected by global warming. The most striking affect is that 40% of the world population relies on melting glaciers for water thatRead MoreGlobal Warming Reflection Paper1510 Words   |  7 Pagesprovide a summary of the film. Additionally, it will describe feelings toward environmental and social implications regarding climate changes. It will answer questions regarding the global warming. Plus, it will recommend survival strategies for the here and now, and the future. Furthermore, it will give a summary of the whole global warming subject. Summary of movie and what it is about The Inconvenient Truth is a documentary film about global warming on planet earth. The film is directed by DavisRead MoreHumans Are Causing Global Warming Essay1669 Words   |  7 Pagesprevalently known effects of global warming is the melting of glaciers, ice caps, and permafrost. Ice and snow reflect a majority of the sun’s rays due to their bright white color which keeps them from immediately melting when the rays touch down; but this is not the case for the surrounding water. The water absorbs many of the rays and heats up, melting the ice from the underside and outer sides. In the last thirty years, as many as one million square miles of ice from the sea has disappeared. There are manyRead MoreThe Day After Tomorrow : Good And Bad Science929 Words   |  4 Pagesfuels. While one degree may not seem all that significant the fact is that such an increase has had an impact on global sea levels due to the melting of Arctic, Antarctic and Greenland Ice. The Antarctic Larse n Ice Sheet has collapsed. Ironically the collapse of the Larsen Ice Shelf actually occurred after it had been written into the movie. Greenland s ice sheet is predicted to melt if global temperatures rise by 5.4 ° Fahrenheit (3 ° Celsius), resulting in a sea level rise of 23 feet (7 meters).Read MoreTaking a Look at Global Warming1562 Words   |  6 Pagesreported in multiple countries. This is a major blow to people who rely on the snowfall water to survive. There are way more dangers than just the ones that were named above. Another threat to humans is the coastline damage. Ice out in the middle of the sea is melting at a much more accelerated pace than it has in the past. That causes the tide to come up higher then it normally does. That does not sound too bad until one realizes the tide comes up to where there are recreational facilitiesRead MoreThe Historical Timeline Of Air Quality Improvement Essay1416 Words   |  6 Pagessure to follow. Along with ozone depletion came the theory of global warming and the hypothesis that GHG emissions induced effects that accelerated the collapse of polar ice sheets that would cause sea levels to rise. Elevated sea levels and increased surface temperatures would induce the melting of large amounts of glacial ice that would drop sea water temperatures and interfere with the oceanic conveyor belt currents that control water temperature, photosynthesis, salinity and mixing of chemicalRead MoreJ ohn Luther Adams Essay833 Words   |  4 Pagesthe impact of human beings on the environment and the sounds that are produced. John Luther Adams piece, Inuksuit is a great example of his opinion of the impact humans are having on the world. In this piece, he references the melting of the polar ice caps and the melting oceans. †¢ John Luther Adams wanted to make an impact with his pieces. He wanted to share what he was experiencing in Alaskan environment and show others the changes may affect everyone in the future. I believe that John LutherRead MoreMercury And Its Effects On The Earth1138 Words   |  5 PagesAs humans continue to live on Earth the climate is changing which is melting the Polar Ice Caps along with rising sea levels. Due to these changes to Earths Climate over the next millennia Earths lands may disappear and be taken over completely by the ocean. The human population is also constantly increasing and we need more space to survive. What can we do to survive? Where can we go? This film Deadliest Planets on YouTube will help us to explore our options. This video looks at 6 other PlanetsRead MoreAnthropogenic Global Warming1356 Words   |  6 Pagessurvey. Al Gore would later state that this was the foundation for all of his work. Mr. Gore would then go on to win the noble peace prize in 2007 for his work on a documentary called the inconvenient truth. The film would also win the prestigious academy award for best documentary film (2007). Mr. Al Gore was also the winner of the Roger Reveille Award 03/06/09. The United Nations also plays a significant role for supporting the belief that manmade global warming is the greatest threat that

Small and Medium Enterprises free essay sample

Granularity: This refers to a situation where the risk grading system at banks does not have the requisite capability to discriminate between good and bad risks. The consequence is tightening of Y. Srinivas (The author is Manager, Compliance Group at ICICI Bank. He can be reached at srinivas. [emailprotected] com) Small and Medium Enterprises (SMEs) play a very significant role in the economy in terms of balanced and sustainable growth, employment generation, development of entrepreneurial skills and contribution to export earnings.However, despite their importance to the economy, most SMEs are not able to stand up to the challenges of globalisation, mainly because of difficulties in the area of financing. With the opening up of the Indian economy, it has become necessary to consider measures for smoothening the flow of credit to this sector. The article provides a crosscountry perspective in this regard and highlights the Indian scenario with reference to SME lending. We will write a custom essay sample on Small and Medium Enterprises or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page rs or managers know more about the prospects for, and risks facing their business than their lenders) exists, lenders may respond by increasing lending margins to levels in excess of that which the inherent risks would require. However, the sheer ticket size of SME lending makes it inviable for banks to invest in development of information systems about SME borrowers. In such situations, banks may also curtail the extent of lending even when SMEs are willing to pay a fair riskadjusted cost of capital. The credit terms, or an increase in prices, or both.From the borrower’s perspective, this leads to an outcome where the bank is over-pricing good risks and under-pricing bad risks. The fact that most banks in India have not developed adequate expertise in SME lending risk assessment exercises leads to the problem of granularity when it comes to SME lending. (c) Pecking Order Theory: Pecking order theory ? ows from the above two issues, which makes SME lending highly dif? cult fo r banks. Un- der this hypothesis, SMEs, which face a cost of lending that is above the true risk-adjusted cost, will have incentives to seek out alternative sources of funding.Evidence suggests that in such situations SMEs prefer to utilise retained earnings instead of raising loans from banks. (d) Moral Hazard: Even when loans are made to SMEs, it may so happen that the owners of these SMEs take higher risks than they otherwise would without lending support from the banks. One reason for this situation is that the owner of the ? rm bene? ts fully from any additional returns but does not suffer disproportionately if the ? rm is liquidated. This is referred to as the moral hazard problem, which can be viewed as creating a situation of over-investment.The moral hazard problem may, thus, result in SME lending turning bad in a short period of time, a situation that all banks would like to avoid. (e) Switching Costs: SMEs may ? nd it harder to switch banks, when countered with any issue. It is a known fact that the smaller the business, the more signi? cant the switching costs are likely to be and, therefore, it is less likely that the bene? ts of switching outweigh the costs involved. This situation results in SME lending becoming a sellers market, which may not be attractive to SME borrowers. Steps for Smooth SME Lending In order to ensure that the 36 The Chartered Accountant September 2005 above issues do not stand between SMEs and Bank Finance, the following steps could be taken as remedial measures: Collateral: Existence of collateral that can be offered to banks by SMEs could be one effective way of mitigating risk. Banks could, therefore, look at collateral when pursuing the question of SME lending. It can also be stated that a borrower’s willingness to accept a collateralised loan contract offering lower interest (relative to unsecured loans) will be inversely related to its default risk. However, not all SMEs would be able to offer collateral to bank s.Hence, Reserve Bank of India (RBI) allows banks, with a good track record and ? nancial position on SSI units, to dispense with collateral requirements for loans up to Rs. 25 lakhs. (a) Relationships: The length of the relationship between a bank and its SME customers is also an important factor in reducing information asymmetry, as an established relationship helps to create economies of scale in information production. A relationship between a SME and a bank of considerable duration allows the bank to build up a good picture of the SME, the industry within which it operates and the calibre of the people running the business.

Outbreak of War in Europe in 1914

Introduction The World War I began when Austria-Hungary declared war against Serbia. However, it later spread all over Europe, especially in Germany, Russia, The Great Britain, and France due to the fact that these countries had formed alliances to defend each other in times of war. Over eight million people died in this Great War.Advertising We will write a custom term paper sample on Outbreak of War in Europe in 1914 specifically for you for only $16.05 $11/page Learn More Factors that led to World War I Assassination of Archduke Franz Ferdinand The assassination of Archduke Franz Ferdinand was the main cause of the outbreak of the war. Ferdinand was assassinated together with his wife by a Serbian nationalist in Sajarevo. He is believed to have been assassinated because Serbia wanted to take control of Bosnia and Herzegovina, however, Austria-Hungary had already taken control of the region. The assassination led to the war between Serbia and Austria-H ungary and with Russia trying to defend Serbia, Germany declared war on Russia and it spread all over with the formation of alliances. Militarism Tension between the European nations in the late 19th and early 20th centuries resulted into an arms race. Germany and The Great Britain had a large military buildup by having a large number of navies which had a great influence on the public. The increase in militarism between the states pushed the countries into war. Imperialism The development of intricate alliances and counter alliances among European nations ignited war among them. The European nations increased their wealth by acquiring additional territories. These European nations were interested in Africa and some parts of Asia due to the availability of raw materials. The increased competition and the aspiration of greater emperors led to confrontations which later led to World War I. Nations like the United Kingdom and France amassed great wealth in the 19th century through thei r command of trade in foreign resources, colonies and slaves. Since Germany, Austria-Hungary, Italy, and Russia wanted to achieve the same growth as France and the UK, an Anglo-German rivalry developed as each nation sought more territories, especially in Africa. Rivalry also occurred in trade routes. Nationalism Nationalism among different countries all through Europe led not only to the start of the war but also to the extension of the war all over Europe. Each nation was convinced that their country was the most superior and this resulted into hostilities among them. For instance, France turned against Germany while Russian turned against Austrian.Advertising Looking for term paper on history? Let's see if we can help you! Get your first paper with 15% OFF Learn More Strong feelings of nationalism created hatred and hostilities among the European nations. The hostilities were mainly felt in the Balkans after Archduke Frank Ferdinand’s assassination. The tensi on seemed to have been resolved but one month later Germany supported Austria to cut off relations with Serbia whereas Russia defended Serbia. Mutual defense Alliances All countries throughout Europe had mutual defense agreements that were intended to bring protection. When Austria- Hungary declared war on Serbia, Russia came in to defend Serbia and this move irked Germany which later declared war on Russia. France joined the war to fight against Germany and Austria-Hungary. Consequently, France was attacked by Germany through Belgium and this dragged Britain into the war. The war continued spreading and soon, Japan joined the war followed by Italy and the United States. U.S. involvement in the War The US had remained neutral in the war until April 1917 when it declared war on Germany. The introduction of unrestricted submarine warfare by the Germans made President Wilson to ask congress to join the war against Germany. Prior to this request, shipd belonging to the US had been attac ked in the Atlantic Ocean by German forces. The sinking of the Lusitania resulted in the death of 128 Americans on board and this pushed the US on the wall, ultimately, they decided to wage war on Germany. Alfred Zimmerman’s attempt to provoke Mexico and Japan to attack the US with A promise of help from Germans also made the U.S. into joining the world war because they had to intercept the Germans’ proposal to Mexico. The United States’ entry into the war was inevitable because they had to support their allies. Besides, it had to protect its economy and also to keep peace in Europe. Conclusion Despite the assassination of Archduke Franz Ferdinand of Austria, successor to the Austro-Hungarian throne, and his wife being the main reason for the war in Europe, there are other reasons that led to WW1. These include nationalism, materialism, imperialism and defense alliances and so on. These factors led to hostilities between the European nations and ultimately led t o the world’s deadliest war in history. The US was not initially involved in the war, but in the latter stages, it got involved to protect its allies and interests. Bibliography Bass, Herbert, America’s Entry into World War I. New York: Holt Rinehart and Winston, 1964. Cipriano, Anne, The United States in the First World War. New York: Garland Publishing, Inc., 1995.Advertising We will write a custom term paper sample on Outbreak of War in Europe in 1914 specifically for you for only $16.05 $11/page Learn More Pope, Steven, and Elizabeth-Anne Wheal, The Dictionary of The First World War. New York: St. Martin’s Press, 1995. This term paper on Outbreak of War in Europe in 1914 was written and submitted by user Jefferson U. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Benito Mussolini Was Born On July 29, 1883 In Predappio. The Essays

Benito Mussolini was born on July 29, 1883 in Predappio. The son of a blacksmith he was largely self-educated. He became a schoolteacher and a socialist journalist in northern Italy. In 1910 he married Rachele Guidi who bore his five children. Mussolini was jailed in 1911 for his opposition to Italys war in Libya. Soon after his release in 1912 he became editor of the socialist newspaper in Milan, Avanti!. When WWI began in 1914 Mussolini advocated Italys entrance into the war on the allied side and was expelled from the socialist party. He then started his own newspaper in Milan, Il Popolo dItalia (The People of Italy) which later became the origin of the Fascist Movement. In 1916 Mussolini enlisted in the military. After his promotion to sergeant he was wounded and in 1917 he returned to his paper. During the Chaos that Gripped Italy after the war Mussolinis influence grew swiftly. Mussolini and other war veterans founded Fasci di Combattimento in March of 1919. This Nationalistic antisocialist movement attracted much of the lower middle class and took its name from the Fasces, an ancient symbol of Roman discipline. The Fascist movement grew rapidly in the 1920s, spreading through the countryside where its Black Shirt Militia won support of the land owners and attacked peasant leagues of Socialist Supporters. To take advantage of the opportunity Fascism shed its initial Republicanism gaining the support of the King and Army. On October 28, 1922 Mussolini led his Fascist March on Rome. Mussolini was immediately invited to form the Italian Government by King Victor Emmanuel III. Although Mussolini was given extraordinary powers to return order to Italy he governed constitutionally until 1924 after the violence of the 1924 elections resulting in the death of Socialist party deputy Giacomo Mattoetti. Mussolini moved to suspend constitutional government and establish a totalitarian regime. He proceeded in stages to establish a dictatorship by forbidding the parliament to initiate legislation, making him responsible to the king alone. By 1926 he had passed decrees issuing him the force of law, establishing total censorship of the press and suppressing all opposition parties. In 1929 Mussolini made one of his greatest diplomatic triumphs when he concluded the Lateran Treaty between Italy and the Holy See. This settled the 60-year controversy concerning the power of the Pope within the Italian State. In 1933 Hitler was appointed chancellor of Germany and was greeted cautiously by the Italians. Hitler in turn expressed friendship for the Italian Fascist government. During Germanys annexation of Austria, Italy improved her French relations when she rushed 75,000 troops to the Italo-Austrian frontier announcing that she would intervene if Germany took overt action. Italy drew closer to he WWI allies in 1935 when she protested Germanys violations of the Treaty of Versailles. Adopting an aggressive foreign policy Italy defied the League of Nations in 1935 by Conquering Ethiopia, which won him acclaim with nearly every sector of the populace. Il Duce, as he became known as, popularity declined as he sent troops to aid General Francisco Franco in the Spanish Civil War. He also Linked Italy with Fascist Germany, Enacted Anti-Jewish Laws and Invaded Albania. Because Mussolini was not militarily prepared she did not enter WWII until 1940 after the Germans had overrun France. The Italians however were driven from Albania and Greece by the Greeks following some major British Victories in Egypt, which shook the foundation of fascist Italy. Mussolini then had to ask Hitler for aid, which left Italy increasingly under German control. In 1941, Italy suffered successive military disasters and growing economic problems caused by an allied blockade. Anti-Fascist ideals quickly began to spread throughout the Italian countryside. The Balkan campaign ended successfully as a result of German intervention and Italy acquired many new territories. By an arrangement between Mussolini and Hitler Italian troops occupied all of Greece. Many Italians realized that their gains in the Balkans were an illusion as they were controlled almost entirely by German troops. Italian foodstuffs began to run low as the Germans increased their demands on Mussolini for military assistance. In June 1941 Mussolini declared war on the USSR to join the Germans at Hitlers request. When the war effort began to have difficulties the Germans became much more pressing on his demands of Mussolini. In March Mussolinis effort became extremely bleak when the U.S. government seized control of 28 Italian merchant ships and impounded all Italian assets in the U.S. On July 10, 1943 allied forces invaded Sicily six days later President Franklin D. Roosevelt and British Prime Minister Winston Churchill sent a joint radio message to Mussolini asking for the surrender of the Italian people. After

Free Essays on Catholicism In Irish Literature

, impure deeds, and that’s what adultery is, Dirty Things in General† (McCourt 291-292). The priests hammered Frank and his community with stories of their beloved Virgin Mary and crucified Jesus, persuading them to believe that sex was a sin, causing a total repression of feelings by followers. â€Å"He says impurity is so grave a sin the Virgin Mary turns her face away and weeps†¦every time you succumb to the vile sin of self-abuse, you nail Christ to the cross†¦I can’t help myself and swear I’ll go to confession and after that, surely a... Free Essays on Catholicism In Irish Literature Free Essays on Catholicism In Irish Literature Irish literature involves largely the prestigious Catholic religion among the people and its affect on their lives. In Angela’s Ashes and in Great Irish Short Stories, the word of the priest was not one to argue against and the Catholic teachings and Bible were a way of life. Due to the rule and power of the Catholic Church over the Irish community, sexuality was a symbol of sin, becoming unhealthily repressed and denied in the people. Any sexual encounter, form of thought, or natural feelings were dutifully abstained from, in fear of sinning or becoming a heathen, for sexuality was shunned upon by the Church. Throughout his childhood, Frank McCourt is burdened with the feeling of guilt for his own sinfulness of his uncontrollable sexual thoughts and behavior. He is frequently talking of his worries that he is condemned or that he may damn other people. However, the root of his worries stems mostly from the Catholicism in which he was raised. Although sexual feelings are natural and occur in every person with hormones, he sees himself as being dirty for even toying with any sexual idea- this because of the control the church has had over his mind. â€Å"I know about the excitement and I know it’s a sin but how can it be a sin if it comes to me in a dream†¦It’s a sin when you’re wide awake and going at yourself†¦Thou Shalt Not Commit Adultery, which means impure thoughts, impure words, impure deeds, and that’s what adultery is, Dirty Things in General† (McCourt 291-292). The priests hammered Frank and his community with stories of their beloved Virgin Mary and crucified Jesus, persuading them to believe that sex was a sin, causing a total repression of feelings by followers. â€Å"He says impurity is so grave a sin the Virgin Mary turns her face away and weeps†¦every time you succumb to the vile sin of self-abuse, you nail Christ to the cross†¦I can’t help myself and swear I’ll go to confession and after that, surely a...

Runaway Chemical Reaction and Vapor Cloud Explosion Literature review

Runaway Chemical Reaction and Vapor Cloud Explosion - Literature review Example The drive needs to be sorted before the start of any reaction process to control the explosion incidences. In addition, during the polymerization process, the people concerned should ensure that there is required amount of polymers and monomers to reduce the reaction process. When unequal amounts of polymers and monomers are used, there can be rapid increase in reaction pressure in reactors manways enabling solvent vapor to be forced out as a flammable cloud Carolina (CSB 2007, p. 2). In most cases, it has been noticed that when the ejected vapor comes into contact with the source of ignition, it results in explosion thereby can lead to killing of workers and several harms. Such killings and deaths need to be controlled by the workers themselves and some organization bodies. The Chemical Safety Board (CSB) should ensure the workers are familiar with basic safeguards tips that prevent, detect and moderate runaway reactions. Moreover, the Board should also ensure that all safety management practices are operating all time. Most preferably, people should reside quite distance from main firms that are involved in several reaction tests. During the process of reaction that may at times leads to severe explosions may cause injuries to the nearby homes Carolina (CSB 2007, p. 3). Some blasts may go beyond the borders causing damage of structures of the nearby residents. The most important necessity for all companies that are involved in chemical reaction processes is a quick mode of transport. Ambulances owned by these firms create immediate access to medical checkups. The injured workers can be transported to various hospitals depending on the nature of harm. The burned labors are taken to burn centers for better treatment. In order to get a complete manufacturing cycle, several reaction steps must be followed. All the levels should be monitored by the operators Carolina (CSB 2007, p. 5). In order to achieve appropriate and successful manufacturing cycle, there

Ethical Issues and Application of Ethics Theories Case Study

Ethical Issues and Application of Ethics Theories - Case Study Example Similarly, Carly also wants to show the work of young artists in his museum as it was a success in a museum in London. This will affect both Z museum and Carly as a successful show will increase the rating of the museum and will help them become a popular place. Similarly, Carly will also benefit by controlling a successful museum as his standing and worth will increase. The other stakeholder in the case is Jeremy Q. Jeremy Q is going donate a good sum of money to museum in an attempt to increase recognition in the corporate sector, which will give him chance to attract a corporate sponsorship for his collections. So, he may also be affected greatly by the success of the show. M's will also not remain unaffected by the show. They have been forced to become a stakeholder by the persuasion of Jeremy and Carly. Both have offered them to use their services in future if they sponsor the show. This means future financial gains for M's if show becomes a success. Similarly, young painters wi ll get exposure and there may be a change that the success of their painting in the show may lead them to fame. These were some of the stakeholders and how ethical or operational issues impact these stakeholders. According to Manuel Velasquez, Teleology theory states that what make an action good or wrong are the consequences of that action. For example, a "right action" always leads to right consequences and vice versa. In our case, all the stakeholders were working for their own benefits. For example, Jeremy wanted publicity and corporate sponsorship for his collections. Similarly M's wanted more business opportunities in the future and Carly wanted to enhance his reputation. In surge of their own benefits, all the stakeholders were working for the success of Z museum. However, according to Teleology theory, this self-interest is justified as long as the final target is achieved, that is the success of Z museum. However, if the Museum fails to put on a great show, the actions of these stakeholders would be classified as unethical or wrong actions, as suggested by this theory. Similarly, Manuel Velasquez defines Deontology theory as "it is not the consequences but the motivation behind thes e actions that determine the actions right or wrong". In our case everyone was lacking the real spirit and working for their self-interest or personal success (2009). Hence, their actions, according to deontology theory were wrong as they were not working for the success of the Museum, which was the main target, but instead everyone was seeking growth in his own personal stature. However, one cannot classify this behavior as truly negative behavior. According to Shaw, egoism theory sets the personal achievement and pleasure as the main goal for one's actions. The behavior of the stakeholders can be justified if their actions are viewed in the light of this theory. The director was working for his growth in reputation, Jeremy for his publicity, M's for future business. All of them were indirectly putting their efforts for the success of the show at the Museum. Their actions are justified by the egoism and Teleogical theories but, their actions cannot be considered as totally ethical under deontology (2005). In order to analyze the costs and benefits of these actions to Z

Project management yara2 Essay Example | Topics and Well Written Essays - 500 words

Project management yara2 - Essay Example From the fact that resources will always remain limited, managers are required to manage the limited resources using systematic ideas, effective methods and theories and good setting of standards to ensure the project succeeds without unnecessary expenditures. Most project managers whose projects have failed can be traced to the poor interpretation of resource availability. It is on this point that the project managers are required to involve all round resource management skills to avoid failing vital company products. An all-round resource management in this case includes both financial and human capital. The elements needed for effective project management under the limited resources include the ability of the managers to plan, organize, direct, coordinate, control and evaluation of the whole process. These elements are always expected to form a key part of any project at the starting point. Knowing or noting the importance of these elements during project is not enough to steer th e project towards success. Leadership traits and practical aspects of the project management must take center stage. A number of projects have failed despite the availability of resources due poor leadership. One of the elements of project management leadership is involvement of all and accurate communication. Good project management must involve a gradual process of introduction of any new items or changes. This study will focus on good project management from leadership to the practical point (Meredith and Mantel, 2012). Organizations and individual managers have experienced a series of project failures. These failures can be traced to poor management within the organization and the project team. The difference between successful and failed projects has been pointed out to be the management aspect. Successful project management as portrayed by this study requires effective management from the

Dubais Tourism Industry

Dubais Tourism Industry Introduction Dubai is a member country of the Middle East region. The whole of this region generally attracts few tourists thanks to political turmoil which over the decades have generated tensions and uncertainties not only in the region but also in the whole world. Some other hindrances to effective tourism development in the region include lack of poor state of infrastructural development, limited promotion and lack of attractions. In spite of all these setbacks, Dubai has however managed to see a flourishing tourism industry save for its tourism policies. The authorities in the country have managed to implement sound economic diversification programmes which together with extensive marketing have resulted in a booming tourism industry. Dubai has heavily invested in expensive state of the art facilities, undertaken deep marketing and these has resulted in the growth of her tourism. Her future expectations are very high as reflected by the setting of sky rocketing arrival targets. Actually Duba i has demonstrated a capability to overcome the challenges faced by the tourism industry and has established itself as an authority in the industry with a very high growth rate. This therefore makes Dubai an interesting example of a booming Middle East centre for tourism that is fast creating new and more opportunities and realizing its full potential. This notwithstanding, there are some constraints that which may inhibit the potentiality of Dubais tourism industry to be achieved. These factors call for review of policies and strategies. Destination development is a key factor in tourism literature and research approaches this theme from various disciplines and perspectives. These perspectives are; Government policies. Destinations spatial evolution Business strategies and marketing Development impacts A critical analysis of these factors helps indicate whether a place considered for resort is likely to grow into a major tourism hub or not. For the case of Dubai, tourism has progressed very well over the last three decades and the figures below affirm to this: Factors central to tourism development in Dubai Socio- Political Stability Unlike most of its neighbors Dubai has enjoyed relative calmness over the centuries. Being stable in terms of economics, political and social domains is very important in ensuring smooth development of tourism. This is because disturbances scare away investors as well as tourists and the whole industry as tour operators and agents are discouraged. Dubai being one of the federations of the United Arabian Emirates has lived to the true spirit of the federation. Proceeds from sale of oil have enabled Abu Dhabi to finance the federation Thereby improving the standards of living and providing security. The rest of the emirates, in return provide Abu Dhabi with some strength both geographically and demographically. Over the years there has been an uninterrupted political stability in Dubai together with economic prosperity. Dubai enjoys autonomy in making of economic policies although it has to support other emirates in such matters as defense and foreign relations. Regionally, Dubai acts as an entrepot and promotes herself as the Gulfs financial nexus. Globally, Dubai is viewed as a liberal cosmopolitan society with almost nil threats of crimes and civil unrest. Dubai is a Muslim state in which women are traditionally inferior to men yet other religions are tolerated. More than 80% of her population is entirely made up of expatriates. Government tourism policy Tourism can only thrive in areas where the political systems clearly define the economic policies in a manner that is consistent with the revolutionary needs of the ever growing tourism industry. The semi- autonomous government of Dubai has been actively involved in initiating sound policies geared towards improving its tourism industry. The federal authorities have identified tourism as a major economic pillar. Accordingly, the government has heavily invested in infrastructure. Pressured by the spirit of the federation policies, Dubai has made significant improvement in her investment in tourism. Interest in tourism grew against a background of decrease in oil production and the need for diversification of economic activities. Dubai positioned tourism at the centre of this diversification programme together with construction, real estate, media and financial trading. Dubai has also engaged the services of international advisers and external consultants to help in preparation of strategies to be adopted in improving the growth of the industry. All these measures have seen Dubai earn a reputation of being a tourism hub in the Middle East. Accessibility Tourism development in Dubai is closely linked to its advances in the transport sector and its accessibility to the outside world. Dubai has clear ambitions of being a major focus in the air transport in the whole region and to this effect the Dubai authorities are putting in place the necessary infrastructural facilities. Dubais civil aviation has progressed quite well and its airport is among the top twenty busiest in the world as measured by the passenger volume. Between 1990 and 2004, about 20 million passengers were carried by 100 airlines serving operating between 145 different destinations. The Dubai airport is expected to handle about one forty million passengers in the next few years. In addition the Dubai government is preparing for a new airport so as to carter for increased freights. The Emirates airline is internationally reputed to offer the most excellent services in the region. Some of her planes are the most technologically sophisticated in the world and has won awards and recognition for good customer services. Dubai boasts of the worlds longest fully automated railway system stretching a distance of 43 miles and serving 47 stations. This project is made up of twelve elevated stations, nine kilometers of an underground truck, and an overground truck stretching fifteen kilometres. An upcoming project is on the way to construct a 1500 railway line. This proposed line will connect Dubai to Oman, Saudi Arabia Qatar and the other emirates. Again Dubai is one of the emirates that provide a hub for large cruise ships. Attractions Dubai has a rich attraction centre on its 64 kilometres long coast line. This magnificent coastline boasts of several high ranking tourist resort centres boasting of such important tourist activities as sailing, skiing, surfing, fishing, bird watching and golfing. The desert provides tourists with magnificent excursions for camel riding, sand skiing, dune driving, exploration of wadis and visits to selected oases and forts. Dubai city also has an extensive network of shopping malls where world varieties are readily stocked. The industrial development of the city has in the recent past attracted large hordes of investors who also double as tourists. Elegant sky scrappers are a common view in Dubai which has greatly added to the scenic beauty of the city. Well designed road networks with underground tunnels as well as over ground networks have gone a long way in eradicating traffic jams which is a common menace in several countries thereby ensuring smooth flow of traffic. Tourists no longer have to spend too much time in the city waiting for traffic jams to recede as was the case a few years ago. Amenities The essential amenities required by tourists are chiefly the accommodation. In Dubai the development of hotel industry is a top government agenda. Hotel rooms have more than doubled in the past decade and the number is fast increasing. Currently there are about three hundred hotels with well equipped recreational facilities. Development of hospitality is largely due to the relaxation of land leasing rules and several five-star properties are expected very soon. Among this is a hydropolis hotel constructed up to twenty meters under water. Review Potential challenges. The emergence of Dubai as a major tourist centre is largely due to the prevailing economic, socio-cultural, political and historical structures which have shaped the tourism growth. This development has been driven by strong government policies which are geared towards reshaping of economic policies for sound development. Dubai actually has pursued a strategy of heavy expenditure and intervention geared towards attainment of tourisms future goals. Internal peace and stability prevailing in Dubai and the neighboring countries has helped a lot to boost tourism activity. This is because the political stability has enabled foreign investors to consider venturing in Dubai in such areas as transport, accommodation and attraction. Vigorous marketing of the tourism industry has assisted in elimination of original inefficiencies and barriers to effective tourism development. By undertaking proper strategic policies, Dubai has been able to surmount the setbacks which are hampering new upcoming tourism destinations. Given the potential setbacks, there are some doubts as to whether Dubais long term vision of becoming the worlds chief tourism hub will be met. One major setback is lack of political stability in the Middle East region. Political turmoil in such countries as Iraq and Afghanistan have reportedly spilled over to neighboring countries and Dubai is never immune to these. Terrorists have of late found flesh grounds for unveiling terror against the West in moderate countries such as Dubai. Elimination of tourism from the Middle East is a key step towards the realization of Dubais tourism vision. Any act of terrorism will have far reaching effects in Dubais economy and the tourism industry in particular. Another impediment to tourism development is lack of enough land for expansion. Dubais geographical size is a natural limitation to its development. Progressive growth of the city requires more and more land for expansion. However, this cannot be achieved in Dubai where land prices are skyrocketing while the available facilities are not enough to meet the demands of modern tourism as necessitated by large numbers of tourists visiting Dubai annually. Another challenge to growth of tourism in Dubai lies in her attractions and promotion. Dubais tourism inventory is scanty compared to its competitors in the Mediterranean, Caribbean and Far East. Dubai has an extremely narrow collection of natural and cultural heritage. Concentration on beach activities and grand shopping malls has not done enough to secure the much envied pride. For a period of less than 50 years Dubai has undergone a lot of industrial progress which has seen it rise to the status of an industrial power in the Middle East. This change is clearly evidenced in the economic, cultural and social development of Dubai. Contrary to major western countries where the industrialization process took a very long time, Dubai has undergone it in only relatively short time. Tourism development in Dubai is still growing and it is important to bear in mind that there are several schemes that are not yet completed. The fulfillment of these schemes and the realization of their visions is the aim of the Dubai authorities. However these will depend on the availability of a favorable and reliable environment clear of uncertainties. Doubts have also been expressed concerning the feasibility of some of these visions. The demands of modern tourism have not yet been met in Dubai. CONCLUSION The study of tourism in Dubai shows how a small and relatively remote country with little natural attractions can become an internationally reputed tourist attraction centre. In Dubai potential weaknesses and threats have been turned into strengths and opportunities. The all year round hot weather and ugly desert landscape have been changed to provide modern needs of tourism. Technology has actually enabled the tourism industry to prevail regardless of the harsh weather conditions and some other geographic impediments. Economic prosperity has provided funds to support the expansion of the infrastructure upon which the tourism industry is pillared. This has seen speed growth of the air transport, modern railway lines and well developed communication infrastructure. The lavish metro-politan state founded on economic prosperity is a natural attraction for tourists. All these features have been tactfully marketed in such a manner that they have been able to lure tourists from all over th e world to this small country which was until recently unknown to the outside world. All this has been achieved in spite of the general perception that the Middle East is a dangerous place unfit for tourists and investors. Dubai has considerably achieved some progress in negotiating the barriers that have for long impaired the development of tourism in the Middle East and areas beyond. The achievements in Dubai are of interest to not only the rest of the emirates but also other tourist destination which aim at attaining the global recognition. However tourism development in Dubai is still ongoing and research is being done to monitor Dubais tourism evolution. Important lessons can then be learnt from Dubais experience with tourism and the relevance of its tourism model can be assessed to ascertain their suitability in the context of other upcoming tourist destinations. The results of this will no doubt contribute to an increased understanding of the tourism industry which has largely been neglected in the Middle East due to misconceptions.

A League of Their Own

The movie also makes It easier to understand the different ethical systems by relating each system to a character portrayed In It. During the duration of World War II, the players of major league baseball were drafted. As a result, the ML used females to fill the teams to keep the American pastime alive. This essay will analyze some of the main characters of A League of Their Own from an ethical stand point. The main character, Dotted Hanson, played by Agene Davis, is the catcher of theRockford Peaches. Dotted Hanson best relates to utilitarianism. Throughout the movie, Dotted was constantly striving to do the right thing, not necessarily thinking about the outcome, but just wanted to be an all-around good person. For example, she wanted to show off as much as possible to reporters and the media in order to keep the women's league around much longer after the war ended so many of the players could keep their jobs. The other mall character, Jimmy Dugan, played by actor Tom Hanks, was the manager of the Rockford Peaches.Although he was portrayed early on as rude and arrogant, he eventually had a change of heart. With that In mind, Jimmy Dugan can be mostly associated with the ethics of virtue because this system is not based on one's actions, but the moral character of that person. We can see that deep down, he is a very caring person. However, sometimes his actions do not display the truth of his personal moral character. Next is Doris Murphy, who is played by Rosier O'Donnell. This character best portrays ethical formalism because f the constant intent to do good deeds.For the most part, she would conduct herself in a positive way to everyone. For example, when her teammate, Mae, was upset because of the proposal of shutting down the female league, Doris stood up for her friend and defended her, not for appraise, but because she knew it should be done. Doris' teammate, Mae Mortal was played by Madonna. Mae best describes natural law because of her moral princip les. When the possibility off league shut-down came about, Mae stayed firm In her beliefs of not wanting to go ace to her former life of dancing provocatively.Natural law can apply to anyone who continually keep their principles upheld. The recruiter of the players, Ernie Caption, was played by Jon Loving. Although a smaller role, he is portrayed as an arrogant and self-centered, thinking mainly of himself. For this reason, he best illustrates the egoism system. When Kit and Dotted were willing to stay behind for Marl, Ernie made it clear he was there specifically to finish his job, whether that would be with or without the girls.Air Loneliness, played by David Stratum, is one character who really tries to keep the league going for everyone involved. In this case, this character can relate to the ethics of care. Although Air is not motherly Like some may associate this system with, he Is still caring enough and emotionally Invested In the girls to fight to keep the league alive. Eac h of these roles helped explain a different system of ethics. Overall, A League of Their Own was enjoyable to watch and interesting to see how each character A League of their Own Through the movie â€Å"A League of their Own,† one can see how the more sexist views of the culture of this time in America permeated throughout this account of the Girls Professional Baseball League which existed from 1943 until 1954.â€Å"A League of their Own† is a snapshot of what was once the â€Å"All-American Girls Professional Baseball League† that was formed when many young men were active in World War II. Philip Wrigley, chewing gum mogul and MLB owner feared the major leagues would disband so he created the girls professional baseball league.One of the obvious cultural views during the time this movie depicts is that of feminizing the baseball players to make them more acceptable to that culture at the time. Although they wore shorts under their baseball skirts, the fact that they were to wear skirts that were very short for this time while playing the athletic sport of baseball is just one of the clues to how the â€Å"All-American Girls Baseball Le ague† was to be as much about show as it was about talent.In one part of â€Å"A League of their Own,† the scout Ernie Capadino intends on passing up the player Marla Hooch who is unattractive yet proves to be a great switch-hitting slugger. Capadino was told to find girls who play ball well and are equally as attractive.Another argument supporting the existent and greater acceptance of sexism represented when putting this â€Å"All-American girls team† togehter was that the female professional baseball players were at least in the beginning of this venture considered more seriously as princesses rather than as serious baseball players in this era, as we hear the announcer comment, â€Å"After the first month of league play, the shine still isn’t off these â€Å"diamond† gals.Alice â€Å"Skeeter† Gaspers says legging out a triple is no reason to let your nose get shiny—Betty Grable has nothing on these gals. Helen Haley has not only b een a member of several championship amateur teams, she is also an accomplished coffee maker† (Marshall, 1992).Even the radio program that is played during the tryouts at Harvey Field makes fun of the idea of a woman’s baseball team. During the radio program, the girls baseball team is referred to as the â€Å"masculinization of women.†The female baseball players have mandatory etiquette classes they must attend to portray a â€Å"lady-like† image. Even some of the names given to these female baseball teams at this time rings of   what we would today consider sexist in its lowest such as â€Å"Rockford Peaches,† â€Å"Racine Belles,† â€Å"Milwaukee Chicks,† â€Å"Fort Wayne Daisies† and â€Å"Muskegon Lassies.†Of course then you hear the announcer say things like: â€Å"Then there’s pretty Dottie Henon, who plays like Gehrig, and looks like Garbo. Uh-uh, fellas, keep your mitts to yourself; she’s married . And there’s her kid sister Kit, who’s as single as they come.Enough concentrated oomph for a whole carload of Hollywood starlets† (Marshall, 1992), today’s announcer need protect their heads if they were to utter such remarks.I think most of us would be thankful that announcers today couldn’t get away with trivializing the talents of those female baseball players, only to make the main focus their various levels of attractiveness and unattractiveness. This we know has never been something acceptable to do to professional male baseball players.Viewing the female as the care taker of the alcoholic baseball manager some can interpret as another female stereotype revealed in the movie and more accurate to the depiction of its acceptability during this time period. The character Dottie Hinson provides a maternal, care-taking role many times for baseball manager Jimmy Dugan, the often drunk manager of her team.Another part of the movie that would be con sidered very inappropriate real life behavior today versus the time incorporated in this film would be when the drunken Dugan relieves himself in the clubhouse. His female baseball players he is supposed to be managing are standing near awaiting instructions to play the game as he completes his task. Today, that would make the evening news along with being connected to legal repercussions.Today, unlike then, one has learned to be a lot more careful of how things one says can be monitored and reported. Even the humorous little prayer where Dugan says:â€Å"Uh, Lord, hallowed be Thy name. May our feet be swift; may our bats be mighty; may our balls†¦ be plentiful. Lord, I'd just like to thank you for that waitress in South Bend. You know who she is — she kept calling your name. And God, these are good girls, and they work hard. Just help them see it all the way through. Okay, that's it† (Marshall, 1992).Whether one sees it as a positive or negative or a little of bo th, one would just have to watch more carefully things they say like that today than one did then.When Jimmy Dugan was attempting to convince Dottie Hinson to stay with the team, he yells at her, â€Å"If you want to go back to Oregon and make a hundred babies, great† (Marshall, 1992). This again, wouldn’t be something any professional could spout out to another, including a female player he manages, without the strong possibility of suffering professional or legal repercussions in today’s society at least in America.While I’m at this point in the movie, the fact that Dottie feels she must make a choice between her marriage and that of playing professional baseball or any professional sport is another noticeable difference. There are many great professional and non-professional married female athletes today. One could just watch the 2008 Olympics and observe the obvious signs of that.

Was Alexander Really Great?

Greatness is an umbrella term that can hold several different meanings and interpretations. In the case of Alexander the Great, it has a very specific meaning that reflects upon the achievements and success of his life time, despite the many character flaws and failings he undoubtedly possessed. Alexander the Great definitely deserves this appellation for three main reasons. Firstly, he conquered an incredibly vast area for his young age and lack of experience; secondly he left his mark on society which has lasted till contemporary day; and thirdly he completely revolutionized military techniques and styles.Firstly, Alexander the Great fought in horrific battles that rewarded him with a huge amount of land, resources and prosperity. He engaged in conflicts including the Battle of Granicus, Battle of Isus and the Battle of Tyre, leading him to conquer nations now known as Turkey,Israel, Lebanon, Syria, and a large portion of India. His ambition certainly paid off, and as Arrian, an hi storian living at the time of Alexander wrote, †Ã¢â‚¬ ¦He would always have searched beyond for something unknown, and if there had been no other competition, he would have competed against himself. This source is quite reliable, as it reinforces other accounts of his attitude correctly, however Arrian basically recorded all the conquests of Alexander the Great, so it may be influenced or recorded with a certain bias that Alexander himself imposed. Secondly, Alexander the Great helped to establish Greek society and spread it over the world. He single handedly created a culture that has maintained itself till this very day. It truly is a great feat to form a society, including language, etiquette, customs and traditions that will last thousands and thousands of years.Historian Professor Paul Cartledge stated in his manuscript Hunting for a New Past â€Å"the great leader's achievements – both in his lifetime and posthumously are simply staggering, as they have lasted th e generations to still be evident today. † Cartledge’s opinion, although we must keep in mind it is only his opinion, is certainly reliable as he is a modern day expert on Greek culture and greek history, quoting in an edited and published official manuscript.Lastly, the military wisdom and knowledge that Alexander the Great not only possessed, but created himself, is astounding. The number of battles and wars he planned and executed is truly great, and especially in such a successful manner. This is one of his greatest attributes, and the skill he is most remembered for. A tapestry called Alexander the Great in Battle, discovered in 1661 by archaeologist Charles le Brun, reflects upon this concept. It depicts Alexander riding into battle and slaying his enemy with strategy and premeditated decision.Although it may be not completely reliable as it seems to portray the romantic myth of Alexander as a ferocious and fearless warrior, it does hold a concise example of his s kill in military prowess. Overall, Alexander the Great deserves his namesake because despite having many character flaws, he was an exceptional man who achieved some astounding feats. The vast land he conquered at such a young age, as well as his long lasting impacts on Greek society, and finally his military intelligence and success prove that Alexander truly was a great individual.

Free Essays on The First English Colonies In The New World

Colonization of the New World by the English, First Settlement in the New World The English’s first encounter with the new world â€Å"Novus Mundus† was in 1497, just few years after Spain’s. John Cabot sailed the northeastern coast of North America, seeking to reach the orient through the New World, his voyage was unsuccessful. It was more than a hundred years before the English started colonizing and establishing themselves in the new world. The reason why English started to think about settling in the new world was because of wars and religious strife that were occurring in their own land. The economic needs were also great, because of the growing demand of wool, most of the crop fields were turned into fields to pastures for sheep. The food supply was decreasing as the population was growing; to some English the New World started to sound like a good place to go. Because England got such a late start in the colonization game, they couldn’t just set up their colonies wherever they wanted. Spain dominated South America, Mexico, the West Indies, the American Southwest, and Florida. The French held sway along North America’s major waterways. In addition, the dense forests and occasionally hostile Native American tribes prevented English settlers from moving westward past the Appalachian Mountains. The early English settlements were therefore concentrated along the eastern coast of North America. The first English settlement in the New World was called â€Å"Jamestown† and it was located in Virginia. It is important to note that before this settlement the English had begun to settle, yet all of these efforts failed. The 105 original Jamestown colonists were all men. Jamestown was a business venture, not a place to raise a family. The colonists focused all their efforts on getting rich, neglecting to tend to any sort of agriculture. As a result, more than half of the colonists died of starvation within the first year. O... Free Essays on The First English Colonies In The New World Free Essays on The First English Colonies In The New World Colonization of the New World by the English, First Settlement in the New World The English’s first encounter with the new world â€Å"Novus Mundus† was in 1497, just few years after Spain’s. John Cabot sailed the northeastern coast of North America, seeking to reach the orient through the New World, his voyage was unsuccessful. It was more than a hundred years before the English started colonizing and establishing themselves in the new world. The reason why English started to think about settling in the new world was because of wars and religious strife that were occurring in their own land. The economic needs were also great, because of the growing demand of wool, most of the crop fields were turned into fields to pastures for sheep. The food supply was decreasing as the population was growing; to some English the New World started to sound like a good place to go. Because England got such a late start in the colonization game, they couldn’t just set up their colonies wherever they wanted. Spain dominated South America, Mexico, the West Indies, the American Southwest, and Florida. The French held sway along North America’s major waterways. In addition, the dense forests and occasionally hostile Native American tribes prevented English settlers from moving westward past the Appalachian Mountains. The early English settlements were therefore concentrated along the eastern coast of North America. The first English settlement in the New World was called â€Å"Jamestown† and it was located in Virginia. It is important to note that before this settlement the English had begun to settle, yet all of these efforts failed. The 105 original Jamestown colonists were all men. Jamestown was a business venture, not a place to raise a family. The colonists focused all their efforts on getting rich, neglecting to tend to any sort of agriculture. As a result, more than half of the colonists died of starvation within the first year. O...

Analyse Pakistan As A Tourist Country Tourism Essays

Analyse Pakistan As A Tourist Country Tourism Essays Analyse Pakistan As A Tourist Country Tourism Essay Analyse Pakistan As A Tourist Country Tourism Essay Pakistan appeared as a modern state on 14 August 1947. There are four states and all four states of Pakistan are gifted with heritage and civilization one of the fertile and alone aggregations of olympian and rugged mountains, exuberant Fieldss, comeuppances, rivers, lakes, coasts and landscapes enriched with friendly and hospitable people therefore doing it a celestial finish for tourers with different gustatory sensations. Pakistan is known in the universe of touristry because of the cragged parts of the North, the Hindukush, Karakoram and the Great Himalaya who form the densest concentration of high extremums in the universe. Kalam ( Swat vale ) in Pakistan is known as the Switzerland of Asia. The Hunza and Chitral vales in Pakistan were the place to a little pre-Islamic animist Kalasha community who claim descent from the ground forces of Alexander the Great ( Mapsofworld.com ) . The historical and archeological sites of Ghandhara and Indus Valley civilisations, Mohenjo-Daro, Tax ila and the Mughal Empire are the illustrations of oldest civilisations in Pakistan. This multicultural nature of the state besides contributes to the touristry industry in the manner that it offers assorted traditions, imposts and festivals for the tourers to research and bask. Problem statement: Harmonizing to the above paragraph, Pakistan seems to be a perfect topographic point for tourers to be visited but still the tourer s reaching is diminishing twenty-four hours by twenty-four hours if we take into consideration the old ages from 1995 boulder clay 2008. Purposes and Aims: The purpose of my thesis is to happen out the positive and negative factors which are impacting the Pakistan touristry industry and besides the cause of tourers worsening ratio. Find out the function of the authorities towards the development of this industry and suggest some schemes that can better this sector and besides detect the concealed potency of touristry industry. Another motive behind this research is to analyze and compare the economic consequence of touristry in footings of money and occupation coevals in our state as compared to the adjacent states. Research Questions: The research inquiries are: What are the factors impacting touristry industry in Pakistan? How much potency Pakistan has got in touristry industry? How touristry industry created gross and occupation for the state? What will be the schemes to develop the touristry industry in Pakistan? What the authorities should make to develop the touristry industry in Pakistan? Literature reappraisal and theoretical background: In this chapter, I will discourse some of the available literature and compare it with my research work giving a broader image of the alone nature of the work and its practical utility. Literature reappraisal: Kakar et Al. 2007, in their research thesis provided a relation between touristry and employment in Pakistan. The intent of this research was to find the rate of employment generated in different businesss from the touristry sector. The study was carried out by personal visit to the hotels, eating houses, souvenir stores, travel agents, auto hire houses, circuit operators and air hose offices. They designed a questionnaire for this intent. The study was restricted in the sense that it was carried out in merely two metropoliss of Pakistan i.e. Swat and Abbottabad and secondly it was carried out in hotels and eating houses. No effort was made to find the entire impact of touristry on different employment sectors like taxis, ushers, amusement, travel bureaus etc. furthermore the statistical informations provided on the figure of hotels, figure of beds and the figure of people employed is limited in the sense that there is no proper information about the time/date/year in which the infor mation was recorded. Baloch ( 2007 ) in his research of pull offing touristry in Pakistan trades with the issue of naming the cause of creeping nature of Pakistan s touristry growing and suggest ways to develop this industry through natural, historical and cultural resources. The research was carried in Chitral valley merely. The methodological analysis used was entering the positions of tourers, locals, hotelkeepers and informations aggregation from Pakistan Tourism Development Corporation ( PTDC ) and Ministry of Tourism. The research is restricted in the sense that the deteriorating status of this industry is explained merely for 2006 and there is no proper statistical informations provided for Chitral vale. The information was collected from the concerned sections and there is no proper findings obtained from the tourers and hotelkeepers. Although some of the surveies found and discussed above are related to the touristry industry in Pakistan but there is barely any research that focuses chiefly on positive and negative factors set uping Pakistan touristry industry on a whole and compare this industry to its adjacent states. I ll concentrate on factors set uping touristry, its impact on employment and the gross earned for the whole state. The research will include statistical informations for last 14 old ages which will assist in comparing the public presentation of this sector with other states besides. Theoretical Background: There are many positive and negative factors which are impacting Pakistan touristry industry. These are as follows: Positive factors: The tourers normally travel to see different topographic points and things other like clime, nature, civilizations, people, imposts, humanistic disciplines, culinary arts, linguistic communications, alone festivals, old historical edifices and sites etc. the ground why Pakistan has a great potency in touristry industry is that it posses every individual thing that could run into the demand of visitants. Following are the types of touristry in Pakistan: Diaspora Tourism: Harmonizing to Clarke ( 2003 ) the term Diaspora refers to a individual who is from one state but originates from another and identifies with the state of beginning. The term Diaspora can be approached from two different waies, as a typological tool and as a societal status. When the term is used typologically it refers to a group of people who have moved from one topographic point to another and who still identify with their fatherland. The fatherland is merely a metaphor, it may non even exist but it still carries significance for the person. Clarke ( 2003 ) argues that Diaspora is people who have relocated for any of five different grounds ; victim, labour, trade, imperial and civilization. All of these grounds are in some manner forced upon the person, which is the cardinal thought behind this type of attack to the Diasporas phenomena. For illustration, the British who immigrated involuntarily to the different settlements were imperial Diasporas. The typological attack to the Di asporas issue is that it disregards the differences within the different groups. So it is more accurate to depict Diaspora as a status. The status of being from one topographic point but of another and place with sentiments towards a fatherland ( Clarke, 2003 ) Harmonizing to Ali Eteraz ( 2008 ) , more than 7 million Pakistani people are populating outside from Pakistan. Pakistan has got a big figure of Pakistani Diaspora which can lend a positive function in the economic system of Pakistan. Apart from Diaspora, sing friends and household touristry is besides really of import. Many of these Pakistani Diasporas have friends and households populating in Pakistan, and they continue to see these friends and households playing more positive function in the development of Pakistani touristry. Domestic Tourism: Harmonizing to Richter ( 1989 ) , many states of the universe take domestic touristry as a hapless cousin and did nt pay much attending but harmonizing to Boniface and Cooper domestic touristry make up 80 % of the universe touristry flow. In Pakistan, there are many worthwhile topographic points which non merely attract international tourers but besides domestic tourers. Heritage Tourism: Pakistan is a place to the most dramatic ancient metropoliss of the universe including the Indus and Gandhara civilisation. Taxila, Moenjodaro and Harrppa, museums, Mughal heritage and the silk path, Badshahi Masjid, Shalimar Gardens, Tomb of Jahangir and the Lahore Fort ( UNIC, 2011 ) . Lahore Fort K Ali Figure 2: Lahore Fort ( Source: hypertext transfer protocol: //www.gardenvisit.com/garden/lahore_fort ) Religious/ Spiritual or Pilgrimage Tourism: Pakistan is besides celebrated for its shrines and temples. Each twelvemonth non merely Muslims from different states come to see the holy shrines but besides the Hindus, Sikhs and Buddhist visit Pakistan for pilgrims journey ( UNIC, 2011 ) . hypertext transfer protocol: https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXnB0YT9ZTCDiQWIEqn3hoTIPkPPSglDZDxfw940AjqbeoZ6mRdlU6h6-cCuVgQUKHd-5dMaRW_ANqKLkutRq_BnuzYB81yPhdGKnAfzpshpzUAoubGA1HH2adjfe1CWEoVf8S_Y_mdjhl/s400/shrine-abdullah-shah-ghazi.jpg Figure 3: Shrines of Pakistan ( Source: hypertext transfer protocol: //pak-istan.blogspot.com/2009/09/shrines-of-pakistan.html ) Cultural Tourism: Besides archeological sites and architecture chef-doeuvres of Mughal emperors and British ancestors, Pakistani culinary art and festivals are yet another interesting portion of rich Pakistani civilization. The nutrient streets in Pakistan are going a major beginning of attractive force for tourers as they can bask the local Pakistani nutrient every bit good as the colourful streets and people shopping in the streets at the same clip. Celebrated nutrient streets in Pakistan are Food Street Gawalmandi and Anarkali in Lahore, Melody and bluish country Food Street in Islamabad, Burns Road in Karachi, and Ghantar Ghar in Peshawar. Festivals tend to supply jubilation, joy, mental and physical refreshment to non merely local people but besides the tourers who come with the purpose to research and bask different civilizations and festivals. Some of the celebrated cultural ceremonials and festivals of Pakistan include Lok virsa mela, Horse and cows shows, Basant or kite flight, Festivals of l amps, Northern countries festivals including the celebrated Kalash festivals and Silk path festivals etc ( UNIC, 2011 ) . Food Street, Lahore Figure 4: Food Street Lahore ( Source: hypertext transfer protocol: //www.studentsoftheworld.info/sites/country/26292.php ) Adventure or ECO Tourism: ECO or adventure touristry is the most important portion of the touristry industry as Pakistan is blessed with universes most beautiful and celebrated mountains, lakes vales, glaciers and base on ballss. Tourists non merely bask the site screening but besides perform activities like skiing, hike, surfing, bivouacing and cruising. Mountaineering and trekking are the most exciting activities that tourists enjoy. World 2nd largest mountain K2 and Switzerland of Asia known as Swat vale is besides located in Pakistan. Silk path is besides included among Pakistan attractive forces as it is an ancient path linking E and the West. Pakistan is besides place to 31 natural and manmade lakes and reservoirs. The chopper or train campaign is besides really celebrated among tourers as they travel to see the most dramatic positions of landscapes and mines across the state. The chopper campaign is the latest agencies of going as it takes the tourers high in the sky so they can bask the highest extrem ums in the North and comeuppances in the South ( UNIC, 2011 ) . chink here to enlarge Figure 5: Ayubia ( Source: hypertext transfer protocol: //www.offthemap.ca/diaster.php ) Wild Life Tourism: There are about 14 national Parkss which give a beautiful glance of the rich Flora and Fauna of Pakistan. And there are 2 safari Parkss with assorted types of animate beings like Liberation Tigers of Tamil Eelams, king of beastss, monkeys, elephants, camelopard, pythons, birds, cervid s etc ( UNIC, 2011 ) . hypertext transfer protocol: https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLa_PMnzVifbVuI8FyidVRtfTDO4LoAMvuxehMy7aVvKxem8dQSyek-qu3QQ6_Yq0MxrDPzneVGFac2B8p_6iS4rWlP7R0VzU7wHc34RuenIitfB3FCWOSRutHZrvprOjS976WFQ4ZmM0/s320/CIMG2056.JPG Figure 6: Kund Wild Life Park ( Source: hypertext transfer protocol: //kiranpalwasha.blogspot.com/2010_03_01_archive.html ) Sports Tourism: Pakistan is popular as a tourer athleticss finish. Himalayan scope which is the universe s highest mountain scope in the universe demands for professional trekking along with general trekking. Other types of athleticss touristry include white H2O rafting, wild Sus scrofa hunting in deep woods, shandur Polo games, mountain biking, golf, ice mounting, stone mounting, snowboarding, skiing, undermining and pot keeping etc. rich people and prince come from in-between E for cervid hunting in Pakistan. hypertext transfer protocol: //www.hakeekat.com/enews/posts/userfiles/Shandur % 20Polo % 20festival % 281 % 29.jpg Figure 7: Polo ( Source: hypertext transfer protocol: //insidesportsmania.blogspot.com/2010/12/polo.html ) All the above mentioned factors contribute positively to Pakistan touristry industry but along with these, there are besides negative factors which are impacting Pakistan touristry industry and have resulted in the loss of tourers reaching in Pakistan. Negative Factors: The negative factors set uping Pakistan touristry industry are the positions and sentiments of domestic and international tourers obtained via questionnaire and interview. Harmonizing to the tourers, the biggest job they are confronting while going is security issues which include the current insurgence in Pakistan. Even the domestic tourers do nt experience like going in their ain state. Second issue of tourers decline is negative image of Pakistan portrayed by media to the outside universe. Lack of substructure, uneffective promotional policies, unequal tourer s services and installations, deficiency of enterprises by concerned authorities sections, unequal cognition and preparation of forces in touristry sector, jurisprudence and order state of affairs particularly in the high tourers attraction countries, unequal substructure installations, deficiency of inducements in the tourer sector, failure to demo and project the positive image of the state via media to the outside universe , low allotment of one-year tourer budget, deficiency of development and installations in the mountain parts, deficiency of understanding to the tourer demands, the passing and alteration of authoritiess and disposal within the state ( army regulation ) and high rising prices rate are the key points which have wholly made touristry an unsuccessful industry in Pakistan. The touristry Ministry is non playing sufficient function and tourer faces troubles in acquiring timely visa and other information s. The touristry governments must concentrate on this sector as touristry is the lone sector, which can lend well in the poorness relief and bettering the life criterions of the local community. Factors Effecting Tourism Positive Factors Negative Factors Security jobs for the tourers Less selling and promotion on international degree Weak travel and touristry model Low allotment of one-year tourer budget High rising prices rate Passing and alteration of authoritiess Lack of inaugural by concerned authorities sections Presence of tourer attractive forces Mountains Valleies Lakes Historical topographic points Rich civilization Rich nutrient Salt mines Spring festivals 5 stars hotel ironss Restaurants Handicrafts Museums Business environment Factors set uping touristry Figure 8: Factors set uping touristry

Nursing scope of practice Assignment Example | Topics and Well Written Essays - 250 words

Nursing scope of practice - Assignment Example First, it will be necessary to collect all the information concerning the procedure, its origin and how it has been used. This will guide the decision as to whether the practice is evidence-based and applicable in our situation (Schluter, Seaton, & Chaboyer, 2011). Next, we will compare the outcomes of the procedure with those of existing alternatives and decide if the new procedure adds to the quality of nursing care. Ideally, any procedure should be in line with the ethical requirements of the profession. Therefore, the investigation should look into how the new procedure aligns with the ethical values of respect to patients’ rights, non-maleficence, benevolence, fidelity, and others. Further, the investigation should look into how the practice contributes to the body of knowledge of the nursing profession and how the practice is applicable in the current situation. This will lead to a decision whether to introduce a procedure to the hospital. Once a decision is made, it will be necessary to plan for educative forums to discuss the need for change. In these forums, a comparison of the current and the proposed will be done, and advantages of the new over the current brought forward. The process will them move to the last phase which will involve pilot testing the procedure on a single ward and actively comparing the outcome. This will be done by all professional in the hospital and will lead to the ultimate adoption of the procedure. Schluter, J., Seaton, P., & Chaboyer, W. (2011). Understanding nursing scope of practice: A qualitative study. International Journal of Nursing Studies, 48, 1211–1222.

General statistic Statistics Project Example | Topics and Well Written Essays - 1250 words

General statistic - Statistics Project Example Formula used for cumulative frequency calculations is Relative Frequency The relative frequency of the distribution shows the largest share of frequencies lies in the age groups of 21-22 and 22-23. The relative frequency also depicts that the majority share of the students lie in the middle age groups Class Boundaries The class boundaries are calculated to be .05 from the class limits. The Mean, Median and Mode The class boundaries and data for the calculations of mean, median and mode have been represented in the table below No. of students F Student ages Class boundaries X (F)*(X) 1 17-17.9 16.95-17.95 17.45 17.45 5 18-18.9 17.95-18.95 18.45 92.25 15 19-19.9 18.95-19.95 19.45 291.75 19 20-20.9 19.95-20.95 20.45 388.55 22 21-21.9 20.95-21.95 21.45 471.9 21 22-22.9 21.95-22.95 22.45 471.45 14 23-23.9 22.95-23.95 23.45 328.3 3 24-24.9 23.95-24.95 24.45 73.35 ?F = 100 2135 Figure ii Mean The mean is calculated from the table to be Mean = = 21.35 The mean suggests that the average of th e data lies at the age of 21.35. Median Here, the number of observations ?F= n=100 This is an even number, so the median is average of (n / 2) th and (n / 2 + 1)th Observations I.e. average of ( 100 / 2 )th and [(100 / 2) + 1]th observation. I.e. average of 50th and 51st observations. Where l = lower limit of median class C.F = cumulative frequency of class prior to median class. f = frequency of median class. h = class size. Median= = 21.4 Mode The mode of a data is the value that has maximum number of frequency. Where: l = lower limit of modal class f1 = frequency of modal class fm = frequency of class preceding the modal class. f2 = frequency of class succeeding the modal class h=class size Here the modal class is of age groups 21-22. Hence,... The mean, median and mode are close to each other, this represents a normal frequency distribution. The close values of mean and median depict the data to be a normal distribution, if the median and mean were far apart that would have meant that the data with the higher value of F*X is dominating the average. But since the median and mean are close together this shows neither the higher nor lower frequencies are affecting the data nor the data average is independent of the extreme end values of the distribution. The graph that shows the frequency distribution is shown below. The graph clearly predicts a normal distribution of frequency that is the age groups of Middle Ages 20-23 have the highest frequencies, and the frequencies fall at either side of the midpoint. The trend line follows a normal bell curve shape. The conclusion can be deduced from looking at the results is that most of the students in a university starting their university at the ages of 19. A few students who excel at school or high school level are granted leaps in their grades and start the university at an earlier age. That is why there are a small group of students in the age category of 17-18. In addition, the age group of 24 and above indicates students who have been relegated in semesters or have started their university at a later age. But looking at the relative frequency they only form 3% of the total specimen. So the majority of the students are normal students who start university at the age of 19 and end up at the age of 23.

The Pareto welfare criterion requires that welfare improvements for Essay

The Pareto welfare criterion requires that welfare improvements for some are not achieved at the expense of damages to others. As it is impossible to imagine a - Essay Example As a decision-making tool, the Pareto chart provides facts and insights necessary for setting priorities. Pareto set up a welfare criterion known as the Pareto optimum which turned out to be an introductory perception in the theory of welfare. This Pareto optimum introduced by Vilfredo is a situation of dealing in which no individual can be improved through welfare while making the other individual worse off. If a change in the economy is in the positive and no individual is worsened off on the cost of one individuals betterment then it is known as Pareto improvement. It can also be said that the situation is Pareto superior. Pareto efficiency is a state resulting in an improvement in welfare of one or more individuals without adversely affecting the welfare of others. Pareto's theory was based upon the equal distribution of resources so that the well being of one person would not affect the well being of the other. This is not being achieved in the now world but in the recent years governments are taking steps to influence proper resource allocation. These steps include the introduction of public goods and services which are an exception and face no rival ness. The governments are increasingly getting involved in the field of semi public goods which are neither owned by the private or public sector companies. The governments provide subsidies which help in lowering the goods prices; lower the cost prices, impose tax penalties to limit the consumption or production of a good and mandate the goods or services like education on the public. This helps the government to properly allocate all the resources available. Tax penalties or legal punishments are enforced on the manufacturers by the government in order to limit the production or consumption of a good for e.g. pollution. They would impose excise taxes on products so that the production of harmful goods is dispirited for e.g. alcohol. The government also has an important role to play in the public Economic En terprises. They could invest more in their public sector and improve the goods in the market provided by them to the public at a much lowered price then available in the market. They could even privatize the companies so that natural monopolies are avoided in the market which exhibit increasing returns to scale. Such types of monopolies are taken over by the government on the basis of efficiency. The government would charge a price for the products less than the average cost and this shortage would be balanced by the tax revenues. And lastly the government could put on economic regulations so that the market works on a safety standard for e.g. providing licenses or patents, setting general anti-trust regulations and etc. This would help the government to change the pattern of resource allocation and thus attain the level of Pareto efficient allocation. Pareto efficiency has proved tremendously helpful for economists; The First Welfare Theorem affirms that when manufacturers and customers both are price takers, the equilibrium allocation is always Pareto efficient. For this reason, a competitive financial system fundamentally will distribute resources proficiently as customers can make the most of their utilities. The Second Welfare Theorem states that any market that is Pareto efficient will include a set of given costs that forms a competitive equilibrium in the economy. Many economists may and

Mhp Nursing Shared Governance Essay Example for Free

Mhp Nursing Shared Governance Essay What is Shared Decision Making †¢ Point of Service Decision Making where staff who perform the work participate in decision making affecting their environment †¢ A 30 year old decision making model meant to give equal voice to nurses †¢ A decentralized style of management that creates an environment of empowerment Shared Decision Making A Journey Not a Destination We TO They Why Shared Decision Making †¢ Essential to achieving the best patient outcomes by giving nurses control of their practice – they know best! †¢ Recognizes the power already present in a role and allows that power to be expressed legitimately †¢ Builds autonomy into the profession Shared Decision Making – The Process A dynamic process that is centered on 4 critical principles of fully empowered organizations: Partnership Accountability Equity Ownership Operational Definitions †¢ Partnership – nursing staff and leadership work together at the unit and system level to move practice forward and achieve the best outcomes †¢ Accountability staff and managers share ownership for the outcomes of our work and are answerable to our colleagues, the institution and the community we serve Operational Definitions †¢ Equity – Integrating roles to achieve outcomes; everyone contributes within the scope of their role as part of the team †¢ Ownership – Everyone must realize that success is linked to how well they do their jobs Shared Decision Making Our Model Professional Advancement Council Administrative Council Safety First C rd oo ina tin g Quality Safety Council Cou ncil Unit Patient Research Evidence Based Nursing Practice Council Great Place to Work Professional Nurse Council Family Community Clinical Excellence Councils Coo Education Council rdin atin g Cou ncil Think of yourself as a Patient APN Council Research Council Financial Strength CCHS Shared Decision Making Councils †¢ Quality Safety Council †¢ Research Evidence Based Nursing Practice Council †¢ Education Council †¢ Professional Nurse Council †¢ Coordinating Council Education Council ï‚ § Collaborates with unit and system councils to identify educational needs, develop educational priorities with appropriate time lines and determine resources for all education impacting the Department of Patient Care Services ï‚ § Disseminates approved educational strategies to unit leaders and support staff ï‚ § Develops and maintains a communication network between unit and systems councils Research Evidence Based Nursing Practice Council ï‚ § Promotes the spirit of inquiry in clinical nursing practice ï‚ § Evaluates the literature in order to use best practices to transform clinical practice at the point-of-care Quality Safety Council ï‚ § Provides planned, systematic and collaborative approaches to oversee and direct quality and safety relating to the nursing process, functions and services provided. ï‚ § The council’s scope includes performance improvement and safety measures throughout the Department of Patient Care Services Professional Nurse Council ï‚ § Works to enhance the professional image of nursing within CCHS and the community ï‚ § Supports the spirit of the professional advancement program ï‚ § Identifies and supports implementation of recruitment and retention strategies Coordinating Council ï‚ § Provides overall coordination of the systems councils. ï‚ § Reviews the system strategic plan and adopts the plan for the Department of Patient Care Services and the nursing Shared Decision Making structure. ï‚ § Serves as the portal for other departments or disciplines requiring assistance with the Shared Decision Making structure of nursing. Problem Solving The Old Way †¢ Problem identified by staff and communicated to manager †¢ Manager may or may not have asked for feedback about solutions †¢ Manager made final decision or had final authority for approving a solution Problem Solving The New Way †¢ Staff identify issues and communicate them to the unit council †¢ Unit council formulates a response and communicates this to staff †¢ Staff provide feedback via the comment form. How Does The New Way Work †¢ Unit Council: ï‚ § Collects Data ï‚ § Develops a proposed plan using evidenced based practice ï‚ § Develops a time line ï‚ § Presents Plan for Feedback (Open Comment) ï‚ § Revises Plan Based Upon Feedback ï‚ § Forewards plan to system council, as needed How Does The New Way Work †¢ Unit Council: ï‚ § ï‚ § ï‚ § ï‚ § Implements Plan Evaluates Outcome Report Results to Unit Staff Seeks staff feedback, formally and informally on council’s performance How Does It Work Problem Solving Methodology †¢ Identify an Issue or a Problem †¢ Gather Data †¢ Design a Solution †¢ Obtain Feedback †¢ Finalize a Proposal †¢ Implement †¢ Evaluate †¢ Report Increased Incidence of Pressure Sores Problem Unit Problem: Unit Council Problem Solving Model Results: Positive Outcomes System Level Practice Research Problem Coordinating Operations Education Problem Solving Model Results: Positive Outcomes Nurse Manager’s Role †¢ Create a climate that is actively supportive and not just tolerant of shared decision making †¢ Facilitate a leaning environment for staff growth and comfort with shared decision making †¢ Support â€Å"release time† for staff to participate in shared decision making activities Nurse Manager’s Role †¢ Share with staff your knowledge of leadership and help staff to minimize implementation barriers †¢ Commit to the â€Å"New Way† Role of Unit Based Council Chair †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ Set meetings Develop the agenda Move council to consensus Ensure members participate (per charter) Facilitate group assignments Ensure consensus for decision making Call emergency meetings, as needed Mentor Chair-elect Benefits of Shared Decision Making †¢ Increased Staff Nurse Satisfaction (increased autonomy, increased control over practice, improved communication between nurses, physicians and administration) †¢ Improved Nursing Retention ($90,000 to replace an RN 2006 Advisory Board) †¢ Improved Patient Safety Outcomes Benefits of Shared Decision Making †¢ Improved collaboration and team Building †¢ Improved quality of care and clinical effectiveness †¢ Increased staff confidence, personal and professional growth †¢ Development of new knowledge and skills †¢ Increased professionalism and accountability Requirements for success†¦. †¢ Place the Patient First and focus on providing the best care possible †¢ Trust and respect is essential †¢ Communicate openly and honestly †¢ Embrace change and strive for improvement †¢ Staff and managers hold each other accountable. †¢ Organizational support of accountability in the performance appraisal process Final Thought Shared decision making is a journey, not an event. It is not achieved overnight, and there is no conclusion – no point when it is fully in place. It only provides a foundation for further growth. Tim Porter-O’Grady