Source for Article:
Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html
Article:
Ethical Awareness: What It Is and Why It Matters
^ m d
Aimee Milliken, PhD, RN
Abstract
Given the complexity of contemporary healthcare environments, it is vital that nurses are able to recognize and address ethical issues as they arise. Though dilemmas and challenging situations create the most obvious, dramatic risks to patients, routine nursing actions have implications for patients as well. Ethical awareness involves recognizing the ethical implications of all nursing actions. Developing ethical awareness is one way to empower nurses to act as moral agents in order to provide patients with safe and ethical care. The aim of this article is to provide an overview of the concept of ethical awareness and the role it plays in patient care. Background information is provided; three everyday scenarios highlight the importance of ethical awareness in everyday nursing practice; followed by additional discussion; and strategies for heightening ethical awareness are suggested.
Citation: Milliken, A., (January 31, 2018) "Ethical Awareness: What It Is and Why It Matters" OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 1, Manuscript 1.
DOI: 10.3912/OJIN.Vol23No01Man01
Key Words: ethical awareness, nursing ethics, ethical sensitivity, moral sensitivity, critical care
Ethical awareness involves recognizing the ethical implications of all nursing actions, and is the first step in moral action.
Given the complexity of contemporary healthcare environments, it is vital that nurses are able to recognize and address ethical issues as they arise. Ethical awareness involves recognizing the ethical implications of all nursing actions, and is the first step in moral action (Milliken & Grace, 2015). This means that nurses must first recognize the potential ethical repercussions of their actions in order to effectively resolve problems and address patient needs. The aim of this article is to provide an overview of ethical awareness and its important role in ethical nursing care. Three everyday scenarios highlight the importance of ethical awareness in everyday nursing practice. Finally, strategies for heightening ethical awareness in the clinical setting are suggested.
Background
...nurses do not often recognize daily activities... as having ethical implications.
Many scholars have addressed the ethical nature of nursing practice (Austin, 2007; Erlen, 1997; Milliken & Grace, 2015; Truog et al., 2015; Ulrich et al., 2010). Though nursing ethics education often focuses on dilemmas and challenging situations (Truog et al., 2015; Zizzo, Bell, & Racine, 2016), ethical awareness involves recognizing .
2. Read the case study entitled You be the Ethicist, presented at .docxRAJU852744
2. Read the case study entitled You be the Ethicist, presented at the end of Chapter 3 (Guido textbook). What are the compelling rights that this case addresses? Whose rights should take precedence? Does a child (specifically this competent 14-year-old) have the right to determine what will happen to him? Should he ethically have this right? How would you have decided the outcome if his disease state had not intervened? Now, examine the scenario from the perspective of health care policy. How would you begin to evaluate the need for the policy and the possible support or lack of support for the policy from your peers, nursing management, and others who might be affected by the policy?
Do the 10 framework questions outlined by Malone in chapter 4 (Guido textbook) assist in this process? Create a process proposal for the organization with possible guidelines, procedures, and policies to address the issues you have identified.
YOU BE THE ETHICIST Until recently, Tyrell Dueck was a normal eighth-grader in Canada, hoping that his favorite team would win the Stanley Cup for the third time. Then, early in the school year, he slipped climbing out of the shower and discovered a lump on his leg. He was then diagnosed with bone cancer. After receiving two rounds of chemotherapy and being told that further therapy would mean the amputation of his leg, he announced that he wanted therapy stopped. He and his parents, devout fundamentalist Christians, decided to leave his health in God’s hands and seek alternative therapy. The decision sparked a court battle between his parents, who supported Tyrell’s decision, and the health care team, who sought to compel continued medical treatment and the planned amputation. The battle ultimately ended when doctors said that his cancer had spread to his lungs and that there was little more that could be done for Tyrell.
ETHICAL QUESTIONS 1. What are the compelling rights that this case addresses? 2. Whose rights should take precedence? 3. Does a child (specifically this competent 14-year-old) have the right to determine what will happen to him? Should he ethically have this right? 4. How would you have decided the outcome if his disease state have not intervened?
Guido, Ginny Wacker, JD, MSN, RN. Legal and Ethical Issues in Nursing (Legal Issues in Nursing ( Guido)) (p. 41). Pearson Education. Kindle Edition.
Do the 10 framework questions outlined by Malone in chapter 4 (Guido textbook) assist in this process? Create a process proposal for the organization with possible guidelines, procedures, and policies to address the issues you have identified.
• What is the problem? • Where is the process? • How many are affected? • What possible solutions could be proposed? • What are the ethical arguments involved? • At what level is the problem most effectively addressed? • Who is in a position to make policy decisions? • What are the obstacles to policy interventions? • What resources are ava.
2. Read the case study entitled You be the Ethicist, presented at .docxlorainedeserre
2. Read the case study entitled You be the Ethicist, presented at the end of Chapter 3 (Guido textbook). What are the compelling rights that this case addresses? Whose rights should take precedence? Does a child (specifically this competent 14-year-old) have the right to determine what will happen to him? Should he ethically have this right? How would you have decided the outcome if his disease state had not intervened? Now, examine the scenario from the perspective of health care policy. How would you begin to evaluate the need for the policy and the possible support or lack of support for the policy from your peers, nursing management, and others who might be affected by the policy?
Do the 10 framework questions outlined by Malone in chapter 4 (Guido textbook) assist in this process? Create a process proposal for the organization with possible guidelines, procedures, and policies to address the issues you have identified.
YOU BE THE ETHICIST Until recently, Tyrell Dueck was a normal eighth-grader in Canada, hoping that his favorite team would win the Stanley Cup for the third time. Then, early in the school year, he slipped climbing out of the shower and discovered a lump on his leg. He was then diagnosed with bone cancer. After receiving two rounds of chemotherapy and being told that further therapy would mean the amputation of his leg, he announced that he wanted therapy stopped. He and his parents, devout fundamentalist Christians, decided to leave his health in God’s hands and seek alternative therapy. The decision sparked a court battle between his parents, who supported Tyrell’s decision, and the health care team, who sought to compel continued medical treatment and the planned amputation. The battle ultimately ended when doctors said that his cancer had spread to his lungs and that there was little more that could be done for Tyrell.
ETHICAL QUESTIONS 1. What are the compelling rights that this case addresses? 2. Whose rights should take precedence? 3. Does a child (specifically this competent 14-year-old) have the right to determine what will happen to him? Should he ethically have this right? 4. How would you have decided the outcome if his disease state have not intervened?
Guido, Ginny Wacker, JD, MSN, RN. Legal and Ethical Issues in Nursing (Legal Issues in Nursing ( Guido)) (p. 41). Pearson Education. Kindle Edition.
Do the 10 framework questions outlined by Malone in chapter 4 (Guido textbook) assist in this process? Create a process proposal for the organization with possible guidelines, procedures, and policies to address the issues you have identified.
• What is the problem? • Where is the process? • How many are affected? • What possible solutions could be proposed? • What are the ethical arguments involved? • At what level is the problem most effectively addressed? • Who is in a position to make policy decisions? • What are the obstacles to policy interventions? • What resources are ava ...
2. Read the case study entitled You be the Ethicist, presented at .docxRAJU852744
2. Read the case study entitled You be the Ethicist, presented at the end of Chapter 3 (Guido textbook). What are the compelling rights that this case addresses? Whose rights should take precedence? Does a child (specifically this competent 14-year-old) have the right to determine what will happen to him? Should he ethically have this right? How would you have decided the outcome if his disease state had not intervened? Now, examine the scenario from the perspective of health care policy. How would you begin to evaluate the need for the policy and the possible support or lack of support for the policy from your peers, nursing management, and others who might be affected by the policy?
Do the 10 framework questions outlined by Malone in chapter 4 (Guido textbook) assist in this process? Create a process proposal for the organization with possible guidelines, procedures, and policies to address the issues you have identified.
YOU BE THE ETHICIST Until recently, Tyrell Dueck was a normal eighth-grader in Canada, hoping that his favorite team would win the Stanley Cup for the third time. Then, early in the school year, he slipped climbing out of the shower and discovered a lump on his leg. He was then diagnosed with bone cancer. After receiving two rounds of chemotherapy and being told that further therapy would mean the amputation of his leg, he announced that he wanted therapy stopped. He and his parents, devout fundamentalist Christians, decided to leave his health in God’s hands and seek alternative therapy. The decision sparked a court battle between his parents, who supported Tyrell’s decision, and the health care team, who sought to compel continued medical treatment and the planned amputation. The battle ultimately ended when doctors said that his cancer had spread to his lungs and that there was little more that could be done for Tyrell.
ETHICAL QUESTIONS 1. What are the compelling rights that this case addresses? 2. Whose rights should take precedence? 3. Does a child (specifically this competent 14-year-old) have the right to determine what will happen to him? Should he ethically have this right? 4. How would you have decided the outcome if his disease state have not intervened?
Guido, Ginny Wacker, JD, MSN, RN. Legal and Ethical Issues in Nursing (Legal Issues in Nursing ( Guido)) (p. 41). Pearson Education. Kindle Edition.
Do the 10 framework questions outlined by Malone in chapter 4 (Guido textbook) assist in this process? Create a process proposal for the organization with possible guidelines, procedures, and policies to address the issues you have identified.
• What is the problem? • Where is the process? • How many are affected? • What possible solutions could be proposed? • What are the ethical arguments involved? • At what level is the problem most effectively addressed? • Who is in a position to make policy decisions? • What are the obstacles to policy interventions? • What resources are ava.
2. Read the case study entitled You be the Ethicist, presented at .docxlorainedeserre
2. Read the case study entitled You be the Ethicist, presented at the end of Chapter 3 (Guido textbook). What are the compelling rights that this case addresses? Whose rights should take precedence? Does a child (specifically this competent 14-year-old) have the right to determine what will happen to him? Should he ethically have this right? How would you have decided the outcome if his disease state had not intervened? Now, examine the scenario from the perspective of health care policy. How would you begin to evaluate the need for the policy and the possible support or lack of support for the policy from your peers, nursing management, and others who might be affected by the policy?
Do the 10 framework questions outlined by Malone in chapter 4 (Guido textbook) assist in this process? Create a process proposal for the organization with possible guidelines, procedures, and policies to address the issues you have identified.
YOU BE THE ETHICIST Until recently, Tyrell Dueck was a normal eighth-grader in Canada, hoping that his favorite team would win the Stanley Cup for the third time. Then, early in the school year, he slipped climbing out of the shower and discovered a lump on his leg. He was then diagnosed with bone cancer. After receiving two rounds of chemotherapy and being told that further therapy would mean the amputation of his leg, he announced that he wanted therapy stopped. He and his parents, devout fundamentalist Christians, decided to leave his health in God’s hands and seek alternative therapy. The decision sparked a court battle between his parents, who supported Tyrell’s decision, and the health care team, who sought to compel continued medical treatment and the planned amputation. The battle ultimately ended when doctors said that his cancer had spread to his lungs and that there was little more that could be done for Tyrell.
ETHICAL QUESTIONS 1. What are the compelling rights that this case addresses? 2. Whose rights should take precedence? 3. Does a child (specifically this competent 14-year-old) have the right to determine what will happen to him? Should he ethically have this right? 4. How would you have decided the outcome if his disease state have not intervened?
Guido, Ginny Wacker, JD, MSN, RN. Legal and Ethical Issues in Nursing (Legal Issues in Nursing ( Guido)) (p. 41). Pearson Education. Kindle Edition.
Do the 10 framework questions outlined by Malone in chapter 4 (Guido textbook) assist in this process? Create a process proposal for the organization with possible guidelines, procedures, and policies to address the issues you have identified.
• What is the problem? • Where is the process? • How many are affected? • What possible solutions could be proposed? • What are the ethical arguments involved? • At what level is the problem most effectively addressed? • Who is in a position to make policy decisions? • What are the obstacles to policy interventions? • What resources are ava ...
SocializationTo begin the process of socialization, having a cle.docxsamuel699872
Socialization
To begin the process of socialization, having a clear understanding of the definition of nursing is essential. We know what nurses do, but how do we define nursing? Why is defining nursing important? To answer this last question, defining nursing is important for several reasons:To differentiate nursing from other professions.To define our practiceTo provide guidelines for nursing educationTo make nursing visible to the public and policy makers
While there may be multiple definitions of nursing from professional organization and state boards of nursing, similar characteristics can be found in all of them.
The American Nurses Association offers the following definition:
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.
Knowing what nursing is, supports your move into the nursing role. Socialization is the process of internalizing knowledge, skills, attitudes and other concepts needed to function in a role. You have been socialized into your current role. However, after graduating with your BSN, there will be another socialization process as you take on the broader role of the nurse with a BSN. Another way of describing the socialization process is Patricia Benner’s (1984) novice to expert stages. Some of you may be familiar with Benner’s work through your facilities clinical ladder. Socialization of the professional nurse involves developing your knowledge and skills and interacting with other nurses who act as mentors. Throughout the education process, students encounter a variety of socializing agents, including faculty, classmates, colleagues and other healthcare professionals, patients, and family, who subsequently contribute to the formation of a professional self-identify (Lai & Lim, 2012, p. 32).
Instructions
You are a licensed practice nurse (LPN) collaborating with a registered nurse (RN) for hospital-wide in-service on healthcare associated infections (HAI). After the in-service, a representative from each hospital department will receive an infographic to post in their respective unit. Your job is to create an infographic on preventing HAIs. The infographic should:
· Be a one-page visual representation of about Healthcare Associated Infections (HAIS)
· Identify common types of HAIs (healthcare associated infections)
· Include data or statistics about HAIs
· Describe prevention strategies for HAIs
Nursing Ethics
The Code of Ethics for Nurses of 2015, given by American Nurses Association (ANA), outlines the ethical basis for the nursing profession. It contains nine provisions, which cover the nurses' responsibilities toward the patients, maintenance of their personal professional growth, and their responsibilities to the profession and community.
Contemporary nur.
SocializationTo begin the process of socialization, having a cle.docxMadonnaJacobsenfp
Socialization
To begin the process of socialization, having a clear understanding of the definition of nursing is essential. We know what nurses do, but how do we define nursing? Why is defining nursing important? To answer this last question, defining nursing is important for several reasons:To differentiate nursing from other professions.To define our practiceTo provide guidelines for nursing educationTo make nursing visible to the public and policy makers
While there may be multiple definitions of nursing from professional organization and state boards of nursing, similar characteristics can be found in all of them.
The American Nurses Association offers the following definition:
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.
Knowing what nursing is, supports your move into the nursing role. Socialization is the process of internalizing knowledge, skills, attitudes and other concepts needed to function in a role. You have been socialized into your current role. However, after graduating with your BSN, there will be another socialization process as you take on the broader role of the nurse with a BSN. Another way of describing the socialization process is Patricia Benner’s (1984) novice to expert stages. Some of you may be familiar with Benner’s work through your facilities clinical ladder. Socialization of the professional nurse involves developing your knowledge and skills and interacting with other nurses who act as mentors. Throughout the education process, students encounter a variety of socializing agents, including faculty, classmates, colleagues and other healthcare professionals, patients, and family, who subsequently contribute to the formation of a professional self-identify (Lai & Lim, 2012, p. 32).
Instructions
You are a licensed practice nurse (LPN) collaborating with a registered nurse (RN) for hospital-wide in-service on healthcare associated infections (HAI). After the in-service, a representative from each hospital department will receive an infographic to post in their respective unit. Your job is to create an infographic on preventing HAIs. The infographic should:
· Be a one-page visual representation of about Healthcare Associated Infections (HAIS)
· Identify common types of HAIs (healthcare associated infections)
· Include data or statistics about HAIs
· Describe prevention strategies for HAIs
Nursing Ethics
The Code of Ethics for Nurses of 2015, given by American Nurses Association (ANA), outlines the ethical basis for the nursing profession. It contains nine provisions, which cover the nurses' responsibilities toward the patients, maintenance of their personal professional growth, and their responsibilities to the profession and community.
Contemporary nur.
Southampton Business School Postgraduate Module Grade Descrip.docxrosemariebrayshaw
Southampton Business School: Postgraduate Module Grade Descriptor
Postgraduate Grade Descriptor for MANG6331 Text Mining and Social Network Analytics
Percentage 0 - 34 35 – 49 50 – 59 60 – 69 70 - 79 80 - 100
Degree Class Fail Compensatable
fail*
Pass Merit Distinction Distinction
Collecting
unstructured data and
conducting
exploratory analysis
Collecting raw tweets of
two different airlines and
conducting exploratory
data analysis
Weighting 20%
No/inadequate
evidence of
collecting and pre-
processing the raw
data.
No/inadequate
evidence of any
data analysis.
Evidence of basic
but inadequate
approaches to
collect and/or pre-
process the raw
data.
Mostly descriptive,
with minimal data
analysis. Argument
is basic and poorly
constructed.
Collecting and/or
pre-processing the
raw data is evident
but with some
confusion.
Data analysis is
reasonable.
Argument is
appropriate but
with some
confusion.
Clear evidence of
data pre-
processing and
exploratory data
analysis with
minimal
omissions/errors.
Clear and effective
analysis. Argument
is structured and is
legitimate.
Data pre-
processing and
exploratory data
analysis are
appropriate and
precise.
Comprehensive
and precise
analysis. Well-
structured
argument that
provides very good
clarity.
Appropriately use
of other sources of
information to
support arguments.
Data pre-
processing and
exploratory data
analysis are
appropriate and
precise.
Excellent analysis,
precise and
concise.
Exceptionally well-
structured
argument that
provides excellent
clarity.
Outstanding use of
other sources of
information to
support arguments.
Gaining customer
insights: traditional
versus social media
Evaluate the pros and
cons of replacing
customer satisfaction
survey by mining twitter
data
Weighting 20%
Not included. Limited and patchy
evidence of
knowledge and
understanding of
the pros and cons.
Limited evidence of
reading.
Lacks focus and
direction with
limited coherent
argument.
Sufficient but
inconsistent
evidence of
knowledge and
understanding of
the pros and cons.
Evidence of some
use of academic/
business literature.
Argument is basic
and poorly
constructed.
Good knowledge
and understanding
of the pros and
cons.
Good use of
academic/
business literature
to support
arguments.
Clear and effective
argument.
A comprehensive
and thorough
awareness of the
pros and cons.
Evidence of
comprehensive
reading.
Well-structured
argument that
provides very good
clarity.
A comprehensive
and thorough
awareness of the
pros and cons.
Excellent coverage
of relevant
literature.
Exceptionally well-
structured
argument that
provides excellent
clarity.
*Compensatable fail is only possible for compulsory or optional modules, subject to University of Southampton Progression Regulation.
Southwestern Business Administration JournalVolume 16 Is.docxrosemariebrayshaw
Southwestern Business Administration Journal
Volume 16 | Issue 1 Article 1
2017
Leveraging Decision Making in Cyber Security
Analysis through Data Cleaning
Chen Zhong
Hong Liu
Awny Alnusair
Follow this and additional works at: https://digitalscholarship.tsu.edu/sbaj
Part of the Business Administration, Management, and Operations Commons, E-Commerce
Commons, Entrepreneurial and Small Business Operations Commons, Management Information
Systems Commons, Marketing Commons, Organizational Behavior and Theory Commons, and the
Real Estate Commons
This Article is brought to you for free and open access by Digital Scholarship @ Texas Southern University. It has been accepted for inclusion in
Southwestern Business Administration Journal by an authorized editor of Digital Scholarship @ Texas Southern University. For more information,
please contact [email protected]
Recommended Citation
Zhong, Chen; Liu, Hong; and Alnusair, Awny (2017) "Leveraging Decision Making in Cyber Security Analysis through Data
Cleaning," Southwestern Business Administration Journal: Vol. 16 : Iss. 1 , Article 1.
Available at: https://digitalscholarship.tsu.edu/sbaj/vol16/iss1/1
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ht.
Spadoni • revised Jan. 2020 —continued— Checklist for .docxrosemariebrayshaw
Spadoni • revised Jan. 2020
—continued—
Checklist for Essay Writers
PART 1. FORMATTING
Follow these steps now to save yourself headaches later and avoid losing credit
Title a word processor file “film-template” or something. Follow the instructions in this Formatting section. For an
essay title, type “[essay title]”. For paragraph text, type a sentence and copy and paste it repeatedly until you have a
paragraph. Do the same to make another paragraph, and another, until you’re onto your second page. Do this to
make sure MS Word isn’t adding extra space between paragraphs (see below) and that you have no first page header
and the correct second page header (see below). When it’s time to write your essay, open this template file and save
it to a new name. Keep the template file for your next essay (and any future course you take with me).
Some formatting instructions below are to ensure students are meeting the same length requirement and that no
formatting deviations are disguising this fact. If I ask you to email me the word-processor copy of your essay and it
shows deviations, you will lose more credit than if you had just handed in a paper under the page minimum. If you
email me a file that is not identical to the essay you handed in, you will lose even more credit.
1. Format the top of your essay like this. To get the above-and-below spacing for your title as below, enter a hard return above and
below your title, then (in your double-spaced document) make these above-and-below lines single space.
Angelo Marconi
Engl 367—Intro to Film
Prof. Spadoni
May 24, 2020
[Center essay title; 12 pt font; no boldface, underlining, or brackets]
Essay text starts here. Make sure no more space precedes and
follows your essay title than you see above. ....
2. Last name and page number in the top-right corner of the second and subsequent pages (not the first page). Don’t hand write this
information on the tops of your pages.
Marconi 6
3. Black ink. Standard white paper. Single sided.
4. Times, Times Roman, or Times New Roman typeface (not Cambria), 12 point—including essay title. Don’t change typeface or
font size to increase page length.
5. Double space your work. Don’t alter line spacing to increase page length.
6. Standard margins (1 inch top and bottom, 1 or 1.25 inch left and right). Don’t adjust margins to increase page length.
7. One space (not two) between sentences.
8. No extra space between paragraphs. MS Word likes to insert extra space. Don’t leave figuring out how to tell it not to for the last
minute.
9. Italicize film titles—and at the first mention, follow title with the director and year in parentheses, like this: In an early scene in
Jaws (Steven Spielberg, 1975), a character tries to… Italicize book titles; essay titles are not italicized and go in double quotes.
10. Staple pages, top-left corner. Unstapled.
SPAN100Course SummaryCourse SPAN100 Title Spanish I.docxrosemariebrayshaw
SPAN100
Course Summary
Course : SPAN100 Title : Spanish I
Length of Course : 8 Faculty : Dallas Jurisevic
Prerequisites : N/A Credit Hours : 3
Description
Course Description:
This course will expose the student to the fundamentals of the Spanish language. The student will learn basic
vocabulary, verb conjugations and grammatical usage through workbook and listening exercises. The student
will also learn about the Spanish culture through reading and listening exercises. Please note the technical
specifications below. These are required to interface with the online version of Rosetta Stone. If you cannot meet
these requirements we strongly recommend you do not take this course. Please contact
[email protected] if you are unsure or have any questions. * The ability to download and install the
speech component. * A working microphone installed on the computer for speech recognition. * Access to
streaming media is also required and should be confirmed before registering for the class.
Course Scope:
Standards for Foreign Language Learning in the 21st Century (1999) “Language and communication are at the
heart of the human experience. The United States must educate students who are linguistically and culturally
equipped to communicate successfully in a pluralistic American society and abroad. This imperative envisions a
future in which ALL students will develop and maintain proficiency in English and at least one other language…”
Our major focus is on learning to communicate appropriately in practical, culturally authentic contexts. Students
are asked, to a limited extent, to use their Spanish to engage in simple dialog and talk about themselves and
create with the language in practical ways. Students also correct peer work and in doing so, students solve
problems (and thus engage in analysis, synthesis, and evaluation).
In these courses, students gradually add to their vocabulary and communication skills, practice question- and-
answer techniques, and apply what they learn in order to communicate and solve problems in practical
situations.
Objectives
Students who successfully complete Spanish 100 should be able to:
► Listening Skills
1. Distinguish all the sounds of Spanish important to meaning.
2. Comprehend brief sentences expressed within the framework of high- frequency vocabulary, grammatical
forms, and sentence structures.
3. Determine the meaning of unfamiliar words or phrases though logical guessing based on contextual clues.
► Speaking Skills
1. Produce all the sounds of Spanish and link sounds together in sentences with sufficient accuracy to
communicate with Spanish speakers.
2. Use high- frequency vocabulary, grammatical forms, and sentence structures to converse in brief sentences in
everyday situations (such as greetings, asking for directions, answering short questions, expressing basic
needs and reactions, exchanging information, or persuading others)
► Reading Skills
1. Comprehend non- technical, narrative Spanish.
.
Sources and Resources for RC004Informed Advocacy in Early .docxrosemariebrayshaw
Sources and Resources for RC004
Informed Advocacy in Early Childhood Care and Education: Making a Difference for Young Children and Families, pp. 107-111
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-628&srcou=6738
WEBSITE: KIDS COUNT DATA CENTER
http://datacenter.kidscount.org/topics
KIDS COUNT Data Center
Annie E. Casey Foundation. (2014). KIDS COUNT data center: Data topics. Retrieved from http://datacenter.kidscount.org/topics
WEBSITE: NATIONAL AND STATE FACTS
http://www.cwla.org/our-work/advocacy/
WEBSITE: U.S. CHILD STATE DATA
http://www.cwla.org/our-work/advocacy/
WEBSITE: DATA TOOLS
http://www.nccp.org/tools/
Consider how this information will be beneficial within the context of Part 1 of your Work Product.
WEBSITE: ASSOCIATION FOR CHILDHOOD EDUCATION INTERNATIONAL
http://www.acei.org/
WEBSITE: DIVISION FOR EARLY CHILDHOOD
http://www.dec-sped.org/
WEBSITE: INTERNATIONAL READING ASSOCIATION
http://www.reading.org/
WEBSITE: NATIONAL ASSOCIATION FOR THE EDUCATION OF YOUNG CHILDREN
http://www.naeyc.org/
WEBSITE: NATIONAL BLACK CHILD DEVELOPMENT INSTITUTE
http://www.nbcdi.org/
BOOK EXCERPT: DEVELOPING INITIATIVES
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-640&srcou=6738
The following links lead to early childhood advocacy initiatives that focus on social change on behalf of children, families, and the early childhood field.
WEBSITE: WORLDWIDE TEACHER SHORTAGE: REGIONAL AND GLOBAL IMPLICATIONS
http://www.businessinsider.com/theres-a-massive-global-teacher-shortage-2016-10
WEBSITE: LEGISLATIVE HOT TOPICS
https://www.literacyworldwide.org/
WEBSITE: TAKEN ACTION NOW
http://www.naeyc.org/policy/action
WEBSITE: WHAT WE DO: POLICY
http://www.nbcdi.org/what-we-do/policy
BOOK EXCERPT: COMPREHENSIVE DEVELOPMENTAL SCREENING
As you read this information and the Guided Notes , consider how these apply to Part 2 and Part 3 of your Work Product.
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-647&srcou=6738
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-747&srcou=6738
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-2320&srcou=6738
This information is beneficial in the context of Part 2 and Part 3 of your Work Product.
ARTICLE: HOW TO BE A VOICE FOR BABIES: USING DATA TO ADVOCATE EFFECTIVELY
https://www.zerotothree.org/resources/496-how-to-use-data-to-advocate-effectively
ARTICLE: EFFECTIVE COMMUNICATION ABOUT THE EARLY YEARS: UNDERSTANDING THE BASICS OF FRAMING
https://www.zerotothree.org/resources/482-understand-the-basics-of-framing-to-communicate-effectively
ARTICLE: EFFECTIVE COMMUNICATION ABOUT THE EARLY YEARS: THE ELEMENTS OF THE FRAME: PART ONE
https://www.zerotothree.org/resources/483-the-elements.
Sources of General Information about the Topic A paragr.docxrosemariebrayshaw
Sources of General Information about the Topic
A paragraph that explains that the follow-
ing sources provide more in depth information about
the topic.
Smith, John. “An Understanding of Animal Experimen-
tation.” The Journal of Animal Husbandry, vol33,
no 2 Jan 2010 pp.70-91. JSTOR,
ww.libray.dcccd.edu. Accessed 10-30-19.
This paragraph will include indicative information
about the source. Other info the reader needs about
the source.
This paragraph will include info about the value
of the source. Other info needed by the reader .
This can/will be multiple pages. The annotation
is to include indicative and evaluative information—a
combined annotation. For this and the following sec-
tions needed will be five(5) sources and associated
annotations for each. The sources are to be in stand-
ard MLA alphabetic order.
An Annotated Bibliography
Of
Topic
First Paragraph will include what the
topic is in language that shows a complete un-
derstanding of the issue.
The second paragraph will include
statements about why this is a topic of concern.
It may also include some background and defini-
tions. Here will also be general information
about the topic (GEN)
The third paragraph will include
some possible reasons why there are views in
favor of the topic( PROs).
The fourth paragraph will include
some possible reasons why the topic has detrac-
tors (CONs).
Sources of Information in Favor of the Topic
This paragraph will explain what some
of the positions in favor of the topic are. It will
provide more detail and depth about the PRO
side of the issue.
Jones, Mary. “Using Animals for Good.” Animals
in Experiments, Society for Ethics in the
Animal World. www.anieths.org. Accessed
10-30-19.
This paragraph provides the indicative
use of the info. It may include the breadth of the
subject covered, the typical use, etc.
This paragraph will discuss the relative
merits of the article. Who can use it, whether it is
complex or simple, is it a good source or is it
somehow lacking.
See above for more details on criteria
for the annotations and bibliography.
Sources of Information Opposed to the Topic
This paragraph will explain some of
the positions taken in opposition to the topic. It
provides more detail and depth about the op-
posed position on the topic.
Hector, James. “Animal Use in Cosmetic Re-
search.” Animals in Our World, edited by
The Staff of the Department of Ecology. 4th
ed. Columbia UP, 2015, pp 456-459.
This paragraph will include indicative
information about the source. Other info the
reader needs about the source.
This paragraph will include info about the
value of the source. Other info needed by the
reader .
.
Sources and Tips for Assignment 1 (History 105; Prof. Stansbury)—.docxrosemariebrayshaw
Sources and Tips for Assignment 1 (History 105; Prof. Stansbury)—3 pages here
LENGTH AND DEVELOPMENT: Each paper in our class is a 5-paragraph essay, plus there is a title page (=cover page) at the start and a Sources list at the end. The body of the paper is to be double-spaced. The body of the paper should be five paragraphs and a total of 500-to-800 words in length. The 500 minimum is firm; you really have not adequately developed the paper if less than that. The 800-word upper limit is really a guideline—ok to go over. Just don’t ramble. To determine length, I look at the BODY of the paper only (not title page or sources list) and consider primarily the word count. (Microsoft Word makes this easy. Just select from the first line of your first paragraph to the last line of your last paragraph. The word-count is provided on the lower left by MS-Word.). [I do not go by number of pages because there are too many ways that gets fudged by margins, font size, line spacing, etc. However, fyi---Typically, if you follow these instructions, the body of your paper will be 2-1/2 to 3-1/2 pages in length—add a page for your title page and another for your sources list and that then gets to 4-1/2-to 5/1/2.]
Your paper must have a numbered list of sources at the end combined with short in-text citations to those sources in the body of the paper. Any direct quote needs both quote marks and an in-text citation to the source. Any paraphrase or summary of information from a source requires an in-text citation to that source.
Use ONLY the sources designated. If for some reason you must use additional sources, do NOT google for them—use the university library. Pages 2 and 3 below show the sources for each topic and the SWS format for listing and citing each.
In this assignment, do NOT include long quotes of 4 lines or more. The paper is too short for that. Keep any quotes short and clearly marked with quote marks and a citation. Most of the paper should be you using mostly your words while using and summarizing information from your sources, as well as commenting and developing the paper according to the instructions. TIP: Before writing your paper, brainstorm first and make a general list or outline of each paragraph and what it will include. Use the class text for examples or specific information, and jot down the page numbers where you found that information. Do the same with other sources used. This will make your writing of the paper much easier. Then, start typing a rough draft. Plan to revise and edit yourself; allot time to polish the paper before you finally submit. Procrastination is the enemy of quality.
--------------------
ON THE NEXT TWO PAGES—How to list and how to cite the sources in your paper. Each of the three topics (as shown on the instruction sheet) identified sources by link and short identification. On the next two pages, you will see how each of those same sources look in an in-tex.
Soria 2Victoria SoriaDean WintherEnglish 101 10 March 20.docxrosemariebrayshaw
Soria 2
Victoria Soria
Dean Winther
English 101
10 March 2020
RAVENArticle 1 by Theresa Capra (2009).
Reputation. The author is a renowned researcher at Mercer County Community College who holds a Ph.D. and specializes in issues of education and children.
Ability to Observe. Being a researcher, the author is in a position to access reliable evidence from other scholarly researchers like her. Working as a director in the College also allows her to observe the effects of poverty on the education of children.
Vested Interest. Being a researcher, the author has no personal interest in the topic. Instead, she seeks to inform the general public about the effects of poverty.
Expertise. The author is an expert in the field of education such that she is even pursuing her Ph.D. She also refers to scholarly sources written by experts as evidence in the article.
Neutrality. The author is neutral about poverty and education. She provides a discussion of the causes, effects, and possible solutions that can be applied to curb the problem. Article 2 by Sean Slade (2015)
Reputation. The author is the director of Global Outreach at ASCD which aims at providing quality education that will grow children emotionally, physically, psychologically, and socially (ASCD, 2020). Thus, the author is in a position of authority.
Ability to Observe. The author is in a position that allows him to access reliable evidence. Being the director of Global Outreach at ASCD, the author works and interacts with children and this allows him to observe how poverty can affect their education.
Vested Interest. The author has some personal interest in the topic. He is a contributor to news being posted on the website. Thus, to get more views and reads, the author has to write something captivating and which will get more reads. This will increase his image in the online world.
Expertise. The author is not an expert in the field of poverty and education. Judging from the website, the author is just a contributor. It is only one evidence that quotes scholarly research. All the other evidence is from news and politics.
Neutrality. The author is biased about the issue of poverty and its impact on education. The author decided to focus on the negative side of poverty only. This painted a bad picture on the government and rich countries who, it is claimed, are the ones who cause poverty. Although this is partially true, the author fails to recognize intervention efforts from these rich countries that have worked to curb poverty. In this biased state, the author presents a one-sided argument only. Article 3 by Kelley Taylor (2017)
Reputation. The author is a contributor to contents on the Insight website which reports news about various issues facing the world today. being a magazine website, the source is not in a position of authority.
Ability to Observe. Being a news reporter, the author is in a position to access reliable evidence through researching on the internet and conduc.
SPC1017 Rubric: Informative Speech
Name: Jhoan Speech Topic: Tanorexia
Time: 4 minutes Points: 81
Introduction 15%
4
Strong attention getter and relevance statement
3
Strong credibility statement
5
Good overview of main points
Main Body 30%
5
Each main point is clear
5
Organization is logical
5
Information is new and relatable to audience, practical
3
Main points supported with research
3
At least one oral citation with needed information
3
Good transitions, good flow from one point to the next
Conclusion 15%
5
Prepared audience for conclusion
4
Summarized main points, no extra information
4
Strong ending, related back to attention getter
Delivery 40%
5
Good volume and speech rate
3
Good vocal variety, speaker was energetic, passionate
3
Good eye contact
4
Good posture and hand gestures, good overall body language
5
Good articulation, pronunciation (few verbal fillers, appropriate language)
4
Professional appearance, business casual attire, professional notes
3
Presentation aid (supportive, easily visible, correct spelling, duration)
4
Time Limit (stayed within designated time limit)
81
TOTAL
5 –Very Good
4 – good
3 – average
2– needs work
1 – unacceptable
.
South University College of Nursing and Public Health Graduate.docxrosemariebrayshaw
South University College of Nursing and Public Health Graduate Online
Nursing Program
Aquifer Internal Medicine
Internal
Medicine
08: 55-year-
old male
with chronic
disease
management
Author/Editor:Author/Editor: Cynthia A. Burns, MD
INTRODUCTION HISTORY
You review Mr. Morales' records on the computer.You review Mr. Morales' records on the computer.
!
You are working with Dr. Clay in her outpatient diabetes clinic this morning.
https://southu-nur.meduapp.com/
https://southu-nur.meduapp.com/document_sets/6094
Your first patient, Mr. Morales, was seen by Dr. Clay once before, eight years ago,
but was lost to follow-up after that time.
Based on review of the electronic medical record you are able to collect the
following information prior to heading into the room to meet Mr. Morales:
Mr. Morales is a 55-year-old Hispanic male, diagnosed with Type 2 diabetes
mellitus thirteen years ago after experiencing a 20-pound unintentional weight
loss, blurry vision, and nocturia.
He was hospitalized six weeks ago with a non-ST elevation myocardial infarction
and required three vessel coronary artery bypass grafting. During his admission,
he was found to have a reduced ejection fraction of 20%.
He was referred for today's visit by the cardiologist to focus on optimizing his
glycemic control and reducing his risk of the comorbidities associated with poorly
controlled Type 2 diabetes mellitus.
His last hemoglobin A1c (HbA1c) was 9.5% eight years ago, and he had
microalbuminuria at that time.
DIABETES CHRONIC DISEASE
MANAGEMENT 1
MANAGEMENT
You review diabetes chronic disease management with Dr. Clay.You review diabetes chronic disease management with Dr. Clay.
!
Before you see Mr. Morales, Dr. Clay reviews diabetes chronic disease
management with you.
Diabetes Chronic Disease Management
Evaluate for and optimize prevention of diabetic complicationsEvaluate for and optimize prevention of diabetic complications
Macrovascular complications:
Cardiovascular disease
Cerebrovascular disease
Microvascular complications:
Retinopathy
Nephropathy
Neuropathy
In particular, cardiovascular disease is the No. 1 cause of mortality for people
with diabetes, and one of the top causes of morbidity.
Hypoglycemia, infections, foot ulcers, and amputations are additional causes of
morbidity and mortality in patients with diabetes.
The American Diabetes Association publishes annual guidelines to assist in the
management of a patient with diabetes.
Remember the large role that the psychosocial aspects of a diabetesRemember the large role that the psychosocial aspects of a diabetes
diagnosis play in managementdiagnosis play in management
Non-adherence with medical recommendations could be due to economic,
work-related, religious, social, or linguistic barriers to care. Care must be taken
to assess the psychosocial status of each person with diabetes at each clinic
visit to ensure that barriers to successful diabetes care are minimized.
Question
Which .
Sources to UseSuskie, L. (2014, March 17). What is good.docxrosemariebrayshaw
Sources to Use:
Suskie, L. (2014, March 17). What is good assessment? A second look [PDF]. Retrieved from http://www.lindasuskie.com/apps/blog/show/41934533-what-is-good-assessment-a-second-look
Suskie, L. (2018, May 27). What are the characteristics of well-stated learning goals? [Blog post]. Retrieved from http://www.lindasuskie.com/apps/blog/show/45689916-what-are-the-characteristics-of-well-stated-learning-goals-
Suskie, L. (2015, March 23). Setting meaningful benchmarks or standards [Blog post]. Retrieved from http://www.lindasuskie.com/apps/blog/show/43191428-setting-meaningful-benchmarks-or-standards
Braskamp, L. A., & Engberg, M. E. (2014). Guidelines for judging the effectiveness of assessing student learning [PDF]. Retrieved from http://www.learningoutcomesassessment.org/documents/BraskampGuidelines.pdf
Hutchings, P., Ewell, P., & Banta, T. (2012). AAHE principles of good practice: Aging Nicely. Retrieved from: https://www.learningoutcomesassessment.org/wp-content/uploads/2019/08/Viewpoint-Hutchings-EwellBanta.pdf
Jankowski, N. A., Timmer, J. D., Kinzie, J., & Kuh, G. D. (2018). Assessment that matters: Trending toward practices that document authentic student learning. Urbana, IL: University of Illinois and Indiana University, National Institute for Learning outcomes Assessment (NILOA).
Banta, T., & Blaich, C. (2011). Closing the Assessment Loop. Change, 43(1), 22–27.
Running head: WEEK FIVE PAPER 1
TITLE OF PAPER 5
Week Five Paper
Your Name
Course Number & Title
Instructor's Name
Month Day, Year
Week Five Paper
Start the first paragraph here. It should introduce your reader to the subject you are writing about, as well as your particular position or claim. Before you can create your first paragraph, check that you Understand Your Assignment. You can use this template to help you format your paper. For longer papers, include sub-headings or levels of heading.
Challenges and Communication Needs
Communication Theories and Use to Effectively Engage Clients
Three Verbal and Three Nonverbal Techniques to Use With Clients
Selected Communication Theories and Benefits and Limitations
How Active Listening Skills Are Used
How Empathy Skills Are Used
Family, Culture and Gender Issues
Personal Communication Strengths and Growth Areas
Conclusion
.
References
The following are commonly used references. Please fill in the required information, and if you need more help, see the Formatting Your References List page. References are listed in alphabetical order.
Ashford Textbook (Online edition): *
Author, A. (Year published). Title of book: Subtitle of book (edition, if other than the first) [Electronic version]. Retrieved from from URL
Example:
Witt, G. A., & Mossler, R. A. (2010). Adult development and life assessment [Electronic version]. Retrieved from https://content.ashford.edu/books/4
Online Journal Article (such as from the Ashford Library):**
Author, A. (Year Published). Article title. Journal.
Sooner or later you’ll find your-self leading a team where one.docxrosemariebrayshaw
Sooner or later you’ll find your-self leading a team where one
or more of your people work
remotely. You can turn this situa-
tion into an advantage by leverag-
ing diverse backgrounds and
highly motivated employees. To do
this, you’ll need to avoid the possi-
ble communication and effective-
ness pitfalls and make sure you’re
making use of all the means at
your disposal to operate effectively
from a distance. Interestingly
enough, my experiences in P&G as
both a remote manager and a
remote employee have made me a
more disciplined manager.
Various situations, be it with
remote teams who work from
their homes or international
employees in different time zones,
bring unique characteristics to
which you’ll need to adjust your
management style. That said, the
basics for any manager remain the
same—you just have to do them
better. Do them well, and you’ll
have a highly energized and driven
work team. The consequences of
not doing so are twice as disas-
trous with remote teams.
What You Can Do
Let me share some of my favorite
must-do items for any remote
leader.
1. Energize your team with a
vision. To win as a team and as an
organization, it’s critical to involve
your remote group in the creation
and deployment of a common
vision. Ask yourself what your
most important breakthrough will
be, and set this as the direction
that propels your people and your
action plan. If it isn’t possible to do
this face to face, take time to have a
brainstorming forum, group chats,
and calls with video where you
come to a clear, meaningful state-
ment of the accomplishment your
team will be known for.
2. Engage them with a robust
action plan. This is probably one
of the most critical aspects of
remote leadership. Each team
member needs to feel engaged and
have a clear understanding about
what will be requested from them
or their teams, how it will be mea-
sured, and when you will expect it.
To do this well is to set a solid
foundation and clear the way for
what will come. Draft an action
plan with a clear link to your
vision, and engage each team
member individually with the
objectives assigned to them. Align
on the way updates will be pre-
sented and on key milestones.
Give examples of the way you like
updates to be presented and the
data you expect to see in them.
3. Be in touch with your team.
You need to be disciplined about
having periodic touchpoints in
order to stay connected. Watch out
for overly independent employees
who think they don’t need direc-
tion and allow the distance to
grow. It’s important to align prior-
ities, review action-plan progress,
and talk about career develop-
ment. It also doesn’t hurt to build
a personal relationship that fosters
trust and open communication.
Though there are various con-
straints, mostly financial, make
sure to schedule face-to-face time
as much as possible, and, again,
make use of the vast array of avail-
able videoconferencing te.
Sophia Bosoni, Tombra Esite & Junhui Liu
February 6, 2020
Innovation and Organization Transformation
The Boston Globe Organizational Transformations and Innovations
Introduction
The Boston Globe is a company that has been running since 1872. They are experiencing great changes due to changes in the media industry. The owner of The Boston Globe is The Boston Globe Media Partners, LLC. Now, the publisher and the owner of The Boston Globe is John Henry (The Boston Globe). Due to technological innovations, the way and how we inform ourselves is different than the past generations (ex: virtually).
The Boston Globe’s structure, human resources, political and symbolic frames activities are changing so quickly due to the new organization’s transformations and innovations. The structure of the media organizations has changed internally and externally. In relation to human resources we are going to focus on the internal and external changes as a result of the structural change. Politically and symbolically The Boston Globehas transformed, as well. We are going to explore how digital innovation has completely transformed The Boston Globe. This issue is important as The Boston Globe is experiencing many transformations and revenue challenges and they have to survive. Moreover, as a group, we will focus on the organizational transformations in relation to the four frames (structural, human resources, political & symbolic).
Main Issue
· Requires organization response involving key decision makers
Underlying Causes
Activity in the Four Frames
Structural Frame
The Boston Globe had to restructure because of the technological changes in this century. The Boston Globe had to adapt; therefore they created the BostonGlobe.com in 1995. The Boston Globe mains goal is to survive; then it is to deliver news. The Boston Globe went from an all paper organization to an electronic and paper organization (BostonGlobe.com). Due to all the new technological innovation and other online website there has been a need to get an IT department. This IT department takes care of the online website. Moreover, there needs to be a cyber security team because of all the hacking. The Boston Globe needs to protect themselves from the hackers. Additionally, jobs at The Boston Globe have changed greatly. They had to fire Truck drivers to deliver the newspapers and paper boys and hire more tech people.
Human Resources Frame
Political Frame
The owner of The Boston Globe, John Henry, is also the “Red Sox” owner. “In February 2013, the Red Sox owner John Henry assumed ownership, marking a new chapter (The Boston Globe).” This involves means that there is a lot of politics involved as John Henry has biases.
Due to the new structure at The Boston Globe it changes a lot of activity that relates to the political frame. Some of the changes are that there is no more need for different jobs that were very important and essential a couple decades ago, a generation ago. .
Soria 2Victoria Soria Dean WintherEnglish 101 04 Februar.docxrosemariebrayshaw
Soria 2
Victoria Soria
Dean Winther
English 101
04 February 2020
Poverty’s Impact on Education in America
Most evidently in America children born or brought up in poverty are faced with insignificant education, versus a child with a higher income background. I have chosen this topic for my research assignment being that an impact of poverty can affect a child’s academic accomplishments significantly. This results in them facing challenges such as lacking intellectual and literary skills. The child readiness for school is reduced by poverty because it brings forth poor physical health and motor skills, dwindles the children's ability to concentrate and remember information, reduces curiosity, attentiveness and motivation. Children from lower-income families who manage to complete high school are less likely to proceed to college. Such children end up not achieving their life goals for lack of education. The effects of poverty on education for some children present unique challenges in breaking the cycle of generational poverty. It further reduces their chances of living productive and rewarding lives.
Featured Research
Exploring the Job Duties That Impact
School Counselor Wellness: The Role
of RAMP, Supervision, and Support
Nicole M. Randick
1
, Shannon Dermer
2
, and Rebecca E. Michel
3
Abstract
The authors examined the predictive relationship between the performance of job duties informed by the American School
Counselor Association (ASCA) National Model and overall wellness of school counselors. We also examined the relationship
between organizational factors (i.e., Recognized ASCA Model Program, supervision, and support), the frequency of job duties
performed, and overall wellness. The results revealed a predictive relationship between some of the job duties school counselors
perform and wellness. We provide implications for school counseling practice and training programs.
Keywords
ASCA National Model, organizational factors, school counselors, wellness
Wellness, defined as a way of life that fosters “the optimum
state of health and well-being that each individual is capable of
achieving” (Myers, Sweeny, & Witmer, 2000, p. 252), is a
central foundation of the school counseling profession. The
American School Counselor Association’s ASCA Ethical Stan-
dards for School Counselors require school counselors to per-
form duties identified by the ASCA National Model (ASCA,
2012, 2016; Standard B.3.c) and to “monitor their emotional
and physical health and practice wellness to ensure optimal
professional effectiveness” (Standard B.3.f). Therefore, school
counselors must balance the dual task of supporting their stu-
dents’ academic, social/emotional, and career development
while also ensuring that their own wellness needs are being
met (ASCA, 2012, 2016; Bryant & Constantine, 2006; Limberg,
Lambie, & Robinson, 2016).
School counselors must balance the dual task of
supporting their students’ academic, social/
emoti.
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You are a licensed practice nurse (LPN) collaborating with a registered nurse (RN) for hospital-wide in-service on healthcare associated infections (HAI). After the in-service, a representative from each hospital department will receive an infographic to post in their respective unit. Your job is to create an infographic on preventing HAIs. The infographic should:
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· Identify common types of HAIs (healthcare associated infections)
· Include data or statistics about HAIs
· Describe prevention strategies for HAIs
Nursing Ethics
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To begin the process of socialization, having a clear understanding of the definition of nursing is essential. We know what nurses do, but how do we define nursing? Why is defining nursing important? To answer this last question, defining nursing is important for several reasons:To differentiate nursing from other professions.To define our practiceTo provide guidelines for nursing educationTo make nursing visible to the public and policy makers
While there may be multiple definitions of nursing from professional organization and state boards of nursing, similar characteristics can be found in all of them.
The American Nurses Association offers the following definition:
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.
Knowing what nursing is, supports your move into the nursing role. Socialization is the process of internalizing knowledge, skills, attitudes and other concepts needed to function in a role. You have been socialized into your current role. However, after graduating with your BSN, there will be another socialization process as you take on the broader role of the nurse with a BSN. Another way of describing the socialization process is Patricia Benner’s (1984) novice to expert stages. Some of you may be familiar with Benner’s work through your facilities clinical ladder. Socialization of the professional nurse involves developing your knowledge and skills and interacting with other nurses who act as mentors. Throughout the education process, students encounter a variety of socializing agents, including faculty, classmates, colleagues and other healthcare professionals, patients, and family, who subsequently contribute to the formation of a professional self-identify (Lai & Lim, 2012, p. 32).
Instructions
You are a licensed practice nurse (LPN) collaborating with a registered nurse (RN) for hospital-wide in-service on healthcare associated infections (HAI). After the in-service, a representative from each hospital department will receive an infographic to post in their respective unit. Your job is to create an infographic on preventing HAIs. The infographic should:
· Be a one-page visual representation of about Healthcare Associated Infections (HAIS)
· Identify common types of HAIs (healthcare associated infections)
· Include data or statistics about HAIs
· Describe prevention strategies for HAIs
Nursing Ethics
The Code of Ethics for Nurses of 2015, given by American Nurses Association (ANA), outlines the ethical basis for the nursing profession. It contains nine provisions, which cover the nurses' responsibilities toward the patients, maintenance of their personal professional growth, and their responsibilities to the profession and community.
Contemporary nur.
Southampton Business School Postgraduate Module Grade Descrip.docxrosemariebrayshaw
Southampton Business School: Postgraduate Module Grade Descriptor
Postgraduate Grade Descriptor for MANG6331 Text Mining and Social Network Analytics
Percentage 0 - 34 35 – 49 50 – 59 60 – 69 70 - 79 80 - 100
Degree Class Fail Compensatable
fail*
Pass Merit Distinction Distinction
Collecting
unstructured data and
conducting
exploratory analysis
Collecting raw tweets of
two different airlines and
conducting exploratory
data analysis
Weighting 20%
No/inadequate
evidence of
collecting and pre-
processing the raw
data.
No/inadequate
evidence of any
data analysis.
Evidence of basic
but inadequate
approaches to
collect and/or pre-
process the raw
data.
Mostly descriptive,
with minimal data
analysis. Argument
is basic and poorly
constructed.
Collecting and/or
pre-processing the
raw data is evident
but with some
confusion.
Data analysis is
reasonable.
Argument is
appropriate but
with some
confusion.
Clear evidence of
data pre-
processing and
exploratory data
analysis with
minimal
omissions/errors.
Clear and effective
analysis. Argument
is structured and is
legitimate.
Data pre-
processing and
exploratory data
analysis are
appropriate and
precise.
Comprehensive
and precise
analysis. Well-
structured
argument that
provides very good
clarity.
Appropriately use
of other sources of
information to
support arguments.
Data pre-
processing and
exploratory data
analysis are
appropriate and
precise.
Excellent analysis,
precise and
concise.
Exceptionally well-
structured
argument that
provides excellent
clarity.
Outstanding use of
other sources of
information to
support arguments.
Gaining customer
insights: traditional
versus social media
Evaluate the pros and
cons of replacing
customer satisfaction
survey by mining twitter
data
Weighting 20%
Not included. Limited and patchy
evidence of
knowledge and
understanding of
the pros and cons.
Limited evidence of
reading.
Lacks focus and
direction with
limited coherent
argument.
Sufficient but
inconsistent
evidence of
knowledge and
understanding of
the pros and cons.
Evidence of some
use of academic/
business literature.
Argument is basic
and poorly
constructed.
Good knowledge
and understanding
of the pros and
cons.
Good use of
academic/
business literature
to support
arguments.
Clear and effective
argument.
A comprehensive
and thorough
awareness of the
pros and cons.
Evidence of
comprehensive
reading.
Well-structured
argument that
provides very good
clarity.
A comprehensive
and thorough
awareness of the
pros and cons.
Excellent coverage
of relevant
literature.
Exceptionally well-
structured
argument that
provides excellent
clarity.
*Compensatable fail is only possible for compulsory or optional modules, subject to University of Southampton Progression Regulation.
Southwestern Business Administration JournalVolume 16 Is.docxrosemariebrayshaw
Southwestern Business Administration Journal
Volume 16 | Issue 1 Article 1
2017
Leveraging Decision Making in Cyber Security
Analysis through Data Cleaning
Chen Zhong
Hong Liu
Awny Alnusair
Follow this and additional works at: https://digitalscholarship.tsu.edu/sbaj
Part of the Business Administration, Management, and Operations Commons, E-Commerce
Commons, Entrepreneurial and Small Business Operations Commons, Management Information
Systems Commons, Marketing Commons, Organizational Behavior and Theory Commons, and the
Real Estate Commons
This Article is brought to you for free and open access by Digital Scholarship @ Texas Southern University. It has been accepted for inclusion in
Southwestern Business Administration Journal by an authorized editor of Digital Scholarship @ Texas Southern University. For more information,
please contact [email protected]
Recommended Citation
Zhong, Chen; Liu, Hong; and Alnusair, Awny (2017) "Leveraging Decision Making in Cyber Security Analysis through Data
Cleaning," Southwestern Business Administration Journal: Vol. 16 : Iss. 1 , Article 1.
Available at: https://digitalscholarship.tsu.edu/sbaj/vol16/iss1/1
https://digitalscholarship.tsu.edu/sbaj?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
https://digitalscholarship.tsu.edu/sbaj/vol16?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
https://digitalscholarship.tsu.edu/sbaj/vol16/iss1?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
https://digitalscholarship.tsu.edu/sbaj/vol16/iss1/1?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
https://digitalscholarship.tsu.edu/sbaj?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
http://network.bepress.com/hgg/discipline/623?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
http://network.bepress.com/hgg/discipline/624?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
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http://network.bepress.com/hgg/discipline/630?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
http://network.bepress.com/hgg/discipline/636?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
http://network.bepress.com/hgg/discipline/636?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
http://network.bepress.com/hgg/discipline/638?utm_source=digitalscholarship.tsu.edu%2Fsbaj%2Fvol16%2Fiss1%2F1&utm_medium=PDF&utm_campaign=PDFCoverPages
ht.
Spadoni • revised Jan. 2020 —continued— Checklist for .docxrosemariebrayshaw
Spadoni • revised Jan. 2020
—continued—
Checklist for Essay Writers
PART 1. FORMATTING
Follow these steps now to save yourself headaches later and avoid losing credit
Title a word processor file “film-template” or something. Follow the instructions in this Formatting section. For an
essay title, type “[essay title]”. For paragraph text, type a sentence and copy and paste it repeatedly until you have a
paragraph. Do the same to make another paragraph, and another, until you’re onto your second page. Do this to
make sure MS Word isn’t adding extra space between paragraphs (see below) and that you have no first page header
and the correct second page header (see below). When it’s time to write your essay, open this template file and save
it to a new name. Keep the template file for your next essay (and any future course you take with me).
Some formatting instructions below are to ensure students are meeting the same length requirement and that no
formatting deviations are disguising this fact. If I ask you to email me the word-processor copy of your essay and it
shows deviations, you will lose more credit than if you had just handed in a paper under the page minimum. If you
email me a file that is not identical to the essay you handed in, you will lose even more credit.
1. Format the top of your essay like this. To get the above-and-below spacing for your title as below, enter a hard return above and
below your title, then (in your double-spaced document) make these above-and-below lines single space.
Angelo Marconi
Engl 367—Intro to Film
Prof. Spadoni
May 24, 2020
[Center essay title; 12 pt font; no boldface, underlining, or brackets]
Essay text starts here. Make sure no more space precedes and
follows your essay title than you see above. ....
2. Last name and page number in the top-right corner of the second and subsequent pages (not the first page). Don’t hand write this
information on the tops of your pages.
Marconi 6
3. Black ink. Standard white paper. Single sided.
4. Times, Times Roman, or Times New Roman typeface (not Cambria), 12 point—including essay title. Don’t change typeface or
font size to increase page length.
5. Double space your work. Don’t alter line spacing to increase page length.
6. Standard margins (1 inch top and bottom, 1 or 1.25 inch left and right). Don’t adjust margins to increase page length.
7. One space (not two) between sentences.
8. No extra space between paragraphs. MS Word likes to insert extra space. Don’t leave figuring out how to tell it not to for the last
minute.
9. Italicize film titles—and at the first mention, follow title with the director and year in parentheses, like this: In an early scene in
Jaws (Steven Spielberg, 1975), a character tries to… Italicize book titles; essay titles are not italicized and go in double quotes.
10. Staple pages, top-left corner. Unstapled.
SPAN100Course SummaryCourse SPAN100 Title Spanish I.docxrosemariebrayshaw
SPAN100
Course Summary
Course : SPAN100 Title : Spanish I
Length of Course : 8 Faculty : Dallas Jurisevic
Prerequisites : N/A Credit Hours : 3
Description
Course Description:
This course will expose the student to the fundamentals of the Spanish language. The student will learn basic
vocabulary, verb conjugations and grammatical usage through workbook and listening exercises. The student
will also learn about the Spanish culture through reading and listening exercises. Please note the technical
specifications below. These are required to interface with the online version of Rosetta Stone. If you cannot meet
these requirements we strongly recommend you do not take this course. Please contact
[email protected] if you are unsure or have any questions. * The ability to download and install the
speech component. * A working microphone installed on the computer for speech recognition. * Access to
streaming media is also required and should be confirmed before registering for the class.
Course Scope:
Standards for Foreign Language Learning in the 21st Century (1999) “Language and communication are at the
heart of the human experience. The United States must educate students who are linguistically and culturally
equipped to communicate successfully in a pluralistic American society and abroad. This imperative envisions a
future in which ALL students will develop and maintain proficiency in English and at least one other language…”
Our major focus is on learning to communicate appropriately in practical, culturally authentic contexts. Students
are asked, to a limited extent, to use their Spanish to engage in simple dialog and talk about themselves and
create with the language in practical ways. Students also correct peer work and in doing so, students solve
problems (and thus engage in analysis, synthesis, and evaluation).
In these courses, students gradually add to their vocabulary and communication skills, practice question- and-
answer techniques, and apply what they learn in order to communicate and solve problems in practical
situations.
Objectives
Students who successfully complete Spanish 100 should be able to:
► Listening Skills
1. Distinguish all the sounds of Spanish important to meaning.
2. Comprehend brief sentences expressed within the framework of high- frequency vocabulary, grammatical
forms, and sentence structures.
3. Determine the meaning of unfamiliar words or phrases though logical guessing based on contextual clues.
► Speaking Skills
1. Produce all the sounds of Spanish and link sounds together in sentences with sufficient accuracy to
communicate with Spanish speakers.
2. Use high- frequency vocabulary, grammatical forms, and sentence structures to converse in brief sentences in
everyday situations (such as greetings, asking for directions, answering short questions, expressing basic
needs and reactions, exchanging information, or persuading others)
► Reading Skills
1. Comprehend non- technical, narrative Spanish.
.
Sources and Resources for RC004Informed Advocacy in Early .docxrosemariebrayshaw
Sources and Resources for RC004
Informed Advocacy in Early Childhood Care and Education: Making a Difference for Young Children and Families, pp. 107-111
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-628&srcou=6738
WEBSITE: KIDS COUNT DATA CENTER
http://datacenter.kidscount.org/topics
KIDS COUNT Data Center
Annie E. Casey Foundation. (2014). KIDS COUNT data center: Data topics. Retrieved from http://datacenter.kidscount.org/topics
WEBSITE: NATIONAL AND STATE FACTS
http://www.cwla.org/our-work/advocacy/
WEBSITE: U.S. CHILD STATE DATA
http://www.cwla.org/our-work/advocacy/
WEBSITE: DATA TOOLS
http://www.nccp.org/tools/
Consider how this information will be beneficial within the context of Part 1 of your Work Product.
WEBSITE: ASSOCIATION FOR CHILDHOOD EDUCATION INTERNATIONAL
http://www.acei.org/
WEBSITE: DIVISION FOR EARLY CHILDHOOD
http://www.dec-sped.org/
WEBSITE: INTERNATIONAL READING ASSOCIATION
http://www.reading.org/
WEBSITE: NATIONAL ASSOCIATION FOR THE EDUCATION OF YOUNG CHILDREN
http://www.naeyc.org/
WEBSITE: NATIONAL BLACK CHILD DEVELOPMENT INSTITUTE
http://www.nbcdi.org/
BOOK EXCERPT: DEVELOPING INITIATIVES
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-640&srcou=6738
The following links lead to early childhood advocacy initiatives that focus on social change on behalf of children, families, and the early childhood field.
WEBSITE: WORLDWIDE TEACHER SHORTAGE: REGIONAL AND GLOBAL IMPLICATIONS
http://www.businessinsider.com/theres-a-massive-global-teacher-shortage-2016-10
WEBSITE: LEGISLATIVE HOT TOPICS
https://www.literacyworldwide.org/
WEBSITE: TAKEN ACTION NOW
http://www.naeyc.org/policy/action
WEBSITE: WHAT WE DO: POLICY
http://www.nbcdi.org/what-we-do/policy
BOOK EXCERPT: COMPREHENSIVE DEVELOPMENTAL SCREENING
As you read this information and the Guided Notes , consider how these apply to Part 2 and Part 3 of your Work Product.
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-647&srcou=6738
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-747&srcou=6738
https://tempolearning.brightspace.com/d2l/common/dialogs/quickLink/quickLink.d2l?ou=6738&type=lti&rcode=walden-2320&srcou=6738
This information is beneficial in the context of Part 2 and Part 3 of your Work Product.
ARTICLE: HOW TO BE A VOICE FOR BABIES: USING DATA TO ADVOCATE EFFECTIVELY
https://www.zerotothree.org/resources/496-how-to-use-data-to-advocate-effectively
ARTICLE: EFFECTIVE COMMUNICATION ABOUT THE EARLY YEARS: UNDERSTANDING THE BASICS OF FRAMING
https://www.zerotothree.org/resources/482-understand-the-basics-of-framing-to-communicate-effectively
ARTICLE: EFFECTIVE COMMUNICATION ABOUT THE EARLY YEARS: THE ELEMENTS OF THE FRAME: PART ONE
https://www.zerotothree.org/resources/483-the-elements.
Sources of General Information about the Topic A paragr.docxrosemariebrayshaw
Sources of General Information about the Topic
A paragraph that explains that the follow-
ing sources provide more in depth information about
the topic.
Smith, John. “An Understanding of Animal Experimen-
tation.” The Journal of Animal Husbandry, vol33,
no 2 Jan 2010 pp.70-91. JSTOR,
ww.libray.dcccd.edu. Accessed 10-30-19.
This paragraph will include indicative information
about the source. Other info the reader needs about
the source.
This paragraph will include info about the value
of the source. Other info needed by the reader .
This can/will be multiple pages. The annotation
is to include indicative and evaluative information—a
combined annotation. For this and the following sec-
tions needed will be five(5) sources and associated
annotations for each. The sources are to be in stand-
ard MLA alphabetic order.
An Annotated Bibliography
Of
Topic
First Paragraph will include what the
topic is in language that shows a complete un-
derstanding of the issue.
The second paragraph will include
statements about why this is a topic of concern.
It may also include some background and defini-
tions. Here will also be general information
about the topic (GEN)
The third paragraph will include
some possible reasons why there are views in
favor of the topic( PROs).
The fourth paragraph will include
some possible reasons why the topic has detrac-
tors (CONs).
Sources of Information in Favor of the Topic
This paragraph will explain what some
of the positions in favor of the topic are. It will
provide more detail and depth about the PRO
side of the issue.
Jones, Mary. “Using Animals for Good.” Animals
in Experiments, Society for Ethics in the
Animal World. www.anieths.org. Accessed
10-30-19.
This paragraph provides the indicative
use of the info. It may include the breadth of the
subject covered, the typical use, etc.
This paragraph will discuss the relative
merits of the article. Who can use it, whether it is
complex or simple, is it a good source or is it
somehow lacking.
See above for more details on criteria
for the annotations and bibliography.
Sources of Information Opposed to the Topic
This paragraph will explain some of
the positions taken in opposition to the topic. It
provides more detail and depth about the op-
posed position on the topic.
Hector, James. “Animal Use in Cosmetic Re-
search.” Animals in Our World, edited by
The Staff of the Department of Ecology. 4th
ed. Columbia UP, 2015, pp 456-459.
This paragraph will include indicative
information about the source. Other info the
reader needs about the source.
This paragraph will include info about the
value of the source. Other info needed by the
reader .
.
Sources and Tips for Assignment 1 (History 105; Prof. Stansbury)—.docxrosemariebrayshaw
Sources and Tips for Assignment 1 (History 105; Prof. Stansbury)—3 pages here
LENGTH AND DEVELOPMENT: Each paper in our class is a 5-paragraph essay, plus there is a title page (=cover page) at the start and a Sources list at the end. The body of the paper is to be double-spaced. The body of the paper should be five paragraphs and a total of 500-to-800 words in length. The 500 minimum is firm; you really have not adequately developed the paper if less than that. The 800-word upper limit is really a guideline—ok to go over. Just don’t ramble. To determine length, I look at the BODY of the paper only (not title page or sources list) and consider primarily the word count. (Microsoft Word makes this easy. Just select from the first line of your first paragraph to the last line of your last paragraph. The word-count is provided on the lower left by MS-Word.). [I do not go by number of pages because there are too many ways that gets fudged by margins, font size, line spacing, etc. However, fyi---Typically, if you follow these instructions, the body of your paper will be 2-1/2 to 3-1/2 pages in length—add a page for your title page and another for your sources list and that then gets to 4-1/2-to 5/1/2.]
Your paper must have a numbered list of sources at the end combined with short in-text citations to those sources in the body of the paper. Any direct quote needs both quote marks and an in-text citation to the source. Any paraphrase or summary of information from a source requires an in-text citation to that source.
Use ONLY the sources designated. If for some reason you must use additional sources, do NOT google for them—use the university library. Pages 2 and 3 below show the sources for each topic and the SWS format for listing and citing each.
In this assignment, do NOT include long quotes of 4 lines or more. The paper is too short for that. Keep any quotes short and clearly marked with quote marks and a citation. Most of the paper should be you using mostly your words while using and summarizing information from your sources, as well as commenting and developing the paper according to the instructions. TIP: Before writing your paper, brainstorm first and make a general list or outline of each paragraph and what it will include. Use the class text for examples or specific information, and jot down the page numbers where you found that information. Do the same with other sources used. This will make your writing of the paper much easier. Then, start typing a rough draft. Plan to revise and edit yourself; allot time to polish the paper before you finally submit. Procrastination is the enemy of quality.
--------------------
ON THE NEXT TWO PAGES—How to list and how to cite the sources in your paper. Each of the three topics (as shown on the instruction sheet) identified sources by link and short identification. On the next two pages, you will see how each of those same sources look in an in-tex.
Soria 2Victoria SoriaDean WintherEnglish 101 10 March 20.docxrosemariebrayshaw
Soria 2
Victoria Soria
Dean Winther
English 101
10 March 2020
RAVENArticle 1 by Theresa Capra (2009).
Reputation. The author is a renowned researcher at Mercer County Community College who holds a Ph.D. and specializes in issues of education and children.
Ability to Observe. Being a researcher, the author is in a position to access reliable evidence from other scholarly researchers like her. Working as a director in the College also allows her to observe the effects of poverty on the education of children.
Vested Interest. Being a researcher, the author has no personal interest in the topic. Instead, she seeks to inform the general public about the effects of poverty.
Expertise. The author is an expert in the field of education such that she is even pursuing her Ph.D. She also refers to scholarly sources written by experts as evidence in the article.
Neutrality. The author is neutral about poverty and education. She provides a discussion of the causes, effects, and possible solutions that can be applied to curb the problem. Article 2 by Sean Slade (2015)
Reputation. The author is the director of Global Outreach at ASCD which aims at providing quality education that will grow children emotionally, physically, psychologically, and socially (ASCD, 2020). Thus, the author is in a position of authority.
Ability to Observe. The author is in a position that allows him to access reliable evidence. Being the director of Global Outreach at ASCD, the author works and interacts with children and this allows him to observe how poverty can affect their education.
Vested Interest. The author has some personal interest in the topic. He is a contributor to news being posted on the website. Thus, to get more views and reads, the author has to write something captivating and which will get more reads. This will increase his image in the online world.
Expertise. The author is not an expert in the field of poverty and education. Judging from the website, the author is just a contributor. It is only one evidence that quotes scholarly research. All the other evidence is from news and politics.
Neutrality. The author is biased about the issue of poverty and its impact on education. The author decided to focus on the negative side of poverty only. This painted a bad picture on the government and rich countries who, it is claimed, are the ones who cause poverty. Although this is partially true, the author fails to recognize intervention efforts from these rich countries that have worked to curb poverty. In this biased state, the author presents a one-sided argument only. Article 3 by Kelley Taylor (2017)
Reputation. The author is a contributor to contents on the Insight website which reports news about various issues facing the world today. being a magazine website, the source is not in a position of authority.
Ability to Observe. Being a news reporter, the author is in a position to access reliable evidence through researching on the internet and conduc.
SPC1017 Rubric: Informative Speech
Name: Jhoan Speech Topic: Tanorexia
Time: 4 minutes Points: 81
Introduction 15%
4
Strong attention getter and relevance statement
3
Strong credibility statement
5
Good overview of main points
Main Body 30%
5
Each main point is clear
5
Organization is logical
5
Information is new and relatable to audience, practical
3
Main points supported with research
3
At least one oral citation with needed information
3
Good transitions, good flow from one point to the next
Conclusion 15%
5
Prepared audience for conclusion
4
Summarized main points, no extra information
4
Strong ending, related back to attention getter
Delivery 40%
5
Good volume and speech rate
3
Good vocal variety, speaker was energetic, passionate
3
Good eye contact
4
Good posture and hand gestures, good overall body language
5
Good articulation, pronunciation (few verbal fillers, appropriate language)
4
Professional appearance, business casual attire, professional notes
3
Presentation aid (supportive, easily visible, correct spelling, duration)
4
Time Limit (stayed within designated time limit)
81
TOTAL
5 –Very Good
4 – good
3 – average
2– needs work
1 – unacceptable
.
South University College of Nursing and Public Health Graduate.docxrosemariebrayshaw
South University College of Nursing and Public Health Graduate Online
Nursing Program
Aquifer Internal Medicine
Internal
Medicine
08: 55-year-
old male
with chronic
disease
management
Author/Editor:Author/Editor: Cynthia A. Burns, MD
INTRODUCTION HISTORY
You review Mr. Morales' records on the computer.You review Mr. Morales' records on the computer.
!
You are working with Dr. Clay in her outpatient diabetes clinic this morning.
https://southu-nur.meduapp.com/
https://southu-nur.meduapp.com/document_sets/6094
Your first patient, Mr. Morales, was seen by Dr. Clay once before, eight years ago,
but was lost to follow-up after that time.
Based on review of the electronic medical record you are able to collect the
following information prior to heading into the room to meet Mr. Morales:
Mr. Morales is a 55-year-old Hispanic male, diagnosed with Type 2 diabetes
mellitus thirteen years ago after experiencing a 20-pound unintentional weight
loss, blurry vision, and nocturia.
He was hospitalized six weeks ago with a non-ST elevation myocardial infarction
and required three vessel coronary artery bypass grafting. During his admission,
he was found to have a reduced ejection fraction of 20%.
He was referred for today's visit by the cardiologist to focus on optimizing his
glycemic control and reducing his risk of the comorbidities associated with poorly
controlled Type 2 diabetes mellitus.
His last hemoglobin A1c (HbA1c) was 9.5% eight years ago, and he had
microalbuminuria at that time.
DIABETES CHRONIC DISEASE
MANAGEMENT 1
MANAGEMENT
You review diabetes chronic disease management with Dr. Clay.You review diabetes chronic disease management with Dr. Clay.
!
Before you see Mr. Morales, Dr. Clay reviews diabetes chronic disease
management with you.
Diabetes Chronic Disease Management
Evaluate for and optimize prevention of diabetic complicationsEvaluate for and optimize prevention of diabetic complications
Macrovascular complications:
Cardiovascular disease
Cerebrovascular disease
Microvascular complications:
Retinopathy
Nephropathy
Neuropathy
In particular, cardiovascular disease is the No. 1 cause of mortality for people
with diabetes, and one of the top causes of morbidity.
Hypoglycemia, infections, foot ulcers, and amputations are additional causes of
morbidity and mortality in patients with diabetes.
The American Diabetes Association publishes annual guidelines to assist in the
management of a patient with diabetes.
Remember the large role that the psychosocial aspects of a diabetesRemember the large role that the psychosocial aspects of a diabetes
diagnosis play in managementdiagnosis play in management
Non-adherence with medical recommendations could be due to economic,
work-related, religious, social, or linguistic barriers to care. Care must be taken
to assess the psychosocial status of each person with diabetes at each clinic
visit to ensure that barriers to successful diabetes care are minimized.
Question
Which .
Sources to UseSuskie, L. (2014, March 17). What is good.docxrosemariebrayshaw
Sources to Use:
Suskie, L. (2014, March 17). What is good assessment? A second look [PDF]. Retrieved from http://www.lindasuskie.com/apps/blog/show/41934533-what-is-good-assessment-a-second-look
Suskie, L. (2018, May 27). What are the characteristics of well-stated learning goals? [Blog post]. Retrieved from http://www.lindasuskie.com/apps/blog/show/45689916-what-are-the-characteristics-of-well-stated-learning-goals-
Suskie, L. (2015, March 23). Setting meaningful benchmarks or standards [Blog post]. Retrieved from http://www.lindasuskie.com/apps/blog/show/43191428-setting-meaningful-benchmarks-or-standards
Braskamp, L. A., & Engberg, M. E. (2014). Guidelines for judging the effectiveness of assessing student learning [PDF]. Retrieved from http://www.learningoutcomesassessment.org/documents/BraskampGuidelines.pdf
Hutchings, P., Ewell, P., & Banta, T. (2012). AAHE principles of good practice: Aging Nicely. Retrieved from: https://www.learningoutcomesassessment.org/wp-content/uploads/2019/08/Viewpoint-Hutchings-EwellBanta.pdf
Jankowski, N. A., Timmer, J. D., Kinzie, J., & Kuh, G. D. (2018). Assessment that matters: Trending toward practices that document authentic student learning. Urbana, IL: University of Illinois and Indiana University, National Institute for Learning outcomes Assessment (NILOA).
Banta, T., & Blaich, C. (2011). Closing the Assessment Loop. Change, 43(1), 22–27.
Running head: WEEK FIVE PAPER 1
TITLE OF PAPER 5
Week Five Paper
Your Name
Course Number & Title
Instructor's Name
Month Day, Year
Week Five Paper
Start the first paragraph here. It should introduce your reader to the subject you are writing about, as well as your particular position or claim. Before you can create your first paragraph, check that you Understand Your Assignment. You can use this template to help you format your paper. For longer papers, include sub-headings or levels of heading.
Challenges and Communication Needs
Communication Theories and Use to Effectively Engage Clients
Three Verbal and Three Nonverbal Techniques to Use With Clients
Selected Communication Theories and Benefits and Limitations
How Active Listening Skills Are Used
How Empathy Skills Are Used
Family, Culture and Gender Issues
Personal Communication Strengths and Growth Areas
Conclusion
.
References
The following are commonly used references. Please fill in the required information, and if you need more help, see the Formatting Your References List page. References are listed in alphabetical order.
Ashford Textbook (Online edition): *
Author, A. (Year published). Title of book: Subtitle of book (edition, if other than the first) [Electronic version]. Retrieved from from URL
Example:
Witt, G. A., & Mossler, R. A. (2010). Adult development and life assessment [Electronic version]. Retrieved from https://content.ashford.edu/books/4
Online Journal Article (such as from the Ashford Library):**
Author, A. (Year Published). Article title. Journal.
Sooner or later you’ll find your-self leading a team where one.docxrosemariebrayshaw
Sooner or later you’ll find your-self leading a team where one
or more of your people work
remotely. You can turn this situa-
tion into an advantage by leverag-
ing diverse backgrounds and
highly motivated employees. To do
this, you’ll need to avoid the possi-
ble communication and effective-
ness pitfalls and make sure you’re
making use of all the means at
your disposal to operate effectively
from a distance. Interestingly
enough, my experiences in P&G as
both a remote manager and a
remote employee have made me a
more disciplined manager.
Various situations, be it with
remote teams who work from
their homes or international
employees in different time zones,
bring unique characteristics to
which you’ll need to adjust your
management style. That said, the
basics for any manager remain the
same—you just have to do them
better. Do them well, and you’ll
have a highly energized and driven
work team. The consequences of
not doing so are twice as disas-
trous with remote teams.
What You Can Do
Let me share some of my favorite
must-do items for any remote
leader.
1. Energize your team with a
vision. To win as a team and as an
organization, it’s critical to involve
your remote group in the creation
and deployment of a common
vision. Ask yourself what your
most important breakthrough will
be, and set this as the direction
that propels your people and your
action plan. If it isn’t possible to do
this face to face, take time to have a
brainstorming forum, group chats,
and calls with video where you
come to a clear, meaningful state-
ment of the accomplishment your
team will be known for.
2. Engage them with a robust
action plan. This is probably one
of the most critical aspects of
remote leadership. Each team
member needs to feel engaged and
have a clear understanding about
what will be requested from them
or their teams, how it will be mea-
sured, and when you will expect it.
To do this well is to set a solid
foundation and clear the way for
what will come. Draft an action
plan with a clear link to your
vision, and engage each team
member individually with the
objectives assigned to them. Align
on the way updates will be pre-
sented and on key milestones.
Give examples of the way you like
updates to be presented and the
data you expect to see in them.
3. Be in touch with your team.
You need to be disciplined about
having periodic touchpoints in
order to stay connected. Watch out
for overly independent employees
who think they don’t need direc-
tion and allow the distance to
grow. It’s important to align prior-
ities, review action-plan progress,
and talk about career develop-
ment. It also doesn’t hurt to build
a personal relationship that fosters
trust and open communication.
Though there are various con-
straints, mostly financial, make
sure to schedule face-to-face time
as much as possible, and, again,
make use of the vast array of avail-
able videoconferencing te.
Sophia Bosoni, Tombra Esite & Junhui Liu
February 6, 2020
Innovation and Organization Transformation
The Boston Globe Organizational Transformations and Innovations
Introduction
The Boston Globe is a company that has been running since 1872. They are experiencing great changes due to changes in the media industry. The owner of The Boston Globe is The Boston Globe Media Partners, LLC. Now, the publisher and the owner of The Boston Globe is John Henry (The Boston Globe). Due to technological innovations, the way and how we inform ourselves is different than the past generations (ex: virtually).
The Boston Globe’s structure, human resources, political and symbolic frames activities are changing so quickly due to the new organization’s transformations and innovations. The structure of the media organizations has changed internally and externally. In relation to human resources we are going to focus on the internal and external changes as a result of the structural change. Politically and symbolically The Boston Globehas transformed, as well. We are going to explore how digital innovation has completely transformed The Boston Globe. This issue is important as The Boston Globe is experiencing many transformations and revenue challenges and they have to survive. Moreover, as a group, we will focus on the organizational transformations in relation to the four frames (structural, human resources, political & symbolic).
Main Issue
· Requires organization response involving key decision makers
Underlying Causes
Activity in the Four Frames
Structural Frame
The Boston Globe had to restructure because of the technological changes in this century. The Boston Globe had to adapt; therefore they created the BostonGlobe.com in 1995. The Boston Globe mains goal is to survive; then it is to deliver news. The Boston Globe went from an all paper organization to an electronic and paper organization (BostonGlobe.com). Due to all the new technological innovation and other online website there has been a need to get an IT department. This IT department takes care of the online website. Moreover, there needs to be a cyber security team because of all the hacking. The Boston Globe needs to protect themselves from the hackers. Additionally, jobs at The Boston Globe have changed greatly. They had to fire Truck drivers to deliver the newspapers and paper boys and hire more tech people.
Human Resources Frame
Political Frame
The owner of The Boston Globe, John Henry, is also the “Red Sox” owner. “In February 2013, the Red Sox owner John Henry assumed ownership, marking a new chapter (The Boston Globe).” This involves means that there is a lot of politics involved as John Henry has biases.
Due to the new structure at The Boston Globe it changes a lot of activity that relates to the political frame. Some of the changes are that there is no more need for different jobs that were very important and essential a couple decades ago, a generation ago. .
Soria 2Victoria Soria Dean WintherEnglish 101 04 Februar.docxrosemariebrayshaw
Soria 2
Victoria Soria
Dean Winther
English 101
04 February 2020
Poverty’s Impact on Education in America
Most evidently in America children born or brought up in poverty are faced with insignificant education, versus a child with a higher income background. I have chosen this topic for my research assignment being that an impact of poverty can affect a child’s academic accomplishments significantly. This results in them facing challenges such as lacking intellectual and literary skills. The child readiness for school is reduced by poverty because it brings forth poor physical health and motor skills, dwindles the children's ability to concentrate and remember information, reduces curiosity, attentiveness and motivation. Children from lower-income families who manage to complete high school are less likely to proceed to college. Such children end up not achieving their life goals for lack of education. The effects of poverty on education for some children present unique challenges in breaking the cycle of generational poverty. It further reduces their chances of living productive and rewarding lives.
Featured Research
Exploring the Job Duties That Impact
School Counselor Wellness: The Role
of RAMP, Supervision, and Support
Nicole M. Randick
1
, Shannon Dermer
2
, and Rebecca E. Michel
3
Abstract
The authors examined the predictive relationship between the performance of job duties informed by the American School
Counselor Association (ASCA) National Model and overall wellness of school counselors. We also examined the relationship
between organizational factors (i.e., Recognized ASCA Model Program, supervision, and support), the frequency of job duties
performed, and overall wellness. The results revealed a predictive relationship between some of the job duties school counselors
perform and wellness. We provide implications for school counseling practice and training programs.
Keywords
ASCA National Model, organizational factors, school counselors, wellness
Wellness, defined as a way of life that fosters “the optimum
state of health and well-being that each individual is capable of
achieving” (Myers, Sweeny, & Witmer, 2000, p. 252), is a
central foundation of the school counseling profession. The
American School Counselor Association’s ASCA Ethical Stan-
dards for School Counselors require school counselors to per-
form duties identified by the ASCA National Model (ASCA,
2012, 2016; Standard B.3.c) and to “monitor their emotional
and physical health and practice wellness to ensure optimal
professional effectiveness” (Standard B.3.f). Therefore, school
counselors must balance the dual task of supporting their stu-
dents’ academic, social/emotional, and career development
while also ensuring that their own wellness needs are being
met (ASCA, 2012, 2016; Bryant & Constantine, 2006; Limberg,
Lambie, & Robinson, 2016).
School counselors must balance the dual task of
supporting their students’ academic, social/
emoti.
Sources and Tips for Assignment 3 (History 105; Prof. Stansbury)—.docxrosemariebrayshaw
Sources and Tips for Assignment 3 (History 105; Prof. Stansbury)—5 pages here
LENGTH AND DEVELOPMENT: Each paper in our class is a 5-paragraph essay, plus there is a title page (=cover page) at the start and a Sources list at the end. The body of the paper is to be double-spaced. The body of the paper should be five paragraphs and a total of 500-to-800 words in length. The 500 minimum is firm; you really have not adequately developed the paper if less than that. The 800-word upper limit is really a guideline—ok to go over. Just don’t ramble. To determine length, I look at the BODY of the paper only (not title page or sources list) and consider primarily the word count. (Microsoft Word makes this easy. Just select from the first line of your first paragraph to the last line of your last paragraph. The word-count is provided on the lower left by MS-Word.). [I do not go by number of pages because there are too many ways that gets fudged by margins, font size, line spacing, etc. However, fyi---Typically, if you follow these instructions, the body of your paper will be 2-1/2 to 3-1/2 pages in length—add a page for your title page and another for your sources list and that then gets to 4-1/2-to 5/1/2.]
Your paper must have a numbered list of sources at the end combined with short in-text citations to those sources in the body of the paper. Any direct quote needs both quote marks and an in-text citation to the source. Any paraphrase or summary of information from a source requires an in-text citation to that source.
Use ONLY the sources designated and listed for this assignment. If for some reason you must use additional sources, do NOT google for them—use the university’s online library.
In this assignment, do NOT include long quotes of 4 lines or more. The paper is too short for that. Keep any quotes short and clearly marked with quote marks and a citation. Most of the paper should be you using mostly your words while using and summarizing information from your sources, as well as commenting and developing the paper according to the instructions. TIP: Before writing your paper, brainstorm first and make a general list or outline of each paragraph and what it will include. Use the class text for examples or specific information, and jot down the page numbers where you found that information. Do the same with other sources used. This will make your writing of the paper much easier. Then, start typing a rough draft. Plan to revise and edit yourself; allot time to polish the paper before you finally submit. Procrastination is the enemy of quality.
--------------------
ON THE NEXT PAGE—How to list and how to cite the sources in your paper. The instruction sheet for Assignment 3 shows the Schultz class text (required for this) followed by a long list from which you may choose for your other sources. On the next three pages below, you will see a sample sources list for this assignment, just illustratin.
Sources of Risk for Chronic Conditions in the State of Flo.docxrosemariebrayshaw
Sources of Risk for Chronic Conditions in the State of Florida
DHA-7010 - Project and Resource Management in Integrated Systems
4/05/20
*
Introduction
A chronic condition is a disease that endures along period.
Chronic illness is one of the health issues which has been prevalent in the United States for an extended period.
Various sources of risk are associated with chronic conditions that directly impact the success of this project.
These sources of risks fall under factors such as technical, managerial, commercial, and external risk factors.
Introduction
A chronic condition is a disease that endures along period. Chronic illness is one of the health issues which has been prevalent in the United States for an extended period. However, multiple sources of risk are associated with chronic conditions that directly impact the success of this project. These sources of risks fall under factors such as technical, managerial, commercial, and external risk factors.
*
Sources of Technical Risk Factors
Technical risk factors in this project are associated with factors such as:
Scope definition in the study
Research design
Research of information (Cachada et al., 2019)
Methods used to conduct the research study
Sources of Technical risk factors
Technical risk factors in this project arise from issues or activities associated with the scope definition, research design, research of information, and methods used to conduct the research study. In this case, conduction research to know more about chronic conditions in the State of Florida will involve in-depth scope definition to understand more the status of chronic illness in the State of Florida (Cachada et al., 2019)
.
*
Sources of Managerial Risk Factors
Managerial risk factors in this project arise from management decisions that affect the flow of performing operations of the activity (Cachada et al., 2019).
Sources of managerial risks affecting the success of this project include the following factors:
Cost factors
Legal factors
Legal factors
Sources of managerial risk factors
Managerial risk factors in this project arise from management decisions that affect the flow of performing operations of the activity. The primary source of such risk includes cost factors, which escalates the cost of conducting a project due to the inability to make proper cost estimations.
Schedule factors is another source of risk that affect how activities of the project should be conducted (Cachada et al., 2019). In the research study, the schedule of performing on the status of chronic illness in the State of Florida will be timed to collect enough information to help in making proper decisions.
Legal risk factors is another set of sources of managerial risks that are likely to affect the effectiveness of this research. These factors arise from regulatory obligations such as contract risks that approve the use of chronic condition data to perform a research project. This set of risks will.
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104 PART ONE DIRECTING THE OPERATION
● Implementation – the way that strategy is operationalized or executed. Three issues are
often mentioned by strategy practitioners as being important in achieving successful
implementation: the clarity of the strategy, the nature of the leadership provided by top
management, and effective project management.
● Monitoring – involves tracking ongoing performance and diagnosing data to make sure
that the changes are proceeding as planned and providing early indications of any devi-
ation from the plan.
● Control – involves the evaluation of the results from monitoring the implementation so
that activities, plans and performance can be assessed with the intention of correcting
future action if that is required.
CASE STUDY McDonald’s: half a century of growth 13
It is loved and it is hated. It is a shining example of how
good-value food can be brought to a mass market. It is a
symbol of everything that is wrong with ‘industrialized’, cap-
italist, bland, high-calorie and environmentally unfriendly
commercialism. It is the best-known and most loved fast
food brand in the world with more than 36,000 restau-
rants in 117 countries, providing jobs for 1.7 million staff
and feeding 69 million customers per day (yes, per day!).
It is part of the homogenization of individual national cul-
tures, filling the world with bland, identical, ‘cookie cutter’,
Americanized and soulless operations that dehumanize
its staff by forcing them to follow ridged and over-defined
procedures. But whether you see it as friend, foe, or a bit
of both, McDonald’s has revolutionized the food industry,
affecting the lives of both the people who produce food and
the people who eat it. It has also had its ups (mainly) and
downs (occasionally) as markets, customers and economic
circumstances change. Yet, even in the toughest times it has
always displayed remarkable resilience. What follows is a
brief (for such a large corporation) summary of its history.
Starting small
Central to the development of McDonald’s is Ray Kroc, who
by 1954 and at the age of 52 had been variously a piano
player, a paper cup salesman and a multi-mixer salesman.
He was surprised by a big order for eight multi-mixers
from a restaurant in San Bernardino, California. When
he visited the customer he found a small but successful
restaurant run by two brothers Dick and Mac McDonald.
They had opened their ‘Bar-B-Que’ restaurant 14 years
earlier, and by the time Ray Kroc visited the brothers’ oper-
ation it had a self-service drive-in format with a limited
menu of nine items. He was amazed by the effectiveness
of their operation. Focusing on a limited menu including
burgers, fries and beverages had allowed them to analyse
every step of the process of producing and serving their
food. Ray Kroc was so impressed that he p.
SolarComm Communication and Collaboration Team BiographiesName.docxrosemariebrayshaw
SolarComm Communication and Collaboration Team Biographies
Name: Sean Flannigan
Functional Group: Engineering
Title: Lead Power Systems Engineer
Location: Boston, MA
Years of Experience: 27
Education: PhD, University of Virginia
Skills: Leadership and employee management; project management; technology and risk assessment; financial modeling; budgeting; working knowledge of power systems and components; photovoltaic systems design; contract review and negotiation; working knowledge of regulations; and construction monitoring
Diverse Cultural Perspectives: Although he would not think of himself as privileged, Sean has progressed in his education and career by identifying goals and working hard until he achieved them. He attributes all of his success to his work ethic. Sean finds common ground with people most easily when they share his interests in science, math, and a functional design.
Characteristics: Analytical; creative; interested in mechanical and technical projects; performs well in technology-focused leadership roles; highly process-oriented; strong verbal and graphical communication skills; data-driven; and a scientific approach to decision making
Behaviors: Sean meets annual project requirements on time and budget. He and his team act autonomously and with minimal oversight in the field. He requests access to research findings, thorough documentation, and other evidence of efficacy before adopting a new product or process. He speaks candidly when he sees reason for concern. Because his work requires him to spend a lot of time managing a team in the field, he prefers brief, tactical phone calls instead of extended, strategy meetings.
Background: Sean has been a lead power systems engineer for 6 years. Before that, he spent 10 years as a systems engineer for a major utility company in the western United States, where he managed a large team of technicians. Prior to that, he was a respected research scientist at a large state institution. The other power systems engineers at SolarComm elected Sean to speak for them and defer to Sean if asked for more participation. They provided Sean with a year of records showing that a dozen essential components arrived behind schedule. Records also showed that four major components were not manufactured to specification. Many of the Engineers told Sean that SolarComm’s problems originated from poorly negotiated procurement agreements that do not penalize the manufacturer when problems occur.
Name: Irma Trujillo
Functional Group: Procurement
Title: Procurement Manager
Location: Austin, TX
Years of Experience: 6
Education: Bachelor of Science, Economics
Skills: Logistics and planning; thoroughly knowledgeable in SolarComm systems, including databases, presentation tools, and contracts database; able to understand and communicate highly technical information in a global, cross-functional, and multicultural work environment; and is fluent in English and Spanish
Diverse Cultural Perspectives: Alt.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Source for ArticleMilliken, A. (2018). Ethical awareness What .docx
1. Source for Article:
Milliken, A. (2018). Ethical awareness: What it is and why it
matters. OJIN: Online Journal of Issues in Nursing, 23(1),
Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved
from
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketp
lace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-
Jan-2018/Ethical-Awareness.html
Article:
Ethical Awareness: What It Is and Why It Matters
^ m d
Aimee Milliken, PhD, RN
Abstract
Given the complexity of contemporary healthcare environments,
it is vital that nurses are able to recognize and address ethical
issues as they arise. Though dilemmas and challenging
situations create the most obvious, dramatic risks to patients,
routine nursing actions have implications for patients as well.
Ethical awareness involves recognizing the ethical implications
of all nursing actions. Developing ethical awareness is one way
to empower nurses to act as moral agents in order to provide
patients with safe and ethical care. The aim of this article is to
provide an overview of the concept of ethical awareness and the
role it plays in patient care. Background information is
provided; three everyday scenarios highlight the importance of
ethical awareness in everyday nursing practice; followed by
additional discussion; and strategies for heightening ethical
awareness are suggested.
Citation: Milliken, A., (January 31, 2018) "Ethical Awareness:
What It Is and Why It Matters" OJIN: The Online Journal of
2. Issues in Nursing Vol. 23, No. 1, Manuscript 1.
DOI: 10.3912/OJIN.Vol23No01Man01
Key Words: ethical awareness, nursing ethics, ethical
sensitivity, moral sensitivity, critical care
Ethical awareness involves recognizing the ethical implications
of all nursing actions, and is the first step in moral action.
Given the complexity of contemporary healthcare environments,
it is vital that nurses are able to recognize and address ethical
issues as they arise. Ethical awareness involves recognizing the
ethical implications of all nursing actions, and is the first step
in moral action (Milliken & Grace, 2015). This means that
nurses must first recognize the potential ethical repercussions of
their actions in order to effectively resolve problems and
address patient needs. The aim of this article is to provide an
overview of ethical awareness and its important role in ethical
nursing care. Three everyday scenarios highlight the importance
of ethical awareness in everyday nursing practice. Finally,
strategies for heightening ethical awareness in the clinical
setting are suggested.
Background
...nurses do not often recognize daily activities... as having
ethical implications.
Many scholars have addressed the ethical nature of nursing
practice (Austin, 2007; Erlen, 1997; Milliken & Grace, 2015;
Truog et al., 2015; Ulrich et al., 2010). Though nursing ethics
education often focuses on dilemmas and challenging situations
(Truog et al., 2015; Zizzo, Bell, & Racine, 2016), ethical
awareness involves recognizing that every nursing action has
the potential to impact the patient, even routine daily actions
(Grace & Milliken, 2016; Milliken, 2016; Milliken, 2017a;
Milliken & Grace, 2015). Recent work suggests that this
awareness may be lacking, and that nurses do not often
recognize daily activities (e.g., taking vital signs, administering
medications, or starting an intravenous line) as having ethical
implications (Krautscheid, 2015; Milliken, 2017a; Truog et al.,
2015). This trend is problematic, and may put patients at risk
3. for harm.
Nursing goals encompass the “the protection, promotion, and
restoration of health and well-being; the prevention of illness
and injury; and the alleviation of suffering, in the care of
individuals, families, groups, communities, and populations”
(American Nurses Association [ANA], 2015, p. vii). For a
nursing action to be considered ethical, it should be aimed at
promoting the goals of nursing in conjunction with the
patient’s wishes. Using the language of ethics, the goals of
nursing can be broadly categorized into actions aimed at
promoting the four major ethical principles. These principles
are autonomy (the right to self-determination); beneficence
(promotion of good); maleficence (avoidance/minimization of
harm); and justice (fairness/equal distribution of benefits and
burdens) (ANA, 2015; Beauchamp & Childress, 2009).
Awareness ideally leads the nurse to take action to practice in
the most ethically acceptable way.
If an action is in conflict with a nursing goal or one of these
principles, or if it ignores a patient’s preferences, the nurse
risks acting unethically. Ethical awareness involves recognizing
the risk that nursing actions could fail to adhere to the goals of
nursing, thereby violating an ethical principle. Awareness
ideally leads the nurse to take action to practice in the most
ethically acceptable way (Milliken, 2016; Milliken, 2017a;
Milliken & Grace, 2015).
Research has suggested that nurses often feel unprepared to
manage ethical challenges they face in practice (Austin, 2016;
Rodney, 2017; Woods, 2005), resulting in possible moral
distress and burnout. Ensuring that nurses have the tools to
manage difficult situations is one way to mitigate this concern
(Jurchak et al., 2017). Ethical awareness is important for nurses
to develop as part of the larger skill set of ethical competence
(Grace & Milliken, 2016; Kulju, Stolt, Suhonen, & Leino-Kilpi,
2016; Lechasseur, Legault, & Caux, 2016). The following
everyday scenarios highlight the importance of ethical
awareness, and focus on the role it plays in day-to-day nursing
4. care. In the interest of confidentiality, these cases are not actual
occurrences, but constructed scenarios that represent common
challenges.
Ethical Awareness: Everyday Scenarios
Even everyday clinical situations require careful consideration
of ethical risk.
Even everyday clinical situations require careful consideration
of ethical risk. Though the risk may seem low at the outset, the
following scenarios highlight the way that even routine
situations can have profound ethical implications for patients.
While there are many ways to conduct an ethical analysis, the
focus here will be on the four primary ethical principles
foundational to nursing practice (defined above) and how they
relate to the scenarios. For the purpose of illustration and
discussion, these scenarios assume nurses who could benefit
from a higher level of ethical awareness, to include potential
everyday challenges, as opposed to higher profile cases more
commonly discussed in the literature (e.g., initiation of
feedings/ventilation).
Scenario One
Mr. M is an 85-year-old man admitted to the neurological
intensive care unit (ICU) after developing a subdural hematoma
due to a recent fall. Mrs. M (his wife) asks to spend the night in
her husband’s room, as she is concerned he may become
distressed if she leaves. The rules in the ICU prohibit family
members from staying overnight, unless the patient is actively
dying. Citing this rule, John, the ICU nurse, sends Mrs. M
home. Overnight, Mr. M becomes acutely agitated, requiring
wrist restraints and repeated doses of intravenous sedatives.
This case suggests several possible ethical concerns. First, it
appears as though John, the nurse, has acted based on routine.
In this sense, we may be concerned that John has not fully
considered Mr. M’s possible unique interests in this case. This
relates to John’s ethical obligation to promote Mr. M’s
autonomy, and involves considering the question: what would
be best for Mr. M, given his clinical situation and what we
5. know about his goals and values? A second ethics-related
concern has to do with John’s obligation to promote good
(beneficence) and to prevent harm (non-maleficence). The harm,
in this case, would be Mr. M’s increase in agitation and the
possible need for restraints and sedation.
Ethical awareness would have helped John to recognize the
range of potential ethical implications of his decisions as they
relate to the possible concerns.
Ethical awareness would have helped John to recognize the
range of potential ethical implications of his decisions as they
relate to the aforementioned concerns. In other words, ethical
awareness would enable John to have a more holistic view of
Mr. M’s predicament and may allow him to develop a plan of
care more in line with this view. In a patient such as Mr. M,
with a neurological injury, minimizing the need for sedation and
restraints is preferable, both ethically and clinically, as any
change in neurologic status may be cause for concern.
In viewing the situation with this lens, John may have decided
to let Mrs. M stay, despite the unit routine, thus promoting Mr.
M’s autonomy. This decision also aligns with John’s obligations
related to beneficence and non-maleficence. Allowing Mrs. M to
stay on the unit may minimize the risk of agitation if her
presence helped soothe her husband. This action may have
successfully prevented use of more restrictive measures (i.e.,
restraints and sedation), thereby promoting a better outcome
(beneficence) and mitigating potential harm.
Scenario Two
Mr. L is a 50-year-old man admitted for gastrointestinal (GI)
bleeding. After a couple of days his hematocrit is still low and
his physician tells him that he is not ready to be discharged
today. Mr. L becomes angry and tells the team he wants to leave
against medical advice (AMA). His nurse, Susan, and his
physician outline the risks of leaving, including the risk of
rebleeding, but he insists and leaves the hospital. That night,
Mr. L ends up back in the Emergency Room with profuse GI
bleeding.
6. ...the provider’s obligation to promote the patient’s best
interests may outweigh the patient’s desire to act autonomously.
While leaving AMA is often viewed as a patient right based on
the principle of autonomy, it is also necessary to consider
whether the patient is putting himself at undue risk for harm.
When the risks of a situation outweigh the possible benefits, the
provider’s obligation to promote the patient’s best interests may
outweigh the patient’s desire to act autonomously (Grace,
2014). Thus, the ethics worry in this case relates to the potential
conflict between Susan’s ethical obligation to promote good
(beneficence) and Mr. L’s right to autonomy.
To promote Mr. L’s ability to act autonomously in the future, it
is necessary to minimize the potential harm to which he exposes
himself in the present.
To promote Mr. L’s ability to act autonomously in the future, it
is necessary to minimize the potential harm to which he exposes
himself in the present. Ethical awareness would help Susan
recognize this responsibility. To address this obligation, Susan
could try to talk through the situation in greater depth with Mr.
L in an effort to uncover the reasoning behind his desire to
leave. There may be additional factors of which Susan is
unaware that are contributing to Mr. L’s anger. If these reasons
are explicated, perhaps they can arrive at a compromise to
appease Mr. L, while keeping him medically safe.
Additionally, Mr. L’s clinical picture includes a low hematocrit.
This factor may be negatively impacting his decision-making
abilities. Susan may wonder whether Mr. L is truly making an
autonomous decision, which would require that he fully
understands and is able to use reason to determine the potential
long-term outcomes of leaving the hospital. Susan could further
explore these concerns to ensure that Mr. L’s decision to leave
is actually fully informed. Should she reach an impasse, she
may consider seeking additional resources to keep Mr. L safe,
including involving psychiatry and possibly an ethics consult.
Scenario Three
Emily is a new nurse on a medical-surgical unit. She has a busy
7. assignment, and is behind on documentation. She has her
patients’ vital signs on a piece of paper in her pocket but has
not written them in the chart. However she is happy to see her
hypertensive patient, Mrs. O, is now normotensive.
The medical team rounds on Mrs. O without Emily, and sees
that the most recent blood pressure (BP) documented in the
chart is still elevated. They order an increase in Mrs. O’s
antihypertensive medications, not realizing her BP is has now
normalized (since Emily has not yet charted it). In an effort to
help Emily catch up, a nurse colleague gives Mrs. O the new
dose of medication. An hour later Mrs. O becomes diaphoretic
and dizzy. When Emily rushes in to re-check her blood pressure,
she is hypotensive.
Because Emily was behind, the plan of care was changed based
on old data, putting Mrs. O in a dangerous situation. Though
Emily had good intentions, her patient was given an improper
dose of medication. Using ethics-language, Emily was unable to
provide beneficent (good) care, and her patient suffered a
potential harm. Nurses often fall behind during the course of a
shift; this is a reality of practice. However, this scenario
demonstrates that even something as simple and routine as
charting vital signs has potential ethical implications. Falling
behind, and being unable to perform necessary duties, can result
in potential harm.
An additional ethics worry is that Emily was so busy that she
missed rounds with the medical team. This means Emily did not
have the ability to fully update the team about Mrs. O’s
progress and to raise any potential concerns or considerations
for the plan of care. This represents a lost opportunity to
advocate for her patient. Advocacy is an important component
of the duty to promote autonomy, particularly when patients are
in a position where they cannot make their own needs or wishes
known, or when patients may not have all the necessary
information to make informed decisions.
... [Emily] has an ethical obligation address the situation that is
leading to her busyness.
8. Ethical awareness would have helped Emily recognize that,
based on her duty to promote good (beneficence), to advocate
for her patient (autonomy), and to prevent harm (non-
maleficence), she has an ethical obligation address the situation
that is leading to her busyness. The inability to meet her
patient’s needs may result in possible harm, as Mrs. O
experienced. This is not only a clinical problem or a possible
bad outcome; this is fundamentally ethical in nature. This
recognition may help Emily feel more confident in asking for
help. Ethical awareness also may prompt Emily to evaluate the
root cause of this issue, so that she (and possibly others) could
avoid similar circumstances in the future.
Discussion
...increasing nurses’ ethical awareness to include the
implications of everyday decisions is important to maximize
safe, ethical patient care.
These three scenarios highlight the importance of recognizing
that even routine and seemingly mundane nursing actions can
have major implications for patients. As noted, nurses have
professional goals and related ethical obligations that should
guide nursing practice. However, routine practice actions may
not always be viewed through this lens. This lack of recognition
is in no way malicious or intentional; it stems from lack of
awareness. Consequently, it becomes clear that increasing
nurses’ ethical awareness to include the implications of
everyday decisions is important to maximize safe, ethical
patient care.
An awareness of the ethical components of a situation ideally
should prompt nurses to take action (Milliken, 2016; Milliken &
Grace, 2015). The scenarios above demonstrate how heightened
ethical awareness may have helped clarify the way that these
nurses thought about the implications of their decisions. This
perspective may have helped them view the scenarios more
completely, and be sensitive the possible range of actions they
might have taken (Rest, 1982). In other words, had the nurses in
these cases recognized that their patients were at risk, they may
9. have been more likely to intervene or take proactive measures.
...ethical awareness is an important first step in sustainable,
optimal ethical practice.
Such a proactive measure, or intervention, is called “moral
agency.” The nurse recognizes a potential ethical issue, and acts
to resolve it. In addition to willingness and ability to take
action, moral agency requires that nurses embody this
perspective in practice, recognizing that as a profession, we
have an obligation to act as agents on behalf of patients
(Liaschenko & Peter, 2016; Musto & Rodney, 2016). Embracing
one’s role as a moral agent in this way can facilitate resilience,
or an individual nurse’s ability to learn and grow from
challenging clinical situations that may cause distress (Rushton,
2016b). Consequently, ethical awareness is an important first
step in sustainable, optimal ethical practice.
The important role of ethical awareness in patient care suggests
that individual nurses, as well as nurse leaders and healthcare
organizations, hold the responsibility to develop this important
skill. Strategies to heighten ethical awareness in the clinical
setting have been discussed in depth elsewhere (Milliken,
2017b). Briefly, these include interventions targeted at the
individual, unit, and organizational level. For example,
individual nurses can improve ethical awareness by developing
ethical competence, or overall ethical understanding and skill-
set (Kulju et al., 2016; Lechasseur et al., 2016). Participating in
ethics-related discussions, utilizing available ethics resources
(Milliken, 2017b), and becoming familiar with the ANA Code
of Ethics for Nurses with Interpretive Statements (Code of
Ethics) are several ways of developing ethical competence.
The ANA Code of Ethics (2015) establishes the “ethical
standard for the profession” (p. vii) and serves as the
profession’s “non-negotiable ethical standard” (p. viii). The
nine provisions outline the expectations to which nurses, as
professionals, must adhere. The Code of Ethics emphasizes that
the scope of ethical nursing practice extends far beyond the
nurse’s role in challenging dilemmas. Recent work suggests that
10. many nurses may be unfamiliar with the Code of Ethics
document (Heymans, Arend, & Gastmans, 2007; Milliken,
2017a). Nevertheless, familiarity with this document has been
identified as an essential part of preparation for ethical practice
and should serve as a foundational step to develop ethical
awareness (Grace & Milliken, 2016).
At the unit and organizational-level, nurse leaders can create
opportunities for individual nurses to develop moral agency and
resilience (Milliken, 2017b). These opportunities may include
unit-based ethics rounds; in-services; formal and informal ethics
training; and participation in interprofessional education
(Hamric & Wocial, 2016; Milliken, 2017b; Rushton, 2016b).
Nurse leaders can also model and contribute to shifting values
toward an organizational culture that supports ethical awareness
and ethical practice (Hamric & Epstein, 2017; Liaschenko &
Peter, 2016). This requires attention to unit-specific issues
(e.g., complex patient populations and staffing issues) and
creation of platforms for nurses and other healthcare providers
to participate in regular discussions about ethics and ethical
issues (Hamric & Wocial, 2016; Liaschenko & Peter, 2016;
Milliken, 2017b).
Interventions such as these can foster individual and collective
ethical awareness. Keeping ethics at the forefront of
conversation, in this way, can help to better ensure that patient
needs are met. It may also help nurses facing everyday, yet
challenging situations, like those in the case scenarios, to feel
more confident in decision making and in their ability to access
ethics-related resources at the moment of concern.
Conclusion
Developing and fostering ethical awareness fundamentally
requires recognition that ethics is in everything that we, as
nurses, do.
Developing and fostering ethical awareness fundamentally
requires recognition that ethics is in everything that we, as
nurses, do (Austin, 2007; Milliken & Grace, 2015; Truog et al.,
2015; Ulrich et al., 2010). While dilemmas and challenging
11. situations create the most obvious, dramatic risks to patients,
routine actions have implications for patients as well.
Consistent recognition of the ethical implications of nursing
actions will, ideally result in care that more consistently
supports patient goals and preferences, and is also aligned with
the ethical obligations of the nursing profession (Milliken &
Grace, 2015). Developing ethical awareness is one way to
empower nurses to act as moral agents to provide patients with
safe and ethical care.
Source for article:
Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost
containment: Considerations to enhance RN practice. OJIN:
Online Journal of Issues in Nursing, 23(1), Manuscript 6.
doi:10.3912/OJIN.Vol23No01Man06. Retrieved from
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketp
lace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-
Jan-2018/Ethical-Nursing-Cost-Containment.html
Article:
Ethical Nursing Care Versus Cost Containment: Considerations
to Enhance RN Practice
^ m d
Paula Kelly, MScN, BScN, RN
Caroline Porr, PhD, MN, RN
Abstract
Registered nurses (RNs) are constantly challenged to provide
quality nursing care while resources are chipped away,
sometimes along with their energy, pride, and ability to provide
holistic patient care. Many experience frustration and a sense of
powerlessness to change their circumstances. We discuss
working in a restructured healthcare system and demonstrate
12. how the business model of healthcare routinely undermines the
professional knowledge of RNs and their ethical mandate to
provide individualized patient-centered care, often causing
tensions, strains, and ethical conflicts. As such, many RNs
experience chafing and displaced aggression that is harmful to
themselves and the nursing profession, and offer suffer in
silence. We offer a call to speak up and out, and conclude with
recommendations to assist RNs to understand the realities of
their work life and improve their practice environments.
Citation: Kelly, P., Porr, C., (January 31, 2018) "Ethical
Nursing Care Versus Cost Containment: Considerations to
Enhance RN Practice" OJIN: The Online Journal of Issues in
Nursing Vol. 23, No. 1, Manuscript 6.
DOI: 10.3912/OJIN.Vol23No01Man06
Key Words: aggression, business model, ethics, frustration,
health resources, holistic care, knowledge, patient/family-
centered care, quality of healthcare
Hartrick Doane and Varcoe (2015) shared a story centered
around a chipped coffee cup in their ground-breaking text, How
to Nurse. The story setting is the transfer of accountability
report. Registered nurses (RNs) are listening to the recorded
report from the previous shift when five minutes into the report,
one RN who had worked the night shift stormed into the room,
slammed down a coffee cup and shouted, “Who chipped my
cup?” A stunned silence from co-workers ensued. Getting no
response, the RN shouted, again, “I want whoever did this to
own up to it now!” Co-workers were immediately shocked and
displayed a look of disbelief at the inappropriateness of her
behavior; however, after exploring the outburst further, they
discovered she had cared for a number of very ill patients with a
novice RN for the entire 12-hour shift. Consequently, some
patient care was left for the day shift staff to complete (Hartrick
Doane & Varcoe, 2015, p. 411-412).
...emotions from small, inconsequential, and even petty events
accumulate over time and contribute to negative work
environments.
13. This story may appear trivial and insignificant to some;
however, when it is unpacked, it can symbolize how emotions
from small, inconsequential, and even petty events accumulate
over time and contribute to negative work environments. This
story resonated with us because we believe it is a realistic
depiction of the current work life of RNs in hospitals across
Canada. Analogous to the chipped coffee cup, RNs are
constantly challenged to provide quality nursing care, while
resources are chipped away, in addition to their energy, pride,
and ultimately, their capacity to fulfill holistic patient and
family healthcare needs (Hartrick Doane & Varcoe, 2015). RNs
undoubtedly experience frustration, exasperation, and a sense of
powerlessness to change their circumstances, at least some of
the time.
We further discuss how RNs routinely experience subordination
and displacement (Campbell & Rankin, 2016; Rankin &
Campbell, 2009; Rankin & Campbell, 2006) of their
professional nursing judgment and knowledge by healthcare
organizations despite knowing what is needed for the patients
for whom they care. We demonstrate how use of standardized,
efficient, and cost effective care routinely trumps the
professional and ethical mandate of RNs to provide
individualized patient-centered care. For example, many
Canadian hospitals use care pathways to standardize clinical
practice (Rotter, et al, 2013) and direct crucial interventions to
occur at certain intervals throughout patients’ hospitalization
(Rankin & Campbell, 2009). Rankin (2014) describes a situation
on a surgical unit whereby a standardized care pathway does not
adjust to the individual and complex needs of patients.
The silence of RNs leads many to experience tension and
frustration, which can trigger displaced aggression harmful to
themselves and the profession as a whole.
We argue that working within the business model of healthcare
silences and prevents RNs from voicing what is the right or best
way to care for patients; it also unconsciously supports a culture
of acceptance and suppresses nursing knowledge. The silence of
14. RNs leads many to experience tension and frustration, which
can trigger displaced aggression harmful to themselves and the
profession as a whole.
It is time for members of the profession to speak up, support,
and mentor those who speak out against the dominant culture
and organizational discourse. It is necessary to expose the
realities of the working lives of RNs in order for them to make a
significant contribution to the health and well-being of patients.
In this article, we discuss working in a restructured healthcare
system and demonstrate how the business model of healthcare
routinely undermines the professional knowledge of RNs and
their ethical mandate to provide individualized patient-centered
care, often causing tensions, strains, and ethical conflicts. We
offer a call to speak up and out, and conclude with
recommendations to assist RNs to understand the realities of
their work life and improve their practice environments.
Registered Nurses Working in a Restructured Healthcare System
Within the past few decades of healthcare reform we have
witnessed healthcare organizations shift from a treat-heal-care
model to a more corporate or business paradigm...
Within the past few decades of healthcare reform we have
witnessed healthcare organizations shift from a treat-heal-care
model to a more corporate or business paradigm, with emphasis
on efficiency and cost outcomes as opposed to patient outcomes
(Grinspun, 2000). This shift occurred in response to a variety of
challenges, namely the mandate for public administrators to
maintain an efficient, effective, and equitable system of
healthcare delivery (Rankin & Campbell, 2006).
Medicare, Canada’s national health program, came under
intense scrutiny in the 1990s. Provincial health system reviews
highlighted Medicare services as too high and not sustainable
(Rankin & Campbell, 2006). Each province was directed by the
federal government to improve the quality and efficiency of
healthcare services through managerial reform, using limited
resources more effectively. Provinces responded in various
ways by closing and merging hospitals; reducing bed numbers;
15. and cutting staffing levels. A move to have acute patients out of
hospitals more quickly to recover at home with family
assistance was initiated (Rankin & Campbell, 2006). Hospitals
also employed new ways of managing patient flow and clinical
treatment decisions (Grinspun, 2000; Rankin & Campbell,
2006).
Product-line management, originating from the manufacturing
industry was viewed as an approach that could provide the
necessary tools and structures to meet the demands of reduced
funding. Cost-contained healthcare thinking traces its roots
back to the work of American engineer W. Edwards Deming,
who worked with Japanese industry leaders to rebuild their
economy in the post-World War II era (Mann, 1989). Deming’s
message was a focus on quality and continuous improvement to
improve productivity, reduce costs and improve business
success. This approach to healthcare was introduced in Canada
as “patient-centered care” (Grinspun, 2000, p. 31). However,
institutional focus on cost-saving measures has resulted in
neglect and a lack of health promotion for patients and families
(Campbell & Rankin, 2016; Grinspun, 2000; Rankin, 2014).
...RNs are the health professionals who gain understanding of
unique patient needs that are so critical to health, healing, and
recovery.
RNs working within this business model of healthcare must
learn to adapt and practice under the auspices of a care delivery
model that is antithetical to philosophical principles learned in
nursing school, including patient-centeredness and holism.
Through daily contact with their patients, RNs are the health
professionals who gain understanding of unique patient needs
that are so critical to health, healing, and recovery. Besides
Carper’s (1978) well documented empirical, aesthetic, personal,
and ethical ways of knowing, RNs use embodied knowledge
(i.e., what they know and learn from being with and caring for
patients and their families), often referred to as knowledge in-
action, that is partly explicit and often difficult to describe
(Blackler, 1995). RNs use their specialized body of professional
16. knowledge to attend to and care for people’s physical bodies
and mental health (Cameron, 2006; Rankin & Campbell, 2009).
The business model requires a reductionist, standardized
approach to care delivery...
The business model requires a reductionist, standardized
approach to care delivery accompanied by often inflexible
organizational policies, regulations, and operating procedures.
There is little room for tailoring healthcare to accommodate
unique or holistic patient needs, offering a harsh and
constraining reality for RNs, and ultimately, their practice
norm. Through a process of socialization within the
organizational culture, RNs find themselves providing
routinized nursing care, all the while practicing in juxtaposition
with the ideals learned in nursing school. Anecdotal accounts
and empirical studies increasingly attest to the growing tension,
strain, and ethical conflicts experienced by RNs today.
Tensions, Strains, and Ethical Conflicts
Chafing occurs especially when RNs know what is the best care
for their patients, yet their professional knowledge about how to
meet unique and holistic patient needs is subjugated by
organizational policies and processes...
The Canadian Nurses Association (CNA) (2013) asserts that
“the nurse’s role as a direct service provider is to be uniquely
connected with patients and families in all health and illness-
related events throughout the lifespan” (p.3). It seems as though
healthcare reform has perpetuated a disconnect amongst the
vision, mandate, and values of the nursing profession and
everyday RN practice. RNs have shared that their nursing care
“chafes” (Rankin & Campbell, 2009, p.15) or rubs up against
institutional cost-containment objectives. Everyday work life
evokes feelings that some have disclosed as “feels like hell”
(p.10). Chafing occurs especially when RNs know what is the
best care for their patients, yet their professional knowledge
about how to meet unique and holistic patient needs is
subjugated by organizational policies and processes (i.e.,
implementation of standardized clinical care pathways).
17. Rankin and Campbell (2009) studied how patient care is
compromised with the use of such standardized approaches to
care. Clinical care pathways direct discharge plans that
frequently result in premature discharge for patients, who often
still have significant needs. RNs in Rankin and Campbell’s
study attempted to provide makeshift temporary plans and teach
patients about self-care and medication administration and side
effects under hurried circumstances. We suggest that
individualized expert nursing care is being chipped away at by
the use of these standardized clinical pathways. Why are RNs
not speaking up to voice the concerns they have regarding
patient care?
The Silence is Deafening
The CNA Code of Ethics for Nurses (2017; hereafter referred to
as Code of Ethics) serves as a foundation for ethical nursing
practice. It is designed to assist RNs to practice ethically and
work through ethical challenges that surface in practice with
individuals, families, communities, and public health systems.
This code also serves as an ethical basis from which RNs can
advocate for delivery of safe, compassionate, competent, and
ethical care, and promote the health and well-being of
individuals for whom they care. However, it is vital for a code
of ethics to influence behaviors without organizational and
policy barriers (Anand, Ashforth & Joshi, 2005).
Healthcare organizations are not always designed to support the
Code of Ethics; the business model of healthcare encourages
RNs to act in ways that accommodate and advance institutional
cost savings, accept organizational norms, and maintain status
quo (Johns & Saks, 2014; Rankin & Campbell, 2006). What is
preventing RNs from advocating for patients and making their
concerns known regarding their inability to provide optimal
nursing care?
Critical to the success of lean implementation is the trust,
support, cooperation, and input of everyone in the
organization...
The Toyota Production System (TPS), or more generically “lean
18. manufacturing,” is based on the concept of standardized work
(i.e., an assembly line with everyone doing the same job exactly
the same way) with a constant focus on continuous improvement
(Mann, 1989). Critical to the success of lean implementation is
the trust, support, cooperation, and input of everyone in the
organization, especially those doing the job, the frontline
assembly workers (Martin, 2012). Early discussions of applying
lean principles in healthcare settings were started by Dr. Dennis
Berwick (1989). Berwick called on the field to adopt a focus on
continuous improvement by empowering frontline healthcare
workers and called for understanding and revision of processes
rather than placing blame on an individual.
Disengaged RNs distance themselves from their own expert
nursing knowledge and judgment in order to perform in keeping
with organizational mandates.
Employee silence exists when there is widespread reluctance to
speak up about critical issues of concern, such as those
experienced by RNs within healthcare institutions. Some keep
quiet out of fear of punishment and in the interest of
maintaining group consensus and cohesiveness. Other RNs feel
pressure to silence their concerns due to organizational or
professional factors that support the status quo (Mitchell &
Ferguson-Pare, 2002) and therefore become disengaged
(Hartrick Doane & Varcoe, 2015). Disengaged RNs distance
themselves from their own expert nursing knowledge and
judgment in order to perform in keeping with organizational
mandates. Other RNs may fear negative labels or believe
organizations will fail to listen to their concerns (Morrison &
Milliken, 2003). Sinclair (2000) cited a judge who was amazed
by how physicians and managers “ignored pertinent information
that was brought to their attention by RNs” (p. 485). Similarly,
Sibbald (1997) described how knowledgeable and expert RNs
voiced serious concerns about patient safety in a pediatric
cardiac program, but were routinely silenced by the
organization and physicians.
Employee status within organizations also influences their
19. decision to remain silent. Newton et al. (2012) illustrated how
RNs had to “accept unsafe conditions;” learn to “suck it up;”
“just accept this is the way it is;” and felt like they were being
“blown off” when they encountered situations deemed unsafe or
unethical (p.97). If employees repeatedly witness situations
where their voices have no impact on outcomes, they become
disenchanted, discouraged, and frustrated (Ashford, Sutcliffe &
Christianson, 2009).
Suffering in Silence
Milliken, Morrison, and Hewlin (2003) described how employee
silence can create stress, frustration, dissatisfaction, cynicism,
and disengagement. These outcomes have serious long-term
consequences for employees and for their relationship within
the organization. Newton et al. (2012) supported this assertion,
reporting that the RNs in their study felt “beaten down” (p.97)
and predicted that they would choose to remain silent if they
encountered a similar situation in the future.
A constant state of frustration, tension and “chafing” builds and
can be displayed as displaced aggression...
RNs who experience ethical tensions and contradictions
between institutional policies and what they believe is the
“correct” thing to do often encounter ethical distress, which can
interfere with their ability to provide safe, ethical nursing care
(Rodney, Hartrick Doane, Storch, & Varcoe, 2006). The quality
of the practice environment is an ethical issue because of its
important effect on the quality of patient care (Aiken, Clarke,
Sloane, Lake, & Cheney, 2008; CNA, 2017; CNA, 2008; Kramer
& Schmalenberg, 2008). It also affects RNs’ sense of health and
well-being in the workplace (Peter, Macfarlane & O’Brien-
Pallas, 2004). For example, Hanna (2004) described how RNs
were physically impacted by unresolved ethical issues. They
spoke of sleeplessness, nausea, migraine headaches,
gastrointestinal upset, tearfulness, and a sense of isolation.
If an organization fails to support ethical practice, RNs may
become apathetic or disengaged to the point of being unkind,
non-compassionate, or even cruel to other healthcare workers
20. and to persons receiving care (CNA, 2008; Rodney et al., 2002;
Rodney et al., 2006; Storch et al., 2009). Such
counterproductive behaviors are often expressed with lateral
violence, incivility, or bullying and are considered a result of
RNs’ inadequate interprofessional skills, for which they blame
themselves (Rankin & Campbell, 2009).
Displaced aggression generally occurs when a person is
constrained from reacting to the source of the frustration.
A constant state of frustration, tension and “chafing” builds and
can be displayed as displaced aggression as outlined by
Bushman, Bonacci, Pedersen, Vasquez, & Miller (2005).
Displaced aggression generally occurs when a person is
constrained from reacting to the source of the frustration. In the
case of the RN reacting to the chipped cup, her feelings of
powerlessness and inability to remedy such situations, coupled
with her status within the healthcare hierarchy, could have
triggered behaviors of aggression and incivility toward
colleagues (Hartrick Doane & Varcoe, 2015).
Time to Speak Up and Out!
Functioning within healthcare organizations where the main
goals are cost containment, efficiencies, and effective care
significantly impacts the ability of RNs to function as
autonomous professionals in keeping with their professional
knowledge, ideals, values and scope of practice. RNs can
clearly articulate the deep gaps amongst what constitutes good
patient care; what actually transpires; and how care is
constrained by barriers such as organizational policies,
resources, and staffing ratios (Hartrick Doane & Varcoe, 2015).
RNs, however, believe their conversations are simply “blowing
off steam” in the coffee room and often end up blaming each
other and/or interpreting their emotional turmoil as a personal
limitation (Hartrick Doane & Varcoe, 2015).
Although RNs have much to say, they may not make their views
known as individuals or professional nursing associations. RN
silence and hesitancy to voice professional opinions related to
healthcare provision contributes to the notion of acceptance,
21. and that RNs have nothing to offer about such matters (Perron,
2013). Buresh and Gordon (2006) contended that RNs are
inclined to assume no one will listen or take their concerns
seriously. Continued silence by RNs inadvertently sustains
adverse conditions detrimental to patients and families, and
themselves. This culture of silence has unknowingly created a
culture of acceptance, and continues to supress nursing
professional knowledge. Unfortunately for many, such
conditions result in sickness, fatigue, stress, workplace
bullying, and some RNs decide to leave the profession.
Springer and Clinton (2017) attribute such silence to the lack of
parrhesiastic nursing leaders. Parrhesiastic is a term coined by
the late French philosopher Michel Foucault (2001) to describe
“one who speaks the truth: (p. 11) and "is sincere and says what
is his opinion” (p.12) and does so through courage and
commitment in opposition to dominant discourses (Springer &
Clinton, 2017). Although professional bodies do address work
environment concerns, this support also can be strengthened and
nurses may be unaware of association level support resources.
This silence has created a culture of acceptance and
maintenance of the status quo. Nursing leaders (i.e., nurse
managers, nursing directors, professional nursing associations,
union heads) tend not to take strong, consistent stands on issues
related to work environment. How often do we hear our nursing
leaders speak out in support of RNs and the ethical issues they
face every day in the institutions in which they work?
To advance the profession, all RNs must lead by example.
Some institutional nursing leaders over identify with the
healthcare organization commitment at the expense of RNs who
work and care for patients and their families (Springer &
Clinton, 2017). To advance the profession, all RNs must lead by
example. They must mentor and support parrhesiastic nursing
leaders who speak out and reveal the realities in which RNs
work if the profession is going to be recognized as a significant
contributor to the health and well-being of individuals, families,
and communities (R.A. Springer, personal communication,
22. August 8, 2017).
Recommendations and Conclusion
As medical and organizational dominance continues to prevail,
nursing knowledge and concerns are not always considered
equally important. RNs will likely continue to react and display
examples of displaced aggression over trivial occurrences such
as a chipped cup, unless more critical research is performed to
uncover the impact of organizational structures on the
relationship amongst ethical climate, moral distress, and the use
of voice (Newton et al., 2013). Healthcare organizations must
also recognize the value of RNs as legitimate contributors to
patient care. Promoting and maintaining quality work
environments is central to the ability of RNs to provide ethical
care.
Raising awareness of the disconnect that exists between
organizational agendas and the ethical obligation of nurses to
provide a certain standard of care may be the first step to
improve understanding...
Buresh and Gordon (2006) proposed that RNs are silent because
they lack the necessary skills to use their voice effectively.
Educating and supporting RNs in techniques that cultivate
effective and respectful communication during challenging and
difficult conversations is warranted. Resources such as those
from VitalSmarts (2017) offer training programs related to use
of essential and effective communication skills in complex work
environments. Healthcare organizations must promote an
atmosphere (regardless of one’s status) of speaking up and
voicing concerns in a style that maintains professionalism and
accountability. We have found documents written by the
Registered Nurses of Ontario (Heathy Work Environments Best
Practice Guidelines, 2007) and the American Association of
Critical Care Nurses (AACN Standards for Establishing and
Sustaining Healthy Work Environments: A Journey to
Excellence, 2016) that offer excellent guidelines to promote and
support positive workplace environments.
Nursing scholars need to build partnerships with RNs working
23. at the point of care. These fundamental relationships will assist
nursing scholars to complete vital research in these areas and,
more importantly, translate that knowledge in an easily
accessible and understandable way for RNs working at the point
of care. In other words, dissemination of research findings
involves moving beyond simple dissemination of knowledge
into actual use of knowledge. The majority of reputable nursing
journals provide excellent and detailed research that outlines
implications for RNs at all levels of healthcare, including
practice issues, patient care topics, healthcare professionals and
policy makers. However, few are written in formats easily
understood and accessible to RNs at the point of care.
Many RNs in clinical areas may not be familiar with research
methodologies. Moreover, if RNs are busy, overworked, and
fatigued from rotating shifts, they may not have the time or
energy to read and synthesize such vital material. It is therefore
up to nursing scholars to make this valuable knowledge readily
available and user-friendly for clinicians to use in practice.
Nurse scholars could translate research findings at nursing in-
services, nursing research conferences, nursing forums, or local
nursing unit journal clubs to highlight the relevance of these
studies to practice environments.
Nurse scholars should also disseminate research findings to
those RNs who participated in their studies by preparing a short
synopsis detailing the study findings. This provides RNs with
opportunities to convey nursing research reports to colleagues
and invites RNs at the point of care to voice ethical concerns by
providing empirical support related to the issues. For example,
in a study conducted on a nursing unit that explored ethical
nursing practice, Hartrick Doane and colleagues (2009)
developed positive working partnerships with participants. This
resulted in motivation for RNs to proactively voice concerns
regarding difficulties routinely faced while attempting to
provide ethical care in complex environments.
Increasing awareness about what is actually happening within
healthcare organizations might help RNs understand how they
24. may be subconsciously contributing to the subordination of
their knowledge. Instead of feeling powerless, this
consciousness-raising could transform RNs from disembodied,
docile, practitioners to ones active in developing ways to bring
about organizational change focused on health improvement and
well-being of patients and families.
...RNs can move from a culture of silence and acceptance to one
that encourages speaking up in a respectful and professional
manner.
Raising awareness of the disconnect that exists between
organizational agendas and the ethical obligation of nurses to
provide a certain standard of care may be the first step to
improve understanding by RNs about what is actually happening
within healthcare organizations. With this new awareness, and
education, RNs can move from a culture of silence and
acceptance to one that encourages speaking up in a respectful
and professional manner. Collaboration among all healthcare
providers, with consideration of the voice of RNs. will foster
positive work settings and ethical nursing care in cost contained
environments.
Acknowledgement: The first author would like to acknowledge
Mr. Aubrey Dawe and Mr. Bill Stirling for their edit
suggestions during the development of this manuscript.