According to Beer et al (1984), human resources management (HRM) has developed as a way to serve workers’ interests, albeit internally within the workplace. This challenges the role of worker advocacy.

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According to Beer et al (1984), human resources management (HRM) has developed as a way to serve workers’ interests, albeit internally within the workplace. This challenges the role of worker advocacy.

Historically, workers’ interests have been served by external representatives from labor unions, and have also been protected through government interventions such as laws and regulations. The purpose of this assignment is to understand the roles of unions and the role of HRM, and examine whether workers have adequate support and protections in the modern workplace. After reading the text chapters for Week One and Week Two and reviewing the resources provided:

Explain how unions, human resources management personnel, and government interventions (such as laws and regulations) serve to address worker rights and worker safety.
Evaluate whether unions and HRM have unique roles for different groups (i.e., the organization, management, and the workers) or if there are areas of overlap.
Assess the following statement, “Workers in the modern workplaces of America are well protected and well supported.” Explain whether you agree or disagree with this statement, based on what you now know about government interventions, unions, HRM, and worker advocacy. Be sure to support your agreement or disagreement with statements of reasoning from your analysis.
The paper must be four to five double-spaced pages in length (excluding the title and reference pages) and formatted according to APA style. You must use at least three scholarly sources (which can be found in the Ashford University Library) other than the textbook to support your claims. Cite your sources in text and on the reference page. For information regarding APA samples and tutorials, visit the Ashford Writing Center, within the Learning Resources tab on the left navigation toolbar, in your online course. In particular, it would be helpful for you to review the In-Text Citation Guide (Links to an external site.)Links to an external site., the APA References List (Links to an external site.)Links to an external site., and the APA Essay Checklist for Students (Links to an external site.)Links to an external site. to ensure you have all of the required components for this assignment.

Reference

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Essentials of Risk Assessment and Management

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Healthcare associated infections are infections that are acquired in hospital or any other healthcare setting. Healthcare associated infections (HAI’s) have an enormous effect on patient recovery and are estimated to cost NHS Scotland £180 million per year (The Scottish Government 2007). Infection control is based on common sense and on safe practice and can be implemented at a minimal cost. A large part of the hospital population are older adults and the increase in age play a huge part of the risk factor for infection (Gould and Brooker 2008). The risk of infection is particularly high where contact with healthcare staff and equipment occurs often and other patients may act as a source of infection (Wilson 2006). It is the intention of this essay to explain the importance of infection control in practice and the pathway of this will follow the five-step model of risk assessment (Health and Safety Executive 2006), which includes looking for the hazards, identifying who may be harmed and how, evaluating the risk, recording the findings and reflecting the importance of infection control.

The first step of the risk assessment model is to look for hazards and identify how infection control might spread within this environment. Many infections occur due to poor infection control within the hospital ward. Micro-organisms which are on and around a patient are inadvertently transferred to a vulnerable site on the same or another patient. Patients receiving healthcare are at increased risk of acquiring infection due to invasive procedures, devices or conditions that impair normal defences against infection. In addition, the healthcare environment provides plenty of opportunities for micro-organisms to transfer between patients and for antimicrobial resistant strains to emerge and spread (Wilson 2006). “An infection can develop if the links in the chain of infection are not interrupted” (Kozier 2008 p.225). The chain of infection being the causative agent, reservoir, portal of exit, mode of transmission, portal of entry and susceptible host. There are four main categories of micro-organisms, these being bacteria, viral, fungal and protozoa.

The second step of the risk model is to identify who may be harmed and in accordance with The Nursing and Midwifery Council (2008) code of conduct, nurses must respect people’s right to confidentiality. Therefore for the purpose of this essay the patient discussed is referred to as Mr. A, and any personal or identifiable information has also been altered so as to protect his privacy and dignity which are also enshrined in the Nursing and Midwifery Council (2008) code of conduct. Mr. A. was placed in a general medical ward within a large general hospital. The ward had a variety of medical complaints including diabetes, gastrointestinal disorders, stroke and alcohol liver disease. Mr. A. was an 81 year old man who already had vascular dementia but was admitted with increased confusion. He had a significant weight loss and his mobility was greatly reduced. Mr. A’s fluid intake was low and his diet was poor. Micro-organisms exist everywhere open to the outside and most are harmless and in fact beneficial to the essential functioning of the body. The extent to which any micro-organism is capable of producing an infection depends on the ability of the micro-organism to enter the body, the susceptibility of the host and the ability of being able to live in the host’s body (Kozier 2008).

People are the most common source of infection and in reference to Mr. A., he was particularly susceptible due to his reduction of food intake. His skin was suffering due to dehydration and undernourishment and being unable to keep the skin healthy does not promote its ability to repel micro-organisms. An adequate diet also helps to keep the immune system functioning well thus resisting any infections. Encouraging fluids helps to flush out the bladder and remove any micro-organisms that could cause infection (Kozier 2008). Having established where micro-organisms are found, the next step is to discover where they are transmitted from and in Mr. A’s condition where his immune system is low, micro-organisms could leave the body through the respiratory tract or gastrointestinal tract, for example, excretions from faeces or bodily fluids, droplets from coughing or scales or flakes of skin.

Kozier (2008) indicates that a method of transmission is required when a micro-organism leaves its source and this may be by direct transmission, indirect transmission or airborne transmission. Infection may spread through the hospital environment by means of direct transmission from person to person, as in touch or from mucous membranes by sneezing and coughing. Indirect transmission maybe from an infectious agent like handkerchiefs, flannels, surgical instruments, wound dressings, bedding or other vehicles of transmission as in water, blood, food, and serum. Airborne transmission may involve droplets or dust and usually enter the patient through the respiratory tract (Kozier 2008).

Before a person can become infected, micro-organisms must entry the body and the skin is a great barrier to infectious agents. As Mr. A’s skin was in poor condition, any break in the skin can serve as a portal of entry. Very often micro-organisms enter the body of the host by the same route they used to leave the source (Kozier 2008). The susceptible host is a person who is at risk of infection and Mr. A. was more likely or not to acquire an infection due to an number of factors including age, diet and mobility.

The most effective way of breaking the chain of infection is through frequent and thorough hand hygiene before and after contact with patients, body fluids and the near-patient environment. Other important considerations include high standards of basic hygiene and environmental cleanliness and the use of personal protective equipment (P.P.E.), that is disposable gloves and aprons. Ensure clinical equipment and personal items such as flannels and wash-bowls are clean and dry (Wilson 2006).

Evaluating the risk is the third step in the model of risk assessment and according to the Royal College of Nursing (2008) “Any infection acquired while in hospital receiving healthcare can lead to distress, disruption, disablement or even death for a patient” (Royal College of Nursing 2008 p.2). As with Mr. A., various activities can be undertaken to minimise the spread of infection. This must include a good knowledge of ways in which to reduce micro-organisms including correct cleaning and sterilising. Infection control training and regular updates should be made available as necessary (Nunkoo and Pickles 2008). Micro-organisms multiply in moist places and dirty dressings, damp and soiled linen are ideal places for this to happen. Urine and faeces also contain micro-organisms. Covering mouths and noses when sneezing and covering open wounds can limit the amount of micro-organisms that escape from the respiratory tract. All patients including Mr. A., may carry potentially infectious micro-organisms that can be transmitted to others, therefore the use of the proper protective equipment is important and hand washing crucial.

Wiseman (2006) suggests that although hand-washing is the most single element for preventing infection, it will not be successful unless proper decontamination of the equipment and environment is not done properly. Mr. A., may have less resistance to another persons micro-organisms than his own and any invasive procedures may penetrate the body’s natural barriers to micro-organisms. Open wounds are particularly vulnerable to infection and patients and nursing staff are at risk of being infected by needle-stick injuries. A number of factors to avoid the susceptibility to infection include an impairment to the bodies natural defences therefore eating a balanced diet with plenty fluids will help to maintain and build the integrity of the patient’s skin and body tissues.

The fourth step of the model is to record the findings and risk assessments should be made to identify procedures likely to involve a risk of infection to either Mr. A., other patients or nursing staff. Malnutrition Universal Screening Tool (MUST) is a nutritional assessment tool used to identify patients at risk of malnutrition. It is based on the body mass index (BMI), unintentional weight loss and the effect of the illness on the nutritional state of the patient (Kozier 2008). Nurses performed a nutritional screening on Mr. A., using this tool and depending on the results then may refer to him to the dietician for further assessment. The MUST tool is acceptable and reliable to healthcare professionals.

Another risk assessment tool that may be used to identify the integrity of the skin and the risk of infection is the Waterlow risk assessment scale. This is the most common pressure ulcer risk assessment tool developed in 1984 by Judy Waterlow (Kozier 2008). Nurses use their clinical judgement to decide whether or not Mr. A., is at risk of developing pressure ulcers by checking his general skin condition, elasticity or areas of oedema. The Waterlow tool uses a simplistic scoring system which predicts potential problem areas of skin that may break-down and therefore be prone to infection. In addition to these risk assessment tools, policies and procedures should be in place at the workplace to enable staff to follow protocols and be aware of what actions to take regarding infection control, accidents or hazards (Wilson 2006).

The fifth and final step in the model is to review and summarise the importance of infection control in healthcare. From the evidence presented in this essay it can be argued that infection prevention and control are the responsibility of all healthcare staff. To minimise the risks of healthcare associated infections for patients and staff effective communications are needed between patients, staff and visitors. Appointing a cleanliness champion is the easiest way for clinical areas to maintain standards. This person can organise training and updates where necessary Florence Nightingale famously said that a ‘hospital should do no harm to its patient’ and this is still true to this day for modern healthcare (Royal College of Nursing 2008). Good infection control in healthcare settings is still basic common sense and can prevent grave consequences for the patient.

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debate: csf or rmf which is better for managing it security risk

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Many businesses follow NIST guidance for identifying, managing, remediating, and monitoring Information Systems Risk. Some follow the guidance because of contractual mandates (i.e. they’re under contract to the US Federal Government). Other businesses follow the NIST guidance because it represents “best practices” and is a widely accepted source of guidance.

Write a 3 to 5 paragraph position statement in which you identify and describe 3 to 5 contributions that your chosen framework (CSF or RMF) will make to effective management of enterprise IT risk.

Provide in-text citations and references for 3 or more authoritative sources. Put the reference list at the end of your posting.

A word file of the following information is included in this link for your reference: Case studies Summer 2015 – BIOL107.docxPreview the documentView in a new window

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A word file of the following information is included in this link for your reference: Case studies Summer 2015 – BIOL107.docxPreview the documentView in a new window

Each illness is caused by a bacterium (NOT viral)

Choose one of the three cases and complete the assignment by following the guidelines.

Write a typed, well-constructed (complete sentences, proper grammar) report of not more than three double spaced pages (4 points).

Devote at least one paragraph to answering each of the 6 questions. (8 points each)

Include a reference section with at least 4 citations, including at least one published reference. Use resources such as microbiology text books, encyclopedias, HCC Library databases (e.g. Pro Quest Biology, Pro Quest Nursing) journals and online medical sites to research these questions. Indicate the source of information you found in APA or MLA format. Do not forget to include in-text citations every time you borrow someone’s idea, even if you paraphrased it. Be sure to include the publication date. Comment on the reliability of the source (why you think this source is reliable) under each reference. (8 points)

All references must be cited, and direct quotes from the references must be indicated as such, using quotation marks. However, in science writing, direct quotes are seldom used. Instead, paraphrase the information in the reference, and supply the citation. In the case of plagiarism, all students involved will receive a “0” on this assignment. Thereafter, plagiarism will be handled according to the College’s Academic Honesty Policy, with possible failure of the course and suspension from the College.

Please submit your case studies through Canvas as either .doc, .docx, or .pdf file types.

Case 1

A 27-year old white female presented at the walking clinic of her local physician on August 15. On physical exam, the patient had a fever of 101.3F. She appeared fatigued, had tender joints, and complained of a headache, a stiff neck and a backache. The physician noticed a circular “rash” about 5 inches in diameter, with a bright red leading edge and a dim center in the form of a “bull’s eye”. The physician noted an irregular heartbeat. The patient complained of lack of ability to concentrate.

The patient gave the following history: She is a graduate student in the wildlife program at the university in town. She was in the field for three weeks in Wisconsin during the months of May and June. She tracks small mammals in the field and studies their behavior. It had been a warm, wet spring and she complained of a large number of biting flies, mosquitoes and ticks in the area. She felt well until about 2 weeks after returning to her home. Since that time, many of her symptoms had progressed. She finally found that she could take it no more.

What microorganism causes this disease?

A. Identify a nursing theory that has influenced your values and goals.Explain how the identified theory from part A can be used to describe, explain, and predict excellent nursing practices.

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A. Identify a nursing theory that has influenced your values and goals.Explain how the identified theory from part A can be used to describe, explain, and predict excellent nursing practices.

1. Explain how the identified theory from part A can be used to describe, explain, and predict excellent nursing practices.

2. Discuss how the identified theory from part A fits your professional practice.

B. Discuss how the contributions of two historical nursing figures in the nineteenth or twentieth century that has inspired your professional nursing practice.

1. Compare the differences in contributions of the two historical figures discussed in part B to your professional nursing practice.

2. Analyze how the two historical figures from part B have influenced your work as a nurse in the twenty-first century.

C. Explain the functional differences between the State Board of Nursing and the American Nurses Association (ANA).

1. Define the roles of these two organizations.

2. Explain how these two organizations influence your nursing practice.

3. Describe the implications associated with failure to maintain your licensure requirements.

4. Compare the differences between registered nursing license requirements in a compact state versus a non-compact state.

D. Discuss how the regulatory agencies define your nursing practice in the role of patient advocacy and patient safety.

1. Describe the implications associated with two regulatory agencies (e.g., FDA, CMS) when a patient requests an alternative therapy.

E. Compare how the Nurse Practice Act functions in two states by doing the following:

1. Discuss the differences and similarities in your selected states from part E.

2. Compare the standards and scope of nursing practice for RNs, LPN/LVN, and unlicensed assistive personnel in your selected states from part E.

3. Compare the rules for effective delegation in your selected states from part E.

4. Compare the rules for safe practice in your selected states from part E.

F. Distinguish the advocacy of a registered nurse, a licensed practical nurse/licensed vocational nurse, and a nursing assistant/unlicensed assistant personnel in the following roles:

a scientist

Geographic Impacts on Health | Reflection

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Have you ever heard the phrase by Margaret Mead, “You are unique – just like everyone else?” I believe everybody is unique but similar in their own way. It is because of this that I consider our perception of health, regardless if it is in the planning, implementation, and evaluation stage, varies tremendously yet remains the same in many ways. Our notion of health strongly depends on so many factors such as demography, ethnicity, religion, tradition, and values.

Demographic distribution of populations has a very big impact on health with regards to the planning, implementation, and evaluation of health interventions because the bigger the population in a certain area, the bigger the intervention. For example, a town of 1,000 people will require less planning, executing the plan will be drastically easier, and evaluating the success of the intervention can be done smoothly compared to a city of 100,000 people. Also, certain areas tend to have a higher prevalence of certain diseases. By studying this, health interventions can be tailored to target certain health concerns or illnesses from certain areas.

Political values of a certain country can affect the different stages of health intervention because most health related projects, these days, needs the approval of the government. Depending on the government, some proposed health projects can take years to fruition while others might not take that long. Furthermore, if the politics of a country is shady, the chances of a proposed health project to be approved or implemented is slim to none.

Religion can be one of the hardest things to deal with when it comes to the stages of healthcare intervention. As a nurse, I have experienced first-hand the impact of religion has on certain medical treatment. There are some religious beliefs that are not too hard to handle but there some religious beliefs that can take it to the extremes. One of the hardest things I have ever been through was when my beliefs and values contradicts a patient’s religious beliefs especially when it involves life and death.

Ethnicity also plays an important role in determining the proper intervention. It is a known fact that there are certain illnesses that affect certain ethnic groups. For example, “the rate of dementia on admission to nursing homes is higher among black residents than among white residents.

[1]
Weintraub D, & et al. (2000).” Even though dementia does not have a cure, people can tailor their healthcare interventions to fit the needs of different ethnic groups. But this is only the tip of an iceberg. There are many diseases and illnesses associated with ethnicity. By knowing such data, people can go out of their way to limit a certain disease or illness thereby, hopefully, preventing the disease or illness from ever happening.

Having been lucky to travel to different countries, I can say that human values really does have an impact on health interventions. One very big example is how Filipinos value the elderly. I am not insinuating that other countries do not value their elderly or Filipinos are better at valuing their elderly. I am just implying that we have a different way of taking care of our elderly. Filipinos seem to get a sense of fulfilment when taking care of their parents. I believe in taking care of my parents when they get old because they took care of me when I was young. I will send them to a rest home not because there are not any rest homes in the Philippines, but because I want to keep them close and connected – they are and will always be a part of the family.

Since my beliefs and values have been instilled in me and because I have seen how my parents took care of their parents, it has now become sort of a tradition in which I and my fellow Filipinos take pride of. This is one way on how tradition impacts healthcare intervention. But there are also other ways. In many countries, especially in remote areas, traditional medicine is still being practiced and people in these areas believe this is the only form of medicine out there. A strong push for knowledge would be the proper intervention here.

Having mentioned all these, it is safe to say that determinants either have a direct or indirect impact on health interventions. Also, some determinants can either be a deterrent or an opportunity. By deterrent, I mean those rare ones where health interventions can’t be implemented because certain beliefs will not permit such mediation. However, determinants can also be an opportunity to come up with a better plan, a more effective implementation, and a more efficient evaluation system of a healthcare intervention.

According to the Merriam-Webster dictionary, Attitude is the way you think about someone or something. Since we are all unique in our own way, it is safe to say that we also have different attitudes towards someone or something. You may like the Miami Heat while I like the San Antonio Spurs. Having this in mind, it would not be a long shot to conclude that our individual attitude towards health can have a great impact, directly or indirectly, towards planning, implementation, and evaluation of healthcare interventions.

The public’s concept of health and illness is different no matter where you go. The World Health Organization defines health as “physical, mental and social wellbeing and not merely the absence of disease or infirmity.”

[2]
These days, we are more united in trusting medicine and research than resorting to traditional medicine. But, that does not mean traditional medicine did not have the same attitude towards health and illness. “Traditional medicine practice (TMP) within Aboriginal Australia encompasses a holistic worldview which reflects that of the World Health Organizations’ definition of health”

[3]
Oliver, Stefanie. (2013).

However, the practice of traditional medicine is slowly becoming a lost trade primarily due to colonisation, medical advancement, research enhancement, and technological improvement. Nowadays, most of us rely on science rather than traditional medicine. Have you ever wondered what brought about the advent of medical advancement? Funny as this may sound, most drugs today are of herbal descent and it is very important to recognize the value traditional medicine had on today’s medicine.

There are still places where traditional medicine is still accepted and is still being practiced. Even in a small country like the Philippines, indigenous areas still believe that illness is caused by “voodoo magic” and that a “witch doctor” and his/her methods serve as the cure for such illness. In Korea, roots of certain plants are mixed in a drink and is believed to improve and restore homeostasis. Acupuncture is a method of needle insertion at various points of the skin to stimulate circulation and improve overall balance. This is believed to originate from China.

How health is accepted and practiced in an area will depend on how the public values the importance of health. With all the different diseases out there, I believe that most countries consider health as a big priority and it is very evident from all the research being done to find a cure for certain diseases such as cancer, diabetes, HIV, and many more. It is not only through research that indicates how much importance the public considers health. Diet programs, exercise programs, and even healthier TV shows are being shared and broadcasted in hopes to help gain and inspire a healthier wellbeing.

The public’s attitude towards health and medical professionals is essential to healthcare interventions because if people were not concerned about their own health, they would not seek the aid of doctors, traditional healers, or medical professionals. If they do not need help from medical professionals then there would not be a need for any planning, implementation, and evaluation. However, most people value their lives. They, generally, value their own health and fear what could happen if they do not take care of themselves. That is why people are slowly learning to consult dieticians to help them eat healthier. People are seeking the aid from trainers to get them into shape. People are even considering the use of traditional medicine and traditional methods (e.g. acupuncture) to do whatever it takes to be healthier.

In my own opinion, especially here in New Zealand, the public is very concern about their health and also their environment. They are starting to open up to a more “organic” way of being healthy. These days, people are slowly “going green” and this is why they are exploring different alternatives to common medicine all for the sake of being healthy. I believe the media plays a vital role for the immergence of the “going green” lifestyle that people all over the world are slowly following suit. The public’s attitude towards health, illness, and medical professionals is very important. Without the public’s support, nothing will get done.

The first thing that comes to mind when people mention New Zealand is the natural beauty this country possesses. New Zealand is surrounded by beautiful coastlines waiting to be discovered and crystal clear pristine waters to be explored. Aside from the coastline, New Zealand boasts of majestic snow-capped peaks and breath-taking waterfalls. We all got to see a glimpse of its immense beauty through the Lord of the Rings movie series and the Hobbit movie series.

But the beauty of New Zealand is not only evident looking form the outside-in but also from the inside-out. Here, beauty runs skin deep. New Zealand is a melting pot of multiple cultures ranging from Maori, European, Pacific Island and Asian descent – all of which are very proud of their ancestry. With all these different cultures, it is hard to imagine how people get along. However, people just make it work here. They respect each other’s variances. This, for me, is what makes New Zealand unique and special.

This kind of respect towards one another is generated from New Zealand’s founding document – The Treaty of Waitangi. This treaty simply implies that Maori people have the same rights as British people. This attitude and way of thinking has been instilled on every resident that it has robbed off on other settlers. So people accept each other equally. More so, people are learning to adapt to each’s culture. This is even evident when it comes to the planning, implementation, and evaluation of healthcare interventions.

For example, the Maori’s cultural influence has been socially accepted that the whole nation is working together to maintain and preserve such a culture. It is a fact that Maoris generally have an obesity problem, which is a potential for diabetes, so the whole community is working hand in hand to provide means to aid the Maoris in tackling this problem. Health leaders are assisting whanau to come up with ways to address such an issues through proper education, training, and other means. But the community is not only helping the Maoris because the Maoris are also helping the community by educating them on their ways of traditional medicine.

Since New Zealand is a very diverse country, all cultures are being treated the same way. More and more acupuncture facilities are popping up all over major cities. People are learning different herbal remedies from Asia to treat numerous ailments. Yoga, which originated from India, is just as popular here. People are learning how to eat healthier and exercise regularly like most Asian countries do. The influence is great and the impact is clear. It is up to us to absorb all these new cultural insights and choose a healthier lifestyle.


[1]
Weintraub D, Raskin A, Ruskin PE, Gruber-Baldini AL, Zimmerman SI, Hebel JR, et al. Racial differences in the prevalence of dementia among patients admitted to nursing homes.Psychiatric Services.2000;51:1259–1264.


[2]
World Health Organization:Declaration of Alma-Ata. Alma-Ata: USSR; 1978. [Proceedings of the International Conference on Primary Health Care] 6–12 September


[3]
Oliver, Stefanie. (2013). The role of traditional medicine practice in primary health care within Aboriginal Australia: a review of the literature. Journal of Ethnobiology and Ethnomedicine, 2013, 9:46. doi: 10.1186/1746-4269-9-46

Policy for Psychiatric Nursing in Ireland: Analysis

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Critically evaluate the relevance of a


current national (Irish) strategic policy


document for your area of practice (Psychiatric nursing)

Introduction

As one of the most important facets of health care, nursing has been and remains one of the most undervalued and undeveloped professions (Salvage and Leenders, 2005). Salvage and Leender (2005) state that countries need a national action plan for nursing as it assists in the development of the profession. They offer the following ten advantages, as evidence for the foregoing that shall aid in serving as a basis for the evaluation of the relevance of the present Irish national strategic policy for Psychiatric Nursing along with other inputs (Salvage and Leenders, 2005):

  1. The presence of a national action plan aids in reinforcing nursing goals, results and orientation in health care.
  2. Through the existence of a national action plan, nursing contributions can be optimized through the focusing of “… nursing resources to achieve the best possible results and … value for money” (Salvage and Leenders, 2005).
  3. A national action plan helps to “… build and maintain vision for nursing …” (Salvage and Leenders, 2005). The preceding is a result of aiding nurses in maintaining their perspectives, which can be lost in the busy and demanding everyday demands of their profession.
  4. The existence of a national action plan can result in “… a clearer sense of direction …” (Salvage and Leenders, 2005).
  5. A ‘plan’ can aid in making “… nursing achievements more visible …” (Salvage and Leenders, 2005). Salvage and Leenders (2005) point to the fact that the contribution of nurses is acknowledged by clients and patients but not “… in medical textbooks, conferences and influential discussions …”.
  6. A ‘plan’ “… can spur nurses and their supporters to be more active …” and through strategic planning, a ‘plan’ “… helps to uncover or inspire unexpected new coalitions …” that can aid in these aspects working “… together to improve health care … (Salvage and Leenders, 2005).
  7. It, a ‘plan’, “… can coordinate current nursing activities …” and aid in nurses identification of projects and innovations that are underway to incorporate these into practice as well as aiding in the development of frameworks for further improvements and implementation.
  8. A ‘plan’ can aid in the creation of “,,, closer links between policy and practice …” (Salvage and Leenders, 2005). They explain that the policy making process is usually remote from those who are responsible to its implementation, and that through the utilization of a planning process that involves as well as includes the “… services users, practitioners and … policy makers …” aids in reducing the “… gaps between thinking and action, data and perceptions, policy and operations, planning and implementation …” (Salvage and Leenders, 2005).
  9. Through the existence of a ‘plan’ the profession of “… nursing is more likely to win support from the people, policy makers and other professionals” if said ‘plan’ states clearly “… where it is going and what it hopes to achieve (Salvage and Leenders, 2005).
  10. And finally, a ‘plan’ “… can help nursing control its own work and future … (Salvage and Leenders, 2005). Salvage and Leenders (2005) explain that the existence of a ‘plan’ can aid in nursing controlling “… its own work and future …” because traditionally they have “… had little control over their destiny …” as a result of them “… as the servants of another profession …” (Salvage and Leenders, 2005). Salvage and Leenders (2005) argue that a ‘plan’ represents the “… starting point for … (nurses) … becoming equal partners in health care work …” as well as in their relationships with the other professions in the field.

In order to better understand the context of this examination, the definition of the profession of nursing is deemed an important underpinning. The ‘Scope of Nursing and Midwifery Practice Framework’ defines nursing as a profession that “… helps individuals, families and groups to determine and achieve their physical, mental and social potential …” (Nursing Board, 2000a). The definition goes on to add that nurses require “… competence to develop and perform functions that promote and maintain health … as well as prevent ill health” and that such “… includes the (assessment) planning and giving of care … (encompassing) … the physical, mental and social aspects …” (Nursing Board, 2000). As the context of this examination represents the field of psychiatric nursing, the following definition as supplied by the ‘International Society of Psychiatric-Mental Health Nurses’ (ISPN) provides clarity. They, ISPN, define this area of nursing, psychiatric, as “… a specialized area of nursing practice committed to promoting mental health through the assessment, diagnosis, and treatment of human responses to mental health problems and psychiatric disorders” (ISPN, 2006). The An Bord Altranais “… was established by the Nurses Act, 1950, (An Bord Altranais, 2007a) “… is the statutory body …(that) … provides for the registration, control and education of nurses … (and other matters) …” related to the practice of nursing in Ireland (An Bord Altranais, 2000). As of 2004, there were 76,045 nurses registered with the An Bord Altranais, as shown by the following (An Bord Altranais, 2007b):


Table 1- Total of Nurses and Qualifications Registered

(An Bord Altranais, 2007b)

Nurses Registered


Females


Male


Active


Inactive


Total

Number of Nurses

60,774

15,271

70,231

5,814

76,045


Table 2 – Total of Nurses and Qualifications Registered


Qualifications Registered

(An Bord Altranais, 2007b)


Females


Male


Active


Inactive


Total

General

60,986

2,677

50,637

13,026

63,663

Psychiatric

8,301

3,525

9,566

2,260

11,826

Sick Children’s

4,578

51

3,759

870

4,629

Intellectual Disability

3,961

473

3,860

574

4,434

Midwifery

16,857

21

13,179

3,699

16,878

Public Health

2,551

1

2,084

468

2,552

Tutor

537

104

513

126

639

Other

585

26

290

321

611

Total

98,356

6,876

83,888

21,344

105,232

The examination of the Code of Conduct and other legislation shall be reviewed against the ten point standards of the World Health Organization and other documents in order to gauge the relevance of policies in this area.

National Strategic Policy for Nurses in Ireland

The strategic national policy document for the nursing profession in Ireland is generated by An Bord Altranais that states that the practice of nursing “… should always be based on the principles of professional conducted …” as contained “… in the latest version of the Code of Professional Conduct for each Nurse and Midwife …” (Nursing Board, 2000b) with practices contained in Scope of Nursing and Midwifery Practice Framework (Nursing Board of Tasmania, 2006) and the Standards for the Scope of Nursing Practice 2001 as prepared by the Commonwealth Department of Education, Science and Training (DEST, 2001). The evaluation of the preceding documents shall be compared against the ten-point plan outline as put forth by Salvage and Leenders (2005) to serve as a guide.


Scope of Nursing and Midwifery Practice Framework

The Scope of Nursing and Midwifery Practice Framework for Ireland states that it utilizes the ANMC National Competency Standards for the Registered Nurse, Australian Nursing & Midwifery Council, (ANMC, 2006) as its basis for the determination of “… regulations, organizational policies and procedures …” (Nursing Board of Tasmania, 2006) as support in its practice setting. The Scope of Nursing and Midwifery Practice Framework (SoP DMF) states that the determinations concerning the “… scope of practice need to be …” (Nursing Board of Tasmania, 2006) 1. “proactive”, 2. “responsive to internal and external forces”, 3. “flexible; and”, 4. “able to provide guidance in decision making by both the individual nurse … and the profession as a whole”. The SoP DMF indicates that the foregoing “… is applicable to all nurses and midwives across all practice settings …” and that such have been put into force to ensure “… that practice decisions are based on the individual context and patient …” as opposed to the “… defining nursing … by tasks or procedures” (Nursing Board of Tasmania, 2006).

The latitude offered from the preceding represents room for individual interpretation that can and also cannot be a wise choice in a profession that represents the fragile state of mind of patients under psychiatric care. Evidence of the problem in having such broad latitude is presented in an article by Sean Fleming “Psychiatric Abuse of Ireland” which details accounts of the use of drugs in treatment that were either later found to be inappropriate, and or had side effects that worsened the patients condition (Fleming, 2005). Such is also the subject of a report issued by ‘Aware’, a voluntary organization devotes to assist those who are afflicted with depression (Aware, 2007a). The report mentions the continuity of care with regard to psychiatric services as an area needing improvement along with eighteen other points and represents an aspect that the broad latitude in interpretation (Aware, 2007b). And while every instance of care treatment cannot be categorized, and set forth procedurally, guidelines represent an effective means to provide tighter controls as well as instructions and steps that nurses can utilize when appropriate. Salvage and Leenders (2005) under item 4 indicate that a national action plan provides “… a clearer sense of direction …” and under item 8 states that the existence of a ‘plan’ can aid in the creation of “,,, closer links between policy and practice.

The SoP DMF states that through providing transparency in its policy that it “… greatly benefits all nurses and that it thus “… provides an effective tool … nurses can maximize their nursing practice …” in the standards of the profession. It states that there are six figures, with “… each supported by a set of guiding principles” that can assist nurses in the discussion as well as clarification of “… practice issues with their colleagues and employers” (Nursing Board of Tasmania, 2006). The preceding are 1. “Guiding Principles for Map of Role Relationships among Health Personnel”, 2. Guiding Principles for Improving the Health Outcomes of the Patient”, 3. Guiding Principles for Delegation among Nurses and Midwives, 4. Guiding Principles for Delegation to Students of Nursing, 5. Guiding Principles for Delegation to Unlicensed Health Care Workers; and, 6. Guiding Principles for Maximising the Scope of Practice for Registered Nurses and Midwives (Nursing Board of Tasmania, 2006). The Sop DMF states that these “… six figures highlight the importance of…” 1. “clinical assessment by the registered nurse or midwife”, 2. “lawful authority”, 3. “preparation and experience”, 4. “risk management”, 5. “confidence”, 6. “competence”, 7. “delegation by the registered nurse or midwife: and”, 8. “acceptance of the delegation and the required level of supervision (direct or indirect” (Nursing Board of Tasmania, 2006). The foregoing harkens back to the room for latitude and actually indicates under item number 1 that nurses are making clinical assessments. This also stated, assessment, under “Scope of Nursing and Midwifery Practice Framework April 2000” (Nursing Board, 2006b). The foregoing analysis with regard to the latitude is indicated in the Sop DMF document under Figure 2. ‘General Principles for Improving the Health Outcomes of the Patient’ which states under “patient … Clinical Assessment … have I considered the consequences of my planned action?” (Nursing Board of Tasmania, 2006). The following further illustrates this issue (Nursing Board of Tasmania, 2006):

The Figure indicates that if the answers to all questions are ‘yes’ that the nurse should proceed, and that if there is a ‘no’ answer to any question, then the nurse should seek advice on the issue (Nursing Board of Tasmania, 2006). The preceding represents a procedural attempt to shore up the wide latitudes present in the guidelines, still leaving room for varied interpretations.


Standards for the Scope of Nursing Practice 2001

The ‘Standards for the Scope of Nursing Practice 2001’ represents a copulation of statutory material that was obtained as a result of the utilization of electronic searching in the sites of Lexis Nexus, Canlii, Austlii and other legal sites. The ‘Standards for the Scope of Nursing Practice 2001’ indicates that there were legislation aspects that could not be accessed and other measures utilized, with an instance whereby no data could be obtained (DEST, 2001). The preceding means that the document is not wholly complete. The ‘Standards for the Scope of Nursing Practice 2001’ also adds the documents from which it was based, in some instances, referred to other documents and or legislation or regulations and standards that were not included is what was accessed, and were unavailable for use in formulating the document as a whole (DEST, 2001).

Interestingly this supports the broad latitude contention as mentioned under “Scope of Nursing and Midwifery Practice Framework” in that it states “Given the complexity and variability of the sources of information about the standards of nursing practice …” that it is reasonable “… nurses might experience some difficulty in keeping abreast of these issues” (DEST, 2001). The preceding is explained in the document as representing the difficulties in the interpretation of the ‘… intent of the legislation (DEST, 2001). DEST (2001) indicates that the primary objective of “… statutory regulation … is the protection of the public. The utilization of the copulation technique to derive the document obviously has flaws that need correcting, however, the fact that the government of Ireland has recognized the need to produce such a document represents a critical step in the right direct, as espoused by Salvage and Leenders (2005).


Quality And Fairness: A Health System for You – Action Plan Progress Report 2005

The National Health Strategy “Quality and Fairness – A Health System for You”, as stated in the document “… was announced by the government … to provide vision and strategic direction for the health and personal social services” and identifies “… a 121 point Action Plan …” as central to implementation of a nationwide strategy and put varied “… aspects of the Strategy into … action (Department of Health and Children, 2005). Under National Goal No. 1, item 2, it sets forth the “Statements of Strategy …” with regard to “… all relevant Government Departments …” that are to devise guidelines and strategy statements for human resources as well as other areas. Its relevance to this examination lies in the preceding.


A Vision for Change” Report of the Expert Group on Mental Health Policy

This document represents “… a comprehensive model of mental health service provision for Ireland” (Department of Health and Children, 2006). Under item 1.5 ‘Vision’, the document sets forth that its policy represents the creation of “… a mental health system that addresses the needs of the population … as a result of focusing “… on the requirements of the individual” (Department of Health and Children, 2006). The ‘Policy Framework’ indicates that its purpose is to create “…. A systematic framework and plan for mental health …” (Department of Health and Children, 2006). This aspect represents the reference to psychiatric nursing, which is the subject of this examination. The document covers ‘Mental Health in Ireland’ covering the differing disciplines, along with “Implementation” that defines relationships in the management of mental health and the plan to bring the diverse aspects into closer proximity from the present system that “… has encouraged isolation of catchments from each other …” which “… has hindered the development of specialist services” (Department of Health and Children, 2006).

The broad areas covered under “Manpower, education and training ”… sets forth “ … the education and training required to produce competent professional personnel …” (Department of Health and Children, 2006). This document does not provide the details of policy and other facets of specificity related to strategic policy for psychiatric nursing, which are contained under “Scope of Nursing and Midwifery Practice Framework” and “Standards for the Scope of Nursing Practice 2001” in limited fashion. It, the document – “A Vision for Change” Report of the Expert Group on Mental Health Policy” does recognize that there are “Shortcomings in Current Education and Training”, but its usefulness as a policy statement for psychiatric nursing is not its intention.

Conclusion

The present strategic policy for psychiatric nursing in Ireland is an area that is still under development. The varied documents reviewed, “Scope of Nursing and Midwifery Practice Framework”, “Standards for the Scope of Nursing Practice 2001”, “Quality And Fairness: A Health System for You – Action Plan Progress Report 2005”, and “A Vision for Change” Report of the Expert Group on Mental Health Policy” as well as other documents referenced herein are in the evolutionary stages. This incompleteness does not actually represent a cause for too much concern and the Government of Ireland, through the issuance of these documents, acknowledges the deficiencies in this area and have set about the process to correct this aspect as stated in “Quality And Fairness: A Health System for You – Action Plan Progress Report 2005” under National Goal No. 1, as well as in “A Vision for Change Report of the Expert Group on Mental Health Policy”.

Salvage and Leenders (2005) indicate the global problem concerning nursing policy and strategy, and the importance of having such plans in place, or under development to enable the profession to achieve higher standards and more connectivity with the field of medicine in general. They, Salvage and Leenders (2005), state that strategic plans are extremely important in providing the foundation for frameworks to develop that will increase the proficiency of the profession through documentation that can be thus shared, compared and utilised for further refinement. Ireland is in the beginning stages of this evolutionary process, as is the United States, the United Kingdom and other countries owing to their lack of attention and importance concerning the contributions of the field of nursing. The criticisms levied at the broad interpretational latitudes that exist in present policy statements in Ireland as found under the document prepared by the Sop DMF concerning the “Scope of Nursing and Midwifery Practice Framework” is an outgrowth of this developmental process. Clearly, a great deal of work still stands before the various governmental agencies and departments in achieving a substantive document that achieves the objective of providing nurses engaged in psychiatric care with the guidelines and procedures to enable them to weave their way through the difficult profession they are engaged in. The present plans, though incomplete, do represent a means whereby psychiatric nursing leaders have a platform to move forward from to collaborate in revising and amending what is established. The preceding is acknowledged by Salvage and Leenders (2005) as a huge as well as important step in the right direction.

Bibliography

An Bord Altranais (2000)

An Board Altranais: The Code of Professional Conduct for each Nurse and Midwife, April 2000.

An Bord Altranais

An Bord Altranais (2007b)

Nurse Registration Statistics – 2004

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http://www.nursingboard.ie/

An Bord Altranais (2007a)

Role and Functions of An Bord Altranais.

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http://www.nursingboard.ie/

ANMC (2006)

National Competency Standards for the Registered Nurse.

Australian Nursing & Midwifery Council

Aware (2007)

Aware.

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Aware (2007b)

Suicide in Ireland: A Global Perspective and a National Strategy

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http://www.aware.ie/online books/suicide.html

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A Vision for Change” Report of the Expert Group on Mental Health Policy.

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Quality and Fairness – A Health System for You: Action Plan Progress Report 2004.

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DEST (2001)

Standards for the Scope of Nursing Practice 2001

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http://www.dest.gov.au/archive/HIGHERED/nursing/pubs/nurse_regulation/3.htm

Fleming, S. (2005)

Psychiatric Abuse in Ireland.

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http://www.critpsynet.freeuk.com/PsychiatricAbuseinIreland.htm

ISPN (2006)

Psychiatric Mental Health Nursing Scope & Standards.

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http://www.ispn-psych.org/docs/standards/scope-standards-draft.pdf

Nursing Board (2000b)

Guidance to Nurses and Midwifes on the Development of Policies, Guidelines and Protocols, December 2000.

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http://www.nursingboard.ie/publications/Guidance2000.pdf

Nursing Board (2000a)

Scope of Nursing and Midwifery Practice Framework April 2000.

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http://www.nursingboard.ie/PolicyGuidelines/SNMidwifePractiFworkApril2000/scope.html

Nursing Board of Tasmania (2006)

Scope of Nursing Practice Decision Making Framework: February 2006.

Nursing Board of Tasmania

Salvage, J., Leenders, F. (2005)

National Action Plans for nursing and midwifery

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Nursing in Europe: A resource for better health

. World Health Organization, Regional Office for Europe, ISSN 0378-2255

Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.

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Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.

Note: Complete the assessments in this course in the order in which they are presented.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 1: Competency 1: Analyze the effects of financial and economic factors in a health care system on patient care, services offered, and organizational structures and operation.

1. Create a budget for relevant expected costs and earnings or benefits over the first five years of a proposed economic initiative.

1. Analyze how a proposed initiative, once implemented, may impact aspects of a care setting and ways in which negative impacts could be mitigated.

. Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.

2. Propose a plan to roll out an economic initiative that will enable a care setting to successfully implement it in an ethical and culturally equitable way that will ensure the initiative achieves quality or service improvements.

. Competency 3: Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues.

3. Justify the relevance and value of the quantitative and qualitative economic, financial, and scholarly evidence used to support recommendations throughout a plan.

. Competency 4: Develop ethical and culturally equitable economic strategies to address dynamic environmental forces and ensure the future security of an organization’s resources and its ability to provide quality care.

4. Explain strategies that have been integrated into a proposed economic initiative that will ensure it can remain a viable asset to a care setting in the face of dynamic environmental forces.

. Competency 5: Apply various communication methods in order to clearly, effectively, and efficiently relate information to stakeholders and colleagues related to economic data, findings, and strategies.

5. Communicate a business and implementation plan in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.

Lifelong Learning And Professional Development

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The world today is changing and being affected by advances in technology, and communication, as well as changes in the political, economic, demographic, and social environment. These changes also affect the delivery of health care services as well as changing of patient’s expectation toward health care system. Traditional task- orientated, routine and habitual nursing management style is no longer able to meet the ever changing health care system. Therefore, it is crucial for present health care worker especially Assistant Medical Officers (AMO’s) to integrate leadership in health care management to meet the needs of contemporary professional practice and consumers’ requirements and expectations (Sofarelli & Brown, 1998). The changing of mindset from bureaucratic management to effective leadership becomes more popular and acceptable in the health care system in Malaysia.

I am Assistant Medical Officer (AMO’s) who is currently working in Out Patient Department in one of the government hospitals in the central region of Malaysia. My department caters to about thousand patients daily. Patients come to the department with several problems. Therefore it is essential for all staff especially AMO’s should endeavor to equip themselves with current knowledge and skills.

I was appointed by my Head of Department to become a committee member in the training as well as an instructor at my department level. My task is to train and facilitate my department’s staff to update and upgrade their knowledge and skills. As an Instructor, I have to facilitate personnel and professional development that encourage reflections, identifying gaps in knowledge and skills also providing structured feedback to enable the all staff more so newly posted staff develop and expand their practice safely and confidently to improve standard of care. Instructors also do play role of leaders by generating student motivation and providing support, and influence staff by using their practice area as practical arena conducive to learning objective. By effectively managing this aspect of a classroom’s culture, it can increase both student and teacher motivation and indirectly impact learning gains. According to Orton (1981), the role of ward manager is not only do they have control of management of the area, but also serve as role model for nursing practice. The leadership style and personality of the ward manager are important determinants of an effective learning environment.

In this paper I will explore the leadership theories and management in which influence staff toward lifelong learning and their own professional development and I also shall use these ideas into my clinical practice. I shall also draw conclusions and recommendations for future practice.

Marquis and Huston (2003) stated leadership is a process of empowering belief, moving, persuading and influencing others toward a goal mostly without any force or threat. Leadership also can define as an interactive process directed toward mutual goal achievements between leader and followers. Leadership emphasizes goal achievement and change, occurs in any setting and is not tied to a specific organization (Manfredi, 1994). Meanwhile, McNay (1998) offers a triangular model of leadership, consisting of three elements; inspiration, organizations and education. Leadership based on education to change the way people think where it will be creating dynamic environment and culture for learning. These situations encourage and foster lifelong learning and own professional development.

Management is defined as the action to plan, organize, direct and control staff (Marriner-Tomey, 1996). Whereas, Quinn (2000) stated that management is essence of rationality. Managers plan, organize, and solve problems. Managers have been described as those people in organizations who honor stability and control, they tend to be task-oriented and are comfortable with that which is rational, quantitative and logical (Rodriguez 1995). Managers often possess positions of authority with the legitimate source of power that accompanies the position through which they delegate and control situations and outcomes (Kouzes & Posner 1987). They are often concerned with short-term goals and objectives and spend much of their time controlling situations by interpreting and enforcing policy and procedures and maintaining the structure of the hierarchical rule of the organization. Concern for the people they manage tends to become subordinated to organizational goals (Covey 1992).

Managers use and hold the power and authority to organize, delegate and control situation through the position justify by the organization. Managers are more task-oriented. They work on assigned goal, control, enforce and maintain policy and procedure through hierarchical rule of the organization (Sofarelli & Brown, 1998). There are differential between leadership and management. Management is about “doing things right”. This contrasts markedly with leadership: effective leaders produce “constructive or adaptive change to help people and firms to grow, they establish direction, align people and motivate them­ Leadership is about “doing the right thing”.

Leaders are open for change, value and concern about people in their group; whereas managers focus at obtaining the best beneficial outcome for the organization (Sofarelli & Brown, 1998). Managers ensure goal achieve efficiently, leaders focus on the effectiveness of the process and the impact on participants (Marriner-Tomey, 1996; Spitzer- Lehmann, 1994).

Burns (1978) stated there are two types of leaders in management. The traditional manager, concerned with day-to-day operations, was termed a transactional leader, the manager on the other hand, who is committed, has a vision, and able to empower others with vision wad termed a transformational leader.

Transformational leadership is a style which is ideally suited to the present climate of change because it actively embraces and encourages innovation and change. A transformational nursing leader will provide the skill for the profession to stretch its boundaries and innovative in the way in which problem are viewed and solve.

Transformational leader are able to create synergistic environments that enhance change. Change occurs because the transformational leader’s futuristic focus values creativity and innovation. The transformational leader also values organization culture and values strongly, perpetuating these same values and behavior in their staff (Wolf, Boland & Aukerman, 1994).

As changing in Medical Science concept, approach, practice and trend due to advances in technology and communication, a transformational leader’s futuristic focus or visionary leadership is important for my clinical practice.

Tyrrell (1994) identifies “visioning” as a mark of the transformational leader, stating that “nurses at all levels are expected to demonstrate leadership in setting direction for nursing practice, and that visionary leadership allows nurses to create a picture of an ideal future.

In sharing this vision, the transformational leader empowers staff to find common ground and a sense of connection. Leaders empower and influence their followers to achieve a goal by communication through open discussion and negotiation without using any power and authority. Transformational leadership is an empowering leadership style and one which is highly suited to the profession of nursing, characterized as it is as being caring and highly ethical (Biordi, 1993).

In the other perspective, Heinzen et al. (1996) describe vision as a personal attribute, and all agree that in order to align the followers and the organization with their vision the leader must possess powerful communication skills. Meanwhile, according to Grohar (1992) to be good leader a person must have basic understanding of communication process which consists of a sender a message and receiver.

Every staff must be motivated for lifelong Learning and own profesional development. According to Cohen (2004) leadership is the best tactic that one can use to motivate others and renew interest in others in attaining goals that are for the good for all. The leaders must have to provide staff development programmed and in service training to keep the staff advance information. For example, staff can go for conference, seminars, courses or continuing education programmed in ethic, which can provide the AMO’s to clarify their legal rights and responsibilities. As discussed in Quinn (1998), continues professional development is a process of lifelong learning aim at meeting client needs and improving health outcomes by systematic improvement and the increase of knowledge, upgrading skills to more advance.

Since an instructor is a role model, it is important for the instructor to be accepted and trusted by the people whom he trains. Skills of persuading and to influence others are important in order to gain confidence and to become to follows. Bennis (1990), state trust is essential in the transformational process. Organizations cannot empower without trust and it is essential that if employees are to align themselves with the goal of the organization that they have built a trusting relationship with leader in order to share the vision. The important to be trusted and accepted by staff and student is to get cooperation. Bass (1998) has defined leadership as terms of specific trait of personality, a set of behaviors, a differentiated role, as the exercise of influence or persuasion, as the art of inducing compliance or getting cooperation, as the emerging effects of interaction (process), as a power relationship, or as a combination of elements.

CONCLUSSION

The World of Medical Science is keep changing, the technology and the evolution of disease pattern, occurrence and distribution constrain present healthcare workers especially AMO’s to update and upgrade their knowledge and skill simultaneously with changing of current concept and practice. Therefore lifelong learning and own professional development is essential.

The Transformational Leadership is the style of leadership that is best suited to the present climate of change, not least because it actively embraces and encourages innovation and change. To change the situation is not an easy job. The leader must quench the remnants of historical influences and balance the complex issues of revenues and profit with the delicate issues of human relation with focus on staffs need and patient care (Dixon 1999). Therefore, the leader is suggested to apply transformational leadership style to manage the complexities of the current health service, they must also foster key competencies and pursue training and development to enhance effective transformational leadership performance. Transformational leader must be motivated, visionary, balanced, self-aware and confident of breaking existing professional boundaries to develop a multidisciplinary team approach to patient care.

In the other perspective, this paper has discussed the need of motivation among staffs, is an aspect in leadership management. Leadership is the ability to influence other to perform and work toward the achievement of a goal. The transformational leader strives to empower others and to motivate followers by articulating his vision and behaving as agent of change. Transformational leadership can be anyone in the organization, regardless of the position held. The function of management is the skills of director of the practice setting to facilitate the mission, goals and work of organization.

In the other perspective, a good leader always motivate his staffs how to delegate his work to the subordinates during his absence in order the organization can function well and smoothly. Hasten and Washburn (1994) define delegation as transferring to a competent individual authority to perform a selected in selected situation. Delegation is high level implementation skills to delegate they must be aware of the client’s need. As a leader, he must be honest for himself and others in whatever situation. The main purpose of delegation is promoting motivation and job enrichment and the personal growth for staff as well as for professional growth of the manager.

Every new staff must be motivated for life learning and own professional development. The leaders must provide staff development programs and in service training to keep a continuous professional development.

RECOMMENDATION

For the recommendation I will suggests that every staffs working in healthcare services must be motivated to upgrade skill, knowledge and developed self leadership and move from rigid hierarchical structure and role, as well as changing in current practice due to advances in technology and communication. The leader must emphasize to the subordinates on how to achieve quality of care and provide health care to patient through one seamless s to go care that continuity of care. Effective communication between leaders, subordinates and student, will bring success to organization in the aspect of health care delivering systems. Therefore student and staff must actively involves in continuous medical education for competency, skills and knowledge. The last and not least the leader must encourage his staff to go for continuous development programs and inculcate lifelong learning culture.

Determine the considerations for and process of ethical business decision making to balance corporate and social responsibilities and address moral, economic, and legal concerns..

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Determine the considerations for and process of ethical business decision making to balance corporate and social responsibilities and address moral, economic, and legal concerns.

Mrs. Pettit was on of those dedicated teachers. Licensed to teach in California, she had been working with mentally challenged children over 13 years when her career can to an end. Her competence was never questioned, and the evaluations of her school principal were always positive. However, she and her husband viewed with favor various “non conventional sexual life-styles,” including “wife swapping.” Because so-called sexual liberation was a hot topic at the time, the Pettits were invited to discuss their ideas on two local television shows. Although they wore disguises, a fellow teacher recognized them and discussed Mrs. Pettit’s views with colleagues. A year later, now 40 years old, she and her husband joined ” The Swingers,” a private club in Los Angeles that sponsored parties intended to promote diverse sexual activities among its members. An undercover police officer, Sgt Berk, visited one of those parties at a private residence which he observed Mrs. Pettit performing fellatio on three different men in a one-hour period. Pettit was arrested and charged with oral copulation, which at the time contravened the California Penal Code (although now it does if one of the parties is under eighteen). After a plea bargain was arranged, she pleaded guilty to the misdemeanor of outraging public decency and paid a fine. The school district renewed her teaching contract the next academic year, but two years later, disciplinary proceeding were initiated against her. The State Board of Education found no reason to complain about her services as a teacher, and it conceded that she was unlikely to repeat her sexual misconduct. But the board revoked her elementary school life diploma (license to teach) on the ground that by engaging in immoral and unprofessional conduct at the party, she had demonstrated that she was unfit to teach. Pettit fought the loss of her license all the way up to the California Supreme Court, which upheld the decision of the Board of Education. In an earlier case, the court had reversed the firing of a public school teacher for unspecified homosexual conduct, concluding that a teacher’s actions could not constitute “immoral or unprofessional conduct” or “moral turpitude” unless there was clear evidence of unfitness to teach. Such an attitude is unrealistic, Justice Tobringer argued, when studies show that 75 to 80 percent of women of Pettit’s educational level and age range engage in oral copulation. The majority opinion “is blind to the reality of sexual behavior” and unrealistically assumes that “teachers in their private lives should exemplify Victorian principles of sexual mortality.”
Pettit’s actions were private and could not have affected her teaching ability. Had there not been clandestine surveillance of the party, the whole issue would have never arisen.
Write a four to six (4-6) page paper in which you:
1.Analyze the questions associated with your chosen case study and discuss them using concepts you learned in this course..
2.Explain your rationale for each of your answers to your chosen case study..
3.Format your assignment according to the following formatting requirements: a.Typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides..
b.Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page is not included in the required page length..
c.Cite your textbook as a reference..
d.Include a reference page. Citations and references must follow APA format. The reference page is not included in the required page length..
.

The specific course learning outcomes associated with this assignment are:
•Determine the considerations for and process of ethical business decision making to balance corporate and social responsibilities and address moral, economic, and legal concerns..
•Analyze selected business situations using the predominant ethical theories, such as utilitarian, Kantian, and virtue ethics to guide ethical business decision making..
•Determine the implications and impact of various civil liberty laws in the workplace, such as hiring, promotion, discipline, discharge, and wage discrimination..
•Use technology and information resources to research issues in business ethics..
•Write clearly and concisely about business ethics using proper writing mechanics..