Discussion board Assignment Example | Topics and Well Written Essays - 500 words - 1

Discussion board - Assignment Example Serving the poor is an ethical issue and should be done by everyone as response to humanity. A major and most tragic manifestation of poverty is hunger as described by Mohammad Yunus in his book Banker to the Poor. In 1974, famine struck Bangladesh and Yunus wrote about his experiences of witnessing agricultural lands left uncultivated due to lack of irrigation technological awareness among the villagers. He described the scenario in Bangladesh as hungry people multiplied every day, â€Å"Hungry people were everywhere. Often they sat so still that one could not be sure whether they were alive or dead† (Yunus, vii). Yunus nurtured the dream of eradicating poverty from the world. He has taken a bold initiative to help the poor people in Bangladesh. At first he physically stepped onto the fields to show the farmers how to cultivate rice to optimize yields. Although his hands-on approach received skepticism, his next step was the launching of Chittagong University Rural Development Project which provided the poor people academic credit. In order to do more for the poor, he next focused on providing small loans to the very poor to buy raw materials. Initially he became personal guarantor to Janata Bank which is one of the largest government banks in Bangladesh. From this concept, Grameen Bank evolved that provides un-collateral loans to the poor. He encourages repayment of the loans on weekly and even daily basis to prevent accumulation of large debts. Yunus’s efforts have proved to be fruitful and he dreams of a poverty free world by 2050, â€Å"poverty does not belong in a civilized human society. Its proper place is in a museum† (Yunus, 248). There are ways in which people can move towards fulfilling the mission of making this world free of poverty, and the process lies in desire among all people to do something for the poor. Rich countries often provide financial resources to the poor countries, but this is not

The Central Intelligence Agency and the Bay of Pigs Invasion :: Cuba, Fidel Castro

The story of the failed invasion of Cuba at the Bay of Pigs is one of mismanagement, overconfidence, and lack of security. The blame for the failure of the operation falls directly in the lap of the Central Intelligence Agency and a young president and his advisors. The fall out from the invasion caused a rise in tension between the two great superpowers and ironically 34 years after the event, the person that the invasion meant to topple, Fidel Castro, is still in power. To understand the origins of the invasion and its ramifications for the future it is first necessary to look at the invasion and its origins. Part I: The Invasion and its Origins. The Bay of Pigs invasion of April 1961, started a few days before on April 15th with the bombing of Cuba by what appeared to be defecting Cuban air force pilots. At 6 a.m. in the morning of that Saturday, three Cuban military bases were bombed by B-26 bombers. The airfields at Camp Libertad, San Antonio de los Baos and Antonio Maceo airport at Santiago de Cuba were fired upon. Seven people were killed at Libertad and forty-seven people were killed at other sites on the island. Two of the B-26s left Cuba and flew to Miami, apparently to defect to the United States. The Cuban Revolutionary Council, the government in exile, in New York City released a statement saying that the bombings in Cuba were ". . . carried out by 'Cubans inside Cuba' who were 'in contact with' the top command of the Revolutionary Council . . . ." The New York Times reporter covering the story alluded to something being wrong with the whole situation when he wondered how the council knew the pilots were coming if the pilots had only decided to leave Cuba on Thursday after " . . . a suspected betrayal by a fellow pilot had precipitated a plot to strike . . . ." Whatever the case, the planes came down in Miami later that morning, one landed at Key West Naval Air Station at 7:00 a.m. and the other at Miami International Airport at 8:20 a.m. Both planes were badly damaged and their tanks were nearly empty. On the front page of The New York Times the next day, a picture of one of the B-26s was shown along with a picture of one of the pilots cloaked in a baseball hat and hiding behind dark sunglasses, his name was withheld.

The weak are forced to create alternative realities Essay

The brain is a crucible: a melting pot of intersecting ingredients that forges a reality that is deceptively the same, but often vastly different for each individual. That reality is a construct is a fashionable term these days; it means that we tend to see reality from a particular frame of reference. There is always a context, whether it be political, social or cultural. For those who are unable to construct a satisfactory reality, it is then that they are forced to create an alternative reality, perhaps that fulfils their dreams and meets their views and values. In the words of cognitive neuropsychologist Kaspar Meyer, â€Å"what is now clear is that the brain is not a stimulus-driven robot that directly translates the outer world into a conscious experience. What we’re conscious of is what the brain makes us be conscious of, and in the absence of incoming signals, bits of memories tucked away can be enough for a brain to get started with†. Reality for each individual differs according to their past experiences and memories, as well as what they choose to perceive to be true. Those with weaker frames of minds – such as individuals suffering from mental disorders, or solely living under delusion – tend to create alternative realities in order to escape the harsh truth. Consider the materialism of the post-war United States. Motivated by prosperity and wealth, all Americans were expected to achieve the profound ‘American Dream’, of which Arthur Miller critiques throughout his play ‘Death of a Salesman’. The play’s lead character Willy Loman struggles to face the true reality, but instead, chooses to believe he is leading the life he had always dreamt of. Willy believes himself to be the best salesman of his company, claiming he is â€Å"well liked† by all, and â€Å"vital in New England†, when in fact, his true reality proves to be quite the opposite. Willy struggles to pay his mortgage, as well as fails to support and provide for his family. Despite his favourite son Biff finding the words to call him out to be what he truly is – â€Å"(a) fake†¦ (a) big phoney fake† and â€Å"a dime a dozen†, Willy remains ignorant towards the truth. Willy’s alternative reality provides him with the motivation to continue his life, despite the loss of his job and loss of  respect from Biff. Alternative realities provide temporary relief from the harsh truth of reality, which is sometimes necessary for those who are considered mentally weak. It is often easier to support the alternative realities created by the mentally weak. Due to their mental state, disregarding what they believe to be true can carry several consequences. In ‘Death of a Salesman’, Willy’s wife Linda remains supportive throughout her husband’s delusion. He claims she is his â€Å"foundation (and) support†, which is simply conforming to the expected role of a 1950’s housewife. Another example includes the 2010 movie directed by Martin Scrosese titled ‘Shutter Island’, which clearly highlights the importance of accepting the alternative realities created by the mentally weak. The film’s protagonist Teddy Daniels believes himself to be a U.S marshal assigned to investigate the disappearance of a patient from Boston’s Shutter Island mental institution. However, in true fact, Teddy is actually Andrew Laeddis, one of the institution’s most dangerous patients they have because of his delusions and his violence towards the staff and the other patients. Andrew (or Teddy’s) delusion created an alternative reality in which he was able to escape the truth about his murderous past. In order to support his alternative reality, the staff at the institution developed a scenario in which Andrew was able to live out his delusion, therefore preventing the otherwise dangerous psychological effects of his true nature. If Andrew was in fact exposed to his true reality rather than living as his alter ego, he may have not been able to survive, hence proving the importance of supporting a mentally weak individual’s alternative reality. Alternative realities may not always be negative. In these cases, the alternative reality protects the individual from harm or negative attention due exposing their true self. Consider the death of Whitney Houston, or the even more recent Robin Williams. Despite their true reality consisting of depression and substance abuse, these two renowned celebrities developed and maintained an alternative reality to allow others to portray them as role models and successful artists. In the case of Robin Williams, his severe  depression led to his suicide. As a comedian and successful actor, Williams was perceived by the majority to be a motivated happy man. In true fact, despite working to ensure other people were laughing, he was diagnosed with severe depression, to the point where he eventually took his own life. Robin William’s alternative reality forced others to see him as he was not, but without the negative attention of showing who he really was. In Whitney Houston’s case, despite her perception as an iconic successful singer, her alternative reality consisted of a cocaine addiction to the point where she drowned in a hotel bathtub. Following their deaths, the public was finally made aware of who they truly were, regardless of what we had previously perceived them to be. Alternative realities such as these can be crucial to ensure happiness and satisfaction for the individual, without highlighting their true selves to the world. Those who are mentally weak tend to create alternative realities in order to avoid their true selves. Whether they are living within a delusion – such as Willy Loman – or suffering from a mental condition – such as Andrew Laeddis, (otherwise known as Teddy), alternative realities may be beneficial for the individual, however difficult for others to accept. Due to individual differences in realities due to social, emotional, cultural and political factors, each person must construct a reality that is most suitable for their views and values, even if that results in alternative realities being created. In the words of author Mignon McLaughlin, â€Å"a critic can only review the book he has read, not the one in which the author wrote†, and therefore we cannot judge an individual’s choice of reality or alternative realities without experiencing it ourselves first hand.

Teaching Teenagers about Sex in Schools Essay - 1805 Words

Introduction As millions of teens are heading back to school, they are going to be learning the same old stuff, the usual studies include-history, math, science. But many students and parent’s surprise, there will be an extra class included in the curricula: Sex Education. In most public schools, there is some form of teaching of sex education. However, there is an even bigger question that is arising. â€Å"What kind of sex education are our children getting and is it enough to help?† There is a huge national debate going on over whether the whole ordeal over if kids should or should not be taught in school about sex. It shouldn’t matter what side of the fence you are on or your school, what is important is to know how to†¦show more content†¦By the prohibition of the discussion of the certain topic, there have been less students learning about the topics such as pregnancy prevention and STD prevention than students have in the 1990s. At this time, there was around 750,000 adolescents were experiencing an unintended pregnancy, along with every one in four sexually active teens contracted a sexually transmitted disease annually. It goes far as some states trying and having succeeding in censorship or distort information for political purposes, â€Å"people become the instruments or tools of the state policies that deprive them of the knowledge and info necessary to make and implement decisions about the reproductive and to express the sexuality safely. It thus involves the state control over some of the most basic elements of what it means to be human.† (L.R Freeman, Censorship and Manipulation of Reproductive Health Information) Abstinence-only programs’ funding was greatly expanded when a welfare reform was passed in 1996. The Community-based Abstinence Education programs have provided grants directly from the U.S. Department of Health and Human Services to communities and many faith-based programs to help and even a third of f ederal programs was created for the use of abstinence only education in 2000. In many people’s beliefs, these abstinence-only programs are doing much more harm than good. Such programs are violating numerous human rights and ethical principles as these areShow MoreRelatedSex Education And Sexual Education1253 Words   |  6 Pageshave public schools teach sexual education classes, or teach abstinence education classes? Pregnancy rates in America are slowly decreasing, but are still extremely high. According to K. F. Stanger-Hall (2011), Pregnancy rates in America are more than double the rates of other countries with 72.2% per 1000 girls between the ages of 15-19 becoming pregnant. The best way to lower teen pregnancy is to teach about prevention in schools with sex education or abstinence classes. Teenagers need to learnRead MoreSex Education : A Part Of American Culture1566 Words   |  7 PagesFor decades, sex education in US public schools has been a debatable issue for a minority of people (Shindel Parish, 2013). Healthcare workers insist that with a rise in sexually transmitted infections and unwanted pregnancies among teenagers, sex education is desperately needed in school. On the other hand, there are some parents and other citizens who strongly believe that sex education is something that parents should be teaching to their children. These individuals feel that sex education coursesRead MoreSex Education Are Essential For Teens1479 Words   |  6 PagesSex Education is a controversial but extremely important topic. Yet, we are doing very little to address it. Teaching sex education in schools are essential for teens to help build a strong foundation of sexual health. Although sex education must begin at home, some parents feel uncomfortable talking about the topic with their children and they believe teaching their children about sex can end up encouraging them to engage in sexual intercourse. Due to that, parents and schools try to em phasize theRead MoreSex Ed By Anna Quindlen963 Words   |  4 Pagescollege before returning to the Times in 1977. â€Å"Sex Ed† by Anna Quindlen in the Wake Tech Reader is an article that distinguished her as being a feminist. Even though â€Å"Sex Ed† was written long ago, it is as relevant today as then because teens today are not much different from then. In Anna Quindlen’s essay, ‘Sex Ed,† she expresses that parents and teachers need to come together and talk to teenagers about sex. In Quindlen’s essay she talks about when she was sitting in a clinic in the poorest neighborhoodRead MoreShould Sex Education Be Taught? High School?997 Words   |  4 PagesTeenagers and sex are two words that are often heard together, whether we like it or not, teenagers are having sex. Some schools don’t teach sexual education and because of that students are suffering. There’s no way to make teenagers not have sex but there is away to teach them about having safe sex, that is why I believe that we need to require sexual education be taught in high school. According to the National Conference of State Legislatures, â€Å"Only 22 states require public schools to teachRead More Education Is Key: A Comprehensive Approach to Sex Education Essay1579 Words   |  7 PagesSex education is about informing students about sex so that they can make educated decisions when the time comes to have sex. Sex education helps students protect themselves from unintended pregnancies, STDs, and HIV/AIDS. Students should leave a sex education course with the right tools so they make informed decisions about their sexual health and well-being. The goal of sex education is to provide a student with as much information as possible so that they can use the skills they learned inRead MoreThe Adolescent Family Life Program Teaches Teenagers About Abstinence1365 Words   |  6 Pagesprogram teaches teenagers about abstinence. The AFL differs from other primary prevention programs, but also has complications to its solution for teaching teenagers about its a bstinence-only program. This paper is to display the effective approach of the AFL in how it contrasts from other programs, but also, how it can be revised. In the end, the program needs adjustment, from its abstinence-only education, in order for it to effectively teach adolescences the consequences of sex. Primary PreventionRead MoreThe Issue Of Sex Education1429 Words   |  6 Pagesteens are very common. Teenagers in schools across the US are at risk of getting pregnant. They may even have a sexually transmitted disease and not know it. Many teenagers and even some adults do not know a lot about sexual health. That is because schools are not giving out some of the most important information to their students in sex education classes. All public schools should require that sex education teaches more than only about abstinence and STI’s. First, schools need to make sure thatRead MoreUnited States has the Highest Rate of Teenage Pregnancies Essay1687 Words   |  7 Pagespregnancy, about 500,000 births per year from girls under twenty. Second in the statistic is Poland, who only has about 30,000 teenage births in a year. When the topic of sex arises, people become uncomfortable because it is a subject that is thought of as personal and secretive. However, people aren’t only uncomfortable with the subject because of it being taboo, people try to avoid the subject because they aren’t always informed correctly about it and don’t have a way to learn about it, excludingRead MoreThe Rate Of Unwanted Teenage Pregnancies And Sexually Transmitted Diseases1502 Words   |  7 Pagessafety precautions and informing teens about healthy sexual activity. Sexual Education is the act of educating others about intercourse, the anatomy of the human body, sexual reproduction, abstinence, and contraceptives. Elizab eth Boskey, a STD expert, believes that schools should teach sex education because of the positive effects it has on the students. However, Sol Gordon believes that the parents should be responsible for teaching their children about sex. Even though Elizabeth Boskey and Sol

Should We Need More Laws Protect Gender Identity Or Not

â€Å"41% of people who are transgender have attempted suicide sometime in their life† (Alpert). SIRS researcher writes, â€Å"The American Psychiatric Association uses the term ‘gender dysphonia’ as the medical diagnosis for people who feel their birth-assigned sex and their gender identity do not match.† The pro view point are excited that laws have been passed to protect transgender people from discrimination harassment and bullying. While the cons are against the law because they are worried that people will claim the opposite sex to get into the opposite sex’s public restrooms, or locker rooms. This paper will examine the pro, con and my viewpoint on whether we need more laws to protect gender identity or not. To illustrate my point,†¦show more content†¦In July President Obama signed an executive order banning workplace discrimination against millions of LGBT employees of federal contractors and the federal government (Thibodeaux). I am extremely happy that the President cares for other people no matter what gender they take or was sex they like. Finally, The OSC reported and noted that the restroom restriction â€Å"had the effect of isolating and segregating† Luserdi from other female employees â€Å"serving as a constant reminder that she was being deprived of equal status, respect, and dignity in the work place (Thibodeaux). So Luserdi a human being was being deprived of using the same restroom as her sex identity and was forced to use another restroom away from people. How cruel. Secondly, New Yorkers are easing the laws for shifting genders in New York, how interesting. In fact, according to a survey by the National Transgender Discrimination 40% of transgendered people who were interviewed had reported being harassed when they showed identification that did not match their gender (Flegenheimer). Can you imagine going on a trip or even buying something and having to show your ID and get harassed for being a different sex then on your ID? This is serving as a constant reminder of their past, and their decision. They will never fully be who they are if people keep discriminating against them. In addition, Levasseur a transgender

Analysis Of Shakespeare s Macbeth - 1068 Words

Salma Farid Mr. Rehm ENG3U1-01 Friday November 14th, 2014 Sleep No More: The Role of Macbeth’s Conscience Traditionally, a tragic hero is a protagonist, usually of noble birth or high-standing, who possesses a flaw in character that brings about his own downfall. The tragedy Macbeth, written by William Shakespeare, has a perfect example of a tragic hero, otherwise known as Macbeth. A tragic hero must be a man who is great and admirable in various ways. He should be placed in society in such a way that everything he does affects all of the members of his society. Macbeth fits the description of being a tragic hero, displaying his strengths, his weaknesses, his tragic flaw, and how influential everything around him is. Macbeth is a tragic hero, because his physical courage is joined by a consuming ambition and tendency to self-doubt and his brutality is balanced by his guilt - a quality that enables the audience to identify with Macbeth throughout the play despite his cruelty. Firstly, Macbeth is a tragic hero, because his physical courage is joined by a consuming ambition and tendency to self-doubt. Macbeth’s ambition is driven by a number of factors. Macbeth’s ambition soon goes out of control and forces him to murder again and again to cover up his previous wrong doing. Macbeth says, â€Å"I am in blood stepp’d in so far, that, should I wade no more, returning were as tedious as go o’er.† (3.4.136-138). By comparing his actions to wading through a bloody river, Macbeth suggestsShow MoreRelatedAnalysis Of Shakespeare s Macbeth 991 Words   |  4 PagesOne of the most famous soliloquies in history is Macbeth s Tomorrow†   speech, aside from Hamlet’s. It goes over many contemplating thoughts, and like all Shakespeare plays, he tries to answer them. During the events of Act 5, Scene 5 of the play Macbeth, Lady Macbeth goes insane and solves it by killing herself. Macbeth hears a scream and doesn’t bother to check who it is. He sends someone to find out, and when he gets the news, he’s mad at her for not being able to see his triumph. His soliloquyRead MoreAnalysis Of Shakespeare s Macbeth s Macbeth 1250 Words   |  5 PagesDeemed Shakespeare’s shortest and most bloody tragedy, Macbeth is the tale of a valiant Scottish general whose unchecked ambition elicited his transformation into an immoral and tyrannical ruler. The story follows Macbeth’s encounter with the three Weird Sisters whose ambivalent â€Å"prophecies† prompted him to murder King Duncan and ultimately triggered his moral decline. Most prominent in the play is the theme of equivocation and a pervasive feeling of uncertainty is felt throughout the entirety ofRead MoreAnalysis Of William Shakespeare s Macbeth 1785 Words   |  8 PagesScotland! A man has a great ordeal on his hands. Some might say that Macbeth has a second chance or a life long dream that could change his future forever. Deep in the heart of Birnam forest, a castle sits upon Dunsinane Hill, with a man made foundation built from paved bricks that have housed the many Kings that have ruled this Kingdom. Macbeth hears a prophecy from three evil and dilapidated witches foretelling his future. Macbeth, terrified yet surprised, is unsure of his morals and is battling betweenRead MoreAnalysis Of Shakespeare s Macbeth s Macbeth 1844 Words   |  8 PagesGender Roles’ association with Success and Failure in Macbeth In William Shakespeare’s play Macbeth, Lady Macbeth and Macbeth fail because they follow strict notions of gender roles; whereas, Macduff is successful because he depicts a healthy balance of both masculine and feminine traits. Macbeth is far on one side of the gender spectrum, being hypermasculine; while, Lady Macbeth is far on the opposite side, being hyperfeminine. To begin with, it is important to understand what the terms â€Å"hypermasculine†Read MoreAnalysis Of Shakespeare s Macbeth 1136 Words   |  5 PagesGielarowiec 1 Paula Gielarowiec English 4A Mrs. Mastrokyriakos Macbeth Essay 1 March, 2013 Women in Macbeth For many years now women have always been slaves towards men. Always doing everything for them. Cooking, cleaning, and taking orders. But that is slowly changing. Everything slowly changes even people. People become more deranged over time. Shakespeare is one of the writers thats shows that in his plays. One of his plays is based on murder and irresponsible choices. The characters in the playRead MoreAnalysis Of Shakespeare s Macbeth 1331 Words   |  6 PagesTalin Davdian Vsevolo Krawczenuik Theatre Art 101 17 July 2015 Critical Paper The play of Macbeth is written between 1599 and 1606 by William Shakespeare, who is a playwright, actor, English poet and greatest English literature. The full title of Macbeth is The Tragedy of Macbeth, which it considered one of his darkest and most powerful works. The play, set in Scotland. In this play, William Shakespeare uses various themes that represent to the social and political life. This story is about theRead MoreAnalysis Of Shakespeare s Macbeth Essay2504 Words   |  11 PagesShakespeare Essay – Georgia Callaghan, 341996 In the play Macbeth written by William Shakespeare, an important character is Macbeth. The writer develops the personality of said character throughout the play using contrast, dialogue, actions, thoughts, and commentary. Through this the audience is able to observe the personality transformation Macbeth undergoes throughout the course of the play. The first mention the audience receives about Macbeth, is from the three witches at the very beginningRead MoreAnalysis Of Shakespeare s Macbeth By William Shakespeare1351 Words   |  6 PagesKnown for his tragedy, intrigue, comedy, and romance, Shakespeare extends his boundary of prowess in the play Macbeth. The irony present in the play, the double-meaning of the characters’ actions, and the complexity of setting all contribute to a thrilling story of murder and looking beyond the superficial. Dramatic, situational, and verbal irony greatly contribute to the theme of things are not what they seem in Macbeth text and film. Shakespeare uses the contrast in irony to convey this in the character’sRead MoreAnalysis Of Shakespeare s Macbeth By William Shakespeare1236 Words   |  5 Pagesit. This idea of equivocation is abundant in Shakespeare’s tragedy, Macbeth. In Macbeth, Shakespeare exposes literary devices such as illustrative imagery, sarcastic similes, and dubious diction to unveil one of his many themes: Things are not always what they seem. Shakespeare beautifully illustrates this fact through the duplicity of Macbeth, his wife, the three suspicious witches, and king Duncan . Starting the play, Macbeth is a very much regarded saint who seems, by all accounts, to be an incredibleRead MoreAnalysis Of Shakespeare s Macbeth By William Shakespeare2081 Words   |  9 PagesShakespeare Essay Shakespeare uses language in his literary creations as a technique to enrich the ideas of his works. In his play Macbeth, Shakespeare uses metaphor as a useful way to enhance language and construct the overall idea. Macbeth revolves around the prospect of ‘power,’ and also focuses on what one is willing to do in order to gain power, and also to maintain it. Throughout the novel, Shakespeare uses metaphors and comparative techniques that link together to develop the

Nursing Management Free Essays

string(147) " points on the action plan meet the SMART \(Jumaa Alleyne, \(1998\)\)criteria: Specific, Measurable, Action based, Realistic and Time bound\." Contents GLOSSARY ABSTRACT/SUMMARY INTRODUCTION DM 45 DEVELOPING MANAGEMENT STYLE 1. Self- assessment analysis 2. Stakeholders analysis 3. We will write a custom essay sample on Nursing Management or any similar topic only for you Order Now S. W. O. T analysis DM 46 RECRUITMENT AND SELECTION DM 47 MANAGING PERFORMANCE DM 48 DEVELOPING TEAMS INDIVIDUALS RECOMMENDATION REFERENCES BIBLIOGRAPHY APPENDIX Glossary D. O. H – Department Of Health N. H. S – National Health Service N. S. F – National Service Framework P. E. S. T. O – Political Economical Social Technological Others 7 S – Shared Values Strategy Structure System Staff Style Skill S. M. A. R. T – Specific Measurable Achievable Realistic Time-bound S. W. O. T – Strengths Weaknesses Opportunities Threats Abstract/Summary I am currently working as a Charge Nurse/ Deputy Ward Manager on Ward X , a Diabetic and Renal ward based at a North London Hospital. The ward contains 21 acute medical male beds and a team of 28 staffs which includes 6 student nurses, 2 domestics, 1 ward clerk, 7 health care assistants, 6 junior nurses, 4 senior nurses and 2 ward sister/charge nurse. Some of my main responsibilities on the ward includes the assessment of care needs for patients, the development of programmes of care and their implementation and valuation and most importantly carrying out all relevant forms of care without direct supervision, and demonstrate procedures to, and supervise qualified and unqualified staff and contribute to the overall good of the organisation by being a positive role model and treating all staff, visitors and service users with courtesy (Appendix 1). In this assignment I will demonstrate the use of knowledge, management concepts and theories that I have acquired while undertaking this module of Managing People and relate them to my clinical area. Certain area of practice will be identified, analysed and evaluated through effective people management using the CLINLAP model (Jumaa (1997) ), ( Jumaa Alleyne (2001) ) within the ward setting. ‘CLINLAP is defined as a strategic nursing leadership and learning process that positions strategic learning as a driving force within health and social care organisations, on a day to day basis, in the management of nursing goals; nursing roles; nursing processes; and nursing relationships’ (Jumaa Alleyne, 1997 2001) Introduction The National service frameworks (NSFs) are long term strategies for improving specific areas of care. They set measurable goals within set time frames. NSFs: †¢ set national standards and identify key interventions for a defined service or care group †¢ put in place strategies to support implementation †¢ establish ways to ensure progress within an agreed time scale †¢ form one of a range of measures to raise quality and decrease variations in service, introduced in The New NHS and A First Class Service. The NHS Plan re-emphasised the role of NSFs as drivers in delivering the Modernisation Agenda. Each NSF is developed with the assistance of an External Reference Group (ERG) which brings together health professionals, service users and carers, health service managers, partner agencies, and other advocates. ERGs adopt an inclusive process to engage the full range of views. The Department of Health supports the ERGs and manages the overall process. (DOH, (2005) ) The NSF makes it clear that the NHS is committed to building a modernisation programme to provide high quality patient care and improving the working lives of all NHS staff. In terms of patient care, it draws the attention to the need to look at each service from the patient’s point of view and to ensure that a patient focus is embedded in the culture. In order to achieve this, new and better ways of working are required through, for example: – Investing in the workforce in terms of more staff and better training Giving frontline staff responsibility, freedom, skills and resources to do a better job, using their initiative for local innovation within national standards – Reducing bureaucracy whilst increasing accountability so that there are clear and transplant process for holding the NHS to account for their delivery of services – Requiring staff to work effectively in teams, for example, through managed clinical networks – Working in partnership with staff and involving them through representation NHS is critically dependent on its employees for delivering the strategic and operational goals at corporate, departmental, functional and team levels and managing people efficiently and effectively has become a central part of the ward manager/sister/charge nurse’s task at all levels particularly with a view to improving the performance of employees and thereby the performance of the NHS in delivering services. Ward managers increasingly are being expected to take great responsibility or the personnel management aspects of their work. This implies that we are able to function effectively in 4 key aspects of managing people : – Developing our own management style – Employee recruitment and selection – Managing performance by motivating and developing staffs – Developing Teams and Individuals by improving staffs performance at both individual and team levels. Dm 45 Developing Management Style In this unit I will identify 3 ways of assessing my curren t skills and competence as a manager. These methods will allow me to discern clearly my strenghs and weaknesses and thereby identify areas on the ward in which improvements can be made and devise action plans which will then be monitored for progress. The 3 methods chosen will be, firstly self-assessment and analysis through appraisal, secondly the stakeholder analysis tool and thirdly the SWOT analysis tool. Self- assessment analysis Self-assessment steps :- 1. Arrange a meeting with Ward Manager to agree on an appraisal date. 2. Ward Manager distributes pre-appraisal meeting self-assessment form. Appendix 2) 3. Work through the pre-appraisal form making notes and identifying potential areas for improvement. (Appendix 2) 4. Meeting with Ward Manager on agreed appraisal date. Work through the Personal Development Plan form (Appendix 3) to reach agreement on the current performance and potential areas for improvement 5. Following the meeting the Ward Manager distributes completed Personal Development Plan and list of pote ntial areas for improvement 6. Ward Manager agrees and complete draft action plan to forward to Matron 7. Matron follows up and verifies the Personal Development Plan. (Appendix 3) 8. Action plan agreed with matron. Ensure that all points on the action plan meet the SMART (Jumaa Alleyne, (1998))criteria: Specific, Measurable, Action based, Realistic and Time bound. You read "Nursing Management" in category "Papers" (Appendix 3) Stakeholders analysis An integral part of the clinical governance review process is feedback from stakeholders. The Hospital’s definition of stakeholders includes staff, patients, relatives of patients, carers, other local NHS organisations, voluntary groups and other people with an interest in the trust. The information provided through stakeholder work helps shape some of the areas that the clinical governance review will concentrate on. Clinical Governance is a framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish. It aims to create not only a culture, but systems and ways of working which assure that the safety and the quality of care is at the heart of the business at every level. Appendix 1, Unit 5) As a Deputy ward manager it is important for me to take into account feedback from stakeholders for effective managerial performance and to provide high standards of care. In order to do so the table that I have produced below will help me to identify the role of individuals, or stakeholder groups who are involved or affected by the clinical governance programme and can thereby affect its success or failure. Stakeholder analysis chart | |Programme |Organisation |External | | | | | | | | | |Clinical Governance |Hospital |Diabetes UK , Patients | | | | |Staffs, Patients |Relatives, carers, PCTs| |Who wants the team to: |Succeed | |Yes |Yes | | |Fail | |No |No | |Who is betting on the |Succeeding | |Yes |Yes | |team: | | | | | | |Failing | |No |No | |Who is supporting the |Visibly | |Yes |No | |team: | | | | | | |Invisibly | |No |Yes | |Whose success: |Affects the team | |Yes |No | | |Does the team affect | |Yes |Yes | |Who does the team’s |Benefit | |Yes |No | |change: | | | | | | |Damage | |Yes |No | |Who can the team’s |Happen without | |No |Yes | |change: | | | | | | |Not happen without | |Yes |Yes | In the above table it can be noted that the group of stakeholder who are mostly involved and influence a programme are mainly the patients and the staffs. As part of my objectives I will in future concentrate on feed back from my staff on the ward and our group of patients. This can be achieve by organising ward meetings with staffs or actually having a one-to-one interview with them at least once in a month. As for feedback from patients this can be organised by their allocated staff nurse in the form of an informal one-to-one interview at some point prior to the patient being discharged home. SWOT analysis A SWOT analysis is a tool, used in management and strategy formulation. It can help to identify the Strengths, Weaknesses, Opportunities and Threats of an organisation. Strengths and weaknesses are internal factors that create or destroy value. They can include assets, skills or resources that the ward has at its disposal to provide care to patients. They can be measured using an internal assessment tool such as Peters Waterman’s 7S’s. The table below will help me assess the internal factors of the ward and identify my goals and make them SMART (Jumaa Alleyne (2001)) This will help me to identify areas for development. Shared Values Current: The ward believes in team working providing quality care Goal: To support staffs and encourage them to carry on working as a team Provide them with feedback from patient on quality of care on the ward. Strategy Current: The ward believes in staffs further development and clinical skills. Goal: To send every qualified staff on in–house study days to develop their clinical skills Structure Current: Staffs does not communicate clearly between each other to promote continuity of Care. Goal: To meet up with staffs on a one-to-one basis or ward meeting and discuss appropriate communication. System Current: Staff appraisals only being carried out once in a year Goal: To discuss with manager if appraisals can be done every 6 months Staff Current: The trust is introducing Senior Health Care Assistant posts. Goal: Identify if any of the present Health Care Assistants on the ward are suitable candidates for the post by appropriate supervision. Style Current : The ward has a team with multicultural staffs Goal: Encourage staffs to respect each others cuture and thereby work more efficiently. Skill Current: The ward has staffs with different skill mix. Goal: Give positive feedback on their skills and encourage them to share their knowledge and attend study days to expand them. Opportunities and threats are external factors that create or destroy value. Usually an organisation cannot control them and they emerge from Political, Economical, Social, Technological and Others. The assessment below using PESTO will help me to identify the goals set up by external factors and which needs to be included on the ward to meet expectations and thereby identify areas for my own professional development. Political Current: The NHS Plan outlines a new delivery system for the NHS and changes for social services, and changes for NHS staff groups. It also sets out plans for cutting waiting times, clinical priorities and reducing inequality. Goal: Have regular ward meetings to discuss with team how to incorporate changes on the ward. Economical Current: The NHS budget has doubled since 1997, and will have almost trebled by 2008. All NHS organisations including my ward are receiving above inflation funding increases, both this year and next. Goal: Meet up with team and prioritise our expenses so we can work within our budget Sociological Current: The Hospital accommodate patients from different ethical background and beliefs. Goal: Ensure that the trust can meet certain requirements for its ethnic minority group. For example providing them with special diet like halal meal in the case of muslim patients. Technological Current: The trust is currently using advance computer system to handle patients’ data. Goal: Ensure that members of the staffs who are not computer literate attend IT course for quicker access to patient’s data. Other Current: The Hospital has performed well in maintaining and encouraging ‘The clean our hands campain’ and reducing the risk of cross infection Goal: Encourage the team by giving them positive feedback and reinforce infection control policy. DM 46 Recruitment and Selection Once a trust has decided on its goals, it is essential that it identifies whether it has the people necessary to achieve them. Trusts need to develop ways of assessing the number of employees that they need to provide specific services. The implications of the recent policy changes in the NHS are that there will be further major changes in the numbers and deployment of employees across trusts. DOH, (2005)) As a Deputy Ward Manager part of my responsibilities is also to have a clear view of the number of staffs that we have on the ward and the number that we need to deliver the trust’s objectives. Currently on my ward we have vacancies for 2 permanent Senior Staff nurses post previously known as g rade E. The new post which is now named Band 5b according to the agenda for change has been created by the trust due to our increase in bed turnover and high demand of standards of care. Before the posts were advertised I had a meeting with my Ward Manager and Matron so we can focus on the basic stages of recruitment which are: 1. Agree the vacancy 2. Prepare a job description 3. Prepare a person specification 4. Attract applicants through good advertisement(Appendix 4a) 5. Selection 6. Induction It is important for us team leaders to use vacancies as an opportunity for re-assessing people’s needs and the organisation’s structure so objectives can be achieved. Therefore an agreement between team leaders is important to reach our goals. – After the agreement me and my ward manager we devised the job description and person specification taking into account an analysis of the following criterias (Kneeland, (1999)) : – the present or expected duties of the job – changes which might impact on the job in the future – existing duties which might be done more effectively or efficiently by some one else – new duties that could be added to the job While preparing the job description my manager and I focused on 5 important aspects which were: Accuracy in order not to understate or overstate the role and duties associated with the post. (Appendix 4b, Section A) – Clarity in terms of tasks, duties, roles and responsibilities(Appendix 4, Section B) – Up-to-date (Appendix 4b, Section A, E) – Flexibility (Appendix 4b, Section A, B) – Non-discriminatory particularly in terms of gender,marital status or ethinic background The use of person specifications have a different purpose and it actually aims to identify the qualifications, skills, experience and abilities which are seen as essential or desirable in the post-holder and is used primarily to assist those involved in the selection process. (Appendix 5) After the posts were advertised and the applications received me and my ward manager short-listed 8 candidates out of 23 applications. This was undertaken by eliminating those who did not meet the pre-agreed essential requirements as set out in the person specification. (Appendix 5). For example some candidates did not have the knowledge of the KSF of Diabetes which is an essential requirement for the post as we specialise in this area or did not have a minimum of 12 months experience as a qualified staff nurse. We made sure that the necessary information about the selection process were recorded and appropriate feedback given to unsuccessfull candidates about their performance at the interview. Once the 2 candidates out of the 8 were successfull and appointed, it was important for me to plan induction and development for them. Given the investment made in new employees it is important that they should receive an appropriate induction so they can bring maximum contribution to the trust. At the Whittington Hospital, the trust induction covers areas such as the trust objectives so that the employee understands what they are trying to achieve, personal objectives so that the staff understands what is expected from them and relevant immediate training so that the person can properly undertake their job. Though it is a policy for every new employees to attend the trust nduction, I would personally recommend that all new starters on my ward should have a mentor to supervise them for at least the first 2 weeks of employment or even suggest an informal visit to the ward prior to interview so that candidates feel that the working environment is appropriate for their futur development . DM 47 Managing Performance Performance management encompasses a range of standard management techniques and is not necessarily a formal system and is not necessarily the same as an appraisal system. (Templar, (2001)). On my ward, performance management systems is a common benefit which enable my staffs to see more clearly their role on the ward and the trust’s objectives. The key elements of managing my group of staffs involve setting objectives for the ward, assessing their development needs, making it happen, review it and doing better. Staffs on the ward need to know what is expected of them. Setting objectives which are S. M. A. R. T for action means that they can be sure what they should deliver, when and how. (Appendix 6). Discussion about individual objectives will also enable my staffs to understand why they should do the things that they have to do and how they fit into and contribute to the wider goals and aims of the trust. It is important to assess the training and development needs of my staffs to improve their ability to reach the standards of performance expected of them in their jobs. This process should result in planned actions to meet individual needs, and will, where appropriate. (Appendix 6). In order to make the assessment happened, communication between me and my staffs should be improved. Many tangible and intangible factors contribute to an effective working environment. As a deputy manager it is important for me to focus on the creation of a shared understanding and sense of purpose in my workplace, in particular, communication,culture and climate. Good communication is essential for effective performance management. For example on my ward internal communication such as team briefings, staff meeting, noticeboards and emails enables me and my ward manager to ensure that all our staffs are clear about the ward’s goals and that messages are given and received to and from staffs. This include aims and objectives as well training and development opportunities. People’s performance is affected by their working environment. Morale,motivation, frustration, enthusiasm and commitment all influence the performance that the trust can achieve, so understanding what is important to staffs and listening to and acting on their views is an essential part of organising effectively. (Templar, (2001)). Having set objectives for individual staffs it is essential that performance and progress are regularly reviewed with individuals so that staffs feel recognised for their achievement and can identify areas where performance can improve. Reviews are necessary to improve individual and organisational performance but at the same time identify poor performance. The scenario below will demonstrate a situation where one of my junior staff nurse was constantly showing poor performance on the ward and the action taken against her. Scenario: Miss X, a junior staff nurse on the ward has been persistently coming late to work and is very slow in carrying out her daily tasks. Several members of Senior staff nurses have been reporting to me that standard of care for the group of patient she was looking after, has been deteriorating. I had a formal meeting on a one-to-one basis with Miss X where her poor performance issues were raised and an action plan was devised. It was discussed that she will be on a 3 months probation and will be supervised at all times by a senior member of staff and feedback will be given to me if her performance was improving. A copy of her job description and a self-assessment form was provided to her so she can set her personal objectives and discuss it with my manager or myself. The disciplinary and grievance process of the trust states that no disciplinary action will be taken against an employee until the case has been fully investigated. However, it should be recognised that there may be occasions when a full investigation is impossible e. g imprisonment. For example individuals will be informed of specific complaints against them in writing and will be given the opportunity to state their case directly to those who are considering disciplinary action before any decisions are made. Individuals and their Trade Union representative will be given a written explanation of any penalty imposed and its duration and in the case of written warnings , will have the right to appeal against this penalty. Usually no employee will normally be dismissed for a first breach of discipline except in cases of gross misconduct where summary dismissal without notice or pay in lieu of notice will be appropriate sanction. It, should, however, be recognised that there will be occasions, not covered by gross misconduct, when it will be necessary, because of the seriousness of the offence, for disciplinary action to begin at any stage of the procedure up to and including dismissal with notice for a first offence. (The Hospital disciplinary and grievance policy, (2006) ) In the case of a first offence or disciplinary measures my role will be to discuss it first with my line manager as they are the one who are allowed to issue oral warning, dismissals and discuss the circumstances with Human Resources. DM 48 Developing Teams individuals To get the best from employees, managers need to know who will be doing what, where the strengths and weaknesses of staffs are and which skills need to be developed by their teams. Properly set, achievable objectives that make clear what is expected, by when and to what standard, benefit both staffs and managers by clarifying roles and responsibilities, and assist in delivering value for money in the use of people resources. Setting performance objectives with staffs will also enable us managers to assess how our team can be best be used productively and identify any areas where staffs are producing different results and output. This can be useful in benchmarking performance and identifying individual, team and departmental areas for improved productivity. (Templar, (2001)) When performance objectives and standards are set for a team, it is necessary to assess whether the team has the skills to meet the standards being set and to agree how skills will be developed if they do not already exist. This is particularly important when ways of working are being changed. The Developmental plan below which has been devised with a team member and also reflect the team’s objectives as a whole, demonstrate the organisational and individual needs that can be met in many ways: Development Plan Individual/Team |Work shadowing |Get full support from Senior members of the team and provide | | |feedback. | |Special Projects |Encourage staffs to actively get involve with hospital projects such| | |as campaings. |Planned self-development |Meet at least every 6 months for appraisal and plan self | | |-development | |Mentoring |Offer support to newly qualified staff in the form of | | |mentorship/preceptorship for the first 2 weeks of joining the team | |Coaching and guidance |Provide staffs with support and guidance whenever and wherever | | |required. |Study for professional qualifications |Encourage staff to go for further studies for example encourage | | |Diploma holder to complete their Degree or send people for | | |specialist course such as the Diab etic Course. | |Planned delegation |Ensure that Senior staff nurses take responsibility in delegating | | |tasks to junior staffs, H. C. As and student nurses | |On-the-job training |Encourage staffs to attend in-house clinical skills study days. |New responsibilites |Allocate new rsponsibilities to members of the team. For example | | |making each member of the staff responsible for certain part of the | | |ward like for instance in charge of the treatment room’s general | | |tidiness. | |Off –the- job training |Negociate with staffs if there is any external training they want to| | |attend and provide them with leave or day off. |Job rotation/secondment |Senior staff nurses to act as team leader in the absence of myself | | |or the ward manager. | |Membership of professional societies |Encourage staffs to join professional bodies like the Royal College | | |of Nursing and UNISON | In the above table it can be noted that the individual development needs add up to the team development needs and trust-wide development needs. Individual managers must have a view of the team needs across the trust so that common needs can be met in the most cost-effective way and competing needs can be prioritised. Recommendations Staff development should be linked to the achievement of the trust’s goals and targets. If a key priority for the trust is to improve patient care, development plans at individual, team, departmental and corporate level should reflect that goal by focusing on enhancing the skills of staffs to deliver the required levels of patient care. Staffs will know which aspects of their work need support and development and are well placed to identify training and development needs to help them perform better in their jobs References Department of Health (2005), ‘The New NHS plan’ London D. O. H Jumaa, M. O Alleyne, J. (2001), ‘Managing and Leading in a constanly changing contexts in Health and Social Care’ Middlesex University Kneeland, S. (1999), ‘Recruiting for Results’ How To Books Ltd Templar, R. (2001), ‘Fast Thinking : Appraisal’ Pearson Education Ltd The Hospital (2006)‘Disciplinary and Grievance policy’ The Whittington Hospital Bibliography Belbin, R. M. (1996). ‘Managing Teams: Why they succeed or fail. ’ Oxford: Butterworth-Heinemann. Johnson, G. Scholes, K. (2001). ‘Exploring Corporate Strategy 6th Edition’ Prentice-Hall Martin, V. Henderson, E. (2001). ‘Managing in Health and Social Care’ Routeledge How to cite Nursing Management, Papers