An examination of assessment tools in relation to Watson's theory of Research Paper

An examination of assessment tools in relation to Watson's theory of human caring - Research Paper Example Caring Tools that expand the abilities of nurses to assess and evaluate clients in the various stages of health, illness and stress are particularly an important part of the knowledge that nurses should have and ultimately impact on the quality of healthcare. Besides this, Watson’s theory of human caring enables nurses to integrate mind-body-spirit dimensions of assessment tools hence delivering better services to patients. The advent of evidence-based practice means that the use of assessment tools is influenced by the data available on them in terms of cost, length, ease of use and suited populations. When using such data, it is also important to evaluate its validity to ensure that the correct assessment tools are utilized. This study will investigate all these aspects focusing on three assessment tools; Dysfunctional Attitude Scale, Health Self-Determination Index (HSDI) and the Spiritual Perspective Scale. The impact of these tools on assessment phase and quality care pro vided by nurses will be evaluated followed by their application to homeless individuals. Assessment Tools Dysfunctional Attitude Scale (DAS) This is an assessment tool that was developed to measure the pervasive/silent maladaptive cognitive vulnerability exhibited by depressed individuals (Antony and Barlow, 2010). It is based on the view that such depressed individuals bear negative attitudes with regard to life and this can be analyzed through determining the views of an individual to self, world and future. This is what is usually referred to as the cognitive triad that can be used to tell apart depressed from non-depressed individuals based on their pessimism. The Dysfunctional Attitude Scale is a self-report 7-point likert scale that measures the occurrence of attitudes that portray underlying dysfunctions and how intense such attitudes are (Weissman and Beck, 1978 cited in Graaf et al., 2009). The original Dysfunction Attitude Scale was based on 100 items but was later simplif ied into DAS-A and DAS-B parallel forms that contain 40 items only. The result of this is that the DAS test is an inexpensive, easy to perform and relatively short undertaking. Graaf et al. (2009) performed DAS on populations whose demographic factors significantly correlated with depression including the unemployed individuals, individuals who were occupationally disabled and individuals with low levels of education. The dysfunctional attitudes measured among such populations include attitudinal approval, entitlement and achievement which perfectly interrelate with the mind-body-spirit dimensions as put forward by Watson hence resulting in a better assessment by nurses translating to better treatment. In terms of reliability and validity of the evidence, Graaf et al. (2009) and many other researchers have performed psychometric experimental studies on DAS and generated reliable and valid results. This is demonstrated through correlation analyses and actual distinction between indiv iduals with and without depression hence the DAS is safe for application in clinical practice. DAS is particularly important as a tool for nurses during the assessment stage as it allows the nurse to get a grip of the major underlying factors behind depressed individuals and as a result aid in the proper interventional measures for example through pharmacopsychotherapy that will deal with both biomedical aspects and psychological aspects of illness. Perceived Stress Scale Cohen, Kamarck and Marmelstein (1983, cited in Peters, 2007) designed a measurement of the level to which individuals perceived their life situations as being stressful in terms of unpredictability, overload and inability to control. It uses 14 items in a likert scale with responses ranked as â€Å"never† to â€Å"very often.† Seven of the items in the scale are positive and through the test the level of self-perceived stress can be

The Face in the Mirror and Sticks and Stones and such-like Essay Example for Free

The Face in the Mirror and Sticks and Stones and such-like Essay Identity is presented through the contents of belonging, values and beliefs. A person’s identity constantly changes and develops in time, depending on aspects of ethnicity, self-image and connection to a person or place. It is this which â€Å"builds† the qualities of identity. Prime examples of expressing the intricate nature of identity is clearly seen through Alice Pung’s short stories â€Å"The Face in the Mirror† and â€Å"Sticks and Stones and such-like† alongside Paul Keating’s memorable eulogy speech â€Å"The Unknown Soldier†. In Pung’s short story â€Å"The Face in the Mirror†, the author explores how ethnicity illustrates how a person’s relationship in the world creates a sense of identity. The idea is seen in the quote: â€Å"For much of my childhood, my Asian-ness was pushed to a crevice in the back of my mind. My friends were white, my family was white, my world was white.† The female protagonist conveys her cultural identity, through the use of a compound word, describing her â€Å"Asian-ness† persona as being part of a white family. Pung also uses the technique of repetition, demonstrated through the word â€Å"white† coupled with the metaphor of â€Å"my world was white† to depict the fact that her whole lifestyle, revolves around â€Å"white† customs, as she neglects her original cultural origin being â€Å"made in Korea†. Through this, the audience are made to empathize for the protagonist as she is forced into neglecting her asian background. Hence, further reinforcing Pung’s concept of how ethnicity can be an aspect of identity. Another way Pung demonstrated her concept of identity is through the use of the technique accumulation, in conjunction with rhetorical question in the short stories ‘Face in the Mirror’. For example. Accumulation is found where Pung lists â€Å"a name, a place, a date and temperature.† She follows this technique with the rhetorical question â€Å"but, what did it all mean?†. Pung uses these techniques to utilize the fact that the protagonist strives to find out more on her self, which illustrates how identity can be achieved through ones ethnicity. In Pung’s short story ‘Sticks and stones and such like’, she establishes her concept of identity through the use of a series of language techniques throughout the text, one of these techniques, would be the use of a metaphor in conjunction with the use of accumulation. The author does this, to strongly utilize her concept. These techniques are found in the quote ‘All talking frantically and loudly in English, Hindi, Kannada, Konkani: Every sentence a masala of different vocabularies†. The metaphor being a ‘masala of different vocabularies’, and accumulation being the list of the different languages. The persona refers to the list of different languages as a ‘masala’, which in her culture means ‘a variety of different spices’. This is done to further reinforce the cultural gap, which conveys how the persona feels a disconnection of identity due to a different ethnicity. Therefore impacting her sense of identity. In addition to ‘Stick’s and Stones and Such-like’, the author has further demonstrated her concept of identity by the use of language techniques describing the connection to the person and their self image. These techniques used by the author are allusion and short sentences, which is demonstrated in the quote, â€Å"Sticks and Stones and Such-like, I’ve been called a lot of things†. This allusion is is an expression which alludes to a different text, â€Å"Sticks and stones may break my bones but words will never hurt me†. This technique indicates the connection between their name and personal identity, although the technique of short sentences portrays the author’s intentions of rising above other people’s perceptions of identity through one’s name. Therefore, a sense of reassurance is achieved. In the related text â€Å"Unknown Soldier† written by Paul Keating. The author uses a series of techniques in order to portray the concept of how a sense of identity can be reached through ones connection to a person or place. â€Å"He is all of them. And he is one of us†. Short sentences are being used in this text to provide an impacting atmosphere to the audience. This relates to identity placing the soldier within a group rather than being anonymous, as the title suggests. Throughout the first stanza, the composer has used repetition repeating the phrase, â€Å"we do not know† in regards to factors of family, religion and ethnicity which have been lost, showing that he was not only a soldier, but a man, creating a sense of identity. In regards to identity, it emphasis’ the several factors of shaping and changing who a person is. The idea of self-image is seen in the quote, â€Å"Out of the war came a lesson†¦It was a lesson about ordinary people, and the lesson was that they were not ordinary†. Irony is seen in this quote, contradicting itself that the soldiers which fought in War were not like everyone else, rather being perceived of having a â€Å"heroic† status in other peoples eyes. The effect of this ironic statement allows the audience to contemplate the impact an individual has on their own self-image. This shows the concept of self-understanding, as without a distinguished self-perception or image. The three texts analysed all share the themes of belonging, values and beliefs, showing that the aspects of ethnicity, relationships and self-image all aid in proving that who you see yourself as an individual can change and develop over time, establishing this through the use of various techniques.

Strategies for Staff Shortages in the NHS

Strategies for Staff Shortages in the NHS Chapter 1 Introduction 1.1 Background: British National Health Service (NHS) has experienced a sensitive shortage of qualified nurses. This has placed retention issues on the political agenda. Nursing shortage is one of the greatest problems for the hospitals in the UK. Hospitals are placing greater importance on retaining their current registered skilled staff. It’s a difficult process and to do this they required to have deep knowledge of the needs and wants of the nursing staff .Management have to know what motivates nurses to stay. From that point of view, many hospitals carry out retention or exit surveys to understand the causes of leaving. According to Seccombe and Smith (1997), from 1987 to1995, within nine years nurse training fell gradually from 19,600 to 14,200 per year. An study (Lader 1995) of the 1991 Census proved that only 68% from them with nursing qualifications in U.K were actually working in nursing profession. Also the research found that 16% of the remaining were working in another profession and 15% out of paid work. Vacancy rate in NHS is very high now. Because of poor recruitment and retention system NHS have been forced to operate with vacancy rates for registered nurses up to 20% which was national vacancy rate of around six thousand six hundred in 1996(Review body for Nursing Staff 1997, cited by Maylor et al. 2000). Suggett (2003) reported that Wandsworth Primary Trust care has 15% vacancy rate for the nursing post at present and same vacancy rate exist for Health Care Assistants. Lowest vacancy rate(8%) exist for Allied Health Professionals. Nursing have the highest vacancy rate (35.9%) of the current labor force within the Trust. Gray and Phillips(1996) said currently NHS facing turnover and it stands at around 14% per annum for registered nurses (RGNs). Supported by (Seccombe and Smith,1997), he also added that it was far higher for nurses who have finished their training in recent times. Research found on turnover which supports these statistics, with around 40% of nurses had a great intention to leave nursing job from NHS within the next three years (Beishon et al., 1995). The reality is that turnover is maximum for nurses under 35 years of age. Hence it is an important economic problem, considering the standard cost of  £50,000 that taxpayers pay to train a RGN(Audit Commission, 1997). Suggett(2003) said from April 2002 to March 2003, statistics report showed that nursing post has turnover rate of 16.3%. Also Allied Health Professionals had 25.2% and Health Care Support Workers had 11% turnover rate. He also said that it was a big issue for the Trust because huge proportions of recruits left the job within two years after appointment. After first two years of employment 22 Allied Health Professionals and 23 Nurses left. Actually from this report it can be found that Nurses are not satisfied with their job and they are leaving early stage of their joining. As a result it creates serious problem for NHS. According to Maben (2008), London has the highest vacancy and turnover rate in the UK, with a dependence on agency and international staff. For example, vacancy rates in London were reported to be twice as high as the NHS average for some occupations, within 2016 the population of the London is projected to grow by 700,000, and well-trained, skilled and motivated nurses are very essential to meet shortage of the city. The Jonas Centre For Nursing Excellence (2006, p.9) reported that substantial attention has been given on improving nurses working environments as a principal approach for improving retention. The Magnet Recognition Program developed by the American Nurses Credentialing Center (ANCC) based on The 1983 Magnet Hospital Study’s findings, have largely supplied the criteria by which such supportive environments are defined and evaluated. According to Kramer and Schmalenberg (2005), the original Magnet study commissioned by the American Academy of Nursing, observed the characteristics of hospitals that enjoyed reputations as good places to work and which, even though a large-scale nursing staff shortage at that time, were successful in retaining nursing staff. One of the Magnet program objectives is recognize nursing services that use the Scope and Standards for Nurse Administrators to build programs of nursing excellence for the delivery of nursing care to patients Nurses across the nation are reporting that stress and dissatisfaction increased significantly with nursing (Boyle et al. 1999). Nurse-physician conflicts add to an already stressful work environment (Rosenstein 2002). One in five nurses plan to leave the profession within the next 5 years (Letvak 2002). Considering all these issues, it becomes vital to search for ways to retain experienced nurses. Researchers are trying hardly to solve the retention problem of NHS. One research (Newman and Maylor, 2000) found on retaining nurses in London region. This study identified the factors of nurse satisfaction and recommended a retention strategy. They recommended improving pay policies, management techniques, training facilities, career progression opportunities, service quality and patient satisfaction 1.2 Why is this area important within the NHS: Audit Commission (1997) reported that High staff turnover and recruitment is a problem for NHS trusts. It causes critical posts to stay vacant for long periods of time with direct consequences for patient care. They explained that Replacing staff can be an expensive business, costing trusts up to  £5,000 for each position filled. There is an also hidden cost of taking on new staff; who may take a year to learn to do the job efficiently and need extra training. Trust managers need to understand why staffs leave, shape the staff attitudes that influence job loyalty, and implement practical measures such as improving opportunities for training, so staffs dont have to leave to increase their skilled. Local and national economic factors may be out of the control of the NHS. The National Health Service is the largest employer in Europe and it has 142,000 staff in London alone .United Kingdom did not have enough doctors and nurses to meet demand. Though, there are staff retention challenges in all the NHS, but the major problems were mainly heard in some busy cites, particularly London(Maben 2008) Finlayson et al.(2002) said that government always feels the pressure of NHS nurse turnover problem. The problem is gradually rising. Government declared to recruit additional 20000 nurses in NHS hospitals within 2004. The demand were to be fulfilled by bringing back nurses who left the NHS, recruiting skilled nurses from abroad and increasing the quality training plan for nurses. Government recruited 6000 and 5797 nurses respectively in 1999 and 2000. In 2001, 713 nurses were recruited. According to The Royal College of Nursing(2000), at present 22000 nursing job are vacant which is whole time  equivalents. The college also reported that NHS will require to recruit more than 100000 nurses by the end of 2004 if retirement levels and other losses remain unchanged. Through training less than half of the demand will be met. From the above report it can be seen that retention is a very big issue for NHS. NHS skilled staffs are leaving their job. Nurses are doing the great job for the society. Those who qualify in Nursing have already demonstrated their intelligence, application and dedication to the sick by undergoing a usually arduous professional training. So, it is our duty to keep the skilled nurses in their profession for the benefit of society by proper retention policy. NHS is concern about how to overcome this problem. Researchers are trying to solve this problem in different ways. Recruiting new people is more costly than retention. Moreover they are not trained and it also time consuming to train them. So it is better to try retain the skilled nurses to reduce the pressure. Considering this situation writer of this report feels the importance of staff retention in NHS. 1.3 Rational: Nurses are the lifeblood of any hospital. The NHS in England employs qualified nurses always. From last 10 years, recruitment and retention of nursing staff has taken on crucial importance; therefore any study that demonstrates that the working environment has an impact on nurses’ recruitment, retention and performance is of importance to the further success of the NHS. NHS facing challenges to retaining nurses at both national and local level. According to Sugget(2003), The local NHS Plan had an aim for Wandsworth primary care trust include 40 nurses and 18 Allied Health Professionals within 2005.The South West London Workforce Confederation recommended that to accomplish these figures Trusts need to attract and support newly qualified nurses and return to practice clinical employees. This means that NHS is trying hard to keep their skilled nurses. Purpose of this research is not only introducing a standardised pay structure but also have a target to improve retention and staff morale. Employees will be identified as facing recruitment and retention problems like works officers or qualified manager. The object of this research is to examine current retention problems for facilities staff experienced by NHS Trusts.  The key purpose of this research is to find out the best Nurse retention strategy for NHS that can be helpful for the other researcher to carry out their future research. As I made my mind to build my carrier as a HR manager, I have chosen research area on staff retention. Staff retention will give me vast experience on HR management. In retention strategy there is a vast scope to gain some practical managerial knowledge and experience relation between manager and staff. Observing the NHS staff problem, I have chosen NHS to carry out my research on staff retention. 1.4 Aims and Objectives: Aim: Aim of this research is to identify good practice in order to make recommendations on how the NHS could retain their nursing staff with a range of skill and experience. It is known that any organisation will have more success in the HRM task if it is committed to valuing its employees by promoting their professional and personal development Research Objectives Review the existing literature on nurse retention Examine the factors that affect retention like pay policies, reward, working flexibility, work-life balance, workload etc. Identify the key retention factors Key theories to be Use: This research will focus on existing HRM model and Retention strategy to achieve the aims and objectives. The conception of new retention strategies will be a major spotlight for nursing administration as a lack of nurses recurs and turnover of staff becomes a strong problem. 1.5 Chapter Outline: Chapter Two provides a critical review of the literature on retain skilled staff working within NHS employment in order to create the context for the research. Key points of this chapter are nurse satisfaction, cause of leaving and retention strategies Chapter Three explains the research methodology, provides information on research process, strategy, data collection, data analysis (qualitative and quantitative) and ethical dilemmas encountered. Chapter Four begins with an data analysis on the research questionnaires. Both qualitative and quantitative analysis was presented. Also analysis findings were presented here. Chapter Five re-evaluates the findings by referring back to the research objectives. It then provides a short review of the research including recommendations for both NHS. It provides an evaluation of the study and suggests areas for further research. It also includes some limitations and shock of the researcher. Chapter-2 Literature Review 1.Introduction: Employee turnover is known as a most important organizational/business phenomenon. Employee turnover is very crucial to organizations, individuals, and society. Employee turnover can cause a considerable cost in terms of socialization, recruiting, training, and disruption. From the company’s point of view turnover also represent the range of indirect cost. Given the impact of turnover, it is vital for the manager and future manager to be able to analyze, recognize, and successfully deal with employee turnover (Mobely 1982). Here he tried to focus on the importance of employee turnover control for an effective management in case of saving cost. (Dell and Hickey 2002) added that turnover has huge economic impact on the organization, both in direct and indirect costs. Translating turnover into numbers that executives understand is essential because they need to appreciate the true costs. Managing retention effectively is a continuous challenge for any business organization. The retention issue had been highly focused since the last decade, and, from all indications, the problem will increase more in future decades. Most HR executives find retaining talent to be big problem even in slow economic times (Phillips and Connell 2003). In a survey during the 2001-2003 recession, ninety percent of 109 executives reported that they were finding it difficult to attract and retain the best people in the organization (Dell and Hickey 2002). Newman and Maylor (2000) reported that National registered Nurse has declined by more than 14,000 leaving the NHS with the worst nursing shortage in 25 years with a record 8-17000 shortfall of qualified nurses. Buchan(2000) said that from 1990 to 1998, the number of qualified nurses decreased by 8000 . This chapter is designed to focus on the existing literature on nursing retention. At first some definition is given. Then cause of nurses’ leaving is focused. Finally some retention strategies are discussed. 2. Definition: An understanding of basic distinctions between retention and turnover is very important. Phillips and Connell (2003, p 2) defined the retention and turnover in following ways: 2.1 Retention: is the percentage of employees remaining in the organization. High levels of retention are desired in most job groups. 2.2 Turnover: On the other hand turnover is opposite to the retention, refers to the percentage of employees leaving the organization for whatever reason(s). 2.3 Turnover rate: refers to the rate of individuals leaving. 2.4 Tenure: is the length of time an individual is employed by the organization and usually related to the concept of the employee loyalty. A loyal employee usually remains with an organization for a long period. In many organizations it is desirable to have long tenured employees, although this situation taken to extreme can also create problem. 3. Retention As a Critical Issue: Retention is a strong critical issue for any organisation. The theory of employer-of-choice has intensified in the last decade. Employees always want to work for best employers. Phillips and Connell (2003, p3) said organisations struggle to be the â€Å"the best company work for†. The statement â€Å"the best company work for† translates into lower rates of turnover. Levering and Moskowitz (1993) supported stating that many companies attempt to build the type of organization that can at least meet the preferred standards. Becoming an employer -of -choice often involves the issue of acquiring the best talent for the organization, motivating employees to improve performance, Keeping them satisfied and loyal, developing employees so they can grow and contribute skills, and ultimately retaining those employees( Fitz-enz 2000) 4. Cause of leaving : 4.1 Social Environment: The social environment of the workplace is the initiator of a nurses plan to stay or leave. Moreover social environment is a determinant of work disappointment (a depressing influence), and work excitement (an encouraging influence). Moos(1994) said that these factors directly influence workplace stress, leading to job satisfaction or dissatisfaction . According to Bratt et al.(2000), Job satisfaction or dissatisfaction is the powerful forecaster of intent to stay or leave the job. 4.2 Burnout: Burnout can cause job dissatisfaction. Garret and McDaniel(2001) said that enviro- nmental uncertainty are very important in all features of burnout. Aiken et al. (2002) reported that nurses with the lowest nurse-to-patient ratio experience less burnout and dissatisfaction than those with highest ratios. The researchers claim that 43% of nurses who said strong levels of burnout and disappointment intended to quit their jobs within a year. Only few nurses did not complain of dissatisfaction. When nurses work rotating shifts, there is a significant decrease in job satisfaction (Bratt et al. 2000).Newer nurses experiencing more job stress as compared to experienced nurses. 4.3 Autonomy: Nurses always desire increased autonomy working environment. (Nevidjon and Erickson 2001).Aiken et al.(2002) claim that autonomy is one of the factors which has decreased emotional exhaustion of nurses in American magnet hospitals. In another research on this hospital showed that autonomy had influenced the managerial trust, their appraisal of the quality of patients care and also job satisfaction (Laschinger and Thomson 2001). Davidson et al. (1997) established the value of autonomy by representing that decreased job satisfaction is connected with decreased autonomy. Bruffey(1997) said autonomy is ultimately influenced by the leadership of their managers. There is a positive connection between job satisfaction and nursing leadership. Management system, allow the nurses to do their jobs effectively, was related to job satisfaction( Bratt et al.,2000). Tumulty et al (1994) found that though autonomy had a significant impact on job stress, it was not a major determinant of stress as task orientation. Also Ingersoll et al. (2002) said that autonomy was a positive observation of task orientation related with increased job satisfaction and aim to stay. This idea is supported by Davidson et al. (1997) with the result of increased scheduling and decreased work load leading to decreased job stress. The researchers argued the advantages of better communication improving the awareness of nurses concerning autonomy burn out, work pressure and task orientation. Some researcher stressed the significance of management or leadership behaviours. Managers or leaders perceived as equitable decreased staff perceptions regarding work pressures and increased perceptions regarding autonomy(Taunton et al. 1997). Bruffey(1997) said these factors collectively led to lower job stress and its expected association with intent to quit. 4.4 Work Pressure: Bratt et al. (2000) identified the work pressure as the most familiar and important factor of organizational work satisfaction/dissatisfaction. McNeese-Smith(1999) identified several factors of work load which bring job stress for nurses. These were: (a) overload due to heavy patient assignment, too many patient needs, and/or too few staff members to meet these needs. (b) exhaustion; (c) fear of making a mistake due to exhaustion and (d) high patient acuity. Bratt et al. (2000) reported some additional work stress factors which influence the nurses to leave the job. These include rapid turnover of patients, shift work, lack of available equipment, managerial pressures, excessive noise and lack of space. According to Aiken et al.(2002), Nurses with increased patient loads in workplace were more likely to explain experience of burnout, job dissatisfaction and emotional exhaustion than their colleagues with less patient loads. So autonomy is a key factor to reduce work stress for work load. Because work load is a originator of nurse intention to leave 5.1 Job Satisfaction of Nurses: There is a lack of agreement on the meaning of nurse satisfaction (Hale 1986, cited by Maylor et al 2000).Two definitions stemming from the 1980 stand out. The first one highlights psychological factors according to Bush(1988), the perception that one’s job fulfils or permit the fulfilment of one’s significant job values, providing and to the extent that those values are congruent with one’s requirements. The second one highlights workplace factors like recognition of achievement, enough staffing, appreciation, autonomy, childcare facilities and quality patient care.(Butler and parsons,1989). Nurse satisfaction can be depends on effective patient care. Maylor et al.(2000) noted that it is very crucial to have ability to give good patient care. 5.2 Determinant of job satisfaction: Job satisfaction analysis is driven by attempts to concentrate on the issues of industrial action, leaving or turnover and personal joy at work. Researchers are interested in the bond between job satisfaction and efficiency and financial and non-financial reward. According to the influential work of Freeman (1978), job satisfaction can be separated into those considering labour force as a whole, those analysing qualified groups such as lawyers, nurses and academics, those which inspect the impact of individual characteristics like age, sex, race/education and those which explore the outcome of job-related features such as trade union membership, self employment and establishment size. Some important determinants of work place satisfaction have been recognized which may be supportive in the thought of job satisfaction in nursing. Diversity of individual characteristics have been identified to have special effects on reports of job satisfaction. That diversity includes gender, race, age, marital status, children and education. The major effects are usually connected with gender and age. According to British Household Panel Survey (Clark and Oswald 1996), Females are highly satisfied with their job in the UK. Earlier proof recommends that age has either a linear or U-shaped bond with job satisfaction (Clark et al. 1996). That means older workers usually being more satisfied with their current job. A set of studies have focused on the analysis of comparison effects on job satisfaction. Comparison effect means, staff may have several idea of relative or ‘comparison’ earnings which enters their utility function. So job satisfaction is not only influenced by a staff’s personal total earnings, but also by their earnings that is comparative to some comparison group/desired level. Clark and Oswald (1996) summarized that satisfaction or dissatisfaction can be created in workers mind because of individuals’ comparison of their present job with the other job. So, job satisfaction is not only affected by individual earnings but also by their earnings related to expected level. Both absolute and comparative incomes have positive influence on the job satisfaction of staff (Sloane and Williams 1996). Clark and Oswald (1996) gave some proof that expectations are influenced by staff’s age, educational background and profession. Determinant of job satisfaction can be found from the inconsistent job features of staff. Working hours, establishment size, union membership and profession have important effects on job satisfaction. In the case of nursing staff, it is very crucial to evaluate the impact of improved working environment on their job satisfaction. Clark (1997) discovers a important influence of ‘work values’ on job satisfaction. More exclusively, staffs that highlight the importance of payment are more likely dissatisfied with job whilst staffs that highlight job place relations are associated to support job satisfaction. Nurses are more likely dissatisfied with their job because they are normally considered as low-paid staff. 6. Nursing in Multi ethnic minority: The racial harassment of ethnic minority nurses continuous to be a regular feature of their working lives in the NHS. This racial harassment from patients could be broken down into two distinct forms. According to (Beishon et al. 1995) First, there was a form of harassment where racial motivation in the incidents was clear because of accompanying verbal insults or because the patients had made it clear they did not want to be ‘nursed’ by an ethnic minority nurse. Secondly there, there was a more subtle form racial harassment where white patients did not explicitly mention nurse’s ethnicity, but rather treated ethnic minority nurses in a relatively unfavourable way to their manners with white nurses. A black nurse reported how differently she was treated from her white colleagues (Alexander and Dewjee 1984). However the things have begun to change and NHS training authority has taken on training projects directed specifically at race issues (Beishon et al. 1995). 7. Retention Strategies: 7.1 Creating A Motivating Climate: Because the organization has such an impact on the factors that extrinsically motivate employees, it is important to examine organizational climates or attitudes that have direct influence on worker morale and motivation. Huston and Marquis(1989) said that frequently organizations overtly or covertly reinforce the image that each and every employee is expendable and that a great deal of individual recognition is in some way harmful to both the individual and the individual’s productivity within the organization . Just the opposite is true. Individuals who have a strong self-concept and perceive themselves to be winners are willing to take risks and increase their productivity to achieve their productivity. Peters and Waterman(1982) stress that organizations must be designed to make individual employees feel like winners. The focus must be on degrees of winning rather than on degrees of losing Another wrong attitude held by some organizations is at the opposite extreme. Korman et al (1981) supported that if a small reward results in desired behaviour, then a larger reward will result in even more of the desired behaviour. That means an employee’s motivation should increase proportionately with the amount of incentive or reward. Nurse managers should think excellence and achievable goals, and reward performance in a way that is valued by their staff. These are the cardinal elements for a successful motivation-reward system for the nursing organization (Kirsch,1988). To the contrary, more incentives or reward systems were actually less motivating, as they produce a felling of distrust or being bought. Increasing incentives may be perceived as a violation of individual norms or of guilt (Bowin,1987). Managers can also create a motivating climate by being positive and enthusiastic role models in the clinical setting. Studies by Jeskins and Henderson (1984) demonstrated that managers’ personal motivations are the most important factor affecting their staffs’ commitments to duties and morale. Positive outlooks, productivity and accomplishment are contagious. Radzik(1985) stated that employees frequently determine their job security and their employer’s satisfaction with their job performance by the expression they see on their manager’s face. That means unhappy managers frequently project their unhappiness on their subordinates and contribute greatly to low unit morale. 7.2 Managing Career Development in nursing: Some philosophies about responsibilities for career development have been reflected in nursing. Donner and Wheeler(2001) have argued that nurses do require to take greater responsibility for career planning and development. They should follow a framework discussed by King (2001) which includes identifying opportunities, developing and implementing a good career progress. Donner and Wheeler(2001) added that to deliver high quality of caring service all educators, employers and professional business organizations should work with nurses on their career development plans and activities . According to (UKCC 1999 ), in UK, for long period it has been known that continuing professional development (CPD) has an significant function in nurses’ individual career development and retention. It also enhances the quality of patient care. There was a debate for a long time that local health service employers must recognize and understand the value of appropriately controlled CPD programmes in attracting, motivating and retaining high quality staff (DH 1998). Strategy for CPD for nurses were set out in Making a Difference ( Robson and Banett 2007) in which it was debated that CPD should include not only attending courses but also learning at work through experience, critical incidents, audit and reflection, maintained by peer review ,mentorship and clinical supervision. It was a matter of great concern that practitioners and employers were puzzled by the creation of new courses and lack of apparent links to career paths and that a more determined structure was needed 7.3 Working Condition: From a human resource management viewpoint, it can be said that working conditions have an affect on staff morale. Good working conditions will contribute to improving retention staff (DH 1997). The different ways in which working environment can affect nurses and manipulate their decisions about direction and retention in the occupation have raised from a substantial body of study on job satisfaction and workplace stress. Reconsidering the previous history on stress among general nurses, McVicar (2003) expressed that the major sources of stress identified are leadership, work pressure, management style, coping with emotional or touching demands of care, and relationships between occupational groups. He also added shift working and lack of reward also emerging from more recent research. Deep study on job or workplace satisfaction in nursing profession has exposed that aspects of work which recognized in the stress literature also come into view as sources of satisfaction or dissatisfaction. Nolan et al (1999) said, staffing levels enough for nurses to feel confidence to offer better quality care if there are availability of supplies and equipment. And it also depends on the nature of work place relationships with colleagues and nursing managers. Positively it has long been acknowledged that both physically and mentally nursing is a challenging work (Davies 1995). Handling and lifting patients and ‘being on one’s feet’ every day is not very easy. It can cause not only work stress but also bodily injury like strained backs. The emotional element of nursing can be equally important and demanding, involving caring for patients when they are dealing with death and dying and loving for upset patients and relatives. Rise of these demanding emotional elements to overcome the challenge can be a source of satisfaction. On the other hand, low moral and work stress can be created when nurses feel under-supported and under resourced in working environment, particularly in relation to staffing. (Cameron and Masterson 2003). McVicar (2003) said study on stress has exposed the level to which a range of physiological and psychological symptoms have been linked with diverse sources of stress and that distress is very much correlated with absenteeism, ill-health and poor retention . Shields and Ward (2001) expressed that Job frustration has been reported as the distinct most vital cause of intention to leave among NHS nurses. In US, it was suggested that when staffing levels are decreasing there is low levels of job satisfaction which causes poor effects on work stress and quality of patient care (Aiken et al 2002). He also added it also affect the retention of nurses in clinical practice. According to Coomber and Barriball (2007), a current review of the international literature illustrates that stress caused for workload, workload scheduling and leadership issues influence disappointment and retention for nurses. From policy development, a range of strategies have been identified and impl

The Young Lords of New York :: Puerto Rico Migrants American History Essays

The Young Lords of New York On 7 June 1969, hundreds of Puerto Ricans gathered in Spanish Harlem, New York City to protest the arrest of Juan" Fi" Ortiz for a series of falsified crimes.[2] As a crowd gathered outside the People's Church in El Barrio, Felipe Luciano addressed those assembled asserting that, " We will not allow the brutalization of our community to go on without a response. For every Puerto Rican that is brutalized, there will be retaliation."[3]Luciano's statements were not ignored, and as the crowd filtered into the streets their shouts of Despierta, Boricua. Defiende lo tuyo filled the air. The events of 7 June 1969 were but one of many moments in the history of New York City's Puerto Rican community that gave rise to and lent support for the Young Lords Party.[4] Indeed over the course of the next five years this ethnic group of radical intellectuals would help bring attention to the plight of the Puerto Rican community in New York City. This essay explores the history of the late twentieth century Puerto Rican migrants in New York City through an examination of the Young Lords Party (1969 to 1974). In doing so, it examines several significant topics, including the growth of the Puerto Rican population in New York City; the unique challenges this ethnic group faced, and the origins, growth and decline of the Young Lords Party. Twentieth Century Migration of Puerto Ricans To New York City For us to clearly understand the Young Lords, it must be understood how the Puerto Rican Community came to be in New York City and other American cities such as Newark and Chicago. With the Spanish American War of 1898 came added difficulty for the population of Puerto Rico. Recently acquired by the United States, citizens of Puerto Rico were actually citizens of nowhere until granted statutory citizenship to the United States in 1917. Yet three years earlier, on 12 March 1914 the citizens of Puerto Rico opposing this imposition of American citizenship sent a "Memorandum to the President and Congress of the United States" stating, " We firmly and loyally oppose our being declared, against our express will or without our express content, citizens of any other than our own beloved country which God granted to us as an inalienable gift and incoercible right."[5] Even without support of the Puerto Rican people the Jones Act was passed. The Young Lords of New York :: Puerto Rico Migrants American History Essays The Young Lords of New York On 7 June 1969, hundreds of Puerto Ricans gathered in Spanish Harlem, New York City to protest the arrest of Juan" Fi" Ortiz for a series of falsified crimes.[2] As a crowd gathered outside the People's Church in El Barrio, Felipe Luciano addressed those assembled asserting that, " We will not allow the brutalization of our community to go on without a response. For every Puerto Rican that is brutalized, there will be retaliation."[3]Luciano's statements were not ignored, and as the crowd filtered into the streets their shouts of Despierta, Boricua. Defiende lo tuyo filled the air. The events of 7 June 1969 were but one of many moments in the history of New York City's Puerto Rican community that gave rise to and lent support for the Young Lords Party.[4] Indeed over the course of the next five years this ethnic group of radical intellectuals would help bring attention to the plight of the Puerto Rican community in New York City. This essay explores the history of the late twentieth century Puerto Rican migrants in New York City through an examination of the Young Lords Party (1969 to 1974). In doing so, it examines several significant topics, including the growth of the Puerto Rican population in New York City; the unique challenges this ethnic group faced, and the origins, growth and decline of the Young Lords Party. Twentieth Century Migration of Puerto Ricans To New York City For us to clearly understand the Young Lords, it must be understood how the Puerto Rican Community came to be in New York City and other American cities such as Newark and Chicago. With the Spanish American War of 1898 came added difficulty for the population of Puerto Rico. Recently acquired by the United States, citizens of Puerto Rico were actually citizens of nowhere until granted statutory citizenship to the United States in 1917. Yet three years earlier, on 12 March 1914 the citizens of Puerto Rico opposing this imposition of American citizenship sent a "Memorandum to the President and Congress of the United States" stating, " We firmly and loyally oppose our being declared, against our express will or without our express content, citizens of any other than our own beloved country which God granted to us as an inalienable gift and incoercible right."[5] Even without support of the Puerto Rican people the Jones Act was passed.

Government Intervention in Venezuela’s Economy

Economic Commentary_1 The article: How can Venezuela be so rich in resources, but so low in supplies? By Douglas French/April 24, 2012 http://www. csmonitor. com/Business/The-Circle-Bastiat/2012/0424/How-can-Venezuela-be-so-rich-in-resources-but-so-low-in-supplies To what extend do a country’s natural resources explain whether consumer goods are on the nation’s shelves for people to buy. Venezuela is a prime example of this question.This is a country having abundant natural resources for it is one of the world’s top oil producers and rich in gold and other minerals, also the rich soil and temperate climate allow the country for productive agriculture. However, there are shortages of staple products like milk, meat and writing paper. This commentary focuses on the main reason causing this problem in Venezuela that is over intervention of the government towards the free market. In order to maintain the level of consumer prices, the president of Venezuela imposed pr ice controls by setting the price ceilings.Government officials claim â€Å"companies cause shortages on purpose, holding products off the market to push up prices. This month, the government required price cuts on fruit juice, toothpaste, disposable diapers and more than a dozen other products. † However, bad consequences of the price ceilings set by the government were inevitable in terms of shortages in supply, decreased market size, elimination of allocative efficiency and black markets. In figure1. 1, the original market equilibrium price under the intervention of free market is at Pe where the quantity demanded and the quantity supplied are equal.After intervention of the central government, a binding price ceiling is set and the new market price is created at Pmax where the quantity supplied is much lower than quantity demanded. The artificially low price has caused more demand for the product, thus creating a movement from Qe along the demand curve to Qd. At the same time, producers cut production in response to the lower price, moving down along the supply curve from Qe to Qs. The distance between Qd and Qs shows a shortage of the good in supply.Because of this, now residents in Caracas are forced to rely on the once-a-week deliveries made to government-subsidized stores. Moreover, as figure1. 2 suggests, the gap between Qs and Qd creates a tension in the market. At Qs there are many consumers who would be willing to pay more than Pmax if Qs is on the market. These consumers may have a strong incentive to gain the goods and services they want on the black market. As a result, the supply curve will shoot right up at Qs and the price will raise right up at that point high on the demand curve.This shows that some price ceilings may actually drive the price higher than the original equilibrium and can be just applied to the case of Venezuela. Also, setting a maximum price lower than the market equilibrium price will result in a decreased market siz e as some of the companies will be driven out of the market. The government setting prices are too low for companies to make money so they either curtail production or stop all together. As shown in figure 2. 1, initially the producer surplus of the private companies, in terms of profit, derived by firms is shown as the area from the initial market price line to the supply curve.After price controls by the government, now the new producer surplus is shown as the area from the new price line to the supply curve which is smaller than before and this reflects a lower producer surplus, therefore a welfare loss in the society. In addition, the price ceilings eliminate an allocative efficiency in the country’s economy in a competitive market as it can only be achieved when the society produces enough of a good so that the marginal benefits is equal to the marginal, in other words, producer supply and consumer demand meet at a market equilibrium price.Due to intervention of the gove rnment, price controls disenable society to get goods and services it wants most. As Times mentions, â€Å"some of the shortages are in industries, like dairy and coffee, where the government has seized private companies and is now running them, saying it is in the national interest. † But the consequence of this action is that the government will turn the markets into monopolies as there would be only state ownership in these industries, so there are no competitions between various firms and consumers will not be able to acquire substitutes in the markets.What’s more, while these industries are being completely controlled by the central planner and create state ownership of the factors of production in addition to the guide of Venezuela socialist government, it will result in the lack of individual property rights and incentive to achieve maximum efficiency in the use of resources which characterize private ownership. To conclude, Venezuela is a typically very rich in resources but very low in supplies, price controls in the markets as well as

Life and Circumstantial Luck

Tic- toc. Tic- toc. Do I go left or do I go right? All these years I have been following the road of life and now it is in my power to take the road that leads to my final destination. Along the way, I have traveled on many types of surfaces, but now I face my greatest challenge. I am stuck between two paths. One path leads to eternal happiness and other leads to eternal sadness. Is it in my destiny to choose the right path? Or will it just be my luck to choose the wrong path? Do I go left or do I go right? Tic- toc. Tic- toc. Life.It is such a simple word, yet the meaning is nothing close to simple at all. We all take a journey on the fabulous road to life, yet does anyone even know what life is? I mean we all live it, but what is it? Anyone know the definition? ( I’d surely would like to know. ) Well if no one truly doesn’t know the answer to life then how can we know for sure why things happen the way they do? Is there some kind of spiritual force out there? Is there some person or thing controlling our every move? Or do things just happen just because they do; coincidences and forces that we have no control over?No one really knows if a god really exists, so things just happen because they just do. Things happen because of coincidences and forces we have no control over. Our life is then based on luck, isn’t it? Think about it this way, luck refers to something that which happens beyond a person’s control. This view incorporates phenomena that chance happenings, a person’s place of birth for example, but where there is no uncertainty involved or where uncertainty is irrelevant. (Huh? English please. ) In other words, luck is just something that we have no control over and just happens.However, there are a few different types of luck. Constitutional luck, it is luck with factors that can’t be changed. Circumstantial luck, it is luck with factors that are haphazardly brought on. Lastly ignorance luck, it is luck with factors one doesn’t know about. (So, where does this luck come in play? ) Luck can be seen everywhere, whether it be in movies, books, paintings, or reality. We live our lives experiencing luck every day. As we step foot into a casino or acquire a lottery ticket, we unlock the emerald doorway to our chances.Chance is the key to any time of game. We spin the wheel of fortune hoping that it will land on something pleasant. Often in literature, luck plays a significant role. When we think of luck, we think of lucky number 7 or the colour green. But in reality, luck isn’t that clear. It is a mystery hidden behind the shadows. Some people are blinded by the concept of destiny that they don’t realize that it is luck that is aiding them. In one of the greatest plays written, Othello, the main character is a person who you would think is unaccepted by society, but is loved.Othello is a moor and a Muslim from Africa. He is this dark angel that many are afraid of, yet lov e. During the 1600s, only men of noble decent became generals with a few exceptions here and there. But a Moor becoming a general was just a preposterous idea. Regardless of this fact, Othello thinks that it was because of his accomplishments that made him become who he is. He had fought in many wars and then Brabantio had invited him to stay with him and â€Å"still questioned [him] the story of [his] life from year to year, the battle, sieges, fortune that [he had] passed. (Othello, 1. 3, 128-130) A white man had shown interest in a black man regardless of the racism in the world at that time. (How does that happen? ) Nevertheless, Othello somehow becomes a general before even meeting Brabantio and coming to Venice. How became a general, is a question no one has an answer to. We can accept the belief that his accomplishments made him successful, but with racism being a major factor nothing seems to add up. We can say that it was in his destiny to become a general, but really is t hat really the case?It is more of a matter of pure luck that Othello obtains such a high rank in society. Overcoming such obstacles especially in the 1600s was simply impossible. A black man could never have a higher rank than even a white surf. White was always greater than black. Goodness always prevails. (Well back then it did. Now does it? Yeah, not so much). So for Othello to have become a general it could not have been because of his accomplishments, it had to have been of random occurrence that made him just a bit better than a white surf and to move up the chain of success.To have luck take control of your life, neither wits nor feelings are involved- just possibility. We depend on random occurrences to aid us for the better. â€Å"Luck never gives; it only lends,† (E. B. White) If life does revolve around luck then you must pay a price for the goodness. You may get lucky for a while, but since luck never gives, it takes back the luck and it is why we experience karma . Luck may give us marvellous things, but sometime along the road all of it gets taken back. Yet the whole concept of luck doesn’t seem to quite add up.Random occurrences and things happening beyond a person’s control do exist, but not everything is random. Life on earth couldn’t have begun randomly. There must have been something that created all of this and luck- just doesn’t seem to quite explain why. Many religions in the world either agree or disagree with the concept of luck. Gautama Buddha, the founder of Buddhism, taught his followers not to believe in luck. The view which was taught by Gautama Buddha states that all things which happen must have a cause, either material or spiritual, and do not occur due to luck, chance or fate.The idea of moral causality, karma is central in Buddhism. In the Sutta Nipata ,the Buddha is recorded as having said the following about luck: â€Å"Whereas some religious men, while living of food provided by the faithf ul make their living by such low arts, such wrong means of livelihood as palmistry, divining by signs, interpreting dreams†¦ bringing good or bad luck†¦ invoking the goodness of luck†¦ picking the lucky site for a building, the monk Gautama refrains from such low arts, such wrong means of livelihood. † Lakshmi, is the Hindu Devi of money and fortune.It is said that by proper worship, with a meticulous prayer procedure the blessings of this powerful deity may be obtained. However, the Catholic Church excludes chance or luck as an explanation for creation. As well, there is no concept of luck in Islam other than actions pre-determined by God and that God alone has power over all things. It is stated in the Qur'an that one’s sustenance is pre-determined in heaven when the Lord says: â€Å"And in the heaven is your provision and that which ye are promised. † However, one should supplicate towards God to better one's life rather than hold faith in un-Is lamic acts such as using â€Å"lucky charms†.Religion is the belief in and worship of a god or gods, or any such system of belief and worship, usually involving devotional and ritual observances, and often containing a moral code governing the conduct of human affairs. (Thank you dictionary. com) Whether one be atheist or follow a certain religion, one still has a belief in something. Many follow religions so they can give the creator of life a name; God. Many believe that God is the spiritual being that has created what we call the universe. No one knows for sure if he exists or not, but many want to believe that he does.In addition, throughout humanity, many messengers of God have walked the surface of the Earth and this gives more of a reason for people to believe that God exists. If God really does exist, then he must be the Supreme Being that had created life for us humans. Hence, he has already planned our life in a way, but in order to fulfil our life we have to put th e pieces of the puzzle together. The bits and pieces are scattered everywhere and it is not easy to find them all nor is it to put them together. Along the way pieces can get damaged or lost.When pieces of the puzzle get damaged it means that your life is going bad or something is not going good, but can still repair your life. Sometimes pieces can get lost to the point where you have not enough pieces to complete the puzzle. In that case you make bad decisions and then something tragic happens to your life, which can result in death. This can be seen as how people die at a young age. Some young individuals make the wrong decisions and then it ends up costing them their life. Searching for the pieces is not as easy as it sounds. The pieces can be right in front of us, but we second guess ourselves and don’t know where to look.Often times we seek advice from fortune tellers and prophets. We go to seek for any clues of the future and hope that we can find our right path. And ot her times, people tell us what our destiny is and it is what we believe and try to achieve. This is most often seen in movies and books about heroes. Many character archetypes are based on the concept of a hero. The hero is a larger-than-life character that often goes on some kind of journey or quest. In the course of his journey, the hero demonstrates the qualities and abilities valued by his culture.