Nursing-Sensitive Indicators Essay Example for Free

Nursing-Sensitive Indicators Essay According to the American Nurses Association, nursing-sensitive indicators â€Å"reflect the structure, process and outcomes of nursing care.† (Nursing Sensitive Indicators, 2015) Understanding the indicators is an important piece of nursing, not only to assist the patient, but the patients loved ones as well, to ensure quality patient care. In this particular case, had the nurse understood the reasoning and data behind the Pressure Ulcer Rate and Restraint indicators, and communicated the necessity to report any pertinent findings the CNA may discover in the nurse’s absence, the CNA would not have dismissed the reddened area over the patient’s lower spine and would have immediately informed the nurse of the finding. Upon returning the patient to bed, the CNA would have also known not to place the patient back in bed on his back and re-apply the restraints. Instead, would have had the patient lay to one side and stressed the importance, to the patient and family member, of frequent turning, to reduce the chance of pressure ulcers. Quality patient care can only be achieved with teamwork and open communication. The discussion of pressure ulcers in hospitalized patients has become an increasing issue with more attention to the prevention of such since the early to mid-1990’s. The Centers for Medicare and Medicaid Services (CMS) state that stage III and stage IV pressure ulcers occurring during admission are considered preventable (Zaratkiewicz et al., 2010). While the gentleman in our case scenario represented what would be considered a stage 1 pressure ulcer, with proper quality care and training, even this stage 1 ulcer could have been prevented or at the very least, the progression halted. If the nurse had a better understanding of nursing-sensitive indicators, or the theory behind them, then maybe he or she would take more ownership in the prevention of pressure ulcers. Harborview Medical Center in Seattle, Washington, conducted their own study regarding pressure ulcers and ways to prevent them. Their study was  intended to track, prevent and improve skin-related outcomes (Zaratkiewicz et al., 2010). While the results of the study showed a large increase in minor pressure ulcers, it showed a huge decrease in stage III and IV ulcers, the most costly and reportable types. Education and staff reinforcement lead to early detection and improvement in practice, ultimately faring better for the patient. Maybe if the hospital in the scenario had communicated such important figures or conducted their own study, the nursing staff and even the CNA’s would have a better understanding and ultimately provide better care. As far as ethical issues such as the request for a kosher meal that ended up not being kosher, we as nurses accept and agree to abide by a code of ethics. If I were the nursing shift supervisor and this case scenario occurred, there are a few different things I would use to discuss with my staff. First of all, I would remind all nursing staff of the code of ethics we all accepted the day we graduated nursing school and offer copies to each of them to serve as a reminder. Specifically, for this scenario, I would point out; â€Å"Human Dignity is respect for the inherent worth and uniqueness of individuals and populations. In professional practice, concern for human dignity is reflected when the nurse values and respects all patients and colleagues† (The Essentials, 2008). While I am not Jewish and not receiving a kosher meal does not seem to be a big deal to me, I know that it is important to my patient and an acceptable request, so it should be a priority for me. Secondly, I would start a monthly ethical education series, choosing a different topic to better educate my staff. In the world we live in today, there are so many cultures and a necessity to be more aware of ethical treatment, that the staff should not be expected to â€Å"just know it.† This knowledge comes from on-going education and it is up to the hospital and staff to make sure they are kept as up to date as possible regarding ethical treatment of patients. I would also involve my Board of Ethics or ethical expert from the hospital to intervene and sincerely apologize to the family. While we won’t be able to fix the meal that was already eaten, we can ensure the patient and family that steps have been taken to support special requests of patients from now on. References Nursing-Sensitive Indicators. (2015). Retrieved from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursi

Role of Management in Improving Workplace Safety and Health :: Workplace Health and Safety

The article â€Å"Role of Management in Improving Workplace Safety and Health† (Admin, 2011) points out the importance of keeping the workplace safety and explains the role of Human Resources managers in workplace safety and health maintenance. The Human Resources managers should be more proactive regarding workplace health and safety (Admin, 2011). Although the employers' responsibilities regarding workplace safety and health are both ethically and legally undeniable, â€Å"Role of Management in Improving Workplace Safety and Health† makes a critical error by placing those responsibilities entirely on the HR Department. Furthermore, it is not possible to be more proactive because the HR department is not specialized in workplace safety and needs to fulfill other functions within the company. The Occupational Safety and Health Administration (OSHA) is a government agency that defines and regulates employer responsibility in creating and maintaining a safe and healthy en vironment for employees. Instead of inspecting, evaluating, and developing solutions by themselves, HR managers are responsible only for following OSHA rules and regulations and keep up with current trends proposed by OSHA. Training Program Development The article â€Å"Role of Management in Improving Workplace Safety and Health† claims HR managers should develop proper training programs to prevent injuries at work and defines the purpose of safety training programs as methods of improving the employees' performance abilities when it comes to preserving themselves from work-related risks (Admin, 2011). The systematical method of developing training programs is through identifying needs after inspections, accident reports, and discussions with the safety committee, followed by planning, implementation, and improvement evaluation (Admin, 2011). Although these are standard protocols in developing training programs, the article does not mention the people or institutions responsible for actual program development. The initial blame for low proactivity on the HR department and its impact on worker safety and health remains unmentioned from the introduction of the article, so it is only natural to assume that the HR department is responsible for carrying out training program development after reading that section. The HR department cannot develop training programs because OSHA and similar agencies specializing in workplace safety are responsible for developing trainings. Furthermore, the HR department cannot even perform the actual trainings because their employees are not authorized to train employees in workplace safety. The HR department is responsible only for providing training for the company's employees, so they can perform work in a safe manner in compliance with OSHA requirements (Michaels, 2010), and they cannot possibly be involved in safety training or safety training program development.

Critical Thinking Essay: the Godfather Essay

The Godfather, a story about a multigenerational crime family by the Italian American author Mario Puzo, was one of the best-selling books since it was published in 1969. Not only the book was a phenomenon, its movie under the direction of director Francis Ford Coppola had also become a landmark in American movie since it was released in 1972. The Godfather detailed impressively the activities of the gangster world, especially the Corleone family which was under the control of the patriarch Vito Corleone starring by Marlon Brando and Al Pacino as his youngest son Michael Corleone who soon inherited his father’s position. The film lived up to the term masterpiece which helped it win three Academy Awards for best actor, best picture, and best adapted screenplay. Although the movie was full of brutal violence and mass killing of people, it also showed the care, the love, and the loyalty of the Corleone family members for each other. Rather than just showing the criminal side of breaking the laws or murdering people, The Godfather showed a brand new vision of the gangster world to the audiences. The criminal genre first started with the film the Little Caesar which was the first movie ever made about the gangster world in 1931. Later, many famous directors had taken advantage of this new trend and released many great movies with this genre, such as director Howard Hawkes with his famous film Scarface in 1932 and director Raoul Walsh with the movie White Heat in 1949. Those were all the big films that gave the audiences the impression of how audacious and dangerous the Mafia was. Mostly those movies focused on a younger gangster who was trying to work his way up in his criminal career to become well-known and powerful in the underworld by all means. Then, the release of the Godfather impressively surprised all the fans of the mob movies with a totally different viewing experience. The film depicted a systematic criminal organization, a â€Å"family business† that was transferred from generation to generation. The audiences are attracted in the very first plot of the movie when it shows Vito Corleone is doing his â€Å"business†. The man is insisting him to take revenge for his daughter who was brutally beaten by her boyfriend and he will pay any price the Godfather wants. The audiences will think that surely the Don will say â€Å"yes† because that is how a mobster is in their mind: Give them money, they will do anything. However, Vito says â€Å"No† because the only thing he wants from the man is friendship and he feels disrespectful when the man is only talking about money. Another plot that shows the breakthrough of the Godfather is when his oldest son, Santino, was butchered by Emilio Barzini’s men, the second most powerful Don, Vito still takes the initiative of renouncing all the vengeance at which audiences think there will be a massacre between the two families. Vito also makes a concession in doing drug business though he mentioned that he never believed drugs. In return, he wants a guarantee from other families for the safety of his own family and the younger son, Michael, who is still in Sicily hiding away from the police. Furthermore, thanks to director Coppola for being determined in choosing the appropriate actors and actresses for every characters in the movie which was a great contribution to the movie that made it become a masterpiece. Marlon Brando was not the first choice for the character Vito Corleone, he was actually refused for casting by the Paramount executives. However, Coppola believed Marlon was the best match for the character so he fought hard for him until the executives agreed. Marlon proved to the executives that Coppola was right by showing his consensus in being a patriarch of a powerful criminal family. The way the Godfather talks to his clients makes him a respectable man to his friends and family but a dangerous and cold-hearted killer to those who wants to go against him. Besides, the great performance of Marlon Brando puts an outstanding development of Al Pacino’s character. Like Marlon, Al Pacino was not highly valued by the executives because of his looks and lack of experiences in acting. However, with his efforts, the viewers can see the improvement in performing Michael Corleone through all the scenes. The scene he played that helped him keep his role is when Michael was in the restaurant with McCluskey and Sollozo. This plot was really breathtaking and terrifying that makes viewers attentively watch it to the end. Michael’s shiver and worry before the shot successfully portrays an inexperienced mobster, a newbie in the underworld of Michael. Indeed, in the second half of the movie, when Michael took over his father’s chair and started the wipe-out of all of the family’s rivals, he showed an image of a young Don who was more wise and dangerous than his father. As a gangster movie, the Godfather has many plots that can make viewers jump out of their chairs or hide their faces behind their hands. As an experienced director, Coppola knew how to combine background music with the plots to emphasize their contents. For example, when Jack Woltz refused the offer from the Godfather of letting Johnny Fontane cast a role in his movie, the next morning he woke up and saw his beloved horse head in his bed. The evil music was playing very small when the scene was showing Woltz’s garden, viewers could even hear the sound of the crickets. Then the camera slowly moved to Woltz’s bedroom where the music was playing louder and louder as it reached near Woltz’s bed. Finally, the music turned to maximum when Woltz was screaming because he saw the horse head. This scene really freaked people out because Coppola used a real horse head. Lastly, the movie is remarkable because it shows deeply the human part of mobsters. A typical example of how the Corleone members care for each other is Santino’s care about his sister, Conny. At the first scene of the movie, there was the wedding of Conny and Carlo. Unfortunately, Carlo did not love her. He purposely married to Conny because he wanted to get involved in Corleone family which was the most powerful Mafia family in New York. However, Vito Corleone did not let any outsiders to be part of the his business. Carlo was disappointed and he started abusing Conny fiercely, his just married wife. In the film, audiences can see Santino was the only member in the family protected Conny. Santino was also a very hot-tempered person. In some plots, because he was so aggressive, he brought a very bad impression on viewers. Nevertheless, watching him beating Carlo on the street, viewers would have a more positive feeling toward him. Another plot that makes the audiences more sympathy with the movie is when Vito retired, he became an old man with very simple joys of doing gardening and playing with his grandson. Later in the movie, he died by a heart attack, a very normal way that could happen to other elders. That scene really surprises viewers because they may think as one of the most powerful Don in the Mafia world, Vito Corleone should have had a more honorable death. Overall, although the Godfather was released in 1972 at which the performance of the actors and actresses were not as good as the casts now, it still has the full attention of audiences every time they watch. It is rated R which means it has many extremely violent scenes and nudity plots. Some people may think its violence is quite tame. However, if parents don’t take seriously consideration before letting their kids see the movie, their kids might still have a nightmare at night. Work Cited Seal, Mark. â€Å"The Godfather Wars.† Vanity Fair. N.p., Mar. 2009. Web. 18 Nov. 2012. . Rovi, Bruce Eder. â€Å"Little-Caesar – Trailer – Cast – Showtimes – NYTimes.com.† Little-Caesar – Trailer – Cast – Showtimes – NYTimes.com. The New York Times, n.d. . â€Å"TheGodfather Trivia: Leavethe Gun, Read the Trivia!(Total Trivia Entries: 147).† The Godfather Trivia. N.p., n.d. .

Excessive of Self-restraint in Saint Augustine’s Confessions

Excessive of Self-restraint in Saint Augustine’s Confessions When it comes to renunciation, no pain, no gain is what Ive slowly, reluctantly, inexorably come to believe. And when Pete opted for scholarly monkhood, I think he was just trying to outsmart his pain. . . . Hed calculated that by considering the physical world illusory and burying his nose in metaphysical texts he could go on doing something comfortable--while his ignorance and sufferings and hometown and troublesome family just fell away like so much excess poundage. Obviously l question his calculations: to slough off half a self in hopes of finding a whole one is not my idea of good math. --David Duncan,The Brothers K In his Confessions, Saint Augustine†¦show more content†¦But Aristotle writes, There is also a type who feels less joy than he should at the things of the body and, therefore, does not abide by the dictates of reason. . . . For a morally weak person does not abide by the dictates of reason, because he feels more joy than he should in bodily things, but the man under discussion feels less joy than he should. (NE22)[2] Aristotle does not give a name to this type of person, so we shall call him the moral martyr. Moral martyrs abandon worldly pleasures such as friendship, food, and entertainment for the apparent benefits of self-restraint. Therefore, they are deficient in their enjoyment of worldly pleasures and excessive in their use of self-restraint. Saint Augustine has clearly taken the path of moral martyrdom. He writes, The eye is attracted to beautiful objects, by gold and silver and all such things. There is great pleasure, too, in feeling something agreeable to the touch, and material things have various qualities to please each of the other senses . . . . But our ambition to obtain all these things must not lead us astray (Conf., 48). In claiming this much, he is in agreement with Aristotle--a man who pursues every pleasurable thing in life is succumbing to moral weakness. But instead of merely advising restraint, Saint Augustine encourages the complete avoidance of worldly pleasures. For example, he writes, I admit that I still find some enjoyment in the music of hymns . . . . I confess