The Moral Mind Essay Example | Topics and Well Written Essays - 1000 words

The Moral Mind - Essay Example The opponents of this argument Ross and Nisbett reject this ideology and hold the view that human behavior is inconsistent across situations. According to Schwartz, one normally has interest for others and it is ‘opposed to egoism’ (148). Hence, at certain occasions people do act upon the interest of the others. Whereas, Ross and Nisbett understand this social psychology in a different manner as a kind of ‘fascinating things about human behavior’ which can either validate or contradict it (187). They understand that human behavior is mysterious and can act upon the circumstances and situations of particular time. Schwartz’s opinion is well substantiated with many evidences. He argues his point of view in the mental functioning of presumption, assuming to be true. Presumption is the very basis of his explanation of the existence of the concept altruism. A normal person holds an instinct to serve the other without making any preferences. Moreover, an al truist act is little or no at all profit or benefit oriented. To substantiate his argument he explains certain fields of study such as biology, economics and psychology. Whereas, he is totally being criticized by Ross and Nisbett as they stick on to a different and unique point of view. They strongly support their view even by establishing a term of ‘fundamental attribution of error’ and believe that the personality can have a greater influence in deciding on decisions (189). Furthermore, personality and human behavior have tremendous influence in every action performed by him. But the situation and the sudden movements always do not encourage an act of altruism. It is a normal understanding that at a particular situation, a person acts accordingly. This concept is better explained in following verses â€Å"the situationist acknowledges that individuals may exhibit behavioral regularity over time across a run of a substantially similar situation† (Ross& Nisbett 1 99). Therefore, they strongly argue that the behavior is completely unreliable. An unreliable human behavior is subjected to change with the change in situation; whereas, the former concept of altruism is further substantiated on the basis its perfection which only possible through a whitewash over the egoistic motives. Ultimately, Schwartz accepts and understands the challenges associated with it such as ‘individualism, atomism and egoism’ but he is optimistic and says â€Å"altruism becomes not impossible but ubiquitous† (.149). However, overcoming every problem is coupled with clear understanding and rational thinking. The tension prevailing is nothing but a contradict view. On the one side Schwartz argues that humans are robustly and consistently altruistic, describing the tendency or the instinct to serve others; while on the other side Ross and Nisbett contradict this view by substantiating their view of inconsistency across situations. Therefore, solving t his debatable issue is not an easy task. Guided by intelligence or rational thinking one would always adapt a mid-way approach as it is well said that virtue lays in the middle. Before coming to a final decision one should always look at both pros and cons of both points of view. The positive sides of the altruistic attitude are remarkable as humans do such kind of activities in their day-to-day life. Similarly, on the other side, the argument for situational act is not a negligible ideology as many at circumstances some hesitate to perform certain good actions. On

South Carolina and Georgia Essay Example for Free

South Carolina and Georgia Essay When the American colonies rebelled against Great Britain, the rebels gave their reasons in the Declaration of Independence. According to the Declaration, people have unalienable rights to liberty. â€Å"The ideology of the revolutionary generation shaped the later American Bill of Rights. This revolutionary ideology combined and wove together both the natural rights of man and the historic rights of Englishmen†. The colonists emphasized natural rights and historic liberties as a result of their view of government. Government was potentially hostile to human liberty and happiness. Power was essentially aggressive. The rebellious colonists dealt with the problem of aggressive political power by several devices: separation of powers, an independent judiciary, the right of people to have a share in their own government by representatives chosen by themselves, and an insistence on the natural and historical rights and liberties of citizens reflected in revolutionary bills of rights of the several states. These concessions to slavery produced some protests. George Mason, delegate from Virginia and a leading advocate of a federal bill of rights, complained that delegates from South Carolina and Georgia were more interested in protecting the right to import slaves than in promoting the Liberty and Happiness of the people. Some framers rationalized the compromise with slavery on the assumption that the institution would soon die out. In truth, however, a compromise was made in the interest of the Union. While the framers compromised with slavery, they took steps to prevent its spread to new states. Particularly after the adoption of the Bill of Rights the Constitution reflected the Jekyll-and-Hyde character of the nation. The nation sought simultaneously to protect liberty and slavery. All in all, the Bill of Rights was adopted because of the fear of abuses of power by the federal government. It simply had no application to the states. The idea that the federal Bill of Rights protects liberty of speech and press, freedom of religion, and other basic rights from violations by the states has become commonplace, even for lawyers. Indeed, many Americans probably accepted this commonplace when careful lawyers knew it was not so. From 1833 to 1868 the Supreme Court held that none of the rights in the Bill of Rights limited the states. From 1868 to 1925 it found very few of these liberties protected from state action. Those the states were free to flout (so far as federal limitations were concerned) seemed to include free speech, press, religion, the right to jury trial, freedom from self-incrimination, from infliction of cruel and unusual punishments, and more. State constitutions, with their own bills of rights, were available to protect the individual, but too often they proved to be paper barriers. Most, but not all, scholars believe that the Supreme Court was right, at least as a matter of history, up to 1868. They believe, that is, that the founding fathers did not intend for the Bill of Rights to limit the states. In contrast to the English Bill of Rights of 1689, in which the powers of Parliament are protected against the encroachments of the monarch, the American Bill of Rights was created to protect the individual against the intrusions of the legislative and executive branches of the government. As James Madison expressed it, If we advert to the nature of Republican Government we shall find that censorial power is in the people over the Government, and not in the Government over the people. Nowhere in the Bill of Rights is this more sharply affirmed than in the words of the First Amendment: Congress shall make no law respecting an establishment of religion or prohibiting the free exercise thereof; or abridging the freedom of speech or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances. Although nine of the thirteen colonies had established churches, four did not (Rhode Island, Pennsylvania, New Jersey, and Delaware). By the time the First Amendment was adopted, however, only three states had an established church -Massachusetts, New Hampshire, and Connecticut. Of even greater significance is that no two states shared the same religious configuration with respect to its population. Not to be overlooked is that in the decade between the Declaration of Independence and the Constitutional Convention, numerous states had made declarations in support of religious freedom prior to the adoption of the Bill of Rights. In 1868 the Fourteenth Amendment was ratified. Beginning in the 1920s, the U. S. Supreme Court began to apply the Bill of Rights to states through a process now called the incorporation of the Bill of Rights into the Fourteenth Amendment. As originally passed, the Bill of Rights applied only to the federal government and not to state governments. The Fourteenth Amendments equal protection and due process clauses clearly applied to the states. Through a series of lengthy cases, the Court engaged in a piecemeal process of interpreting the Fourteenth Amendment clauses to include the various freedoms protected in the Bill of Rights. In Near v. Minnesota (1931) the Supreme Court applied freedom of the press to the states. In this case, the city of Minneapolis tried to suppress the publication of scandalous, malicious and defamatory material in newspapers. A newspaper publishers association, fearing censorship, challenged the Minnesota law on the grounds of violation of freedom of press. The Supreme Court struck down the law by contending that it represented prior restraint of future issues. The most important freedom given to the press is freedom from prior restraint, the freedom not to be censored. The process of nationalizing the Bill of Rights through the Fourteenth Amendment continued in the area of free exercise of religion. In Hamilton v. Board of Regents (1934), the Court held that freedom of religion was protected by the First Amendment against invasion by the national government and by the states. This decision was confirmed in Cantwell v. Connecticut (1940). This case questioned the constitutionality of a Connecticut law which banned solicitation of money for religious or charitable reasons unless approved by the secretary of the public welfare council. This particular official had the authority to decide whether a fund-raising cause was truly a religious one. In a unanimous decision, the Supreme Court ruled that the statute violated religious freedom and the due process clause of the Fourteenth Amendment. From the critical standpoint, the Bill of Rights not only constitutionally protects individual rights of citizens, such as freedom of religion, peaceable assembly, right to keep and bear arms, trial by jury, but it also secures the entire system of American democratic values and implementation of democracy in reality. For instance, freedom of press, declared of in the First Amendment, does not mean only that â€Å"Congress shall make no law†¦ abridging the freedom of†¦press. † Considering the fact independent media is one of the pillars of modern democracy, this constitutional guarantee aims to secure democratic principles of the country. Moreover, the freedom of press implies automatically the absence of any censorship limiting the execution of freedom of speech, which is too declared in the First Amendment and similarly is to protect democratic principles. The Bill of Rights has been created not only to protect freedoms and liberties of American citizens on individual levels, but also to secure the position of a person before the government. For example, the Fifth Amendment provides that no person shall be forced in any criminal case to be a witness against oneself. At the same time, from my personal viewpoint, the fundamental importance of the Bill of Rights is its long lasting effect and its tremendous influence on American legislative and judicial system. Firstly, the Bill triggered the adoption by the Congress of several important acts protecting civil liberties like Civil Rights Act. Secondly, because the Bill is an integral and vital part of US Constitution, and thus the ultimate legal power, legislative and judicial system have been continuously improving constitutional doctrine on individual rights. For example, one can notice during 1960-70s the constitutional rights of public employees to freedom of speech and association, procedural due process, and equal protection have also been vastly expanded. Historically the Constitution has retained its flexibility because interpretations of its meaning have changed. Choosing between two or more sets of competing values, the Supreme Court has played a major role in maintaining this flexibility. A significant trend has been the extension of civil rights to the previously powerless. For instance, the involvement of the U. S. Supreme Court in civil rights for blacks is long-standing, dating back to issues from the days of slavery. In the Dred Scott case (1857), Chief Justice Taney ruled that no blacks, slave or free, were citizens, and that blacks had no citizenship rights (Hall, 38). In 1883, two decades after the Civil War and the official end of slavery, the Court ruled on five separate suits affecting the rights of blacks, and collectively called the Civil Rights Cases (1883). These cases arose in response to the Civil Rights Act of 1875 which prohibited racial discrimination in jury selection and public accommodations. In these cases, the public accommodations portions of the 1875 act were challenged. The Court recognized that the Fourteenth Amendment forbade discrimination by states but it made no mention of discriminatory acts committed by individuals. Since the Civil Rights Act prohibited discrimination by individuals and private businesses, the Court ruled that the act had overstepped congressional authority and was therefore unconstitutional. By the end of World War II, the Supreme Court had become more supportive of civil rights for blacks. It struck down the all-white primary in Smith v. Allright (1944), arguing that the Democratic party was in essence an agent of the state and was therefore subject to the Fifteenth Amendment. During the late 1940s and the 1950s, the Court followed the trends begun earlier of moving away from the doctrine of separate but equal (Hall, 51). This may be seen in the cases of Sipuel v. Oklahoma (1948), Sweatt v. Painter (1950) and McLaurin v. Oklahoma State Regents (1950). In the Sipuel case, which was similar to the Gaines case, the Court ordered Oklahoma to provide a separate but equal law school for a black woman and stressed the need for equality in facilities. In Sweatt v. Painter, the state of Texas had established a separate black law school but it was inferior to the white law school at the University of Texas in the size of its faculty and the quality of its library and student body. The court ruled that the black law school had to be improved. The Court nearly overturned the separate but equal doctrine in the McLaurin case in which Oklahoma had allowed a black student to attend a white graduate school but had segregated him from the rest of the students by designating separate sections of the library, cafeteria and classrooms for him. The Court struck down these segregation provisions, claiming that they interfered with the ability of the black student to exchange ideas with other students, a requisite for a good education. Although these cases fell short of invalidating the separate but equal principle, they made segregation at the graduate school level more difficult to implement. Perhaps the most significant civil rights cases to aid blacks in the fight for equality were the two Brown cases in the 1950s. Brown v. Board of Education I (1954) arose as the result of a suit against Topeka, Kansas where Linda Brown, a black child, was not permitted to attend a segregated white school four blocks from her home. In Brown I, under the leadership of Supreme Court Chief Justice Earl Warren, the Court overturned the Plessy decision of separate but equal in the public schools by declaring that the separate but equal doctrine made black children feel inferior. In Brown v. Board of Education II (1955), the Court ruled on how to accomplish desegregation, concluding that local school boards should establish plans for desegregation under the supervision of federal district judges and with all deliberate speed. Despite these court rulings, southern school boards were slow to respond and avoided court orders by closing public schools and placing white children in private schools. Consequently, desegregation was only implemented very slowly. Women are not a minority but they have historically experienced legal discrimination based on their gender. The Supreme Court has played an important role in the expansion of rights for women. Overall the Court has been less important in the expansion of womens rights than it has been in the extension of rights to blacks and other racial minorities. A major reason for the less important role of the Court is that womens rights have mostly been broadened through legislation. Many womens rights cases addressed by the Supreme Court have been concerned with employment. Early court decisions followed a trend of protectionism and upheld restrictions on the nature and conditions of employment for women. In Bradwell v. Illinois (1873), the Supreme Court upheld a state law preventing women from practicing law. Not until the 1970s did U. S. Supreme Court rulings begin to move away from the restrictive, protectionist trend of the past. Reed v. Reed (1971) was the first instance of the Court striking down a state law which discriminated against women. Taylor v. Louisiana (1975) overturned the precedent set in Hoyt v. Florida. Phillips v. Martin-Marietta (1971) ruled that employers could not discriminate against mothers of preschool children, despite fears that they might often miss work to care for their children. In Stanton v. Stanton (1975) the Court struck down a Utah law which required divorced fathers to support sons until they were twenty-one under the assumption that they would need support while being educated, while daughters had to be supported only until they were eighteen under the assumption that they would get married and be supported by their husbands. Beginning in the 1920s, the U. S. Supreme Court began to apply the Bill of Rights to states through a process now called the incorporation of the Bill of Rights into the Fourteenth Amendment. As originally passed, the Bill of Rights applied only to the federal government and not to state governments. The Fourteenth Amendments equal protection and due process clauses clearly applied to the states. Through a series of lengthy cases, the Court engaged in a piecemeal process of interpreting the Fourteenth Amendment clauses to include the various freedoms protected in the Bill of Rights. In Near v. Minnesota (1931) the Supreme Court applied freedom of the press to the states. In this case, the city of Minneapolis tried to suppress the publication of scandalous, malicious and defamatory material in newspapers. A newspaper publishers association, fearing censorship, challenged the Minnesota law on the grounds of violation of freedom of press. The Supreme Court struck down the law by contending that it represented prior restraint of future issues. The most important freedom given to the press is freedom from prior restraint, the freedom not to be censored. In many cases the statements embedded in the Bill of Rights are impacted directly or indirectly through the process of governance in the United States. One of the most peculiar examples of this impact is adoption of the Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act of 2001, commonly known as the Patriot Act. This act significantly expands the power of the federal government to investigate, detain, and deport those people who the government suspects are linked to terrorist activity and other crimes. The Fourth Amendment of the United States Constitution requires the government to prove to a judicial officer that it has probable cause of a crime before it conducts an invasive search to find evidence of that crime or in exact words, this Amendment declares that â€Å"the right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause†¦Ã¢â‚¬  Before the enactment of the Patriot Act, if the primary purpose was a criminal investigation, the law enforcement officials had to first prove the higher standard of probable cause. Investigating criminal activity cannot be the primary purpose of surveillance. Now American society witnesses how one of the most fundamental statements of the Bill of Rights, particularly that one protecting individual freedoms from the state, is challenged. The change made by Section 218 of the Patriot Act authorizes uncon stitutional activity by impinging on the Fourth Amendment protection that requires probable cause. Section 218 now provides law enforcement officials with a tool to avoid probable cause when conducting criminal investigation surveillance. The adoption of the Patriot Act has been triggered with the war the United States declared against terrorism. Interestingly, the same event, the war on terrorism, challenged another important element of the Bill of Rights, namely the due process clause of the Fifth Amendment, which states that â€Å"no person shall be deprived of life, liberty, or property, without due process of law. † Practically, this statement aims to secure individuals from unconstitutional exercise on the behalf of the government. Importantly, this article provides Americans with the right to be tried by unprejudiced courts with application of lawful procedures and laws. However, during the war in Afghanistan and Iraq, the US government intentionally deterred in prisons many prisoners of war (identifying them as terrorists) without court orders, indictments and further court hearings. Here one can notice the constitutional collision, in which the rights of the US government during wartime (including deterring of individuals without due process clause) challenges the statements embedded in the Bill of Rights. Works Cited Barnett, Randy E. ed. , 1989. Ninth Amendment. supra note 29, at 18 Bailyn, Bernard. 1967. Ideological Origins of the American Revolution. Cambridge, Mass. : Harvard University Press. Ely, J. 1980. Democracy and Distrust. Cambridge, MA: Harvard University Press. Hall, Kermit L. 1989. The Magic Mirror. Law in American History, New York: Oxford University Press. Levine, James P. 1992. Juries and Politics, Pacific Grove, CA: Brooks/Cole Publishing Company. Madison, James. November 27, 1794. Republicanism. Speech in Congress. Annals of Congress 934. Nelson, William E. 1988. The Fourteenth Amendment: From Political Principle to Judicial Doctrine. Cambridge, MA: Harvard University Press. Schwartz, B. 1971. The Bill of Rights. A Documentary History. pp. 222-226. Wiecek, W. 1976. The Sources of Antislavery Constitutionalism in America, 1760-1848. Ithaca: Cornell University Press. P. 74

Inter professional Team Working Risk Management Resuscitation department

Inter professional Team Working Risk Management Resuscitation department This assignment focuses on teamwork and the management of patients requiring emergency treatment. In health care, teamwork or inter-professional collaboration is an essential component of safety. As breakdowns in teamwork can lead to poor patient safety, I aim to critically evaluate and defend the importance of inter-professional collaboration in the resuscitation department. Example scenarios of patients that were brought into the resuscitation department requiring immediate care management will illustrate different team approaches to working, barriers to effective team working, and leadership of teams. The nurses role in the maintaining patient safety via risk management strategies will also be explored. This is important because the resuscitation department is a fast paced environment potentially vulnerable to risks. I intend to conclude how each scenario was managed and from these, draw up recommendations for streamlined nursing care and inter-professional team working in a resus citation department. A reference list is included. Introduction In the Accident and Emergency (AE) department, a key function is to receive asses and treat injured or sick people quickly at any time of the day or night. Anything can appear in an AE department; from patients with cuts, sprains and limb fractures, to patients with more serious life threatening conditions such as cardiovascular emergencies, gastrointestinal problems, neurovascular emergencies and traumatic injuries. Due to the nature of work in this environment, nursing care and management often occurs as a rapid sequence of events commencing with the recognition of life-threatening needs (Etherington 2003). Patients attending AE are seen immediately and there needs for treatment assessed. This initial assessment is a process known as triage designed to allocate clinical priority (See appendix). The Manchester triage group set up in 1994 is the most widely used triage method in the UK. The system selects patients with the highest priority first and works without making any assumptions about diagnosis. This is deliberate as AE departments are largely driven by patients presenting with signs and symptoms (Mackaway-Jones 1997). Once patients are triaged they are categorised according to a scale of urgency. The triage scale is colour coded for example: patients requiring immediate resuscitation and treatment are coded red, and would normally be met by a team standing by after prior notification by the ambulance service (Crouch and Marrow 1996). People presenting with serious injury or illness require a skilled team who follow recognised life support protocols within agreed roles (Etherington 2003). This assignment will focus on red coded patients brought into a resuscitation department requiring immediate care management for the preservation of life. Effective management of these patients is pivotal in reducing mortality rates and a skilled team is of great importance. In health care, teamwork or inter-professional collaboration is an essential component of safety. Research suggests that improvement in patient safety can be made by drawing on the science of team effectiveness (Salas, Rosen and king 2007). However, literature regarding emergency teams suggests that human factors such as communication and inter-professional relationships, can affect a teams performance regardless of how clinically skilled the team members are (Cole Crichton 2006, Lynch and Cole 2006). Ineffective teamwork can lead to errors in diagnosis and treatment (Salas, Rosen and king 2007) and is apparent in the many accusations of poor care and inadequate communication evident in malpractice lawsuits (Gro ff 2003). As breakdowns in teamwork can lead to poor patient safety, I aim to critically evaluate and defend the importance of inter-professional collaboration in the resuscitation department. Example scenarios of patients that were brought into the resuscitation department requiring immediate care management will illustrate different team approaches to working, barriers to effective team working, and leadership of teams. The nurses role in the maintaining patient safety via risk management strategies will also be explored. This is important because the resuscitation department is a fast paced environment potentially vulnerable to risks. I intend to conclude how each scenario was managed and from these, draw up recommendations for streamlined nursing care and inter-professional team working in a resuscitation department. Throughout this essay, I will adhere to confidentiality as stated in the Nursing Midwifery Councils Code (2008) and no identities regarding the patients or the trust shall be named. I acknowledge that some reference sources used in this assignment are dated, however they are still commonly cited in much up-to-date literature. The resuscitation room and the nurses role The resuscitation room is designed for the assessment and treatment of patients whose injury or illness is life-threatening (Etherington 2003). Anything can emerge with little warning (Walsh and Kent 2000) however, departments often receive prior warning of a patients arrival which allows the preparation of the resuscitation area and the team (Etherington 2003). All team members should be appropriately prepared to care for the patient in a systematic manner. AE nurses are vital components of the team (Hadfield-Law 2000) because they are usually among the first team members to meet patients and typically remain with them throughout their stay within the department (OMahoney 2005). A nurse with advanced life support (ALS) training is best placed to care for patients in the resuscitation room (Etherington 2003). This is where their training can be best utilized and this assists the inter-professional team to practice mutual working skills modelled on evidenced based protocols (DH 2005). Successful resuscitation depends on a number of factors, many of which can be influenced by AE nurses such as the environment and the equipment. Patient (2007) highlights various elements of AE nurses role in the preparation for patient arrival. This would include preparing the area, having equipment in ready and working order and having a team on stand by. These tasks underline the risk management strategies involved in maintaining a safe environment such as checking and cleaning everything on a regular basis (Etherington 2003), a practice which I observed is routinely carried between patient occupancy. The importance of carrying out such checks contributes to teams being prepared with equipment ready and working to treat patients safely. Once the patient has arrived, other roles and tasks the AE nurse might undertake include: maintaining a patients airway, patient assessment, taking vital observations, monitoring intravenous therapy, managing wound care, pain management, keeping rubbish clear to maintain a safe working environment, catheterisation, and communication and liaison between patients, relatives and the inter-professional team (Patient 2007, Etherington 2003). McCloskey et al., (1996) cited in Drach-Zahavy and Dagan (2002) describe this linking role of nursing as glue function as it is nurses who maintain the holistic overview of the care given to the patient by all members of the inter-professional team. From the literature (Patient 2007, Etherington 2003, McCloskey et al., 1996), it is evident that nurses working in the resuscitation area must be able to integrate with the inter-professional team and not only maintain the safety of the patient, but also everyone working in that environment. It is the nurses responsibility to manage the resuscitation room which incorporates preparing the environment and ensuring equipment is in working order. Investigation into the resuscitation room and the nurses role within that area has highlighted that nurses have many important management roles to carry out. For the purpose of this assignment, focus will be upon the nurse working as part of the inter-professional team, and the risk management strategies that take place to support that team. I had the opportunity to observe how inter-professional teams worked together to benefit the patient and ensure safety. Two examples of patients brought into the resuscitation department within the same week will now illustrate different team approaches to care management. Example 1 10:00 Saturday morning, the department receives a call from ambulance control warning that they have a patient with cardiac arrest on the way in approximately ten minutes. Immediately the lead nurse of the emergency department informs the two nurses managing the resuscitation department of the patient en route. The Nurses put a call out to the emergency inter-professional team to stand by and prepared the area by having the defibrillator in position, the oxygen mask ready and the adrenaline at hand. The emergency inter-professional team start flooding into the area and there is a mixture of bodies standing around in rubber gloves and aprons. The team consisted of three nurses, an anaesthetist, a physicians assistant, two junior medical students, two nursing students, a registrar, and a consultant equating 11 people. The ambulance crew arrived and they rushed the patient in promptly transferring her over from stretcher to trolley. The paramedic commenced a detailed handover to the team. The patient was a 69 year old woman who was found unconscious and not breathing at a holiday camp. The ambulance crew had been doing cardiac pulmonary resuscitation (CPR) for 45 minutes from scene to hospital. The patient was still not breathing. During the time of this handover, it was observed by the nurse that there was a short hesitancy between continuity of CPR. After the ambulance crew transferred the woman over to the trolley, no one took the lead of directing the team or continuing CPR. After this brief hesitancy a nurse took the lead by suggesting someone start CPR. Another nurse then stepped forward and commenced chest compressions whilst the anaesthetist placed a bag and mask over the patients airway. The team crowded around and the consultant stepped forward and started making orders loudly in relation to current advanced resuscitation guidelines. The defibrillator was attached and the team was advised by the nurse operating it to stand clear. Shocks were delivered without success. The team took it in turn to do chest compressions for fifteen minutes whilst other members gathered around obtaining intravenous access. The consultant then suggested that they stop. The team stood back and started to disperse out of the resuscitation room leaving the nurses to continue care and management of the patient and her family. The patient was disconnected from the defibrillator and a nurse cleaned the resuscitation area. Example 2 At 02:30 ambulance control report that they have a patient involved in a road traffic collision (RTC) on route due in approximately twenty minutes. The lead nurse informs the two nurses running the resuscitation area who then inform the inter-professional team to stand by. The resuscitation area is prepared and a team of seven including two nurses, a registrar, an anaesthetist, a physicians assistant, an orthopaedic doctor, and a nursing student await the patients arrival. The team pre-decided on who is to do what tasks. The ambulance crew arrive with the patient on a spinal board. The crew hand over the patient, a 42 year old male who was intoxicated with alcohol and overdosed on analgesics, had been involved in a high-speed police chase and sped off the road overturning his car and going through the windscreen. The patient had recently discovered that his wife was having an affair and this was the suspected cause of his actions. The police awaited outside the resuscitation department. The patient was semi conscious maintaining his own airway. The registrar took the medical lead advising calmly who to do what. The anaesthetist took the management of the airway, a nurse provided comfort and reassurance to the patient whist taking observations. Another nurse cut the patients clothes off him and covered him with sheets. The protocol used for patients involved in trauma is the Advanced Trauma Life Support (ATLS) system (American College of Surgeons 1997) which is a widely adopted management plan for trauma victims. Initial assessment consists of preparation, a primary survey, resuscitation, secondary survey and definitive care phase which is the ongoing management of trauma. Because the ATLS involves medical and nursing staff, they encourage inter-professional learning. This occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care (DH 2007). Most AE departments use the ATLS protocols (Etherington 2003) as this system of managing the severely injured has now become part of best practice (Royal College of Surgeons 2000). The registrar and the nurses all appeared highly familiar with ATLS protocol and a primary survey, secondary survey followed by definitive care phase was carried out systemically and smoothly. The team anticipated each others actions and care management resulted in the patient being able to maintain his own airway, breathing and circulation. Other team members that became involved in the care management of this patient included the radiographer, lab technicians and the police. The nurses liaised with all these people and acted as a mediator of communication between the team. This reinforces Drach-Zahavy and Dagans (2002) concept of glue function as it is nurses who maintain the holistic overview of the care given to the patient by all members of the inter-professional team. It is worth noting that these examples are comparatively different in relation to the time of day they occurred, the teams that attended, and the age and presentation of the patients. These factors will be taken into consideration during discussion of the two examples. Inter-professional team working Nurses are obliged to adhere to the NMC Code which in relation to team working, clearly states that nurses must work effectively as part of a team and respect the skills, expertise and contributions of colleagues (NMC 2008). The importance of inter-professional working has been emphasised in a succession of government white papers addressing care (Hewison 2004) which call for more team working, extended roles for professionals and the removal of hindrances to collaboration (DH 2000a/b, 2004, 2005). During a critical care emergency, effective teamwork, prioritising and speed of care delivery may mean the difference between life and death (Denton and Giddins 2009). National Patient Safety Agency (NPSA 2008) and National Institute for Health and Clinical Excellence (NICE 2007) agree that healthcare professionals are required to be able to respond appropriately in emergency situations. This entails an up-to-date knowledge of current evidence-based resuscitation guidelines (Resuscitation Council 2005, 2006) and the need for a team approach to care management of acutely ill individuals (Denton and Giddins 2009). An exploration of inter-professional team working in a resuscitation area will now follow, using the above examples to appraise the importance of inter-professional collaboration. Teams and team effectiveness will be discussed as this is essential in identifying the mechanisms of teamwork involved in patient management and safety (Salas, Rosen and King 2007). The DH (2005) recognise that outcomes of health care services are a product of teamwork and, the use of the word team is a broad spectrum term aimed to include all healthcare professionals working inter-professionally. Mohrman et al., (1995) definition includes individuals who work together to deliver services for which they are mutually accountable and, integrating with one another is included among the responsibilities of each member. Leathard (1994) depicts inter-professional practice to refer to people with distinct disciplinary training, working together making different yet complementary contributions to patient focused care. The philosophy of care in the local AE department incorporates these definitions stating; professionals aim to promote team spirit with support to each other and encourage relations with other disciplines (Trust AE nursing philosophy 2008). Salas, Rosen and King (2007) suggest effective teams have several unique characteristics including: a dynamic social interaction with significant interdependencies, a discrete lifespan, a distributed expertise, clearly assigned roles and responsibilities, and shared common values and beliefs (Wiles and Robinson 1994). These characteristics require goal directedness, communication and flexibility between members (Webster 2002). From these definitions, it is apparent that in healthcare a common and vital feature in teamwork is shared values and goals (Salas, Rosen and King 2007, Wiles and Robinson 1994). This serves as the teams focus point and appears to be at the pinnacle of what members strive towards. In example 1, shared values and goals are evident in the ALS protocols that the team followed. However, individuals roles were not clearly recognised and the team did not seem to be familiar with one-another. In example 2, the team again demonstrated shared values and goals by following agreed protocols (ATLS). This was further demonstrated in how the team interacted with each other and anticipated one-anothers actions. Pre-agreed tasks were organised by the team and they demonstrated mutual understanding of one-anothers roles. When members of trauma teams are given pre-assigned roles, they can perform a practice known as horizontal organisation which refers to the ability of performing several interventions simultaneously (Patient 2007 and Cole 2004). Taking on pre-agreed roles and responsibilities can influence patient outcomes, limiting resuscitation times and lowering mortality rates (Lomas and Goodall 1994). Salas, Rosen and King (2007) advise teams take time to develop a discipline of pre-brief where the team clarifies the goals, roles and performance strategies required. Example 2 demonstrates how, this preparation is proven to amplify performance levels when functioning under stressful conditions (Inzana et al., 1996 cited in Salas, Rosen and King 2007). A team approach in resuscitation has proved highly effective in reducing mortality rates (Walsh and Kent 2000). However, evidence suggests that human factors such as poor communication and lack of understanding of team members roles can breakdown team effectiveness leading to poor patient safety. (Xyrichis and Ream 2008, Atwal and Caldwell 2006). In relation to example 1, there were many team members present; nobody knew clearly who was who. To understand what makes an effective team, barriers inter-professional teams face and what can be done to overcome these obstacles shall be explored. Barriers to Inter-professional team working We have established that emergency care management involves many professionals each with their own discipline, knowledge and skills. Due to this diversity, professionals may have limited knowledge of each others roles and so undervalue the contribution of care delivered to patients, making inter-professional team working difficult (Spry 2006). Also, the way which individuals work together depends greatly on personalities and individual compatibility (Webster 2002). If personalities clash, this is a barrier to team effectiveness. In example 2, the team were familiar with one another and had evidently worked together in many trauma care situations as they seemed to trust and respect each other. This team were on their 3rd consecutive night shift working together therefore they had built a rapport with each other. Similarly in Cole and Crichtons (2006) study exploring the culture of a trauma team in relation to influencing human factors, many respondents described an amity and familiarity. They argued that teams work when people know their roles, have the required technical expertise and are knowledgeable about trauma. Cole and Crichton (2006) interviewed a consultant team leader who reports; you can have the most gruesome scenario where you have a new surgical SHO and a new anaesthetic SHO, no-one knows each other and its atrocious! Teams made up of individuals who are familiar with each other work with greater efficacy than teams composed of strangers (Guzzo and Dickson 1996 cited in Cole and Crichton 2006). This report illustrates the challenges that team unfamiliarity poses. In Cole and Crichtons (2006) study, focused ethnography was used to explore the culture of a trauma team in a teaching hospital. Many ethnographic studies focus on a distinct problem amongst a small group. This method is appropriate when focussing on the meanings of individuals customs and behaviours in the environment in which they are occurring (Savage 2000). Six periods of observation of trauma teams attending trauma calls was undertaken followed by 11 semi-structured interviews with purposively chosen key personnel. Their findings are based on the trauma teams working in one hospital; therefore this study is quite narrow. Cole and Crichton acknowledge that this method of study can be criticized for producing only one snapshot in time, potentially reducing its credibility. Taking these limitations into account, I believe their findings could be used to inform best practice where if the opportunity existed teams could be facilitated to practice working together. This would allow me mbers to become familiar with each others personalities and roles. Teams operating within an emergency medicine context face complex, dynamic and high-stress environments (Salas, Rosen and King 2007). However Denton and Giddins (2009) suggest staff in these areas become experienced in managing emergencies, know each others roles and have developed close team-working skills. Example 2 shows evidence to support this. Conversely, in example 1, the team seemed disjointed and nobody seemed to know each other. They assembled for the resuscitation but a lack of role perception hindered the teams ability to work effectively together. Research into inter-professional team working and resuscitation attempts is limited (Denton and Giddins 2009). However, a small study of cardiopulmonary resuscitation conducted in a trust hospital by Meerabeau and Page (1999) found that, although team members of a resuscitation attempt may have a common goal (to resuscitate the patient) and some of the attributes associated with effective teams, many features may not be present . These features encompass regular interaction and clear roles as their evidence concludes, CPR teams generally did not work together nor practice their skills together. These findings support Cole and Crichtons (2006) results and could be applicable to example 1 indicating that; although CPR teams trained specifically to react in CPR situations, factors such as regular interaction and clear roles influence team effectiveness. If integrated inter-professional working is to become a reality, it is fundamental that people have opportunities to work closely together to build up personal relationships and understand others roles (Hewison 2004). Professional education needs to play a vital part in supporting this (Webster 2002). The DH actively encouraged initiatives in the NHS and in higher education institutions to encourage greater role awareness amongst health professionals and support effective team working (DH 2007, 2004a, 2000b). This allows team members to devise precise expectations of their team mates actions and requirements during high-stress work episodes (Salas, Rosen and King 2007). This is a logical solution but like Salas, Rosen and King (2007) note, teams come together for a discrete lifespan and depend upon who is on duty and time of day. Consequently having opportunities for developing personal relationships and understanding each others roles becomes a challenge. A lack of specialist skills required to manage the care of critically ill patients is a potential barrier to delivering effective team care as this could escalate into inter-professional conflict. This is when nurses skills and doctors expectations of these skills differed (Tippins 2005). This barrier highlights the relevance of the ATLS training. Patient (2007) confirms that individuals who have undertaken the ATLS course claim they have gained an insight into each others roles and resultantly, can communicate with one another better (Hadfield-Law 1994). The number of staff available varies between departments and is influenced by time of day (Etherington 2003). Example 1 took place on a busy Saturday morning and the department was bustling with staff. The team that attended to the patient was large and appeared disorganised. There were 11 members to this team, 4 of which were students who were perhaps encouraged to attend and observe the situation. The team that attended the patient in example 2 was comparatively smaller and appeared more organised. In an article by Tippins (2005) exploring nurses experiences of managing critical illness in an AE department, one nurse describes how the nature of the experiences depended on the size and dynamics of a team: Because it was such a big trauma, there were so many people there, actually you feel its not managed very well because there were so many people. It was just a bit chaotic really. This example along with example 1 demonstrates that large numbers of people can make inter-professiona l working difficult. The ideal number of team members in a resuscitation team is uncertain (Patient 2007). Etherington (2003) reinforces that effective teamwork is possible with just 3 people present providing leadership, trust and collaboration are achieved. Relating back to example 2, leadership, trust and collaboration was evident. There was also a strong awareness of roles and task distribution as opposed to example 1 where the team appeared to gather in an unorganised fashion. These examples demonstrate that the size of a team does not reflect quality. It is influencing factors such as role perception, communication and good leadership that make an effective team. Within inter-professional teams individuals also need emotional intelligence to work effectively with colleagues and patients (Mc Callin and Bamford 2007). According to Goleman (1998), someone with high emotional intelligence is aware of emotions and how to regulate them and use this data to guide their thinking and actions (Faugier and Woolnough 2002). Self-awareness, social awareness and social skill are central to emotional intelligence. This is the heart of effective teamwork and influences excellence and job satisfaction (Mc Callin and Bamford 2007). The team in example 2 displayed emotional intelligence in their interactions amongst each other and the patient. For example, the registrar and the nurses constantly communicated with the patient recognising his distress. Team members also displayed horizontal organization demonstrating their awareness and anticipation of one anothers roles and task allocation. Breakdown in communication has been highlighted a root cause of serious incidents (National Patient Safety Agency 2006) and trauma resuscitations are especially vulnerable. Heavy workload and constantly changing staff can inhibit communication between team members and so affect adversely patient outcomes for example; medication errors or amputation of wrong limbs (Lynch and Cole 2006). Salas, Rosen and King (2007) highlight how communication often breaks down in the inherently stressful nature of responding to crises which can consequently result in clinical errors during decision making. Paradoxically, this is when communication needs to be at its finest (Haire 1998). Many examples of high-quality nursing practice in managing critically ill patients involve good communication skills between staff, patients and relatives (Tippins 2005). Good communication begins and ends with self (Dickensen-Hazard and Root 2000). This relates back to the concept of emotional intelligence and awareness where every person, particularly the leader, should have a clear picture of self, of what is valued and believed and how that blends with the organisation served. Overall, clear, precise and direct channels of communication need to be in place to enhance patient outcome, team functioning (Haire 1998), patient safety and quality care. Leadership The concept of inter-professional team working and the barriers that hinder team effectiveness has been discussed. Now an analysis on team leadership will follow. Leadership is defined as a particular form of selected behaviour that manages team activity and develops team and individual performance (Lynch and Cole 2006). There is a strong focus on leadership within the health service as a resource for delivering quality care and treatment. This is noted in the NHS plan (DH 2000b) which states: Delivering the plans radical change programme will require first class leaders at all levels of NHS. By having visible leaders at all levels contributes to setting high standards and amending errors efficiently. Consequently this contributes to maintaining a safe environment. A resuscitation team needs a visible leader who has the knowledge and communication skills to direct team members (Etherington 2003). In relation to example 1, there was no immediate visible leader who took the task of preparing the team. Only later did the consultant take the lead. As suggested earlier, resuscitation teams are effective when team members adopt specific, pre-agreed roles, which can be carried out simultaneously. The consultant was unable to prepare the team as he arrived only seconds prior to the patient. In the AE department, effective leadership is of prime importance due to the fast paced nature of the environment, which lends potential for staff to feel threatened by the perceived chaos. The leader needs to foster an environment where care delivery has some structure, and staff have guidance and security (Cook and Holt 2000). This role of team leader is pivotal for the effective functioning of the team (Cole and Crichton 2006). The consultant in example 1 and the registrar in example 2 were the identified team leaders. There are few recommendations made about the education necessary to become a team leader other than experience and seniority. The Royal College of Surgeons (2000) report that the team leader should be experienced in emergency management from either an emergency, intensive care or surgical specialty and have completed an ATLS course (Cole and Crichton 2006, American College of Surgeons 1997). From observation of leadership in the local resuscitation department, it appears that the most senior team member takes the lead. Etherington (2003) argues that many AE nurses perform the leader role as well as their medical colleagues. Meanwhile, Gilligan et al., (2005) argue that in many emergency departments AE nurses do not assume a lead role in advanced resuscitation. Their study investigated whether emergency nurses with previous ALS training provided good team leadership in a simulated cardiac arrest situation concluding that, ALS trained nurses performed equally as well as ALS trained emergency Senior House Officers (SHOs). This study was conducted at five emergency departments. All participants went through the same scenario. Participants included 20 ALS trained nurses, 19 ALS trained emergency SHOs, and 18 emergency SHOs without formal ALS training. The overall mean score for doctors without ALS training was 69.5%, compared with 72.3% for ALS trained doctors and 73.7% for ALS trained nurses. The evidence drawn from Gilligan et al., (2005) suggests it may be

Envy and Beauty in Snow White Essay examples -- essays research papers

Envy, Beauty, and Snow White Few people can grow up within today's society without knowing the tale of Snow White. From the Grimm Brothers to Disney, it has been told and retold to children throughout the ages. However, what is often overlooked are the true meanings within the story. Fairytales typically have underlying messages that can be found written between the lines, generally in terms of the key themes. Snow White discusses the themes of envy and beauty, and shows how humans' obsessions can lead to their own downfall as well as the harm of others. When focusing on the relationship between Snow White and her step-mother the Queen, it is evident that the combination of these two themes results in a power struggle in which beauty is seen as a commodity and is the basis for the step-mother?s envy towards Snow White. From the very beginning of the tale it is obvious that the Queen is obsessed with beauty, ?the King took another wife, a beautiful woman, but proud and overbearing, and she could not bear to be surpassed in beauty by anyone(Grimm and Grimm 166). Further evidence of her narcissism is her daily ritual in which she consults her magic mirror on who is the most beautiful person in the kingdom. As she repeatedly expects the answer to be in her favor, she is outraged when it appears that Snow White has surpassed her. This information drives the Queen to hate Snow White and soon she orders her death. By looking at beauty as a commodity through which power can be gained, this action can be interpreted as a means for the Queen to preserve her power through beauty. The fact that Snow White was beautiful may not have been reason enough alone to kill her, but the fear that Snow White could use her beauty in orde... ...intertwined as main themes within the story. The Queen?s fixation with her own beauty, and then her envy over Snow White?s, was the main component in causing her death. As she attempted numerous times to murder Snow White, she was in effect writing her own death sentence, because her obsession drove her beyond rational thinking to the point where her triumph over Snow White was more important than her own life. Works Cited: Grimm, Jacob, Wilhelm Grimm, Edgar Lucas, Lucy Crane, Marian Edwardes, and Fritz Kredel. Grimms' Fairy Tales. Illustrated junior library. New York: Grosset & Dunlap, 1945. Haase, Donald, ed. The Reception of Grimms' Fairy Tales : Responses, Reactions, Revisions. Detroit : Wayne State University Press, 1993. Sale, Roger. Fairy Tales and After: From Snow white to E. B. White. Harvard University Press, 1979.

Philosophy: What Is Justice

To answer this question I must first define what justice is. Justice is â€Å"the quality of being just, impartial or fair† in your dealings with others according to Merriam Webster’s Collegiate Dictionary. Keeping that definition in mind, I now must turn to the Voices of Wisdom in order to find an example of a situation in which all parties feel that they are being treated justly. After examining examples such as: Euthanasia, discrimination based on sexual orientation, and equal opportunity offered within the book, it becomes clear to me that there is in fact no possible way for there to be justice for all because everyone’s judgement is in some way or another clouded by their own self interests. Euthanasia, people can decide exactly how they want to live but should we as a society allow them the right to decide exactly how they want to die? On the one hand you have the question â€Å"is it just to kill someone or allow them to die when help is available? † The obvious answer is no of course not. This is a prime example of why there can be no justice for all, because on the other hand you have the question â€Å"is it fair to force someone to live through unbearable pain in anticipation of an agonizing death? † The obvious answer to that question is also no. This is where our self-interests come into play. It is in the patient’s own self interests to die because it will ease her pain, but is not in mine to alleviate her of her life â€Å"because death is final and irreversible†, and because â€Å"euthanasia contains within it the possibility that [I] will work against [my] own interest if [I] practice it or allow it to be practiced on [others]. (J. Gay-Williams, pp. 185). This is why our own self-interests unavoidably will not allow us to have a just society. A society is only as equitable as the treatment accorded its most vulnerable members. Therefore, discrimination against anyone based on his or her sexual orientation is a clear and incurable symptom of an unjust society. For example, should someone’s sexual orientation be grounds for restricting their rights? (Daniel C. Palm) The impartial answer would of course be no, everyone should be treated the same. But we still hear the chant â€Å"No gays or lesbians in the military†. This is because it is in the self interests of the heterosexual people in the military have homosexuals in the military. The injustice of this idea becomes crystal clear when we examine the opposite statement of â€Å"No heterosexuals in the military† an idea that is equally ludicrous. (Kessler, pp. 74) As a result of the way we instinctively treat those that are different because they are seen as a threat, our society is will remain perpetually unjust. (Richard E. Mohr) Because of widespread discrimination based not only on race, but also on sex, religion and sexual preference it is impossible for society to offer each and every individual a perfectly equal chance at opportunities such as hiring, promotion, housing, and educational practices that should be within their reach; as a consequence, it is impossible fo r society to be just for all. According to the formal principle of justice, it is required â€Å"that benefits and burdens be distributed fairly according to relevant differences and similarities. † (Kessler, pp. 175) Using this principle it would seem that affirmative action programs of preferential treatment are in truth unjust to white males in that such programs require that â€Å"all things being equal† preferential treatment should be given to minorities and females which violates the formal principle of justice by not treating equal people equally. On the other hand, â€Å"such preferential treatment programs are often justified by appeal to the principle of compensatory justice, which states that whenever an injustice has happened a just compensation must be made to those who have been injured. † (Kessler, pp. 194) According to that principle affirmative action should be considered just in relationship to minorities. As a result, because equal opportunity legislation is not in accordance with the best self-interests of most white males but it is in accordance with those of most minorities, this is another example of a situation in which injustice is inevitable. After closely examining these three specific situations in which injustice—because of our natural tendency to look after our own best self-interests—is certain, it can be concluded that it is hopeless to try to attain such an idea as a society that is just for all. Because these perpetually unjust situations such as euthanasia, discrimination based on sexual preference, ideas like affirmative action or situations similar to these will most likely permanently exist, a society in which there is justice for all is unreachable.

Biblical Literature NOTES Essay

Biblical Literature NOTES Essay Biblical Literature NOTES Essay Reliability of Scripture- Walter J. Harrelson Debates have raged within the churches with regard to the reliability of this biblical text in its various forms The bible can be said to be reliable if it can be reasonably claimed that is contents as preserved through centuries are what the original writers spoke and said The consensus of biblical scholarship is that readers do indeed have reason to accept current translations of the bible as close approximations to what the biblical authors said and wrote ïÆ'   because the bible is based upon centuries of study of the actual manuscripts of the biblical books, collected and preserved in libraries museums and other repositories around the world The Hebrew text: Hebrew bible (old testament) is available on two complete leather codicesïÆ'   ancient manuscripts in book form dating to the early 10th and early 11th CE. Leningrad codexïÆ'   exact same copy of the OT is available to scholars in printed form Alepo codexïÆ'   makes up a good portion of the OT but some of it has not survived. Codices are what make up the OT dead sea scrolls was a milestone in biblical studies and research Cave 1 findingsïÆ'   provided evidence of the care that harnessed the meaning and texts of the bible ( meaning wasn’t lost) However dead sea scrolls also proved that there were variationsïÆ'   manuscripts found in the dead sea area differs considerably from the medieval biblical codices. Scholars through the centuries have noted the difference between medieval Hebrew text of the Hebrew bible and the text that lies behind the Greek translation made in Egypt by the 2nd century. Other dead sea copies have a text that differs from both the medieval Hebrew and the LXX texts, a phenomenon that has led: 1. some scholars to propose that there exists a fixed text of the Hebrew scriptures in Egypt from which the LXX stems , another fixe text developed in Babylonia from which the medieval Hebrew tradition comes and a third text not so fixed developed in Israel/Palestine 2. other scholars think of a single fixed text of the Hebrew scriptures, completed no later than the 2nd cent. BCE with the text traditions of Egypt Babylonia and Israel/Palestine preserving variations from that single text The Jewish bible consisted of three distinct parts: 1. the law or teaching (Torah) 2. the prophets 3. the writings Masoretes: scholars who continued to work on standardizing the spelling, vocalization, and the arrangement of the text for public reading By 800CE the Hebrew text was fully vocalized (what it is today) Translation of the Hebrew text: Started as early as the 5th century BCE By the 3rd century BCE the largest Jewish community in Egypt found the need to have the Torah translated into Greek which had become the dominant language in the entire eastern Mediterranean world The importance of the greek translation for the early Christian community is unmistakable pauls letters quote from the greek translation and in general the NT shows that the greek OT was more readily at hand for its writers than was the Hebrew bible The Greek new testament: The NT books were written in Hellenistic greek, a development from the classical Greek of earlier times. Most of the lit. was written down during the 1st century although only fragments of NT books are available from as early as the 2nd cent CE manuscripts of the entire NT, which also contain the OT and the apocrypha, date to the middle 4th cent CE and soon thereafter In some churches these apocryphal writings are highly valued treated almost as scripture in the life and piety of the community The Apocrypha: Biblical texts not considered genuine/ not part of the accepted canon of scripture The texts of some of the apocryphal books is as well preserved as the text of the OT and NT Their popularity declined due to the standardization of Hebrew scripture Modern and Contemporary Translations of the Bible: The authorized or kings James version of the bible published in 1611 came to be the