Questions Essay Example | Topics and Well Written Essays - 250 words - 38

Questions - Essay Example When sales increase and the fixed expenses remain constant, a high OL will result to very high profits since variable expenses, for instance the cost of goods sold, will increase continuously in relation to increasing sales and the company will not incur additional costs to produce the added sales. 2. Let’s say you are developing a business plan, but decide that your OL is too high. What could you do (operationally) to lower that ratio? What common technique is available to you to solve this dilemma? Increasing variable costs and decreasing fixed costs. This is because fixed costs do not change with production/sales while variables costs are very flexible and can be controlled. Ways of converting fixed costs to variable costs include: hiring temporary workers instead of permanent workers, paying hourly wages instead of monthly salaries, increasing bonuses related to profits/sales instead of basic salary, using free technology, leasing buildings and other capital assets instead of buying them and hiring outside companies to do essential work. Reilly, Chris. Break-Even Analysis- Making it Work for Your Franchise. International Franchise Association, July 2009. Web. Feb. 15, 2015.

LEGAL ASPECT OF CONSENT IN NURSING Essay Example | Topics and Well Written Essays - 1000 words

LEGAL ASPECT OF CONSENT IN NURSING - Essay Example In case that explicit consent is not available, implied consent or authorisation by primary care givers can be utilised. Legal stipulations require that nurses need to acquire consent before any major medical procedures are carried out. Legally, a person should be in senses, of the legal age of consent and able to form decisions if they are to provide consent. However, it may not be possible for the patient to make decisions if they are not of the legal age of consent, are out of senses or are affected enough not to make sane decision. In such cases, the next of kin are responsible for providing explicit consent for medical procedures. In any of these scenarios, it is the nurse’s responsibility to ensure total confidentiality as a part of essential ethical practice. Confidential information available to nurses may be used against the subject individual who was gained consent from. A breach of confidentiality may occur if the nurse provides information on the patient wi llingly or unwillingly to any unconcerned party without the patient’s consent. Nursing entails a number of different ethical and moral responsibilities much like other professions. One of the key ethical responsibilities of nurses is to ensure that consent is obtained prior to performing any routines on a patient as described by Gallagher and Hodge (2012, p38). Carvalho et al. (2011, p12) detail that it is the responsibility of nurses involved to ensure that all stakeholders including the patient and his care givers are on board in terms of consent to avoid problematic situations later. In addition to the conventional roles of nurses as carers of patients, the roles of nurses and their ethical responsibilities have been on the increase. Parahoo (2006, p469) outlines how consent is also involved in nursing research, where it is essential to obtain the patient’s or their care giver’s consent after being properly informed on how the obtained information will be ut ilised. The Royal College of Nursing (2011, p5) mandates that it must also be taken to note that the ethical dimensions of informed consent in nursing have given way in certain areas to legal principles and codes. Healthcare has required extensive ethical involvement since various procedures are risky, invasive as well as needless at times. Informed consent has been an increasing part of the healthcare sector given the need to protect the interests of the patients. The initial development as ethical guidelines has given way over time to legal practices. This has ensured that patients get to choose what kind of treatment they want to undertake for any medical condition. However, informed consent is not without its complications. Bosek and Savage (2006) relate instances where the patient is unable to express himself or herself such as in the state of a coma or in an emergency where the patient is unconscious. In such cases, legal guidelines and practices exist to ensure that the patie nt’s rights are not encroached upon in the name of necessary and indispensable action. Dimond (2009, p140) provides that this ensures that patients who are unable to speak for themselves still have their rights looked after in the realm of healthcare. Essentially informed consent and its legal and professional aspects tend to protect the interests and rights of both the nurse and the patient alike. The patient is provided with rights to choose treatment and following the applicable laws allows the nurses to avoid professional as well as legal ramifications. It is the primary responsibility of the nurse under the law to ensure that the patient is fully informed before any medical procedures begin. Wood and Wainright (2007, p35) explain that the nurse is under

Ethical and Legal Issues in Nursing

Ethical and Legal Issues in Nursing INTRODUCTION Ethical and Legal Issues in Nursing are applicable for any nurse, from beginner to expert. They are often considered as the vital part of nursing. This assignment will discover ethical and legal implication of the nurse who disguises the information of the lethal ill patient at the request of his family. The family does not want the nurse to notify the patient about the lethal nature of his disease. The family also desires that the nurse should not tell the patient about the medications prescribed to him. Johnstone (2011, p 21) says that nursing professional is very uncertain. The nurse is always in dilemma whether she should cooperate with the family or not. Now the questions that arises here is that if the nurse does not disclose the truth to the patient then what would be the legal implications. Moreover, the nurse is uncertain whether she would go after the wishes of the family or not. In the following discussion, I will look at the ethical principles and legal implications of hiding information from the patient and administering morphine without his information or approval. PALLIATIVE CARE According to WHO, palliative care is defined as an approach that helps in improving the quality of life of the patients and their families facing the problem associated with life-threatening disease. Patients need a palliative care to support their long and slow treatment procedure Tang, (2006, p. 360). It is focused on providing comfort and relief from the pain and the other distressing symptoms of a serious illness. It integrates the psychological and spiritual aspects of patient care. It offers a support system that helps patients to be lively as much as possible until death. It also provides a firm support to the family to cope up with the patient illness and also includes bereavement support for the family. Palliative care uses a team approach to handle the needs of the patients and their families. It is a team based effort of care giving and it is also responsible for initiating the concept of dedicated palliative care development team. The team includes doctor, nurse, massage therapists, nutritionists and pharmacists. A number of medical professionals from different fields of medical sciences are constantly working on developing and designing new measures to provide the best palliative care to the patients who are suffering from serious illness. All the principles of the palliative care must be applied from the time of diagnosis. Palliative care is often associated with terminal diseases like Cancer and AIDS but now the concept has been changed. There are various palliative regimes which are applicable for other diseases, such as cardiac or renal disease, so as to help the patient to cope with the suffering (Johnson et al. 2011). Sometimes, a term ‘Long term care’ is used to describe the palliative care. ETHICAL PRINCIPLES (Hodkinson 2008) state that â€Å"The therapeutic nature of this nurse–patient relationship is a central concept in nursing. The most important issues related to this bond are disclosure of truth, kindness and communication.† The patients who are suffering from terminal illness generally prefer to hear the truth but they wish it to listen to it in a receptive way (Maria, Ann Anna 2011). Autonomy The main principle of autonomy is that the patient should have adequate information about his condition so as to make a significant choice of treatment (Moulton King 2010). The nurse should properly converse with the patient and make sure that the patient is well aware of all available treatment options (Johnstone 2011). (Collis 2006) suggested that before disclosing the information to family members it is must to seek the patient’s consent. It expresses the respect for their autonomy. The nurse should consider patient’s autonomy before administering morphine. (Starzomski 2009) noted, â€Å"Patients and families from diverse communities have different beliefs about autonomy and may not envision disclosure of information in the same way as their health care providers. In these cases this is an area that needs to be carefully explored with patients to ensure their wishes are respected and they are included in the information process in the way that they wish to be.† In this scenario nurse should communicate with the family members in order to convince and find out their preferred way to disclose the diagnosis and prognosis of disease. Beneficence- The principal of beneficence as a ‘do good’ describes applications of interventions that are carried out by nurse and physician for the benefit of patient .It also include the protection of right of health service consumer (Staunton Chiarella 2008). Health professional should treat the person ‘autonomously’ and prevent him/her from harm and care provider should also aware of legal implication of action taken(Ulysse, Balicas Yiquing 2011). Telling truth is not harmful for patient it will cause the peaceful death(OSullivan 2009). The health professional should motivate the family introducing them the benefit of therapeutic discloser and harmful effects of concealing information e.g. administer medication without consent. Justice -Justice described as treat everyone ‘equally and fairly’. It is a primary phenomena in resolving ethical dilemmas .It required to be supplemented by providing good care to health service user (Botes 2000).In order to apply justice health professionals provide care evenly to all the patients in hospital not patient and family. Non – maleficience This principle is based on the phenomena of ‘does no harm’ for example in health care when privacy hard to maintain for research or study purpose then health professional ensure that they do not disclose the patient’s personal details .This principal helps in prevent the occurrence and possibilities of harm. Nurse should access the risk of interventions that she /he is doing.(Ford Reutter 1990) .It also refrain the nurse from the intentional commission of a wrongful act.(Carlson et al. 2010) In many communities for instance Muslim and Indian cultures diseases are perceived as a family matter. Decision making is also â€Å"family centered† so withholding truth is not rare practice. Therefore beneficence and non-malfeasance play vital role in their moral values as compare to patient right to consent in western countries (Pentheny et al ,2011). It is also encouraged that in case of a dilemma a professional should seek help from their regulatory body or councils which can guide them towards a legally and ethically rightful path Hui, (2010, p.76). LEGAL AND ETHICAL IMPLICATIONS Ethics and legal implications are very closely related with each other. Ethics deal with the standards of conduct and ethical judgement whereas legal issues deal with nursing practise which includes licensing, nurse practice acts and standards of care (Chaloner 2007). According to Criminal Code (Palliative Care) Amendment Bill 2003, â€Å"Section 282A does not address consent. The administration of medical treatment including palliative care is already governed by a legal regime. If a person has capacity to decide their medical care the patient will consent to their medical treatment. Unauthorised administration of medical treatment would be assault†. AMA Queensland emphasize that health professionals should respect the ‘autonomy’ terminally ill patients in order to refusal and acceptance of their medical treatments. Ethical and legal implications in palliative care are very significant because it is an end stage treatment where majority of patient are moving towards an impending death. It is a legal right of every Australian citizen to have complete and correct information about their medical situation. Because of this entitlement professionals delivering palliative care and family members of the patient involves in legal and ethical dilemma. Where they are not sure which course of action would be appropriate in both ethical as well as legal manner. Due to these legal issues and emotional disturbances families of the patient and patient itself undergo a lot of stress and psychological trauma. It is also agreed by many experts of palliative care that increased stress would also impact the ability of the patient to cope with the trauma Oonagh (2009, p.123). In this case study patient is facing an impending death from cancer and terminal diagnosis of cancer which will brings her life to the end. This result in deteriorating in her physical health and she may ask question about her situation and prognosis of the disease. With an adult patient it is relatively important to understand the concept of death and disease and they can take a realistic approach towards it by spending their remaining time in a productive manner saying good bye to dear ones and taking care of all formalities before meeting a demises. (ACMA 2011). It is very complicated to reveal the information opposite to relative’s desires (Cavanna et al ,2009) In this scenario, the wishes of the family to hide information from the patient is not unusual.Ethically it looks wrong for a health care practitioner to lie to the patients regarding her medical situation and not inform her about her forthcoming death. There might be things which she wants to do before dying if she would have been informed. There is also legal implication with the fact that a patient is being treated without her consent and it is also violation of the law which gives a patient right to refusal for treatment on her body. For example many patients want to sign DNR (Do Not Resuscitate) forms to ensure that no attempts should be made to revive them if they are close to death. In this case study patient is being denied of this right as well Hanson (2002). If by family here it is implied that her legal guardian wishes to keep this information hidden from the patient, then according to Giacalone (2007, p.368) the nurse is not legally bound to honour their desires to do so would run counter to the law etc. Prima Facie it is a clear case of violation of constitutional rights of a patient if nursing professional does not inform the patient about her medical condition and learn her desire and judgment in designing and developing her future treatment and palliative care plan. According to Australian constitutional law the patient have the first right on information regarding his medical condition and it is on his discretion that with whom this information should be shared. If a patient expressively states that he doesn’t wish to share his medical information with his family then it is legal obligation of hospital and medical professional to maintain the wish of the patient. Law handbook Victoria recognizes another law governing certain aspect of hospital care and ethical issue. This law is known as doctor patient confidentiality law this state that medical practitioner doctor, nurse or a paramedical personnel cannot divulge information about his patient to a non related person or a person without patient’s medical attorney until and unless directed by the court of law. . This regulation ensures that dignity and privacy of the patient is maintained and there is no legal or ethical negligence from the doctor in the entire transaction Vickers, (2004, p.232). SOLUTIONS AND BEING ETHICALLY RIGHT In the past years, the physicians were very reluctant to tell the truth to their patients regarding their existing health conditions. On the other hand, in these times the patients do want their physicians to tell them the truth about the diagnosis and the medical therapies. According a survey conducted almost three decades ago, it has been cleared that 97% of the physicians felt that it is correct to tell the truth to the patients regarding all the relevant aspects of their illness which includes the nature of the illness and its expected outcomes. Sometimes it is seen that there is psychological impact on the patient’s mindset and it’s really hard for them to cope with such a stressful situation (Kendall 2006). In such a situation, palliative care specialists can be proved quite helpful as they can provide resources to help the patient and his family deal with emotions that come with a serious illness. They may provide counseling, organize family meeting or make refer rals to mental health professionals if needed (Bush Bruni 2008). However, if the conditions are presented in an undignified manner then it is possible that it may create a negative picture of the situation in the patient’s mind and in that case it is obvious that the sufferings and stress of the patient would increase instead of decreasing and the patient may lose the hope to live (Li et al. 2008). Tuckett suggests that it is necessary to understand the mental state of the patient before passing on the entire information to him. The final decision is made by the doctor and his medical team regarding the disclosure of the truth to the patient after analyzing all his mental status (2012). Even the court of law has approved this argument that if the doctor and his medical team prove with an evidence that the information would have a devastating effect on the patient then they have a full power to hide the information from the patient or they reveal the truth to the patient when they believe it is appropriate time to tell Seymour (2004, p. 165). On the other hand, it may be possible that the patient does not want to listen to the information regarding his health but in such a situation it is the duty of the physician to provide the basic information to the patient (council 2004). IMPACT ON NURSING PRACTICE When the medical practitioners communicate with the patients, being honest is a fundamental way to develop trust and respect for the patient. Patients show a great deal of trust in their physician and they may feel deceived if they discover that there is lack of honesty by the physician. But, sometimes a situation arises when the physician thinks that disclosure would create a harmful effect on the patient and it may be validated to hold back the truthful information in that case. (Robinson January-February) explains that sometimes holding back the truthful information from patient may lead to feeling of regret in the health care providers. It can also be one of the main reasons of moral distress on them. (Goethals, Gastmans de Casterlà © 2010) state that many a times the moral distress may lead to less involvement of nurse in his work. It can also cause some kinds of health problems which may eventually leads to resignation from job. Ulysses et al (2011) asserts that in health pra ctise the therapeutic nondisclosure may lead to frustration which in turn affects the practitioner’s responsibility towards his patient and his family. CONCLUSION Many types of complex situations are often faced by several nurses throughout their professional life. Some professionals consider such types of suffering more badly than death. It is totally unfair to withhold the truth from the patient about his existing health conditions, especially when the patient is capable enough to give the consent about various medications and procedures. According to the constitution of Australia, it is not at all acceptable to claim the life of a person for any medical reason and direct any medications without his consent. This case study has proved very beneficial in developing a very in depth understanding of the various medical laws and legal problems which are faced by the health professionals. It should be the duty of every medical professional that in any situation he should not break any of the legal obligations. It also provides detailed information about the various significant steps that should be taken to handle these types of ethical dilemmas.

Inclusion: Beyond Special Needs Essay -- Educational Issues

Inclusion in education is an approach to educating students with special educational needs; under this model students with special needs spend most or all of their time with non-disabled students. Evidence from the last decade reveals that segregation of special needs students, as opposed to spending time with non-disabled students, is actually damaging to them both academically and socially. Segregating students placed in the special education category is a trend that has been vastly common in public schools, but in the last few years inclusion in general education settings is becoming a more credible option. Placing students in an inclusive classroom is effective in positively adjusting not only their academic performance, but also social and developmental skills needed throughout life. Despite concerns of successfulness and outlook, the inclusion of special needs students in general education classrooms within the public school arena proves to be beneficial for all aspects of edu cation. In contrast to the beneficial validities of inclusive education, there are also particular disputed concerns that are occasionally brought to light and require attention in inclusive classrooms. â€Å"Despite a move toward inclusion being the most significant trend across†¦countries†¦the academic consequences of educating students with special needs in inclusive rather than separate settings remain contested† (Canadian Council on Learning 2). One of the leading worries being noticed because of this growing trend is generally how attention will be divided in the classrooms among all types of learners. â€Å"The growing demand for inclusive practices within mainstream schools has resulted in classroom teachers having to take direct responsibility for the ... ....† British Journal of Special Education 33.2 (2006): 76-81. Academic Search Premier. Web. 27 Feb. 2012 Roffman, Leslie, Todd Wanerman, and Cassandra Britton. Including One, Including All: A Guide to Relationship-Based Early Childhood Inclusion. St. Paul: Redleaf Press, 2011. 8. Print. Roffman, Leslie, Todd Wanerman, and Cassandra Britton. Including One, Including All: A Guide to Relationship-Based Early Childhood Inclusion. St. Paul: Redleaf Press, 2011. 9. Print. Schulz-Hamsa, Irene. Inclusion and Technology: A Marriage of Convenience for Educational Leaders. 1998. ERIC. Web. 27 Feb. 2012. Yuen, Mantak, Westwood, and Wong. â€Å"Meeting the Needs of Students with Specific Learning Difficulties in the Mainstream Education System: Data From Primary School Teachers in Hong Kong.† International Journal of Special Education 20.1 (2005): 67-68 ERIC. Web. 27 Feb. 2012.

Critical period in language development Essay

The concept of a critical period is well in nature. In human beings there seems to be a critical for the first language acquisition. Research shows that any human who is not exposed to any language before puberty, becomes completely unable to the syntax of their first language later in life. From my personal experience I have learnt that any individual who learns their first language at infancy and later (at puberty) gets to move from their motherland to foreign land where no one speaks their language, no matter how long these individuals stay from home they can never forget their mother tongue. Accent may change but they will always remember their first language Here is another practical example to prove that there is a critical period in language development. I happen to be living in Africa; my bosses are Italians (man and wife) they have had to learn English and Kiswahili for easy communication with the locals. They have a five year old baby. When the baby is with her parents they always speak in their first language; when she is left behind with the nanny she is spoken to in Kiswahili all the time. The nanny knows no other language apart from her mother tongue and Kiswahili. This baby has been looked after by this same nanny since she was born. At the age of three a teacher from America was employed to teach this girl. She knew no other language but English. Now look at this closely; the baby is now very fluent in two languages; her first one Italian and her second one; Kiswahili. She is so fluent that she corrects her parents on it! She seems to be doing just fine in English for the last two years she has been taught. Interestingly her teach who is very interested in learning Kiswahili asks her enough times to translate to her in English what has been said in Kiswahili by colleagues. I would say that all depends with the stage at which the language was introduced to an individual. The stage in life. †¢ Kiswahili is a language for the East African state and some of the West African.

Fighting for Our Rights

I have been witness to many movements and many campaigns that involve rights of those concerned. Human rights, animal rights, women’s rights, child rights, minority rights, prisoner’s rights, right to freedom, right to education, right to potable water, right to fight, right to eat, right to sleep, rights of the aged, rights of the marginalised, rights of refugees and war victims, rights of these and rights of those, rights of the left and rights of the right, etc,etc. The list is endless. It is not my intention to mock those who are suffering and those whose rights have beendeprived but I at times wonderwhy the activists and concerned souls who are serving the deprived don’t want to delve into their own duties and the duties & responsibilities of those whoserights they seem to support, uphold and protect. For after all, rights and duties are the two sides of the same coin, just as remembering and forgetting are The problem has assumed such epic proportions in the West that parents are even scared to punish their own children for fear of invoking the wrath of the child rights activists who seem to forget that in the long run a certain amount of discipline is good forthe children whose rights they appear to support and vouch for. I therefore presume they have never heard of the saying â€Å"spare the rod and spoil the child†. The lack of discipline, respect and values may all be attributed to this forgetfulness of duties. I am completely in favour of animal rights and protecting the natural environment of animals but let me tell you about a champion of the environment and animal rights whom I had the misfortune of meeting during my sojourn in Chennai. The person in question is an illustrious personality with undisputable credentials but if you were ever to walk into the office of the aforementioned you will find that the way the staff there are treated is worse than the way animal haters would treat an animal. This person has completely forgotten that it is not only ourduty to protect animals but it isalso our duty not to treat humans like animals. Not only do we have to take care of theenvironment at large but we should also realize that we should provide an ideal environment for our subordinates to work, grow and flourish. I’m not talking merely of the physical environment but also of the environment wherein the individual employee is treated humanely so that he or she realizes that it is their duty to work harder and serve better. I am also a firm believer in the right of children to good and quality education but I do believe that it is also the duty of these children who are provided this quality educationto treat their teachers, parents and the general publicwith respect and love. I believe in the rights of the aged but I cannot simply acceptor forgive those aged who during their better and younger days failed to fulfill their duties as a parent and therefore do not obtain the love or respect of their children who then disown them and abandon them to their ownends. I believe in the rights of war victims and refugees but I alsobelieve that it is the duty of such victims and refugees to ensure that they respect their aggressors and also respect the laws of the host country that provided refuge rather than turning into a fifth column within the host country. I believe in the right of all to uninterrupted supply of potable water but I also believe that it is the duty of allto ensure that they do not pollute the water source and damage the water table. I believe in the rights of minorities but I also believe that it is the duty of the said minorities to treat their majority brethren with love and respect. I believe in my right to believe in a lot of things but also believe that it is my duty to fulfill a lot of responsibilities. Therefore my dear friends may I beseech each and everyone of you who may chance upon this post to obtain and enjoy your rights with a senseof duty and responsibility for as I mentioned earlier rights and duties are two sides of the same coin. If only each one of us were to enjoy our rights with a sense of responsibility and duty, the world would certainly be a better place to live in.