Positive and Negetive Aspects of Emergency Care and Emergency Rooms essays

Positive and Negetive Aspects of Emergency Care and Emergency Rooms essays Many problems face the emergency room staff in their efforts to care for a variety of patients with a variety of needs and injuries. One of the negative aspects faced in the emergency room is the very real possibility of misdiagnosis because of the frenzied environment and the element of time are two of the reasons emergency room patients may be misdiagnosed. One researcher notes, "For example, an emergency room physician is sometimes forced to make a decision on the basis of inadequate patient information. Instant information about the patient's medical history, allergies, and medications would decrease the incidence of these forced errors" (Bogner 149). In addition, often the emergency room staff work long shifts, and during particularly busy shifts they may become overly tired and more prone to make mistakes in diagnosis and treatment. One emergency room failed to detect a punctured intestine in an elderly woman, and she collapsed two days later with peritonitis. Another failed to x-ray a young mountain biking accident victim, and two days later, he collapsed with a broken neck (Bogner 57, 151). These are examples of misdiagnosis and treatments that could have been prevented, and this is one negative aspect of busy emergency rooms, they may simply miss some symptoms, or misdiagnose some patients because of time constraints or shoddy information. Another negative aspect of emergency care is the overcrowding of many emergency rooms, and the long wait patients may have to endure, which can actually add to their medical woes. In fact, in 2001, only 3 percent of national emergency rooms said they never experienced overcrowding, and the problem is expected to get worse for a number of reasons ("Overcrowding," 2001). First, there is a nationwide shortage of nurses, and this translates into personnel shortages in all areas of the hospital, including the emergency room. ...

All About Exterior Paint Problems and How to Fix Them

All About Exterior Paint Problems and How to Fix Them What are the safest ways to remove paint? Does exterior paint need to be taken off down to the bare wood? Do heat guns really work? These are questions homeowners around the world face. You are not alone. Fortunately, the paint problems of one persons home are the same faced by other homeowners. Believe it or not, the  U.S. Department of the Interior has come to the rescue. It wasnt until 1966 that the U.S. became serious  about preserving its historic heritage. Congress passed the National Historic Preservation Act and charged the  National Park Service (NPS)  with supporting historic preservation programs and activities. Their handy series of preservation briefs are geared toward historic buildings, but the information is great professional advice that anyone can use. Exterior Paint Problems on Historic Woodwork,  Preservation Brief 10, was written by Kay D. Weeks and David W. Look, AIA for the Technical Preservation Services. Although written back in 1982 for historic preservationists, these recommendations are good starting points for homeowners to come to terms with what needs to be done. Here is a summary of the historic preservation guidance and expertise for painting exterior wood siding - with links to more information from the original brief. Selecting the Safest Method to Remove Paint Removing paint involves work - that is, the manual labor of abrasion. How much time and effort are put into paint removal (or paint preparation) is a judgment call and may be the most difficult decision you make. Basically, you can remove paint from your homes exterior siding by three methods: 1. Abrasive: Rubbing, scraping, sanding, and generally using friction. Use a putty knife and/or a paint scraper to dislodge anything loose. Then use sandpaper (orbital or belt sanders are okay) to smooth each area. Do not use rotary drill attachments (rotary sanders and rotary wire strippers), do not water blast or pressure wash, and do not sandblast. These abrasive methods may be too harsh to the siding itself. Pressure washing above 600 psi may force moisture into places where it should not go. A gentle garden hose for cleaning up is okay. 2. Thermal and Abrasive: Heating paint to a melting point and then scraping it from the surface.  For thick layers of built-up paint, use an electric heat plate, an electric heat gun, or a hot air gun that heats from 500 °F to 800 °F. The blow torch is not recommended. 3. Chemical and Abrasive: Using a chemical reaction to soften the paint to make it easier to scrape away. For many reasons, use chemicals only as a supplement to other methods of paint removal. They are too dangerous for you and the environment. Two classes of chemicals are solvent-based strippers and caustic strippers. A third category is biochemical, which may be marketed as bio- or eco- but its the chemical part that makes it work. Paint Removal Precautions Any house built before 1978 may have lead-based paint. Do you really want to remove it? Also, dont substitute speed for safety. Only use the recommended methods listed above. Keep yourself safe and your house in one piece. Paint Surface Conditions and Recommended Treatments Ask yourself why you want to paint your house. If there is no paint failure, adding another layer of paint may actually be harmful. When paint builds up to a thickness of approximately 1/16 (approximately 16 to 30 layers), say the authors of Preservation Brief 10, one or more extra coats of paint may be enough to trigger cracking and peeling in limited or even widespread areas of the buildings surface. Repainting buildings for cosmetic reasons are not always good reasoning. Sometimes you dont need to remove old paint at all, especially for these conditions: Dirt and Grime: Sometimes road dirt and salt can make siding look worse than it is. Clean it with l/2 cup of household detergent in a gallon of water with a medium soft bristle brush and then a gentle hosing.Mildew: Clean with a medium soft brush using one cup non-ammoniated detergent, one-quart household bleach, and one gallon of water. Try to open the area to the sun to avoid further mildew.Paint chalking is that white film on the surface of old paint that is breaking down. Clean the area with a medium soft brush using l/2 cup household detergent to one gallon of water.Stained paint occurs most often from metal or wood becoming moist and coloring the painted surface. Determine the cause of the stain, but its usually unnecessary to remove the paint. Limited paint removal can be considered for these conditions: Paint Crazing: Crazing is fine, jagged interconnected breaks in the top layer of paint. It happens when a house has many layers of paint that become hard and brittle, not allowing expansion and contraction with the wood. Sand off a layer and repaint.Paint Blistering: To distinguish between solvent blistering and blistering caused by moisture, a blister should be cut open.Wrinkled Paint: This happens when the paint has been put on incorrectly. The authors call this an error in application. In a historic building, leave a small out-of-the-way patch untouched for archival purposes. A record of all of the paint layers through the history of the house is useful for future historians. Unfortunately, some conditions require complete removal of exterior paint: Paint Peeling: Before painting, remove sources of moisture inside and outside, as described by the authors: Excess interior moisture should be removed from the building through installation of exhaust fans and vents. Exterior moisture should be eliminated by correcting the following conditions prior to repainting: faulty flashing; leaking gutters; defective roof shingles; cracks and holes in siding and trim; deteriorated caulking in joints and seams; and shrubbery growing too close to painted wood.Cracking and Alligatoring: These symptoms are advanced stages of crazing. General Paint Type Recommendations Paint type is not the same aa s paint color. The type of paint to choose depends on the conditions, and most old (historic) homes will have oil-based paint somewhere in the mix. Remembering that this article was written in 1982, these authors seem to like oil-based paints. They say, The reason for recommending oil rather than latex paints is that a coat of latex paint applied directly over old oil paint is more apt to fail. Justification for Paint Removal A major purpose for exterior paint is to keep the moisture out of your home. Often you dont need to remove paint down to the bare wood. To do so usually requires harsh methods that may damage the wood. Also, the layers of paint on a house are like the rings of a tree trunk - they provide a history that future owners may want to analyze in a laboratory during an architectural investigation. Painting a house every 5 to 8 years protects exterior wood siding from moisture penetration - and can add some zing to your homes curb appeal. Regular maintenance of a house will include mere cleaning, scraping, and hand sanding. Where there is a paint failure, determine and fix the cause before you even begin a painting project. Treating paint problems often means a total painting of the structure may be unnecessary. However, if you determine that you need to paint your house, keep two things in mind before you repaint: (1) only remove the top layer of paint down to the next sound layer; and (2) use the gentlest means possible. The authors summarize their findings by repeating their cautious approach to painting and paint removal. The bottom line is this: There is no completely safe and effective method of removing old paint from exterior woodwork. Learn More PDF Secretary of the Interiors Standards for the Treatment of Historic Properties With Guidelines for Preserving, Rehabilitating, Restoring, Reconstructing Historic Buildings by Kay Weeks and Anne E. Grimmer, 1995, revised 2017 by Anne E. GrimmerNotes: Headings are linked to the complete section of Preservation Brief 10 on the NPS website. Quotations are from that online version. The order of sections on this page may differ from the official version. A 12-page, black and white PDF version of Preservation Brief 10 is also available.

Motivating Factors for Strategic Planning Essay Example | Topics and Well Written Essays - 500 words

Motivating Factors for Strategic Planning - Essay Example Management needs to take the staff members into confidence regarding how the strategic planning process would benefit them individually and collectively. Three key motivating drivers for organizations to engage in the strategic planning process are obtainment of competitive advantage, preparing for the future, and The first motivator to engage in the strategic planning process for an organization is to gain competitive advantage over its contemporaries in the market. Many entrepreneurs with money establish businesses but they do not know what it takes to expand and sustain the business. â€Å"If a business has little idea where it is headed, it will wander aimlessly with priorities changing constantly and employees confused about the purpose of their jobs† (Online Business Advisor, 2006). Strategic planning process allows an organization to focus its manufacturing, marketing, and research efforts in such a way that the end product or service caters for the interest of exactly the population that needs it. The second motivating factor for organizations to engage in the strategic planning process is to prepare for the future. The golden principle that organizations follow is, â€Å"If you don’t know where you’re going, you’ll probably end up someplace else† (Waechter, 2012). The strategic planning process help the organizations achieve this by delineating the steps that lead an organization to its desired future. An additional benefit it provides is that it helps the organizational personnel to optimize on their potential and enhance their productivity since they know what roadmap they have to follow. In short, the strategic planning process helps the management make informed decisions to have long-term benefits for the organization and all people associated with it. Another very important motivating factor for organizations to engage in the strategic planning process is to prepare for change. In the present age, when technology advances

Watersheds Research Paper Example | Topics and Well Written Essays - 2000 words

Watersheds - Research Paper Example Mississippi river has watershed called Mississippi watershed which flows in the United States of America. The river emerges from the western part of Minnesota and flows southwards at 4,070 km/hr towards the delta of the Mississippi river. It has a number of tributaries that drains to approximately 31 states within the United States of America between the Appalachian Mountains and the rocky extending to the southern Canada region .The River Mississippi-according to the order of rivers-is positioned as the fourth longest and tenth largest river in the world (Carluer and De Marsily 87). Watersheds have since played a key role (Naiman 78) in various scientific studies on the impacts of anthropogenic and natural phenomenon on the quantity and quality of water. The effects of silviculture and agriculture have always been outlined basing on watersheds. Data to evaluate the effectiveness of various ecological regions on the basis of Watersheds have been used by researches in places such as C oweta .A number of people mind less to the safety and source of their drinking water implying little concern is put on domestic water channeled to their homes on the basis of treatment. In addition, prior awareness should be availed to people on treatment process the water they consume undergoes. Since water is life, clean water is paramount to every individual and issues concerning the degree to which water meant for consumption is cleaned should never be looked at with little respect. This view serves to limit the extent to which non-clean or un-treated water affects the livelihood/health of the parties concerned though many people have taken cleanliness of water/non-cleanliness of water at the expense of their health concerns for granted. This essay in particular will give an analysis of Mississippi watershed within Mississippi River with a goal of enlightening the society on the scientific process of water treatment and water resource forms within their reach. Carluer and De Mar sily (95) refer to a watershed as that specific area of land that drains into river, stream, lake or other types of water bodies. Watersheds can either be large or small. For instance a small stream located in neighborhood may consist of a watershed. The Mississippi watershed of the Mississippi river covers approximately 31 states which represent about two thirds of the North America (Naiman 78). Figure 1: Mississippi watershed in Mississippi river (Schertzer, 124) In this case take an example of a small stream located at the top of the mountains. The watershed of this specified stream will be constituted by few underground springs and precipitation runoffs resulting from the lands that are up above the stream. As a result the stream continually flows down the hill and drains far and wide to bigger water bodies which include larger rivers, lakes and streams before finally discharging into the oceans and seas which significantly posses watersheds that are larger. It is important Howe ver, to point out that all watersheds be it large or small have complex processes arising from the presence of chemical compounds that in a way or the other may impact on the quality of water being drawn and used by the human fraternity for various reasons and usages. Sivapalan (2266) argues that the human population does not only use water for their domestic needs i.e. cleaning, cooking and drinking but also for cleaning and draining their waste systems. To attain proper sanctity of water and good levels of hygiene, treatment plants, dams and pipes have to be put in place to safeguard the water before and after it is directed to the homes of people in the society and also to factor

Magnet Hospital Characteristics Research Proposal

Magnet Hospital Characteristics - Research Proposal Example This study will seek to explore the various ways in which magnet characteristics could be appropriated towards the objectives of empowerment, reduction of burnout and enhancing employee satisfaction within the healthcare facilities. Problem Statement The matter of job dissatisfaction and work related stress continues to engage the concern of stakeholders in the nursing profession. Nurses are continually subjected to adverse working conditions that affect their levels of production and dedication to duty (Earie & Denny, 2005). Despite the consistent improvements of other areas of the healthcare sector, there seems to be insufficient focus on the challenges that afflict the nursing fraternity. The general perception is that the healthcare system, as presently constituted, lays obstacles to the empowerment of nurses. The system is structured in such a way that assigns a subservient role to the nurses despite various research findings that emphasize the centrality of nurses to the succes s levels of every health care system. Among the many suggestions on the improvement of the nursing industry is the inclusion of magnet hospital characteristics. This study seeks to explore the possible effect of magnet hospital characteristics in solving the challenges of empowerment, work-related stress and burn-out within the nursing industry. Objectives of the Study The general objective of the study is to explore the impact of utilizing magnet hospital characteristics on fostering nursing empowerment, reducing the levels of burnout and job dissatisfaction. Specific Objectives 1. To determine the relationship between magnet hospital characteristics and power relationships within a healthcare institution with specific focus on the nurses and the... This paper stresses that researchers on nursing have established that fragmented systems often promote negative competition and conflict between the nursing fraternity and the doctors. Systems that exclude nurses from decision-making processes often foster non-cooperation. Naturally, lack of cooperation between nurses and doctors will impact negatively in quality matters. Poor coordination could result in accidents and other elements of professional malpractice in the nursing community. Generally, nurses will tend to operate in ways that do not promote the general good of the hospitals due to the detached interest that follows. The need for harmonization of systems is consistent with the realization that quality service must involve processes of collaboration and delegation of roles. Technology also helps in the decongesting of hospitals thus promoting ample working environment for the nurses. This report makes a conclusion that poor staffing is usually associated with the negative impacts of staff burnout and stress. Generally, the aim of magnet hospital characteristics is the improvement of all the processes, associations and arrangements in the hospital for the benefit of all the stakeholders. Other studies have associated it with the concept of total quality management as understood within the framework of management. Harmonization of the different systems, processes, and individuals within the framework of the core mission of the hospital is the chief objective of magnet hospital characteristics.

The Chief Operations Officer’s Essay Example for Free

The Chief Operations Officer’s Essay The Chief Operations Officer’s role focuses on the execution of day-to-day operations and oversight of all the departments; to include morale, welfare, and employee conduct in the company. In order for the company to successfully prepare for an Initial Public Offering we will need to revise the employee handbook, resolve some specific internal employee matters and implement a whistleblower policy. Employment-at-will refers to common law which holds employees that work for an unspecified time period work at the will of their employers and employment can be dismissed any time (Zachary, 2012, p. 25), for good cause, bad cause or no cause, by either the employer or the employee. Some exceptions of dismissal for employment-at-will include discrimination against race, national origin, color, religion, sex, age, and disability, other exceptions are wrongful discharge in violation of public policy or breach of contract, the promise of â€Å"good faith and fair dealing† in a contract of employment or suggesting contractual requirements based off of the company’s handbook or policy statement (Halbert Ingulli, 2012, p. 50), and tort whether the policy is found in legislation, constitutions, legal hearings, administrative practices, or other sources (Zachary, 2012, p. 25). The tort law offers the employee the chance to convince a jury to award damages (money awards) for â€Å"wrongful discharge† (Halbert Ingulli, 2012, p. 51). Some state and federal statutes may also prohibit the discharge of employees for their participation in jury duty, filing workers compensation claims, involvement in the union, conducting military duty or certain occurrences in whistle-blowing (Zachary, 2012, p. 21). Our company operates off of voluntary employment; therefore, general counsel reviewed the employment-at-will doctrine and exceptions mentioned above and legal termination is an option for all eight employees based off of either personnel misconduct or violation against our company’s rules and regulations cited in the employee handbook. Table 1, titled, â€Å"Employee Conduct and Rational for Termination or Continued Employment†, illustrates the eight personnel actions under investigation and the decision for termination or continued employment. The decisions to terminate or retain the employees stem from a reflective approach that melds traditional theories and modern theories of ethics. Two particular theories that support the decision are the consequences-based approach which provides the greatest good to the majority of the people, in this case, the company as a whole and the Proactive theory decision based off of recommendations or actions are just from the very start (Harcourt, Hannay, Lam, 2013, p. 312). One of the decision rules from the Proactive theory used is the parity rule which ties all similar actions performed in a similar environment receive the same or similar consequence (Harcourt, et al, 2013, p. 313). If the company is to become successful with the launch of the public offering then employees must be accountable for their actions of misconduct or violations against the company employee handbook. In addition to personnel actions mentioned above, I recommend we adopt a whistleblower policy based off the internal allegations against the accounting department for falsified expense reports and before we take the company public. Implementing a whistleblower policy will provide the employees a voice of the company, reduce monitoring expenses, stimulate additional decision-making (Moberly, 2012, p. 11) among employees, supervisors, and senior management, will protect against illegal conduct and provide greater oversight of company resources and assets (Shackelford, 2009, p. 3). Furthermore, the Securities and Exchange Commission and the New York Stock Exchange issued regulations under the Sarbanes-Oxley Act that listed companies must provide their Codes of Ethics to the public (Moberly, 2012, p. 19). Our commitment to the workforce is to implement a whistleblower policy that focuses on the three fundamental items of clear guidelines, policies, and procedures (Gould, 2009, p. 3) for reporting organizational misconduct. Our whistleblower policy and Code of Ethics should be included in the revised employee handbook, posted on the company website and a hardcopy distributed and signed by each employee. The policy guidelines should contain our objective and scope of the policy so we can address what we want to accomplish (Shackelford, 2009, p. 3). Our policies will indicate that all employees, hourly to senior level management salary employees, are required to report organizational misconduct and to assist in any investigation by law enforcement or regulatory agency. Step-by-step reporting procedures will also be included in the policy. Employees will have the right to submit the report directly to their first line supervisor unless that individual is involved in the matter then report the situation to the next supervisor in the chain. If employees feel uncomfortable using their direct reporting chain then they can submit the report through the company action hotline, anonymously or directly to the audit committee. The individual’s confidentiality will remain as confidential as practicable (Shackelford, 2009, p. 3). Our company encourages the employees to report the wrongdoing internally through the use of our open-door policy or through the various avenues aforementioned rather than blowing the whistle externally. Our company will not tolerate retaliation against employees reporting wrongdoing or whistleblowing. In conclusion, as the Chief Operations Officer, I reviewed the employment-at-will doctrine, conducted and resolved eight thorough employee investigations that required my immediate attention, and provided background information that supports my recommendation on implementing a whistleblower policy prior to our public offering.

Frederick Douglass’s Narrative :: Essays Papers

Frederick Douglass’s Narrative In Frederick Douglass’s Narrative, Douglas himself narrates the novel using story telling to bring both the reader into the story, and the theme into focus. Through his narration, Douglass also uses narrative strategies like anecdotes, and plot twists. Even with it being a true story, Douglass brings the readers’ attention to a peak with these techniques making the story interesting and appealing. The most influential technique used by Douglass is story telling. He uses little stories, or stories-within-a-story, to make the reader pay attention. With descriptive tales of the plantations he worked on, the beatings and torture of slaves, and learning to read and write, he not only gets the attention of the readers, but he gets them to understand his point of view. For example at the beginning of the narrative Douglass tells a story of his aunt being beating, â€Å"I have often been awakened at the dawn of day by the most heart-rendering shrieks of an own aunt of mine,† (3). He goes on and gets even more graphic and descriptive, â€Å"The louder she screamed, the harder he whipped; and where the blood ran fastest, there he whipped longest.† (4). Also early in the novel, Douglass writes of the plantation he grew up on, â€Å"There were no beds given the slaves, unless one coarse blanket be considered such,† (6). Soon after being sold to Mr. and Mrs. Au ld, he was taught the alphabet. He uses this experience to show to his audience that he is very literate despite his masters’ wishes, â€Å"If you teach that nigger how to read there would be no keeping him,† (20). So this story shows some more cruelty from his master. Just for reading he would be sold, which shows unfair treatment to the reader. Another similar technique used by Douglass very effectively is anecdotes. He uses anecdotes throughout the story to bring a humorous or interesting little side story into the readers’ minds. One good example of this is when he is talking about slave songs, â€Å"I have often been utterly astonished, since I came to the north, to find persons who could speak of the singing, among slaves, as evidence of their contentment and happiness.† (9). This shows the readers of his concerns by just adding a brief story in to interest the reader.