Nursing Career and its Advantages in doing Higher Education Essay Example for Free

arrest locomote and its Advantages in doing Higher Education EssayAbstract Nursing image is changing totally(prenominal) day from ancient gown and cap to colored scrubs. state choose care for for different reasons. I chose this profession because I like to be a role model for the new controls. after I graduated as a Registered Nurse (RN) in 1999 my first patient said, If an Angel has dropped from heaven that is you nurse. R.Mariam (personal communication, June, 1999). This sentence inspired me a lot and gave hope in my travel. Job satisfaction is an essential part in all profession especially in this field since, we deal with life and death and it aids to raise patients safety, performance, quality of care, patients satisfaction and productivity of the organization. Like in any other field, this field likewise has some frustrations, but facing the problem and coping with frustrations is what helps us to reach the goal.This paper also explains the advantages of doing continuing precept since, nursing profession is widely spreading and changing every day and it needs highly qualified knowledge adequate to(p) and competent employees to serve. Keywords Nursing profession, Career, Job satisfaction, patients safety, quality of care, performance, productivity, frustrations, and continuing education.Nursing Career and its Advantages in doing Higher EducationNursing is an art, science and profession by which we render care for the patients irrespective of all ages, religion, caste or gender who are acutely ill and in critical condition. Nurses around the world make the largest group of health professionals. They are the back bone of the healthcare system. Nurses are not only providing care for the patients, but they are also responsible for the emotional welfare of patients and their families too.Career as a Critical Care NurseWhen I was a kid, I always wanted to pursue a career in nursing or aesculapian field. I have a sister who is a nurse. At the a ge of 19 old age in India, Idecided to go for nursing peak and I graduated as a Registered Nurse in 1999. Nursing profession touched me a lot and it made my career interesting. I started my career as an Operating Room scrub nurse and circulating nurse. It was interesting everyday by not only taking care of the patients, but also managing the operating room activities, ensuring that the equipments are safe and sterilized, equipments are properly audited and consent forms were filled and signed by concerned members of the family. It is very all important(p) to be an operating room nurse, as the entire procedure depends on the efficiency and job knowledge. It is the responsibility of the nurse to be the mediator between the patients, families and the physicians. existence an operating room nurse I did not have much interaction with my patients.Almost all patients in operating room gets general anesthesia. As an OR nurse, I felt I am not interacting with the patients well and I am n ot fulfilling my job as a nurse completely. After few years, I decided to become an Intensive Care Unit (ICU) nurse. Transition from OR to ICU nurse was little hard for me initially, but I enjoy working with the patients and spending enough time with them and their families. At times, I have to be an advocate between the patients, families and doctors because we deal with critically ill patients. tenableness for Motivation to continue in NursingAccording to Locke and Lantham (2002), Personal goals play an important part in direction and maintenance of behaviors which is needed to achieve rewards. People who are confident, believe in their ability to achieve goal and believe that the attainment of goal will lead to successful career are the ones able to complete their task effectively to reach their goals (Lent, Brown, Hackett, 1994).Nursing profession is one of the widely expanding fields that call for passion according to (Raye, L. 2006). It is a good filling for people who find themselves more comfortable and satisfied in helping people who are in need to maintain and achieve normal health. Nursing offers wide variety of opportunities according to each individuals interests such as critical care unit, labor and delivery, pediatrics, geriatrics, telemetry, med-surg, oncology, infectious diseases, pain clinic, outpatient clinic etc. And alsoit offers continuing education and competencies to keep the knowledge and skills up-to-date (Raye, L.2006). It offers flexible working hours such as three twelve hour shifts or four ten hour shifts (Blanche, J.2010). And due(p) to the availability and shortage for nurses it offers incentive and bonuses for extra hours. It is a lifetime career which is flexible and rewarding. If we lose jobs in one position there are separate of available jobs in the market for talented individuals.It is also well-paying job with good benefits such as tuition reimbursement for higher education, medical benefits, life insurance and chur l care. Overall it is flexible. The reason why I have chosen nursing career was, a nurse who inspired me in my life and my interest towards, pity for human beings. The American Association of Colleges of Nursing (1998, 2008) and the National League for Nursing (2007) identified caring as the foundation for nursing. At the age of 15 years old, my dad had a massive heart attack and he was in Intensive care unit. He was intubated, on the ventilator, with so many drips infusing, with monitor dire all the time. My whole family was very upset and hopeless. The nurse who took care of my dad was very dedicated , honest and very knowledgeable , she went above and beyond in helping us in that situation, keeping track of vital signs, maintaining his breathing, keeping him hemodinamically stable, giving back care, mouth care, sponge bath and giving emotional harbour to the family and explaining whats is going on with him.Few days later my dad died in the hospital but the nurse who took care of my dad stayed in my mind. Since wherefore I always wanted to be a nurse who is caring, attentive to the emotional wellbeing of the patients and their families, providing emotional support because family place trust and self-respect in our hands. They want us to keep their loved ones comfortable, pain free and monitored all the time and not left alone. My passion for nursing grew when a patient or family member smiles at me and say Thank you, it enlightens me and lights up my day with more energy and spirit.Frustrations in Nursing ProfessionThe most important thing that frustrates me is the charting. right off most of the hospitals are computerized, but some hospitals still do paper charting and add more and more paper work every day. This means I have to spend more time doing paper charting than taking care of the patients.Sometimes we are short staffed and we have to do not only the registered nurse jobs, but we also have to be a house keeper doing accidental cleaning, secreta ry entering orders, patient care tech, Phlebotomist doing lab draws and also duty doctors with the patients lab and radiology results if we dont see them on rounds. These are the thing which frustrates me, because it reduces the time which we spend for the patient care. Overall, Frustrations are special K and it can happen in any other field but the nature of frustration may differ.Advantages due to addition Education in my Career1. Now most hospitals in New Jersey prefer Bachelors degree in nursing and there is a global shortage for nurses, it gives us job security (Blanche, J.2010). 2. It offers potential high income for well qualified employees. 3. More choice availability to go back to school to continue in higher education for nurse practitioners, nurse anesthetist and nurse educator. 4. It also helps us to interact with the other hospital nurses and health care professionals in classes which help me to improve patient care and make my job more enjoyable. 5. It gives knowledg e and skills in critical thinking in assessment and problem solving in everyday practice. 6. It offers opportunity to be a mentor for the new nurses and to be a resource nurse. 7. By doing Bachelors degree in nursing, I am sure by the end of the course I will be well trained in areas such as effective communication, lead and critical thinking which is very important in todays nursing practice as well as it is necessary for administrative position, question and teaching.ReferencesAmerican Association of Colleges of Nursing. (1998). The essentials of baccalaureate education for professional nursing practice. Washington, DC Author. American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC Author. Blanche, J. (2010). 10 reasons a nursing degree is a good best in education today. Retrieved from http//www.nurses-forum.com/blog/246/10-reasons-a-nursing-degree-is-a-good-bet-in-education-today/ Locke, E. A., Latham, G. P. (2002).

Bukidnon Deer Park and Wildlife Center Reaction Paper Essay Example for Free

Bukidnon Deer Park and Wildlife nubble Reaction Paper EssayOn August 26, 2012 I visited the Bukidnon Deer Park and Wildlife Center located at San Miguel, Maramag, Bukidnon. The purpose of the trip was to look at some fascinating wild zoologys that live from different parts of the world and to learn much about them.The first animals I visited were the mammals. Mammals atomic number 18 part of warm-blooded vertebrate animals that perk up, in the female, milk-secreting organs for feeding the young. The animals available at the park that represents this class were the Long-tailed Macaques (Macaca fascicularis), Palawan brook Cat (Arctictus binturong), Common Palm Civet (Paradoxuros hermaphrodites), Balabac Mouse Deer (Tragulus nigricans), Leopard Cat (Pronailarus bengalensis), Philippine Mouse Deer (Cervus marianus), and lastly the Wild Pig (Sus philippinensis). After we have visited the mammals we then go straight to the Aves. But on the way to the Aves we came along to pass by the Japanese Koi (Cyprinus carpio). These are carps with red-gold or white coloring, unploughed as an aquarium or ornamental pond fish, native in Japan. They were so fun to watch.Finally we arrive where the Aves are caged. Aves are two-legged, warm-blooded animals with wings, a beak, and body covered with feathers. These animals lay eggs from which their young hatch, and most of the species can fly. The animals available at the park that represents this class were the Philippine ophidian Eagle (Spilornis holospilus), Brahminy Kite (Haliastur indicus), Single-wattled Cassowary (Casuarius unappendiculatus), Dwarf Cassowary (Cassuarius bennetti), Indian Blue Peafowl (Pavo cristatus), Indian Ringneck Parakeet (Psittacula krameri), Blue-naped Parrot (Tanygnathus lucionensis), Pied Imperial Pigoen (Ducula bicolor), Nicobar Pigeon (Caleonas nicobarica), Golden Pheasant (Chrysolophus pictus), Spotted Imperial Pigeon (Ducula carola), dame Amherst Pheasant (Chrysolophus amherstiae), Bla cked-chinned Fruit Dove (Ptilinopus leclancheri), True Silver Pheasant (Lophura nycthemera), Mindanao Rofous Hornbill (Buceros hydrocorax mindanensis), Visayan Hornbill (Penelopide panini), and lastly the African Ostrich (Struthio camelius) which I liked the most because of its beautiful eyes and long eyelashes.Ostrich is in like manner the largest and fastest living bird. It is a two-toed fast-running bird with a long bare neck, small head, and fluffy dropping feathers. But sad to say, it cannot fly. The third and last animal I visited were the reptiles. Reptiles are animals with tough, dry skin covered with horny scales. Reptiles are vertebrates animals with backbone. They share characteristics common to other vertebrates fish, amphibians, birds, and mammals. But reptiles display a unique gang of characteristics that distinguishes them from other vertebrates. Like amphibians, modern reptiles are cold-blooded, or ectothermic.This means that they are unable to produce their own body heat, so they rely on the sunshine for body warmth, and much of their behavior is directed toward regulating their body temperature. Some of the most widespread living reptiles are turtles, lizards, snakes, crocodiles, and alligators. The park only exhibit crocodiles among the class reptilian. They have the Saltwater Crocodile (Crocodylus porosus), and the Philippine Crocodile (Crocodylus mindorensis). The Bukidnon Deer Park and Wildlife Center helped for the maintenance of these wild animals that are near to endangerment and they also hatch eggs and do make for these animals to survive in this cruel world. This is very important so that our next generation can still see this wonderful creatures and gain knowledge at them.

Permanent versus Transitory Earnings and Security Valuation

Permanent versus Transitory Earnings and Security ValuationIn this conceive we testify the role of permanent and short-lived pelf and silver flows in explaining guarantor r in three major(ip) capital markets, UK, regular army and France. We hypothesize that the relationship between alter flows and security upshots improves when net profit be transeunt and this robustness is country specific. The dataset consists of to a greater extent than 40,000 USA, UK and french firm- stratum observations altogether over a ix year period. Multivariate statistical retrogression abstract is undertaken to test the major research hypotheses. Results auspicate that when meshwork argon fugitive ( non stable), investors pay more oversight to interchange flows and less assist to lolly, a way out indicating that investors penalize firms with unstable pay. In summary, the evidence provided in this study supports that indeed there atomic number 18 substantial differences in the way investors and monetary analysts perceive pecuniary breeding such as simoleons and exchange flows in the UK, France and the USA. These results should be of great brilliance to the major stakeholders such as investors, creditors, financial analysts, especi altogethery afterward the recent global financial crisis and the collapse of giant organizations worldwide.Keywords Permanent and Transitory Earnings, Capital markets, Earnings, Cash flows, France, confirmable.* Dr. Melita Charitou is an Assistant Professor of Finance and Accounting, University of Nicosia, Cyprus. Address for correspondence partition of Finance and Economics, School of Business, University of Nicosia, Cyprus, email emailprotected.1. INTRODUCTIONCapital markets emphasized to a great extent the entertain relevancy of pelf in the marketplace. The usefulness of winnings has likewise been examined recently in conjunction with notes flows (Bali et al (2009), Banker et al (2009), Bartov et al., 2001 Charit ou et al., 2001, B altogether et al., 2000, among others). Empirical research provided evidence to support that earnings are more useful than notes flows in the capital markets. Existing evidence on the association of operating capital flows beyond earnings in explaining security returns has been inconclusive. Furthermore, to fitting comparative international research on the think of relevance of cash flows has been limited. Moreover, researchers argue that when aggregate data is used, it is assumed that the relationship between earnings and cash flows with security returns is equivalent across firms. It should be noted that this assumption that investors react identically to earnings and cash flows of all firms is not that pragmatic.The present study hypothesizes the repute relevance of earnings and cash flows is country specific and it depends on the transitoriness of earnings.Earnings persistence studies consistently report that earnings persistence is significantly positiv ely associated with ERC (Easton and Zmijewski, 1989 Donnelly and Walker, 1995 Ali and Zarowin, 1992 Chambers, 2004). Cheng et al. (1996) extended prior studies on this topic and added cash flow variables in their models. They found that the incremental information content of cash flow from operations(CFO) should increase with a decrease in the permanency of earnings. Furthermore, Ali (1994) using non-linear models concluded that earnings, cash flows and working capital from operations(WCFO) contribute incremental information, which increases the lower are the unconditional changes in earnings, cash flows and WCFO respectively. Finally, Ali and Zarowin (1992) show that the more transitory the previous periods earnings are, the greater the increase in the ERC and the anticipate incremental explanatory power from inclusion of the level variable. tally to Cho and Chung (1991) the persistence measure used in those studies has 3 limitations first, although persistence is changing ove r time, a constant parameter assumption is made which is problematic, especially when estimations are based on annual data for several year time series. Second, a measurement illusion problem exists, from using time-series reported earnings. Easton and Zmijewski (1989) use revisal coefficient avoiding to some extend the latter problem. The third limitation is that persistence as measured by the time series of earnings is a crude legate for the construct because it contains little economic content.Researchers also extended prior studies in order to examine the value relevance of the permanent and transitory earnings. Cheng et al (1996), Ali (1994), Ali and Zarowin (1992) and Easton and Zmijewski (1989) among others examine the impact of permanent and transitory earnings on the relations between returns and earnings or between returns and cash flows. Ali and Zarowin (1992) concluded that for firms with permanent earnings in the previous period, when the earnings level variable is i ncluded in the model, the incremental explanatory power and the increase in Earnings Response Coefficient (ERC) are small. Cheng et al. (1996) investigated whether the incremental information content of cash flows increases when earnings are transitory. Transitory earnings have smaller marginal impact on security returns. Moreover, their results showed that the incremental information content of accounting earnings decreases, and the incremental information content of cash flows increases with a decrease in the permanence of earnings. retroversion analysis was undertaken to test the major hypothesis. A sample of more than 40,000 USA, UK and cut firm year observations was used to test the research hypotheses. The major conclusions of the empirical results are summarized as follows. First, regarding our sanctioned advise which stated that earnings and cash flows are associated with impart prices in USA, UK and France, results indicate that indeed both earnings and cash flows are t aken into consideration by investors in their investment decisions. Second, regarding our major hypothesis which stated that the value relevance of earnings and cash flows is country specific and depends on the transitoriness of earnings, results indicate that when earnings are transitory (not stable), investors pay more attention to cash flows and less attention to earnings, a result indicating that investors penalize firms with unstable earnings.In summary, evidence provided in this study supports that indeed there are substantial differences in the way investors and financial analysts perceive financial information such as earnings and cash flows in UK, France and USA and that the value relevance of cash flows depends on the transitoriness of earnings..2. LITERATURE REVIEW and Hypotheses development.Earnings are of primary importance to managers, because managerial administrator compensation contracts are usually based on earnings. Managers select financial reporting methods to maximize the value of their bonus awards through incentives created by bonus schemes. In addition, managers indulge in income smoothing, that is, taking actions to dampen fluctuations in their organizations earnings, as investors pay more for a firm with a smoother income stream (Dechow et al. 2003 Barth et al. 2005).In the sometime(prenominal) few years there has been an increased interest in the role of earnings and cash flows in explaining security returns.Contextual factors, such as earnings transitoriness, have a common objective. To identify specific circumstances where the value relevance of earnings and cash flows is altered (improves or deteriorates). Using USA data, freeman and Tse (1992) and Ali (1994) showed that transitory earnings have smaller marginal impact on security returns. Cheng et al (1996) and Charitou et al (2001) extended these studies by hypothesizing that when earnings are transitory, the value relevance of earnings diminishes, whereas the value relevanc e of cash flows is expected to increase. Earnings transitoriness was measured as the earnings change scaled by the ancestor of period price and also by the earnings to price ratio. Extreme values of these measures could be considered as an indication of earnings transitoriness. Transitory items are expected to have limited valuation implications. Examples of transitory items in earnings include current and long-term accruals such as losses ascribable to restructuring, current light through asset sales of previous periods increases in market values, one time impact on income from changes in accounting standards. The results of the Cheng et al. (1996) study indicated that a) when level and changes in earnings and cash flows are included in the model, all are value applicable in the marketplace, and b) when earnings are transitory the value relevance of earnings diminishes substantially, and simultaneously the value relevance of cash flows increases.In summary, these results are in deed of great importance since earlier studies assumed that the earnings returns relation is homogeneous across firms. These studies, however, disprove this assumption and indeed show that the value relevance of earnings and cash flows depends on the permanence or transitoriness of these measures.The present study goes a step further to examine whether the value relevance of earnings and cash flows is country specific and whether it depends on the transitoriness of earnings.2.2 Research HypothesIsEmpirical evidence supports that earnings are valued more than cash flows in the marketplace. Extant evidence though on the incremental information content of cash flows beyond earnings in different countries when earnings are transitory has been inconclusive (Barth et al., 2004, Bartov et al., 2001). The inconclusive results in prior studies, and the limited research on this figure provide motivation for this study. The research hypothesis to be tested isHypothesis 1 The value relevance o f cash flows improves when earnings are transitory, whereas the value relevance of earnings decreases when earnings are transitory.The framework developed thus off the beaten track(predicate) suggests that both earnings levels and changes have explanatory power when they are included simultaneously in explaining stemma returns. Earning changes are used as a proxy for unforeseen earnings, followers the assumption that earnings follow a random walk. ground on these arguments, in developing the theoretical framework on the transitoriness of earnings, it is proposed that annual earnings follow an Integrated Moving Average, IMA (1,1) process, which includes both levels and changes, i.e. permits for both transitory and permanent components. IMA was chosen because prior theoretical and empirical evidence shows that annual earnings follow a random walk (Cheng et al., 1996 Easton and Harris, 1991).This hypothesis predicts that the value relevance of earnings decreases when earnings are transitory and therefore, the value relevance of cash flows improves in all three countries when earnings are transitory. The issue of the time permanence of earnings has raised the stimulus in the present study in examining the role of operating cash flows when earnings are transitory. As Cheng, Liu and Schafer (1996) argue, earnings whitethorn contain transitory items with limited valuation implications. For example, transitory items that whitethorn be included are current and long- term accruals such as losses due to restructuring, current citation (through asset sales) of increases in market value previously (or currently), one-time impact on income from changes in accounting standards etc. Moreover, because of compensation contracts and debt covenants are a great deal based on reported accounting income, incentives exist for managers to introduce transitory elements in earnings. Dechow (1994) and Charitou et al (2001) also argue that because management has some discretion ove r the recognition of accruals, this can be used to manipulate earnings.Following Ali and Zarowin (1992) and Cheng, Liu and Schafer (1996), included in the theoretical framework, both levels and changes in order to characterise the unexpected components of earnings, whereas they also include levels and changes of cash flows from operations. This is done in order to test the hypothesis that when earnings are transitory the earnings response coefficients (ERCs) on both levels and changes ordain have reduced significance in explaining security returns. In this situation the importance of cash flows from operations will be greater. As in freewoman and Tse (1992) and Ali (1994) transitory elements are more likely to be present when unexpected earning values are large relative to price. Hence in the model 58, the coefficients c1t + c2t and c3t+ c4t pretend the estimates of the earnings and cash flow response coefficients when earnings are mainly permanent. The coefficients c5t+ c6t and c 7t+ c8t capture the additional information content of earnings and cash flows for firms with predominantly transitory earnings. It is expected c5t+ c6t to be prejudicial and c7t+ c8t to be positive. In summary, following the aforementioned theoretical framework, I hypothesize that the incremental information content of cash flows from operations is expected to increase as the permanence of earnings decreases (see also Freeman and Tse, 1992 Ali, 1994 and Cheng, Liu and Schafer, 1996. anterior studies that examined earnings transitoriness include Cheng et al (1996) for the USA and Charitou et al (2000) for the UK. Prior studies have not examined the role of the cash flows when earnings are transitory in both Anglo-Saxon and code legality countries.3.0 Research Design3.1 Dataset every industrial firms that belong in the Manufacturing Industry (SIC 100-4299, 4400-4799), Retail Industry (SIC 5000-5999) and Service Industry (SIC 7000-8999) from the USA, UK and France over the recent ni ne year period were selected. Industrial firms that had all the information available for the computation of operating cash flows, operating earnings and security returns were included in the sample, resulting in the following firm-year observations for the recent nine year period USA =36695, UK =4234 and France = 1181. Consistent with prior empirical studies, observations that were regarded as outliers were excluded from the sample, i.e. observations with absolute change in earnings/market value, absolute change in cash flows/market value, earnings/market value and cash flow/market value greater than 150%. Also observations that were in excess of three absolute studentized residuals were considered outliers and were excluded from the sample. These restrictions resulted in approximate reduction of the sample size of about 2%, which is consistent with prior empirical studies. Therefore, the final sample size used for regression analysis purposes equals to 35872 firm-year observations for the USA sample, 4178 firm-year observations for the UK sample and 1165 firm-year observations for the French sample.3.2 Measurement of financial and market variablesIn order to examine whether investors in UK, USA and France take into consideration in their investment decisions the levels and changes of earnings and cash flows, independent of each other, the following univariate regression model will be usedUnivariate (Simple Regression) ModelRETit = b0 + biXi + eI (1)whereXi is replaced byE Operating EarningsE Change in operating-earningsCFO Operating cash flowsCFO Change in operating cash flows.RETit stock return for firm i measured over a 12-month return interval ending three months after the fiscal-year-end.b0 the intercept termbi slope coefficientei error termIn order to test whether both the levels and changes of earnings and cash flows are valued differently in the capital markets, namely in USA, UK and France, the following variable regression model will be used3.3 Per manent vs transitory earnings modelsIn order to investigate the role of permanence of earnings, the basic regression model that includes the level and changes of earnings and cash flows will be extended to include additional dummy variables.The following model will be testedRETit = c0 + c1Eit + c2Eit + c3CFOit + c4CFOit + c5Eit*D + c6Eit*D + c7CFOit*D + c8CFOit*D + eitwhere RETit= Security returns for the year,Eit = operating earningsCFOit = operating cash flows for firm i in period t, denotes the change in a variable,eit is the error term for firm i in period tD is a dummy variable taking a value of one when earnings are transitory and zero otherwise.Consistent with Cheng et al. (1996), devil alternative definitions are used to determine D. Under one approach, D equals 1 (0) when Eit/ Pit-1 is greater than (less than) its yearly cross-sectional median (Ali, 1994). Under the second approach, firms are ranked each year according to their Eit/ Pit-1 , placing firms with positive Ei t/ Pit-1 into the first nine groups with equal number of firms per group and firms with negative earnings in the tenth group. Earnings are classified in the bottom two and top two groups as transitory (D=1) and earnings in the middle six groups as permanent (D=0) (Ali and Zarowin, 1992, Charitou et al, 2001).4.0 EMPIRICAL RESULTS4.1. Descriptive Statistics table 1 presents basic descriptive statistics for all the earnings, cash flows and security returns variables examined in the study for all three countries (USA, UK and France) for the recent nine year period. Results indicate the following a) the mean security return for UK and USA is the highest (0.092 and 0.08, respectively), whereas in France is somewhat lower, 0.055, b) the mean earnings level is high for UK (0.057) and lowest for USA. For the French dataset the mean of earnings levels is 0.037 c) the mean of the cash flow levels is shown to be the highest for the French dataset (0.184) and lower for UK and USA (0.123 and 0. 057, respectively) d) as expected the standard deviation of the levels and changes of cash flows is always higher than the level and changes of earnings in all three countries. These results are consistent with the results provided in prior empirical studies. Moreover, untabultated correlation analysis results indicate that there are no significant correlations that may possibly affect the results.4.2. Regression analysis results4.2.1 Univariate and multivariate regression analysis results on the value relevance of earnings and cash flows for the USA, UK and France.Univariate results presented in table 2 indicate the following. First, as far as the value relevance of earnings is concerned, as expected, the results indicate that both the levels and changes in earnings are positive and statistically significant in all three countries. Interestingly, the size of the levels of earnings and the size of the changes in earnings is approximately equal in all three countries, in spite of the fact that the French financial reporting system is much more conservative. Specifically, the coefficients of the level of earnings are 0.759, 0.767 and 0.793 for the USA, the UK, and France, respectively. The coefficients of the changes in earnings are 0.701, 0.612 and 0.669, for the US, UK and France, respectively. As far as the R2 is concerned, results indicate that French earnings (levels and changes) are more value relevant than the earnings in the USA and the UK, even though the financial reporting system in France in more conservative. The R2 for the level of earnings is 11.20%, 8.80% and 6.70% for France, the UK and the USA. The same ranking applies to the changes in earnings, although the R2 is somewhat lower, indicating that the level of earnings is more value relevant than the changes in earnings.As far as the value relevance of cash flows is concerned, as expected, results indicate that cash flows are value relevant in all three countries. any the coefficients of the le vels and changes in cash flows are positive and statistically significant. The size of the coefficients of cash flows as well as the magnitude of the R2 are somewhat higher in the Anglo-Saxon countries, suggesting that cash flows could be less value relevant in France. Moreover, as it was expected the size of the earnings coefficients and the magnitude of the R2 are comparatively higher than the equivalent cash flow statistics. These results are consistent with our hypotheses, expectations and consistent with prior empirical evidence. This is due to the fact that earnings are considered more value relevant in the stock markets.4.2.2 Multivariate regression analysis results for examining the valuation of earnings and cash flows when the earnings are transitory.Hypothesis 1 predicts that the value relevance of earnings decreases when earnings are transitory and thus, the value relevance of cash flows is expected to improve in all three countries when earnings are transitory.The issue of the earnings permanence has raised the stimulus in the present study in examining the role of operating cash flows when earnings are transitory. As Cheng, Liu and Schafer (1996) argue, earnings may contain transitory items with limited valuation implications. For example, transitory items that may be included are accruals such as losses due to restructuring, current recognition through sale of assets of previous periods, increases in market value, one-time impact on income from changes in accounting standards etc. Moreover, because of compensation contracts and debt covenants are usually based on profit, incentives exist for managers to introduce transitory elements in earnings and thus manipulate earnings.Results in Table 3 provide evidence to support hypothesis 1, that is, when earnings are transitory the role of earnings in stock markets decreases and the role of cash flows improves. Consistent with prior studies and with my theoretical framework, I included in my multivariate regression model in Table 3 both the level and changes of earnings and cash flows (Cheng, Liu and Schafer, 1996), in order to characterise the unexpected components of earnings and the unexpected components of cash flows from operations. This is done in order to test the hypothesis that when earnings are transitory the earnings response coefficients on both levels and changes will have reduced significance in explaining security returns. In this situation the importance of cash flows from operations will be greater. Therefore, in the model in Table 3, the coefficients c1t + c2t and c3t+ c4t represent the estimates of the earnings and cash flow response coefficients when earnings are mainly permanent. The coefficients c5t+ c6t and c7t+ c8t capture the additional information content of earnings and cash flows for firms with predominantly transitory earnings. It is expected that c5t+ c6t to be negative and c7t + c8t to be positive.Specifically, results in Table 3 indicate the followin g. First, as expected, the sum of the coefficients of earnings (c3+c4) are positive and statistically significant in all three countries, the USA, the UK and France. These results indicate that in all three countries, the earnings are taken into consideration in the valuation of stock prices by security analysts and investors. Second, as expected, the sum of the coefficients of cash flows is positive and statistically significant in all three countries. Again, these results show that cash flows are distinguished to security analysts and investors in the USA, the UK and France for stock valuation purposes. These results are consistent with the results provided thus far in all previous models. Third, the sum of the coefficients of earnings c5+c6 is negative and statistically significant in all three countries, the UK, the USA and France. These results are consistent with my expectations and with my hypothesis. These results mean that when earnings are transitory, i.e. when the variat ion of the earnings compare to stock prices is relatively high (in the present study above its median), then the stock market does not perceive this information as good news and the relative importance of earnings on stock prices decreases. This is measured by the sum of the coefficients of (c1+c2) + (c5+c6). To give an example to make things clearer, let us assume that earnings are stable, not transitory. In that case the effect of earnings on stock prices in the UK will be 5.65 (sum of coefficients of earnings c1+c2). In contrast, when earnings are transitory for a firm in the UK, the effect of earnings on stock prices will not be 5.65 as above, but it will be 5.65 damaging 4.933 (b5+b6), which is 0.68 solo. So for, stable or permanent earnings firms in the UK the effect of earnings on stock prices is 5.65 whereas for transitory earnings firms the effect of earnings on stock prices in the UK is only 0.68.As far as the USA and France is concerned the results are consistent with t he UK results just discussed. Specifically, in the USA results indicate that when earnings are permanent the effect of earnings on stock prices is 5.88 (c1+c2), but when earnings are transitory (not permanent), then the effect of earnings on stock prices is only 1.08 (i.e. 5.88 minus 4.8 or c1+c2 minus c5+c6). Results in France also support the results of the UK and the USA. French results in Table 20 indicate that when earnings are permanent, the effect of earnings on stock prices is 5.66 (c1+c2), but when earnings are transitory (not permanent), then the effect of earnings on stock prices is only 1.15 (ie., 5.66 minus 4.51 or c1+c2 minus c5+c6).Fourth, as hypothesised, results in Table 3 support that the cash flow variables are taken into consideration by investors in investment decisions. Specifically, the sum of the coefficients of cash flows c3+c4 is positive and statistically significant in all three countries. For example, in the UK it is 0.15, in the USA it is 0.095 and in F rance is 0.18. These results are consistent with the results provided thus far in all previous models and hypotheses.Fifth, as hypothesised, results in Table 3 support that when earnings are transitory, investors and security analysts in the UK and the USA pay more attention to cash flows. This is evidenced by the sum of the coefficients of cash flows c7+c8. For example, in the UK when earnings are transitory, stock prices are affected more by 0.03 (c7+c8) from changes in cash flows. Similarly, in the USA, when earnings are transitory, stock prices are affected by 0.02 more from changes in cash flows. These results are very interesting because they show that in Anglo-Saxon countries such as the USA and the UK, investors do pay additional attention to cash flows because they do know that earnings are of lower value when they are transitory. On the other hand, consistent with prior evidence in previous models and tables of this study, French analysts and investors pay more attention t o earnings because their code law system make financial reporting in France much more conservative, and thus the variability of earnings is not that high as the variability of earnings in the UK and the USA.Sixth, in all countries examined, results support that the model is statistically significant and the variation of stock returns as explained by the R2 is 15.6 in the UK, 12.8 in the USA and 17.2% in France.In summary, results presented in Table 3 support my hypothesis that when earnings are transitory (not permanent), investors pay less attention to earnings and more attention to cash flows.5.0 ConclusionsConsistent with our hypotheses and our expectations, these results indicate that earnings and cash flow information is country specific, that is investors and financial analysts pay different attention to earnings and cash flows depending on the country under investigation and on whether earnings are transitory or permanent. Specifically, results indicate that earnings and cash flows are perceived differently by investors, depending on the country to which they belong. When earnings are transitory, investors in Anglo-Saxon countries penalize more these firms because the effect of earnings on stock returns is much more negative (c5+c6= -4.933 and -4.8 for UK and USA, respectively, whereas it is only -4.51 for France).The results of this study have practical implications as well and should be of great importance to the major stakeholders such as investors, creditors, financial analysts, especially with the modish events that are taking place, and the major collapses of giant organizations worldwide such as Lehman Brothers, Bear Stearns, among others. Regulatory bodies, investors, financial analysts and the financial press, blamed among others, the possible manipulation of financial information supplied to the investors by these organizations. The question raised, is whether this type of information is taken into consideration by investors in their investme nt decisions.

Communication Skills in Nursing

Communication Skills in NursingCommunication is a merry part of the nurses role. Theorists such as Peplau (1952), Rogers (1970) and King (1971) all emphasise remedial talk as a primary part of breast feeding and a major focus of nursing practice. Long (1992) further suggests that colloquy contains many comp adeptnts including presence, listening, perception, caring, disclocertain(p), acceptance, empathy, authenticity and respect. Stuart and Sundeen (1991, p.127) caution that while talk flowerpot facilitate the development of a therapeutic relationship it can also create restrictions between clients and colleagues.Within Healthc be, communication may be described as a transitional outgrowth that is dynamic and constantly changing (Hargie, Saunders and Dickenson, 1994, p.329). It to begin with involves communication between the nurse and the patient. If the interaction is to be meaningful, knowledge should be change overd this involves the nurse adopting a planned, holis tic approach which leveltually forms the basis of a therapeutic relationship.Fielding and Llewelyn (1987) contend that poor communication is the primary cause of complaints by patients. This is supported by Young (1995) who reports that one third of complaints to the Health Service Commissioner were related to communication with nursing staff. Studies by Boore (1979) and Devine and score (1983) demonstrate that good communication actually assisted the rate of patient recovery thus reducing hospital admission clippings. This suggests that good communication skills are cost impressive.In this assignment, I overhear reflected on piazzas that have taken place during my clinical work have it off. These military posts have helped to develop and utilise my social skills, luck to maintain therapeutic relationships with patients. In this instance, I have used Gibbs (1988) ruminative cycle as the example for my watching.Gibbs (1988) reflective cycle consists of six stages in nurs ing practice and learning from the experiences.Description of the situation that arose.Conclusion of what else would I could have done.Action plan is in that location so I can prepare if the situation rises a slay.Analysis of the feelingEvaluation of the experienceAnalysis to make sense of the experienceMy Reflective CycleBaird and Winter (2005) illustrate the importance of reflective practice. They narrate that reflecting will help to generate k forthwithledge and professional practice, increase ones ability to oblige to new situations, develop self esteem and greater job satisfaction. However, Siviter (2004) explains that blame is nearly gaining self confidence, identifying ways to improve, instruction from ones own mistakes and behaviour, looking at other peoples perspectives, being self aware and making future improvements by learning from the past. I have come to realise that it is important for me to improve and build therapeutic relationships with my patients by helpi ng to wee a rapport through presumption and mutual understanding, creating the special link between patient and nurse as described by Harkreader and Hogan (2004). Peplau (1952), cited in Harkreader and Hogan (2004), nones that good contact in therapeutic relationships builds consider as well as raising the patients self esteem, often leading to the patients personal growth. Ruesh (1961), cited in Arnold and Boggs (2007), states that the purpose of therapeutic communication is to improve the patients ability to function. Therefore, in order to establish a therapeutic nurse/patient interaction, a nurse must possess certain qualities e.g. caring, sincerity, empathy and intrustworthiness (Kathol, 2003) (P.33). These qualities can be uttered by promoting effective communication and relationships by the implementation of interpersonal skills. Johnson (2008) defines interpersonal skills as the ability to go through effectively. Chitty and Black (2007, p 218) mention that communicat ion is the exchange of information, thoughts and ideas via simultaneous verbal and non verbal communication. They explain that while verbal communication relies on the spoken word, non-verbal communication is just as important, consisting of gestures, postures, facial nerve submitions, plus the tone of voice and level of volume of ones voice. Thus, my reflection in this assignment is based on the development of therapeutic relationships between the nurse and patient using interpersonal skills.My reflection is about a particular patient, to whom, in order to maintain patient information confidentiality (NMC, 2004), I will refer to as Mr R. It concerns an event which took place when I was working on a surgical ward. Whilst there were male and female wards, female and male surgical patients were encouraged mingle. On this particular day, I sight that one of the male patients was sitting alone on his bed. This was Mr R., a 64 year old gentleman who had been diagnosed with inoper fit ted cancer of the pancreas, with a life apprehension of 18-24 months. He was unable to control his pain, and whilst slightly relief could be provided by chemotherapy, Mr R. had a good understanding of his condition and knew that there was no cure available. He was unable to walk by himself and always needed assistance even to stand up or sit down. Because of his mobility problems I offered to get him his cup of teatime and I then sat with him as he was lonely.I would now like to treat the feelings and thoughts I experienced at the time. Before I gave Mr R. his cup of tea, I approached him in a friendly manner and introduced myself I tried to establish a good rapport with him because I wanted him to feel well-heeled with me even though I was not a family member or relative. When I first asked Mr R. if I could get him a cup of tea, he looked at me and replied I have asked the girl for a cup of tea, I dont fuck where she is. I answered Well, I will see where she is and if I cant find her, I will gladly get one for you Mr R. In doing this, I demonstrated emphatic listening. According to Wold (2004, p 13), emphatic listening is about the willingness to understand the other person, not just judging by appearance. Then I touched MrR.s shoulders, kept talking and raised my tone a little because I was shy(p) of his reaction. At the same time, I used body wording to communicate the action of drinking. I paused and repeated my actions, provided this time I used some simple words which I though Mr R. would understand. Mr R. looked at me and nodded his head. As I was giving him his cup of tea, I maintained affectionateness contact as I didnt want him to feel shy or embarrassed.Fortunately, using body language helped me to communicate with this gentleman. At the time I was worried that he would be unable to understand me since English is not my first language but I was able to communicate effectively with him by verbal and non-verbal message, using appropriate g estures and facial expressions. Body language and facial expressions are referred to as a non-verbal communication (Funnell et al. 2005 p.443). I kept thinking that I needed to improve my English in order for him to better understand and interpret my actions. I thought of the language barrier that could break verbal communication. Castledine (2002, p.923) mentions that the language barrier arises when individuals come from different sociable backgrounds or use slang or colloquial phrases in conversation. Luckily, when dealing with Mr R. the particular gestures and facial expressions I used helped him to understand that I was offering him assistance. The spunk contact I maintained helped show my willingness to help him it gave him reassurance and encouraged him to place his confidence in me. This is supported by Caris-Verhallen et al (1999) who mention that direct eye contact expresses a sense of interest in the other person and provides another form of communication. In my dealings with Mr R., I tried to communicate in the outflank and appropriate way possible in order to make him feel comfortable as a result he placed his trust in me and was much co-operative.EvaluationIn evaluating my actions, I feel that I behaved correctly since my actions gave Mr R. both the assistance he needed and provided him with some company. I was able to successfully develop the nurse-patient relationship. Although McCabe (2004, p-44) would describe this as task centred communication one of the key components missing in communication by nurses I feel that the situation twisting both good patient and task centred communication. I feel that I treated Mr R. with empathy because he was unable to perform certain tasks himself due to his mobility problems and was now refusing chemotherapy. It was my duty to make sure he was comfortable and felt supported and reassured. My involvement in the nurse-patient relationship was not restricted to task centred communication but included a p atient centred approach using basic techniques to provide warmth and empathy toward the patient.I found that I was able to improve my non-verbal communication skills in my dealings with Mr R. When he first mentioned having chemotherapy, he volunteered very little information, thus demonstrating the role of non-verbal communication. Caris-Verhallen et al (1999, p.809) state that the role of non-verbal communication becomes important when communication with gray people with incurable cancer (Hollman et al 2005, p.31)There are a number of effective ways to maximise communication with people, for example, by try oning to gain the persons attention before speaking this makes one more visible and helps to prevent the person from feeling intimidated or under any kind of twinge the use of sensitive touch can also make them feel more comfortable. I feel that the interaction with Mr R. had been beneficial to me in that it helped me to learn how to change my communication skills both ver bally and non-verbally. I used body language to its full effect since the language barrier make verbal communication with Mr.R. difficult. I used simple sentences that Mr R. could easily understand in order to encourage his participation. Wold (2004, p.76) mention that gestures are a specific type of non-verbal communication intended to express ideas they are useful for people who have limited verbal communication skills.I also used facial expressions to help encourage him to have chemotherapy intervention which might not cure his problem but would give him some relief and make him feel healthier. Facial expressions are the most expressive means of non-verbal communication but are also limited to certain cultural and age barriers (Wold 2004 p.76). My facial expressions were intended to encourage Mr R. to reconsider his decision with regard to chemotherapy treatment. Whilst I could not go into all the details about his treatment, I was able to advise him to complete his treatment in order to alleviate his symptoms.AnalysisIn order to analyse the situation, I aim to evaluate the important communication skills that enabled me to provide the best level of nursing care for Mr R. My dealings with Mr R. involved interpersonal communication i.e. communication between two people (Funnell et al 2005, p-438).I realised that non-verbal communication did help me considerably in providing Mr R. with appropriate nursing care even though he could only understand a few of the words I was speaking. I did notice that one of the problems that occurred with this style of communication was the language barrier but despite this I continued by using appropriate communication techniques to aid the conversation. Although it was quite difficult at first, the use of non verbal communication skills helped encourage him to speak and also allowed him to understand me.The situation showed me that Mr R. was able to respond when I asked him the question without me having to wait for an answer he was unable to give. Funnell et al (2005, p 438) point out that communication occurs when a person responds to the message received and assigns a meaning to it. Mr R. had indicated his agreement by nodding his head. Delaune and Ladner (2002, P-191) explain that this channel is one of the key components of communication techniques and processes, being used as a medium to send out messages. In addition Mr R. also gave me feedback by showing that he was able to understand the messages being conveyed by my body language, facial expression and eye contact. The channels of communication I used can therefore be classed as both visual and auditory. Delaune and Ladner (2002 p.191) state that feedback occurs when the sender receives information after the receiver reacts to the message, however Chitty and Black (2007, p.218) define feedback as a solution to a message. In this particular situation, I was the sender who conveyed the message to Mr R. and Mr R. was the receiver who agreed to t alk about his chemotherapy treatment and allowed me to assist. Consequently I feel that my dealings with Mr R. involved the 5 key components of communication outlined by Delaune and Ladner (2002, p.191) i.e. senders, message, channel, receiver and feedback.Reflecting on this event allowed me to explore how communication skills play a key role in the nurse and patient relationship in the delivery of patient-focussed care. Whilst I was trying to assist Mr R. when he was attempting to walk, I realised that he needed time to adapt to the changes in his activities of daily living. I was also considering ways of successful and effective communication to ensure a good nursing outcome. I concluded that it was vital to establish a rapport with Mr R. to encourage him to participate in the exchange both verbally and non-verbally. This might then give him the confidence to communicate effectively with the other staff nurses this might later prevent him from being neglected due to his age or his inability to understand the information given to him about his treatment and the benefits of that treatment.I have hatful out an action plan of clinical practice for future reference. If there were patients who needed help with feeding or with other procedures, I would ensure that I was well prepared to deal patients who werent able to communicate properly. This is because, as a nurse, it is my role to ensure that patients are provided with the best possible care. To achieve this, I need to be able to communicate effectively with patients in different situations and with patients who have differing involve. I need to communicate effectively as it is important to know what patients need most during there stay on the ward under my supervision. Whilst I have a lot of experience in this field of practice, communication remains a primordial part of the nursing process which needs to be developed in nurse-patient relationships. Wood (2006, p.13) states that communication is the key to unlock the foundation of relationships. Good communication is essential if one is to get to know a patients individual health status (Walsh, 2005, p.30). Active learning can also help to identify the existence of barriers to communication when interacting with patients. Active learning means listening without making judgements I always try to listen to patients opinions or complaints since this gives me the opportunity to see the patients perspective (Arnold, 2007, p.201). On the other get through, it is crucial to avoid the barriers that occur in communication with the patients and be able to detect language barriers. This can be done by questioning patients about their health and by asking them if they need help in their daily activities. I set about overcoming such barriers by asking open-ended questions and interrupting when necessary to seek additional facts (Funnell et al, 2005, p.453).Walsh (2005, p.31) also points out that stereotyping and making assumptions about patients , by making judgements on first impressions and a lack of awareness of communication skills are the main barriers to good communication. I must not judge patients by making assumptions on my first impression but should go out of my way to make the patient feel valued as an individual. I should respect each patients fundamental values, beliefs, culture, and individual means of communication (Heath, 300, p.27). I should be able to know how to establish a rapport with each patient. Cellini (1998, p.49) suggests a number of ways in which this can be achieved, including making oneself visible to the patient, anticipating patients needs, being reliable, listening effectively all these meanss will give me guidelines to improve my communication skills. Another important factor to include in my action plan is the need to take into account any disabilities patients may have such as poor hearing, visual decline in quality or mental hinderance. This could help give the patient some control a nd allow them to make the best use of body language.Once I know that a patient has some form of disability, I will be able to prepare a course of action in advance, deciding on the most appropriate and effective means of communication. Heath (2000, p.28) mentions that communicating with patients who have an impairment requires a particular and certain type of skill and consideration. Nazarko (2004, p.9) suggests that one should not repeat oneself if the patient is unable to understand but rather try to rephrase what one is saying in limits they can understand e.g. try speaking a little more slowly when communicating with disabled people or the hard of hearing. Hearing problems are the most common disability amongst enceintes due to the ageing process (Schofield. 2002, p.21).In summary, my action plan will show how to establish a good rapport with the patient, by recognising what affects the patients ability to communicate well and how to avoid barriers to effective communication i n the future.ConclusionIn conclusion, I have outlined the reasons behind my choosing Gibbs (1988) reflective cycle as the framework of my reflection and have discussed the importance of reflection in nursing practice. I feel I have discussed each stage of the cycle, outlining my ability to develop therapeutic relationship by using interpersonal skills in my dealings with one particular patient. I feel that most parts of the reflective cycle (Gibbs 1988) can be applied to the situation on which I have reflected. Without the model of structured reflection I do not feel I would have had the confidence to consider the situation in any depth (Graham cited in Johns 1997 a, p.91-92) and I fear reflection would have been remained at a descriptive level. I have been able to apply the situation to theory as Boud Keogh Walker (1985, p.19) explain that reflection in the context of learning is a generic term for those intellectual and effective activities whereby individuals engage to explore t heir experiences in order to lead to a better understanding and appreciation. Boyd Fales (1983, p.100) agree with this and state that reflective learning is the process of internally examining and exploring an issue of concern, trigged by an experience that creates and clarifies meaning in terms of self and which results in a changed conceptual perspective. However, I personally believe that the reflective process is merely based on each individuals own personality and beliefs as well as their attitude and approach to the life.AppendixMr R., a 64 year old gentleman, was an inpatient on a surgical ward. Earlier that day his consultant had directly informed him that he had inoperable cancer of the pancreas with a life expectancy of 18-24 months. Some relief might be offered by chemotherapy, but there was no cure. Mr R. was understandably shocked, but had suspected the diagnosis. At that time he remained in the care of the specialist nurse. Later in the day, as I was passing through t he ward, I notice Mr. R. alone on his bed. normativeA prescriptive intervention seeks to direct the behaviour of the client, usually behaviour that is outside the client-practitioner relationship. My first intervention was to open the conversation and demonstrate warmth. I provided information myself and gave Mr R. the choice of staying on his own or engaging with me. By shaking Mr R.s hands I was attempting to provide reassurance and support as well as communicating warmth in order to reduce his anxiety and promote an effective nurse-patient relationship. practitioner Hello Mr. R, I am one of the nurses here thismorning with Dr. M. Is there any affaire I can get you or would you rather be on your own? (Shook hands).Mr. R NO, I remember you from this morning, come and sit down. Ive asked the girl for a cup of tea, I dont know where shes got to.Practitioner Well give me a minute and Ill bring you one in. Do you take sugar?Mr. R I suppose I shouldnt, then why worry. Two please.Practit ioner (Returning with a cup of tea) Here we are, dont blame me if its horrible, I got it from the trolley. (I smiled at Mr.R. and tried to establish eye contact, then sat down in the chair next to him).Mr. R Thanks, thats just what I need.2. InformativeAn informative intervention seeks to impart knowledge, information and meaning to the patient. My intention was to reinforce the nurse-patient relationship by smiling and attempting to establish eye contact as well as using facial expressions to bewilder the patient at ease and establish a good rapport. By making Mr. R a cup of tea it created a pleasant response in a time of crisis.Practitioner Jane (specialist nurse) was here this morning, what did you think about what she had to say?Mr. R Oh yes she was very nice, mind you Im an old hand at this, I looked after my wife when she had cancer.Mr. R She was riddled with cancer, but we kept her at home and looked after her. She could make a cracking cup of tea (Mr.R. smiles)Practitioner (smiles and nods) When did she pass away?3. ConfrontingA confronting intervention seeks to raise the clients consciousness about limiting behaviour or attitudes of which they are relatively unaware. By meeting the patients needs at that time I felt the urge to continue to show a display of warmth and develop the relationship further.Mr. R It will be two years next month that she died.Practitioner You must miss her.Mr. R Theres not a day goes by that I dont talk to her. worth knows what she would make of all this, its brought it all back.4. CatharticA cathartic intervention seeks to enable the client to discharge/react to a painful emotion primarily grief, fear and/or anger. Mr. R spoke emotively and angrily by using such words as riddled and cancer. He spoke loudly and angrily with congruent non-verbal cues.Practitioner Has what youve been discussing with Jane reminded you of your wifes death?Mr. R Yes, (patient covers his face with his hands).Practitioner What is it about what yo uve heard that is worrying you, do you think you can tell me?5. CatalyticA catalytic intervention seeks to elicit self-discovery, self direct living, learning and problem solving in the client. Mr. R had a broad scope in which to discuss any concerns he may have had, but his response only concerned his wife, not him as his wife was the one who suffered from cancer.Mr. R (Pause)..Im an old hand at this and I dont want any of that chemo.Practitioner What is it about the chemotherapy you dont like?Mr. R My wife had it and we went through hell.Practitioner You went through hellMr. R The doctors made her have the chemo and she still died in agony.6. SupportiveA supportive intervention seeks to affirm worth and value of the clients person, qualities, attitudes and actions. It is done to encourage the client to say more and to explore the issue further. Support is provided by non-verbal means like giving warmth, supportive posture and maintaining eye contact. I wanted to convince Mr. R tha t I was interested in what he had to say and help him believe that he was worth listening to that his opinions really mattered.Practitioner Do you think the same thing will happen to you?Mr. R Yes, thats the one thing Im worried about.Practitioner.em, if Im honest with you chemotherapy treatment is not a subject I know a lot about. (Pause), would you like to see the specialist nurse again? She can go over things with you and explain your options.Mr. R Well if she doesnt mind, Im just not sure the chemo will be worth it.Learning outcomesFrom this experience, I have learned the importance of-Practice in accordance with the NMC (2004) code of professional conduct, performance, when caring for adult patients including confidentially, informed consent, accountability, patient advocacy and a safe environment.Demonstrating fair and anti-discriminatory behaviour, acknowledging differences in the beliefs, spiritual and cultural practices of individuals.Understanding the rationale for undert aking and documenting, a comprehensive, systematic and close nursing assessment of physical, psychological, social and spiritual needs.Interpreting assessment data to prioritise interventions in evidence based plan of care.Discussing factors that will influence the effective working relationships between health and social care teams.Demonstrating the ability to critically reflect upon practice.

Overview of Bristol, Rhode Island

Overview of Bristol, Rhode IslandSilva 1Thousands upon thousands of cities and towns blanket this beautiful planet. Many different cities and towns are indeed interesting subjects for study and analysis. 1 particular town in general possesses many characteristics that help to build what this planet is. Bristol, Rhode Island definitely is a magnificent town to visit, live, or study. Why Bristol? Bristol, Rhode Island and its extraordinary history, culture and other geographic characteristics make it a wonderful place to live.To understand the Bristol of today, one must critically analyze the history of the area. Bristol has a long, bountiful historya history that dates back over 1000 years. Around the year 1000, Vikings from Iceland are believed to flip landed on the shores of what is today Mount believe Bay (Almy 8). This is the maiden recorded contact from the outside perimeter of the world to Bristol. Many believe that the name Mount Hope has been passed down from these Viki ngs to the indigenous Amerindians of the region. The Amerindians in the long run passed the name onto the first English settlers (Almy 8). The first European settler to make his home in the Mount Hope Lands was John Gorham. Gorham was granted 100 farming of land by the Plymouth resolution, and has been given credit to be the official founder of Bristol. Much of the surrounding clock saw little English settlement. However, much of the clipping was devoted to a series of conflicts between Amerindians and English settlers. The somewhat notable conflict was the King Phillips War (1675-1676). The Amerindians were subsequently crushed by the English settlers and Amerindian manage over the lands was lost forever. The Mount Hope Lands were now under full control of the Plymouth Colony and not the Amerindians (Funk Wagnalls 358). The colonial administrators took little time in making attempts to develop the area, and in 1680 the process of settlement took a momentous step. Four pr oprietors bought a tract of land (what is now Bristol). At this time the congenator location of Bristol was as follows The Mount Hope Lands lied between get day Taunton and the Mount Hope Bay on the East and the Narragansett Bay on the west the land also extended from Bristol Ferry some 6 miles from the northeastward (Almy 8). The Proprietors took their land and broke it up, selling portions to other English settlers. The following year, 1681, the first town meeting was held and a decision was reached close to the future name of the Mount Hope Lands. The settlers saw the opportunities that were before them and they chose to name the Mount Hope Lands after(prenominal) the seaport city of Bristol, England in the hopes that one day, Bristol of the New World would emulate the success of Bristol, England (Funk Wagnalls 358).Bristol finally had a name and a mass a settlers that would plant the seed and develop the area to what it is today. It is important to understand at this parti cular point in history the town of Bristol was under the auspice of the Plymouth Colony, which today is present day Massachusetts. The surrounding areas, most notably Taunton, do attempts to diminish the utilization of Bristol within the colony therefore, Bristol attempted to remove itself from the Plymouth Colony and chose to be annexed by the colony of Rhode Island. At a town meeting in 1747, Bristol decided to officially break away from Plymouth Colony, and Rhode Island was there to take the potential seaport. Bristol was now part of Rhode Island (Almy 9). Bristol, as it is known today, came into existence.To better understand the Bristol of today, dickens important aspects of Bristols history must be understood. The history of industry and the history of immigration helped to shape Bristol immensely. From 1680 until about 1830 the town of Bristol was engaged in commerce and agriculture. Everything from onions to slaves was exported from this busy seaport all around the world (Almy 9). A tonic industry sprang up in 1832 as ships were sent out in search of whales on the Pacific Coastwhaling was successfully profitable for nearly 10 years. At about the same time the Industrial Revolution took hold in Bristol. Distilleries, gristmills, tanneries, and shipbuilding sprung up all over Bristol to support the commerce she engaged in (DiGati 15). The industrial age dominate Bristol for the remainder of the 19th century and most of the 20th century, but today Bristol is not engaged as heavily in manufacturing as it once was. A general shift, nationwide, has been to service industries.Another important historical aspect that has shaped Bristol is immigration. Several ethnic groups agree come to Bristol throughout the years. The history of immigration in Bristol is necessary to understand the demographic composition of present day Bristol. In 1846 a massive potato famine struck Ireland, which led many Irish to flee their homeland and immigrate to the United State s. Some of these immigrants ended up in Bristol, and by 1852 there were hundreds of Irish residing in Bristol. The Irish brought with them many new cultural traits among those was their religionRoman Catholicism. In response to the Irish presence in Bristol, the first Roman Catholic Church was built in Bristol in 1855. However, industry in Bristol was growing faster than the rickforce, and a massive campaign was launched to recruit cheap foreign labor, or more specifically the Italians. The Italians were the present moment study wave of immigrants to reach Bristol a high concentration immigrated around the 1880s (DiGati 16). The third major migration to reach Bristol is the most important, and the reason why today half the add population is from Portuguese ancestry and 20% of the homes still speak the Portuguese language (Census 1990). The Portuguese influx into Bristol has been steady and constant throughout most of the 20th century, and exploded immensely during the late 1970 s as vol moveic eruptions created havoc among the Azorean Islands (DiGati 16). The Portuguese, bid other ethnic groups, brought a culture that is clearly unambiguous today in Bristol.Unfortunately, there is a dark side to Bristols history that must be mentioned. Bristol actively, and openly engaged in the trading of slaves. among the years of 1804 and 1807, 8,238 slaves were delivered to be sold by Rhode Island ships (DiGati 15). How could Bristol engage in this enterprise? The answer is money.Today Bristol is a prominent town in the State of Rhode Island and economy Plantations, and serves as the seat of Bristol County in Rhode Island. Located on a peninsula between Narragansett and Mount Hope Bays, Bristol is about 12 miles southeast of Providence and 12 miles north of Newport. With a population of 22, 000, Bristol is easily accessible from despatch 114 or Route 136 via Route 195, and from the Mount Hope Bridge via Route 24 (http//www.town.bristol.ri.us/about1.htm). To the we st of Bristols border is the Narragansett Bay, which gives Bristol excellent access to the Atlantic Ocean.The demographics of Bristol help to create a diverse town. Census data reveals many changes and patterns of certain demographics within Bristol. Population demographics revealed by the 1960 census give keen insight into the town of Bristol during the 1960s. The total population of Bristol in 1960 was 14,570 of this total a mere 26 were nonwhite who inhabited Bristol (1960 Census). The African American population in Bristol at that time was to the highest degree nonexistent. In terms of the minority presence in Bristol, nothing has changed over the years. From 1960 to 1990 the population of Bristol has grown to 21,624 persons of this quash a mere 60 are from African decent (1990 Census). A coarse disparity exists between the population of whites and blacks in Bristol. Statements made by minorities in Bristol gives insight into the reasons why this disparity exists. There is a feeling that opportunities are available, but, maybe, the property is too expensive for minorities to afford to buy. Donald Isom, a concerned occupant of Bristol, stird, position is expensive in Bristol, and minorities just cant afford it. Hopefully as wages for minorities increase, property will become more affordable for minorities in Bristol.Another interesting demographic characteristic that has remained intact over the years is the relative stability of the ethnic composition in the town of Bristol. In 1960 the total number of foreign born residing in Bristol was 2,367 of this total 1,476 were Portuguese a distant second were the Italians, which had 474 foreign born residents in Bristol (1960 Census). At the present time, little has changed in the ethnic composition of Bristol. According to the 1960 Census, 9,146 declared Portuguese ancestrynearly half of the total population of Bristol again the Italians were a distant second with 4,768 declaring Italian ancestry. These st atistics leave little doubt that the Portuguese are a dominant factor in the population of Bristol. The impact of the Portuguese on Bristol can also be seen by the language grouping in the area. A whopping 4,554 persons speak Portuguese at home, which constitutes 20% of the total population. The Portuguese have been able to preserve their culture in Bristol the language data clearly explains this.Bristol is getting old these days. The population of Bristol has been growing gradually older throughout the years. In 1960, 10% of the total population was ages 65 or older. As of 1990 the proportion has doubled to nearly 20% (1960 1990 Census). The aging of Bristol can be attributed to improved health check treatments since 1960. The proportion of men to women in Bristol has remained the same since 1960, equally divided between men and women (1960 1990 Census).Income statistics in Bristol raise questions about equality in the town. A great disparity exists between men and women and the ir average yearly income. However, the gap in income has closed somewhat since 1960. In 1960, the average male, working full time, earned approximately $3,846 per year, while the average woman earned less than half that totala mere $1,828 dollars (1960 Census). By 1990 the gap had closed significantly, but not equal to merit full equality. The median income of a female working full time was $18,402, while the median income of a male working full time was $27,422 (1990 Census). Although the situation has improved, there is a long way to go, not only for Bristol but also for the rest of the country. The disparity between wages is not a problem just for Bristol, but its a problem that faces the nation as a whole. Sandra Pereira, an employee of Coastal Medical in Bristol, stated her concerns on this matter, men are the ones who own most of the businesses in Bristol and they hire other males and pay them the big money. More women have to get better educated and take an active role in b usiness, and hopefully women will make more money than men.Housing statistics reveal interesting traits in Bristol. In 1960 there were 4,284 homes in Bristol, and 3832 of them were engaged. The owner occupied 3,326 homes or 86.8%, while the remaining 506 homes were rented (Census 1960). Obviously, as of 1960, a great number of Bristolians owned a home, compared to those who rented. Things have changed in the modern Bristol. By 1990 the homes in Bristol grew from 4,284 in 1960 to a staggering 7,959. The owner occupied 4,863 housing units, while 2,592 units were rented (1990 Census). Although the proportion of renters has changed since 1960, there is still a greater majority of those who own homes compared to those who rent.What is life like today in Bristol? The answer to the question depends upon the person who is answering the question. The question What do you like/dislike about Bristol and Why? met different answers from different people. A young teen living in Bristol, answered the question with a resounding No There isnt anything exciting to do in this town. His answer is perhaps a little harsh, but it does have some validity. There is Colt State Park, but the beach there is not a major tourist attraction. It is a park where families can have cookouts, but nothing overly exciting. There are museums and historical houses that can be visited, but again nothing compares to an entertainment park or a mall, which Bristol has neither. Most of the younger people yearned for something of that magnitude in Bristol. When the question was posed to older people different answers were acquired. Sandra Pereira a town resident in her mid forties proclaimed, I really love Bristol because it is a quiet, close community. An African American in his early 20s answered, Bristol would be a better place if more opportunities are made available to all races. champion major complaint that seemed to plague most residents was the horrible traffic that engulfs Bristol. congestion is most common among routes 114 and 136. These are the two main roads that go through Bristol, and these are the two roads that are most congested with traffic. One possible solution to this problem would be converting route 136 into a four-lane road to ease traffic congestion. However, local government cannot solve this particular issue. Route 136 is a state road therefore it must be augmented by the state. As of today the traffic problem is in a state of gridlock between Bristolians and the State of Rhode Island.Another issue that faces Bristol is the after effects of Bristol/Warren regionalization. For the past 6 years the Bristol and Warren school departments have been merged in the hopes of saving money. Students from Bristol are bussed to certain schools in Warren, while students from Warren are bussed to certain schools in Bristol. This new system has been in effect for over 6 years, and complaints are rising from Bristol. The Bristol/Warren nurture Committee was promised f unds from the state, but the new governor reneged on that proposal. Now Bristol has swallowed much of the debt inherited from the Warren School Department. Property taxes have also increased when they were supposed to decrease. Anger and frustration are themes of school committee meetings. Residents of Bristol and Warren must work together to do what is best for the education of our young people. We must cooperate or we will suffer, stated Thomas Scuba, member of the Bristol/Warren School Committee. The issue is a warm one and definitely needs cooperation for it to succeed. Regionalization is too far along to reverse, so it must be dealt with.Bristol, indeed, is a great place to live, work, and recreate. Violent crime is virtually nonexistent in Bristol, and the community seems more like a family than anything else. This is best seen by the massive 4th of July Parade that engulfs Bristol each year. The oldest continuous independence march in the country attracted 250,000 people to Bristol last year (http//www.town.bristol.ri.us/hmepge.htm). Colt State Park and many museums make Bristol a fun and cultural place to live in and visit. Jobs are widely available in Bristol. Manufacturing of machines, the fishing industry, and the service industry make Bristol an easy place to find a job. There is, undoubtedly, room for progress in the town of Bristol. Opportunities must be available for minorities and women must earn a wage equal to that of men.In an interview with a longtime resident of Bristol, many emotions were uncovered. Maria Menezes, an immigrant into Bristol in 1944, has seen Bristol go through many changes. She has first hand knowledge of Bristols changing from a manufacturing powerhousedominated by mills, and factoriesto the service economy of today. Its bad that plants closed, but I still love my homeBristol. Throughout her life she has loved Bristol, and it is understandable why.I have great faith in the future of Bristol. Bristol has a rich history, and dynamic ambiance. Certain problems within Bristol need to be addressed. More funds should be made available to decrease traffic and make roads more efficient. The state of animosity between Warren and Bristol over regionalization must also be dealt with. The two sides ought to come together, put aside their differences and do what is best for the both of them. If that means separationso be it. There is no doubt that Bristol will work through these problems and continue to progress. All in all, I look forward to the future and success of the town of Bristol.

Gangs: Power, Conflict, And Trust :: Gang Essays

Gangs suck become a harsh reality in todays society. But despite what one skill think, gangs illustrate many communication theories. This is done through the superpower gangs possesses, "gang warfare", and the trust between gang members.Gang power can be seen in many communication theories. There are several types of power that gangs and gang leaders f solely under. An example of this would be referent and legitimate power. denotive power can be described as the role model power. We identify with this person and therefore try to be like them. Legitimate power comes from people who we believe should be in power, like children to teacher, law-abiding citizen to the police. Therefore referent and legitimate power go hand in hand, because of the organizational bodily structure within the gang, a gang may "have officers much like that of a cooperation." (Internet Source 1) Generally "adults play leadership roles." (Internet Source 3) Also youngsters who have had severe prison terms are usually found to be the leaders of the gangs, thus being an example of respectable power. The reason this is considered an example of expert power is because the individual possesses special knowledge in prison life, etc. By serving a prison term they can come pricker to the streets, "with more knowledge than ever could have been gained on the streets." (Internet Source 2)Attitudes, meaning how we as people respond to a subject, values, what we perceive is right and wrong, and beliefs play a major role in what brings youngsters into gangs. How does one develop a "gang attitude" to begin with? To answer this we must life at the culture. The values we Americans lam to have, make the alternative life style very appealing, this in conjunction with the glorified gang life style portrayed through the lyrics of the "Gangsta" rap artists all influence the young impressionable mind. This may make the child feel a sense of power, identi ty, or family, reflecting on the childs attitude. Also one must look at the neighborhood. A child can turn a corner and buy cocaine, see a gang war being played out, etc. It is obvious that the child cannot help but be influenced by this.Gang conflicts boils down to who has power and who wants, and/or deserves it. Most conflict is not within in the gang itself but between two gangs. Conflict can be described as a struggle over ideas or concepts between two parties, or people.

The Police Exception And The Domestic Abuse Law Essay -- essays resear

The Police Exception and the Domestic Abuse LawBeating a spouse is wrong. Fighting is wrong. Domestic Abuse is wrong. Thisis a very simple concept and lawmakers, police police officers, and citizens of ourcountry for years have been in majority agreeance with these concepts. champion ofthe punishments our government has come up with for convicted domestic abusersis revoking the privilege to choose weapons in public. This prevents convictedabusive citizens from having the ability to tote a potentially murderous weaponaround, at any time ready to be assistance to their destructive and unstablepersonalities wishes. Police amendended. Officers have recently been added tothe list of mickle who are not allowed to carry guns in public if they have beenconvicted of Domestic Abuse. Some precincts are outraged, however this seems tobe the proper law and should stay as it isLaw officers are human, and expert like everyone else, they make mistakes. An up-and-coming officer could get in a s kirmish at the local bar and be charged withDomestic Abuse. This same officer could become one of the most effective lawenforcers in the country. With this law, this officer would not be allowed tocontinue his services for his county and his fellow police officers. Manypeople feel that this officer is being done a great injustice and should beallowed to continue his otherwise flawless career as an officer of the law.Interesting. maven simple conviction could ruin the lives of every cop in the cou...