Healthcare External and Internal

Question: Create a mission and vision statement for your organization. Determine three specific strategic goals that align with the ideals in those two statements. Answer: External And Internal Factors Affecting Healthcare Organizations The present scenario for hospitals is very unpredictable, uncertain and complex. To sustain in the business of healthcare, organizations need to provide quality care to the patients, meeting their need and satisfaction. Patients satisfaction is associated with their loyalty and belief in the organization, adding up to the profitability. However, currently one of the major challenges to the healthcare system is the advent of patient protection and affordable care act- 2010 (PPACA), which further affects the internal functioning of hospitals. According to the act, hospitals and physicians will be altering their practices by demanding lesser fees and providing technologically and clinically efficient treatment for better health outcomes of patients. Thus, it has put an extra burden on these organizations to sustain their services, causing many of them to shut. Although being one of the most regulated industries, healthcare industry is getting weaker owing to this act, wherein underpayme nts to physicians has compromised the patient care. Hence, to provide quality care to the patients and remain financially solvent, strategic management has become a necessity. Internal and External Factors in Healthcare A clear understanding of antecedents to quality care can help develop a better strategy and framework for an organization to excel in medical services. Proper functioning of an organization is dependent on its productivity, profitability, and patients satisfaction. Hence, firstly it needs to identify the internal and external forces in their growth. (Templeton et. al., 2016) External factors. a) Government laws. Certain state and federal level regulations by government in favor of the patients negatively impact the healthcare organizations. The PPACA act in US has pressurized the healthcare systems to cut down the cost and increase the quality and technology of treatment. However, in small scale organizations like ours, due to lack of sufficient finance it gets difficult to implement the changes. Additionally, lowering down of primary physician fees and prescription of less costly generics as compared to innovators will ultimately affect revenue and profitability of the hospital. Thus, making it all the more complex in installation of advanced equipments and systems for patient control. The Medicares physician reimbursement further increases the burden by increasing the staffing cost to hospitals while decreasing reimbursements, thus, disturbing the balance within the organization as a result of decreasing quality of service (Fodeman, 2016). b) Availability of resources. Quality of services and profits are highly dependent on the availability of healthcare resources. Due to higher demand for advanced diagnostic equipments and effective medicines, the resources are becoming limited. Therefore, the problem of allocation of resources and funds arise, leading to insufficient infrastructure, limited access to new effective drugs and hence low quality service and patient dissatisfaction. As a consequence, it can cause poor patient reviews further leading to shutting down of the organization (Mosadeghrad, 2013). Internal factors. a) Job dissatisfaction. Changes in the regulations have led to an increase in job dissatisfaction among the physicians and nurses. Some of the factors crucial in job satisfaction are pay, management, policies in the organization, job security, promotions etc. With changes in laws, most of the healthcare providers are getting paid less in comparison to the amount of work and time they devote to patients. To maintain previous income they are forced to treat more number of patients. This, on the more is responsible for increased employee turnover in the organization. Thereby the organization to get its finance has to increase the number of beds with limited attention to the patients. Thus, the burden of this is faced by the patients, with decrease in face-time with doctors, compromised care, and quick discharges. The regressive environment of the hospital ultimately hinders the quality of care. Moreover, the promotion rules, being majorly based on the number of articles published, years in service and exams passed rather than quality of service provided and patients treated, have added to the dissatisfaction among the doctors (Scheppersa et.al., 2006). b) Physician competence and skills. Keeping all the other factors aside, for a hospital to have excellent quality of service, it is necessary to have competent physicians. Technically sound workforce, with knowledge, experience and capability is a key to success. No matter how adverse the other situations are, if a hospitals staffs and physicians are superior, patients will believe in its service. Additionally, being acquainted with recent therapies, treatments and discoveries in their field, the employees should also be well informed of the organizations culture and regulations. This necessitates the modification in the recruitment and management procedures of our organization, wherein attitude, knowledge, skills, expertise etc. of a physician should be kept forth (Mosadeghrad, 2014). Competitive strategy development. For the care and services to prosper in the organization, it is essential to develop a strategic planning that recognizes and deals with the changes in external and internal threats. But targeting these factors with a single competitive strategy is a challenge for the management. Changes in government laws, job satisfaction and resource limitation are somewhere linked to each other. However, for efficient workforce development, approaches such as training programs and stringent recruitment procedures are required. These identified factors weaken the hospitals position in the external competitive environment, questioning its managerial system. With changing government laws, it is complex to balance between the finance/funds and services of the hospital, including payment to the staffs and physicians, which leads the employees to switch their job. As a result, the organization runs short of good healthcare providers and treatments. This will further hamper the strategy building process , as lack of good and satisfied staffing will make the strategy implementation even more difficult. Additionally, the factors identified make it complex for the management to decide whether to allocate funds on physicians salary, recruitment of excellent physicians and staffs or on advanced treatment procedures and resources for achieving quality care. Therefore, an efficient strategy needs to be built for minimizing the negative impacts of these factors (Rivers and Glover, 2008). Addressing threats with strategic planning. In the recent scenario, with all the new discoveries being made in the healthcare sector and introduction of new techniques, the competition has increased. This has further strengthened the impact of the above factors. Hence, for maintaining the momentum of strategic plan and becoming resilient to changes in the healthcare sector, the organizations goals should first be made clear with focus on limited number of services. Supplementary to this, a deep study of all the threats, their possible causes and consequences along with their relational perspectives must be done. To address the currently persisting major issues the management should utilize the factory approach i.e. focusing on specific diseases such as cancer, diabetes and heart diseases. This will minimize the resource allocation problem and increase efficiency of patient treatment and quality of care. It further solves the problems of job dissatisfaction among the physicians due to low pay, as the limited number of specialists for specific diseases can be paid higher. Additionally, narrowing down the scope paves way for patient-centered treatment approach that facilitates more attention to the patients rather than less face-time. This patient-centered approach, educating the patients about their health, and providing full freedom to participate in the decision making process, will make them more comfortable and satisfied (Kim et. al., 2015). Patients satisfaction increases their loyalty for an organization and helps in improving its reputation and profitability, because when it comes to health people opt for quality rather than paying less. Conclusion Although in the current scenario, with changes in external environment the internal hospital momentum is getting disturbed. However, with the application of several analytical models, these negatively impacting forces can be analyzed. The organization must not divert from the original goal, which is patients welfare, other requirements including profitability, employee satisfaction and resources will follow that ultimately. References Fodeman, J. The new health law: bad for doctors, awful for patients. The institute for healthcare consumerism. Retrieved January 13, 2016, from https://www.theihcc.com/en/communities/policy_legislation/the-new-health-law-bad-for-doctors-awful-for-patie_gn17y01k.html Kim, H.S., Kim, Y. H., Woo, J.S., and Hyun, S. J. (2015). An analysis of organizational performance based on hospital specialization level and strategy type. PLoS One, 10(7), e0132257. Mosadeghrad, A. M. (2014). Factors affecting medical service quality. Iranian journal of public health, 43(2), 210220. Mosadeghrad, A.M., Ferdosi, M., Afshar, H., Hosseini, N.M. (2013) The impact of top management turnover on quality management implementation.Medical archives, 67, 13440. Rivers, P.A., and Glover, S. H. (2008). Health care competition, strategic mission, and patient satisfaction: research model and propositions. Journal of health organization and management, 22(6), 627641. Scheppersa, E., Dongenb, E. V., Dekkerc, J., Geertzend, J., and Dekkere, J. (2006). Potential barriers to the use of health services among ethnic minorities: a review. Family practice,23(3), 325-348. Templeton, A.R., Young, L., Bish, A., Gnich, W., Cassie, H., Treweek, S., Bonetti, D., Stirling, D., Macpherson, L., McCann, S., Clarkson, J., Ramsay, C. (2016). Patient-, organization-, and system-level barriers and facilitators to preventive oral health care: a convergent mixed-methods study in primary dental care. Implementation Science, 1(1),5.

Global Business World Economic Development

Question: Discuss about theGlobal Business for World Economic Development. Answer: Introduction: Globalisation has captured the imagination and fancy of the various businesses on a global scale as it has completely captured the marketplace. With the scope and size of globalised economy is increasing at a rapid pace, it is having implications for the various stakeholders of the society including domestic businesses. The wave of globalisation had led to rapid economic development in the third world countries. Also, it has limited the movement of goods and capital across borders and therefore enhanced the overall integration of the global economy (Weiss, 2002). In this backdrop, the given essay aims to comment on the significance of globalisation for the survival and growth of domestic businesses globally. Globalisation has led to a fundamental change in the business environment globally and has become a key force behind the survival of businesses while presenting them with a growth opportunity. In case of developed nations, globalisation has led to global access to products and services through the e-commerce route (Akram, 2011). As a result, it has becomes imperative for the domestic businesses in these countries to enhance their cost competitiveness so as to continue to survive. This is enabled through globalisation which presents lucrative outsourcing operations to cheaper destination based in Asia. Most of the non-core works are outsourced and also manufacturing operations are outsourced to third world countries in a bid to save cost (Rodrik, 2002). Further, globalisation also presents a lucrative opportunity to the domestic businesses based in developed nations as these can now expand their markets to lucrative developing nations. For most of these businesses, the domestic market is also saturated and hence the presence in huge consumer markets of Asia with rich purchasing power is an exciting opportunity to deliver sustainable returns for their shareholders. This only has led to the increasing presence of MNC (Multinational Corporations) based out of developed countries. Also, there are other businesses which set up their manufacturing bases in the developing nations and therefore leverage the local resources available (Redding, 2000). Globalisation also brings significant gains on the table for businesses based in developing nations as these nations have limited availability of capital and technology but abundant supply of labour. As a result, most of the work processes are labour dominated and therefore the productivity is comparatively lower. Over a period of time, this inefficiency starts taking a toll on the businesses and hence these are not able to survive in the long run especially as competition enhances owing to the entry of foreign firms (Hamdi, 2013). With globalisation as an enabling force, the developing nations business tend to gain access to capital and latest technology and therefore witness economic progress (Berman Machin, 2000). Further, owing to globalisation the business flow to businesses in the developing world tends to increase in the form of outsourced jobs. Besides, with the global companies shifting their manufacturing bases, a lucrative opportunity for expansion is presented to local b usinesses. Also, the local businesses can look to market their products to the western markets and hence grow their business (Hartungi, 2006). However, while globalisation is considered to a game changer but essentially it is a double edged sword as it has adverse implications also. In case of businesses based in developed countries, globalisation implies that the big companies have put in place a global supply chain based on significant outsourcing which has resulted in lowering product costs. However, for the small businesses, this is not a viable option and thus these are not able to compete with the MNCs. This is also true for developing nations where as a result of globalisation, the MNC are leading to the shutting down of small businesses (Stiglitz, 2002). Hence, on one hand globalisation leads to efficiency gains and on the other it eliminates the inefficient businesses globally (Weiss, 2002). The arguments above lead to the conclusion that there are potential negative impacts of globalisation but the positive impact on businesses tend to exceed the negative ones. Globalisation has enhanced the efficiency of various businesses globally by using that resource usage is decided in the global economy rather than national economy. In the developing world, the domestic businesses have reaped efficiency gains, rapid economic growth, export market and outsourcing contracts. In the developed world, the domestic businesses have become more cost competitive and also gained access to new and lucrative markets. In the modern world, international trade is a critical activity which enables the nations to make up for any deficiency. International trade plays an important role in ensuring that the scare resources are used in an efficient manner. The theoretical framework of international trade was laid more than couple of centuries ago in the form of theory of absolute advantage and theory of competitive advantage. These theories provided the basis for indulging in international trade and have been since modified so as to reflect the modern norms (Mankiw, 2012). In this backdrop, the essay aims to highlight the difference between these along with limitations. It is noteworthy that international trade is advocated since the various nations have differential access to factors of production and therefore their efficiency in production of goods tends to be different. The primary difference between the two theories is in the metric used for measurement of efficiency. Adam Smith gave the theory of absolute advantage, As per this, the advantage with regards to production of good is determined by the production cost and hence the nation which produces a given good at a lower cost would tend to have absolute advantage with regards to that particular good. For efficiency gains, this theory advocates that only the nation having absolute advantage must produce the good and export to the other country where it is expensive to produce the same good (Dombusch, Fischer Startz, 2012). The absolute advantage theory does have some limitations. It assumed that there would be no currency fluctuations and hence the exchange rates would continue to remain constant which does not happen in the real world. Besides, it simply ignores the transportation costs involved in export which needs to be added to the production cost before comparing with cost in the importing nation. Another, simplistic assumption in the theory is the use of labour for production of different goods with the same amount of efficiency. This would be incorrect especially in modern businesses where level of specialisation has increased only (Krugman Wells, 2012). The usage of absolute advantage theory also presents a confusing situation when a given nation possesses absolute advantage over the other nation in production of all products and therefore it is not clear as to what the importing nation should do with its resources (McConnell, Brue Flynn, 2014). The theory of comparative advantage given by Ricardo provides viable solution to the given situation. Unlike absolute advantage, Ricardo advocates that the economic efficiency in production should not be measured by the underlying production cost but by the opportunity cost incurred for production. Hence, in case of nation which manufactures all goods with absolute advantage, opportunity cost must be computed and compared with the other nation. Therefore, usually this would result that both countries tend to utilise their resources in the best possible manner and through trading reap gains (Mankiw, 2012). Even though the theory of comparative advantage is considered better than corresponding theory of absolute advantage, but it does have some flaws which has resulted in this being modified over the years. It simply ignores the transportation costs involved in export which needs to be added to the production cost before comparing with cost in the importing nation. Further, due to increase specialisation caused due to comparative advantage may lead to inefficiency in the form of diseconomies of scale (Dombusch, Fischer Startz, 2012). Besides, no consideration during the theory is given to the presence of various government restrictions in the form of various trade barriers (both tariff and non-tariff) which tend to play a critical role in modern international trade. Also, the model looks at advantage in a static manner and is not open to the possibility of alterations in the comparative advantage due to developments in factors of production (Krugman Wells, 2012). The discussion conducted above in wake of the arguments clearly indicates that the main point separating the two theories is the fact that absolute advantage is based on lower cost of production unlike comparative advantage which is derived from lower opportunity cost. These theories have limited direct utility in the modern world due to their simplistic assumptions with regards to nonexistence of transportation cost, government barriers in trade, alterations in factors of production along with currency fluctuations. Despite the above shortcomings, these two theories were pioneers in international trade theories and hence most of the modern day theories tend to derive their conceptual source from one of these theories only. References Akram, M, Faheem, FA, Dost, MKB Abdullah, I 2011, Globalization and its Impacts on the World Economic Development, International Journal of Business and Social Science, vol. 2, no.23, pp. 291-297 Berman, E Machin, S 2000, Skill-biased Technology Transfer around the World, Oxford Review of Economic Policy, Vol.16 No 2, pp.12-22. Dombusch, R, Fischer, S Startz, R 2012.Macroeconomics, McGraw Hill Publications, New York Hamdi, FM 2013, The Impact of Globalization in the Developing Countries, Development Country Studies, Vol. 3 No. 11, pp.141-143 Hartungi, B 2006, Could developing countries take the benefit of globalisation?,International Journal of Social Economics, Vol. 33 No. 11, pp.728 743 Krugman, P Wells, R 2012. Macroeconomics, Worth Publishers, London Mankiw, G 2012. Principles of Macroeconomics, Cengage Learning, London McConnell, C, Brue, S Flynn, S 2014. Macroeconomics: Principles, Problems, Policies, McGraw Hill/Irwin Publications, New York Redding, S 1999, Globalisation,Economic Review, Vol. 17 No. 2, pp.16à ¢Ã¢â€š ¬Ã‚ 19, Rodrik, D 2002, Globalization for whom?,Harvard Magazine, Vol. 104 No. 6, pp. 27-32 Stiglitz, JE 2002, Globalism's Discontents,The American Prospect, Vol. 13 No. 1, pp.37-43 Weiss, J 2002,Industrialisation and Globalisation: Theory and Evidence from Developing Countries, Routledge,London.

Grapes Of Wrath Essays (1083 words) - U.S. Route 66, Dust Bowl

Grapes Of Wrath The Grapes of Wrath is a novel by John Steinbeck that exposes the desperate conditions under which the migratory farm families of America during the 1930's lived. The novel tells of one family's migration west to California through the great economic depression of the 1930's. The bank took possession of their land because the owners could not pay off their loan. The novel shows how the Joad family deals with moving to California, and how they survive the cruelty of the landowners that took advantage of them, their poverty, and willingness to work. The Grapes of Wrath combines Steinbeck adoration of the land, his simple hatred of corruption; resulting from materialism (money), and his abiding faith in the common people to overcome the hostile environment. The novel opens with a retaining picture of nature on rampage. The novel shows the men and women that are unbroken by nature. The theme is one of man verses a hostile environment. His body destroyed but his spirit is not broken. The method used to develop the theme of the novel is through the use of symbolism. There are several uses of symbols in the novel from the turtle at the beginning to the rain at the end. As each symbol is presented through the novel they show examples of the good and the bad things that exist within the novel. The opening chapter paints a vivid picture of the situation facing the drought-stricken farmers of Oklahoma. Dust is described as covering everything, smothering the life out of anything that wants to grow. The dust is symbolic of the erosion of the lives of the people. The dust is synonymous with "deadness". The land is a ruined way of life (farming), people uprooted and forced to leave. Secondly, the dust stands for profiteering banks in the background that squeeze the life out the land by forcing the people off the land. The soil, the people (farmers), have been drained of life and are exploited: The last rain fell on the red and gray country of Oklahoma in early May. The weeds became a dark green to protect themselves from the sun's unyielding rays... The wind grew stronger, uprooting the weakened corn, and the air became so filled with dust that the stars were not visible at night. As the book continues a turtle, which appears and reappears several times early in the novel, can be seen as standing for survival, a driving life force in all of mankind that cannot be beaten by nature or man. The turtle represents a hope that the trip to the west is survivable by the Joad family. The turtle further represents the migrants struggles against nature/man by overcoming every obstacle he encounters: the red ant in his path, the truck driver who tries to run over him, being captured in Tom Joad's jacket: And now a light truck approached, and as it came near, the driver saw the turtle and swerved to hit it. The driver of the truck works for a large company, who try to stop the migrants from going west, when the driver attempts to hit the turtle it is another example of the big powerful guy trying to flatten or kill the little guy. Steadily the turtle advances on, ironically to the southwest, the direction of the migration of people. The turtle is described as being lasting, ancient, old and wise: horny head, yellowed toenails, indestructible high dome of a shell, humorous old eyes. The driver of the truck, red ant, and Tom Joad's jacket are all symbolic of nature and man trying to stop the turtle from continuing his journey westward to the promise land. The turtle helps to develop the theme by showing its struggle against life comparing it with the Joad struggle against man. The grapes seem to symbolize both bitterness and copiousness. Grandpa, the oldest member of the Joad family, talks of the grapes as symbols of plenty; all his descriptions of what he is going to do with the grapes in California suggest contentment, freedom, the goal for which the Joad family strive for. The grapes that are talked about by Grandpa help to elaborate the theme by showing that no matter how nice everything seems in California, the truth is that their beauty is only skin deep, in their souls they are rotten. The willow tree that is located on the Joad's farm represents the Joad family. The willow is described as being unmovable and never bending to the wind or dust.

feminists perspectives on fema essays

feminists perspectives on fema essays The concept of female criminality is one which has until recently been given very little consideration to in terms of its unique needs and characteristics. Like most areas of research, the study of criminology is one which until recently has been dominated by male researchers which seemed logical in the sense that the majority of crimes committed were by men. Therefore any crimes committed by women were just explained using the theoretical concepts created for men. It is only since the beginning of the 1960s that feminist groups have taken an interest in the roots and causes of crimes committed by women. The reason for this current interest is the realization that crimes committed by women cannot simply be understood using theories created to explain male activities. To explain the phenomena of female criminality, many theoretical perspectives have been put forth. Rather than focusing on physiological and biological causations, which were the main ideologies proposed in the past, contemporary feminist theorist are now analyzing female criminality through an economic and social context. In doing so, feminist criminologists have put forth various theories to serve as an aid in explaining the rise of female criminality in Canada. A very well known criminology theory that was presented by Caesare Lombroso in the late 19th century was the theory of the Female Offender (Bowker, 28). In a time period when women were recognized as individual beings and respected for their needs and rights, Lombroso proposed the theory that female criminality was due to biological abnormalities. He based his research on womens prisons and courts that he had visited and on the measurements he had taken of the womens various body parts. In his findings, Lombroso noted that that the majority of the female inmates had physical abnormalities such as heavy lower jaws, large nasal spines, simple crania...

IT and Society Essay Example | Topics and Well Written Essays - 2500 words

IT and Society - Essay Example E-mail and instant messaging is also an effective way to communicate by sending and receiving messages. An optimistic view of this is that information technology promotes communication between people and must therefore help to spread social and international understanding. People who are thousands of miles apart, either literally or socially speaking, can communicate through 'chat' groups, bulletin boards or e-mail; they can obtain information on different ways of life through World Wide Web sites and even experience the 'virtual reality' of other ways of life through interactive programs. More efficient production using IT creates more wealth, which can be shared amongst all the groups concerned. It can thus be argued that the technology has a built-in bias in favour of reducing social and economic divisions. (Tansey, 2002, p. 214) Perrons (2004) holds the opinion that technology develops within specific sets of economic and social arrangements and technological possibilities are not realised automatically, that is social change does not automatically follow technology. Indeed the technology underpinning existed and was being implemented in the 1920s, but sustained accumulation did not follow. Changes were necessary in the prevailing mode of regulation, that is in the institutional arrangements within which individual and social reproduction takes place. (Perrons, 2004, p. 131) Perrons (2004) further states that the precise effects of e-commerce on economic and social development are contingent, varied and rapidly changing and therefore need to be explored empirically. The same processes or technologies that allow small firms access to world markets, which may enhance local development, simultaneously give peripheral consumers access to firms in the centre thereby facilitating the development of 'superstar' firms, and in turn potentially promote superstar regions. (Perrons, 2004, p. 180) In a broader spectrum IT helps telecommunications (TC) and networks to constantly implement to support organisational goals. Stair & Reynolds while providing an IT implementation example explains: suppose a business needs to develop an accurate monthly production forecast. Doing so requires a manger to download data from customers' databases of sales forecasts. TC can provide a network link so that the manager can access the data needed for the production forecast report, which in turn supports the company's objectives of better financial planning. (Stair & Reynolds, 2001, p. 146) The more individuals and organisations grasp the nature of the technology and its possibilities, the greater the probability they can influence the direction of change. A modest hope is that increased communication and a greater pooling of information should in the long run make it easier for people, organisations and states to reach, if not a consensus on what should be done, at least informed compromises on how to live together. (Tansey, 2002, p. 214) Presently, IT has enabled our social system to confront with social change in the

Best Assessment Strategies in Secondary Schools Essay

Best Assessment Strategies in Secondary Schools - Essay Example Interactive assessment in the classroom assumes special significance at the secondary level as students need constant feedbacks for the learning activities they undertake. There should be regular assessment at the secondary level. This is rightly suggested by E.C. Wragg when he remarks: " In most of the class rooms, assessment tends to be regular and informal, rather than irregular and formal. This is because teaching often consists of frequent switches in who speaks and who listens, and teachers make many of their decisions within one second." (Wragg, 2001). The purpose of this paper is to analyse critically the best assessment strategies in secondary schools. Interactive assessment, coherent assessment systems, self assessment, peer assessment, and feedback are identified as the most effective strategies in the assessment of the learning outcomes of secondary students. The teaching-learning process is highly interactive and assessment during each stage of the interaction is an essential prerequisite for effective learning process. ... One of the major advantages of the interactive assessment is that it creates a strong conviction in the minds of the learners that they are an active part of the instructional process and that their views and thoughts are being taken into account. This can provide them with better confidence to take part more enthusiastically in the teaching learning process. A remarkable study conducted by Eichorn, D. & Woodrow, J. (1999) "indicate that the use of interactive assessment promotes student self-monitoring, goal setting, time management, responsibility and mastery learning. Teachers report that the use of interactive assessment facilitates and supports student-centred, instructional practices." (Eichorn & Woodrow, 1999, P.193-199). Celina Byers (2001) also believes that the teacher has to measure and evaluate whether all the instructional objectives have been achieved and how far learning has taken place is to be assessed. She is of the opinion that there should be a learner centred act ive assessment in the classroom itself :- "Making the measurement an integral part of class activity allows the identification of problems and consequent improvements even while the course is ongoing. Learner-centred active assessment both provide direct objective measurement of learning and stimulate the use of holistic assessment tools to assess the entire learning environment." (Byers, 2001). For her assessment in the secondary school should never be limited to mere summative evaluation. Instead, there should be interactive assessment in the class room as "it permits important course improvements, made in conjunction with the collaboration of the students themselves, while the course is ongoing.

Professional Issue Essay Example | Topics and Well Written Essays - 3000 words

Professional Issue - Essay Example In nursing, a combination of clinical experience, technical skill and theoretical knowledge is required in providing high standard care (Funnell et al 2009). Hence, an Act of Parliament in 2002 created the Nursing and Midwifery Council (NMC) to regulate nurses, and protect the public by ensuring that nurses provide high standard of care to the patients (Kozier et al 2008). NMC code of conduct stipulates that nurses are obligated to act ethically and are accountable for their own actions (NMC 2010). This essay will reflect on the roles and responsibilities of a registered nurse in relation to consent to treatment. For this reflection, I will apply Driscoll’s (2007) reflection model that asks three main questions: What? So what? and Now, what? (Bulman & Schultz 2008). To protect the anonymity of patients and staff, real names shall not be used (NMC 2008). Nurse role in relation to consent What? Luke is an 18 year old male with a diagnosis of major depressive with psychotic sympt oms. He was admitted informally to acute mental health inpatient following an impulsive overdose few months after the death of his father. On a morning shift during my placement, Luke was elated in mood, very anxious and was observed to be experiencing auditory hallucination saying that â€Å"he wants to go and rest with his deceased father". Hence, Nurse A decided to urgently administer his medication after consulting with the duty doctor who prescribed Risperidone 2mg. Luke refused to take the medication stating that his mum has not been informed. However, Nurse A had an informal discussion with Luke where she informed Luke that he would not be allowed to the servery if he does not take his medication. Hence, Luke reluctantly took the medication without formally consenting to it. Hence, Nurse A breached the informed consent requisite to care when she failed to adequately provide information to Luke and his mother and enable them to make an informed decision. So What? Luke was adm itted informally and had previously made an advanced directive to have his mother make the medical decisions for him. Elkin et al (2007) noted that in advance directives, patients communicate their wishes or values about future medical care to help guide decisions that include overwhelming illness, sedating drugs or unconsciousness, when the patient can no longer participate. It is a means of empowering a person with mental illness by increasing autonomy and decreasing coercion in the treatment they receive (Kozeir et al 2008). According to the Department of Health (DoH 2008), patients may want to nominate a person to be notified of, or involved in, decisions related to their treatment and care. The involvement of his mum can have a major benefit for the treatment and care of Luke. DoH (2008) asserts that such involvement can provide reassurance to Luke, who may feel distrustful of practitioners who are relatively unfamiliar and unknown to him, or able to impose compulsory measures on him. However, Nurse A administered the medication without adequately informing the patient and his mother. Thus, nurse A’s actions violate Luke’s right to informed consent. The role of nurses is to gain informed consent based on the provisions on standards of conduct indicated by the Nursing and Midwifery Council (2008). Even if Luke handed the reins of the decision-making authority to his mother, Mental Capacity Act (MCA 2007) stipulates that patients must be informed in which circumstances they can be treated without