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While Many Ancient Cultures Developed Sophisticated Astronomical… My Assignment Essay Help London

While many ancient cultures developed sophisticated astronomical ideas, the Greeks had a large influence on cultures in Europe and the Middle East because of their cultural interaction. Did any of the Greek measurements or ideas discussed in the video surprise you? What ideas were “lost” and “rediscovered” centuries later?
While it may look like the stars are all attached to a giant rotating sphere, we know that isn’t the case. So why would astronomy teachers still discuss the celestial sphere and teach students about it? In what way is the concept still useful?
How much of the sky can you see from the north pole? How much of the sky can you see from a latitude of 45°? Is there any place on Earth where a person could observe all of the stars during the course of the year? Explain your answer.
What preconceptions kept people like Aristotle and Ptolemy from building a correct model of the solar system? Why did they have those preconceptions? How did the observations that Galileo made help other people to give up those preconceptions?
The Copernican model of the solar system did not have Earth at the center of the universe. What were the cultural and philosophical implications of that?
Galileo had conflicts with the Catholic Church over his support of the heliocentric model of the solar system. Give a modern example of a time when someone or some group objected to a scientific theory without addressing the evidence itself. Why did they object to the theory? What were the preconceptions they had that kept them from accepting the theory? How could you try to address such objections?

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Character Analysis of Death of a Salesman high school essay help

Arthur Miller’s play Death of a Salesman takes on a lot of different themes in the course of the story. It focuses quite clearly on the idea of the American Dream and how the American Dream affects and influences people. While there are certain features of the American Dream that remain unchanged from person to person, Miller’s play reveals how other elements of the Dream differ from person to person. The audience is exposed to several different versions of the American Dream in the course of the play which are compared and contrasted as the conversations between the characters unfold.

But these conversations reveal more than the hopes and dreams of the characters in the play; they also reveal a great deal about the relationships between the characters. The main relationship of the play is the one between Willy, the titular salesman, and his son Biff. A lot of criticism focuses on their dynamic, suggesting that ultimately that relationship contributed to Biff’s inability to please his father and Willy’s (ambiguous) decision to commit suicide. But there is another relationship that bears closer examination: the relationship between Willy and his wife Linda. These two appear to talk “around” important subject matter, and this habit reveals several things about their relationship as well as about the characters, including the lack of trust between them, the disintegration of Willy’s mind, and Willy’s lack of respect for Linda.

When one speaks of talking “around” a subject, sometimes it is because the people involved – or maybe just a single person – aren’t sure they’re on the same page. Sometimes one person isn’t sure how much the other person understands. Perhaps, such as may be the case with Linda, as suggested by Miller, the people involved in the conversation simply lack “the temperament to utter and follow to their end” their inner feelings and desires (12). But one must also consider that their mutual refusal to directly engage on important topics is founded in a lack of trust.

When Willy returns home at the beginning of Act One, she asks him twice whether something has happened to make him return early, with the second question being surprisingly direct: “You didn’t smash the car, did you?” (Miller 13). Willy, of course, answers “with casual irritation” that “nothing happened. Didn’t you hear me?” Her asking that question twice implies that she didn’t trust the first answer, and his response of “Didn’t you hear me?” suggests that he doesn’t believe she listens to him. And at the end, after Willy’s death, Linda still can’t open up and say the words she wants to say to him. He can’t mock her or hurt her anymore, and yet she cannot ask him “Why did you kill yourself?” She can only ask “Why did you do it?” (Miller 139). This suggests that their intimate connection ended even before his death and continues in death, that her ability to trust any answer that might come from him or as regards him is gone.

One might also consider their inability to talk directly about things to be a symptom of Willy’s disintegrating mind. It seems obvious from the beginning of the story that something is going on with Willy mentally. Willy tells Linda at the beginning of the play about losing track of himself coming home: “Suddenly I realize I’m goin’ sixty miles an hour and I don’t remember the last five minutes. I’m – I can’t seem to – keep my mind to it” (Miller 13). He tells her it’s not his glasses when she proposes that that could be the problem, answering that “No, I see everything.” The idea that he sees everything is contradicted throughout the play, from his ability to truly see his own shortcomings to understanding how his behavior affects those around him (especially Linda) to his ability to acknowledge his suicidal tendencies.

Additionally, when Linda tries to engage with him, it is almost as though he cannot hear her, so wrapped up as he is in his own mind. In Act One Willy has a memory of his Uncle Ben describing how he walked into the jungle 17 and then walked out rich at 21, but the memory seems as much hallucination as it does memory. Linda finds him in this conversation and tries to engage with him, but he’s still stuck in the memory/hallucination of wealth. When he attempts to go take a walk, she tries to stop him – “But in your slippers, Willy!” (Miller 53). He seems not to hear her and wanders off. He cannot find comfort in her or her support – he only seems to find comfort in dreams and delusions. His inability to reveal to her his inner life, and her unwillingness to admit that there might be something wrong with him, are revealed in their inability to talk about things directly.

This inability to talk directly also reveals Willy’s disrespect of Linda, which says a lot about each of them separately. In Act Two, Willy tells Linda he wants to plant some seeds in the backyard; she replies that “not enough sun gets back there. Nothing’ll grow any more” (Miller 72). Willy’s response suggests that he’s not really listening to her, that she doesn’t know what she’s talking about, that her opinions aren’t worth noticing. Linda, for her part, instead of asserting herself or defending her opinions, simply replies, “You’ll do it yet, dear” (Miller 72). She allows Willy to dominate her and stream-roll her opinions, revealing her as a submissive, placating character, while Willy is revealed as a dominating, dismissive, disrespecting character.

Sometimes what isn’t said is just as telling as what is said. The fact that Willy and Linda talk “around” important topics reveals things about their relationship and about who they are as individuals. Their interactions reveal a lack of trust between them. They also reveal the disintegration of Willy’s mind (that is, maybe he’s not a jerk, he’s just losing his grip on reality). But regardless, those interactions also demonstrate that Willy doesn’t respect Linda, and she allows him to disrespect her, as she is submissive and his is dominant.

Death and Rebirth high school essay help

While Many Ancient Cultures Developed Sophisticated Astronomical… My Assignment Essay Help London

The importance of the concepts of death and rebirth to that of initiation are in one sense so fundamentally linked that it appears that one cannot speak properly of initiation without also referring to death and rebirth. Such an account is explicit for example in the work of Eliade, who writes that “the central moment of every initiation is represented by the ceremony symbolizing the death of the novice and his return to the fellowship of the living.” (xii) For Eliade, therefore, any process of initiation entails by definition the concepts of death and rebirth. Such a conclusion appears entirely coherent on an intuitive level. When we think about our common sense conceptions of initiation, this means a certain point of transition. The initiation, whatever it may be, from the ceremony of marriage or baptism to something more bureaucratic, such as graduating high school or college, means that we have finished with one stage of our existence. But this end point is not our end, but a new beginning, and thus it becomes apparent how both death and rebirth are fundamental to the initiation process.

Eliade concisely summarizes the symbolic value of death and rebirth to the initiation ritual as follows: “All the rites of rebirth or resurrection, and the symbols that they imply, indicate that the novice has attained to another mode of existence, inaccessible to those who have not undergone the initiatory ordeals, who have not tasted death.” (xiii) At the center of initiation, in other words, is a premise which implies a differentiation in what Eliade terms modes of existence, or, more simply put perhaps, how a given individual lives. The initiation is a point of transition, from one way of living to another. Returning to the marriage example, the individual who enters the marriage ritual lives in a different way than he or she has before, through the initiation of marriage now essentially leading an existence which is entirely different than that of the single person, an existence which is deeply tied to the marriage partner. Contemplating this initiation process and point of transition from the perspective of concepts of death and rebirth, therefore, the death aspect clearly indicates the end of the first mode of existence.

After an initiation, let us say, from university, one is no longer a student, but someone with a degree, a social status that has been changed forever. Therefore, there is a death of this first way of living of the individual. But this death, clearly, is also not the end: there is a rebirth, a rebirth into what Eliade would call the new mode of existence, which is now the university graduate, who now enters into a different world. Using this mundane example, therefore, there are now new possibilities for the university graduate, new jobs that he or she can pursue, as well as a new status within society as a whole.

Arnold van Gennep provides a similar point of view to that of Eliade about the integral link between an initiation process and the concepts of death and rebirth, whereby “the recurrence of rites, in important ceremonies among widely differing peoples, enacting death in one condition and resurrection in another” (13) becomes the basis of all forms of initiation. Once again, the theme is similar to that of Eliade: there is in a given rite or initiation the termination of one mode of existence and the beginning of another. The person who enters the ritual, as van Gennep writes, “enacts” death, that is, the ritual marks an end to the person’s former way of living, his or her in a certain sense past life. But this is clearly not the end of the initiation process: there is a subsequent step, the step of what von Gennep calls resurrection or rebirth, whereby the individual now continues to exist but in an entirely different manner than before.

Following the readings of Eliade and van Gennep, in one sense it appears inconceivable to think about initiation without a conceptual symbolic language of life and death. Every initiation marks a point of transition, a change in the individual’s life. In this case, there is a clear symbolic language of death and rebirth. This is because change in itself marks a point of transition, the end of one way of living and the beginning of another.

Society in Chronicle of a Death Foretold high school essay help

This paper describes the society depicted in this novel. It discusses the values accepted in this town, and in particular how they relate to gender roles. Finally, it discusses prejudices within the novel, and described the role those prejudices play in the murder.

The novel Chronicle of a Death Foretold depicts a society in which honour and reputation are values of paramount importance, particularly where those values concern the sexuality of women. The novel is shaped by the prejudice within this society that a woman’s sexual behaviour reflects her status and the status of her family, as it is this prejudice that forms the primary motivation for the murder.

Feminist theory describes the way in which women are raised in patriarchal societies to have no authority or independence, but instead to be possessions utilised for the furtherance of male status. This particularly the case in the novel, where the women – including the central character, Angela – form identities based on the assumption of marriage. Márquez writes that in Angela’s family “The brothers were brought up to be men. The girls were brought up to be married” (Márquez, 1996, p. 30). This demonstrates the clear value placed in this society on gender separation, with the women identified only by their connection to a man, even as the men are able to form identities based more solidly on their behaviour.

Marriage is important in the novel because of the prejudice against women’s sexual freedom, which is seen as reflecting poorly on their families as well as themselves. The prejudice against Angela’s illicit pre-marital sexual encounter is the prime motivator for the murder, as her family attempts to regain status within the society by erasing the evidence of Angela’s lack of honour. Describing the moment when Angela reveals Santiago’s name as her lover, Márquez writes that “she nailed it to the wall with her well-aimed dart, like a butterfly with no will whose sentence has always been written” (Márquez, 1996, p. 47). This metaphor demonstrates Angela’s vulnerability to the control of her male brothers, and the lack of authority she has over her own sexuality and life.

Despite the legal consequences suffered by Angela’s brothers, it is clear throughout the novel that society tacitly condones violence as a consequence of Angela’s illicit sexuality: although many people are aware of the threats of the Vicario brothers, no real effort is made to prevent the murder, nor to protect Angela’s rights or desires. The real murder in this novel is not of Santiago, but of Angela’s reputation. The actions of Santiago, Bayardo, and her brothers combine to destroy Angela’s hopes for a happy and respectable life, as her society views her purely in terms of her sexual behaviour.

As we can see then, this novel shows a society prejudiced against female authority and sexuality, and which values control over women’s honour.

Death and the Maiden Review high school essay help

The play “Death and the Maiden” was written by Ariel Dorfman in 1991 and it tells the story of a woman and man still recovering from the effects of violence in their home country. This is closely related to the playwright’s experience since she had just come from Chile which had been ruled by a dictatorship under General Augusto Pinochet. Research into his regime suggests it was very violent and regularly used terrorism to keep people in line, so people have speculated that some of the events in the play might have been true for Dorfman or people she knew.

The action of the play takes place in a remote beach house, but we don’t know just where this beach house is so it could be any country anywhere. What we do know about the country where the house is located is that it has just emerged from a dictatorship much like the one that Chile had experienced. Although the people are living mostly peacefully, they are still dealing with the effects of torture and violence from the past. The main characters in the play are Gerardo who is making his way as an attorney, and his wife Paulina. While Gerardo is finding a great deal of success since he was just given a presidential commission to work on human rights violations from the past, Paulina is having trouble dealing with her PTSD over the treatment she received herself, especially the time that she was raped and tortured by a doctor whose face she never saw but who played Schubert’s string quartet #14, also known as “Death and the Maiden.” When Gerardo’s car breaks down on the way home one night, he is given a ride by an older man named Dr. Roberto Miranda who is invited to stay for the night and Paulina becomes convinced that he is her assailant from that time based just on his voice, his skin, and his smell.

While the play is meant to convey a deep sense of danger and menace, Paulina spends a lot of time with a gun in her hand threatening Roberto for example, the way that she traps him at the house and forces an informal inquiry with Gerardo does not seem especially believable, such as Paulina sneaking out and hiding Roberto’s car so that he cannot get away. It also seems strange that two men who pride themselves on being so manly are unable to figure out a way to overpower a distraught woman who is not thinking clearly. Gerardo’s plan to record Paulina’s testimony and give it to Roberto to use for his false confession, after convincing Roberto that a false confession is the best way to calm Paulina down, also seems off somehow for a rising attorney. As they work through these different plot twists, we also find out that there was earlier betrayal between Paulina and Gerardo since she discovered him in bed with another woman when she first escaped from her torturers.

Thus, the fact that she doesn’t trust Roberto’s confession at the end is not surprising. She has no reason to trust either man’s sincerity through the process and claims she slipped inaccuracies into her testimony to Gerardo to see if Roberto would correct them accidentally, which he did and which prove that she never trusted either man through the process. When she puts the gun to Roberto’s head, the play prevents us from finding out what actually happened to Roberto by forcing us to question our own motives and relative victimhood or abuser status. In the end, the play offers no resolutions for the audience or for the characters making it seem very unsatisfying but forcing questions about it to continue circulating in the mind.

Death of a Salesman: Written Task high school essay help

Had Arthur Miller’s “Death of a Salesman” been written in Communist China in the same time period, the different context would create different meaning and interpretation of the theme of the failed American Dream. In order to support that different meaning, the play would likely be written slightly differently. It would be in the Chinese language; Biff would dream of Communism, rather than returning to the land; and the Loman’s would become Chinese migrants to American who thought they too could achieve the American Dream.

The play captures the last day before the death of Willy Loman, a victim of the American Dream. Even though each member of the family tries their best, they are not successful in meeting each other’s’ expectations or achieving their own dreams. Willy Loman is a travelling salesman in his sixties who has two sons and a wife. He has not always been faithful to his wife, and he has high expectations of his son Biff. Willy’s wife is committed to Willy and his dreams. She is willing to help Willy ignore reality and asks her sons for help. Willy’s oldest son had a lot of promise as a football player. Willy hoped for great success from Biff. After Biff discovered his dad’s affair in Boston he lost his interest in succeeding in business. Happy is Willy’s youngest son has a job and hopes to advance a career in business. He has many of the same dreams as his father. If the audience were Chinese Communists, the purpose of the play would change to one of empathy of the struggle to one of illustrating the wrongs of the American way.

The Loman’s might become a family of Chinese migrants who had come to America to seek a better life thirty years before. This would reinforce empathy with the characters for the Chinese audience. The play moves between Willy’s life between 1928 and 1942, which is the present in the play, in random order. The American Dream is what creates Willy’s expectations in life. This includes succeeding in business, becoming rich, and essentially winning. Willy has not been succeeding, and he is near the end of his career and his life. He realizes that his only way to cash in on the American Dream is to kill himself, as he is worth more dead and can give his child a chance at succeeding.

Willy said “After all the highways, and the trains, and the appointments, and the years, you end up worth more dead than alive”. This might be interpreted as the soulless nature of capitalism and the superiority of Communism (Miller, Act 2). The single act which would make him successful and reach the American Dream is his death, not his life and not the hard work that he has done for over thirty years. If Willy Loman were a Chinese immigrant worker who worked hard for 30 years without much benefit, this would become strong propaganda regarding not leaving China for the American Dream. The government of China in the twentieth century was very concerned about Western influences, and all manner of the arts were subject to review by government policy. For this reason, it would be wise to write the play in a manner that assures it will pass such reviews.

When Happy says “I’m gonna show you and everybody else that Willy Loman did not die in vain. He had a good dream. It’s the only dream you can have – to come out number one” it is clear that Happy does not fully understand all of the facts, or the short-sightedness of his father’s dreams (Miller, Act 2). Willy chooses to leave the insurance money to Biff, who wants to live close to the land, rather than his son Happy, who wants to succeed in business, and this displays the inefficiency and unfairness of the “system”. In a play rewritten for a Chinese audience, Biff, as the new head of the family, uses the insurance money to bring his mother and brother back to China. In this way the play would have a happy ending for this Chinese audience.

For a Chinese audience this link to the land would likely be well understood, although China was also going through an industrial revolution and more people were leaving farms for cities. Still, rather than the dream of returning to the land as a farmer, Biff might dream of Communism as the foil to his father’s love of the American Dream. This part might be written with specific government message lines in mind, as Chinese propaganda against America was a part of life in those times.

Miller’s play talks about hopes and dreams, and not reaching them. After the war, there were a lot of tensions with Russia, and there was fear of communism. In fact, Death of a Salesman was accused of being against capitalism and the American Dream (Griffin. 5). Because of this, there was controversy for Miller. He was also accused of being a communist. Given that this was the interpretation of his play by many of his contemporaries, Chinese communists, who had real fears and concerns about the American Dream, would have an even stronger connection to the criticism of capitalism inherent in this play. With just a few changes to the text it could serve as a strong warning to the Chinese of the dangers of Capitalism.

Nursing Theorist Jean Watson english essay help

It is remarkable to consider how, a century after Nightingale defined nursing as the caring and skilled profession it must be, a need arose for another nurse theorist/leader to reaffirm these basic values. This is the achievement of Jean Watson who, beginning in the 1970s, emphasized the humane values innate to nursing, yet widely lost in the 20th century’s focus on expertise and technology.

As Watson identified and promoted the carative factors supporting her philosophy of Human Caring Science, she modified and adapted these elements over time, yet the foundation has always remained in place, and it emphasizes a trusting and genuine relationship between the nurse and patient. In simple terms, Watson holds that the patients spiritual, personal, and emotional needs are as crucial to well-being as the physical, and the nurse’s authentic empathy translates to the patient to promote health in all ways. Evidence-based and skilled practice is essential (Chokwe, Wright, 2013, p. 2), but the greatest degree of expertise is inadequate if no caring exists within the nurse, and on the most visceral level.

The carative factors emphasized by Watson include practicing loving-kindness with the context of a caring consciousness, the nurse’s moving beyond ego-self, creating a healing environment, and allowing for miracles in healing which, when the theory is adopted, are by no means mysterious or even miraculous; they are the consequences when the entirety of the patient’s being is known and cared for by the nurse. In Watson’s thinking: “Both nursing and the teaching of nurses are careers that are life-giving and life-receiving, enabling lifelong learning and growth” (Ball, McGahee, 2013, p. 62).

All of this combines to reinforce that Jean Watson’s commitment and theory has established a necessary sense of the totality of the human being, as nurse and as patient, which in turn promotes the authentic and empathetic relationship crucial to all concerned. It is, in plain terms, a vitally needed reinforcement of the essential humanity within nursing initially stressed by Nightingale, and a theory of immense value.

Ball, J., & McGahee, T. W. (2013). Dedication of hands to nursing: A ceremony of caring. Journal of Nursing Education and Practice, 3(10), 58-63.
Chokwe, M. E., & Wright, S. C. (2013). Caring during clinical practice: Midwives’ perspective. Curationis, 36(1), 1-7.

Unionization and the Nursing Profession english essay help

In the past, nurses were hesitant to be associated with unions. However, that thought is changing and the idea is becoming associated with the ability of nurses to control nursing practice as well as the quality of care that is rendered to patients. Unions allow nurses to regain control over the quality of care they deliver. This is helpful in combating the decline in quality of care that is related to the increase in the number of for-profit healthcare organizations who are more concerned with reporting dividends to stockholders and plan officers than in upholding the commitment to excellent patient care (Yoder-Wise, 2015).

Outside healthcare, unionization is a frequent practice by the labor pool. Unionization has been slow to come to the healthcare industry. The basics of collective bargaining in any industry, include cooperation between labor and management. This goal will not come to fruition without both sides sharing in the power, profits, and responsibility (Levitan & Johnson, 1983.) Many suggest that the union model is outdated because trends have changed and this framework is no longer useful. However, other voices in nursing are embracing unionization and take the approach that nurse leaders need to use this formal partnership to advance nursing and nursing management (Yoder-Wise, 2015).

Nursing managers will need to be involved in the collective bargaining process. Issues that may necessitate the need for collective bargaining, presided over by the manager include: working conditions, overtime that is mandatory, unsafe nurse-patient ratios, and limited opportunities to participate in decision making. During the process, the nurse manager will need to utilize excellent communication. Management also will maintain the counseling record, if there is disciplinary action involved. The process of knowledge workers unionizing develops organizations that are more similar to associations rather than traditional unions. Ultimately, unionization will help elevate the profession as nurses are given more control over their own workplace rights and the ability to deliver professional care within industry standards (Yoder-Wise, 2015).

Levitan, S., & Johnson, C. (1983). Labor and Management: The illusion of cooperation. Harvard Business Review, 61, 8-16.
Yoder-Wise, P. S. (2015). Leading and managing in nursing (Sixth edition). St. Louis, Missouri: Elsevier Mosby.

The New Charge Nurse and Listening english essay help

Sally Besnick is a newly promoted charge nurse with a BSN degree. The nurses she supervises all have A.A. degrees in nursing, considered a lower level degree. This could make for strained relations between a charge nurse and those she supervises due to a sense of superiority. However, in this case it seems as if the opposite is occurring. Besnick appears to be acting overly permissive and non-directive, failing to provide the guidance and instruction necessary to maintain proper respect on the unit. As a result there is a great deal of dissatisfaction.. In order to correct this, one on one mentorship could be used to help Besnick develop the mental framework and skills needed to do the job properly, she could be demoted back to staff nurse, or she could be re-assigned to supervise other nurses. The best solution is to have a mentor work with Besnick to develop her sense of leadership and understanding of the hierarchy of leadership on the unit. She should then be assigned to supervise nurses she did not work with as a staff nurse.

To accomplish this, I would first get Besnicks and the floor nurses opinions of the problem. I would review the problem with Besnick and have several sessions with her weekly during which we discuss leadership techniques, her hesitancy to be directive, provide guidance and discipline as necessary and go over examples since the last session. It would also be important to determine the reasons for her own administrative work not being completed. I would help her develop a stronger leadership style helping her work through issues while developing new leadership skill. To measure improvements I would monitor absenteeism, measure moral regularly through short anonymous surveys and obtain Besnick’s self-ratings of her own performance in different areas. If the nurses she is working with have developed an attitude that decreases the chance of positive change, I would switch her teem assignment with another nurse so she would not already have a history with the nurses she was supervising.

Billy and Bobby, two patrons at the hospital cafeteria have complained numerous times to staff about the toaster not working properly. Although staff assured them they would talk to management nothing was done until the patrons met with the manage themselves. It appears the managers style is to only correct problems when brought directly to her by patrons. Otherwise, it appears that she may be letting staff take the consequences of unsolved problems. Staff seem to feel their role with customers is to provide them with high quality food items as well as properly working equipment, becoming frustrated when management won’t assist them in making that happen. When working in a cafeteria, customer satisfaction must go into performance improvement as this is the reason the cafeteria exists, to provide patrons with healthy options that they enjoy and are satisfied with. Any performance evaluations and plans for improvement must include this variable as a main indicator or service. Solutions to these types of problems could include a number of possibilities.

First, the manager could be required to be at the cafeteria at different times of the day when the greatest number of patrons are available wearing a manger nametag. That would make sure she was in touch with the problems directly. Second, complains brought to her attention could be recorded with date and time solved which could become part of her performance evaluation. Finally, customer satisfaction cards could be completed by patrons and copies addressed and sent directly to her making the problems seem more salient and increasing the likelihood she will be motivated to address them.

Servant Leader english essay help

Being a servant leader to me means showing others how to serve as well. Being a role model for others is very important especially when it comes to being able to give of yourself. I try in my life every day to show others how to help others and work on lifting up those who are struggling. Being a servant leader means not only giving of yourself to those who need help but also showing others how to give their time and resources to others as well.

It is because of my belief that we should help others that I chose the field of nursing. I enjoy helping others, and I want to be able to do that as a career. I enjoy taking care of others and being a comfort to them in times of stress and sickness. Being a servant leader is also having the ability to help people when they may be at the worst point in their lives. Being able to cheer them up and be a bright light in a dark time is something that to me at least is one of the most important jobs a person can do. People need to have loving, caring individuals with them when times get hard, and there is no time harder than when a loved one is sick.

I think that we should always lead by example if people see you doing good it motivates them to do good as well. In the world today, we have so much tragedy that having people who will step up and lighten the load for others is desperately needed. It is because of this need that I think I have chosen the right path for my life. Being a caring person and showing others how to take care of others is my passion in life.

Serving and helping others is why I chose to become a nurse it is something that I have always wanted to do and I think that I can help to show others how to serve and lead others. Being a servant leader is something that I see myself doing for the rest of my life, and I hope that I can help to make the lives of others better every day and that I can show others how to be servant leaders as well. Having more servant leaders will make the world a better place overall.

Role And Responsibilities Of The Doctor Of Nursing Practice english essay help


Nurses all over the world play vital roles within and outside healthcare facilities. The practice of nursing is known to be the most diverse as it is a profession that addresses needs like; clinical, public policy, leadership and public health care. Nurses caring for the patients’ wellbeing and ensure their health is not at stake. In collaboration with patients, they assist them to take responsibilities for their health by taking care of them, treating them and educating them on preventive measures to curb future occurrences. With the diverse mix of responsibilities and roles, many people including healthcare providers are sometimes confused on the exact roles that a Doctor of Nursing Practice plays in the profession along with the healthcare team. The new docket of nursing focuses on practice competencies rather than just academic research; this prepares learners to address critical skills required to translate evidence-based care to practice, measure the general outcome of patients or communities and improve health systems of care. In addition to the typical clinical responsibilities, DNP has a variety of roles including; leadership and administrative roles, informatics, policy making and system change; this is meant to better the nursing practice in the field.

The role of DNP in nursing theory focuses on the education part of the field. Nursing is mainly a practical profession interacting directly with patients on a day to day basis. With DNP, less of practical work is involved. The majority of the tasks involved are theoretical. Challenges nurses face while in practice are addressed by DNP as such healthcare providers have a wider scope of understanding beyond practical skills (Bryant‐Lukosius, DiCenso, Browne & Pinelli, 2004). The nurses cannot perform without having a theoretical framework, however; their primary focus is on practical skills.

With the unique presentation of different patients’ problems regularly, there is a need to do continuous research so as to be in a position to manage every new challenge in the practice; A lot of investigation by the DNP on issues about the Nursing profession. Many nurses can handle practical problems but require a theoretical framework to make this possible; getting an explanation for what to do can sometimes be challenging. Having a background structure on the explanation behind every act is crucial; this allows one to find alternative measures when a given method does not work in a particular situation (Edwards, Chapman & Davis, 2002). When nurses are in training, they are provided for with a layout to handle given situations in the practice; it is unfortunate however that sometimes challenges arise requiring the input of the healthcare. Under such circumstances, some nurses tend to panic not knowing what to do; it is at this point that knowledge from research is essential.

DNP practice scholarship is when the principles of learning about nursing are combined with DNP Essentials to generate a graduate who is prepared to improve the outcome of health and care. The integration of these skills combined result to quality improvement of processes, translating evidence into practice among many other ways. The aspect of scholarship is what provides knowledge development within a discipline. DNP effectiveness is by its contribution to intended improved outcomes rather than its contribution to general knowledge in the given field; therefore, DNP focuses on the translation of new science, its applicability, and final evaluation (Cotton, 1997). Results have to be attained as the knowledge is needed to better the lives of patients and the profession as a whole.

The DNP as a scholar role entails blending academic theory in collaboration to firsthand knowledge to enrich learning experiences by learners and broaden their perspective on issues that are latest so as to offer best practices in the field of Nursing. A DNP holder has diverse opportunities to access information and knowledge regarding different aspects of the Nursing profession. At this level of Doctorate in Nursing, the learners are exposed to a wide range of roles making it advantageous to them to handle diverse issues (Lorensen, Jones & Hamilton, 1998). Many of these holders are responsible for training nurses doing their degrees or diplomas to synthesize knowledge during training and expand their thinking to accommodate different ideas within and outside the practice.

According to National League for Nurses Recommendation, there has been the need to advance the quality of services offered to patients by healthcare practitioners. Nurses are encouraged to follow their code of conduct by their practice without compromising any of them. Compromising has been the greatest challenge leading to the decline of standards in the Nursing arena. Dealing with different cultural diversity also calls for adjustments in handling patients. New nurses in the market are encouraged to be culturally sensitive while dealing with patients. Culture defines people way of life; ignoring this fact can be disastrous to people (Woods, 1997). Interacting and dealing with patients without understanding their worldview can be dangerous. A combination of all aspects should be in play while treating and taking care of patients.


Nurses are important people in our society. They are crucial in the roles they play to assist patients. Their main tasks are mainly practical; however, the introduction of DNP has diversified the roles about nursing. The mandate of Nurses is to offer quality healthcare services to clients. The advancement of this role by DNP practitioners provide more than the typical tasks by nurses ranging from leadership roles to advanced research on upcoming issues and bettering the general wellbeing of the Nursing fraternity through improved health care systems; this paves the way for better quality services.

Bryant‐Lukosius, D., DiCenso, A., Browne, G., & Pinelli, J. (2004). Advanced practice nursing roles: development, implementation and evaluation. Journal of Advanced Nursing, 48(5), 519-529.
Cotton, A. H. (1997). Power, knowledge, and the discourse of specialization in nursing. Clinical Nurse Specialist, 11(1), 25-29.
Edwards, H., Chapman, H., & Davis, L. M. (2002). Utilization of research evidence by nurses. Nursing & health sciences, 4(3), 89-95.
Lorensen, M., Jones, D. E., & Hamilton, G. A. (1998). Advanced practice nursing in the Nordic countries. Journal of clinical nursing, 7(3), 257-264.
Woods, L. P. (1997). Conceptualizing advanced nursing practice: curriculum issues to consider in the educational preparation of advanced practice nurses in the UK. Journal of Advanced Nursing, 25(4), 820-828.

Pathopharmacology of Depression english essay help

The pathophysiology of many diseases, including psychiatric disorders such as depression, can be viewed from several different levels of organization. At the level of the synapse, depression appears to be accompanied by changes in neurotransmitters such as norepinephrine, 5-HT (related to serotonin), and dopamine. On the level of neural pathways, glutamergic and acetycholinergic connects are diminished. The activity of the immune system, especially in response to stress levels, changes during depression. Endocrine processes, such as the hypothalamus-pituitary-adrenal (HPA) axis, are disturbed as well. Finally, the balance in activity between areas of the brain becomes abnormal in the person with major depression (Murck, 2013).

In the synapse, the tiny physical gap between one neuron and another, neurotransmitters move back and forth to ferry excitatory and inhibitory signals along the neural pathways. Biochemical studies of depression have revealed decreases in acetycholinergic and glutamergic activity in the synapse. Other research has shown a functional deficiency in the monoaminergic neurotransmitters norepinephrine, 5-HT, and dopamine. It has been suggested that this represents a depletion in neurotransmitters due to overproduction of the enzymes that degrade them, but healthy volunteers who were depleted of neurotransmitters did not become depressed (Bondy, 2002). However, in depressed individuals the depleted neurotransmitters may be accompanied by changes in their transporters and receptors.

The hypothalamus is a deep brain structure that is the initiator for several pituitary-controlled endocrine processes such as the hypothalamus-pituitary-adrenal (HPA) axis (stress hormones) and the hypothalamus-pituitary-thyroid (HPT) axis (metabolism). Endocrine pathways such as these are often abnormal in the presence of depression; in fact, extended periods of stress and decreased levels of thyroid hormones are associated with depression (Xin & Pang, 2015). Excess stress hormones are known to alter the function of the frontal cortex, the hippocampus, amygdala, and basal ganglia – brain structures that are related to mood and mood disorders. There are a number of other chemical processes in the brain that are believed to affect or to trigger major depression: neuroimmune chemicals such as cytokines, neurotrophic factors, and other modulating factors such as vasopressin, neuropeptide Y, and excitatory amino acids. (Northoff, 2013)

As an episode of depression deepens, the intrinsic activity of the brain at rest shifts from balanced attention to inner and outer stimuli to a focus on the inward focusing task-negative network. This network consists of the medial brain and cortical midline structures (CMS). The task-positive network, which produces environmental perception and other outward thoughts, rests in the lateral prefrontal and parietal cortex. Imaging studies of the brain indicate that during depressed states there is an increase in midline activity and a decrease in lateral activity (Belzung et al., 2015). Behaviorally, this change is accompanied by an increased focus on rumination, self-deprecation, and other facets of the inner self (Northoff, 2013). Perceptions, cognitions, and motivation are primarily focused inward. This results in a feeling of disconnectedness, a loss of emotional connection to the environment. Many depressed individuals feel numb, and because they feel disconnected, they withdraw even more from the outer environment (Northoff 2013).

In New York, the algorithm for assessment, diagnosis, treatment, and patient education begins with the primary care provider who will routinely ask patients if a) they have lost interest in activities they enjoyed or b) they are feeling down, depressed, or hopeless. An answer in the affirmative would be followed for a screening tool for diagnosis and severity. The chosen tool is PHQ-9, which is a nine symptom checklist. The list includes items such as feeling tired or having little energy, poor appetite or overeating, and trouble concentrating, which are graded on a Likert-type scale. Based on the PHQ-9, the PCP determines a tentative diagnosis of major or minor depressive syndrome. Next is an assessment of suicide and/or homicide risk. If the patient is not at risk, the PCP goes on to prescribe treatment (HealthNow New York, 2013). The PCP refers the patient to a mental health professional if there are signs of psychosis, suicide or homicide risk, psychological therapy is needed, or substance abuse is indicated.

Evidence-based pharmacological treatments begin with antidepressant monotherapy, typically selective serotonin reuptake inhibitors (SSRIs), serotonergic noradrenergic reuptake inhibitors (SNRIs), bupropion, or mirtazapine. These drugs have shown similar efficacy in patients who have never been treated before. If the individual partially responds (reduction in PHQ-9 but not to remission level), augmentation with an additional SSRI, SNRI, bupropion, mirtazapine, buspirone, or thyroxine is suggested. If there is no response, monotherapy with a different antidepressant is indicated. This may be augmented as above if required. If the patient still does not respond, combination treatments with two or three of the above drugs, or combinations including tricyclic antidepressants, lithium, or monoamine oxidase inhibitors should be tried. At stage four, a different combination may be tried, or olanzapine, risperidone, or lamotrigine may be added, or electroconvulsive therapy may be indicated. When a medication or combination is successful, is should be continued for six to nine months following remission, then reduced to a maintenance dose (Rogge, 2014).

This algorithm for pharmacologic depression treatment is extensive and, in the first four stages, firmly based on evidence. Fortunately, the number of individuals who have not remitted by stage four is relatively small. At that point the evidence for suggested treatments is less robust. Throughout the pharmacological algorithm, evidence-based psychotherapy and lifestyle interventions are recommended (Rogge, 2014). The algorithm is followed relatively closely in the community, especially in the county clinic. This is required due to Medicaid regulations. Providers in the clinic must show that they are following the state prescribed processes. Private physicians are more able to adjust; however, the algorithm provides a number of alternatives for treatment-resistant patients.

A patient who manages her major depression well has easy, affordable access to both outpatient and inpatient care as needed. She is able to buy her prescriptions or they are provided through Medicaid, insurance, or pharmaceutical company programs. She has transportation to her appointments, which are initially frequent then, as she achieves remission, become farther apart. She is compliant with medication, therapy, and lifestyle changes as suggested by her doctor. Social support, whether from family, friends, support groups, or all three, is extremely important. If she has recurrent depression, she is always able to see her doctor and get new treatments or hospitalization if required. Because of proper management, her disease does not impinge too greatly on her life, and she has a normal life expectancy with positive quality.

According to the World Health Organization (WHO), depression is a common problem around the world, and it is increasing. There is a gap between provision of other types of health care and provision of mental health care in many countries. Therefore, the WHO has devised the Mental Health Gap Action Programme which includes depression as a priority. This programme helps non-specialist health care workers learn to assess, diagnose, and treat depression as well as other mental, neurological, and substance use disorders. The goal is to help people around the world with mental disorders to live normal lives even when there is an absence of mental health specialists (WHO, 2015).

Financial resources, whether private funds, insurance, or public aid (Medicare or Medicaid), are absolutely essential for management of a disease like depression which is typically chronic. Without proper management, the individual will have a poor quality of life, a shortened life expectancy, and may get into trouble with the law. Access to care is also crucial. People living in rural or exurban areas sometimes have difficulty getting to doctors, especially if a specialist is required. Programs that provide transportation to proper medical care as well as pharmacies can mean the difference between life and death (literally). Social support is very important. Withdrawal and isolation are symptoms of depression that also work to keep the person depressed. It is imperative for depressed persons to have some kind of social interaction. Support groups are particularly good because the person feels that other people understand (sometimes families and friends do not understand, and say harmful things unknowingly). Again, people living in isolated areas are likely to have difficulty finding support. If groups can be arranged that they attend when they go for medical appointments, this would help to increase their recovery.

If a person has major depression and does not have the financial resources, the access to care, and the social support required to manage the disease, his depression could last for years and become deeper until he is psychotic, suicidal, and/or homicidal. He may turn to alcohol or drugs to self-medicate. Jails and prisons are full of people with unmanaged depression and other mental illnesses. Psychosis may cause him to believe others are conspiring against him, or that he is actually dead inside, or that he sees and hears frightening images.

The depression process affects patients in life-altering ways. Stigma and lack of understanding of mental disorders can lead to loss of relationships, jobs, and self-respect. Even if family and employers try to understand, the depressed person’s behavior may be such that it is intolerable. For instance, if a man works as a car salesman and becomes depressed, he may fear talking to customers, feel like a failure, and eventually have no sales at all. He may begin to stay at home in bed every day. His employer would be hard pressed to keep him as an employee, no matter how much he tried to understand. The same would be true of a woman who is an executive in a company. Depression would cause her to lose faith in her ability to make decisions, and her indecisiveness would affect others in the company.

Similarly, depression can be devastating to families, especially those whose culture does not included the concept of mental illness. They do not understand what is happening to their family member and they may feel shame about his or her behavior. The financial costs can be considerable if they do not have insurance or public aid. Treatment of any chronic illness can become very expensive over time. Minority populations in my community tend to have less financial resources, and the availability of help is sometimes limited. In particular, there are families who slip through the cracks – they make too much money to qualify for Medicaid, but not enough to be able to buy insurance on their own. These families have difficulty paying for treatment and are especially stressed when inpatient treatment is needed.

Best practices for management of depression in my organization begin with screening individuals for the disorder. Many people put on their “happy face” even around their health care personnel, but in fact they feel like dying inside. Screening can help to find these people so they can be treated. It is important to let them know that depression is an illness just like heart disease – it is based in the brain and dependent on chemicals as well as other properties of the brain. Another best practice is knowledge of resources. Nurses and other personnel, as well as doctors, should be aware of resources available for people who have financial or transportation constraints. It is also important to know about area support groups for depression. Finally, nurses and other caregivers should be knowledgeable about the most-used psychiatric medications and should have written information at hand whenever it is needed.

The first strategy to implement best practices would be to routinely apply the two-question screening about loss of interest in activities and feeling down, depressed, or hopeless. Signs could be posted in each room to encourage this screening. Second, a survey of resources should be conducted and compiled into a brochure to give to patients. Finally, written material about the most commonly-used depression treatments should be developed to give patients (with alternate languages represented), and nurses should be familiar with the SSRIs, SNRIs, bupropion, and mirtazapine. The success of these practices could be evaluated by recording the number of patients identified with depression before and after the screening was invoked, devising a questionnaire to give to patients for feedback about resources, and a similar questionnaire for feedback concerning the pharmacology materials.

Belzung, C., Willner, P., & Philippot, P. (2015). Depression: from psychopathology to pathophysiology. Current Opinion In Neurobiology, 30(SI: Neuropsychiatry), 24-30. doi:10.1016/j.conb.2014.08.013
Bondy, B. (2002). Pathophysiology of depression and mechanisms of treatment. Dialogues in clinical neuroscience, 4, 7-20.
HealthNow New York. (2013). Practice Guidelines for Providers. Retrieved from
Murck, H. (2013). Review: Ketamine, magnesium and major depression – From pharmacology to pathophysiology and back. Journal Of Psychiatric Research, 47955-965. doi:10.1016/j.jpsychires.2013.02.015
Northoff, Georg, M.D., PhD. (2013). Psychopathology and pathophysiology of depression. Psychiatric Times, 30(9), 3-16C,16D,16E. Retrieved from
Rogge, T. (2014). New York Methodist – Depression. Retrieved from
World Health Organization (WHO). (2015). Depression. Retrieved from
Xin, D., & Pang, T. Y. (2015). Is dysregulation of the HPA-axis a core pathophysiology mediating co-morbid depression in neurodegenerative diseases?. Frontiers In Psychiatry, 61-33. doi:10.3389/fpsyt.2015.00032

Nursing: Pathophysiology english essay help

Case Study 1

Ms. A most likely has, based on the circumstances and her preliminary workup, iron deficiency anemia (IDA) due to internal bleeding from overuse of aspirin, secondary to possible rheumatoid arthritis (RA). Despite her age, RA, usually considered an age-related condition, is still possible in younger women and also is more prevalent in women than in men – 73% versus 38%, respectively (Victor, 2012) and relates to her description of “stiffness in her joints” (Mayo Clinic Staff, 2016). Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) have long been known as culprits in causing internal bleeding due to their antiplatelet activity, particularly in the gastrointestinal (GI) tract (Wedro, 2016), and Ms. A’s symptoms match those of the lightheadedness, shortness of breath (SOB), and low blood pressure associated with intra-abdominal bleeding (Wedro).

Ms. A’s “menorrhagia and dysmenorrheal [sic]” which have been a self-proclaimed “problem for 10-12 years,” most likely since she began menstruating, is a bit more problematic in terms of causality and effect, leading to a kind of chicken-or-the-egg dilemma, for, although IDA is possible in “a few young women with extremely heavy menstrual periods” (Wilson, 2016), aspirin itself may be the cause of the heavy menstrual bleeding (CDC, 2015); or, conversely, she may have had an initially excessive menses, took high doses of aspirin for it and continued to do so, continually exacerbating the problem from the beginning and ever since.

Addressing her IDA, her lab results of a Hemoglobin of 8 g/dl, Hematocrit of 32%, and Reticulocyte count of 1.5% in particular represent the low red blood cell (RBC) count and low hemoglobin levels associated with anemia, as does her reported low levels of energy and enthusiasm (Wilson, 2016). Although these same results could also be indicative of normocytic anemia secondary to aspirin use for RA where, in one case, the lab results came back for another patient of a Hemoglobin of 11 g/dl, Hematocrit of 33%, and a Reticulocyte count of 1.0% (Brill and Baumgardner, 2000); however, the giveaway here is Ms. A’s RBC smear that showed microcytic and hypochromic cells. Microcytic hypochromic RBCs are the hallmark of IDA (Wilson) and, along with her other lab results, what can determine a differential diagnosis for her.

The lower oxygen content of the air attributable to the altitude of the high, mountainous course on which was golfing today may have been a contributing factor that helped to exacerbate her already underlying condition, but it was by no means the sole reason for it. Ms. A most likely would have still become symptomatic at some point, if not today, then at some point in the near future.

Treatment options for Ms. A include, first and foremost, discontinuation of the offending agent at the heart of her problem, aspirin, and the recommendation to instead take a non-aspirin, non-NSAID analgesic such as acetaminophen (Tylenol) for the “stiffness in her joints” (Wedro, 2016). Next, her iron intake needs to be increased in some fashion. This can be accomplished by either adding more meat and eggs to her diet, or by her taking an iron supplement, with care taken to use chelated iron or liver tablets, as most regular iron supplements can be hard on the intestines and often cause constipation (Wilson, 2016).

In summary, Ms. A most likely has IDA due to aspirin-induced GI bleeding, secondary to possible RA; circumstances and preliminary lab workup support this diagnosis. Treatment should consist of discontinuation of aspirin, recommendation of acetaminophen instead, and an increase in her iron intake, either through diet or a non-GI irritating, non-constipation causing iron supplement. Additional treatment, if any, would be warranted depending upon additional lab results, and follow-up with the patient, including follow-up bloodwork should be performed in four to six weeks.

Brill, J. R., & Baumgardner, D.J. (2000). Normocytic anemia. American Family Physician.

Retrieved from
CDC (Centers for Disease Control and Prevention) (2015). Blood disorders in women: Heavy

menstrual bleeding. Retrieved from
Mayo Clinic Staff. (2016). Rheumatoid arthritis. Retrieved from causes/dxc-20197390
Victor, J. U. (2012). Possible causes of anemia in a patient with rheumatoid arthritis. Ternopil

State Medical University, Ukraine. Retrieved from with-rheumatoid
Wedro, B. (2016). Internal bleeding. Retrieved from
Wilson, L. (2016). Anemia and other blood disorders. The Center for Development.

Retrieved from

Importance of Nursing Informatics english essay help

This week’s readings focused on definition of nursing science from the perspective of nursing informatics, discussed basic concepts of information technology, and described the process of cognition in nursing informatics (McGonigle & Mastrian, 2015). It also focused on the role of nursing informatics in the context of the currently changing nursing profession (Johnson et al., 2012). This paper discusses my impression of nursing informatics after reading the assigned texts that reveal the meaning of nursing informatics, its building blocks within the profession, and its role in nursing science.

The biggest change has occurred in my perspective on nursing informatics.

Whereas earlier I thought of nursing informatics skills as an rather optional and not requiring specific education, after I have read the assigned texts I realize that nursing informatics is a full-formed branch of nursing science which has emerged at the intersection of information technology and nursing science. From Johnson et al. (2012) report “Nursing’s Future. What’s the Message?”, it becomes clear that nursing informatics is one of the greatest priorities in nursing profession development. As a matter of fact, it has been distinguished as one of four key messages regarding the future development of the nursing profession along with nursing practice, nursing education, and partnership for progress. In particular, the ability to make data-based decisions while delivering healthcare and use information technology to upgrade the quality of all nursing processes is the priority of the nursing science development for the years to come.

Some examples of where nursing informatics knowledge is applied are  “full implementation of electronic medical records (EMRs), radio frequency identification technology for inventory control, and bar coding for medication and laboratory services” (Johnson et al., 2012). From the book Nursing Informatics and the Foundation of Knowledge, I have developed an understanding of nursing informatics as a field with a solid theoretical background. In particular, nursing informatics redefines the concept of a nursing professional as “information-dependent knowledge worker” and emerges as the field within both nursing science and information science/computer science that can be viewed within the Foundation of Knowledge Model (McGonigle & Mastrian, 2015).

Overall, it is surprising how nursing informatics plays a key part in nursing profession development. It provides a wealth of opportunities for improving nursing processes and aligning them with the requirements of our modern cyber world.

Johnson, J. E., Veneziano, T., Malast, T., Mastro, K., Moran, A., Mulligan, L., & Smith, A. L.

(2012). Nursing’s future: What’s the message? Nursing Management, 43 (7), 36-41.

McGonigle, D. & Mastrian, K. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett.

Nursing Administrator english essay help

The demand for nurses is growing in response to an increasing patient load resulting from the Affordable Care Act and mandated health insurance. Consequently, nurses are stressed, and the retention of registered nurses (RNs) in the industry has decreased. Many nurses blame the relationship or behaviors of their nursing administrator as their reason for leaving the workforce (Feather, Ebright, & Bakas, 2014). Therefore, nursing administrators need to be aware of the behaviors that influence perceptions of their nursing staff, so they can better manage their staff’s needs.

DISC Assessment

Supporting and Encouraging a Good Practice Environment

Supporting and encouraging a good practice environment for nursing staff involves three key subjects: communication, respect and feeling cared for. According to a study by Feather, Ebright and Bakas, nurses in hospitals with higher than average retention rates voiced these behaviors are necessary to perceive nurse administrators as good leaders (2014).

The need for communication stems from nurses wanting to be part of the decision-making process, or at the very least, being aware of the process. Allowing nurses to be cognizant of decisions being made in administration allows them to also see consistency in the actions taken by leaders. Communication extends to listening to the needs of staff, both personally and professionally. Promoting open discussion and keeping confidentiality builds trust. Nurses also appreciate direct verbal communication that opens the channels for responses, which should be handled in a timely manner (Feather et. al, 2014). Many of the communication processes in dysfunctional environments occur, not because the decision-making process did not happen, but because a lack of communication with staff created a poor working environment.

Nursing administrators are not likely participating in purposefully disrespectful behavior, but RNs report needing respect in a good practice environment. A perception of respect, according to RNs, involves consistent appreciation and discipline. Praise must be given in order to provide balance to criticism. Fairness is perceived when all workers are treated the same in regards to accountability, and this includes administration. Nurse administrators should model behavior they’d like to see in their employees. In that regard, employees reciprocate the respect they see from their administrators (Feather et. al, 2014).

Lastly, nurses report that they need to feel that their administrators care. Administrators are often perceived as being disconnected from staff, and nurses complain to charge nurses or workers they feel can relate to their complaint. Nursing administrators should be present rather than constantly in a closed office or in meetings. They need to respond to stressful days by making sure busy nurses get breaks and meals (Feather et. al, 2014). This shows a caring environment where nurses feel the support they need from leadership

Hindering and Discouraging a Good Practice Environment

It is easy for nurse administrators to create a bad practice environment unintentionally by not responding to the needs of nursing staff. The absence of communication makes staff feel excluded, and they begin to lose trust in the organization. Confidentiality also builds trust that can easily be broken if disciplinarian actions are made public. Lastly, nursing administrators cannot engage in disruptive behavior, such as gossip (Feather et. al, 2014). The biggest hindrance to a good practice environment that a nursing administrator can create is a culture lacking trust, which eliminates the communication, respect, and caring required for a good environment.

Personal Leadership Style

In my own leadership style, I would incorporate all of the elements necessary to create a good practice environment, but one that stood out is being present. A nursing administrator cannot be everywhere at once, but he or she should have an open door as much as possible and visit the floor regularly to avoid disconnects. This also forces the two-way communication pathways that foster communication and respect. One notable complaint by a nurse in an article cited discouragement because the nurse administrator was never present on the night shift (Feather, et. al, 2014). I would make it my responsibility to oversee each shift at least once weekly to show presence and support, which would encourage staff with limited administrative figures.

Handling Disruptive Behavior in the Practice Environment

Disruptive behavior is harassment, bullying and gossip among other activities that negatively impact staff and patients. These behaviors occur amongst all workers in healthcare organizations including doctors, nurses and patients. Handling them involves clear guidelines and consistent discipline to create a culture where disruptive behavior is discouraged.

Clear guidelines come from a code of conduct that describes disruptive behavior and discusses how to report disruptive behavior. The disciplinary actions involves verification of the behavior, intervention, and then coaching or mentoring the problem to limit the chance of recurrence. Harsh disciplinary actions are a last resort but must be considered in some cases. The best defense in the case of disruptive behavior is a good offense, and that means preventing disruptive behavior. This can be done by educational initiatives that improve the working relationships between different types of workers, such as nurses and doctors (Longo, 2010).

Lifelong Learning and the Professional Administrator

Lifelong learning is essential to the career of the RN and the nursing administrator. Nurses are charged with performing best practices and being leaders in healthcare advancement and excellence. This is no light task and involves a constantly evolving body of knowledge that must be consistently studied.

Nurse administrators must obtain continuing education credits, but a nursing administrator must also attend conferences, read journals and network with other nurses to become a lifelong learner. The nurse administrator must be a lifelong learner and challenge staff to adopt the same lifelong learning goals.

Feather, R.A., Ebright, P., and Bakas, T. (2014, Jan.) Nurse manager behaviors that RNs perceived to affect their job satisfaction. Nursing Forum. doi: 10.1111/nuf.12086
Longo, J. (2010, Jan. 31). Combating disruptive behaviors: strategies to promote a healthy work environment. OJIN: The Online Journal of Issues in Nursing (15)1. doi: 10.3912/OJIN.Vol15No01Man05

Nurse Leadership english essay help

Presented with the case of Cindy Jennings and how to best address it, it seems that the first step should be the nurse manager’s attention to Justin McDonald’s own failures as the charge nurse. If Justin is to continue on in this role, it is essential that he understand how vital it is that any problem in a nurse’s performance be addressed as immediately as possible. Remarkably, he failed to document any interaction with Cindy, as she has been lacking in performance in a range of ways. Before the need to address Cindy’s situation is dealt with, then, the manager must be confident that Justin understands how important it is to document transgressions and/or have third party witnesses present during verbal and written reprimands.

Given Justin’s lack of any address of the issues with Cindy, then, the best means of dealing with her tardiness, etc., would be for the manager and Justin to meet with her and discuss the realities of poor performance. Management must acknowledge that it neglected to address the issues earlier, in any form, so this is in effect the first disciplinary action. All of Cindy’s performance problems should be covered, and Cindy should sign documentation affirming the process. She should as well be made to understand that, as this is an initial warning, any further performance issues will result in additional, written reprimands followed in turn by disciplinary measures. The forms of the latter are within the manager’s discretion but, and the failure to address the problems earlier notwithstanding, the measures should be strong, as in possible suspension or termination, because Cindy’s performance is consistently poor. It must be emphasized at the meeting that this action is a warning, and the first such that Cindy has received.

As to policy guiding actions from this point, it is repeated that any nurse with authority over others is obligated to address issues as they arise, and also document them. Then, this goes to communication in general. It seems that Justin failed to understand how performance expectations of nurses must be made clear, and in an ongoing process (Cherry, Jacob, 2013, p. 298). Communication is critical because both nurse and leader/manager must be “on the same page” regarding what each understands the responsibilities of the nurse to be. This in turn relates to the understanding that any issues in meeting these expectations will have repercussions. Consequently, with regard to Cindy and all nursing staff, a structure of discipline must be the policy, and supervisors failing to follow this will be subject to discipline themselves.

Justin’s failures regarding Cindy definitely impact on both patients and staff, and not in positive ways. Cindy was, importantly, a relatively new hire, and it is then all the more important that supervision be maintained consistently (Cherry, Jacob, 2013, p. 357); his lack here then suggests a similar irresponsibility with other nurses. This then endangers the nurses themselves. The level of competency of a nurse is crucial to his or her career, as any charge of poor performance may bring action against that nurse from patients, doctors, or administration itself. Also, and given the nature of health care in general, the nurse who, like Cindy, is repeatedly late or absent presents serious risks to patients, and also requires the nursing staff to make adjustments not serving the interests of the patients as they should be served. This reality is reinforced by how a single complaint against a nurse may lead to an investigation (Duclos-Miller, 2004, p. 44). In brief, then, Justin’s negligence affects patients receiving less than proper care, and nurses who are not given the opportunity to improve their performance because their issues are not addressed.

Cherry, B., & Jacob, S. R. (2013). Contemporary Nursing: Issues, Trends, & Management, 6th Ed. St. Louis: Elsevier Health Services.
Duclos-Miller, P. A. (2004). Managing Documentation Risk: A Guide for Nurse Managers. Marblehead: HC Pro, Inc.

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  • Free bibliography
  • Free simple outline (on request)

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