The Use of Spearman Rank Correlation Coefficient by Messina and Coyne Term Paper

The Use of Spearman Rank Correlation Coefficient by Messina and Coyne - Term Paper Example From this research it is clear that in statistics the Spearman’s rank correlation coefficient (SRCC), also known as the Spearman’s rho, is greatly used. This provision derives its name from Charles Spearman and may be denoted by symbols rs or P. Maturi and Abdelfattah clearly explain that as a non-parametric measure used to gauge statistical independence that may exist between two variables, the Spearman’s rho is used to assess the most appropriate way of describing two variables through the use of a monotonic function. The Spearman’s rho is used mostly when both independent and dependent variables are ordinal, or when one of the variables is a continuous one, and the other an ordinal numeric. Conversely, Spearman’s rho may be used when the variables being measured are both continuous. In the article by Messina, Scott, Ganey, Zipp and Mathis it is clear that the use of the Spearman’s rho is very plausible. This is because patient satisfaction is not only the independent variable in Messina’s research analysis but also a continuous variable. At the same time, patient admission across teaching and nonteaching hospitals acts as both a dependent and continuous variable. Thus, in this work by Messina et al. the Spearman’s rho is used to study the relations that exist between the dependent variable and independent variable, and these variables are being represented by the volume that has been measured by admissions and the patient contentment mean score respectively. The use of Spearman’s rho’s correlation analysis is seen in the fact that Messina and his companions carried out the analysis on a pooled sample of seven nonteaching and seven teaching hospitals. It is from this development that the differences between the subsamples in teaching and nonteaching hospitals are analyzed through the use of Mann-Whitney U-Test. From this juncture, it became possible to determine whether or not there is an e xplicit association between admissions and patient satisfaction mean score in respect to the two variables. As one reads the study, it becomes clear that the mean for all admissions in teaching and nonteaching hospitals is 19,111 within the time frame of 1999-2003. The range is from 4,513 to 70,465. The mean score for the aggregate patient satisfaction is 82.57 within the five-year timeframe. The minimum aggregate is 79.0 while the maximum is 86.18. The use of Kurtosis as a form of descriptive analysis indicates that the mean score for patient satisfaction was normally distributed. In a nutshell, the use of the Spearman’s rho indicates a strong negative correlation between hospital admission within a given sample and patient satisfaction (rs = -.287, P = .018). The import of all these results is that lower inpatient volumes (in both teaching and nonteaching hospitals) are compatible with or relatable to higher patient satisfaction mean scores. 2) Comments on the Variables Use d and Spearman Rank Correlation Coefficient It is a fact that the variables that have been used by Messina, Scott, Ganey, Zipp and Mathis (2009) are very appropriate and applicable to the determination of the Spearman’s rho. Spearman’s rho determines the statistical independence between two variables, and it is a fact that Messina and his group use two variables: patient satisfaction and inpatient admissions in teaching and nonteaching hospitals. Again, just as Maturi and Abdelfattah (2008) explain, the Spearman’s rho is applicable in an area where one variable is continuous and the other an ordinal numeric, or where both variables are continuous in nature. Messina’s et al. (2009) independent (patient satisfaction) and dependent (inpatient admissions in teaching and nonteaching hospitals) variables are both continuous. These characteristics make the variables used qualify for Spearman’s rho analysis, so that, in light of the specific requirements o f SRCC, there is

Indiana Religious Freedom Restoration Act Research Paper

Indiana Religious Freedom Restoration Act - Research Paper Example In addition, the team conducted a research of former attempts that have been made in addressing the issue in question (Payne, 2015). The subsequent part of the essay covers the stakeholder analysis where issues related to them have been discussed. The section also provides the stakeholders who are adversely affected by the problem associated with the Act. The stakeholders have different objectives that are with policies that are implemented by the relevant institutions. Conversely, the section discusses how stakeholders are affected by the implementation of the Act. The next section provides alternative solutions that can be used to resolve the issue related to the Indiana Religious Act. In addition, an evaluation of the possible outcomes of the alternatives has been provided. The results demonstrate the effectiveness of the alternatives given to mitigating the problem that arise from the application of the policy in the business environment. Lastly, the last section provides the anticipated future trend of the problem (Robertson and Pà ©rez-Peà ±a, 2015). The Act was introduced in Indiana after it was enacted by the Governor of the State. One of the problems that have been widely associated with the Act is that it discriminates certain groups of people in the society. Critics argue that the move to introduce the policy was intended to exclude particular groups such as the gay community in the business sector. In the year 1993, President Bill Clinton signed a law allowing states to have their religious laws. The senators who participated passing the law voted overwhelming in support of the law. However, it was established the Indiana State operated in contrast to the legislation of the federal government. The decision to allow states to come up with their religion created a loophole in the legal system where the state of Indiana legalized gay marriage. The decision to allow gay marriage in State came with negative implications especially to

Counselling, Caring and the Ambulance Service Essay Example for Free

Counselling, Caring and the Ambulance Service Essay Introduction In order to discus counselling and its meaning both generally, and in my workplace, it is necessary to come up with a definition. The dictionary describes it in terms of advice but this interpretation is a traditional one and carries an immediate implication of inequality for those involved. It is a narrow interpretation of the concept when compared to modern attitudes, which usually include a psychological aspect. Nevertheless, the traditional view still bears three of the fundamentals of counselling. These are: * That it involves at least two people, thus constitutes a relationship. * That there is agreement about the nature of the interaction, i.e. it is cooperative. * The aim is to help those involved. According to Stephen Murgatroyd (1990, P.5) counselling is not the sole prerogative of professional counsellors. It is a process that is widely used in within a community, which can take many forms. I have found this particularly true in my own profession. As a Paramedic within the NHS for ten years I have used techniques, which I now recognise as essentials of counselling practice, but have never considered myself a counsellor. Rather a professional who can learn much from the subject. In my workplace I find frequent examples of the more traditional model of counselling, as described by Murgatroyd (1990 P.7) as prescriptive or directive but also of other the facilitative or developmental forms, which seek to encourage patient centred self-actualisation. These I will seek to analyse. I hope to draw out some of the problems involved and discuss ways in which to improve. Counselling, Caring and the Ambulance Service Once upon a time ambulance staff had a clear job specification, or at least their managers liked to believe so. Crews were told their mission was to preserve life and transport to hospital with the minimum of deterioration in the patients well-being. In reality things are not that simple and ambulance staff deal with a myriad of human responses and emotions every day. In the past many of my colleagues thought of counselling as a nebulous concept, which had no place at the cutting age of ambulance work. More attention was paid to physical trauma than emotional. With hindsight we can see that the best ambulance staff were those that used the skills that we now identify and welcome, in a natural and confident way. Usually they were also those that had plenty of experience. Just as my job covers a range of human conditions, so counselling and guidance demands a range of approaches to those being counselled. In my job these can be patients, their friends, relatives, bystanders or other professionals. Also though, it includes my colleagues. I have discussed briefly the nature of counselling, now I would like to examine it in more detail. Nelson-Jones (1983) talks of a distinction between skills and specialism or counselling relationships, whereby counselling is the primary activity, and helping relationships in which counselling skills form part of the helpers relationship with another person. Clearly the latter applies to my own job as well as many others. Our primary role is not that of counsellors but we use some of those skills so as to be effective practitioners. Davis Fallowfield examine four models of psychological theory that have had a major impact on counselling. These are: * Behavioural * Cognitive Behavioural * Person Centred * Psychodynamic Each of these allows us a better understanding of the processes of helping by affording us a different view of the human psyche. In my work I can recognise elements of all the models in patients and colleagues. Rogers, (Person Centred), gives insight into the importance of the conditions necessary to create an effective relationship. Based on humanistic philosophy he espouses the belief that all people have the capacity to achieve self-actualisation, if the basic conditions can be created. Freud, (Psychodynamic) demonstrates the importance of the relationship, the unconscious processes which arise from them and the insight into them in dealing with problems The behaviourist theories espoused by Pavlov, Skinner, Ellis and others, deal with the nature of behaviours learned and observable, and how maladaptive thought processes can be unlearned by the use of cognitive processes. A fifth model, that of Gerard Egan, integrates many of the ideas of the former to create an eclectic model that I believe has particular relevance to my workplace. In The Skilled Helper (1994) Egan incorporates some of Rogers and Maslow`s humanistic ideas in a pragmatic way, to outline some of the counselling skills that we use so much as teachers or carers. As Egans model is concerned with problems other than just psychological it provides a more relevant ethical base for those in teaching or healthcare and has been increasingly embraced by those professions in recent years.(Burnard 1990 P.27) Egan mirrors modern healthcare by treating the patient in an holistic way. He proposes a need for empathy, respect, genuiness and mutual respect. All of these are very necessary to accomplished ambulance staff. The Three-Stage Model Egan uses a three-stage model to outline the helping process. The first stage concentrates on the social skills that I find so important to my job, setting the scene and allowing a warm relationship to flourish through showing genuine empathy. Skills such as body language active listening and attention giving are prerequisites. Communication is established and advanced. Stage two moves the process forward by drawing out themes to allow the subject a new perspective. The subject is gently challenged so as to recognise themes, feelings and experiences. . Building on the previous stages, the third seeks to encourage a creative ambience. Problem solving drawing on points raised, maybe seeking solutions and encouraging the subject to establish a plan of action. The establishment of communication is common to the whole process. This is a massively important. The process may also move backwards or forwards. It is not intended to be prescriptive but rather to draw out the empathetic human qualities that can help. I can recall so many instances where Egans ideas have been used in my workplace that it is hard to select examples. We are often called upon to assess our patients well being in a very short time. Once we have established that avenues of communication are possible, i.e that the patient is able to communicate in a rational way, we embark on a dialogue that seeks to put them at ease, allow them insight and hopefully afford them a feeling that they have some measure of control over the situation. Power thus becomes an important issue. In Davis Fallowfield (P.15) the patient/practitioner relationship is discussed. They state that one of the most common problems encountered is the need for medical staff to take on the role of expert in order to reach conclusive goals. Very often this leads to neglect of the patient as a whole. Sanders (1994) identifies two qualities that he describes as non-counselling. One of them, he describes as being distant and expert. Sometimes, in a medical emergency, this is a necessary quality but creates feelings of guilt. I have often left relatives at the scene of a cardiac arrest at home whilst taking the role of expert and wondered at the emotional carnage that we have just encountered as we speed towards hospital with their loved one. Many times I know that we have not even begun to address their needs. It is certainly easier not to shoulder that sort of emotional involvement, as mentioned by Burnard (P.148), when he talks of the possibility of burnout. But sometimes assuming the role of expert can be used as an excuse to avoid emotional involvement. I believe that in my workplace this is a very common problem and have many times taken issue with colleagues who have deliberately refused to move away from the expert mode and address the patient as a whole person. In one such incident a young female patient was brought by chair into the AE department by a crew. Wheeled into the centre of the busy department she sat hunched, clearly embarrassed, and hiding her face. One of the crew held a large collection of empty pill packets, making it obvious to those who could see that the patient had overdosed. Overdoses are a very common emergency and can bring out negative attitudes from all medical workers. Whilst the patient remained on public view the ambulance man walked up to the nursing station and ritualistically poured the packets onto the desk in an obviously condescending way. The patient began to cry quietly. The behaviour of this colleague incensed me. He had ritualistically humiliated his patient presumably because of his intolerance and judgmentalism and a refusal to see the patient as anything but a manipulator. I believe that the ability to extract necessary information and perform tasks in an empathetic way is not only achievable using Egans techniques, but also vital to patient well-being. During my time in the ambulance service time I have passed through stages that have been identified by Maynard Furlong (1998) as distinct points in development, from early idealism to realism and occasional disenchantment. I have found that after several years a degree of cynicism is a common occupational hazard and is probably to be expected. Staff have to come to terms with what is achievable within the constraints of the job and workplace stress is common. Very often in my workplace I witness a range of abilities in communication. Simple techniques such as positioning, eye contact and general body language can be taught but I am convinced that without a genuine love for ones fellow man these techniques are not convincing. The humanistic approach that I have discussed is not always easy. It is easy to dismiss, especially when staff are tired and demoralised. Judgmental attitudes are commonplace and to some extent inevitable. The ability to rise above these and retain an open mind is something that can be massively affected by peer pressure in a working situation where crews work in twos. Usually one crewmember is senior and the dynamic of the relationship is affected by experience, sex, strength, (psychological and physical), age etc. This can often create an imbalance of power, between crewmates. This particularly affects less experienced younger staff in a workplace where experience is such a valuable commodity. Sometimes staff suffer because of their role as unofficial counsellors. Burnard (1990) talks of the potentially painful relationship between the parties. I believe that prolonged exposure can lead to problems and in my workplace this had lead to the formation of a structure designed to aid the problem. Five years ago the ambulance service started an in-house Staff Support Scheme network, in order to create a pathway to help to reduce the impact of psychological problems. It was thought that staff who had been trained to identify some of the symptoms of psychological or emotional problems were in an excellent position to guide the subject to help in the form of professional counselling. Whilst I wholeheartedly supported the concept and became a member, I had doubts about some of conditions attached, particularly about the principles of confidentiality and supervision. We were trained in debriefing techniques (not as counsellors) by a very experienced professional counsellor. However the trust felt bound to encourage us to disclose not only health safety and legal confidences, but also those that may contravene trust rules. This I felt was unethical and impractical. They also had no formal supervision structure in place and no mechanism for further development. All these factors left the idea profoundly flawed. I continue to serve as a staff support member but refuse to create reports on individuals or to pass on confidences. This is a position that is supported by Nelson-Jones (P.143) who maintains that breaking confidences is a serious breech of ethics. Counselling and helping work colleagues outside the classroom can be a much more intimate affair. Crews routinely spend twelve hours in each others company, often on standby or on station, alone, un-chaperoned and unsupervised. Thus if there are emotional needs and issues the workplace can become extremely intense. Staff obviously have issues themselves, quite apart from the problems they may face with patients and support can be close at hand. But the operational ambulance environment can also become a minefield of ethical limits and the process of helping can be impaired as well as enhanced. Burnard (P.139) discusses the problems of transference and countertransference. In the above-mentioned situation where an inappropriate relationship develops he suggests the transfer of the client to a more senior counsellor. Although the obvious solution, this is not always possible and it is obvious that problems will continue to occur. Development The back of an ambulance is no respecter of class and ambulance work can be a great leveller. As a developing teacher of ambulance staff I am in the privileged position of teaching those who I believe are routinely placed in a position of power and privilege that can be used or abused. I believe a major part of my teaching role is to encourage the use of the humanistic approach, and to encourage students to reflect on their own attitudes and judgements in order to allow them to better use the skills described by Egan and the key aspects required as described by Carl Rogers in Kischenbaum Henderson, (1989). The humanistic approach is already practised in my workplace and has been by the more experienced staff for years. Even though they did not attach labels to their skills they were using the humanistic approach espoused by Egan, Rogers and others. In the emergency care setting they have honed these skills to bring benefit to their patients as quickly as possible. It remains a joy to watch I see my future role as that of a champion for the humanistic approach, by my actions and my teaching methods. As more demands continue to be heaped on staff this may become more difficult. We are in danger of becoming more concerned with the product than the process. Bibliography Murgatroyd. S (1985) Counselling and Helping. Haworth Press Nelson-Jones.R (1997) Practical Counselling and Helping Skills. Cassell Davis.H and Fallowfield.L (1993) Counselling and Communication in Health Care Wiley Sons Burnard.P (1990) Counselling Skills For Health Professionals Chapman Hall Borck.L and Fawcet. S (1982) Learning Counselling and Problem Solving Skills. Haworth Press Kirchenbaum Henderson (1989) The Carl Rogers Dialogues (From Course Handout)

Pursuing a Career as a Registered Nurse

Pursuing a Career as a Registered Nurse Confucius once stated, Choose a job you love, and you will never have to work a day in your life (Stevenson, 1987). Those profound words truly encourage the importance of choosing a career that one is passionate about in order to attain happiness. However, many individuals fail to recognize that they must be well-suited for their chosen career. While becoming a nurse may not be for everyone, the job can definitely be worthwhile. The abundance of demands and responsibilities that the job entails may be intimidating, but there are so many different opportunities within the nursing field that make it advantageous. Pursuing a career as a registered nurse will certainly be challenging, but it will be an extremely rewarding profession. A career in nursing is one that has a long history, although it has evolved over time into one of the most demanding careers in the medical field. A nurse is defined as a person formally educated and trained in the care of the sick or infirm, especially a registered nurse (Random House, 2001, p. 911). However, nursing has not always been considered a profession in which training or education was required. According to The New Book of Popular Science, in earlier times nurses were generally untrained, learning only what was needed for the specific situations in which they worked (2005, p. 482). Eventually, nursing transformed into a profession that entailed a great deal of knowledge and skill. Nursing as a modern profession can be traced back to the mid 19th century (The New Book of Popular Science, 2005, p. 482), as Florence Nightingale became known as one of the first pioneers of nursing. Nightingale cared for wounded British soldiers during the Crimean War, which showed the importan ce of skilled nursing and in 1860, the first nursing school, based on Nightingales methods, was founded in affiliation with Saint Thomas Hospital in London (The New Book of Popular Science, 2005, p. 482). Nursing schools gradually became more popular, and in 1872, Bostons New England Hospital for women and children established the first U.S. nursing school, which awarded a nursing diploma to Linda Richards, the first trained nurse in the U.S. (The New Book of Popular Science, 2005, p. 482). Since then, millions of men and women have entered the medical field as trained nurses, as it has proven to be an excellent career. While I have always had an interest in the medical field and a strong desire to care for and help people, being exposed to a hospital environment and observing a hospital staff allowed me to discover my desire of pursuing a career in nursing. The nurses, so intelligent, compassionate, and understanding, had not only provided their patients with necessary treatments, but offered them their utmost support and companionship. Knowing that I possess those attributes, it is that vision that has given me the drive and the willingness to help others. As an aspiring registered nurse, one must be committed to working diligently in preparation for her career. Although each approach is quite challenging, there are three educational routes to becoming an RN: 1) Two year associate degree programs offered by community, junior, and technical colleges. 2) Three year diploma programs offered by hospitals. 3) Four year bachelors degree programs offered by colleges/universities. These award the bachelors of science in nursing (BSN) degree (S. Wischnitzer E. Wischnitzer, 2005, p. 172). These three educational routes allow individuals to pursue a career as a registered nurse, while being able to choose a program that is tailored to suit their needs. Nevertheless, nursing students are all required to take several pre-requisites. For example, basic courses cover anatomy, physiology, sociology, English, psychology, philosophy, microbiology, and nursing concepts and techniques (S. Wischnitzer E. Wischnitzer, 2005, p. 172). If a student opts to e nroll in a four year bachelors degree program, they must also take courses in precalculus, chemistry (both general and organic), biology, anthropology, and epidemiology, as well as several advanced nursing courses (S. Wischnitzer E. Wischnitzer, 2005, p. 172). Regardless of which program a student is enrolled in, all prospective nurses must obtain a nursing license before they are able to work. To do so, candidates must pass a written state board examination after graduating from an accredited nursing school (S. Wischnitzer E. Wischnitzer, 2005, p. 172). While education is obviously an integral part of becoming a nurse, its important that nurses possess certain characteristics in order to be successful medical professionals. For example, the U.S. Department of Labor explains that nurses should be caring, sympathetic, responsible, and detail oriented. They must be able to direct or supervise others, correctly assess patients conditions, and determine when consultation is required. They need emotional stability to cope with human suffering, emergencies, and other stresses (2010-2011). Providing a student possesses these characteristics and is capable of doing well throughout her nursing program, she should be fully prepared to succeed in a career as a registered nurse. The job of a registered nurse is certainly one that involves a great deal of responsibilities. According to the U.S. Department of Labor, registered nurses treat patients, educate patients and the public about various medical conditions, and provide advice and emotional support to patients family members. RNs record patients medical histories and symptoms, help perform diagnostic tests and analyze results, operate medical machinery, administer treatment and medications, and help with patient follow-up and rehabilitation (2010-2011). However, depending on the nurses specialty and/or job location, her duties may vary. Therefore, a nurse must be able to apply her newly acquired knowledge and skills from school to the job of her choice. For example, registered nurses have a very wide choice of work settings these include hospitals of different types, nursing homes, schools, community health centers, public health offices, and industrial facilities (S. Wischnitzer E. Wischnitzer, 2005, p. 170). Fortunately, most nurses work in facilities that are clean and well lighted and where the temperature is controlled, although some work in rundown inner city hospitals in less than ideal conditions (Careers in Focus, 2006, p. 165). Nursing is definitely a very demanding job regardless of work setting, as it can be both physically and emotionally exhausting. For example, caring for patients often requires a great deal of strenuous activity, as patients who are ill are usually very weak. Additionally, nurses typically work long hours that include either twelve or eight hour shifts. Those in hospitals generally work any of three shifts: 7:00 A.M. to 3:00 P.M.; 3:00 P.M. to 11:00 P.M.; or 11:00 P.M. to 7:00 A.M (Careers in Focus, 2006, p. 165). Nurses also spend a large portion of their day either walking or standing, which is definitely physically taxing. Consequently, it is not unlikely for nurses to feel as though they are going to burn out. For example, one nurse reported t hat if you are doing a good job, it is mentally as well as physically exhausting, demanding you are going to burn out, as no one supports you you are always working, always on your feet, always thinking. It doesnt end ever your brain is always in overtime (Industrial Engineer, 2011). The abundance of work and the effort a nurse must put into her job may seem very unpleasant at times, but it is undoubtably a financially rewarding career. According to the New York State Department of Labor (2010), the average salary for a registered nurse working in New York City is $82,920. Furthermore, nurses are entitled to a fair amount of time off. As for vacation time, new employees earn 13 days per year, and bonus days are added each year for the first 7 years (NYS Department of Civil Service, 2011). Also, employees can earn 5 days of personal leave per year and sick leave can be accumulated to a maximum of 200 days (NYS Department of Civil Service, 2011). Registered nurses put an enormous amount of time and energy into helping people and providing patients with proper health care, proving that they are definitely deserving of a high salary and adequate time off. Despite the disadvantages of becoming a registered nurse, the various job opportunities and possibilities to advance make it a very desirable career choice. Besides the chance to help others and put ones skills to work, nursing offers diversity, ready availability of jobs, reasonable starting salaries, attractive employee benefits, a choice of educational programs, and plentiful financial aid (Tise, 1988). These advantages are usually very appealing to interested nursing students, as the field of nursing is extremely broad and offers so many different options. Furthermore, nurses typically enjoy interacting with different types of people on a daily basis. For example, a study showed that despite nurses decision to quit, they identified interactions with patients and families as being emotionally satisfying, and the loss of this interaction as their biggest regret since leaving practice (Mackusick Minick, 2010). However, patient interaction is not always so enjoyable, as RNs may be i n close contact with individuals who have infectious diseases (U.S. Department of Labor, 2009), which can be quite dangerous if one is not cautious. Nurses have also reported that they dislike the people they work with, which is evident in an article from Medsurg Nursing, which states unfriendly workplace was evidenced by nurses reporting issues of sexual harassment; verbal or physical abuse from co-workers, managers, or physicians in the workplace; and/or consistent lack of support from other RNs (Mackusick Minick, 2010). However, as with any career, it is important to understand that some co-workers are going to be more friendly than others. In addition to an unfriendly workplace, overwork and stress are common in nursing long hours, inconvenient hours, and little rest have always been a nurses lot (Tise, 1988). For example, researchers found that the average total sleep time between 12-hour shifts was only 5.5 hours (Healthcare Traveler, 2010), reiterating the fact that the job of a nurse is extremely exhausting. Moreover, nurses can be held legally accountable for providing the wrong medication to a patient even if ordered to do so by a doctor (Tise, 1988), which is definitely a rather unattractive aspect of nursing. Nevertheless, the disadvantages of becoming a nurse should not undermine the fact that nursing has a very promising future. Current projections are that employment of RNs is expected to grow faster than average for all occupations through 2012, and many jobs will result (S. Wischnitzer E. Wischnitzer, 2005, p. 172). The large amount of employment opportunities is attributed to a severe shortage of nurses, which will be exacerbated by the increasing numbers of baby boomer aged nurses who are expected to retire, creating more open positions than there are graduates of nursing programs (Careers in Focus, 2006, p. 165). In addition to benefiting from a very favorable job market, registered nurses have the opportunity to continue their education and advance in their career. With additional experience and training, an RN may move into a supervisory, management, or administrative position such as head nurse. Other potential directions for advancement include specialty training, especially in one of the advanced-practice nursing specialties (S. Wischnitzer E. Wischnitzer, 2005, p. 172). Of the various advancement opportunities, an advanced-practice nurse is the highest degree of specialty within the field of nursing. Advanced-practice nurses are highly trained specialists with one of four professional titles: clinical nurse specialist, nurse-anesthetist, nurse practitioner, or nurse-midwife (S. Wischnitzer E. Wischnitzer, 2005, p. 171). If a registered nurse decides to become an advanced-practice nurse, he or she must obtain a masters or doctorate degree. Many nurses choose to follow this career path, as it allows them to assume a higher ranking position with enormous financial benefits. It is evident that endeavoring towards a career as a registered nurse is demanding, but it will absolutely be worthwhile. I am definitely suited to become a registered nurse, as I am a hard-working and compassionate individual, which are characteristics that are imperative to achieve success in nursing. This upcoming fall, I will begin to actualize my goal of becoming a nurse, as I have chosen to attend Wagner Colleges nursing program. After earning a bachelors of science degree in nursing, I hope to someday further my education and become a nurse practitioner. I am certainly aware that it is a major commitment, but I am fully prepared for the challenge and will continue to work diligently to attain my goal. I am completely confident that I will someday be an excellent nurse, but above all, as a registered nurse, I intend to never have to work a day in my life.

Educating Rita :: Free Essay Writer

Educating Rita Although Rita knows that intellectual enlightenment is important, to Rita, education provides much more to her in Willy Russell’s Educating Rita. Rita’s education is not restricted to scholastic learning alone, her transformation from the uneducated Rita to the educated Susan is all encompassing. Rita sees and understands the importance of being well educated, but for Rita, education helps her to overcome her background and break away from the traditional role expected of a woman in the 1970s. Rita has set herself on a course of self-discovery, she has a determination to control her own life and make her own choices. Rita believes it is education that will give her these choices. Rita knows that the value of education goes far beyond simple intellectual enlightenment. Education entirely changes Rita which, though she is prepared for a change, effects her life enormously. Rita’s background has held her back and put her at a disadvantage. There was a great deal of research done in the 1970s to show that middle class children were far more likely to do well at school and to go on to university than working-class children like Rita. Rita’s schooling disadvantage is shown in her recollection of school life: â€Å"†¦borin’, ripped-up books, broken glass everywhere, knives an’ fights. An’ that was just in the staffroom. Nah, they tried their best I suppose, always tellin’ us we stood more of a chance if we studied. But studyin’ was just for the whimps, wasn’t it? See, if I’d started takin’ school seriously I would have had to become different from me mates, an’ that’s not allowed.† (Act 1, Scene 2, p17) Rita felt the need to conform to the way everyone around her lived their lives until she realised that there was a way out. The class antagonism that pressures Rita can be seen through language misunderstandings between Frank and Rita: Frank: You are? Rita: What am I? Frank: Pardon? Rita: What? Frank: Now you are? Rita: I’m a what? (Act 1, Scene 2, pp2-3) Education is the only way Rita can fulfil her desire to overcome the working class background she has been born into. Rita feels that through education she can break away from the traditional expectations placed on a working class woman in the 70s. Pressures and influences on Rita are mostly from her family, in particular her husband. â€Å"I told him I’d only have a baby when I had choice.

Captain John Smith Is Successful Than John Rolfe :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚   Captain John smith was more important to the success of Virginia by 1630 then John Rolfe.. Like many famous heroes, John Smith was feisty, abrasive, self-promoting, and ambitious. He was an experienced soldier and adventurer, the man who boldly went out and got things done. If not for him, the colony may have failed at the start.   Ã‚  Ã‚  Ã‚  Ã‚  John Rolfe is best successful for having introduced tobacco as a commercial crop to Virginia colonists. The production of this valuable commodity shaped the future development of the colony and provided an economic incentive for future expansion and settlement of the New World. Rolfe is best remembered of his marriage to Pocahontas. This marriage brought a much-need period of peace between the Indian and the colonists until Powhatan’s death. But John Smith was more successful then John Rolfe because of the myths he himself created. Smith promoted the Virginia company’s interests in the New World and he provided the leadership necessary to save the colonists during the early years of the settlement. Although many of his narratives seem boastful and swashbuckling, his accounts were intended to lure adventurous new settlers to Virginia.   Ã‚  Ã‚  Ã‚  Ã‚  When the colonist suffered harsh winter, lack of fresh water, and the spread of disease made in Jamestown difficult for the settlers. Attacks by the native Indians, hoping that the settlers would give up and leave, raided their camps, stealing pistols, gunpowder, and other necessary supplies. Captain John Smith stepped forward as the leader of the colony when it became apparent that the council of seven was ineffective. He led expeditions into the interior and traded with the Indians for corn. In 1607, Smith and several other colonists left the fort to explore the local area. Unfortunately they ran into an Indian hunting party and were promptly captured by the Indians. Smith was treated kindly and a great feast was prepared in his honor. When Smith was not well received in Jamestown, Captain Christopher Newport and Gabriel Archer had assumed leadership during Smith’s absence and the colonists still suffered from a lack of food and proper shelter. Smith soon escaped from the tension of the fort and proceeded to explore the Potomac and Rappahannock rivers and the Chesapeake Bay during the summer of 1608. His explorations of Virginia were later complied in his Map of Virginia.   Ã‚  Ã‚  Ã‚  Ã‚  Due to bed government, Smith was eventually elected president of the local council in September 1608.

Positive environments for children and young people Essay

Positive environment A positive environment is one that supports all aspects of the child’s development; staff members/carers can provide the children different ways to extend their developments. By doing activities and guiding the children through their learning, this creates a positive environment for them. Example: Reading and writing activities will help the child or young person’s cognitive and intellectual development. Singing and speaking to the children or young people will help further their communication and language development. Praising and positive responses will encourage good behaviour and will help them understand right from wrong. This will help extend the child or young person’s physical and intellectual development. In the nursery that I am training in we allow the children and young people to have access to outside and inside, we call this ‘free play’. We have some staff inside and some outside to supervise the children and young people. Inside: We will set out an activity for them on the tables and in the ‘role-play. These activities could be finger painting, gluing and sticking; each activity we do with the children and young people will cover all aspects of their developments. All of these activities are supervised by either a member of staff or a student to ensure they are behaving and that they are all safe. ’ We have a baby gate that’s blocking the children and young people from the kitchen area, where the adults (members of staff will prepare their food, this is to ensure their safety. Outside Children and young people will have sand and water activities outside. They also have a variety of toys and places to explore such as the ‘shed shop’ and the ‘outdoor kitchen’. The children and young people also play with the bikes and scooters, these will only be taken out by and adult/member of  staff. The garden itself is surrounded by a wooden fence that has a gate (fire exit), this gate has a high bolt that can be moved by a member of staff. For both inside and outside we ensure that all the children and young people are supervised and that their needs are met; nappy changing, nap time and their lunch/snack time. We also provide the children and young people with a cold compress if they have had a bump or fall; we have a first aid kit for any other injuries the children may get when doing an activity. Regulatory requirements that underpin a positive environment for children and young people Early Years Foundation Stage (EYFS) Framework All early year providers must ensure that children and young people’s educational and intellectual needs are met and that the child or young people develop well. Ensures children are kept healthy and safe Ensures that children have the knowledge and skills they need to start school EYFS ensures that every child or young person makes good progress and no child gets left behind Learning and development opportunities which are planned around the needs and interests of each individual child and are assessed and reviewed regularly Partnership working between practitioners and with parents and/or carers Childcare Act 2006 Reduce child poverty: To support parents and carers to work, and focus on the provision of good quality childcare for working parents or adults. Reduce inequalities between young children: Focus on supporting children most at risk of poor outcomes because of deprivation and disadvantage and promote social mobility. Improve wellbeing for young people and children HSWA (the health & safety at work act 1974) Securing the health, safety and welfare of persons at work; Protecting persons, other than persons at work, against risks to health or safety arising out of or in connection with the activities of persons at work; Controlling of highly flammable or otherwise dangerous substances, stored correctly or locked away to prevent any harm or danger to any persons Cleaning and ensuring the work equipment is in working order and that instructions, training or supervision is given if needed Providing protective clothing or equipment if risks cannot be removed but can be prevented Report certain accidents, injuries, diseases and dangerous occurrences Care Standards Act 2006 People running day-care services for children up to eight years old must register with Ofsted Early Years (Office for Standards in Education, Children’s Services and Skills) Regular inspections must be carried out to ensure that the childcare setting is both safe and suitable for all young people and or those that are vulnerable In a childcare setting there must be an activity plan for all children and young people to ensure their educational needs and to help extend all their developments Safeguarding and welfare requirements Protection to all child and young persons Data protection Qualified staff, Training, Support and Skills Safety and Suitability of Premises, Environment and Equipment Confidentiality Staff Record Sheet Complaints Procedure Registration Form Safeguarding Children Policy Safeguarding Children Procedure Social Networking Policy Partnership with Parents Policy Settling In/Child Induction Policy Accident Record Form Recruitment Policy & Procedure Staff Employment Contract First Aid Box Guidance References Contribute to the Support of Positive Environments for Children and Young By lillie94 | March 2012 People http://www.studymode.com/essays/Contribute-To-The-Support-Of-Positive-944399.html How is Childcare Regulated? Page last updated: 11 September 2013 http://www.tameside.gov.uk/surestart/childcare/regulations#reg gov.uk Built by the Government Digital Service https://www.gov.uk/government/organisations/ofsted