Philippine Art Movement Essay

Sabel and the Dreamer Mark Justani created an oil painting entitled Abot Tanaw last 1997. In this painting, there’s a flying white kite and a floating person trying to reach for some sort of star in the night sky. The first thing that I noticed was the star the subject was trying to reach. It was quite noticeable because of the use of very bright colors on top of a dark night sky as background. The night sky was painted dark with highlights on the clouds. The subject was painted using bright colors as well. Shapes and lines were not very evident, though. There were no visible outlines on the subject. The only apparent shape was the diamond-shaped kite while the only evident lines were the stripes on the subject’s shirt. The dominant textures in the painting were soft ones, seen on the clouds, clothes and the skin of the subject. These elements of art give the feeling of being in a dream-like state. In the year 2002, Benedicto Reyes Cabrera, also known as Ben Cab, painted Homage to Sabel using acrylic paint on canvas. The name speaks of the subject, Sabel, a woman living in the streets. In this painting, she wears some sort of plastic material covering her body. Her face and hair was painted with brown and black colors respectively and white and grey for the covering on her body. I did not notice any shapes on the painting, yet I saw lines which were the apparent brushstrokes in every part of the subject. She smiles in the painting, drawing my eyes to her face. It was probably day time when this was rendered for the plastic seemed to be reflecting a lot of light. With the bright plastic and bright smile, the painting seemed to impart a warm, happy feeling. The colors used in the painting, Abot Tanaw, were well blended, making it look soft, giving the impression of a vague dream. Using bright colors on the subject made it stand out from the dark background. The absence of strong outlines and the use of light and shadow made the painting look 3 dimensional or realistic. The shadows show the contours of the body parts of the subject, adding to the realism of the subject. The presence of the flying kite on the night sky gives the impression of ironic events that usually happens in dreams since people don’t usually fly kites during the night. Meanwhile, Ben Cab used apparent brushstrokes for his painting of Sable, making it look rough, adding to the character of Sabel, a woman living in the streets. Sabel’s face was painted dark on top of a light background, also lifting it from the background, such as the subject of Abot Tanaw. Her plastic covering had a very apparent reflective texture because of the contrast between the shadows and lit areas, showing some bulkier areas. The covering also had stiff and flowing areas, like folded plastic, shown by both rigid brush lines and curved brush lines. The white plastic stands out from the red background as well. Abot Tanaw whispers â€Å"Dream.† I think what Mark Justani was trying to say that dreaming is the first and biggest step to achieving our goals, hence the nearness of the boy’s hand to the star. Without dreams, we cannot think of the possibilities we want to create for our lives. And to achieve our goals, we must believe in ourselves, as the subject believes that he can float and reach the star. The artwork speaks to me, telling me to believe in myself that I can be as great of an artist as Mark Justani is. I constantly bring myself down when I make mistakes or create a â€Å"bad† artwork because others bring me down as well. They constantly criticize my artworks: â€Å"where’s the other foot,† â€Å"she’s too fat,† and countless more. But, it is because of these critiques that I pursued to become better. The star is our goal, and the floating boy is each and every one of us. Mark Justani made this for us to see that he has reached hi s goal. He wants us to reach for ours too by believing in ourselves. Ben Cab oversteps the boundaries of classical or romantic art, whose subjects are usually beautiful women. He chose a very different muse, a woman living in the streets, using plastic or scraps of waste for clothes. Yet he was able to paint Sabel as real as she can be. Muses don’t have to be beautiful, nude ladies or women of high status. Society always dictates what is right or wrong, beautiful or ugly. I have found myself following these dictations, in art and in myself. I am used to following classical teachings regarding art. My subjects are usually people and animals, and I perfect them according to their anatomy, according to what I see with my eyes. I also dress myself according to what recent fashion magazines tell what is in. I perfect my artwork and myself according to what others see as beautiful. One thing that captivated me was Sabel’s smile. She smiles even though she has nothing. The painting imparts that we can be whoever we are and still be beautiful an d happy, paint whatever we want, see it beautiful and be happy about it. The boy in Mark Justani’s artwork looks a bit unappealing to me because, as I have mentioned, I grew up appreciating classical and romantic artworks. The face in not â€Å"ideal,† as classicists would say, yet I was able to appreciate its very Filipino rendering for it conveys an important message for us Filipinos that we can dream and try to reach for the stars. Sabel’s beauty portrayed by Ben Cab also changed my perception of beauty and happiness. Though I have the feeling that most people would not understand the portrait the way I have seen it, and think of it only as a portrait, it does not lack anything. Even though the subject is a repulsive person in real life, she is still meaningful. Society cannot tell us what we should dream of, how to be beautiful or how to be happy.

Sales Promotion Technique

Laura Schneider says that marketing is everything that we do to reach and persuade prospects. Marketing consists of the measures we use to reach and persuade our prospects. All of marketing components will cost producers or manufacturers that in turn will influence the retail price of a product. To exploit a potentially lucrative market is not as easy as just opening a room, and playing music. Diligent marketing research will actually be crucial to the success of conducting personal selling. Careful consideration should be given to a number of different factors such as location, demographic detail, and existing competition of the prospective market place. This is done so to conduct marketing campaign effectively, which is a combination of advertising, personal sales, public relations, and sales promotions in a creative and cost-effective way to increase gross sales. 2. Sales Promotion Technique 2. 1. Web-based solution Basically, sales promotions are non-personal promotional activities that intend to have direct impact on sales of a product. Some activities that are in the sales promotion category include media and non-media marketing communication, increase consumers demand, and improve product availability. One of sales techniques that can help a company in maximizing its sales promotion efforts is the MediaVisor. The product is uniquely created to help salesperson of the company in executing and analyzing their interactive sales promotion programs much better (DoubleClick, 2006c). For example, figure 1 shows a company’s online sales promotion that aims at having direct impact to sales. Figure 1 Double Click’s Various Customers Solutions Source: www. oubleclick. com In order to simplify the sales promotion, MediaVisor can help Sprint Nextel in creating an easy-to-use interface, which is designed to reduce the number of clicks required to perform common actions. Therefore, the use of MediaVisor will significantly enhance the effectiveness of sales promotion process (DoubleClick, 2006c). 2. 2. Direct Mail O ne of the greatest marketing tools is direct mail, also known as database marketing. This kind of promotion is so effective since a company deliver information/offering directly to customers or prospects although it has one obvious drawback: high cost. According to one report, direct mail has a high â€Å"cost-per-thousand,† meaning it costs more to send message to a thousand people through direct mail than it does through television. However, this high cost-per-thousand can be offset by a much higher return rate. 2. 3. Personal Selling Another type of marketing tools is personal selling which is oral communication with potential buyers of a product with the intention of making a sale. The personal selling may focus initially on developing a relationship with the potential buyer, but will always ultimately end with an attempt to closing the sale. There are several benefits of conducting personal selling as follows: ? Personal selling is a face-to-face activity; customers therefore obtain a relatively high degree of personal attention ? The sales message can be customized to meet the needs of the customer ? Personal selling is a good way of getting across large amounts of technical or other complex product information ? The face-to-face sales meeting gives the sales force chance to demonstrate the product ? Frequent meetings between sales force and customer provide an opportunity to build good long-term relationships The main disadvantage of personal selling is the cost of employing a sales force and other utilities such as building rental. In addition to the basic pay package, a business needs to provide incentives to achieve sales such as commission and bonus arrangements and the equipment to make sales calls including car, travel and subsistence costs, mobile phone etc. Moreover, conducting personal selling has one limitation: personal selling is not a cost-effective way of reaching a large audience since a sales person can only call on one customer at a time. 2. 4. Cash Rebates/Cash back Selecting one or more target markets then developing a marketing mix (product, price, promotion & distribution) that satisfies the needs of the target market. One of the strategies is to give cash rebates/ cash back as incentives for target market to keep visiting stores By definition, cash back Program is an incentive program that rewards customers for repeatedly shopping at stores. Hence, it generates more revenue from particular selling points. For example, if a company wants to increase the number of sales from online stores, they may present additional discount for customers who purchase online.

Linguistic imperialism Essay

Linguistic imperialism can be defined as the enforcement or imposition of one language onto another; it tends to be a key tool of the colonialist seeking to mend the ‘backward’ societies that they find, generally to their own purpose. Thus, writers such as Friel and Achebe have sought to rectify the still ever present colonialist perceptions of the west by attacking the use of language in their societies, for example, Hiberno-English in Translations. Furthermore, it is necessary to analyse the form and structure of the primary texts, for instance, how Achebe and Friel both manage to structure their texts in such a way that it gives a distinctly ‘foreign’ aesthetic, whilst still creating a subtly intelligent and critical narrative. Also, it is important to look at the literary techniques and devices that are used within Translations and Things Fall Apart, for example, dramatic irony (e. g. the reference to the potato famine in Translations) or symbols like Mr. Brown in Things Fall Apart, who represent a could-have-been harmonious presence between two vastly different cultures. In addition, it is necessary to contrast and compare the primary texts with secondary texts such as Ngugi wa Thiong’o’s ‘The Language of African Literature’, and analyse how relevant or constructive Things Fall Apart and Translations are in their underlying criticism of linguistic imperialism. Overall, it is a crucial to explore these various threads of investigation to come to an overall conclusion in terms of how Friel and Achebe present the issue of linguistic imperialism and how successful they are. George Steiner, in After Babel, writes that â€Å"Translation exists because men speak different languages† (1998, p. 51). He goes on to question it, by asking â€Å"Why should human beings speak thousands of different, mutually incomprehensible tongues? † (1998, p. 51), that homo sapiens are basically biologically the same; why have we not evolved to speak one common language? Steiner’s study of language and communication concludes that with the death of a language comes the dissolution of cultures and identities: â€Å"Each takes with it a storehouse of consciousness† (1998, p.56). This was of consequential influence to Brian Friel and Translations, notable throughout the play. For instance, the various ways in which Friel portrays translation – the cartographers; Owen’s â€Å"not-completely-correct† translation of Lancey; Maire and Yolland’s romantic tryst and so forth – create the notion that the English language is not compatible with Irish culture. This is an overarching idea that reaches its crescendo with the Donnelly twins, Friel’s representation of the Provision IRA within the play i. e. the violent end of Yolland, inferred by the actions of the Donnelly twins, is an echo of 1980s era conflicts. These conflicts were created by tensions still remaining today, by Protestants and Catholics in Northern Ireland; the Catholics calling for the reunification of Ireland, and Protestants wishing to remain separated – realistically, these tensions would have not necessarily existed had there been no British colonising of Ireland, and Translations has been identified as echoing Friel’s political interest in the matters. The reader or audience of Translations are bound by Friel to a highly complex idea of translation and the place of language in a culture; similarly, we are made aware of this in Things Fall Apart. One of the most accessible passages that exemplify this goes as follows: â€Å"When they had all gathered the white man began to speak to them. He spoke through an interpreter who was an Ibo man, though his dialect was different and harsh to the ears of Mbanta. Many people laughed at his dialect and the way he used words strangely. Instead of saying ‘myself’ he always said ‘my buttocks’. † (Things Fall Apart, p. 136) Subtly, Achebe feeds the reader linguistic perspective alien to most Western culture – that Africa was not, and is not, a land full of savages who cannot communicate as well as the Europeans, and instead a variety of different tongues that is not necessarily exactly recognisable from one clan to another. In regards to Translations, Friel has been left relatively unscathed by those in Ireland who may have felt abandoned by Friel’s artistic decision to employ Hiberno-English as opposed to contemporary Gaelic, whilst both authors have clearly chosen English as a medium to address linguistic imperialism (using the tool of colonialism against the colonialists). Achebe has been highly criticised for writing in English. Ngugi wa Thiong’o criticised African authors who chose English over their native tongue to write in. He asked â€Å"How did we arrive at this acceptance of ‘the fatalistic logic of the unassailable position of English in our literature’, in our culture, and in our politics?†¦ † (1995, p. 287) Thiong’o goes on to say that as the bullet is to physical subjugation, â€Å"language was the means of spiritual subjugation† (1995, p. 287). To understand Thiong’o’s logic, the reader needs to take into context a passage further on in the essay, which refers to his experiences at a colonial school and the use of his mother tongue, Gikuyu: â€Å"Thus one of the most humiliating experiences was to be caught speaking Gikuyu in the vicinity of the school. The culprit was given corporal punishment – three to five strokes of the cane on bare buttocks – or was made to carry a metal plate around the neck with inscriptions such as I AM STUPID or I AM A DONKEY †¦ † (1995, p. 288) Thiong’o is asserting that the use of English was imposed upon many of the African tribes and with it the enforcement of superiority and supposed civilisation†¦ to use Gikuyu was to be made to feel inferior and stupid, and to speak English fluently would be the height of education achievement. A further statement by Thiong’o states â€Å"Literary education was now determined by the dominant language while also reinforcing that dominance. Orature in Kenyan languages stopped. † (1995, p. 288). The loss of such orature and its replacement by the English written word was heavily destructive, according to Thiong’o – he concludes the essay be acknowledging that human society and culture is formed by the interactions and communication of people, that complex systems of ethics and experience, these systems creating one distinctive society from another. If the means of communication that has developed such a community is, like Tobair Vree in Translations â€Å"something is being eroded† (p. 53), or destroyed, then, much like Steiner, that society is lost. To Thiong’o, Achebe’s use of English over his native tongue is, rather than delicate manipulation for the anti-colonialist purpose, actually conducive in destroying that particular culture forever. However, despite Thiong’o’s clear dissatisfaction at Achebe’s use of the English language as a general point, this point could be considered moot. Early on in the essay, Thiong’o quotes Achebe as saying: â€Å"Is it right that a man should abandon his mother tongue for someone else’s? IT looks like a dreadful betrayal and produces a guilty feeling. But for me there is no other choice. I have been given the language and intend to use it. † (1995, p. 285 citing 1975, p. 62) This is evident in the careful construction and consideration of Things Fall Apart. Achebe has written a novel in which the reader could easily imagine themselves around a blazing fire with an elder of a Nigerian clan, with the story being meticulously recited to them. The rhythm of the novel is manipulated in such a way that it becomes less like an English-written novel and more a native piece of orature. For example, Achebe makes good use of drums in the novel, to create the rhythm of the traditional narrative: â€Å"Just then the distant beating of drums began to reach them†¦ the drums beat the unmistakable wrestling dance – quick, light and gay, and it came floating on the wind. † (Things Fall Apart, p. 41) A further use of language to create an ‘African English’ is the utilisation of proverbs, which play a central part in emphasising the Ibo culture, as â€Å"proverbs are the palm-oil with which words are eaten†. In addition, Achebe ‘peppers’ Things Fall Apart with Ibo words – this digression is an act of defiance to the colonists who felt they could just translate Ibo culture (religion, education and so forth). By this, Achebe means to illustrate the barriers of translation, in that there is no suitable word for, as an example, ogbanje, â€Å"one of those wicked children who, when they died, entered their mother’s womb to be born again†. Similarly, Achebe’s conquest to turn the Colonialist’s language back in on itself, Achebe wrote an essay called ‘An Image of Africa: Racism in Conrad’s Heart of Darkness’. Achebe analyses Western views of Africa (such as those of â€Å"that erudite British Historian Regius Professor of Oxford, Hugh Trevor Roper† (Achebe, 1961)) in stinging rhetoric which delivers the idea of that prolific early ‘anti-colonialist’ novelists like Conrad were, maybe unwittingly, racist in themselves. Achebe writes: â€Å"Conrad was born in 1857†¦ it was certainly not his fault that he lived†¦ [in a] time when the reputation of the black man was at a particularly low level. But†¦ there remains still in Conrad’s attitude a residue of antipathy to black people†¦ Certainly, Conrad had a problem with niggers. His inordinate love of that word itself should be of interest to psychoanalysts. Sometimes his fixation on blackness is equally interesting as when he gives us this brief description [of a black person]: A black figure stood up, strong long black legs, waving long black arms†¦ as though we might expect them to†¦ wave white arms! † (Achebe, 1961) In this short except, it is noticeable how Achebe associates Conrad’s conduplicatio of ‘black’ as sinister, and potentially in itself, a form of linguistic imperialism – in this, it is the fact that the word black (and nigger) has previously been held to have negative connotations or was created for a negative purpose, but both create a â€Å"‘reputation of the black man†¦ at a particularly low level† (Achebe, 1961). Achebe also goes on to say that these psychoanalysts who have already written at length about Conrad fail to recognise his attitude to black people, even in discussion over anti-Semitic values, â€Å"which only leads one to surmise that Western psychoanalysts must regard the kind of racism displayed by Conrad as absolutely normal† (Achebe, 1961) and that this same book of â€Å"vulgar fashion prejudices insults from which a section of mankind has suffered untold agonies† (Achebe, 1961) has been â€Å"described by a serious scholar as ‘among the half dozen greatest short novels in the English language† (Achebe, 1961). From this, the audience of this essay can understand that Achebe, in as short a summary as possible, suggests that one of the most famous – or in this case infamous – novellas to be written on the subject of Africa by a European stranger epitomises how the English language has been used as Thiong’o’s subjugation of the soul – even if Conrad’s intentions in writing it were not consciously racist, in trying to purvey a certain message he colonised the African peoples by associating them with pejoratives and otherwise negative descriptors. Friel and Achebe are both influential authors for similar reasons; they attack subversive, modern perceptions of ‘lost’ worlds that have in recent years movements like African National Congress in South Africa and the IRA in Ireland sought to revert nation-states to their ‘natural’, pre-colonial state. In this, they have both similar and not so similar approaches to literature, and have incorporated techniques to manipulate ideas incorporated in their book. For example, both authors make use of particular styles of writing to mimic the native language whilst writing in the colonial language (i.  e. English). In Friel’s case, this is Hiberno-English, which is a form of Irish that retains its Gaelic lexical structure whilst being spoken in English, for instance, when Doalty says to Manus â€Å"Hi, Manus, there’s two bucks down the road there asking for you† (Translations, p. 46) – in strict grammatical terms, Doalty’s syntax does not make sense in proper English, demonstrating inherent intimacy and deitis. Friel is applying the idea of Continual Presence of Gaelic to the English language. This application is also a theatrical device – or conceit – whereby Hugh is usually portrayed with an English accent, as he does not use Hiberno-English. Similarly, Achebe put simply, â€Å"both in vocabulary and sentence structure, he opts for the straightforward instead of the obtuse† (Easthope, 1988) and in doing so imitates traditional Ibo storytelling. Another literary device used by Friel and Achebe in their respective texts is their use of symbolism. In Things Fall Apart, Achebe uses locusts to symbolise the invading colonialists: â€Å"And then the locusts came†¦ the elders said locusts came once in a generation, reappeared every year for seven years and then disappeared for another lifetime. They went back to their caves in a distant land, where they were guarded by a race of stunted men. † (Things Fall Apart, p. 51) The above quote inferences that the locusts are the colonialists, by Achebe carefully alluding to the ‘race of stunted men’ that lives in a ‘distant land’. Achebe goes on: â€Å"Then quite suddenly a shadow fell on the world†¦ At first, a fairly small swarm came. They were harbingers sent to survey the land. And then appeared on the horizon a slowly moving mass like a boundless sheet of black cloud drifting towards Umuofia. † (Things Fall Apart, p. 52) In this, Achebe’s symbolism is clear – those like Mr. Brown and initial missionaries were assigned only to convert those ‘African savages’ into morally correct Christians, and to some extent allowed their cultures to live as congruently as possible. It is only with the materialisation of the District Commissioner who declares the Ibo people to be â€Å"in the dominion of our queen, the most powerful ruler in the world† that this comes to a head. Achebe foreshadows the ‘jumping ship’ of characters like Nwoye, by referencing the consumption of the locusts – such members of the community have consumed the colonialist culture, in all its forms, including language. Unlike Achebe’s extended metaphor of the locusts, Friel uses a passing, but nonetheless poignant, subtle symbolic reference to the potato famine. Bridget proclaims â€Å"†They say that’s the way it snakes in, don’t they? First they smell; and then one morning the stalks are all black and limp† (Translations, p. 18) with Maire exclaiming: â€Å"Sweet smell! Sweet smell! Every year at this time somebody comes back with stories of the sweet smell. Sweet God, did the potatoes ever fail in Baile Beag?†¦ There was never a blight here†¦ but we’re all sniffing about for†¦ a disaster. † (Translations, p. 18) This is symbolic of the rotting Irish culture, and failing language as contextually the potato was the staple foodstuff. The potato famine was not only symbolic, but also highly ironic – when Maire says â€Å"did the potatoes ever fail in Baile Beag? † the audience knows fully well that they would. This device, more specifically referred to as ‘dramatic irony’, is used often by Friel in Translations, and serves to foreshadow eventual destruction too. Another use of it is Hugh’s recital of The Aeneid: â€Å"†¦ Such was – such was the course – such was the course ordained – ordained by fate †¦ What the hell’s wrong with me? Sure I know it back ways, I’ll begin again. Urbs antiqua fuit†¦ † (Translations, pp. 90-91) This is doubly ironic, as on the one hand, Hugh cannot seem to fully remember it – Latin and Greek are often referenced throughout the play by Jimmy Jack and Hugh, both of them themselves being dead languages and cultures. Perhaps in further reference to After Babel by George Steiner, the fact that Hugh cannot remember it is a reflection of Gaelic – even intelligent scholars like him will eventually lose a tongue they have worked so hard to protect. A further projection of irony in Hugh’s recital is the content of Virgil’s The Aeneid. The Aeneid is a parallel between the destruction of Carthage, a city on the North African coast, by the Romans and the destruction of Baile Beag by the English. What is highly ironic about The Aeneid, and almost makes this piece of dramatic irony self-parodying, is that The Aeneid was written in the language of those that destroyed Carthage (the Romans). Again, irony is quite prevalent in Things Fall Apart with the most pertinent example falling, like Translations, at the end of the novel. This is the District Commissioner’s reaction to Okonkwo’s suicide: â€Å"Everyday brought him new material. The story of this man who had killed a messenger and hanged himself would make interesting reading. One could almost write a whole chapter on him. Perhaps not a whole chapter but a reasonable paragraph, at any rate. † (Things Fall Apart, p. 197) This is ironic because after the lengthy and tumultuous tale of Okonkwo and his struggles to not be like his father, the complex hierarchy of elders and the intricacy of Okonkwo and his struggles to not be like his father, the complex hierarchy of elders and the intricacy of their traditions and religion, the District Commissioner feels it can only ‘almost’ be written about in one chapter, and designates to only a paragraph. This is highly representative of the failure of the white man to ‘translate’ the Ibo culture and ability into being a highly complex culture, and instead treats the colonisation of the Ibo people as â€Å"The Pacification of the Primitive Tribes of the Lower Niger† (Things Fall Apart, p. 197). In conclusion, both Achebe and Friel carefully construct stories using literary devices that serve to recreate their personal heritage of a realistic and pitiful community who fall victim to unrepentant imperialism. In this, they have been able to repudiate colonial superiority in particular in regards to language and colonial ideas of ‘progression’. Whilst both portray three dimensional characters in that they are atomistic – for example, in Translations, Hugh’s view of the English is different to Owen’s which is in turn separate from Manus’s – and provides a highly explorative analysis of linguistic imperialism and its effect on individuals and the community. To summarise, all of the text referred to in this essay, in their own ways, are deeply critical of the effects of linguistic imperialism, particularly in the context of colonialism and so-called ‘progression’.

A needs orientated approach to care

This will be discussed in detail providing evidence of strengths and weaknesses of the model. The nursing process that will be discussed will be APIE which is assess, plan, implement and evaluate. A nursing process is a systematic approach which focuses on each patient as an individual ensuring that the patients holistic needs are taken into consideration. These include physical, social, psychological, cultural and environmental factors. . The nursing process is a problem solving framework for planning and delivering nursing care to patients and their families (Atkinson and Murray 1995). When used collaboratively the nursing model and the nursing process should provide a plan of care that considers the patient holistically rather than just focusing on their medical diagnosis (Moseby’s 2009). It will also discuss an example of a care plan done for a fictional patient and evaluate and discuss how the nursing plan and the nursing process have created a plan of care and how effect ive this was or was not. Care planning is a highly skilled process used in all healthcare settings which aims to ensure that the best possible care is given to each patient. The Nursing and Midwifery council state that care planning is only to be undertaken by qualified staff or by students under supervision. The Department of health (2009) says that â€Å"Personalized care planning is about addressing an individual’s full range of needs, taking into account their health, personal, social, economic, educational, mental health, ethinic and cultural background and circumstances† with the aim of returning the patient to their previous state before they became ill and were hospitalized considering all of these needs to provide patient centered care. It recognizes that there are other issues in addition to medical needs that can impact on a person’s total health and well being’.It provides a written record accessible to all health professionals where all nursing interventions can be d ocumented. Care planning is extremely important as it enables all staff involved in the care to have access to relevant information about the patients current medical problems and how this affecting them in relation to the 12 activities of living as well as any previous medical history. Barrett et al (2009) state that taking care of an individuals needs is a professional, legal and ethical requirement. There are many different nursing models all of which have strengths and weaknesses and its up to the nurse to choose the right one for individual patient, the model which is used will vary between different speciailties depending on which is more relevant to the patient and their illness and needs. Although a vast majority of hospitals now use pre-printed care plans it is important to remember that not all the questions on them will be relevant to all patients. An example of this would be that activity of breathing may not have any impact on a healthy young adult be would be a major f actor for an elderly man with COPD. There are four stages to the nursing process which are Assess, plan, implement and evaluate (APIE) but Barrett et al state that there should be six stages to include systematic nursing diagnosis and recheck (ASPIRE) as although they are included in the nursing process they are not separate stages and could be overlooked.(Barrett et al 2009). It is important that a nursing process is used and it is set out in a logical order, the way in that the nurse would think this helps minimize omissions or mistakes. Roper, Logan and Tierney model of nursing suggests that there are five interrelated concepts which need to be taken into consideration when planning and implementing care which are activities of living, lifespan, dependence/independence continuum, factors influencing activities of living and individuality in living (Roper, Logan and Tierney 2008). Assessment Assessment is fundamental to gaining all the information required about the patient in order to give the best possible care. â€Å"Assessment is extremely important because it provides the scientific basis for a complete nursing care plan† (Moseby’s 2009). The initial assessment untaken by nurses is to gather information regarding the patients needs but this is only the beginning of assessing as the holistic needs of the patient including physical, physiological, spiritual, social, economic and environmental needs to be taken into consideration in order to deliver appropriate individualized care (Roper, Logan and Tierney 2008). When using the 12 activities of living (ALs) for assessment it gives a list a basic information required but must not just be used as a list as the patient will respond better to questions asked in an informal manner and when just part of the general conversation. RLT (2008) state that although every AL is important some are more important than o ther and this can vary between patients. It is important for nurses to obtain appropriate information through both verbal and non-verbal conversation patients are more likely to give correct information but without jumping to conclusions or putting words into their mouths. ‘Assessment is the cornerstone on which a patients care is planned, implemented and evaluated (RLT 2008). â€Å"Poor or incomplete assessment subsequently leads to poor care planning and implementation of the care plan† (Sutcliffe 1990). Information can be gained from the patient, the patients family and friends as well as any health records (Peate I, 2010) During this process of gathering information it is important to find out what the patient can do as well as what they cant. , McCormack, Manley and Garbett (2004) state that gathering the information requires a certain kind of relationship between the nurse and the patient and nurses need to be able to communicate effectively in order to be able to build this relationship. A full assessment needs to consider how the patient was before they became ill or hospitalized in relation to their medical diagnosis as well as how the patient was dealing with it, how they are now, what is the change or difference if any, do they know what is causing the change, what if anything they are doing about it, do they have any resources now or have they have in the past to deal with the problem (barrett et al). RLT (2008) state that there are 5 factors that influence the 12 activities of living which are biological, psychological, sociocultural, environmental and politicoeconomic, these may not all hav e an effect on each patient but all need to be taken into consideration.The more information gained in the assessment process the easier the other steps will follow. RLT (2008) suggest that assessing is a continuous process and that further information will be obtained through observations and within the course of nursing the patient. At the end of the initial assessment the nurse should to identify the problems that the patient has. There are limitations to using a nursing process which are the 12 als are often used as a list as part of a core care plan and are not always individualized Walsh (1998) argues that the 12 activities of living may just be used as a list which could result in vital information being missed which could be detrimental to the patient. The Nursing and Midwifery Council (NMC 2008) states a nurse is personally and professionally accountable for actions and omissions in practice and any decisions made must always be justifiable. There are many benefits to using a nursing process it is patient centered and enables individualized care for each patient. It also gives patients input into their own care and gives them a greater sense of control it is outcome focused using subjective and objective information which helps and encourages evaluation of the care given. It also minimizes any errors and omissions. When I carried out the assessing stage on mabel I did this using the 12 activities of living as suggested by Roper et al (2008) but this was used too much like a checklist. I didn’t gather enough information in order to be able to do the best plan of care possible for her although I don’t feel this could have been detrimental to the care she received it needed more information than I had. I also found it difficult deciding which information should go where so I endened up repeating information in more than one of the 12 als, Which although this wouldn’t have made a difference to the planning of the care plan there was too much irrelevant information which could mean that it wasn’t read thoroughly just skimmed over as it would take too much time. As I am inexperienced in doing this I realized when writing the care plan that there were many questions that I didn’t ask so there where many parts that could not be filled in. I also didn’t gather e nough objective data for certain parts so I didn’t have any evidence that the care had worked or how effective it had been. This is where Barrett et al (2009) state that there should be a systematic nursing diagnosis where nurses establish a nursing diagnosis rather than just a medical diagnosis. This is where the holistic needs of a patient are taken into consideration. Although nursing diagnosis differs from a medical diagnosis the two do interlink but a nursing diagnosis considers the physical, psychological and spiritual aspects of the medical diagnosis and problems that may arise from these. Another part of the systematic nursing diagnosis is to provide baselines to state where the patients are at at the present time so that a needs statement can be written in conjunction with the patient in terminology that they can understand(Barrett et al 2009). Planning The next stage of the nursing process is planning this is where all the information gained in the assessment part to plan the care of the patient. The planning stage of the process is where achievable goals need to be made through discussion with care givers and the patient or the patients representative. These goals need to contain both subjective goals and objective goals in order for them to be measurable and evaluated. The plan of care is to solve the actual problems the patient has and to prevent potential problems from becoming actual ones. It also aims to help the patient cope with their illness in a positive way and to make them as comfortable and pain free as possible (RLT 2008). Planning needs to be totally individualized and patient centered they need to feel they have a voice and part of the team. The more information gathered in assessment the easier the plan of care will be. The main objective of a nursing plan is to ‘provide the information on which systematic, i ndividualized nursing can be based and individualized nursing can be based and implemented by any nurse’ (RLT 2008). Through a detailed individualized plan of care any nurse caring for a particular patient should be able to see exactly what is required of them as all the information will be recorded in the care plan. The NMC (2008) says that nursing interventions need to be specific for that particular patient, based on best evidence, measurable and achievable. There are many different criteria for setting goals just one of these is PRODUCT which stands for, Patient centered, recordable, observable and measurable, directive, understandable and clear, credible and time related. This is just meant as a way of helping nurses to set goals (Barrett et al 2009). When planning care a great emphasis needs to be based on the dependence/independence continuum which will have been established in the assessment phase. The care to be given will encourage the patient to get back to as rea sonably possible or as close to where they were on the continuum as they were before they were admitted to hospital. Planning also needs to take into account the resources available to implement the care as they need to ensure that the care they are planning is achievable and will not be compromised by lack of resources or a shortage of nursing staff (Roper et al 2008). When I did a plan of care for mabel it quickly became evident how inexperienced I was. I didn’t gather enough information in the assessing period to be able to do an effective plan of care. I also didn’t know how achievable the goals where as I wasn’t aware of how long they would take to improve or if they where achievable or not, I also found it difficult determine which problems were interrelated and as a result tried to link anxiety in with another problem when in fact it was a problem on its own. I was able to write the needs statements effectively that were not long but on a couple of these the influencing factors were missed out which would be necessary when providing holistic care. Planning care for a patient requires a great deal of knowledge in the chosen specialty which is why it must be carried out by a qualified member of staff or a student under supervision. Implementation Implementation is the next part of the nursing process and where all the goals which were set in the planning stage are put into motion and the goals can start to be achieved through nursing and medical interventions. The main component of the implementation stage is the delivery of the care to the patient. This is done with nursing staff, the multidisciplinary team members involved in the patients care such as doctor, dieticians and physiotherapists and the patient themselves in order for the patient to be able to return to how they were previously before they were admitted to hospital. The plan of care will be specific to the particular patient and will focus on the biopsychosocial aspects of the patient (Marriner 1983).Implementation provides great emphasis on individualized care which is why it is important to establish in the previous phases where they are on the dependence/independence continuum and what they are able to do now and what they were able to do before. Individualis ed care is associated with how the patient did things before such as how the person carries out the ALs and how often they carry these out. An example of this would be when carrying out the AL of personal cleansing and dressing to individualise the care it would be necessary to have determined in the assessing stage how the patient usually did this and how often it wouldn’t be individualized if in the care plan it was stated that they got a shower every morning if at home they only did this once a week. Core care plans may be used in certain situations this can provide a greater level of care as potential problems can be foreseen if related to a certain problem on the other hand it is also important not to standardize care as patients react differently to different illnesses and treatment. (Faulkner A, 2000). The NMC (2008) state that nurses are required to ‘Make the care of people your first concern, treating them as individuals and respecting their dignity’. In order to deal with certain problems or situations people often develop coping strategies which can be either adaptive or maladaptive. Adaptive coping strategies are usually helpful to the patient whereas maladaptive ones could be detrimental to their health such as smoking or drinking, the patient may feel this helps them to deal with a present situation but it is actually causing them harm. Patients need to be discouraged from using maladaptive coping strategies this could be done by introducing them to adaptive coping strategies and encouraging them to change their maladaptive ones into adaptive ones. Diamond (2008) states that there are also legal and ethical issues when it comes to implementing care as consent needs to be gained before any care is implemented and if this is not given the care cannot be given this will obviously have an effect on how effective the care has been when evaluating the care. The Nursing and Midwifery Council (NMC) state in section 3 of the code of c onduct ‘you must obtain consent before you give any treatment or care’ (2002). During the implementation of Mabel I found that although I was able to implement the care effectively I hadn’t recognized all of the nursing interventions needed to provide holistic care and I wasn’t fully aware of timescales of the planned care. I feel I also needed to research further into Mabel’s problems in order to gain the appropriate knowledge to provide the best care available as this would ensure that are the interventions are evidence based and best practice (NMC 2008). Barrett et el (2008) state that this is where recheck should take place which would enable the health care provider to establish how effective the plan of care is before the treatment ends this would enable them to re-evaluate the plan of care while the treatment is still ongoing and adjust the goals accordingly. Evaluation Evaluation is where the care that has been given can be assessed to evaluate the care given and whether it has worked or not. Chalmers (1986) describe that it is an ongoing and continuous process and also occurs at timed points in a formal setting. Roper et al (2000) say that evaluating care also provides a basis for ongoing assessment, planning and evaluation. There are two different parts to evaluation summative evaluation and formative evaluation. Formative evaluation is done with the patient taking into account whether they feel the care given has worked when done with consideration of the dependence/independence continuum information regarding the patients previous place on the dependence/independence continuum can be obtained from the patient, their friends and relatives as well as other health care professionals in the multidisciplinary team involved in the care of the patient. Summative evaluation is when the holistic view of the patient is taken into consideration how they feel about the treatment, whether they felt that the goals were achievable. It so where all the measureable data stated in the baselines and data received after this time are analyzed to show how effective or not the treatment has been. When evaluating care consideration needs to be given to the influencing factors such as biological factors as the bodies physical ability varies according to age the physical ability of an older person is generally less efficient, therefore therefore the plan of care needs to take this into consideration so that when the evaluation takes place it its hoped to have been effective. A nurse needs to evaluate her patient’s status regularly for some patients this will be just once a day but for others it will be much more frequent depending on their illness and healthcare status. RLT (2008) says that evaluation must be individual to the specific patient and not just a standard goal that is related to a specific problem. If goals haven’t been achieved then it is up to the nursing staff to determine why. Maybe the goals set weren’t measureable or achievable. Parsley and Corrigan (1999) say that if goals haven’t been measureable or achievable then new goals need t o be set. It could also be that the nursing interventions were not successful in which case new interventions should be set. Through my evaluation of Mabel it was evident that I did not require all the information to do a comprehensive plan of care. Although I did set baselines which meant I could compare data I wasn’t experienced enough to set goals to the correct timeframe I also didn’t obtain enough measureable information in certain problems to be fully able to assess how effective or ineffective the care had been. Had I had more experience I feel that the evaluation wouldn’t be a problem. Evaluation requires checking and rechecking in order to see the effectiveness of the care delivered. It requires knowledge and expertise to be able to effectively evaluate and amend the goals and interventions set as necessary. The whole care planning process took me a long time and I still was not very good at certain aspects of it. When setting goals a lot of detailed information is required in order for the plan of care to be effective so I can now understand why it is necessary for a trained member of staff to carry out the task. Conclusion This assignment has shown that when used together the nursing process and the nursing model provide a good basis to providing care. It sets out a systematic approach to providing care. Care needs to be set out in a way that both the nurse and the patient know exactly what is happening as well as any other health care professional in the multidisciplinary team providing care for the patient. It has also shown that involving patients in their care enables them to feel they are part of the team and are more likely to help themselves with their care. Reference list Sutcliffe E 1990, Reviewing the process progress. A critical review of literature on the nursing process. Senior Nurse, 10(a), 9-13. Applying the Roper-Logan-Tierney model in practice 2008 Elsevier ltd. Roper N, Logan W, Tierney J (2008) The Roper Logan Tierney model of nursing, Churchill Livingstone:London. Dimond, B. (2008) Legal Aspects of Nursing, 4th ed. Harlow: Pearson Education. Barrett D, Wilson B, Woolands A (2009) Care planning a guide for nurses: Pearson, Essex. Faulkner A (2000) Nursing The reflective approach to adult nursing. Stanley Thornes: Cheltenham. Peate I (2010) Nursing care and the activities of living 2nd ed. Wiley-Blackwell: West Sussex. Yura H, Walsh M (1983) The nursing process: Assessment, Planning, Implementing, Evaluating. Appleton Century: Crofts Norfolk. Cook S (1995) The merits of individualized measures within routine clinical practice. . http://www.dh.gov.uk/en/Healthcare/Longtermconditions/DH_093359(2009) (29/04/11 Alfaro R (2002), Applying the nursing process: Promoting collaborative care 5th ed. Lippincott: London. Moseby’s Medical Dictionary (2009), 8th ed, Elsevier. http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Accountability/[Date Accessed 11/04/2011]. McCormack B, Manley K and Garbett R (2004) Practice Development in Nursing, Blackwell Publishing, Oxford. Atkinson L Murray E, (1995), Clinical guide to care planning, McGraw, Oxford. NMC (2002), The NMC code of professional conduct, Nursing and Midwifery Council Publications A needs orientated approach to care This will be discussed in detail providing evidence of strengths and weaknesses of the model. The nursing process that will be discussed will be APIE which is assess, plan, implement and evaluate. A nursing process is a systematic approach which focuses on each patient as an individual ensuring that the patients holistic needs are taken into consideration. These include physical, social, psychological, cultural and environmental factors. . The nursing process is a problem solving framework for planning and delivering nursing care to patients and their families (Atkinson and Murray 1995). When used collaboratively the nursing model and the nursing process should provide a plan of care that considers the patient holistically rather than just focusing on their medical diagnosis (Moseby’s 2009). It will also discuss an example of a care plan done for a fictional patient and evaluate and discuss how the nursing plan and the nursing process have created a plan of care and how effect ive this was or was not. Care planning is a highly skilled process used in all healthcare settings which aims to ensure that the best possible care is given to each patient. The Nursing and Midwifery council state that care planning is only to be undertaken by qualified staff or by students under supervision. The Department of health (2009) says that â€Å"Personalized care planning is about addressing an individual’s full range of needs, taking into account their health, personal, social, economic, educational, mental health, ethinic and cultural background and circumstances† with the aim of returning the patient to their previous state before they became ill and were hospitalized considering all of these needs to provide patient centered care. It recognizes that there are other issues in addition to medical needs that can impact on a person’s total health and well being’.It provides a written record accessible to all health professionals where all nursing interventions can be d ocumented. Care planning is extremely important as it enables all staff involved in the care to have access to relevant information about the patients current medical problems and how this affecting them in relation to the 12 activities of living as well as any previous medical history. Barrett et al (2009) state that taking care of an individuals needs is a professional, legal and ethical requirement. There are many different nursing models all of which have strengths and weaknesses and its up to the nurse to choose the right one for individual patient, the model which is used will vary between different speciailties depending on which is more relevant to the patient and their illness and needs. Although a vast majority of hospitals now use pre-printed care plans it is important to remember that not all the questions on them will be relevant to all patients. An example of this would be that activity of breathing may not have any impact on a healthy young adult be would be a major f actor for an elderly man with COPD. There are four stages to the nursing process which are Assess, plan, implement and evaluate (APIE) but Barrett et al state that there should be six stages to include systematic nursing diagnosis and recheck (ASPIRE) as although they are included in the nursing process they are not separate stages and could be overlooked.(Barrett et al 2009). It is important that a nursing process is used and it is set out in a logical order, the way in that the nurse would think this helps minimize omissions or mistakes. Roper, Logan and Tierney model of nursing suggests that there are five interrelated concepts which need to be taken into consideration when planning and implementing care which are activities of living, lifespan, dependence/independence continuum, factors influencing activities of living and individuality in living (Roper, Logan and Tierney 2008). Assessment Assessment is fundamental to gaining all the information required about the patient in order to give the best possible care. â€Å"Assessment is extremely important because it provides the scientific basis for a complete nursing care plan† (Moseby’s 2009). The initial assessment untaken by nurses is to gather information regarding the patients needs but this is only the beginning of assessing as the holistic needs of the patient including physical, physiological, spiritual, social, economic and environmental needs to be taken into consideration in order to deliver appropriate individualized care (Roper, Logan and Tierney 2008). When using the 12 activities of living (ALs) for assessment it gives a list a basic information required but must not just be used as a list as the patient will respond better to questions asked in an informal manner and when just part of the general conversation. RLT (2008) state that although every AL is important some are more important than o ther and this can vary between patients. It is important for nurses to obtain appropriate information through both verbal and non-verbal conversation patients are more likely to give correct information but without jumping to conclusions or putting words into their mouths. ‘Assessment is the cornerstone on which a patients care is planned, implemented and evaluated (RLT 2008). â€Å"Poor or incomplete assessment subsequently leads to poor care planning and implementation of the care plan† (Sutcliffe 1990). Information can be gained from the patient, the patients family and friends as well as any health records (Peate I, 2010) During this process of gathering information it is important to find out what the patient can do as well as what they cant. , McCormack, Manley and Garbett (2004) state that gathering the information requires a certain kind of relationship between the nurse and the patient and nurses need to be able to communicate effectively in order to be able to build this relationship. A full assessment needs to consider how the patient was before they became ill or hospitalized in relation to their medical diagnosis as well as how the patient was dealing with it, how they are now, what is the change or difference if any, do they know what is causing the change, what if anything they are doing about it, do they have any resources now or have they have in the past to deal with the problem (barrett et al). RLT (2008) state that there are 5 factors that influence the 12 activities of living which are biological, psychological, sociocultural, environmental and politicoeconomic, these may not all hav e an effect on each patient but all need to be taken into consideration.The more information gained in the assessment process the easier the other steps will follow. RLT (2008) suggest that assessing is a continuous process and that further information will be obtained through observations and within the course of nursing the patient. At the end of the initial assessment the nurse should to identify the problems that the patient has. There are limitations to using a nursing process which are the 12 als are often used as a list as part of a core care plan and are not always individualized Walsh (1998) argues that the 12 activities of living may just be used as a list which could result in vital information being missed which could be detrimental to the patient. The Nursing and Midwifery Council (NMC 2008) states a nurse is personally and professionally accountable for actions and omissions in practice and any decisions made must always be justifiable. There are many benefits to using a nursing process it is patient centered and enables individualized care for each patient. It also gives patients input into their own care and gives them a greater sense of control it is outcome focused using subjective and objective information which helps and encourages evaluation of the care given. It also minimizes any errors and omissions. When I carried out the assessing stage on mabel I did this using the 12 activities of living as suggested by Roper et al (2008) but this was used too much like a checklist. I didn’t gather enough information in order to be able to do the best plan of care possible for her although I don’t feel this could have been detrimental to the care she received it needed more information than I had. I also found it difficult deciding which information should go where so I endened up repeating information in more than one of the 12 als, Which although this wouldn’t have made a difference to the planning of the care plan there was too much irrelevant information which could mean that it wasn’t read thoroughly just skimmed over as it would take too much time. As I am inexperienced in doing this I realized when writing the care plan that there were many questions that I didn’t ask so there where many parts that could not be filled in. I also didn’t gather e nough objective data for certain parts so I didn’t have any evidence that the care had worked or how effective it had been. This is where Barrett et al (2009) state that there should be a systematic nursing diagnosis where nurses establish a nursing diagnosis rather than just a medical diagnosis. This is where the holistic needs of a patient are taken into consideration. Although nursing diagnosis differs from a medical diagnosis the two do interlink but a nursing diagnosis considers the physical, psychological and spiritual aspects of the medical diagnosis and problems that may arise from these. Another part of the systematic nursing diagnosis is to provide baselines to state where the patients are at at the present time so that a needs statement can be written in conjunction with the patient in terminology that they can understand(Barrett et al 2009). Planning The next stage of the nursing process is planning this is where all the information gained in the assessment part to plan the care of the patient. The planning stage of the process is where achievable goals need to be made through discussion with care givers and the patient or the patients representative. These goals need to contain both subjective goals and objective goals in order for them to be measurable and evaluated. The plan of care is to solve the actual problems the patient has and to prevent potential problems from becoming actual ones. It also aims to help the patient cope with their illness in a positive way and to make them as comfortable and pain free as possible (RLT 2008). Planning needs to be totally individualized and patient centered they need to feel they have a voice and part of the team. The more information gathered in assessment the easier the plan of care will be. The main objective of a nursing plan is to ‘provide the information on which systematic, i ndividualized nursing can be based and individualized nursing can be based and implemented by any nurse’ (RLT 2008). Through a detailed individualized plan of care any nurse caring for a particular patient should be able to see exactly what is required of them as all the information will be recorded in the care plan. The NMC (2008) says that nursing interventions need to be specific for that particular patient, based on best evidence, measurable and achievable. There are many different criteria for setting goals just one of these is PRODUCT which stands for, Patient centered, recordable, observable and measurable, directive, understandable and clear, credible and time related. This is just meant as a way of helping nurses to set goals (Barrett et al 2009). When planning care a great emphasis needs to be based on the dependence/independence continuum which will have been established in the assessment phase. The care to be given will encourage the patient to get back to as rea sonably possible or as close to where they were on the continuum as they were before they were admitted to hospital. Planning also needs to take into account the resources available to implement the care as they need to ensure that the care they are planning is achievable and will not be compromised by lack of resources or a shortage of nursing staff (Roper et al 2008). When I did a plan of care for mabel it quickly became evident how inexperienced I was. I didn’t gather enough information in the assessing period to be able to do an effective plan of care. I also didn’t know how achievable the goals where as I wasn’t aware of how long they would take to improve or if they where achievable or not, I also found it difficult determine which problems were interrelated and as a result tried to link anxiety in with another problem when in fact it was a problem on its own. I was able to write the needs statements effectively that were not long but on a couple of these the influencing factors were missed out which would be necessary when providing holistic care. Planning care for a patient requires a great deal of knowledge in the chosen specialty which is why it must be carried out by a qualified member of staff or a student under supervision. Implementation Implementation is the next part of the nursing process and where all the goals which were set in the planning stage are put into motion and the goals can start to be achieved through nursing and medical interventions. The main component of the implementation stage is the delivery of the care to the patient. This is done with nursing staff, the multidisciplinary team members involved in the patients care such as doctor, dieticians and physiotherapists and the patient themselves in order for the patient to be able to return to how they were previously before they were admitted to hospital. The plan of care will be specific to the particular patient and will focus on the biopsychosocial aspects of the patient (Marriner 1983).Implementation provides great emphasis on individualized care which is why it is important to establish in the previous phases where they are on the dependence/independence continuum and what they are able to do now and what they were able to do before. Individualis ed care is associated with how the patient did things before such as how the person carries out the ALs and how often they carry these out. An example of this would be when carrying out the AL of personal cleansing and dressing to individualise the care it would be necessary to have determined in the assessing stage how the patient usually did this and how often it wouldn’t be individualized if in the care plan it was stated that they got a shower every morning if at home they only did this once a week. Core care plans may be used in certain situations this can provide a greater level of care as potential problems can be foreseen if related to a certain problem on the other hand it is also important not to standardize care as patients react differently to different illnesses and treatment. (Faulkner A, 2000). The NMC (2008) state that nurses are required to ‘Make the care of people your first concern, treating them as individuals and respecting their dignity’. In order to deal with certain problems or situations people often develop coping strategies which can be either adaptive or maladaptive. Adaptive coping strategies are usually helpful to the patient whereas maladaptive ones could be detrimental to their health such as smoking or drinking, the patient may feel this helps them to deal with a present situation but it is actually causing them harm. Patients need to be discouraged from using maladaptive coping strategies this could be done by introducing them to adaptive coping strategies and encouraging them to change their maladaptive ones into adaptive ones. Diamond (2008) states that there are also legal and ethical issues when it comes to implementing care as consent needs to be gained before any care is implemented and if this is not given the care cannot be given this will obviously have an effect on how effective the care has been when evaluating the care. The Nursing and Midwifery Council (NMC) state in section 3 of the code of c onduct ‘you must obtain consent before you give any treatment or care’ (2002). During the implementation of Mabel I found that although I was able to implement the care effectively I hadn’t recognized all of the nursing interventions needed to provide holistic care and I wasn’t fully aware of timescales of the planned care. I feel I also needed to research further into Mabel’s problems in order to gain the appropriate knowledge to provide the best care available as this would ensure that are the interventions are evidence based and best practice (NMC 2008). Barrett et el (2008) state that this is where recheck should take place which would enable the health care provider to establish how effective the plan of care is before the treatment ends this would enable them to re-evaluate the plan of care while the treatment is still ongoing and adjust the goals accordingly. Evaluation Evaluation is where the care that has been given can be assessed to evaluate the care given and whether it has worked or not. Chalmers (1986) describe that it is an ongoing and continuous process and also occurs at timed points in a formal setting. Roper et al (2000) say that evaluating care also provides a basis for ongoing assessment, planning and evaluation. There are two different parts to evaluation summative evaluation and formative evaluation. Formative evaluation is done with the patient taking into account whether they feel the care given has worked when done with consideration of the dependence/independence continuum information regarding the patients previous place on the dependence/independence continuum can be obtained from the patient, their friends and relatives as well as other health care professionals in the multidisciplinary team involved in the care of the patient. Summative evaluation is when the holistic view of the patient is taken into consideration how they feel about the treatment, whether they felt that the goals were achievable. It so where all the measureable data stated in the baselines and data received after this time are analyzed to show how effective or not the treatment has been. When evaluating care consideration needs to be given to the influencing factors such as biological factors as the bodies physical ability varies according to age the physical ability of an older person is generally less efficient, therefore therefore the plan of care needs to take this into consideration so that when the evaluation takes place it its hoped to have been effective. A nurse needs to evaluate her patient’s status regularly for some patients this will be just once a day but for others it will be much more frequent depending on their illness and healthcare status. RLT (2008) says that evaluation must be individual to the specific patient and not just a standard goal that is related to a specific problem. If goals haven’t been achieved then it is up to the nursing staff to determine why. Maybe the goals set weren’t measureable or achievable. Parsley and Corrigan (1999) say that if goals haven’t been measureable or achievable then new goals need t o be set. It could also be that the nursing interventions were not successful in which case new interventions should be set. Through my evaluation of Mabel it was evident that I did not require all the information to do a comprehensive plan of care. Although I did set baselines which meant I could compare data I wasn’t experienced enough to set goals to the correct timeframe I also didn’t obtain enough measureable information in certain problems to be fully able to assess how effective or ineffective the care had been. Had I had more experience I feel that the evaluation wouldn’t be a problem. Evaluation requires checking and rechecking in order to see the effectiveness of the care delivered. It requires knowledge and expertise to be able to effectively evaluate and amend the goals and interventions set as necessary. The whole care planning process took me a long time and I still was not very good at certain aspects of it. When setting goals a lot of detailed information is required in order for the plan of care to be effective so I can now understand why it is necessary for a trained member of staff to carry out the task. Conclusion This assignment has shown that when used together the nursing process and the nursing model provide a good basis to providing care. It sets out a systematic approach to providing care. Care needs to be set out in a way that both the nurse and the patient know exactly what is happening as well as any other health care professional in the multidisciplinary team providing care for the patient. It has also shown that involving patients in their care enables them to feel they are part of the team and are more likely to help themselves with their care. Reference list Sutcliffe E 1990, Reviewing the process progress. A critical review of literature on the nursing process. Senior Nurse, 10(a), 9-13. Applying the Roper-Logan-Tierney model in practice 2008 Elsevier ltd. Roper N, Logan W, Tierney J (2008) The Roper Logan Tierney model of nursing, Churchill Livingstone:London. Dimond, B. (2008) Legal Aspects of Nursing, 4th ed. Harlow: Pearson Education. Barrett D, Wilson B, Woolands A (2009) Care planning a guide for nurses: Pearson, Essex. Faulkner A (2000) Nursing The reflective approach to adult nursing. Stanley Thornes: Cheltenham. Peate I (2010) Nursing care and the activities of living 2nd ed. Wiley-Blackwell: West Sussex. Yura H, Walsh M (1983) The nursing process: Assessment, Planning, Implementing, Evaluating. Appleton Century: Crofts Norfolk. Cook S (1995) The merits of individualized measures within routine clinical practice. . http://www.dh.gov.uk/en/Healthcare/Longtermconditions/DH_093359(2009) (29/04/11 Alfaro R (2002), Applying the nursing process: Promoting collaborative care 5th ed. Lippincott: London. Moseby’s Medical Dictionary (2009), 8th ed, Elsevier. http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Accountability/[Date Accessed 11/04/2011]. McCormack B, Manley K and Garbett R (2004) Practice Development in Nursing, Blackwell Publishing, Oxford. Atkinson L Murray E, (1995), Clinical guide to care planning, McGraw, Oxford. NMC (2002), The NMC code of professional conduct, Nursing and Midwifery Council Publications

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Intellectual Property - Essay Example The paper the looks at areas for opportunities to devise a new innovative customer-focus service, how and where to search to devise and develop a new customer-focused service idea, and the new services development (NSD) process. The paper then looks at the potential risks and costs that will be determine by the successful development of new or modified services and the intellectual property issues. Finally, the paper makes a conclusion based on the discussions from the research conducted. There has been an increased attention on innovation which is the key to organizational growth and development. Most organizations today face increased competition because of the fast pace of improved technology, and the market external change that has pushed economic and organizational growth. Innovation has become a crucial part of organizations which has been driven by excellent labor force and advanced machinery. Therefore, innovation has become a powerful method of securing a competitive advantage and as a way of defending the strategic position. The research and development plays a crucial role in product and service innovation process. Innovation does not only apply to product or services, but also aims at improving the way people work, live, and play. Innovation has two aspects, which include radical and incremental innovations. Radical innovation refers to a total change in the way people think and use products or manufacture new products as compared to the way they did things before. This form of innovation aims at taking advantage of new technology, thus, creating new opportunities. On the other hand, incremental innovation is involves a day to day change in an organization in order to make sure that there is a continuous improvement in the productivity and quality of products and services through innovation. There are four types of innovation that includes the process

Particle Physics Essay Example | Topics and Well Written Essays - 7000 words

Particle Physics - Essay Example Search for a complete or full particle physics model is still on and experts are exploring the options of either producing a completely new innovative theory or model or constructing an efficient model merging the relative gravity and the Standard Models. This search saw the emergence of a variety of new-age models beyond the Standard Model. However, merging these theories is not so simple as it sounds and there are some difficulties that need to be tackled (Green et. al., 1987). These models are build upon different basic assumptions and concepts and this is why one finds it difficult to merge such models. QFT depends on particle fields embedded in the flat space-time of special relativity whereas, General Relativity accounts gravity as a curvature within space-time that changes as mass moves (Zee A., 2003). The simple option of merging these two theories considering gravity as another particle field seems to end up creating the so-called renormalization problem. As per the traditional understanding, gravity particles would attract each other and add up all the interactions resulting in many infinite values which cannot be easily cancelled out by methematical interventions (Linde, 1990), thereby ruling out the possibility of getting any sensible or finite results or values. This outcome is in contrast with quantum electrodynamics where, the addition of the interactions results in comparatively lesser infinite values which can be removed or cancelled out via renormalization (Banks, 1985). The long-range forces like the electromagnetic and gravity forces are believed to be meditated by massless particles with spin j 1 and as such, proper description of such massless particles in quantum field theory (QFT) is very important (Aitchison & Hey, 1989). This directionally brings in the fascinating approach of emergent gravity indicating that gravity may not be a component of fundamental physics. However, this concept of emergent gravity theory has been branded to be a misguided one by Steven Weinberg and Edward Witten (See, Jackson & Okun, 2001). Gravity was speculated to be an emergent phenemonon during the 1980s and supporting this, many theories like the 'Preon theories', Technicolor theories', etc. went on to regard that gluons might be composite. Noticing this, Weinberg & Witten came out with a 'no-go theorem' called the 'Weinberg-Witten Theorem' that excludes the hypothetical composite and emergent theories (Wienberg & Witten, HUTP-80). This theorem indicates that an i nteracting graviton cannot emerge from an ordinary Quantum Field Theory (QFT) in the same space-time. The Weinberg-Witten theorem forbids the existence of any massless particles with helicity j>1 in any theory with a Lorentz covariant energy-momentum tensor and also restricts charged massless particles of helicity>1/2 in any theory with a Lorentz covariant conserved current. This basically prohibits the existence of both graviton and the gluon but this can be avoided due to gauge symmetries. Taking on from here, this paper proceeds to decode and

Media studies Essay Example | Topics and Well Written Essays - 2000 words

Media studies - Essay Example It shall aim at the way the newspapers are written edited and made. Research proposal Review of the prior newspapers I endeavored the reviewing of the earlier newspapers so as to have the prior knowledge of the news papers. The review is aimed at establishing the exploration degree in the field of research. It is now vivid that after the analysis of the other newspapers, I realized that this field has been explored thoroughly but I will conduct a research or the other reasons that I will mention later. After conducting the prior review, I realized that the main problems likely to occur during the actual study. The problems that occurred There were power shortcuts There were no cooperative respondents. There was a lot of the work There were several researchers in the site. Schedule 7.00-7.30: The troop left to the media house. 8.00-8.30: The troop arrived in the news room and introduced to the attendants 9.00: The troop started the study and answering the questions. 10.00-10.30: The t roop went for the breakfast in the canteen within the compound. 10.30-1.00: The team proceeded and conducted the actual study. 1.00-4.00: After the lunch hour, the troop proceeded and conducted the study. ... I have an aim to promote the newspaper publishing press by informing the companies the essence of advertising through the newspaper. I will also encourage the upcoming generations people like the students the essence of studying the journalism so as to promote this newspaper sector. Buy establishing the exact figure of the company that advertises its products through the news papers, I will deliver the information to the relevant companies and prospective consumers of the companies. Then the information that is delivered shall be used by the customers to gauge when to find the products, where to find it and who supplies the product. Similarly, the associated companies shall serve to find the potential customers through the newspapers and also know when to meet them. A successful research shall help to establish the major challenges that are usually faced by the editors. This is because, by getting to know what the editors are bored largely with, we shall try to solve the situation. I f it is the idea of the modern printing devises or any thing else, stands a chance to be solved. In this case, solving means that working on it and getting him better ways. This is through writing the report to the willing people who can help donate the cash to bring out the change. The report is also written to the central government to help solve the problem (Greene, 2005). This research shall only help to gauge out net requirements t to meet the position of editing. This is because; I have to stimulate most of the upcoming minds and students to pursue the related courses so as to become the editors of the newspapers. This is because; editing is one of the fields of study that should be thoroughly pursued by most people (Basu, 2010). My research is also aimed at establishing