Union Membership Essay Example for Free

Union Membership Essay With great attention being placed on medication safety and reduction of healthcare costs, involvement of information technology in health care is increasing (Kuperman Gibson, 2003). Examples of this so-called patient care information systems are order entry systems, medical records systems, radiology information systems and patient information systems with Computerized Provider Order Entry, or Computer Physician Order Entry, (CPOE) receiving valuable attention (Ash, Berg, Coiera, 2004). Thus, this paper will be focused on CPOE as an emerging health care technology. CPOE, as defined by (Campbvell et al. , 2006), is: †¦the process by which physicians or their surrogates (but not intermediaries) directly enter medical orders into a computer application (p. 547). With this transformation from handwriting orders into encoding them into the computer, CPOE is seen as an important platform for the enhancement of health care delivery (Gibson Kuperman, 2003). Gibson and Kuperman (2003) have noted the positive outcomes of CPOE in the following areas: a) preventive care measures; b) compliance with drug monitoring; c) laboratory test ordering; d) radiologic test ordering; e) medication error reduction; f) decrease length of hospital stay; g) time-saving communication with the healthcare team; h) standardization of practice; i) clinical decision support; and, j) storage of data for management, quality, and research monitoring. Thus, CPOE is seen as the ticket for the avoidance of underuse, misuse, and overuse of health care (Gibson Kuperman, 2003) with endorsements from the Leapfrog Group as being an important leap for health care quality (Gibson Kuperman, 2003). Yet, as in any other technology, the complexity, advanced features, and high demands of CPOE can lead to consequences that are unintentional (Campbell et al. , 2006). Though CPOE also bears positive and beneficial UC’s, the alarming negative consequences which affects the healthcare, especially that of nursing services, will be the focus of this study with the aim of presenting the adverse UC’s of using such an emerging health care technology. CPOE: NOT ALL GOOD Campbell and colleagues (2006) conducted a study that pointed out to 9 different unintended consequences of CPOE to healthcare. In decreasing frequency, these UC’s are: a) more/new work for clinicians; b) workflow issues; c) never ending system demands; d) paper persistence; e) changes in communication patterns and practices; f) negative emotions; g) new kinds of errors; h) changes in the power structure; and i) overdependence on technology (p. 549). (See table 1). Among these UC’s, others affect the medical professionals or the healthcare organizations only while some encompasses its effect on nursing services. Since this paper is focused on the UC’s that affect the clinical nursing care, focus is given on the following UC’s of CPOE: a) workflow issues; and, b) changes in communication patterns and practices. Workflow Issues Clinical workflows are complex thereby necessitating dynamism (Campbell et al. 2006). With traditional health care workflows, steps are more adaptable and include a variety of checks and balances, interventions and exceptions (Campbell et al. , 2006). These consist of several concurrent and asynchronous steps that could adjust, cease, or intervene in the processing of medical orders (Campbell et al. , 2006). CPOE, as evidenced by the study of Campbell et al. , (2006), abolish these multiple interdependent steps resulting in lesser procedure reviews and greater potential hardships. CPOE has clinical ordering processes that follow predictable steps where the doctor encodes and order, the system delivers it to the rightful destination, the order is processed, and the request is acted upon (Campbell et al. , 2006). But then, this rigid adaptation of hospital procedures is different from what occurs in the real setting (Campbell et al. , 2006). In actual practice, simultaneous actions on wide dimensions like assessing patients, carrying out orders, and responding to emergencies, require flexibility by healthcare providers especially that of nurses (Ash, Berg, Coiera, 2004). As Campbell et al. (2006) note, nurses are with good experiences are able to blend orders as necessary. Ash, Berg, and Coiera (2004) agrees to this by stating that in everyday health care work, experienced nurses are more often knowledgeable about medications than many other junior physicians who populate the ward. With the strict implementation of rules by CPOE, this flexibility of nurses especially in areas of emergency care and â€Å"stat† actions are disregarded and are not permitted (Campbell et al. , 2006). This is in favor of quality and management control, but has great risks for health care provision (Campbell et al. , 2006). This shows CPOE’s failure to support individual role players and work-shifting in the health care area that may lead to ineffective work activity synchronizations (Capmbell et al. , 2006). As such, this lack of support for the highly flexible and fluid ways of real life clinical workflow is burdensome for medical and nursing professionals (Ash, Berg, Coiera, 2004). Changes in Communication Patterns and Practices Health care professionals are connected by sharing professional opinions and needs through noting progress and conducting referrals (Ash, Berg, Coiera, 2004). CPOE alters this traditional pattern by replacing previously interpersonal conversations regarding provision of care with a computer system that creates problems in the clinical care work (Campbell et al. , 2006). By communicating only through the computer, physicians are provided with an â€Å"illusion of communication† by believing that entry of an order into the system guarantees that proper people will receive it and take appropriate actions (Campbell et al. , 2006). This places the blame on nurses for non-carrying out of orders as they are expected to have performed it (Campbell et al. , 2006). But with a fast-paced work in wards and special areas, nurses are more often on bedside care rather than facing the computer resulting in delayed notification of new orders, or worse non-information at all (Campbell et al. , 2006). Also, the time that elapsed from the physician seeing the patient and encoding the order may take precious moments that may consist of changes in the status of the patient’s condition (Campbell et al. , 2006). This results in untimely orders received by nurses, who are the implementers of such encoded orders. Communication also involves more than transferring information. More importantly, it is about evaluating the person’s reception and understanding of the situation and the willingness to intervene on that information through feedbacks (Ash, Berg, Coiera, 2004). With face-to-face conversations by doctors and nurses, timely feedbacks are given by each resulting to more appropriate interventions (Campbell et al. , 2006). With CPOE, the lessened feedback leads to orders missed, diagnostic tests delayed, and medications not given at all because timely feedbacks have not been exchanged (Ash, Berg, Coiera, 2004). This disregard for interpersonal communications by CPOE can be troublesome for the clinical work. With a reduction in face-to-face communications, errors due to miscommunications, delayed actions, and fewer team-wide discussions may result (Campbell et al. , 2006). CONCLUSION With the complexity and imperfections of human operations, even emerging technologies with good intentions are expected to have, in one way or the other, unintended consequences. In the light of CPOE’s, though intentions are directed towards improving safety and quality of health care, some effects result as this new technology is embraced by healthcare practice that has long survived without the use of such. As it affects aspects of healthcare, nurses, who implement most of the orders entered by doctors through CPOE’s, are also affected. As CPOE disrupts the conventional health care workflow, it also changes the flexible roles of nurses and care providers in terms of clinical work and responsibilities. In the light of CPOE changing interpersonal communication practices, the traditional face-to-face interactions are lessened thereby leading to poor coordination among nurses and physicians and other ancillary care providers. Thus, with the promise benefits of CPOE, a clear review of the already known and possible unintended consequences to health and nursing care must be made if CPOE is to be imposed in health settings. By doing so, preparations for these effects may be made leading to a more enjoyment of CPOE good effects rather than suffering from its adverse unintended consequences. References Ash, J. S. , Berg, M. , Coiera, E. (2004). Some unintended consequences of information technology in health care: The nature of patient care information system-related errors. Journal of the American Medical Infromatics Association, 11, 104-112. Campbell, E. M. , Sittig, D. F. , Ash, J. S. , Guappone, K. P. , Dykstra, R. H. (2006). Types of unintended consequences related to Computerized Provider Order Entry. Journal of the American Medical Infromatics Association, 13 (5), 547-556. Coyne, C. J. (2008). Unintended consequences. In: Fortier, J. (Ed. ), Key concepts in free markets: Executive summaries in the History and theory of free market economics, 115-138. Vancouver, BC: The Fraser Institute. Kuperman, G. J. Gibson, R. F. (2003). Computer physician order entry: Benefits, costs, and issues. Annals of Internal Medicine, 139, 31-39. Merton K. (1936). The unanticipated consequences of purposive social action. American Sociological Review, 1, 894-904. MSN Encarta (2008). Side effect. Retrieved October 23, 2008, from http://encarta. msn. com/dictionary_/side%2520effects. html Spratto, G. R. Woods, A. L. (2008). PDR Nurse’s Drug Handbook, vii-xvii. United States: Thomson Delmar Learning.

From Unilineal Cultural Evolution to Functionalism Essay examples -- e

From Unilineal Cultural Evolution to Functionalism Several anthropological theories emerged during the early twentieth century. Arguably, the most important of these was Functionalism. Bronislaw Malinowski was a prominent anthropologist in Britain during that time and had great influence on the development of this theory. Malinowski suggested that individuals have certain physiological needs and that cultures develop to meet those needs. Malinowski saw those needs as being nutrition, reproduction, shelter, and protection from enemies. He also proposed that there were other basic, culturally derived needs and he saw these as being economics, social control, education, and political organization Malinowski proposed that the culture of any people could be explained by the functions it performed. The functions of a culture were performed to meet the basic physiological and culturally derived needs of its individual constituents. A. R. Radcliff-Brown was a contemporary of Malinowski’s in Britain who also belonged to the Functionalist school of thought. Radcliff-Brown differed from Malinowski quite markedly though, in his approach to Functionalism. Malinowski’s emphasis was on the individuals within a culture and how their needs shaped that culture. Radcliff-Brown thought individuals unimportant, in anthropological study. He thought that the various aspects of a culture existed to keep that culture in a stable and constant state. Radcliff-Brown focused attention on social structure. He suggested that a society is a system of relationships maintaining itself through cybernetic feedback, while institutions are orderly sets of relationships whose function is to maintain the society as a system. Goldschmidt (1996): 510 At the same time as the theory of Functionalism was developing in Britain; the theory of Culture and Personality was being developed in America. The study of culture and personality seeks to understand the growth and development of personal or social identity as it relates to the surrounding social environment. Barnouw (1963): 5. In other words, the personality or psychology of individuals can be studied and conclusions can be drawn about the Culture of those individuals. This school of thought owes much to Freud for its emphasis on psychology (personality) and to an aversion to the racist theories that were popular within A... ...ture’, and as he reveals elsewhere, his conception of a social structure concentrates on ‘the political institutions, the economic institutions, the kinship organization, and the ritual life. Carrithers (1992): 12-33. However, Carrithers thought that Radcliff-Brown â€Å"displayed an orientation to diversity which in important respects is fundamentally similar to Benedict’s†. Carrithers (1992): 12-33. They both ‘took the natural sciences as a model of knowledge’ and thought that such knowledge could be applied to a culture occurring any place or any time in history. Carrithers goes on to note that Benedict, representing the school of Culture and Personality and Radcliff-Brown representing the Functionalists had their work criticized, and built upon by later generations of anthropologists. Eric Wolf’s criticisms of the functionalist approach can be seen as building upon the body of knowledge accumulated up to that time. References Anthropology 103 Text. 2000. Unpublished: University of Otago, Dunedin. Abbink, Jan & Hans Vermeulen eds. 1982 History and Culture: Essays on the Work of Eric R. Wolf. Amsterdam: Het Spinhuis. Barnouw, Victor (1963) Culture and Personality.

After Reading “The Nightingale and the Rose”

â€Å"The Nightingale and the Rose† Oscar Wilde Topic: What do you think about the statement: â€Å"Life is very dear to all† Almost people realize that life is really marvellous when they are in the boundary between life and death. Even the nightingale could see so clearly that she cried â€Å"Life is very dear to all† as she knew the price that she had to pay for getting a red rose.In the nightingale’s eyes, life gives her a large number of nice things such as watching the golden Sun, the pearly Moon and the natural sweet. People do not have the good sense of those like the bird. However, they know that love is one of the most beautiful given things. That is a long-lasting and great relationship in the bird’s thought. Because of this, she was willing to give up her life to bring the Student a gift which would make him happily.The birth’s death to have a red rose seems to be the thing that life gave to the Student. Thanks to the bird, he had a rose to give to his loved girl. â€Å"Life is really dear to all† is the statement that leads people to many thoughts. Life is not nice all the times. In another words, it gives people a lot of drawbacks. However, each day is an unforgettable moment, and each disadvantage is a lesson to help people become more mature. â€Å"Life is really dear to all† when people are contented with all they have now.

Essay on Weapons Accountability - 988 Words

Weapons Accountability in the Military The history of weapons started centuries ago when cave people initially developed a weapon called a bow and arrow, for hunting purposes. They created this weapon from yew or elm for the bow and the arrow’s shaft, and used animal ligaments, or sinew to add tension to the bow. Archeologists have also found arrow heads made of sharp rocks and angled bones from different types of animals. These artifacts are all over the world displayed beautifully in museums to make new civilization realize the important role weapons have played in daily life. The next major improvement in weapons technology came from the Chinese civilization, the inventers of gun powder. Initially used for the purpose of demolition†¦show more content†¦We seem to take it for granted that we’re going to have our weapon on us at all times. Here in a war zone, as much as in a survival situation back stateside, there will be many times when a soldier is not within arm’s length of his firearm. He might be working on a vehicle in the motor pool, or having a cigarette outside, or just hanging around his living quarters. At none of these times is his rifle likely to be in hand or slung behind his back. Another factor is that, despite the fact that we’re in a war zone, in this war at least, soldiers don’t fire their rifles too terribly often. Those of us in signal units certainly don’t. Most of the time, your firearm is less a weapon than a damned thing you have to carry around all the time. This leads to complacency. A soldier’s job type can be a distraction factor, too. My job description doesn’t have anything to do with shooting at people, and when I’m sitting in the TCF checking on link and reading mail, I don’t give my rifle a second thought. The same is true of most other soldiers; even combat arms soldiers lose track of their rifles when they’re working on vehicles, doing work detail, and so on. Out of sight, out of mind. Survival situations can bring their own share of distractions, too. What does this teach us? Very simply, it teaches us that even in a place where you would think your weapon is the most important thing youShow MoreRelatedWeapon accountability Essay775 Words   |  4 PagesWeapon Accountability 20140320 The date was September 14, 2012. At around 10 p.m. Camp Leatherneck was attacked by 15 insurgents. These attackers, organized into three teams, began an assault on the airfield of Bastion. While wearing U.S. Army uniforms, the attackers toted automatic rifles, rocket-propelled grenade launchers and suicide vests. While aboard Camp Leatherneck/Camp Bastion, they inflicted incredible damage to the air-wing. 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