This course has greatly impacted me from an academic and professional point of view. As a result of this course, I have expanded my thinking in terms of identifying applicable alternatives to ethical problems. In the health care sector, professionals should expect different types of ethical issues. For instance, a professional might be tempted to manipulate patient records in order to cover up an error. Through the knowledge gained in this course, I will be in a position to make the most ethically acceptable decision under these kinds of circumstances. Without having the relevant knowledge, it would be challenging for any health care professional to address these types of ethical issues (Benjamin, 2010).
However, the course has equipped me with tremendous knowledge as well as skills in relation to ethical challenges. From an academic perspective, this course has equipped me with valuable knowledge concerning research. In order to maintain the highest standards of research in the human subjects, it is essential to consider all ethical perspectives. Informed consent is one of the most sensitive issues of ethical consideration in health research. According to this principle, informed consent must be obtained from the research participants. This ensures that the researcher does not manipulate or exploit the participants in any way. Intellectual property serves as another critical aspect of consideration in medical research. Through this course, I have familiarized myself with the vital role played by intellectual property rights in research. As an academician, it is always crucial to acknowledge the work and ideas of other people in any research framework. The infringement of intellectual property rights undermines the quality of research (Morrison, 2010).
Additionally, such an infringement can easily undermine the researcher’s integrity. This course has also been invaluable to me from a professional point of view. The knowledge gained will come in handy in my daily duties as a health care practitioner. For instance, I will seriously consider the needs and concerns of any patient before making any decision. Whereas some decisions may be justified from a professional perspective, they might not conform to the ethical principles of health care. Perspectives such as the patient’s social values and religious beliefs are important towards achieving the highest standards of ethics in health care. Even though the course encompassed numerous issues, there are several concepts that greatly interested me. Firstly, I was greatly interested by issues pertaining to the impact of unethical practice in health care. This is because some professionals have the tendency to disregard the critical role played by ethics in health care (Elger, 2010).
Ethical considerations are critical towards the outcome of any health intervention plan. Practitioners must always work towards the enhancement of health standards among the patients. This cannot be achieved without maintain the stipulated ethical standards. Another area of interest pertains to ethics in research. This is because research serves as an important foundation of health care practice. Consequently, all types of medical research must conform to the stipulated standards of ethics. I will apply the knowledge gained in this course to my profession and also to other areas of life. In all decisions, I will critically examine the potential ethical implications. Through this approach, I will offer the highest standards of health care. In life, the knowledge gained in this course will help in interacting with other people regardless of their background.
Benjamin, M. & Curtis, J. (2010). Ethics in nursing: Cases, principles and reasoning,NY, Oxford: Oxford University Press
Elger, B. (2010). Ethical issues of human genetic databases, Surrey: Ashgate Publishing
Morrison, E. (2010). Ethics in health administration: A practical approach to decision making, Mississauga: Jones & Bartlett Learning
ADN Vs BSN
Nurses usually work to prevent diseases, promote health, and to help patients to cope with their illness. A nurse is a health educator and advocate for patients, communities, and patients. When nurses are providing patients with care, they usually assess, observe, and record the symptoms of the patient (Masters 2009). Nurses work in collaboration with the physicians during treatment and examination, administration and medication, and provision of direct care to the patient. The nurses usually work in a constant changing environment so that they can make sure they provide the best care to patients. They have to continuously learn about the latest technology and also consider the evidence in which the nursing practice is based on. Nursing is a welcoming and a large field. It offers a satisfying path for the associated degree nurses and bachelor degree nurses. No matter what path one chooses, the essential wisdom is always to continue to enhance once education and skills so that the patient, organization, and community can benefit from this practice.
Role of associate degree nurse
Associate degree nursing practice is designed in a way to prepare the nurses who administer patient centered safe and nursing care in nursing homes, clinics, hospitals, and other health care facilities. A graduate from the associate degree nursing program is usually structured by three roles. The three roles are the manager of care, provider of care, and the member with the nursing discipline (Haase 1990). Within these three key roles, there is also the role of a patient teacher and a communicator.
Provider of care
An associate degree nurse performs the role of a provider of care. The role of provider of care is usually characterized by accountability, critical thinking, commitment to caring, and clinical competence. This practice usually applies to patients in their life span. There is more emphasis on the adults who have chronic and acute health needs and requires assistance to restore and maintain optimum health or support to die with dignity. Nursing process is normally used as a basis for decisions. In order for the nurse to be able to provide care, they must make use of the current knowledge on nursing processes, skills, and concepts. An associate degree nurse as a provider of care requires competence (Haase 1990). ADN have the ability to identify and assess the changes in health status and select the right nursing diagnosis after the analysis and interpretation if the assessment information.
It is the role of the nurse to develop a plan for care in collaboration with the patient, the health care team and other significant people. As an associate degree nurse, it is the role of the nurse to establish the priorities of care, promote safety, implement interventions using safe performance and technology, demonstrate caring, revise the plan of care as it is needed, administer medical regime and to determine the nursing intervention effects on the patient’s status. The nurse also plays the role of a communicator. The nurse has to establish effective communication, promote psychological safety, communicate in writing and verbally, have knowledge of the available resources and make referrals based on the needs of the patient. The nurse is a teacher whereby they must implement the teaching plans specific to the level of the patient of knowledge, development, and learning needs.
Manager of care
In associate degree nursing, the role of manager of care is characterized with delegation, advocacy, collaboration, accountability, organization, and respect for the other health care workers. The nurse coordinates and provides care for a group of the patients who have health care needs. In the role of manager of care, in order for the nurse to be competent, they must understand the principle of communication, care management, the legal parameters of nursing, delegation, and responsibilities and the role of the health care team members (Huston & Marquis 2009). As manager of care, the nurse practice in a cost effective and timely manner, they follow procedures and policies, utilize the appropriate channels of communication, and promote effective teamwork (Haase 1990). The nurses manage the nursing care of the families, groups, and individuals. The nurse has to make sure that all the patient is provided with all the necessary attention so as to be able to recover fast. It is the role of the nurse to manage the medication of the patient so as to ensure they do not miss their medication.
Role as member with nursing discipline
In this role, the associate degree nursing practice is characterized by continuous learning, self development, and commitment of professional growth. The nurses practice within the ethical and legal framework of nursing, communicating truthfully, maintaining confidentiality, value nursing as a career, and uses constructive criticism for improvement (Haase 1990). Communication is what facilitates all the actions of nursing. It is through communication that the nurse is able to communicate to other personnel in the health care, and the nursing interventions planned for each client. It is the role of the associate degree nurse to make sure that they maintain confidentiality of the patient’s information. They should also value the nursing career as something significant and be dedicated to making sure that they offer the best services to patients.
Role of Bachelor Degree Nurse
Bachelor degree in nursing program is designed to provide students with opportunities to develop in a clinical and theoretical foundation for the practice of professional nursing. The nurses in this practice are usually prepared for different roles in nursing homes, hospitals, and community health safety (Lundy, et al 2003). Bachelor degree nurses are able to practice in their communities with the responsibility of taking care of individuals, communities and families, prevention of diseases, and health promotion. A bachelor degree nurse usually receives experience in clinical training, in non hospital setting. This practice usually prepares the nurses to perform as professional nurses in different settings. Bachelor degree nurses understand others and themselves, and they stimulate intellectual curiosity, and they develop the ability to work with others in identifying and resolving health problems in community, families, and individuals (Kowalski & Rosdahl 2008). Bachelor degree nurse play different roles. They are counselors patient advocates care giver, manager, leaders, coordinator, and teacher.
The nurse plays the role of a caregiver which is to convey an understanding on what is necessary and provide support. The nurse usually supports the client by action and attitude through showing concern for the welfare of the client and accepting the client as a person and not a mechanical being. BSN are also advocates for the patients. They ensure that the needs of the client are met, and their rights are protective. BSN are social advocates who advocate on behalf of the community or a population so as to effect positive change (Kowalski & Rosdahl 2008). When nurses are the patient’s advocate, they create a healthy environment through community education, political actions, and also involvement in a professional organization. It is through critical thinking that the nurses are able to solve problems and also make decision making in their role as advocates. The nurse is a counselor who provides help to individual so as to develop new feelings, attitudes, and behavior. The nurse usually encourages the clients to look at the alternative behaviors, to recognize the choices, and then develop a sense of control (Kowalski & Rosdahl 2008).
Bachelor degree nurses play the role of leading counseling groups where the nurse might be a member, leaders, or a resource person. The nurse usually assumes the role of fostering climate and structuring activities that are favorable to productive work and group interaction. In counseling, the nurses apply their therapeutic communication skills. The nurse has to use the effective leadership skills, communication skills, and quality improvement skills with all members to improve the care of the patient. Bachelor degree nurses also play the role of a leader. The nurse helps the client in making decisions in establishing and achieving the goals to improve the well being of the client. In the role of a leader, the nurse assists by trying to improve the health status of the families or individuals. They assist in increasing the level of satisfaction and effectiveness among other colleagues providing care. They are able to develop a mutual relationship with the team members of the health care through working interdependently, independently, and dependently to deliver patient centered care to communities, individuals, and families (Kowalski & Rosdahl 2008).
Bachelor degree nurses play the role of manager. The nurses manage the nursing care of the families, groups, and individuals. They play the role of delegating nursing activities to subordinate, and they supervise and evaluate their performance. When managing the care of the patients, they deal with health care delivery. This includes how the patient care services are financed, organized, the structuring method of reimbursement, how the health policies are changed and developed, and how the regulatory agencies determine the nursing practice scope (Huston & Marquis 2009). Bachelor degree nurses are coordinators who help in shaping the relationship between nurses and the clients, the nurses and colleagues, and nurses and the support persons. Communication is extremely essential in the role of a nurse as a communicator. Communication is what facilitates all the actions of nursing.
It is through communication that the nurse is able to communicate to other personnel in the health care, and the nursing interventions planned for each client (Lundy et al 2003). The nurse correctly assess, plan, diagnose, intervene, and ethical nursing practice for caring for communities, families, and individuals from diverse background. The nurses apply their knowledge of wellness, chronic and acute illness, health promotion, disease management, and incorporate future and current technical skills into nursing responsibility. The nurses apply this knowledge in the diverse health care delivery context. It is the role of BSN to provide disease and injury and health promotion across the life span. They help individuals, groups, families, and communities to prepare for and to minimize the adverse related consequences of mass casualty disaster and emergencies.
Haase, T (1990). The origins and rise of associate degree nursing education Duke University Press
Huston, C & Marquis, B (2009). Leadership roles and management functions in nursing Lippincott Williams & Wilkins
Janes, S Bergamini, A & Lundy, S (2003). Essentials of community based Nursing Jones and Bartlett Publishers
Kowalski, M & Rosdahl, B (2008). Textbook of basic nursing Lippincott Williams & Wilkins
Masters, K (2009). Role development in professional nursing practice Jones and Bartlett Publishers
Peterson’s (2011). Nursing programs 2011 Peterson’s
Corticosteroids in Treatments
Corticosteroids are sort of chemical modifications that are used to make different types of drugs. They are natural glucocorticosteroids chemicals that are mixed in order to make drugs. The main natural modifications used in corticosteroids are prednisolone and prednisone. The two are almost the same although their bonds are slightly different. In the modification process, prednisone must be activated or converted from its state to prednisolone. There are so many reasons why corticosteroids are used in the treatment of autoimmune diseases and prevention of graft rejection, (Isayama, 2007).
Physicians use corticosteroids in different health conditions such as non-inflammatory as well as inflammatory conditions. Research shows that corticosteroids alter the lymphocyte recirculation by inducing a transient lymphocytopenia. Physicians use a lot of corticosteroids to patients simply because it activates the T cells that are useful for the molecule production. When the molecules are produced, the process of recovering speeds that gives a patient hope to live longer. One of the main reasons, why most physicians recommend the use of corticosteroids is that they provide positive results even to conditions that are not as a result, from lack of hydrocortisones. Study shows that corticosteroids cures diseases and also improves health conditions of patients hence recommendable in health related matters , (Nakajima et al. 2004).
Since the introduction of corticosteroids, study shows that patients’ health progress in disease is much better in many ways. They can be used long enough without negative effects as compared to other form of dose for the same treatment. Adequate dose in this circumstance must be used in order to get desired results, and it has no effects that other dose develops when used frequently. There are minimal therapy risks associated with corticosteroids, and that is why most patients as well as physicians recommend the use of corticosteroids. Although patients must know any risk associated with the use of dose, physicians always apply a lot of care in the use of corticosteroid therapy thus its response to patients health tends to be positive, (Beck et al, 2010).
Research shows that the use of corticosteroids should have a specific plan so as to reduce its use in the long run. Although the approach in health related matters is slightly positive, it is recommended for few days so as to prevent the long term effects. Corticosteroids are used to minimize pains in inflammatory conditions where patients suffer. Reducing or minimizing pain in such cases helps patients recover easily, and that is another reason that makes physicians recommend the use of corticosteroids for patients, (Chari & Ghazale, 2009).
Another important reason why corticosteroids are used and recommended by physicians to patients is due to graft rejection. Saving lives calls for preserving some organs so as to graft them to the needy patients. Research shows that extensive usage of corticosteroids, unlike other dose helps prevent graft rejection of organs. If the dose is applied in the correct volume, patients suffering from autoimmune disease have the potential to donate their organs. This is one of the reasons why the usage of excessive corticosteroid therapy in patient treatment is not bad. Corticosteroids unlike other form of drugs can be used by immunosuppressive drugs that reduce the level of pain that patients go through, (Nakajima et al. 2004).
Beck R. W. et al (2010). The effect of corticosteroids. N Engl J Med. 329:1764-9
Chari, T. S & Ghazale, A. (2009). Optimising Corticosteroid Treatment for Autoimmune Pancreatitis. Retrieved from, http://gut.bmj.com/content/56/12/1650.full, on September 11, 2012
Isayama H. et al (2007). Long term prognosis of autoimmune pancreatitis without and with corticosteroid treatment. Gut
Nakajima H. (2004). Morphological changes after steroid therapy in autoimmune pancreatitis. Scand J Gastroenterol
End User Policies
An end user policy can be termed as a set of measures that explain which actions employees are required to take or avoid. This is done so as to protect assets of the organization. The end user policy can be in form of set informal guidelines that are provided to employees. An end user policy can also be a formal contract that has been signed by involved parties and whose violation is opens grounds for charge or dismissal. Barman (2001).
Information security policies appropriate for distribution to all users
Access management policy
This policy states that access to and use of information and organizational resources is to be controlled based on business and legal requirements that are defined. This policy applies to anyone who has access to organizational assets and information, technology resources and other facilities. The policy applies especially to all information technology resources such as systems and networks that are controlled, owned or leased by the company. Given that there are numerous individuals who may wish to access such resources, the policy is appropriate for distribution to all users. It, therefore, includes but is not limited to employees, customers, visitors, business partners, and organizational consultants among many others.
Systems security policy
The policy states that all computers that are operated and/or owned by the organization ought to be configured securely in accordance with their intended purpose. This policy applies to everyone who can be able to access organizational resources, information, technology resources, as well as other facilities. All computers that are owned and operated by the organization are required to be configured respectively. Passwords and usernames should be put in all computers in the organization and only the users of the computers should be provided with the passwords. This, therefore, means that nobody is able to contact the data that is saved in the computer without permitted approval. This policy applies to everyone who has access to computers in the organization. It, therefore, targets employees in the company business partners and consultants among others.
Data security/ management policy
The policy states that there must be protection of integrity, confidentiality and availability of information assets in accordance to classification of data. Similar to the other policies this policy is also applicable to everyone who has access to the systems in the organization. This policy applies to all information facilities, systems and networks owned or controlled by the organization. The policy applies and is not limited to employees of the organization, clients, business consultants and other associates of the organization.
Importance of information security and policies
Information security and policies are considered to be extremely essential for any organization. Information security is termed as vital as it enables an organization to protect an integral part of its assets, which is information. Information security enables the organization to protect information from getting into individuals who might use the information to against the organization. Information policies are also essential for an organization. It is through information policies that the company is able to set rules for expected conduct by the users of the system. This includes: system administrators, security personnel, management and employees of the organization. Information policies also serve to provide authority to security personnel to monitor, investigate and probe on issues that are related to information security. Russell, C. (2006).
In situations where there has been realization of violation of information requirements, information policies are used. They are used in defining and authorizing consequences of violation. Information policies are also use in defining the company’s stand on security of information. They aid in converting employees in the organization to participate in the efforts of the company in securing information assets. Through information policies, information risk is minimized and the organization is able to track compliance with regulations and legislation. It is, therefore, the process of creating these policies that aids in defining a company’s information assets.
The access management policy is essential as it ensures effective mechanisms that are based on legal and business requirements are provided. These mechanisms avail the administration, control and tracking of access to use of systems of the organization as well as company information. The mechanisms also protect unapproved and unauthorized activity that could lead to destruction of organization systems and information.
The system security policy provides standards that ensure the security of computer equipment that is owned or operated by the organization. These standards are designed to reduce chances of having damages of intellectual property and confidential data.
The data security/management system serves to ensure that data security is implemented to secure organizational business and information systems. They policy also serves to provide security measures such as data recovery and back up systems.
Employees’ commitment to honor and obey the policies
All employees of the organization have unanimously agreed to act in conformity with the requirements of the policies. They have also agreed that any employee found in violation of information security standards stands to face the consequences as per the policies.
Barman, Scott. (2001) Writing Information Security Policies. New York.
Russell, C. (2006) Security Awareness: Implementing an Effective Strategy. New York.
Alcoholism During Pregnancy And Current Responsibilities Of Professional Nurses
Today, the government advices that pregnant women should, altogether, avoid alcohol. Some women are used to taking alcohol in their daily lives. As a result, they end up intentionally or unintentionally taking alcohol during their pregnancy months. For women who cannot do without alcohol, it had been advised that a unit or two per week were alright for the pregnant alcoholic mothers. This advice has also been extended to women with the trying to conceive. During conception and during pregnancy, women should not only avoid heavy drinking of alcohol but should avoid drinking alcohol altogether to avoid harmful conditions on the baby.
Alcoholism in women is found throughout history (Ornoy, and Ergaz, 2010). Today women account for about one third of all Americans with disorders related to alcohol dependence or alcohol use. However, there has been a major issue related to alcohol and women which is alcohol during pregnancy.. Sir Francis Bacon, in the 17th Century warned women not to take alcohol during pregnancy. Since the 17th century, there has been increased knowledge on alcohol and pregnancy. In the 18th century, the British Government recognized the impact of alcohol on the outcomes of pregnancy and took necessary measures to counterattack such deadly trends. In the 19th century, the British House of Commons reported starvation and imperfect look as observed in infants of alcoholic mothers. By the end of the 19th century and researchers began examining alcohol effects on fetus (Ornoy, and Ergaz, 2010). Originally, it was believed that genetic shock and not exposure to alcohol resulted to birth defects in children of alcoholic mothers. However, from reliable research carried out in Germany, Sweden, and France, pattern of malformations, defects of the central nervous system, and growth deficiencies were found in children of alcoholic mothers.
Effects upon maternal-child health
The dependence of fetus on the mother to feed means, when mother takes alcohol during pregnancy, so does the baby. This also implies that the alcohol level in the mother’s blood is the same level in the baby’s blood. The only difference in the two blood alcohol levels is that the baby has very small liver that cannot regulate the alcohol blood levels thereby ends up being hurt during development (Ornoy, and Ergaz, 2010). This results FASD or fetal alcohol spectrum disorder. Alcohol can also result to birth defects, preterm birth, low birth weight, hearing or vision problems, disabilities in learning, delayed speech and language, sleeping and suckling problems, and behavior problems.
The total amount of money estimated to treating birth defects by 1985 was estimated more than $1.3 billion. Other related elements include FAS in adolescence, and adulthood. FAS are also associated with women of low social economic status especially amongst African American an native Americans. Both Hispanics and whites have lower FAS incidence rates compared to African Americans, Hispanic Americans, and Alaskan native groups.
Professional disciplines involved in managing alcoholism during pregnancy
The professional involved is maternal-child health.
Health care responses
Women are always warned to stay away from alcohol to avoid such harmful FAS conditions. Occasional drinkers will be required to have regular prenatal care and communication of any concerns, or contact with alcohol treatment program.
Nursing participation, actions, and interventions
Major nursing intervention to reduce alcohol-exposed pregnancy is motivational intervention coupled with brief motivational information to pregnant women. Introduction of alcohol educational programs in schools is also an effective intervention measure. For the children born with FAS conditions, creation of diagnostic centers for consultation and treatment is an essential way to guide alcoholics on how to deal with their children. Again, nursing can also establish programs to educate and train professionals on significant information that needs to be known. Information campaigns also play an important role in addressing future mothers and society while new interview models will be used in identifying dangerous alcohol consumption patterns.
Nursing interventions are intended at providing significant information on alcoholism and pregnancy to children, vulnerable women, and childbearing women. Child bearing women are vulnerable to ineffective use of birth control especially if alcoholic. In addition, binge drinking among these women is worse than just low level daily drinking. Advising such women on alcohol intake at pregnancy and the use of effective birth control will play a major role in reducing alcohol exposure pregnancy. By maintaining routine health maintenance, child bearing women are informed about safe sex, use of alcohol, and contraception. For the pregnant women, intervention information should require them to stop usage and screening used during prenatal care visit. While dealing with heavy drinkers, brief intervention will include provision of advice, obtaining feedback, setting goals, and additional contacts. Brief intervention could be very brief-five minute session-, brief- up to 15 minutes, and multicontact brief session 15 minutes initial session with successive visit taking lesser time (Mengel et al. 2006).
Evolution of nursing roles and responsibilities
The role of nursing in healthcare is to provide preventative and curative care to patients. During pregnancy, alcoholism has deleterious effects on the Central Nervous System as well as other embryonic and fetus organs. The impact of alcohol on embryo and fetus is dependent on duration, dose, and developmental stage. The role and responsibility of nursing evolved with the aim of reducing alcohol consumption during pregnancy to as low as possible. However, the definition of minimal pregnancy alcohol consumption is difficult which is why nursing is advocating for cessation in alcohol consumption for those trying to conceive as well as for the pregnant women. Since alcohol is a toxin associated with numerous children abnormalities, nursing intervention has become handy in the assessment, education, and intervention.
Future nursing solutions
For a brighter future on nursing responsibilities in preventing FAS, Family physicians’ clinical practice should integrate screening, assessment, education, and brief intervention to be part of their practice (Mengel, 2006). This is important especially for alcoholic women who do not make it to the health care institutions. Educating healthcare professionals is not a sufficient measure in ensuring that the attained skills are integrated into practice. As a result, nursing responsibilities in preventing FAS should include support systems to facilitate educational intervention (Mengel, 2006). Some women tend to deny the existence of alcoholism problem. As a result, they end up being at high risk and later delivering babies with FAS. For such women, overlapping reinforcement levels of education and persuasion, incentives, and intervention will work well in ensuring women remain truthful. After admission of alcohol use, the healthcare professionals can now use gained knowledge to understand the probable contributing factors and focus on root cause elimination other that curing the symptoms (Mengel, 2006).
Mengel, M., Searight, H., and Cook, K., (2006). Preventing alcohol exposed pregnancies. The Journal of American board of family medicine. Vol. 19. Iss. 5. P. 494-505. http://www.jabfm.org/content/19/5/494.full
Ornoy, A., and Ergaz, Z., (2010). Alcohol abuse in pregnant women effects on the fetus and newborns, mode of action and maternal treatment. International Journal of environmental research and public health. Vol. 7. Iss. 2. P. 364-379. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872283/
The Lemon Tree by Sandy Tolan
Migration of Jewish Bulgarians
Bulgaria aligned itself with the Axis powers and Germany during the build-up to World War II1. These countries perceived the Jews as anticommunists. Approximately 50 000 Jews lived in Bulgaria at the time the Holocaust started. Bulgarian had signed a pact with Nazi Germany that would allow the handover for annihilation of Bulgarian Jews. Bulgaria subjected the Jews to discrimination and so in 1943 it began to prepare them for mass deportation to the German authorities in Treblinka, where they would be put to death. However, resistance from Bulgarian parliamentarians, the orthodox clergy, and intellectuals prevented the government from deporting the Jews. This paved way for the migration of the Jews to Israel in 1948.
King Abdullah of Transjordan: Abdullah is the former King of Transjordan, the modern-day Jordan 2 He annexed the Palestinian territory of West Bank in 1947 and under his reign, Ramla, modern-day Ramallah, which falls within West Bank, became Jordanian-controlled. During the reign of King Abdullah’s, Ramallah became a cardinal transport hub and communications center of the territory of West Bank. It is a center of conflict between Israel and Palestine and, hence was a crucial military base for the King. In 1948, King Abdullah led the Arab Legion (Jordanian Army) into war with Israel 3. He transformed Transjordan into Jordan. A Palestinian nationalist assassinated him in 1951 due to his collaboration with Zionists (Israel) against the creation of the state of Palestine.
- Sofia University. “Soviet and East European Jews during World War II”. Conference
Paper. International Academic Conference, November 2-4, 2012. Sofia University
- Tolan, S. “The Lemon Tree”. London: Transworld, 2008
- Kashgari, T. “Transjordan and Israel: Examining the Foundations of the Special
Relationship”. Student Pulse, 3, 3 (2011): 2
Future Goals and Vision
As a PhD student in the bioethics program, I have several main goals for the future. Firstly, I intend to help in training upcoming health care practitioners. As a result of the knowledge gained in this program, I am equipped to guide the upcoming health care practitioners towards the right direction in terms of career. I also have the goal of establishing a research center specializing in bioethics. Research serves as an important aspect of health care. Through the research center, it will be possible to enhance the quality of health services offered to the population. In the future, I intend to work on a publication on bioethics. Through this publication, I will share my insights with other professionals and also enlighten upcoming practitioners. The publication will emphasize on the importance of bioethics and what should be done to enhance bioethics standards in health care.
Throughout the program, I have gained a lot in terms of knowledge. Whereas most of the lessons learnt are theoretical in nature, they will be beneficial when it comes to actual application. Firstly, I have grasped the various concepts that govern bioethics in health care. Informed consent serves as an essential principle that governs bioethics in all parts of the world. The participants should not be forced to take part in any experiment or trials. The participation of all individuals should be voluntary in order to maintain the highest standards of human dignity. Apart from informed consent, bioethics is also governed by the principle of respect for autonomy. Individuals should be allowed to make independent decisions free of any form of influence.
Throughout this program, I have also gained the knowledge to solve problems depending on the prevailing conditions. These lessons will come in very handy for my future career. This is because I will have the relevant knowledge of addressing different types of issues in bioethics.
Importance of Bioethics
As mentioned earlier, bioethics serves a crucial role in medicine. Essentially, it provides an excellent framework for establishing a regulatory mechanism. In academic institutions, bioethics also serves different types of roles. Firstly, it helps in averting dangerous medical surveys. (Johnstone, 2008)
In all academic institutions, the fulfillment of the fundamental principles of bioethics is a mandatory requirement. Medical surveys are disapproved if they do not conform to the basic principles of bioethics. Bioethics also helps in establishing an appropriate framework for distributing the gains derived from the survey. Essentially, bioethics also helps in preparing the students for future careers in medicine or health care. This is because they are provided with adequate exposure.
Within a hospital setting, ethics consultations may be handled in numerous ways. Firstly, it is essential to ensure that all health care practitioners in the hospital are familiar with the fundamental principles of bioethics. Through such an approach, it is possible to minimize errors. Minimization of errors within the health care organization helps in enhancing the standards of patient safety. (Johnstone, 2008) Additionally, it is also crucial to adjust the hospital’s policies in accordance to the various principles of bioethics. As a result of this approach, the quality of decision making in the hospital is enhanced. When the hospital’s entire structure conforms to the various provisions of bioethics, it is easier to facilitate ethics consultations. Additionally, this approach helps in averting potential conflicts.
Johnstone, M. J. (2008). Bioethics: A nursing perspective, Elsevier Health Sciences
Misconducts Within Animal And Human Subject Research
Animals and humans have been the center for medical research for a long period of time. Clinical as well as other researchers have continued to use animals and humans for experimental purposes. Over time, there have, however, been misconducts that have been conducted by researchers in their process of research. Such misconduct has been conducted mostly on animals as they do not have to provide consent for them to be used in research. This has resulted to researchers violating animal rights with impunity for years. It is such violations and misconducts that have resulted to formation of animal rights organizations. Such organizations are geared towards ensuring that researchers who use animals for research do not engage in any misconduct. In the recent past, human beings have also been the subject of research by scientists. There are various issues that have risen with regard to use of humans for research purposes. This has resulted to a debate on whether the wide use of person subjects in study is in itself misconduct. Paul M. (1993).
Misconduct in animal research
Animal rights activists have been opposed to the use of animals for purposes of medial research. They have had this stand with views that human beings do not have the mandate to use animals. With extremely little exceptions, experiments are not carried out on human subjects without seeking for their consent. Animals activists have made claims that it would, therefore, be gross misconduct to carry out experiments on non- human animals. Animals do not contain the capacity to provide informed consent and it is on this basis that it would misconduct to use the animals for experiments.
Another misconduct that is carried out on animals is the degree and extent of experiments that are conducted on animals in research. Researchers have often conducted experiments on animals that involve procedures that are detrimental. Such procedures involve practices that jeopardize the physical condition and lives of the animals. The procedures are injurious and invasive on the animals and it results to them being prone to immense pain. Given the extent of the procedures it is with no doubt that human beings can not allow such practices to be conducted on them. It is, therefore, can be considered as misconduct that scientists and other researchers have continuously performed such procedures on the animals. The experiments that are conducted on animals sometimes are so extreme and dangerous that the lead to the death of those animals. Kevin D. (2002).
Since those animals do not have the ability to advocate for their rights, researchers have continued to practice the experiments on the animals. Just as unethical experimentation on certain humans can not be justified by a benefit to humanity at large, the same ought to be true for animal experimentation. Just as humans have consciousness as well as interests in their own lives and freedom animals too have similar interests. The only different is that when animals’ interests are violated, they can not be able to forward their concerns. Treating animals differently and try and justify experimentation without consent on them but not on humans would be termed as some level of misconduct.
The misconduct on animals and violations against them has resulted to animals’ rights activists standing up for the animals. The activists have provided evidence of medical advancements that were discovered without the use of animals. Such include the cure for scurvy which did not involve animals, but studies were carried out on human subjects who already had scurvy. The first vaccine was invented in the eighteenth century and it did not involve animal experimentation. This was when people were immunized with cowpox so as to be able to build on their resistance to smallpox. Other medicines such as penicillin were also discovered without using animals to conduct research. In the recent past Heimlich maneuver was crated without vivisection and has resulted to saving of numerous lives. Some of the researchers have studied human populations and this has lead to significant medical discoveries. Part of this has included the link between cardiovascular ailment and cholesterol as well as the connection between smoking and cancer. Daniel W. (2001).
Legislation against misconduct in animal research
Various measures have been taken with the aim of reducing the misconduct against animals during scientific and other research. In the United States of America, the animal welfare act has looked to set various minimum requirements. These requirements are related to the humane treatment of animals that are used for research purposes in laboratories and other settings. The animal welfare act requires organizations that carry out vivisection to have institutional animal care. They are required to use committees that have the mandate of overseeing and approving the proposed used of animals in research. The measures that have been taken, however, appear to have certain levels of ineffectiveness. For instance, the animal welfare act has in its provisions explicitly excluded from protection all rats and mice. This is with concern as rats and mice make up approximately 95% of the animals that are used in laboratories. Furthermore, the act does not consider it illegal for researchers to practice invasive practices or the demise of the animals after experiments have been concluded.
Misconduct in use of humans in research
Humans although not as widely as animals have also been used in scientific as well as other research. This has also seen instances when misconduct has occurred when humans are being used for research. Though scientists are required to get consent from individuals prior to using them for research, this does not always happen. Some of the scientists in organizations have violated human rights and have used them for research without accessing their consent. This usually happens when individuals have been diagnosed with various ailments. This results to them being admitted in medical facilities so as to get treatment. It is during this time when they are under anesthesia that medical practitioners take advantage of the situation. They in some instances get some body samples from the patients and are used for research purposes that are not related to the ailment of the patient. Jonsen A. (1982).
Some of the researchers have also used young children with no family backgrounds and have carried out research on them. They sue such individuals as the children do not have anybody under their care hence the scientists would not be answerable to anyone. Some of the medical practices and research that are carried out on human beings end up being detrimental to the individuals. They usually result to various complications that may have an eternal outcome on the lives of the victims. In instances when the research practices are extreme, they can even result to death of the victims. This usually occurs when the researchers carry out scientific or other research on human beings that they do not know of the effects.
Another major concern that has resulted to claims that it is misconduct is the practice of cloning. Scientists have claimed that there is not anything incorrect with cloning and that it ought to be conducted. They have added that cloning of human beings would result to individuals who are more resistant to diseases and can live longer. The claims from scientists have resulted to great uproar from various quarters. This has included religious leaders as well as other leaders who claim that this is gross misconduct as no man has the power and authority to create another. The concerns have been immense and this has resulted to placing of a ban that makes cloning of human beings to be illegal. Legislation has been put in place that has made it illegal for scientists to use human beings to create other ‘human beings’. Jay (1987).
Scientific and other research ought to be encouraged as long as it does not violate animal as well as human rights. When researchers make a decision that thy have to use animals, they should make sure that the procedures are not dangerous. Animals ought not to be subjected to pain and injury when they are being used by scientists and other researchers. When it comes to use of human beings for research, human rights should not be taken for granted. Children who have no family background ought to be protected by government from having their rights violated.
Paul M. (1993) The ethics and politics of human experimentation: New York.
Daniel W. (2001) Laying ethical foundations for clinical research, Public Health Classics, Bulletin of the World Health Organization.
Kevin D. (2002) Ethics of health care: an introductory textbook, Georgetown University Press.
Jay Katz (1987) The Regulation of Human Experimentation in the United States: A Personal Odyssey, IRB: Ethics and Human Research.
Jonsen A. (1982). "The Evolution of Regulatory Influences on Research with Human Subjects". New York.
Restricting Health Care Delivery System
The restructuring of the health care delivery system result on great emphasis on measures for cutting cost, which will lead to a reduction of nurses who provide direct patient care. Accountable care organizations are integrated groups of physicians, hospitals, and other providers who are responsible for the need of health service in a defined population of patients (Goldsteen, K et al 2012). Accountable care organizations offer a pathway for controlling cost through the payment reform. It establishes collaboration of providers who enter into an agreement with payers so as to be financially accountable of the provision of the health care services to the defined population. Through the collaboration, the providers will be able to build an existing local relationship among themselves. The method of payment will include a variety of the provider incentives that will meet the cost targets including the shared risks, the shared savings, partial capitation, and beneficiary incentives like different co pays. The Accountable care organization will depend on several organizational and structural features so that to be able to meet their quality and cost targets.
The coordination and care management adopted by ACO will require a nurse workforce that is linked to the patient. The nurse who will be employed by Accountable care organizations will be responsible of management of care to the most complexly ill patients in the group, and also for the transition of their care. The transition that the nurse will be responsible will include from home to hospital, hospital to home, or from primary care to intensive outpatient secondary care. When restructuring the health care delivery system, the demand to build primary care nursing work force for nurses will grow. The demand will grow as the accessibility to service setting, coverage, and services will be increasing. The nursing jobs will increase with a large number because of the increase in the demand for primary care services. The demand for primary care services will be because of the expansion in the health coverage.
Restructuring the health care delivery system will change how the nursing practice performs their responsibility. The way the nurses plan, document, deliver, and review clinical care will change. The process of reviewing and obtaining diagnostic information, communicating with the patients, carrying out clinical interventions, and making clinical decisions will radically change from how the activities have been performed. The time that most of the nurses take when performing their tasks will change. The restructuring will change all facets of care, which will be mediated by digital workflow, decision support, and computerized knowledge management. The introduction of electronic health records will make it easy in caring for patients as medication, diagnostic tests, and some therapies will be will be managed and directed by support from the computer (Kongstvedt, P 2007).
With the introduction of electronic health record, the cost of services will be lower, and the quality of care will improve as measured by the achievements and outcomes of the other end points. With the restructuring of health care delivery systems, the demand for nurses will increase. Training and education for nurses will also be improved where the education sector will be able to produce nurses who are prepared and ready to deliver acute care services in acute care settings. Health care institutions will have no shortage of nurses, which will help in improving the care provided to patients.
Pozgar, G (2007). Legal aspects of health care administration Jones & Bartlett Publishers
Kongstvedt, P (2007). Essentials of managed health care Jones & Bartlett Publishers
Jonas, S Goldsteen, R & Goldsteen, K (2012). Jona’s Introduction to the US Health care system Springer Publishing Company
Who Attends Clinical Supervision? The Uptake Of Clinical Supervision By Hospital Nurses
In this study, the researchers sought to establish the efficacy of clinical supervision and the number of nurses who attend such programs. The study was in Kuopio university hospital, in Finland. The participants of the study were two hundred and fifty seven registered nurses and ninety six assistant nurses. The study found out that few registered nurses attend the programs as compared to the assistant nurses. Nurses who attend the programs expressed more motivation to work; they expressed a positive attitude to work as opposed to those who did not involve in clinical supervision. Clinical supervision was a paramount tool to nursing. It reduces burnout at work. Nurses who do not subscribe to CS expressed low self-confidence at work, less empowerment and low, work orientation. The researchers recommended for clinical staff to ensure nurses attend the services through the creation of time and opportunity for them, Saarinen, Hyrkas & Koivu (2011).
The benefit to the participants of the study was the understanding which was to be derived on the relevance of clinical supervision. The respondents would get a better understanding of CS at the end of the study and would, therefore, be motivated to participate in such programs. There was no risk of participation identified. There were no risks involved in the research. There was participants’ consent prior to their inclusion in the sample. There was notification of the hospital management about the undertaking before the study, and participants’ consent obtained. There was voluntary participation of the respondents to the study as there was no risk of participation. There was approval from the management staff before the study. Confidentiality of the participants was also through anonymity of the participants. Return of questionnaires indicated consent by the participants.
The major variables for the study were job demands, social interactions and perception of mastery. Job demands refers to the demands of the workplace that prevent nurses from attending the clinical supervision programs. The researchers found out that some nurses involuntarily failed to attend the programs due to high demands of the workplace. There was time constraint that prevented the nurses from attending the programs. Social interaction refers to the benefits that participants to the programs obtained. The interactions during the programs made work more interested and developed the self-confidence of the nurses. Perception of mastery refers to how the nurses responded to the benefits that are to be derived from the programs.
Questionnaires were the method of data collection used. The nurses provided their responses on their opinions of the CS programs. They also stated whether they had at any one time attended such programs. The author used this data collection because the interview questions were not complex to respond to, the participants would effortlessly fill the questionnaires by themselves. The use of questionnaires was also due to the large number of participants in the study. This would reduce time wastage. The study was in three days. However, there were follow up studies whose time frame is unknown. The sequence of data collection events for the participants was the reception of the questionnaires, filling them and then returning the filled questionnaires to the researchers. There was limited interaction between researchers and respondents in this study.
Data management and analysis was through use windows SSPS program. There was also transforming of data collected was into an electronic form and storage into computers. This was to ensure that it could not be lost. The researchers also kept paper trail of the questionnaires for reference whenever there was any conflict with the findings. Rigor was through the use of SSPS software for data management and analysis. There was also paper trail for the findings in case any discrepancies arose during the data analysis. The elimination of bias was through ensuring representativeness of the selected sample. The sample was not at the discretion of the researchers but on the basis of its representativeness of the target population.
The researchers interpret the findings on the impact of their efficacy to nursing. Nurses who attend the clinical supervision were more efficient at work than those who did not. The findings are accurate and reflective of reality. Nurses who attend to CS program have the opportunity to better their profession through interaction. It also reduces burnout, Burns & Grove (2011). The researchers identified the inaccuracy of some of instruments such as the QPSNordic scale as one of the limitations to the study. There was coherent logic in the presentation; the presentation of data in tables made it easier for researchers to analyze. The researchers found out that clinical supervision improved the nursing practice. This presents an opportunity for nurses to better their carriers. Medical institutions should also ensure that clinical supervision programs are available in their institutions and provide opportunities for nurses to enroll. No recommendation for future research in the article.
Burns, N., & Grove, S. (2011). Understanding Nursing Research (5th Ed.). Elsevier. ISBN-13: 9781437707502
Saarinen, I. P., Hyrkas K. & Koivu, A. (2011). Who attends clinical supervision? The uptake of clinical supervision by hospital nurses. Journal of nursing management, 19: 69-79. DOI: https://ehis.ebscohost.com/eds/pdfviewer/pdfviewer?vid=2&hid=120&sid=9b7c1399-5e56-4f26-a748-c2f9ff542adf%40sessionmgr111