Sunday, May 24, 2020
Identifying with Alexei in Dostoevskys The Gambler The literary character that I most readily identify with would be Dostoevskys Alexei, The Gambler. I can relate to him because like me, he is a man of many passions. He is also all but helpless against his addiction to gambling. I have also felt helpless to certain circumstances in my life, as have we all. He is capable of much more than what his society allows him to be. That is to say he may be a lowly tutor, but he cares about justice and the atrocities committed by the high-born class. I, through faults of my own and Injustices of my schools administration, also was limited, as Alexei was as to what people thought of me and how they treated me. AlexeiÃ¢â¬ ¦show more contentÃ¢â¬ ¦Instead, she realized that his one true love was not her but gambling. Whenever I read this story, I think of how much this character that Fyodor Dostoevsky created is similar, in a lot of ways, to myself. I find myself the object of addictions in general. I used to smoke cigarettes and feel helpless against it. Sure, Id stop for a day or two here and there but once I forgot about the misery cigarettes brought me, I would light up another. I feel better now that I stopped smoking but I am scared that it wont last. Like Alexei, I have been interested in the same girl for many years. Just of late, something that I thought would never happen, is happening. I have the chance to be with this girl and I think Im messing it up. She has been my friend for many years and now its moved past friendship into something better and worse. Even though this is happening in the present and I know what to look for, I find myself powerless to the seemingly definite ruin that I feel is coming. Its so frustrating knowing all these things and not being able to change them, or at least feeling as though you cant change them. In my junior year in high school, I took up a personal crusade against what I called the evil administration at my school. I repeatedly got in trouble for things I deemed acceptable but were still against the rules. For instance, one morning I decided that I didnt want to salute the flag. I was sent down to
Wednesday, May 13, 2020
The Jewish faith revolves around the theme of relationships between the Creator, mankind and the land of Israel. It is through these relationships that Jewish Beliefs, Customs and Sacred Writings interlink throughout the Jewish religion. The festival Rosh Hashanah is a prime example of where Jewish practices strongly associate with the beliefs and Sacred Scriptures of Judaism. Through the links between customs, traditions and Sacred Writings, adherents to the Jewish faith affiliate with not only their communities, but with themselves and God. Sacred Texts and Writings are the foundations of all beliefs and practices in Judaism, providing and guiding adherents with basic laws and customs to abide by. Judaism is often referred to asÃ¢â¬ ¦show more contentÃ¢â¬ ¦Progressive Jews believe in the adaption of laws and customs in a religion as society modernises, for example, women are now able to become rabbis. As every Jew has different devotion to their religion, beliefs and practices will be performed differently throughout Rosh Hashanah. Beliefs and conjectures are drawn from the investigation of Sacred Texts, furthering growth and relationships throughout the Jewish faith and establishing rituals performed in festivals such as Rosh Hashanah. Rosh Hashanah is referred to as the Jewish New Year, marking a 10 day period of self-condemnation. Rosh Hashanah occurs on the first and second day of the Tishri, the first month on the traditional Jewish calendar with the word Rosh Hashanah meaning Ã¢â¬Ëhead of the yearÃ¢â¬â¢ or Ã¢â¬Ëbeginning of the yearÃ¢â¬â¢. The Bible itself does not use the words Rosh Hashanah to expostulate the New Year, alternatively referring to it as Yom Ha-Zikkaron, meaning Ã¢â¬Ëday of remembranceÃ¢â¬â¢. This is shown in Leviticus 23:24-25, Ã¢â¬Å"Say to the Israelites: Ã¢â¬ËOn the first day of the seventh month you are to have a day of Sabbath rest, a sacred assembly commemorated with trumpet blasts. Do no regular work, but present a food offering to the Lord.Ã¢â¬ The religious practices that occur throughout this Jewish festival focus on the sovereignty of God. The Torah refers to Rosh Hashanah as a day of remembrance, to celebrate the creationShow MoreRelatedRastafarian79520 Words Ã | Ã 319 Pages299Ã¢â¬ ².676Ã¢â¬âdc21 2002074897 v To Donnaree, my wife, and Donnisa, my daughter, the two persons around whom my life revolves; and to the ancestors whose struggles have enabled us to survive and thrive This page intentionally left blank Foreword One of the most useful things about Ennis Edmondss Rastafari: From Outcasts to Culture Bearers is that it correctly traces the connection between the emergence of Rastafarianism and the history of resistance and black consciousness that has been
Wednesday, May 6, 2020
string(172) " due to the nature of the concerns we operate within that our nucleus hours needed to alter to accommodate, with applied scientists start and finish times being staggered\." My professional aim to be achieved in the following 2 old ages is to go General Manager of Grantfen Fire Security Ltd. As this function does non presently exist within the company I have researched the function of a General Manager. 1. We will write a custom essay sample on General Manager Person Specification Commerce Essay or any similar topic only for you Order Now 1 Ã¢â¬â General Manager Person Specification A General Manager has to be an enthusiastic leader with a demonstrative personality, behavior and credibleness to put, keep and transcend consistent high quality criterions commensurate with organizational outlooks. They need to hold sound analytical and computing machine accomplishments with an ability to pass on at all degrees. This individual would besides necessitate to be aim goaded Ã¢â¬â with the ability to work to, and set, timely public presentation goals/targets and clear aims with a motivational and supportive direction manner. All in all would necessitate to be a strong individualist and determination shaper with high finding to win. 1.2 Ã¢â¬â General Manager Job Description The function of a General Manager would include but non be limited to the undermentioned duties Planing Administration Supplying leading Reporting on long / short term programs Research / analyse proposals for long / short term programs HR Management Recruitment Development / Training Employee Relationss Performance Management Undertaking Management Operating WIP Reports Oversee Management of Individual Projects Budget Planning Management of Sub-Contractors Application of Specifications and Standards Selling and PR Manage Ad Opportunities Oversee Content, Publication and Distribution of all Marketing and Publicity Manage Press Development Fiscal Management Provide Recommendations sing Investment / Cash Schemes Oversee Preparation of Annual Budgets. Provide Vision and Advise sing Overall Financial Health and Long Range Fiscal Planning Administrative Management Ensure Accurate Quality Control through ISO9001 Procedures / SSAIB / BAFE Oversee High Standards of Health and Safety Aid in Development of Quality Processes and Procedures to Guarantee Continuing Efficiency 1.3 Ã¢â¬â Ideal General Manager Competencies The function of General Manager takes duty for all countries of a concern including the gross and cost elements of the concern. I believe to be able to transport out this function efficaciously I will necessitate to posses the undermentioned accomplishments and competences. Leadership Skills Ã¢â¬â To be able to steer the company towards a united end and supply our clients with a quality service. Organizational Commitment Ã¢â¬â To be 100 % committed to the company and its ends in order to actuate the company and supply leading. Conceptual Thinking Ã¢â¬â To happen new and advanced ways to develop the concern and supply new services and experiences to clients Self Control Ã¢â¬â To help in determination devising and executive maps Developing Others Ã¢â¬â To guarantee that the company succeeds in all enterprises and strains loyal and determined staff. Energy and Passion Ã¢â¬â To drive a squad and actuate them to transport out responsibilities to the best of their ability. 1.4 Ã¢â¬â Ideal General Manager Competencies The makings required for the function of General Manager would be as below, this is non an thorough list but I believe that these makings and experiences are critical to transport out this function successfully. Preferably a grade in Business Management or tantamount degree of experience. A lower limit of 5 old ages concern experience. Demonstrable record of success at a senior degree within a general direction function in a comparable administration, sooner including the direction of preservation and proficient staff. Wide commercial experience, including finance, concern direction, human resources and IT. Prove IT competency in fiscal bundles i.e. Sage Strong interpersonal accomplishments, with the ability to pull off and develop staff making good squad work. Ability to develop, implement, manage and proctor effectual concern and fiscal systems and processs Experience and apprehension of human resource patterns, policies and processs Previous experience of Health and Safety policies, processs and patterns 2 Ã¢â¬â Professional Competencies Development I have provided below a competences matrix that identifies countries in which I have proved I meet the needed competences for the General Manager Role. I have besides identified spreads that will necessitate attending and action before 2.1 Ã¢â¬â Competence Matrix Competence Situation / Action / Outcome Further Actions Required Leadership Skills I have over 200 security and fire systems that require care and reactive plants. A portion of my occupation is to supervise the planning of these plants and do hourly determinations on which calls are reacted to first due to urgency. We late had a state of affairs where a edifice had been struck by lightning and this had efficaciously blown up the fire dismay system. As the edifice was a wellness Centre with 24/7 occupants this proved a wellness and safety exigency as without an operating fire system the edifice would hold to be evacuated. Checking which staff were on displacement I re-routed applied scientists over to site, this had to be completed in relay due to the length of clip it took to repair to guarantee that applied scientists did non compromise their ain wellness and safety. Completing plants like this encourages my staff to work efficaciously as a squad go forthing the site with every bit much information as possible for the following applied scientist to take over. Whil st finishing these exigency works we besides have to cover any other calls that arise throughout the twenty-four hours, so on this juncture I made the determination to use impermanent sub-contract labor to transport out plants to guarantee continuance of service. The wellness Centre fire dismay system was fixed within 24 hours with occupants of the site non being cognizant that there was of all time such an issue and other clients were dealt with expeditiously with the production of sub-contract labor. Whilst being an effectual leader I find I am still sometimes intimidated when confrontation arises with technology staff. I have put this bullying down to a limited proficient cognition and this should be improved. Organizational Committedness I late changed the manner our service section runs. We used to run applied scientists within nucleus concern hours 08:30 Ã¢â¬â 17:00, with an exigency service to cover outside these times. It became evident to me that due to the nature of the concerns we operate within that our nucleus hours needed to alter to accommodate, with applied scientists start and finish times being staggered. You read "General Manager Person Specification Commerce Essay" in category "Essay examples" I spoke to my technology and office staff as this would non merely consequence the applied scientists we would besides hold to alter our office hours ( including mine ) . After explicating to everyone the nature of the sites we looked after and the operational troubles they incur I was pleased to observe that everyone was really willing to come in into treatments sing a alteration in working hours. These alterations have had positive and negative effects on the lives of my staff but I was pleased and proud to observe that they were all willing to co-operate and move in a new way with the company. This resulted in the company being able to accommodate to new concern and supply an drawn-out service where required. I find that there are no spreads within my organizational committedness. When employed by a company I am highly loyal and set all attempt and energy into doing the company a success. Conceptual Thinking As the companies ISO9001 internal hearer it is within my function to finish a full set of process and procedure audits every 12 months. There have been a batch of alterations within the company over the last 12 months and this has led to the re-evaluation of our company procedures. I believe that procedures and processs are implemented to help a concern in running with professionalism and quality, non a hinderance. I try to instil in the sections that I audit that these processs are non set in rock and if they do nÃ¢â¬â¢t work for the company so we should happen something that does. With this in head I started the audit process for this twelvemonth, we looked at the current procedures and processs within the section and I sat down with the Undertaking Managers that have to work to the processs and asked them how they felt the processs aided or hindered them. They mentioned that the processs within their section worked good but the quality of information they received through from t he gross revenues section hindered them in finishing their occupation. I asked them what farther information could be provided to relieve this and we came up with a list of extra information. In this instance the best option was non to alter the processs for the installing section but to alter the processs for the gross revenues section. I created and implemented a checklist of information that the gross revenues section must finish before a occupation can be passed for contract reappraisal. In this state of affairs I understood the job the installing section had by placing forms or connexions, and addressed the cardinal implicit in issue. Conceptual thought includes the integrating of issues and factors into a conceptual model utilizing inductive logical thinking that lead to solutions or feasible options that may non be evidently related or easy identified. I feel I am comfy with this portion of my function and plume myself on seeing declarations through conceptual thought. The weakness I have at this point would be that I am rather protective of the quality system as I built and monitor it. Therefore any unfavorable judgment of the system I take personally and drop everything to measure whether the unfavorable judgment is validated or non. The quality system has been in topographic point for 5 old ages and is audited and reviewed for its effectivity every twelvemonth. Self Control The concern I work within is mostly client service based and whilst my frontline staff will cover with issues that arise ab initio if clients or applied scientists are non happy with a state of affairs so the issue gets passed to me. I was walking through the office when I heard one of the client service misss covering with a ailment. I heard the gentleman on the phone shouting down the line at the miss who was going rather upset. The miss told the client that she would set him through to her director and put the call on clasp. She informed me that the client had his system installed over 6 old ages ago and had a mistake with it. The miss told the client that she could organize an applied scientist and there would be a cost as the system was no longer under guarantee. Once the client realised that he had to pay for an applied scientist he started shouting at the miss stating her that he should nÃ¢â¬â¢t hold to pay anything and we should repair the mistake for free. I picked up the line to the client and asked how I could assist, he informed me of the same information my staff had and told me I should repair his job for free. I brought up his inside informations from the database and saw the age of the installing and that there was no care contract in topographic point. We offer a 12 or 18 month guarantee period with any installing we provide so this installing was surely out of guarantee. As antecedently the gentleman started to shout down the line about how he expected better aftercare than he had received. I asked the gentleman to quiet down and advised that he would non obtain any declaration whilst shouting at my staff and being opprobrious. We had no duty to this client and it would hold been really easy given his mode to inquire him to travel elsewhere and decline to function him. However, I do non like clients go forthing us with a feeling of ailment will so I advised the client that there was no care contract in topographic point and if he would take out a care contract with us I would direct an applied scientist to finish the care and expression at the mistake at the same clip which would intend no charge for the mistake. The client was happy with this result and agreed to take out the care contract, he so asked to be put back through to the client service miss and apologised for the mode in which he spoke to her. This was a state of affairs where my response to the job could hold made the state of affairs worse but by exerting a small ego control we obtained a little but long term client. I feel that this is the country in which I need to develop the most as I sometimes find it difficult to show myself with understanding and sympathy. this is chiefly with employees instead than clients and clients. Further HR consciousness would be good. Developing Others We believe in developing our staff to help them in their calling development. We take on staff as learners and develop them throughout their employment at Grantfen. For illustration, as my personal calling and preparation advancements their can non be a whole in the company, person has to be trained to finish the occupation I am presently assigned to. With this in head along with the managers we have chosen the individual to develop into my function and she spends clip alongside me larning the function and placing countries in which preparation is required. We have invested clip, attempt and money in this individual and have put her through legion NVQ Ã¢â¬Ës. I believe that puting in people and their development helps the company from a accomplishments position but besides provides the employee with a sense of trueness towards the company Whilst at present the idea of taking over my function is rather dashing to her I am confident that one time all preparation is complete she will be a really capable director. I am sometimes uncomfortable giving employees assessments and happen myself singling out the employees that I feel are more committed to the company and will bring forth long term benefit through preparation. Energy and Passion I love the company I work for and am invariably endeavoring to guarantee that our service section is amongst the best in the state. I believe that one individuals energy and passion to work can be infective and if you have the right squad of people they can feed off of each other Ã¢â¬Ës energy. With this in head I set myself a end for the current fiscal twelvemonth that we increase the turnover for the service section by A ; Acirc ; A ; lb ; 200K. This was a new country for me as my function has non been specifically gross revenues oriented in the yesteryear. If this end is reached this means the service section will necessitate another applied scientist and client service decision maker. I have communicated this end to our squad and everyone is on board and motivated to win, everyone has expressed a privation to be involved in a underdeveloped section as this creates new calling chances for everyone within the section. As we are still within the fiscal twelvemonth I can non stat e whether we have succeeded but I will province that we are decidedly on mark. Again I do non believe I require development in this country as a am really self motivated and believe in the abilities and end of the company I am employed by. I include below a soul-searching that identifies the countries in which I find myself strong and the countries which will necessitate farther attending every bit good as chances and menaces that this function will supply me with. Self Analysis Strengths Failings Opportunities Menaces Good at Working Alone or in a Team Can Become Obsessive Over Certain Tasks Wider Career Prospects Male Dominated Environment Flexible Lack of Personal Assurance New Challenges Less Experience of Business Management Excellent Communication Skills Can React Emotionally to Work Related Issues Fewer Restraints Current Staffing Requires Re-assignment Well Thought of by Stakeholders Impatient / Want Resolutions Quickly More Autonomy Multitude of Every Day Demands Passionate About the Job / Company / Goals To Learn From Others in Similar Roles Ambitious Loyal Thorough 3 Ã¢â¬â Professional Knowledge Development I have been working in the Fire and Security industry for 10 old ages and have obtained an highly good working cognition of the industry including a on the job proficient cognition. Over my ten old ages I have been in legion occupation functions and have complete undertakings that did non needfully fall within my occupation function. I feel confident that I can finish most undertakings within the concern which makes me a good campaigner for the function I wish to obtain. But even with this in head I feel that I would necessitate more experience in certain countries before I felt comfy taking a General Manager function. I am on my manner to finishing a grade in Business Management and so will see whether if it would be good to go on on to obtaining an MBA. I feel that I need to obtain farther apprehension in the fiscal field and whilst I have completed the AAT Levels 2 and 3 in Accounting I would profit further from a more in depth cognition of direction accounting. I besides identified a demand for farther Human Resource preparation to enable me to cover with staff efficaciously and reasonably. 4 Ã¢â¬â Professional Development Plan To accomplish the right degree of competences and makings for the function of General Manager I have completed an action program detailing what activities I will necessitate to set about to turn to all spreads that have been identified Areas for Development How Area was Identified Action to be Taken Target Dates Short Term Goals 1. To better proficient cognition Feedback from equal observation. To pass clip with applied scientists on site mistake happening July 2013 2. To go more empathetic with employees Through treatment with co-workers. Complete more staff assessments December 2013 3. To larn how to drive and actuate all squad members Through observation of managers. Through farther HR preparation December 2013 4. To derive assurance in personal accomplishments and abilities Through contemplation in my completion of PDP Through assessments and ongoing pattern of accomplishments and abilities December 2013 Long Term Goals 5. To accomplish a BA ( Hons ) in Business Management After treatments with Directors of sequence within the company To transport on in the completion of class at MMU July 2014 6. To obtain farther apprehension of direction accounting Following completion of AAT degrees 2 and 3 I identified that a farther apprehension of direction histories would be good To take finance as an option in my concluding twelvemonth December 2014 7. To set about farther Human Resources preparation We presently have a HR adviser and following treatments with him i believe farther HR preparation would be good To near the HR adviser and place any preparation available to farther enhance cognition December 2014 How to cite General Manager Person Specification Commerce Essay, Essay examples
Monday, May 4, 2020
Bioethical issues are relevant to nursesÃ¢â¬â¢ work in everyday practice, but in matters of bioethics nurses usually are not autonomous decision makers. Nursing ethics, as a unique ? eld, continues to be debated. Fry, Veatch, and Taylor (2011) continue to support the view that both nursing ethics and medical ethics are valid subcateÃ © Jones Bartlett ? eld of bioethics. Additional views are that everyday ethicalBartlett Learning, Ã © Jones gories of the larger Learning, LLC NOT nursing NOT practiceSALE OR DISTRIBUTION FOR in nursing is situated within an interdisciplinary team and thatFOR SALE OR DISTRIB ethics is distinctive from other disciplines in bioethics but is not yet unique (Volker, 2003; Holm, 2006; Wright Brajtman, 2011). The experiences and needs of practicing nurses, along with explorations of the meaning of nursing ethics, are areas of emphasis in nursingBartlett Learning, LLC Ã © Jones Bartlett Learning, LLC Ã © Jones ethics. Johnstone (2008) de? ned nursing ethics as Ã¢â¬Å"the examination of all kinds of ethical and NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION bioethical issues from the perspective of nursing theory and practice, which, in turn, rest on the agreed core concepts of nursing, namely: person, culture, care, health, healing, environment and nursing itselfÃ¢â¬ (p. 16). JohnstoneÃ¢â¬â¢s de? nition of nursing ethics is consistent with a common view that a strong Jones Bartlett Learning, LLC bond between nursing ethics and nursing theory distinguishes nursing ethics Ã © Jones Bartlett Learning, LLC from other areas of healthcare ethics. FOR SALE OR DISTRIBUTION OT FOR SALE OR DISTRIBUTION NOT NursesÃ¢â¬â¢ professional relationships to patient care and within the healthcare team bring about ethical issues unique to the nursing profession. To practice nursing ethically, nurses must be sensitive enough to recognize when they are facing seemingly obscure ethical issues in everyday work. Ã © Jones Bartlett Learning, LLCin Nursing Professional Codes of Ethics NOT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, NOT FOR SALE OR DISTRIB Professional nursing can be traced to England in the 1800s, to the school that was founded by Florence Nightingale, where profession-shaping ethical precepts and values were communicated. By the end of the 1800s, modern nursing had been established, and ethics was becoming a discussion topic in nursing. The NightinÃ © Jones Bartlett Learning, LLC written under the chairmanship of a Detroit nursingLearning, LLC Ã © Jones Bartlett school gale Pledge of 1893 was NOT FOR SALE OR DISTRIBUTIONto establish nursing as NOTand a science. SixOR DISTRIBUTION principal, Lystra Gretter, an art FOR SALE years later, in 1899, the International Council of Nurses (ICN) was established and became known as a pioneer in developing a code of ethics for nurses. Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 22183_CH03_Pass3. qxd 1/11/12 Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION 3:13 PM Page 71 Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Professional Codes of Ethics in Nursing 71 Ã © Jones 20th century, Learning, LLC Ã © By the turn of the Bartlett the ? rst book on nursing ethics, titled Nursing Jones Bartlett Learning, Ethics: For Hospital andSALE Use (1900), had been written by an American nurse NOT FOR SALE OR DISTRIB NOT FOR Private OR DISTRIBUTION leader, Isabel Hampton Robb. In RobbÃ¢â¬â¢s book, the titles of the chapters were descriptive of the times and moral milieu, such as Chapter 4: The Probationer, Chapter 7: Uniform, Chapter 8: Night-Duty, and Chapter 12: The Care of the Patient (nurseÃ¢â¬âphysician, nurseÃ¢â¬ânurse, nurseÃ¢â¬âpublic relationships). The focus in Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC the nursing code initially was on physicians, because, typically, male physicians NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION trained nurses in the Nightingale era. NursesÃ¢â¬â¢ technical training and obedience to physicians remained at the forefront of nursing responsibilities into the 1960s. This emphasis was re? ected in the ICN Code of Ethics for Nurses as late as 1965. However, by 1973, the ICN code re? ected a shift in nursing responsibility from a focus on obedience LLC Bartlett Learning, to physicians to a focus on patient needs, where Bartlettto this day. LLC Ã © Jones it remains Learning, Jones OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION American Nurses AssociationÃ¢â¬â¢s Code of Ethics for Nurses Ã¢â¬Å"A Suggested CodeÃ¢â¬ was published in the American Journal of Nursing (AJN) in 1926 by the American Nurses Association (ANA), but was never adopted; in 1940 Ã¢â¬Å"A Tentative CodeÃ¢â¬ was published in AJN, but again was never adopted (Davis, Fowler, and Jones Bartlett Learning, Ã © Jones Bartlett Learning, LLC Ã © Aroskar, 2010). The ANA adopted its ? rst of? cial code in 1950. Three more code reviNOT FOR SALE OR DISTRIB NOT FOR SALE OR DISTRIBUTION sions occurred before the creation of the interpretative statements in 1976. The word Ã¢â¬Å"ethicsÃ¢â¬ was not added to the title until the 1985 code was replaced with its sixth and latest revision in 2001. Within the code are nine moral provisions that are nonnegotiable with regard to nursesÃ¢â¬â¢ work. Detailed guidelines for clinical Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC practice, education, research, administration, and self-development are found in NOT FOR accompanying DISTRIBUTION of each provision (see Appendix A for OR DISTRIBUTION NOT FOR SALE the SALE OR interpretive statements the ANA Code of Ethics for Nurses with Interpretive Statements). A clear patient focus in the 2001 code obliges nurses to remain attentive and loyal to each patient in their care, but nurses must also be cognizant of ethical issues and con? icts of interest that potentially have a negative effect on patient care and Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC relationships with patients. Other forces to be reckoned with in todayÃ¢â¬â¢s environOT FOR SALE ORment are the politics in institutions and cost-cuttingFOR SALE (see Box 3. 1). DISTRIBUTION NOT strategic plans OR DISTRIBUTION In the code, the ANA (2001) emphasized the need for the habitual practice of virtues such as wisdom, honesty, and courage, because these virtues re? ect a morally good person and promote the values of human dignity, well-being, respect, health, and Jones Bartlettin nursing emphasize what is important for the Jones Bartlett Learning, Ã © independence. Values Learning, LLC Ã © nurse personally and for patients. The ANA emphasized the magnitude of moral NOT FOR SALE OR DISTRIB NOT FOR SALE OR DISTRIBUTION respect for all human beings, including the respect of nurses for themselves. Personal regard involves nurses extending attention and care to their own requisite needs, as nurses who do not regard themselves as worthy of care usually cannot fully care for others. Recognizing the dignity of oneself and of each patient is essenÃ © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC tial in moral reasoning. There are other statements in the code about wholeness of NOT FOR SALE ORpertains to recognizing the values of the nursing professionSALE OR DISTRIBUTION DISTRIBUTION NOT FOR and character, which oneÃ¢â¬â¢s own authentic moral values, integrating these belief systems, and then expressing them appropriately. Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 22183_CH03_Pass3. qxd 1/11/12 Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION 3:13 PM Page 72 Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 72 CHAPTER 3: Ethics in Professional Nursing Practice BOX 3. 1 Ã © JonesFORMATIONS: CODE OF ETHICS APPLICATION Bartlett Learning, LLC ETHICAL NOT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, NOT FOR SALE OR DISTRIB In the Code of Ethics for Nurses with Interpretive Statements, the ANA currently emphasizes the word Ã¢â¬Å"patientÃ¢â¬ instead of the word Ã¢â¬Å"clientÃ¢â¬ in referring to the recipients of nursing care. Do you agree with this change? Please explain your rationale for your answer. Take a few minutes to review the ANA Code of Ethics for Nurses with Interpretive Statements Ã © Jones Bartlett Learning, LLC there be additional provisions of the Bartlett you Ã © Jones code? Would Learning, LLC (2001) in Appendix A. In your view, should NOT FOR SALE ORnine provisions? Please explain your rationale for yourFOR SALE OR DISTRIBUTION DISTRIBUTION NOT answers. remove any of the After reviewing the interpretive statements in the code, discuss random brief scenarios on how nurses can justify their actions with the following approaches or frameworks: the principles of autonomy, bene? cence, nonmale? cence, and justice; KantÃ¢â¬â¢s categorical imperatives based on deontology; a utilitarian Bartlett Learning, LLC framework; a virtue ethics approach; and an ethicLearning, LLC Ã © Jones Bartlett of care approach. Jones OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION International Council of NursesÃ¢â¬â¢ Code of Ethics for Nurses In 1953, the ICN adopted its ? rst code of ethics for nurses. (See Appendix B for the 2006 ICN Code of Ethics for Nurses. ) The multiple revisions illustrate a reaf? rmaÃ © Jonesof the code as a universal global document for ethical practiceÃ © Jones TheBartlett Learning, tion Bartlett Learning, LLC in nursing. NOT FOR SALE OR DISTRIB NOT four major elements contained in the code involve standards related to nurses and FOR SALE OR DISTRIBUTION people, practice, the profession, and coworkers. The elements in the code form a framework that must be internalized before it can be used as a guide for nursing conduct in practice, education, research, and leadership. Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC Common Thread between American Nurses Association and NOT FOR SALE OR DISTRIBUTION of Nurses Codes NOT FOR SALE OR DISTRIBUTION International Council A common theme between the ANA (2001) and ICN (2006) codes is a focus on the importance of compassionate patient care aimed at alleviating suffering. Nurses are to support patientsÃ¢â¬â¢ self-determination and are to protect the moral space where Jones Bartlett Learning, LLC receive care. The interests of variousBartlett Learning, LLC Ã © Jones nursing associations and healthcare patients OT FOR SALE OR DISTRIBUTION NOT FOR of patients. Nurses are to uphold the institutions must not be placed above thoseSALE OR DISTRIBUTION moral agreement that they make with patients and communities when they join the nursing profession. Nursing care includes the primary responsibilities of promoting health and preventing illness, but the primacy of nursing care has always involved caring for Learning, LLC Ã © Jones Bartlettpatients who are experiencing varying degrees of physical, psy-Bartlett Ã © Jones chological, and spiritual suffering. NOT FOR SALE OR DISTRIBUTION Learning, NOT FOR SALE OR DISTRIB Professional Boundaries in Nursing Professional ethical codes serve as useful, systematic, normative guidelines for providing direction and shaping behavior. The ANA and ICN codes apply to all nurses Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC regardless of their role, although no code can provide a complete and absolute set NOT FOR SALE ORrules free of con? ict and ambiguityÃ¢â¬âa rationale often cited in favor of the use DISTRIBUTION NOT FOR SALE OR DISTRIBUTION of of virtue ethics as a better approach to ethics (Beauchamp Childress, 2009). Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 22183_CH03_Pass3. qxd 1/11/12 3:13 PM Page 73 Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION Qualities of Ethical Nurses 73 Ã © SomeÃ © Jones Bartlett Learning, LLCvirtuous character cannot Jones Bartlett Learning, people contend that nurses who are without a be depended on to act SALE or moral ways, even with a professional code as a NOT FOR SALE OR DISTRIB NOT FOR in good OR DISTRIBUTION guide. In the 30th-anniversary issue in 2006 of the Journal of Advanced Nursing, the editors reprinted and revisited a 1996 article by Esterhuizen titled, Ã¢â¬Å"Is the Professional Code Still the Cornerstone of Clinical Nursing Practice? Ã¢â¬ , and solicited three responses. One respondent, Tschudin, agreed with Esterhuizen Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC that nursing lacks opportunities for full autonomy in moral decision making. NOT FOR SALE OR DISTRIBUTION engage in moral decisions, but theySALE OR DISTRIBUTION NOT FOR still There is abundant ground for nurses to do not have enough opportunity to participate. In the current uncertain moral landscape, nurses often wonder about the benefit of codes of ethics. TschudinÃ¢â¬â¢s key message was that virtuous nurses with full autonomy and accountability have an internal moral compass to guide their practice and do not necessarily need a Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC OT FOR SALE ORcode of ethics. DISTRIBUTION NOT FOR SALE OR DISTRIBUTION However one perceives the value of the codes of ethics for nurses, they still serve as mandates for accountability in practice. Professional boundary issues occur in all settings of nursing. Professional nursing boundaries are commonly de? ned as limits that protect the space between the nurseÃ¢â¬â¢s professional power and the Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, patientÃ¢â¬â¢s vulnerabilities. Boundaries facilitate a safe connection in a relationship, NOT FOR SALE OR DISTRIB NOT FOR SALE OR DISTRIBUTION of legitimate control, because they give each person in the relationship a sense whether the relationships are between the nurse and patient, the nurse and physician, the nurse and administrator, or nurse and nurse. Boundary crossings or violations are actions that do not promote the best interest of the other person(s) in a relationship; crossings pose a potential Ã © Jones Bartlett Learning, LLC risk, harm, or exploitation to the other(s) Ã © Jones Bartlett Learning, LLC in the relationship. The blurring of boundaries between persons in a relationship NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION is often subtle and unrecognizable at ? rst. The ANA (2001) included numerous boundary issues in the code. See Box 3. 2 for a few examples of these boundary topics and moral obligations. Jones Bartlett Learning, of Ethical Nurses Qualities LLC OT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Numerous qualities, or virtues, could describe the ideal ethical nurse. The foremost quality, often considered the ? ber for all others, is moral integrity. Some people believe that moral integrity is necessary for the individual as a whole to ? ourish. A person with moral integrity usually is described as having honesty, truthfulness, trustÃ © courage, Bartlett Learning, LLC Ã © worthiness, Jones benevolence, and wisdom. In this section, there is a discussion Jones Bartlett Learning, NOT FOR SALE OR DISTRIB NOT FOR SALE OR DISTRIBUTION of (1) moral integrityÃ¢â¬âhonesty, truthfulness, and moral courage; (2) concernÃ¢â¬â advocacy and power; and (3) culturally sensitive care. Other qualities, such as respect for others and con? dentiality, are explored in the previous chapter. Moral Integrity Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC Moral integrity represents a personÃ¢â¬â¢s wholeness of character. T. G. Plante (2004) NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION stated that although no one is mistake free, people with moral integrity follow a Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 22183_CH03_Pass3. qxd 1/11/12 Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION 3:13 PM Page 74 Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 74 CHAPTER 3: Ethics in Professional Nursing Practice Ã © Jones Bartlett Learning, BOX 3. 2 Ã © JonesFORMATIONS: PROFESSIONAL BOUNDARIES AND MORAL ETHICAL Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION CODE OF ETHICSNOT FOR SALE OR DISTRIB OBLIGATIONS FOR NURSES AS SPECIFIED BY THE ANA FOR NURSES WITH INTERPRETIVE STATEMENTS (2001) Clinical Practice Boundaries Respecting patientsÃ¢â¬â¢ dignity Ã © Jones to self-determination Ã © Jones Bartlett Learning, LLC Right Bartlett Learning, LLC Delegating tasks appropriately NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Practicing good judgment Accepting accountability in practice Alleviating suffering Being attentive to patientsÃ¢â¬â¢ interests Bartlett Learning, LLCnurse practice acts and nursing standards of practice Learning, LLC Ã © Jones Bartlett Working within the Jones OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Professional Practice Boundaries Maintaining authenticity in all relationships with others, such as nurse-to-nurse relationships, nurseÃ¢â¬âphysician relationships, nurse-to-patient relationships, and multidisciplinary collaboration Addressing and evaluating issues of impaired practice; fraternizing inappropriately with patients Ã © Jones Bartlett Learning, LLC Ã © Jones or others; accepting inappropriate gifts from patients and families; con? dentiality and privacy Bartlett Learning, violations; and unhealthy, unsafe, illegal, or unethical environments NOT FOR SALE OR DISTRIB NOT FOR SALE OR DISTRIBUTION Self-Care and Self-Development Boundaries and Obligations Participating in self-care activities to maintain and promote moral self-respect, professional growth and competence, wholeness of character in nursesÃ¢â¬â¢ actions and in relationships with others, and preservation of integrity Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC Advancing knowledge and research through NOT FOR SALE OR DISTRIBUTION professionalism, practice, education, and OR DISTRIBUTION NOT FOR SALE administrative contributions Collaborating with other healthcare professionals and the public to promote community, national, and international efforts Promoting healthy practices in the community through political activism or professional organizations LLC or Jones practices that have the potential Jones Bartlett Learning, by addressing unsafe, unethical, Ã © illegal health Bartlett Learning, LLC to harm the community OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION moral compass and usually they do not vary by appeals to act immorally. Most of the time, when people speak of a personÃ¢â¬â¢s moral integrity, they are referring to a personÃ¢â¬â¢s Bartlett Learning, LLC Ã © Jones quality of character. Ã © Jones Bartlett Learning, People with moral DISTRIBUTION integrity pursue a moral purpose in life, understand their NOT FOR SALE OR DISTRIB NOT FOR SALE OR moral obligations in the community, and are committed to following through without any constraints imposed on them by their moral stance. In a qualitative study on moral integrity by Laabs (2011), nursesÃ¢â¬â¢ perceptions of the de? nition of moral integrity were, Ã¢â¬Å"[A] state of being, acting like, and becoming a certain kind Ã © Jones Bartlett Learning,person is honest, trustworthy, consistently doingBartlett Learning, LLC LLC Ã © Jones the right thing and of person. This NOT FOR SALE OR DISTRIBUTION despite the consequencesÃ¢â¬ (p. 433). NOT FOR SALE OR DISTRIBUTION standing up for what is right Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 22183_CH03_Pass3. qxd 1/11/12 Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION 3:13 PM Page 75 Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Qualities of Ethical Nurses 75 Ã © of moral integrity include good character, Ã © FeaturesJones Bartlett Learning, LLC intent, and performance. Jones Bartlett Learning, Nurses with moral integrity act consistently with personal and professional values. NOT FOR SALE OR DISTRIB NOT FOR SALE OR DISTRIBUTION When nurses are asked or pressured to do something that con? icts with their values, such as to falsify records, deceive patients, or accept verbal abuse from others, moral distress may occur. In a healthcare system often burdened with constraints of politics, self-serving groups or interests, and organizational bureaucracy, threats to moral Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC integrity can be a serious pitfall for nurses. When nurses with moral integrity must NOT FOR SALE the compromise usually does not interfere with their personal or SALE OR DISTRIBUTION OR DISTRIBUTION NOT FOR procompromise, fessional values. To have moral integrity means that a personÃ¢â¬â¢s character is made of up several virtues; three of those virtues are honesty, truthfulness, and moral courage. Moral Distress Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC Moral distress occurs when nurses or other healthcare professionals have multiple OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION or dual expectations and cannot act according to the guidance of their moral integrity. Jameton (1984) popularized and de? ned the term moral distress as occurring Ã¢â¬Å"when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of actionÃ¢â¬ (p. 6). NursesÃ¢â¬â¢ work Ã © involves Ã © Jones Bartlett Learning, LLCof patients, emotional and Jones Bartlett Learning, hard choices that sometimes result in avoidance physical NOT FOR SALE OR DISTRIBUTION suffering, painful ambiguity, contradiction, frustration, anger, and guilt. NOT FOR SALE OR DISTRIB Since JametonÃ¢â¬â¢s initial work, authors have continued to research and develop the conception of moral distress. Numerous scholars have linked moral distress to incompetent or poor care, unsafe or inadequate staf? ng, overwork, cost constraints, ineffective policy, futile Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC care, unsuccessful advocacy, the current de? nition of brain death, objecti? cation NOT FOR SALEand unrealistic hope (e. g. , Corley, 2002; Corley, Minick,FOR SALE OR DISTRIBUTION OR DISTRIBUTION NOT Elswick, of patients, Jacobs, 2005; Pendry, 2007; Schluter, Winch, Holzhauser, Henderson, 2008; McCue, 2011). Moral distress is de? ned in the context of institutional constraints. Research has revealed that nursesÃ¢â¬â¢ work environments have a strong effect on the degree of moral distress experienced (e. g. , Redman Fry, 2000). Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC Leaders of nursing continue to search for strategies to reduce moral distress and OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION promote healthy work environments. The American Association of Critical-Care Nurses (AACN) published a position statement to accentuate the seriousness of moral distress in nursing: MoralÃ © Jones Bartlett Learning, LLChealthcare work environdistress is a critical, frequently ignored, problem in ments. Unaddressed it restricts nursesÃ¢â¬â¢ ability to provide optimal patient care and to NOT FOR SALE OR DISTRIBUTION ?nd job satisfaction. AACN asserts that every nurse and every employer are responsible for implementing programs to address and mitigate the harmful effects of moral distress in the pursuit of creating a healthy work environment. (American Association of Critical Care Nurses [AACN], 2008, p. 1) Ã © Jones Bartlett Learning, NOT FOR SALE OR DISTRIB The AACN ethics work group developed a call-to-action planÃ¢â¬âThe Four AÃ¢â¬â¢s to Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC Rise above Moral DISTRIBUTION NOT FOR SALE ORDistressÃ¢â¬âfor use by nurses to identify and analyze moral distress OR DISTRIBUTION NOT FOR SALE (AACN, 2004): Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 22183_CH03_Pass3. qxd 1/11/12 3:13 PM Page 76 Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION 76 CHAPTER 3: Ethics in Professional Nursing Practice Ã © Jones AskBartlett Learning, LLC aware that moral distress Jones Bartlett Learning, appropriate questions to become Ã © is present. Af? rm your distress and commitment NOT FOR NOT FOR SALE OR DISTRIBUTION to take care of yourself and address SALE OR DISTRIB moral distress. Assess sources of your moral distress to prepare for an action plan. Act to implement strategies for changes to preserve your integrity and authenticity. Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Honesty Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION In the 2010 Gallup poll, just as it had been over the past 11 years, nurses were rated as the most honest and ethical health professionals (Jones, 2011). Nurses continue to be ranked consistently as the most trusted voice among the healthcare professionals; Jones Bartlett Learning, LLC nurses have earned this trust becauseBartlett Learning, LLC to Ã © Jones of their commitment and loyalty their patients. According to Laabs (2011), nurses voiced that being honest was OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION important for three reasons: (1) honesty is a prerequisite for good care, (2) dishonesty is always exposed in the end, and (3) nurses are expected to be honest. In a phenomenological study of nurses on honesty in palliative care, Erichsen, Danielsson, and Friedrichsen (2010) stated that nurses had some dif? culty de? ning Ã © Jones Bartlett Learning, LLC Ã © Jones honesty. In an attempt to clarify their perception of honesty, nurses often de? nedBartlett Learning, NOT FOR a NOT lying orSALE OR DISTRIBUTION FOR dishonesty as sharp contrasts to honesty. Nurses perceived honesty as SALE OR DISTRIB virtue related to facts, metaphors, ethics, and communication, while perceiving truthtelling as a palpable feature in trusting relationships. Honesty, in simple terms, can be de? ned as being Ã¢â¬Å"real, genuine, authentic, and bona ? deÃ¢â¬ (Bennett, 1993, p. 597). Honesty is more than just telling the truth: it is Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC the substance of human relationships. It involves people having the ability to place NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION emphasis on resolve and action to achieve a just society by exercising a willingness to dig for truth in a rational, methodical, and diligent way. A person with maturity in honesty will place bits of truths into perspective and prudently search for the missing truths before addressing the issue. In other words, honesty is well-thought out and rehearsed behavior that re? ects commitment and integrity. Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC There are many ways that nurses can portray honesty. For example, nurses must OT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION stay committed to their promises to patients and follow through with appropriate behaviors, such as returning to patientsÃ¢â¬â¢ hospital rooms, as promised, to help them with certain tasks. If nurses do not follow through with their commitments, trust may be broken, and patients potentially will see those nurses as dishonest or Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, untrustworthy. NOT FOR SALE OR DISTRIB NOT FOR SALE OR DISTRIBUTION oneÃ¢â¬â¢s self. For example, if a nurse was Honesty is also about being honest with in the process of administering medications and a pill fell on the hospital floor, would the nurse be justi? ed in wiping it off and placing it back in the cup if no one was there to see the action? Nurses might be tempted to wipe off the pill and administer it just to required form for a replacement Ã © Jones Bartlett Learning, LLCkeep from completing a Ã © Jones Bartlett Learning, LLC medication, but if nurses NOT FOR SALE OR DISTRIBUTION evaluate their problems and make decisions based on the NOT FOR SALE OR DISTRIBUTION thought Ã¢â¬Å"always be honest with myself,Ã¢â¬ it is more likely that they will make rational, trustworthy decisions regarding the care of patients. Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION Ã © Jones Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION 22183_CH03_Pass3. qxd 1/11/12 Jones Bartlett Learning, LLC OT FOR SALE OR DISTRIBUTION 3:13 PM Page 77 Ã © Jones Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION Qualities of Ethical Nurses 77 Ã © Jones Bartlett Learning, LLC Truthfulness Ã © Jones Bartlett Learning, AristotleNOT FOR SALE OR the mean between imposture (excessiveness) recognized truthfulness as DISTRIBUTION NOT FOR SALE OR DISTRIB and self-deprecation (de? ciency) and as one of the 12 excellences (virtues) that he identi? ed in his book Nicomachean Ethics (Aristotle, 2002, C. Row Trans. ). People accomplish their ultimate goal of happiness only by exercising rational and intellectual thinking, which is known as wisdom or contemplation. Aristotle explained Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, LLC his view of a truthful person as being the truthful sort (see Box 3. 3). NOT FOR SALEthe principle of veracity, truthfulness is what we say and FOR SALE OR DISTRIBUTION OR DISTRIBUTION NOT how we say Based on it. Truthfulness, translated to Ã¢â¬Å"truthtellingÃ¢â¬ in the healthcare environment, means that nurses are usually ethically obligated to tell the truth and are not intentionally to deceive or mislead patients. Because of the emphasis in the Western world on Jones Bartlett Learning, LLC about their personalÃ © Jones Bartlett Learning, LLC patientsÃ¢â¬â¢ right to know health care, truthtelling has become OT FOR SALE ORthe basis for most relationships between healthcare professionals andOR DISTRIBUTION DISTRIBUTION NOT FOR SALE their patients (Beauchamp Childress, 2009). In the older, traditional approach, disclosure or truthtelling was done with more of a bene? cent or paternalistic approach and involved basing actions on answers to the questions such as, Ã¢â¬Å"What is best for my patient to know? Ã¢â¬ Ã © Jones Bartlett Learning, LLC Ã © Jones Bartlett Learning, The ethical question to ask is: Are there ever circumstances when nurses should NOT FOR SALE OR DISTRIB NOT FOR SALE ORtruth to their patients? The levels of disclosure DISTRIBUTION be ethically excused from telling the in health care and the cultural viewpoints on truthtelling create too much fogginess for a clear line of distinction to be drawn between nurses telling or not telling the truth. The ANA Code of Ethics for Nurses (2001) obligates nurses to be honest in Bartlett Learning, LLC Ã © Jones matters involving patients and themselves, and to express a moral point of view Ã © Jones Bartlett Learning, LLC when they become aware of unethical practices. NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION In some Western cultures, such as the United States, autonomy is so valued that withholding information is unacceptable. Under this same autonomy principle, it is assumed that patients also have a right not to know their medical history if they so desire. Some cultures, such as those in several Eastern countries, do not prize Jones Bartlett Learning, this way; the head of the family or the elders usually decide how much Ã © Jones Bartlett Learning, LLC autonomy in LLC OT FOR SALE ORand what information needs to be disclosed to the family member as patient. DISTRIBUTION NOT FOR SALE OR DISTRIBUTION BOX 3. 3 ETHICAL FORMATIONS: ARISTOTLEÃ¢â¬â¢S Ã¢â¬Å"THE TRUTHF
Friday, March 27, 2020
Background Alcoholism is a behavior arising from physical addiction to alcohol by an individual. A victim of alcoholism will continue to drink despite experiencing health problems that may be physical, social or mental. Alcoholism is different from alcohol abuse since alcohol abuse describes a situation where drinking may result from problems emanating from the act of alcoholism, it is more behavioral than physical addiction (PubMed Health, 2011).Advertising We will write a custom research paper sample on Concept and Treatment of Alcohol Abuse specifically for you for only $16.05 $11/page Learn More Alcoholism is a disorder in which an individual takes alcohol despite being aware that it will ruin their lives. Alcoholics cause several problems with the people who are close to them, and they demonstrate some sense of irresponsible behaviors, for instance, by abandoning school or jobs. Alcoholism results from several years of alcohol drinking and it worsen s further with more drinking. When alcoholism is not treated, it will likely destroy the emotional and physical well being of an individual; extreme alcoholism might even lead to death. Alcoholism is a family disease since it hurts and directly and indirectly affects the lives of victimÃ¢â¬â¢s family members and the people who are close to the alcoholic person (Cleveland Clinic, 2010). People drinking alcohol do not always have knowledge of when alcohol drinking gets out of hand. The problems of alcoholism may be mind as well as life threatening, and they affect the individual, family and the society. Alcoholism is the taking of alcoholic beverages to an extent that it can interfere with the physical behavior and activities of the alcoholic person (Gifford, 2009). Thesis Alcohol is a widely used and an accepted psychoactive drug that disrupts the neurochemistry in the brain causing emotional, social, behavioral, spiritual and vocational problems. Alcohol.Ã Definition Alcohol is as a central nervous system depressant that when taken in limited quantities, it can have a small and mild stimulant effect. Alcohol is a legal drug accepted by societal and cultural norms of particular jurisdictions. Consistent consumption of alcohol may lead to the body adapting to its persistent presence. Neurochemistry.Ã Absorption, Distribution Metabolism Since alcohol is a beverage and hence it dissolves in water, it has the potential to diffuse easily into the body tissues, body fluids, and to the brain as well.Advertising Looking for research paper on psychology? Let's see if we can help you! Get your first paper with 15% OFF Learn More Classification.Ã Depressant As a depressant, alcohol as the ability to slow down the functioning of a neural system of an individual; it achieves this by blocking messages from reaching the brain. Effects of Alcohol Short Term Physical Effects Unconsciousness In the context of alcohol, this unconsciousness is a form of a bl ackout. This is a situation where a patient loses his/her senses and thus appearing as if they are in a dreamless sleep, but they will try their best to appear as though they are conscious, which may not be possible. Alcohol poisoning Alcohol poisoning is an illness caused by excessive intake of alcohol. Alcohol poisoning can cause damage to the lung, and it might as well lead to cases of heart attack. Hangover When alcoholics drink late into the night, they may suffer from hangovers in the following morning. This is because alcohol has the effect of irritating the stomach. Furthermore, heavy drinking can cause sickness and nausea. Hangover is because of the dehydrating effect of alcohol (Wekesser, 1994). Sleep disturbance Irritability and anxiousness Alcohol is a depressant substance, which has a stimulating effect. Due to this effect, it can slow down the brain and the entire central nervous system hence resulting to loss of sleep. Death Intoxication, which results from alcohol co nsumption, may lead to death. When people drive under the influence of alcohol they can easily lose control and cause a fatal accident. Physiological Central Nervous System (CNS) Alcoholism undermines an individualÃ¢â¬â¢s mental judgment resulting to low inhabitation and alteration in the thoughts and the emotions of the alcoholic person. Persistent drinking can lead to the inability of the victim to coordinate body muscles (Gifford, 2009).Advertising We will write a custom research paper sample on Concept and Treatment of Alcohol Abuse specifically for you for only $16.05 $11/page Learn More Brain and chemical imbalance Alcohol affects the brain and the entire neural system and brain cells. An individual who has been dependent on alcohol, in the event stops drinking, he/she will experience a chemical reaction which will excite the nervous system and can agitate the level of body chemicals which in turn can prevent stress and impulsivity. Consequently , the drinking of alcohol can trigger the release of neurotransmitters like serotonin that produce euphoric feelings and reward sensation (National Institute of Heath, 2003). For a particular period, excessive consumption of alcohol can deplete the stores of serotonin, also consistent drinking may result in loss of mood. Fatty Liver Too much consumption of alcohol may result in fat deposits in the liver. Continuous drinking of alcohol can lead to the inflammation of the liver, which may in turn result, into hepatitis. Hepatitis can cause the liver to fail leading to death. Alcohol Abuse and Dependency Alcohol Use Alcohol use is like a disease. This is due to the reason that alcohol use characterized by a maladaptive drinking pattern of alcohol may lead to adverse effects. Factors of Intoxication Intoxication is the primary cause of all alcohol problems. Intoxication may lead to injuries and in extreme circumstances death. Diagnostic and Statistical Manual of Mental Disorders (DSM) T his is the universal standard used by mental health practitioners in the United States of America for classifying metal disorders. It has three components namely: diagnostic classification, diagnostic criteria sets and the descriptive text.Advertising Looking for research paper on psychology? Let's see if we can help you! Get your first paper with 15% OFF Learn More Progression of the disease Alcoholism is a progressing disease in the sense that an individual continues drinking even if he/she is already drunk to the capacity. Continued drinking may result in the individual being irresponsible. Alcoholism is a situation where an individual develops persistent culture of drinking even after experiencing the problems due to drinking. The loss of control is progressive and the victim can spend most of his time drinking (Manzardo Goodwin, 2006). An alcoholic person may drink more and he/she will be accustomed and more reliant on alcohol; the alcoholic becomes obsessed with alcohol. Consequences Associated with alcohol Abuse and Dependency Behavioral The behaviors emanating from alcoholism can be particularly risky. Alcoholism exposes the victim into risky behaviors that may result from their impulse actions. Risk takers and sensationally oriented behaviors are because of the use of alcohol. High consumption of alcohol may result to high susceptibil ity to risk taking behaviors (National Institute of Health, 2003). Social Alcoholism has an adverse economic impact on the entire society. Alcoholism may result in low productivity, massive expenditure in health care, diseases and illness and premature deaths. Much of the costs resulting from alcohol abuse are borne by those who do not take it. Alcoholism may also result in the commission of crimes. Emotional Alcohol suppresses emotional pain; it is a loyal friend in the event of relationships failing. Alcoholics are often, tempted by the negative feelings that might force them to return after a long period of withdrawal (New York Times, 2011). Vocational Employment Assistance Program Alcohol can affect every aspect of a patientÃ¢â¬â¢s life. According to the Occupational Health and Safety Administration, most of the people that are addicted are in employment hence leading to hazards in workplace and development of an unproductive workforce. Treatment and Recovery Background on the organization Alcoholic Anonymous (AA) is a self-help group of both men and women who are recovering from alcoholism. This group involves individuals who share similar hope, aspirations, strengths and experiences. It is interested in proving emotional assistance to people with the problem of alcohol dependence. They have braches in several countries on the globe. The group utilizes a 12-step approach to achieve its mission and objectives. The group has a common agenda of assisting others to recover from alcohol dependency (Grapevine, 1958). Founding principles The addicts should meet one and the only demand of stopping to drink before joining the group, and there are no charges or subscription fee. AA is a non- governmental organization and not affiliated to any religious or political group; twelve steps to realize its objectives guide the group members. Problems and resistance Aexperiences a lot of problems and resistance in its desire to achieve the desired goals. This resistance and problems are: Its stressing on absolute abstinences: for many alcoholics, total abstinence is a difficult task; various alcoholics would prefer treatment that will permit them into taking alcohol again than abstinence. Stigmatization: stigmatization of alcoholics is a reality in every society, alcoholics therefore avoid joining AA due to the fear of stigmatization and they instead opt to remain alcoholic. Fear of being noticed by friends or acquaintances: there is the fear by the victims that in the course of AA meetings, they risk noticed by their friends or business associates. Medication therapy and other philosophies Naltrexone The patient is injected with a version of a Naltrexone which can be administered to the patient once in month. There are, however, some circumstance where the patient can take a pill, recommended that the patient take the injectable drug since it is preferable for people who are highly dependent on alcohol. Injected drug also has the advantage of cons istency. The drugs aid in blocking the brain hence reducing the demand and the craving for alcohol by the patient. Rehabilitation After the victim undergoes detoxification, rehabilitation can enable him/her to stay away from alcohol. In the rehabilitation, the patient is counseled, provided with psychological help, nursing service and medical attention to prevent cases of lapse. Behavioral therapy This is a crucial part of alcohol dependency treatment. It is acknowledged that alcoholism can have a deep psychological roots and therefore a perfect therapy program is necessary to assist the victim understand what has caused his/her behavior as an alcoholic and this will enable him/her to make some amendments into his/her life (Maltzman, 2008). New treatment and research Very many drugs that if taken can assist in suppressing the withdrawal symptoms. Some medications can be effective in blocking part of the brain that is responsible for producing sensations when there is intake of alcoh ol. There are two main kinds of treatment: long-term and short-term while others may be in in-patient and outpatient. Longer duration of treatment can be effective and can produce better results. These treatment facilities can be private or public. Sober living and independence According to many alcoholics, overcoming or avoiding intake of alcohol is a difficult task. Stopping to drink alcohol is the best remedy. Abstinence does not depend on the duration within which the alcoholic has been drinking alcohol neither does it depend on the degree of addiction but it takes individual decision (Siclair Escapa, 2008). Conclusion Alcohol is a socially accepted drug that can devastate all areas of oneÃ¢â¬â¢s life. It disrupts the neurochemistry in the brain and gets progressively worse if not treated. Although there is still much to learn about alcohol and addiction, today research offers promising hope for those addicted to alcohol. Alcohol is progressive disease and if not arrested at its early stages, it may lead to health, physical and emotional problems, and at the extreme case, it may lead to death. Alcoholism may be because of addiction, compulsion and obsession. References Cleveland Clinic. (2010). Alcoholism. Cleveland Clinic. Web. Gifford, M. (2009). Alcoholism. New York, NY: ABC-CLIO. Grapevine, A. (1958). AA: other problems than alcohol. Alcoholics Anonymous. Web. Maltzman, I. (2008). Alcoholism: its treatments and mistreatments. New York, NY: World Scientific. Manzardo, A., Goodwin, D. (2006). Alcoholism (4th ed). Oxford, UK: Oxford University Press. National Institute of Health. (2003). Understanding Alcohol: investigations into Biology and behavior. Science Education. Web. New York Times. (2011, October 28). Alcoholism and Alcohol Abuse. New York Times. Web. PubMed. (2011). Alcoholism and alcohol abuse. PubMed Health. Web. Siclair, D. Escapa, R. (2008). The Cure for Alcoholism: Drink Your Way Sober Without Willpower, Abstinence Or Discomfort. New Y ork, NY: BenBella Books. Wekesser, C. (1994). Alcoholism. New York, NY: Greenhaven. This research paper on Concept and Treatment of Alcohol Abuse was written and submitted by user Darth Maul to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.
Saturday, March 7, 2020
Three Things You Can Do to Help Your Child Do Better in School Importance of education The place of education cannot be overestimated in the modern world. Elder people understand that knowledge is one of the main ways for success in the future. Those who have profound knowledge in different spheres and specialize in one specific field can achieve high results in their careers.Advertising We will write a custom article sample on Three Things You Can Do to Help Your Child Do Better in School specifically for you for only $16.05 $11/page Learn More But, this information is available and understood by parents, children are not so conversant with this issue. Thus, it is possible to conclude that parents are those who should encourage and help their children study. There are a lot of different strategies which may be helpful for parents in this question, but there are three main things each parent should do to help a child to do better at school. ChildrenÃ¢â¬â¢s success depends on their parents One cannot reject that each c hild has a right to attend public school and succeed there. All parents want their children to be prosperous and they are to help them. School education is the process which should be guided by parents. Much research has been provided in the sphere of the connection between school and home. Scientists have proved that school-home collaboration in the questions of a childÃ¢â¬â¢s studying is useful. Close connection between school and home enhance studentsÃ¢â¬â¢ desire to study as they see that parents support them in this difficult but really interesting initiative. The research conducted by Jan Hughes and Oi-man Kwok shows that children study better when they see collaboration between parents and school. Thus, if childrenÃ¢â¬â¢s success also depends on the actions of their parents, they should act. We would like to offer a list of three main things parents should do to help their children do better at school. First of all, parents should make sure that their children use modern textbooks, up-to-date sources and innovative technologies, like computers and the Internet. Second, parents should motivate their children to study and explain that school is not the only place where they can learn. It is necessary to deliver the idea that learning is an interesting and exciting process which does not finish with leaving school. Third, parents should create special room for studying and set particular hours for this process. These actions help parents influence their childrenÃ¢â¬â¢s psychological needs and make those interested in studying on unconscious level. Up-to-date information and innovative technologies Innovative technologies have entered human life so strong that it is impossible to imagine a house without a computer and the Internet. The Internet allows students get new information as soon as possible. Moreover, fast change of the information becomes available for students.Advertising Looking for article on education? Let's see if we can help you! Get your first paper with 15% OFF Learn More In comparison with the time when the Internet was not created, students had to buy books and use those for many years. Nowadays, many books and other sources are republished almost every year. Parents should check the books their children use and do all possible to get the most recent editions. Parents should follow this process. Furthermore, parents have an opportunity to sign for journals with the necessary information. At the same time, it is important to check what information children read. Having too much available data, parents should set control on the sites children visit and the sources they download. Thus, having personal computers children should provide their parents with free access. The use of the innovative technologies in the educational process should be supported. Parents are to consider childrenÃ¢â¬â¢s curriculum and try to get additional programs and software aimed at increasing student sÃ¢â¬â¢ knowledge in the form of games. There are also a lot of tests which may be used as additional source of knowledge. But, using this kind of software parents should not go too far. Children should use the Internet as the source of entertainment as well, otherwise, they will lose the interest and the studying will become a torture for them, even with the use of the innovative technologies. So, the first thing parents should do to help their children is to provide those with the most recent information and direct the use of the computers and the Internet to the learning purposes. Strong motivation Parents play important part in studentsÃ¢â¬â¢ motivation. There are a lot of different ways how they can influence their children. Personal experience, school recollections, reasonable arguments and other means of motivation may be used for encouraging children study better. Motivation is a strong factor in education. Parents should remember that they are to encourage their c hildren for studying constantly reminding them that their success depends on knowledge they are able to get at school. Motivation is the basis for any action and students should be reminded the main purpose of their school attendance. Parents are free to motivate their children in different ways. They should remind that school is not the final stage of education and the whole life will bring children new lessons to study. Children should feel that education is not only obligatory, it is the thing they like and are ready to accept as nothing is made without the desire. Parents, who were successful in school, have managed to get good education and now remain successful in their careers and social life positively influenced their children. The difference between vocational and academic education dos not play crucial role in the motivational reasoning. It is important that parents should have positive recollections and great achievements in the present time. Children in this ca se will desire to repeat the success their children have.Advertising We will write a custom article sample on Three Things You Can Do to Help Your Child Do Better in School specifically for you for only $16.05 $11/page Learn More This is like the behavior on the basis of the personal experience, but deeper. Children not only try to copy the behavior of their parents relaying on parental guarantees that it is useful, they have an opportunity to see that success at school gave them an opportunity to achieve high results in their careers. The ability to observe the connection is a good motivator for children. Thus, appropriate motivation is the second way for improving childrenÃ¢â¬â¢s success in school and parental role in this process. Special room and particular time It is natural that each individual should have its personal space. Looking deeper at the problem it may be stated that each person should also have space for particular activities. If students have specific place where they make their homework and parents control time children spend on this process, the results are going to be great. Parents should help their children create successful environment at home. The atmosphere of studying may encourage children for better ideas, the general mood of studying should be present. Parents are responsible for this. It is appropriate if parents have an opportunity to connect this place with school it would be better as students will feel as it at classes and at the same time at home. Time scheduling is also important. When parents set specific time for homework, children know that they should spend it with profit. When this time is over, children will have time to do all they want. Three aspects of parental success When parents try o help their children with studying, they should remember that they must not be too insistent. To make the process of parental intrusion into childrenÃ¢â¬â¢s learning natural, parents should follow these steps. First, parents should provide their children with the information about how strategies and sources should be used. It is important not to teach but to offer the suggestive ideas about the use of the received information, not the information itself. The second stage of parental intrusion is an attempt to deliver the necessary information by means of trying to check childrenÃ¢â¬â¢s level of understanding and speciation of the information parents want to provide to their children. The final stage of parental intrusion is emotional one. Parents should show that they care about their children and about their emotional condition. It is important to make children understand that self regulation is one of the best ways to remain in good mood and be able to cope with the tasks. Therefore, it may be concluded that the role of parents in the learning of their children is great, but parents should not insist on direct participation in it. It is important to supply children with nec essary information, provide those with required tools and follow the conditions they study in without forgetting about constant motivation and encouraging. Endnotes Anthony Feiler, et al, The Home School Knowledge Exchange Project: linking home and school to improve childrens literacy (Support for Learning, 23(1), 2008) 17. Jan Hughes Oi-man Kwok, Influence of student-teacher and parent-teacher relationships on lower achieving readers engagement and achievement in the primary grades (Journal of Educational Psychology, 99(1), 2007) 46. C. McBryde, J. Ziviani, M. Cuskelly, School readiness and factors that influence decision making (Occupational Therapy International, 11(4), 2004) 194. Kathleen Vail, School technology grows up (American School Board Journal, 190(9), 2003) 36. Teklu AbateBekele, Motivation and Satisfaction in Internet-Supported Learning Environments: A Review (Journal of Educational Technology Society, 13(2), 2010) 124. Abrudan Caciora Simona Veronica, Motivation i n language learning (Annals of the University of Oradea, Economic Science Series, 17(1), 2008) 558. Carin Neitzel, Anne Dopkins Stright, Mothers scaffolding of childrens problem solving: Establishing a foundation of academic self-regulatory competence (Journal of Family Psychology, 17(1), 2003) 156. Hannu Rty, Parents own school recollections influence their perception of the functioning of their childs school (European Journal of Psychology of Education EJPE (Instituto Superior de Psicologia Aplicada), 22(3), 2007) 395. Anne Dopkins Stright, Carin Neitzel, Kathy Garza Sears, Linds Hoke-Sinex, Instruction begins in the home: Relations between parental instruction and childrens self-regulation in the classroom (Journal of Educational Psychology, 93(3), 2001) 457. Reference List Bekele, T. (2010). Motivation and Satisfaction in Internet-Supported Learning Environments: A Review. Journal of Educational Technology Society, 13(2), 116-127.Advertising Looking for article on education? Let's see if we can help you! Get your first paper with 15% OFF Learn More Feiler, A., Andrews, J., Greenhough, P., Hughes, M., Johnson, D., Scanlan, M., Yee, C. W. (2008). The Home School Knowledge Exchange Project: linking home and school to improve childrens literacy. Support for Learning, 23(1), 12-18. Hughes, J., Kwok, O. (2007). Influence of student-teacher and parent-teacher relationships on lower achieving readers engagement and achievement in the primary grades. Journal of Educational Psychology, 99(1), 39-51. McBryde, C., Ziviani, J., Cuskelly, M. (2004). School readiness and factors that influence decision making. Occupational Therapy International, 11(4), 193-208. Neitzel, C., Stright, A. (2003). Mothers scaffolding of childrens problem solving: Establishing a foundation of academic self-regulatory competence. Journal of Family Psychology, 17(1), 147-159. Rty, H. (2007). Parents own school recollections influence their perception of the functioning of their childs school. European Journal of Psychology of Education EJPE (Instituto Superior de Psicologia Aplicada), 22(3), 387-398. Stright, A., Neitzel, C., Sears, K., Hoke-Sinex, L. (2001). Instruction begins in the home: Relations between parental instruction and childrens self-regulation in the classroom. Journal of Educational Psychology, 93(3), 456-466. Vail, K. (2003). School technology grows up. American School Board Journal, 190(9), 34-37. Veronica, A. (2008). Motivation in language learning. Annals of the University of Oradea, Economic Science Series, 17(1), 557-562.
Wednesday, February 19, 2020
Towards a Virtuous Surveillance Society - Essay Example The present government will, for example, be interested in the impact on social exclusion and on the modernizing government agenda. They may also question the potential offered for addressing the 'wicked issues' that transcend departmental boundaries. They will almost certainly be interested in costs and the potential for savings. They will be aware of the issues surrounding openness and security. They should have regard for the impact of the electronic services on democratic structures. In spite of potential benefits of information availability and easy access, it allows the state and military agencies to control society and introduce effective surveillance methods to monitor social processes and maintain social order Surveillance is achieved through different channels including business information and personal information. Companies are increasingly finding that, if they combine their information assets with those of other companies, the combined information resource is considerably more useful to all sides: two and two, in this instance, can make a lot more than four. Put together a social security or tax database with another database of people who owe debts and you have a means of tracking individual debtors over long periods of time and collecting the debt from them when they finally have the money to repay it (a process known as debt surveillance and already being offered by some companies) (Lister 2003). This is the virtual equivalent of the synergies that merging companies have traditionally sought, and its compelling economics mean that companies in the future are more probably going to be looking for ways to combine their information with others than looking to maintain the conventiona l barriers between industries (Green 1999). It is inconceivable that the government would launch electronic services in anything other than a partnership with the private sector. It is, therefore, necessary to take the perspective of the IT supply industry into account. This is an industry looking at a big prospective market. They will be making comparisons with other market sectors and, given the multinational nature of the players in the industry, with developments in other countries (Lievrouw and Livingstone 2005). For the industry, the issues will be associated with the speed of market growth, their likely market share, the level of initial pump-priming investment they will be expected to make, and with their ability to deliver the agenda set by government. For electronic government, as for most other services, it is possible to identify three main groups of player: the users or recipients of the service, the providers, and the wider society or community within which the service is offered. Each of these, however, may have important sub-groups that need to be taken into account. Before attempting to measure the impact of electronic government, it would, therefore, be necessary to identify the different players, to establish what they will use as benchmarks and points of comparison and to explore what, for them, are the important issues that need to be considered in any assessment of impact (Lister 2003). Surveillance is achieved through control of circulation of information and news available in the internet and in mass media. Sales of national, regional and local newspapers have been falling in the many countries for a number of years. They were falling before the Internet and the World