Effective Strategies Essay Example for Free

Effective Strategies Essay â€Å"Some unions feel that the organization does not compensate its members fairly, or that the organizational working conditions are less than desirable. Conversely, some employers feel that unions interfere with management decisions and impede on a positive relationship between managers and employees. There may be some truth to both perceptions† (Ashford University). I will provide a â€Å"†¦detailed explanation of the effective strategies an organization can implement to create and maintain a conducive working relationship with unions, as well as the effective strategies a union can implement to create and maintain a conducive working relationship with management† (Ashford University). I will begin by briefly describing the role of management in an organization. Management is responsible for the smooth running of the company. Keeping employees happy on the job would be one of the duties involved. Keeping up with industry standards and always moving forward with innovation, while heeding all safety regulations and laws. Working with and not against the flow of the operation to be successful while making a profit is where management can soar. Secondly I will briefly discuss the role of a union in an organization. A basic requirement of unions is that members give up their individual rights (e.g., raises based on performance) to benefit the collective (e.g., cost of living increases to all employees). Is this equitable and fair? Well members of unions negotiate as a group with the employer and this ensures more power than if they were just alone on their own. While it has been documented that union employees make 27 percent more than nonunion workers. Ninety-two percent of union workers have job-related health coverage versus 68 percent for nonunion workers. Union workers also have a great advantage over nonunion workers in securing guaranteed pensions (howstuffworks.com). This is the bright side of union membership, so it seems that giving up rights to obtain these advantages would be sound advice. In my opinion if the union performs the duties the member/employee signed up for, then yes it would be equitable and fair to give up their rights. On the other hand if the union  performed poorly in its duties, I would consider leaving for another position elsewhere. Some of the positives that involve unions would be the capitalist ideas that make this country what it is today. Unions are there for each employee who is represented by them and protected in the work place from unfair tactics. â€Å"Capitalism is directed towards the pursuit of profits and unions are directed towards the rights of workers.† The way these opposing viewpoints can be advantageous, yet destructive, to the business community depends on the way they balance the two. A profits interest is often referred to as a carried interest. A profits interest is typically given as a reward for the performance of services (myllcagreement.com) This method serves as an incentive for partners to become more proactive in pursuing bigger and better profits thus contributing towards the companies growth (investopedia.com). Growth is essential to the success of the business and the union, without losing sight of the interests of the employee (member). Growth indicates a profit is made and a company should hold in high esteem the people who made this so. So as a company grows it should ensure the employees are happy and treated fairly. They should not lose sight of the bottom line which is the business itself: them and the employees. Unions step up to make sure the employee is treated right with fair conditions and proper raises as the company moves forward. The destructive issue could occur if the employee was not rewarded as the profits increased. An unhappy employee will make for an unsuccessful business. There are some downsides to unions. Let me first say that strikes are a big part of what could possibly be the one downside, if issues do not work for the benefit of the employee represented. Although strikes were intended to get management’s attention, â€Å"The incidence of strikes has been almost steadily decreasing, and strikes now consume a minuscule portion of total working time—in the neighborhood of one-twentieth of 1 percent in most recent years† (Sloane, 2010, pg. 4). Many times a settlement takes place which will avert a strike and this is when both sides reach a compromise. If a strike ensues only a percentage of employees’ wages are paid, if they participate in picket duty. But, â€Å"For most unionized employees who agree to strike: †¢They stop getting a paycheck. †¢Their family’s healthcare and dental benefits are suspended. †¢They are not  eligible to receive state unemployment benefits. †¢Their job can be filled with a replacement worker.  Ã¢â‚¬ ¢Their job can be impacted in the future, if there is a loss of customers during the strike† (cintasfreedomtochoose.com). Depending on the results of the strike, winning or losing could alter the reputation of the union and also of the employer, for better or worse depending on the results. Appropriate circumstances where a strike would be an appropriate bargaining tactic would be when a failure to communicate occurs and further negotiations need to happen. A total breakdown in communication is most always when strikes occur. Sometimes though strikes occur in an inappropriate manner and this is when the employee suffers. It is when this happens or when the public welfare is affected that a strike would be deemed inappropriate. There are many global major players are union run, I realistically know that we would be in a world of trouble without them, in example: AFL-CIO and the SEIU. To be honest with you I have the impression that unions such as these actually perform better on a political platform. With all the money and power there comes responsibility, and more often than not we hear about the corruption unions flex influencing (lobbying) individuals in the position to pass laws with ‘dark money’. â€Å"Dark Money? AFL-CIO accused of campaigning without disclosing† (watchdog.org). This in no way seems to be connected with the absolute values unions initially professed, which was to stand up for the worker and give strength to the small guy. Now as things have progressed, the red tape becomes likened to fly paper, very sticky. Unions favorably represent the needs of the higher ups and I give again the article in our Course Materials about the ‘Bitter Bargain’. The bigger the union size the less likely the small guy’s needs will be met, since large money/power weld negative actions. But with a small union it becomes an intimate task to please your members and therefore a more positive vibe is felt. â€Å"Selected Evidence About Globalization’s Impact on the U.S. Labor Market Effects on Overall Incomes and Wages† (dol.gov) is another issue that affects the bottom line of the globally competitive work environment. Free trade influences the profits or losses/jobs or unemployment of this country. It makes one wonder if this is not why large unions have become much like a small country with a government playing king of the hill. I will present two strategies/actions an organization can  implement to create and maintain a conducive, working relationship with unions. Employers set the pay scale for each job and two strategies/actions they implement to keep the peace with union members is to use the comparative norm strategy and the ability-to-pay (cost of living increase). There are different circumstances where it would be more appropriate for an organization to follow the comparative norm strategy to determine an employees wage rate, versus the ability-to-pay or the cost of living strategy. Depending on the industry the employee is in will be the determining factor in whether the employer has the capabilities to meet economic demands. There are classifications in the different industries, and even subgroups within the different industries. Another factor at work that divides the comparative norm would be job titles. Each place of work has a different description for job titles and they vary greatly, so in many situations a certain wage would not be appropriate for employees at different work places with the same title. Wage systems are another way that the comparative norm may not work, since the pay may be ‘by hour’, incentive systems paid individually, and group incentive systems. Benefits cannot go unnoticed and are a part of the pay system. Depending on where you live in the nation may also have an impact on the wage an employee is given (i.e. cost of living differences). Typically the minimum wage increase I have experience with would be the annual 4% cost of living wage, and this is in the American south west states. Profits made by the company you work for hold major criterion on the ability to pay a cost of living increase. In the engineering world in which I worked as a drafter for over 30 years competition to obtain the best workers and keep them is all based on wages and benefits. If some other company wanted to pull you away from your employer, they would offer more money and/or better benefits. I can recall a time when my wages were increased significantly when another company made me an offer. Finally, I will present a minimum of two strategies/actions a union can implement to create and maintain a conducive, working relationship with management. Grievances and arbitration are two of the main strategies/actions that keep the peace while a member of a union. â€Å"Grievance legal definition: A claim by a union or a unionized employee that a collective bargaining agreement has been breached†¦. The formal document in which a union claims that the employer has breached the collective  bargaining agreement and for which, arbitration is convened† (duhaime.org). The way the use of the grievance and arbitration processes and procedures can enhance the relationship between a union and management is that is can reach a position that both parties can find common ground and satisfaction. Where this same effort can be destructive is when the breakdown in trust and commitment fall into place where once the opposite was true. Monetary losses occur at this point and sometimes the union fails to properly represent the employee and resentment occurs. When â€Å"†¦confusion and uncertainty in the area of employer–employee relations† (Sloane, 2010, pg. 217) occurs, both parties lose. In conclusion, we all know that unions have their place in our society and can be run using effective strategies that have proven to work in the past and changing those strategies as new ideas surface in the workplace, effectively. There is a place for unions and people who would benefit from them. In assessing the changing complexion of the U.S. labor force two things come to mind: baby boomers and immigrants. Why, because these types of workers may find unionization attractive. New retirees and new citizens might be looking for jobs where unions have a foothold: like grocers. Do not forget the fiasco with the strikers in California who fought for 5 months and got something unwanted. â€Å"United Food and Commercial Workers’ Union†¦ The ratified contract contains no raises for the 70,000 supermarket workers it covers, but it does preserve most health benefits for current employees. However, new workers will receive lower wages and fewer benefits. Many workers said they voted for the contract reluctantly. The lengthy labor dispute took an emotional and financial toll† (Bitter Bargain). This will be copied, presumably, by fellow unions, and it leads to a running comment that unions no longer provide for the common worker as its mission statement once led its members to believe. Leaving citizens with less money in their pocket when benefits are not included on payday will erode the backbone of unions. It used to be 35% of American workers belonged to a union in 1959, now a fraction of that is true. Additionally predictions have commented that some baby boomers will exit the workforce leading to a â€Å"lower (the) overall labor force participation rate, leading to a slowdown in the growth of the labor force† (Toossi). This comes from the other side of the podium in the in the debate of how labor force will be affected. The complexion of America has changed and without changing for the better, I  fear unions will run their course, or transform into a totally new idea, without all the corruption that comes with power and money. Unions are here to stay and change is on the way if using effective strategies are on the agenda. References Retrieved from article by Mitra Toossi: http://www.bls.gov/opub/mlr/2005/11/art3full.pdf` Bitter Bargain: http://www.pbs.org/newshour/bb/business/jan-june04/strike_3-1.html# Retrieved from: http://www.dol.gov/oasam/programs/history/herman/reports/futurework/conference/trends/trendsVI.htm Sloane, A., Witney, F. (2010). Labor relations. (13th ed.). Upper Saddle River, New Jersey: Pearson Prentice Hall. Pearson Learning Solutions. VitalBook file. Retrieved from: http://watchdog.org/131467/money-afl-cio-union/ Retrieved from: http://www.investopedia.com/terms/p/profits-interest.asp Retrieved from: http://www.myllcagreement.com/relevant-articles/what_is_the_difference_between_profits_interest_and_capital_interest.html Retrieved from: http://money.howstuffworks.com/labor-union2.htm Retrieved from: http://www.cintasfreedomtochoose.com/strikes.asp Retrieved from: http://www.duhaime.org/LegalDictionary/G/Grievance.aspx

Revenge in Shakespeares The Tempest Essay -- The Tempest Essays

Revenge in Shakespeare's The Tempest The nucleus of the plot in Shakespeare's The Tempest revolves around Prospero enacting his revenge on various characters who have wronged him in different ways. Interestingly enough, he uses the spirit of Ariel to deliver the punishments while Prospero delegates the action. Prospero is such a character that can concoct methods of revenge but hesitates to have direct involvement with disillusioning his foes. In essence, Prospero sends Ariel to do his dirty work while hiding his involvement in shipwrecking his brother, Antonio, from his daughter, Miranda. Prospero, the "rightful" duke of Milan, primarily seeks revenge against two people, Antonio and Caliban. But, Prospero allows his anger toward them to trickle to the other castaways on the island. He encourages Ariel to separate Sebastian, Duke Alonso's brother, from his son Ferdinand during the raging sea storm, causing Sebastian to assume his son has drowned. (1.2.213-224) The other "drunkards" on the island also feel the brunt of Prospero's revenge against Caliban when Ariel tempts them with a banquet stocked with alcohol and then disillusions them into thinking the banquet was a figment of their imagination. (2.1) But why the tendency toward revenge in the first place? What was it about the personality and mental disposition of Prospero that caused him to lust for revenge against his brother, Antonio? And Caliban. Why couldn't Prospero overlook his social naà ¯vetà © when it came to handling a woman? (1.2.350) In this portion of the website, I will examine those questions and attempt to provide an answer and an insight into the psychology of Prospero. Further, I will examine the relationship between Pr... ...Melancholia in English Literature from 1508 to 1642. East Lansing, Michigan: Michigan-State University Press. 1951. 2. Bowers, Fredson. Elizabethan Revenge Tragedy. Princeton University Press. 1940. 3. Burton, Robert. The Anatomy of Melancholy. Oxford, England: Clarendon Press. 1990. 4. Dillon, Janette. Shakespeare and the Solitary Man. Totowa, NJ: Rowman and Littlefield. 1981. 5. Draper, John W. The Humors and Shakespeare's Characters. New York: AMS Press. 1965. 6. Hallett, Charles A. and Elaine S. The Revenger's Madness. Lincoln, NB: University of Nebraska Press. 1980. 7. Kahn, Coppe`lia. Man's Estate: Masculinity Identity in Shakespeare. Berkeley, Los Angeles: University of California Press. 1981. 8. Jardine, Lisa. Still Harping on Daughters. Sussex: The Harvester Press. 1983.

Exploring the Relationship Between Mother and Baby Essay

Exploring the relationship between mother and baby in the NICU in relation to nursing support. Abstract Aim -To explore the effect of interaction related to care-giving and information exchange between nurses and mothers in relation to maternal stress and maternal-infant relationship in the newborn intensive care unit (NICU) throughout the hospital stay. Background – Mothers in the NICU experience depression, anxiety, stress, and loss of control, and they fluctuate between feelings of inclusion and exclusion related to the provision of health care to their neonate. This literature review helps to identify nursing interventions that promote positive outcomes between mother and baby by reducing maternal feelings of stress and anxiety. Search Method – A literature search covering the period 2008-2012 was conducted. Five articles reporting both quantitative and qualitative studies relative to the subject were retrieved. Findings – Findings reveal that positive and trustful relationships between nurses and mothers develop when nurses communicate and interact with mothers. This alleviated mother’s anxiety and enhanced their confidence when interacting with their baby. Discussion – Critical analysis as well as strengths and weaknesses of the relative journals reviewed is given together with useful recommendations that emerge from the evidence. Conclusion – The literature reviewed shows that nurse-mother interaction improves mother-infant relationship. In turn, this will eventually assist in decreasing maternal stress and improve the maternal well-being. INTRODUCTION Mothers develop attachment to their baby during pregnancy, which continues and develops more fully after the child is born (Cleveland 2009). However, the pathway to becoming a mother is threatened with the admission of the baby to the NICU. This occurs due to the unfamiliar and intimidating environment of the NICU (Obeidat et al 2009). During the initial admission parents can believe that the healthcare team is more able to care for their baby and this can instill feelings of inadequacy (Cockfort 2011). As a result, maternal attachment may be delayed by the lack of socialisation between mother and baby as most of the care is done by nurses (Cleveland 2009). DeRouck and Leys (2009), found that the parents of an infant admitted to the NICU face challenges including access to information, disclosure about the diagnosis, treatment and prognosis of their newborn, as well as a lack of control over the care of their newborn. Adding to this distress is the uncertainty of survival or the eventual impact of the infant’s condition on later health and well-being. In addition, feeling guilty to mother an unhealthy infant creates fear of social prejudice. Further, the structure of the NICU places significant barriers on mothers’ abilities to enact the parental role since decision-making and the daily care of the infant is taken over by medical and nursing staff restricting interactions with the babies stripping off their maternal authority (Cleveland 2009). In fact, when babies are in the NICU, traditional conceptualizations of the parental role are altered. The situation demands heightened parental participation while simultaneously placing severe restrictions on parental involvement. In response, parents need to negotiate this tension and traditional definitions of the parental role, which must be continually redefined throughout their experience What emerges is that the predominant source of distress is inability of the mother to protect the infant from pain and provide appropriate pain management. (Fenwick et al 2008). A lot of procedures cause pain in the neonate creating concerns for the mother, starting from peripheral cannulas, indwelling catheters and intubation to mention a few. In intubated babies, even though morphine infusions are administered, the baby still shows signs of distress during nursing times. In this case, we administer a small bolus of pain relief prior to nursing so that the baby would be more comfortable. Conversely, Fenwick et al (2008) describes factors that contribute to parents’ satisfaction in the NICU. These include; assurance and psychological support, the provision of consistent information, education, environmental follow-up care, appropriate pain management, and parental participation and proximity, as well as physical and spiritual support. Therefore, it is imperative that nurses should do their best to improve the mothers’ sense of confidence, competence and connection with her infant through guided participation (Domanico et al 2011). Johnson (2008) notes that skin-to-skin holding or kangaroo care promotes maternal-infant feelings of closeness, builds maternal confidence, and may be a stress-reducing experience for both the mother and infant. Hence the importance of providing the opportunity for kangaroo care to occur. Hunt (2008), notes that KMC is also crucial to stabilize parameters, such as cardio-respiratory parameters whilst being beneficial for maintaining body temperature. They add that even the incidence of nosocomial sepsis and the duration of hospital stay decreased with practicing KMC. In addition, Ali et al., (2009), found that Kangaroo mother care also showed positive outcomes towards practicing exclusive breastfeeding. Cockfort (2011) notes that, continuity of care needs to be ensured hence the importance of documentation. Therefore, it is suggested that handover should not be rushed, whilst a more comprehensive handover can ensure the smooth transition of care for staff and the family. When parents ask questions relating to their baby they feel assured in the competency of staff when information has been passed on correctly. When information is not shared effectively parents can lose trust and the partnership breaks down. In Malta, even though handover of 2 consecutive days is given, conflicting advice is still given at times due to the nurses’ different view-points. Consequently, this requires ward meetings in order to clarify important issues so that advice given and practice is consistent. In Malta, about 373 babies are admitted yearly (Grech et al 2012). In view of the benefits discussed, nurses should do their utmost to improve the overall experience of the mothers of such babies. Search Method A review of published research consisted of the following steps; broad reading to determine areas of focus, identification of inclusion and exclusion criteria, literature search (appendix 1) and retrieval, critical appraisal and analysis of the research evidence and synthesis of evidence. Evidence was reviewed with the aims of identifying barriers that affect the motherinfant interaction within the neonatal intensive care unit and how nurses can actively support attachment. Articles were included if the setting was primarily in a neonatal intensive care unit (neonatal unit or neonatal intensive care unit) and the participants were mothers of infants admitted to neonatal intensive care units or nurses working within that setting. In addition, All articles were critically analyzed with two primary questions in mind: (a) What are the needs of parents in the NICU? (b) What nursing behaviors support parents in meeting these needs? Articles were also included if they were primary research studies published between 2008 and 2012 and written in the English language. Primary and secondary literature searches were conducted through the EBSCO, ERIC, Sciencedirect and Medline databases. The primary search terms included â€Å"NICU,† â€Å"Neonatal Intensive Care Unit,† â€Å"family support,† â€Å"communication,† â€Å"nurse† and â€Å"early intervention.† The secondary literature search terms included â€Å"nursing support,† â€Å"efficacy,† â€Å"family,† â€Å"communication,† â€Å"support†, â€Å"neonatal† and â€Å"Kangaroo Mother Care†. These terms were used and utilised in all possible combinations to perform an extensive literature search of the above mentioned electronic databases. Thirdly, a review of references was conducted of the identified articles for any further studies. Eighteen articles were found through the search. Six studies met the inclusion criteria of which, 3 were qualitative and 3 quantitative (appendix 2). The subject was limited to the last 5 years. This time frame helps in the getting the most recent experiences since NICU is a changing environment especially as regards to technology which effects the mothers as well as the nurses. Both quantitative and qualitative studies were found. Both qualitative and quantitative research was conducted to identify what is known about the needs of NICU parents and what behaviours support these parents. Both methods of research were included because of the potential for each to contribute to a more complete understanding of this topic. In selecting a research design, researchers should be guided by one overarching consideration: whether the design does the best possible job of providing trustworthy answers to the research questions. One needs to note that both studies have limitations (Cottrell & McKenzie, 2011). In quantitative research, the researcher’s aim is to determine the relationship between one variable (an independent variable) and another (a dependent or outcome variable) in a population (Morrow 2009). In contrast to quantitative designs, qualitative designs do not result in numerical data for statistical analysis (Schira, 2009). In qualitative methods, researchers are interested in interpreting social phenomena and exploring the meanings that people attach to their experiences (Polit and Beck 2010). Moreover, views, attitudes and behaviours may be explored (Wood & Kerr, 2011), through grounded theory as it develops theories that are â€Å"grounded† in the group’s observable experiences, but researchers add their own insight into why those experiences exist. Findings Table 1 includes information about the 5 studies that met the inclusion criteria . Once an infant is admitted into an NICU, many factors account for parental stress. Admission of the infant to the NICU places mothers in a stressful situation where they must cope with the NICU environment and its associated demands. In the study conducted by Parker (2011), a grounded theory approach was used to understand feeling and stressors of 11 mothers whose new-borns were in the NICU. It was found that the early days shock and numbness accompanied feelings of none or little control over their lives. Moreover, all mothers described feeling unprepared for the premature delivery and the sight of their baby in the NICU. Comparative results were found by Lee et al (2009), with regards to the shock experienced with the initial sight of the baby. Everyday unpredictable changes occur leaving no time for adjustment or preparation. Constant fears about the life and death of the baby do not subside and several mothers spoke about their experience of always anticipating the death of the baby. These findings are also reflected in my clinical setting when mothers would be recounting their experience once the baby’s condition improves. This is in line with the findings of Fenwick et al (2009) and Lee et al (2009). In addition, the findings imply that the positive reassurance of the effects of a positive and caring environment and support network between parents and nurses in the NICU is not always evident among every unit. Nicholas-Sargent (2009) found that assurance is the most important aspect to be fulfilled. Her quantitative study of 46 mothers found that the length of stay in the NICU and mothers’ information needs were found to be significantly inversely correlated. Therefore, this suggests that the longer an infant remains hospitalized in the NICU, the less emphasis the mother places on receiving information about the infant’s condition. This shows that the needs of the mothers in the NICU can change over time. My observations match these findings since mothers familiarise themselves and adapt to the situation. Moreover, they would eventually want to be successful with the care of the baby. This is reflected in the grounded theory analysis conducted by Fenwick et al (2008), using semi-structured interviews. They found that the nurse-mother relationship had the potential to significantly affect how women perceived their connection to the infant and their confidence in caring for their infant which occurred through a three way interaction. Being successful in their desire to care for the baby, engendered feelings associated with being a ‘‘real’’ mother. However, not all women in this study were able to successfully employ these strategies. In the situation where the mother perceived herself as ‘‘quiet and unassertive’’, and in a position without any power, it was very difficult to gain the confidence needed in order to be able to openly question, negotiate and direct the care of her infant. Therefore, it is very important to identify these mothers in order to help them by giving them continuous reassurance. This would particularly be required when the situation changes from support needing to encouragement in participation. Lee et al (2009) found that mothers received support from the healthcare professionals and the social networks that mothers made. These helped to create the connections that developed between the mothers and infants making their journey towards parenthood possible. They discovered that challenges are further compounded in Taiwan, where women are traditionally required to practice the cultural ritual which includes confinement to the house with a special balanced diet for the first month postnatal. Lee et al (2009) used the grounded theory approach with in-depth interviews and constant comparison. All interviews were audio-taped and notes were made during and immediately after the interview concerning actions and body language of the mother during the interview. The finding of this study further indicated that the initial sight of the life-support equipment was shocking. The technological environment created a fearful atmosphere, and the medical equipment attached to their infants caused the mothers further physical separation. The mothers indicated that they were so afraid of the equipment that it took them a long time to be able to participate in their infants’ care. In turn, this hampered them from establishing positive mother–infant interactions. Chiu and Anderson (2008), found that preterm births often negatively influence mother–infant interaction due to lack of physical contact. In addition, they found that skin-to skin contact post-birth has positive effects on infant development. These researchers conducted a randomized controlled trial (RCT) using questionnaires for data collection. In addition, mothers were further video-taped during a feeding session. Ali et al., (2009),highlight the importance of kangaroo care in their RCT where the researchers conducted their study with one hundred and fourteen infants. This study showed that the infants exposed to kangaroo mother care had an increase in rectal temperature compared to conventional care, therefore having a decreased risk of hypothermia. The mean temperature during kangaroo mother care was of 37 degrees Celsius while the mean temperature during conventional care was of 36.7 degrees Celsius. The data collected was through posted questionnaires. Discussion In the 3 qualitative studies found, the data was collected through interviews of which 2 were semi-structured while 1 was unstructured. Parker (2011), Fenwick et al (2008) and Lee et al (2008), used the Grounded theory approach. However, while Parker and Fenwick use semi-structured interviews, Lee uses unstructured interviews. In semi-structured interviews there is a topic guide with list of areas or questions to be covered with each respondent. This technique ensures that researchers will obtain all the information required, and gives respondents the freedom to respond in their own words, provide as much detail as they wish, and offer illustrations and explanations. Lee et al (2009) uses ground theory approach but incorporated with unstructured interviews. Unstructured interviews also known as are flexible but are more time-consuming than semi-structured since the interviewer listens and does not take the lead. The interviewer listens to what the interviewee has to say. The interviewee leads the conversation (Wood & Ross-Kerr, 2011). However, anonymity for confidentiality which is of utmost importance is not possible. When using unstructured interviews, the researchers have to be able to establish rapport with the participant. The reason is that the interviewers have to be trusted if someone is to reveal intimate life information. This may lead to interviewee bias. Also, it is important to realise that unstructured interviewing can produce a great deal of data which can be difficult to analyse. Lee et al (2008) and Fenwick et al (2008) conducted the interviews themselves while Parker (2011) did not, thus reducing the bias. However, interviewer bias occurs even if someone else is conducting the interview. The number of mothers in the study of Lee et al (2008) was adequate since with in-depth interviews 20 participants are enough. However, to account for the small sample, more interviews and observations were done with the same participants in order to reach theoretical saturation. Usually informants are selected for in-depth interviews in a purposive manner questioning the generalizability of the results (Wood & Kerr, 2011). A major controversy among grounded theory researchers relates to whether to follow the original Glaser and Strauss procedures or to use the adapted procedures of Strauss and Corbin (Polit & Beck 2010). Grounded theory method according to Glaser emphasizes induction or emergence, and the individual researcher’s creativity within a clear frame of stages, while Strauss is more interested in validation criteria and a systematic approach. Parker (2011) uses the original Glaser and Strauss (1967) paradigm while Lee et al (2008) and Fenwick et al (2008) use Strauss and Corbin (1998) procedures. One of the fundamental features of the grounded theory approach is that data collection, data analysis, and sampling of study participants occur simultaneously. A procedure referred to as constant comparison is used to develop and refine theoretically relevant categories. Categories elicited from the data are constantly compared with data obtained earlier in the data collection process so that commonalities and variations can be determined. As data collection proceeds, the inquiry becomes increasingly focused on emerging theoretical concerns. All 3 studies use constant comparison. All the above 3 studies use audio-taping for data collection except for Fenwick et al (2008) who used field note documentation as well. Audio-taping enables eye contact to be maintained and to have a complete record for analyses, however, some interviewees may be nervous of tape-recorders. On the contrary, in note taking on the other hand, a lot of eye contact is lost unless a type of short-hand is learnt. However, the interviewer will have plenty of useful quotations for report when transcribing the interview. Randomized controlled trials consist of a complete experimental test of a new intervention, involving the random assignment of a large and varied sample to different groups (Polit & Beck, 2010). The intention of an RCT is to arrive to a judgment as to whether the novelty of an intervention is more effective than the traditional intervention (Polit & Beck, 2010). This intention was well noticed throughout the RCTs chosen by Ali etal., (2009). Wood & Kerr, (2011) sustain that RCTs are the most rigorous method to determine a cause-effect relationship between the treatment and the outcome. Furthermore, RCTs were also described as the gold standard trial for evaluating the effectiveness of a clinical intervention ((Muijs 2010). One of the primary aims of RCTs is to prevent selection bias by distributing the patient, randomly between the two groups, so that the difference in the outcome and results can be justified and attributed only to the intervention under study. Thus, through random selection there is a better balancing of any confounding factors, therefore creating similarity between the groups (Cottrell & McKenzie, 2010). In effect in this literature review, RCTs were found to be useful and beneficial to compare the effect of KMC and conventional care on the physiological aspects of the infant. Ali et al., (2009) chose to add blocking to randomisation so as to ensure a better balance in the number of infants allocated in the groups. These groups were randomized through simple randomization and the disruption of groups was achieved by delivering a concealed envelope technique. Through random sampling, Polit & Beck (2010) explain that each element in the population has an equivalent, autonomous chance of being chosen. However, this design is not used frequently as it is lengthy and may be expensive (Wood & Kerr, 2011). Chiu and Anderson (2008), use mixed methods of data collection by using both questionnaires and video-taped interviews. The use of multiple sources or referents to draw conclusions about what constitutes the truth is called triangulation. This is one approach in establishing credibility as it enables the researcher to counteract the weaknesses in both designs. The use of video-taping provides the most comprehensive recording of an interview since it captures body language, facial expressions and interaction (Gerrish and Lacey 2010). However the interviewee may become uncomfortable and act differently than in normal circumstances questioning the reliability of the data collected. In addition, questionnaires are the main research tools used in quantitative research. They are very advantageous as they can be constructed in such a way as to meet the objectives of almost any research project. In the Family Needs Inventory used by Nicholas-Sargent (2009), the ‘not applicable’ part was removed from the Likert scale in order to report definite opinions. Questionnaires can measure the participants’ factual knowledge about a certain subject or an idea or else they can be used to explore opinions, attitudes or behaviours (McNabb, 2008). Moreover, questionnaires are also less expensive than most other research instruments and are also less time-consuming . Self-administered questionnaires provide the participants with anonymity, and responses are not affected by the interviewer’s mood or presence (Wood & Ross-Kerr, 2011). On the other hand, the main disadvantage of questionnaires is that there is a high possibility of a poor response rate since some questions are ignored, misinterpreted, incorrectly completed or inadequately detailed (Polit and Beck 2010). The RCT of Chiu and Anderson (2009) and Ali etal. (2009),, is one of the most powerful tools of research where people are allocated at random to receive one of several clinical interventions. However RCT’s are vulnerable to multiple types of bias at all stages of their workspan (Geretsegger et al 2012). Hence the need to establish validity and reliability. In the study done by both Ali etal.,(2009) and Chiu and Anderson (2009),the researchers increase the rigor on the study by using a large number of participants. In addition, Chiu and Anderson (2009) use the Nursing Child Assessment Satellite Training Program (NCAST) Feeding and Teaching scales. Nicholas-Sargent (2009), improved the rigour by using the Critical Care Family Needs Inventory (CCFNI), as a framework for the FNI. CCFNI has been thoroughly reported with results indicating internal consistency and construct validity (Gerrish and Lacey 2010). Despite this, Nicholas-Sargent (2009), use a small scale study and therefor e the results cannot be generalized. Limitations In the study done by Lee et al (2008), the data were only collected from one hospital in this present study causing generalisability of the results to be low. Moreover, the sample was restricted to those who did not have additional social, cultural or medical circumstances to consider. Moreover, coding was done by researcher itself and this might have caused some bias. Both Nicholas-Sargent (2009) and Parker (2011) use small scale studies but these were qualitative studies. Therefore, to a certain extent the findings cannot be generalized across the population of families involved with the NICU. In addition, Parker (2011) uses a retrospective study, which might have been subject to bias in recalling information. There was absence of pilot study in both Nicholas-Sargent (2009) and Chiu and Anderson (2009). The use of pilot studies helps to assess the design, methodology and feasibility of the tool and typically includes participants who are similar to those who will be used in the larger research study ( Wood & Kerr 2011). Hence, their importance. Also, the instruments chosen by Chiu and Anderson (2009), being the (NCAST and the feeding and teaching scales) for this study might not be sensitive enough to capture any between-group difference in changes resulting from the intervention. Finally, Ali et al., (2009) fail to mention intention to treat analysis where researchers can introduce reality into research by outlining that not all randomised participants will continue throughout the study. Therefore, this might be a potential weakness in this study. It was also noted the there was no detailed report about the time intervals between the two different groups. Hence, this may also have introduced performance bias. In the grounded theory approach taken by Fenwich et al (2008), limitations lie in the method of data collection itself through semi-structured interviews that were tape-recorded and field note documentation done. The authors did not acknowledge limitations in the study. Recommendations Maternal contact Fenwich et al (2008) suggests prioritising maternal-infant closeness when underpinning policies and protocols and suggests the unrestricted access to their child. Lee et al (2008) found that in Taiwan mothers are allowed to visit for 30 minutes twice a day. In Malta, mothers are allowed to stay with the child 24 hours a day. In addition, skin-to-skin contact is recommended by both Lee et al (2008) and Chiu and Anderson (2009). The latter suggests that all mothers, if they are able and whether or not they ask for it, skin-to-skin contact should be encouraged. My suggestions on interventions for critically ill infants include encouraging the parents’ presence at the bedside, assisting the parents in personalizing the bedside, and teaching the parents to gently touch their infant. Another approach is to hang a simple picture board with the first names of nurses and practitioners near the entrance to the unit. This picture board helps anxious families feel welcomed in this healing environment. In our unit, those babies who have central lines such as umbilical arterial catheters (UAC), the mothers are not allowed to hold the baby for fear of bleeding if the UAC gets dislodged. However, if the mother shows signs of needing contact with the baby, we allow her to hold the baby with constant supervision. In the case of babies that are ventilated mothers are only allowed to hold their baby if the prognosis is very poor. Therefore, this shows that, if the baby is on long term ventilation, skin-to-skin is hindered from being introduced. Fenwich et al (2008), recommend the development of tools that can better evaluate the satisfaction of the mother. Hence, the need for longitudinal qualitative research. In my opinion this would yield good results when past experiences would show which improvements were helpful and which were not. NICE standards (2010), specify the use of surveys. We can incorporate these surveys after consideration with the midwifery officer. Mother-nurse-infant interaction Because of the complexity of illness, parents of critically ill infants are anxious and fear the worst with every visit to the NICU. Strategies need to be adapted to decrease maternal anxiety while supporting the needs of these infants. (Nicholas-Sargent 2009). Nurses play a vital role in helping parents throughout the stressful and challenging experience of the NICU by developing therapeutic relationships and providing emotional support. These approaches enable parents to feel more supported, more involved, confident, and more effective as parents of their vulnerable newborn. The experience of parents in the NICU occurs during an emotionally intense period fraught with anxiety, stress, depression, and feelings of hopelessness. Therefore, Nicholas-Sargent (2009) suggests that, it would be vital to do an NICU orientation for expectant parents with a high risk of giving birth to a premature infant or a compromised newborn. Supporting and facilitating their parenting role will help decrease their stress, strain, anxiety, and depression. Lee et al (2008), nurses need to respect the cultural preferences of mothers as this would promote desired health outcomes. This would aid in meaningful, holistic and individualized care. According to Nicholas-Sargent (2009), personalized one-to-one as opposed as opposed to group support would be helpful. In addition Nicholas-Sargent (2009), suggests that nurse education is needed to improve the awareness of the impact of the counselling service. However, the service needs to be more flexible due to fluctuations in the health condition of the baby. In fact, what we notice is that mothers would require counselling at different stages of the hospitalization. Therefore, if the service was refused once, it may still mean that mothers would need it at some other point in time. Nicholas-Sargent (2009), further suggests that the counselling service would be extended to the whole family from the hospital as well as in the community., Both the DH (2009), and NICE (2010) highlight the importance of Family-Centered Care (FCC) views the family as the ‘child’s primary source of strength and support’ and allows for collaboration, respect, and support with the parents and family during all levels of the service delivery. To foster participation in care for the infant, unrestricted visiting hours should be encouraged for the nuclear family of the neonate. In Malta, visiting hours are restricted to parents only due to increase in cross infection when family members were allowed to visit for 1 hour everyday during the day. However, timing of care may still be arranged to facilitate parents’ participation. In addition, special moments such as baby’s first time off CPAP (continuous positive airway pressure) needs to take place during parents’ presence. Cockfort (2011), highlights that missed opportunities to involve parents in care, heighten anxiety and can create a sense of sadness and loneliness . Information for mothers Mothers vary in the amount of information they can assimilate under stress. Therefore identifying parents’ feelings through active listening and observing will help us to pick up on parents cues and respond appropriately in order to provide parents with accurate and clear information (Fenwick et al 2008). Nicholas-Sargent (2009), adds that, information regarding the health status of the baby needs to be give in a timely provision. Parker (2011), recommends the access to certified interpreters for non-English speaking parents to enable them to ask questions and get the information they need as well as information regarding the counselling services. Likewise, an updated information board at the infant’s bedside helps mothers retain information while feeling welcome at the bedside. In my opinion, these interventions create an environment that facilitates maternal- infant attachment by promoting maternal competence with meaningful positive parenting skills and fostering partnership in care.. Conclusion In summary, the findings showed that parents of infants admitted to the NICU experience stress, depression, anxiety, and feelings of powerlessness, hopelessness, and alienation within the environment of the NICU. These situations are often overwhelming and catastrophic for the mothers keeping in mind that the process of motherhood is a protecting and loving phenomenon. Therefore mothers should participate in the care of their sick, fragile infant in the NICU through mother-infant interaction. Nurses need to be supportive and informative in dealing with parents in the NICU. Therefore, the need for parents to be given the access of interpretation by certified interpreters in order to overcome language barriers has been identified. Further, information and emotional support is required throughout the stay in the NICU, However, it was further found that information in preparation for discharge planning is vital. This enhances parental knowledge and decreases stress, which promotes more effective parenting. Further, as understanding of the parents’ experience of having an infant admitted to the NICU increases, nurses will be better prepared to meet parental needs and alleviate parental suffering. Providing holistic, developmentally supportive care and open communication with parents in this stressful experience is essential. Moreover, the need for family-centered care has been identified. REFERENCE LIST Ali, M.S., Sharma. J., Sharma. R., & Alam. S. (2009). Kangaroo mother care as compare to conventional care for low birth weight babies. Dicle Tip Dergisi. 36(3), 155-160. Chiu S. & Anderson G.C., (2009). Effect of early skin-to-skin contact on mother–preterm infant interaction through 18 months: Randomized controlled trial. International Journal of Nursing Studies, Vol. 46, pp.1168–1180. Cleveland, L.M., 2008. Parenting in the neonatal intensive care unit. Journal of Obstetric, Gynecologic, and Neonatal Nursing, Vol. 37 (6), 666e691. Cockfort S., (2011). How can family centred care be improved to meet the needs of parents with a premature baby in neonatal intensive care? Journal of Neonatal Nursing, Vol.95(5), pp.365-368. Cottrell, R.R. & McKenzie, J. F. (2011). Health Promotion and Education Research Methods using the Five-Chapter Thesis/Dissertation Model (2nd ed.). Sudbury, Canada, United Kingdom: Jones and Bartlett Publishers. DeRouck, S. & Leys, M., (2009). Information needs of parents of children admitted to a neonatal intensive care unit. A review of the literature. Patient Education and Counselling, 76 (2), pp.159-173 DH: Department of Health, 2009. Toolkit for high-quality neonatal services. DH, London. Domanico R., Davis D.K., Coleman F. & Davis B.O. (2010). Documenting the NICU design dilemma: comparative patient progress in open-ward and single family room units. Journal of Perinatology, Vol.31, pp. 281–288 Fenwick J., Barclay L., & Schmied V.,(2008). Craving closeness: A grounded theory analysis of women’s experiences of mothering in the Special Care Nursery. Women and Birth, Vol. 21, pp.71—85. Geretsegger M., Holck U. and Gold C., (2012). Randomised controlled trial of improvisational music therapy’s effectiveness for children with autism spectrum disorders (TIME-A): study protocol. BMC Pediatrics Vol.12(2), pp.1471-2431. Gerrish K. & Lacey A. (2010). The Research Process in Nursing. Blackwell Publishing Ltd. UK. 6th ed. Glaser, B.G., & Strauss, A., 1967. The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine, NewYork. Gray, D. E. (2009). Doing Research in the Real World (2nd ed.). London, California, New Delhi, Singapore: Sage Publications. Grech V., Cassar M. & Distefano S., (2012). Nurse staffing levels on a regional neonatal paediatric intensive care unit. Journal of Paediatric Intensive Care, Vol. 1(1), pp.25-29. Johnson, A.N., 2008. Promoting maternal confidence in the NICU. Journal of Paediatric Health Care, Vol. 22 (4), 254e257. Lee S., Long A. & Jennifer B. (2009). Taiwanese women’s experiences of becoming a mother to a very-low-birth-weight preterm infant: A grounded theory study. International Journal of Nursing Studies, Vol.46, pp. 326–336 McNabb, D. E. (2008). Research Methods in Public Administration and Non-Profit Management: Quantitative and Qualitative Approaches (2nd ed.). New York: M. E. Sharpe Incorporation. Morrow V., (2009) ‘The Ethics of Social Research with Children and Families in Young Lives: Practical Experiences’. Young Lives. Oxford: Department of International Development. Muijs D., (2010). Doing Quantitative Research in Education with SPSS. London: Sage Publications NICE: National Institute for Health and Clinical Excellence, (2010). Quality Standard for Specialist Neonatal Care http://www.nice.org.uk/media/17A/A8/ Obeidat H.M, Bond E.A. & Callister L.C., (2009). The Parental Experience of Having an Infant in the Newborn Intensive Care Unit. The Journal of Perinatal Education | Summer, Vol. 18(3), pp.23-29. Parker L., (2011). Mothers’ experience of receiving counselling/ psychotherapy on a neonatal intensive care unit (NICU). Journal of Neonatal Nursing, Vol.17, pp.182-189. Polit D.F. & Beck C.T. (2010) Essentials of Nursing Research: Appraising Evidence for Nursing Practice, 7th ed. Wolters Kluwer Health | Lippincott Williams & Wilkins, Philadelphia. Nicholas-Sargent A., (2009). Predictors of needs in mothers with infants in the neonatal intensive care unit. Journal of Reproductive and Infant Psychology, Vol. 27(2), pp.195–205. Schira, M. (2009). Appraising a single Research Article. In Mateo, M. A. & Kirchhoff, K. T. (Eds.), Research for advanced practice nurses: from evidence to practice (pp. 73-85). New York: Springer Publishing Company. Strauss A. & Corbin J.( 1998). Basics of qualitative research. 2nd ed. Newbury Park, CA: Sage Publishers;. Watson, H., Booth, J. & Whyte, R. (2010). Observation. In Gerrish, K. & Lacey, A. (Eds.), The Research Process in Nursing (6th ed.) United Kingdom: Blackwell Publishing Limited. (pp. 382-394). Wood, M. J. & Ross Kerr, J. C. (2011). Basic Steps in Planning Nursing Research: From Question to Proposal (7th ed.). Sudbury, Canada, United Kingdom: Jones and Bartlett Publishers.

John F. Kennedy One of Greatest U.S. Presidents - Free Essay Example

Sample details Pages: 3 Words: 892 Downloads: 1 Date added: 2019/05/05 Category Politics Essay Level High school Tags: John F Kennedy Essay Did you like this example? President John F. Kennedy is arguably one of Americas greatest U.S. Presidents. Don’t waste time! Our writers will create an original "John F. Kennedy One of Greatest U.S. Presidents" essay for you Create order Elected in 1960, he brought an energy and grace to the Oval Office (John F. Kennedy: World War II Naval Hero to President). John F. Kennedy, the 35th President of the United States, was assassinated in Houston, Texas on November 22, 1963. He was commonly known by his initials, JFK. John F. Kennedy possessed many qualities that helped him become a great President. He had incredible charisma, was highly competitive, a risk taker and he was very courageous. claim When President Kennedy was assassinated the United States became immediately immersed in a state of mourning for this great leader. John F. Kennedy was full of charisma. This was definitely part of his leadership style. He was able to win over the people of the United States with his charm and become one of the most well known Presidents. In an essay written concentrating on JFKs leadership qualities, it was written, What makes a charismatic leader different from others is his vision to encapsulate obedience of the followers. Using unconventional methods allows a charismatic leader to convince followers that they are not the ?normal leaders-they are new, different, and inspiring. Trust and credibility comes from the willingness of these people to sacrifice themselves for the betterment of people and organizations. Charismatic leaders usually have high follower expectations, and are able to encourage these expectations by using unconventional behaviours to establish credibility, sensitivity, and appeal (John F. Kennedy and His Leadership Style History Essay). A study of President Kennedy and his many traits could not overlook his competitive nature. One of the most common personality traits found among presidents is a highly competitive nature. This makes sense, as any person who wants to become a president has to be constantly striving towards the top. As a result of wanting to be president, John F. Kennedy was known as being highly competitive. Whether this was a simple game or the presidency of the United States, John F. Kennedy always put his heart and soul in what he did (John F. Kennedy Personality Traits). Data #1 He was highly competitive and rarely settled for anything in his life other than the best. Is this a continuation of competitive? John F. Kennedy, himself, stated There are risks and costs to a program of action. But they are far less than the long-rang risks and costs of comfortable inaction. data #2 JFK believed and lived by the thought that a person would not get anywhere unless they were willing to take risks. The trick is knowing what risks to take and what risks to not take. The Cuban Missile Crisis helped solidify ?risk taker as a trait of John F. Kennedy. Along with a series of other risks taken both in his presidency and during his election, John F. Kennedy was not adverse to taking risks when it benefited himself and his country (John F. Kennedy Personality Traits). Data #3President Kennedy knew, also, when not to take risks. Even though it caused problems with some of his staff, he did not back down. Many people admired John F. Kennedy for his courage and bravery. He exhibited these qualities even before he was elected President of the United States. Jack joined the U.S. Navy in 1941 and two years later was sent to the South Pacific, where he was given command of a Patrol-Torpedo (PT) boat. In August 1943, a Japanese destroyer struck the craft, PT-109, in the Solomon Islands. Kennedy helped some of his marooned crew back to safety, and was awarded the Navy and Marine Corps Medal for heroism (History.com Staff). Data #1 After he became president, JFK continued to exemplify the great trait of courage. At one particular time, he found himself at odds with the Soviet Union and its volatile leader, Nikita Khrushchev. After a U.S.-backed invasion of communist Cuba in April, 1961 ended in disaster at the Bay of Pigs, Khrushchev concluded that JFKs administration was weak. In the autumn of 1962, the Soviet Union began shipping nuclear missiles to Cuba, from there they could be aimed at t he United States from just a few hundred miles away. When JFK found out about these missiles, he imposed a naval quarantine on Cuba and pondered an invasion (SparkNotes Editors). Data #2 needs backing between these two datas. After two weeks, where the entire world was on the edge of nuclear war, Khrushchev finally agreed to remove the missiles, ending the crisis (SparkNotes Editors).Data #3 There is no doubt that his courage during this time in history saved our country many lives and much destruction. Most people considered John F. Kennedy to be a really good person. A lot of people liked him as President of the United States of America. His predominate characteristics helped him to win over many voters and citizens of the United States. His incredible charisma helped him foster the trust of the people. John F. Kennedys competitive nature drove him to constantly strive towards the top of whatever he was endeavoring. He was willing to be a risk taker knowing that he would not achieve his goals if he was willing to take the risks. The courage he exhibited in making the hard decisions was part of his nature and one that helped him to become a beloved President of the United States of America.