Policies for Partnership Working in Health and Social Care

Policies for Partnership Working in Health and Social Care The partnership between health and social care services policies in UK Introduction For the past decade or so, the focus within health and social services has been on improving all-round services through partnership between different organisations. The aim of this has been to improve integration, efficiency and provide better care for all types of patients in the community. However, the policies involved in both health and social care services have not always allowed the partnerships to work as they should. Whilst there have been some successes and partnerships have improved integration and overall care, there have also been mistakes that in some cases have made things worse rather than better.[1] The aim of this essay is to track the development of the partnership between health and welfare services over the last ten years or so, and how effective this partnership has been. There will be a critical review of partnership policy, and a focused case study on the Sure Start partnership as an example of how partnerships between health and social services in the UK are fairing. The development of a partnership between health and welfare service The development of partnerships between health and welfare services has been a critical focus of New Labour policy over the last ten years. However, these terms are often not defined particularly well and are therefore fairly difficult to analyse. The problem is that collaboration and partnership between the organisations is difficult in light of different cultures and power relationships within the professions.[2] However, this has not stopped attempts by New Labour to create partnerships between health and social care through various initiatives and policies. It was in 1999 that the government set out its radical NHS Plan that promised to transform the way in which health and social services interacted. The development of Care Trusts meant that health and social services would be dealt with by a singular organisation in certain areas for the first time. The main focus of the changes being on child services, service for the elderly and mental health services.[3] The first problem of developing partnerships was to overcome the difficulties and issues between new staff committed to the partnership and older staff who had worked in the organisations as separate entities. The UK Centres of Excellence funded by the DfES were created in an effort to combine high quality services in one place. These then led to specific Children’s Centres. The idea was to combine disciplines of health and social care in one arena as a focus on a specific group of individuals – in this case families and children.[4] The focus for many of the partnership policies and initiatives has been on children, families and the elderly in an effort to provide better integrated care for these groups. One of the biggest developments within partnerships between health care and social care has been to empower those who use the services in an effort to smooth over integration. The idea is that with user participation these organisations will better understand how to work as a partnership to help the needs of the user. If the users can help to shape service standards, then differences between the organisations will be reduced and effective partnership will be increased.[5] The idea behind this is also to manage internal diversity within the country as a society and the diversity within organisations so that these different parts can work together more easily.[6] The partnerships and their success are looked at in two ways. Firstly, how well the partners can work together to address mutual aims, and also how service delivery and effects on health and well-being of service users has been improved.[7] The focus of policy has been on inter-organisational partnerships between health and social care, rather than focusing on individual professionals working together between organisations. The development should be seen as ‘NHS working with DfES/DCSF’ rather than ‘GP’s, doctors and nurses working with social workers’.[8] The biggest shift has been the creation of the Primary Care Groups and Care Trusts which are responsible for the welfare of healthcare services in the community. These organisations are being encouraged to work with social services so that intermediate care can be provided, hospital waiting lists can be cut and the roots of issues can be sorted rather than merely the outcomes being treated. The formation of Care Trusts that try to combine health and social services in one organisation has been somewhat hit and miss in the UK.[9] The next section will critically examine these policies. Critical review of partnership policy One of the biggest problems with these policies is that many of the terms used are extremely vague and it is hard to evaluate their effectiveness. ‘Partnership’ is not accurately defined by most of the policies, and this leaves the concept open to interpretation.[10] The concept of user participation and feedback within the policy is also rather poorly defined, and this means that the effectiveness of user participation to bring together health and social services tools is rarely monitored.[11] There needs to be more feedback for users on their participation within these organisations, and the participation of users needs to be tied directly into policy to improve partnerships.[12] The term ‘culture’ is also given importance in the policies because it determines how the organisations work together in the partnership and work with users of the services. However, studies have shown this term has not been given a universal meaning and local organisations have given the term different meanings. This leads to inconsistent services and fluctuating success within a partnership.[13] However, there have been some benefits of the increased user participation within health and social care partnerships. It has allowed users to gain more power within the relationship and in many ways help to self-manage their own needs more clearly. This is certainly the care within health and social care partnerships for the elderly community. Rather than being seen as a drain on resources, the older generation can now work with health and social services to maintain a higher quality of life and continually contribute to society. With health and social care working together in this way, the elderly community have better access to their needs as well as being more efficiently care for due to the organisational collaboration.[14] The difference here is that whereas before an elderly person would be seen separately by the NHS and by private and government-based social services agencies, these organisations now work together to provide all primary care needs in one package. This makes it easier for all involved in the process.[15] It removes the boundaries that have been such an issue for many older people over the decades within the UK welfare system.[16] The problem of course arises when the partnership as a whole is not serving the needs of individuals. Whereas before an individual may be failed by one organisation, now the failure will cover all the services they require. With the health and social services organisations also working with private entities such as insurers, if one area fails then the service package as a whole can fail.[17] The problem is still that the two markets of health and social care are organisationally opposed. The culture within the organisations is geared towards competition rather than cooperation, and this has been extremely hard to overcome.[18] The disciplines have found it hard to build up levels of trust that allow for successful communication and partnership.[19] Despite these problems with policy, there have been cases where policies have established partnerships between health and social services. One of these partnership initiatives is known as ‘Sure Start’. The next section will present a case study of this partnership to evaluate its strengths and weaknesses. Case study of sure start The Sure Start program was created in the ‘early years’ of the New Labour government and looked to help children and families both before and after birth in a holistic and integrated way. This includes provided healthcare and social care for children, as well as providing in-need adults with social care that they can benefit from. The government put a large amount of money into the project from 1998 onwards, and has rolled the program out across the country.[20] The program sees all health and social care service providers work together to benefit parents and children in a wide variety of ways, particularly for vulnerable children and those with learning difficulties. These issues can benefit from an integrated approach that combines different aspects of health and social care in one package.[21] Reports from this program in local areas show that commitment to partnerships and cooperation has been high amongst the staff involved. Those involved in the partnership, whether health and social services staff or parent members, found the experience to be positive and allowed for a more integrated approach to family welfare. Work with families has improved somewhat, although there are still problems. The biggest problem to the effectiveness of the partnership is differing organisational cultures. These cultures mean that health and social services cannot always work effectively together, and that there are also limits on parental involvement. Parents found that the bureaucratic cultures of the organisations meant they were reluctant to participate further in the partnership. Likewise, staff within the different organisations found it hard to work with certain other staff because of differences in organisational culture.[22] In other studies, the results were even poorer. Rutter found that the objective of Sure Start to eliminate child poverty and social exclusion was not being met. The results of National Evaluations of the Sure Start Team were analysed and showed that after 3 years, there was no significant service improvement. In fact, in some areas the service had got worse and had made the situations of families worse.[23] The problem here was that whilst the partnership was working successful in bringing together health and social services, this was not improving the actual services offered on both sides. With only one organisation to now use, the most disadvantaged families were being let down in all areas rather than just in a few areas. It seems that many of the weaknesses of both organisations were combined in the partnership rather than their strengths. Other results show mixed results. One study showed that the partnership had been effective for teenage mothers in improving their parenting, but the actual children of such mothers were in some cases worse off. The problem seems to be not with the concept of the partnership itself, but the actual practical effectiveness of the local organisations involved in the particular partnership and the level of communication and cooperation between different staff.[24] Overall, the project has certainly been a success in developing integrated support networks for children and families throughout the UK. However, the effectiveness of this support network has been hindered in many areas because of different organisational cultures and a lack of adequate management capacity across the disciplines. These cultural problems have also limited the effectives of service user participation in some areas, and this is something that needs to be addressed in the future if these partnerships are to be successful.[25] Conclusion The policies of the New Labour government have tried to overcome the previous problems of drawing together the health and social services into one partnership. These organisations have always been highly separate, and attempts in the 1980’s and early 1990’s to foster cooperation between them often failed because of the differences in the organisations.[26] The issue has been that trying to find a fast and effective solution to the boundaries between health and social care is difficult, although it is attainable in the long-term.[27] The partnerships themselves have actually been quite successful in creating sustainable and integrated local support networks across the UK. However, the effectiveness of these partnerships has been damaged by a number of factors. Firstly, there is still too much competition and a culture of ‘blaming the other organisation’ between health and social services. Both organisations would prefer to absolve themselves of responsibility and compete for success rather than work together to solve the problem together. Although when things go right the partnership can work, when things go wrong both parties look to blame the ‘other side’. This means many users are let down by the partnership with no-one taking responsibility for the failure.[28] Also, there has been too much emphasis on inter-organisational cooperation rather than inter-professional cooperation. Whilst organisations as a whole are difficult to change because of imbedded cultures and management styles, individual professionals can quickly be shown how to work together to both achieve better results for their respective organisations. The government policies should be more focused on getting individuals within different organisations (e.g. doctors and social workers) than looking at combining whole organisations. This gives the user the integrated support they need whilst still allowing the different organisations to concentrate on what they do best.[29] In conclusion, partnerships between the health and social services in the UK can work to improve support for those who need it. However, the focus needs to shift from inter-organisational cooperation to inter-professional cooperation if the partnerships that have been successfully set up are to be effective in the future. Bibliography Anning, A (2005) Investigating the impact of working in multi- agency service delivery setting in the UK on early years practitioners beliefs and practices. Journal of Early Childhood Research, 3(1), pp.19-50 Balloch, S and Taylor, M (2001) Partnership Working: Policy and Practice. Bristol: The Policy Press. Barnes, M, Newman, J and Sullivan, H (2004) Power, participation and political renewal; theoretical and empirical perspectives on public participation under new Labour. Social Politics, 11(2), pp. 267-279. Belsky, J et al (2006) Effects of Sure Start local programmes on children and families: early findings from a quasi-experimental, cross sectional study. BMJ, 332, p. 1476. Brown, L, Tucker, C, and Domokos, T (2003) Evaluating the impact of integrated health and social care teams on older people living in the community. Health and Social Care in the Community, 11(2), pp. 85-94. Carnwell, R and Buchanan, J (2005) Effective Practice in Health and Social Care: A Partnership Approach. Maidenhead: Open University Press. Carpenter, J, Griffin, M and Brown, S (2005) The Impact of Sure Start on Social Services. Durham Centre for Applied Social Research. Available at: http://www.dcsf.gov.uk/research/data/uploadfiles/SSU2005FR015.pdf Carr, S (2004) Has service user participation made a difference to social care services? London: Social Care institute for Excellence. Available at: http://www.scie.org.uk/publications/positionpapers/pp03.asp Clarke, J (2005) New Labours citizens: activated, empowered, responsibilized, abandoned? Critical Social Policy, 25, pp. 447-463. Dowling, B, Powell, M, and Glendinning, C (2004) Conceptualising successful partnership. Health and Social Care in the Community, 12(4), pp. 309-317. DCSF (2008) Sure Start Partnership Work. SureStart Website. Available at: http://www.surestart.gov.uk/stepintolearning/setup/feinvolvement/partnership/ (Accessed 27th December 2008). Gilson, L (2003) Trust and the development of health care as a social institution. Social Science and Medicine, 56(7), pp. 1453-1468. Glasby, J and Peck, E (2004) Care Trusts: Partnership Working in Action. Oxford: Radcliffe Publishing. Glass, N (1999) Sure Start: the development of an early intervention programme for young children in the United Kingdom. Children and Society, 13(4), pp. 257-264. Glendinning, C (2002) Partnerships between health and social services: developing a framework for evaluation. Policy and Politics, 30(1), pp. 115-127. Glendinning, C, Powell, M A and Rummery, K (2002) Partnerships, New Labour and the Governance of Welfare. Bristol: The Policy Press. Ham, C (1997) Health Care Reform: Learning from International Experience. Plenary Session I: Reframing Health Care Policies. Available at: http://www.ha.org.hk/archives/hacon97/contents/26.pdf Hudson, B (1999) Joint commissioning across the primary health care–social care boundary: can it work? Health and Social Care in the Community, 7(5), pp. 358-366. Hudson, B (2002) Interprofessionality in health and social care: the Achilles heel of partnership? Journal of Interprofessional Care, 16(1), pp. 7-17. Leathard, A (1994) Going Inter-professional: Working Together for Health and Welfare. London: Routledge. Leathard, A (2003) Interprofessional Collaboration: From Policy to Practice in Health and Social Care. New York: Routledge. Lewis, J (2001) Older People and the Health–Social Care Boundary in the UK: Half a Century of Hidden Policy Conflict. Social Policy and Administration, 35(4), pp. 343-359. Lymbery, M (2006) Untied we stand? Partnership working in health and social care and the role of social work in services for older people. British Journal of Social Work, 36, pp. 1119-1134. Maddock, S and Morgan, G (1998) Barriers to transformation: Beyond bureaucracy and the market conditions for collaboration in health and social care. International Journal of Public Sector Management, 11(4), pp. 234-251. Martin, V (2002) Managing Projects in Health and Social Care. New York: Routledge. Myers, P, Barnes, J and Brodie, I (2003) Partnership Working in Sure Start Local Programmes Early findings from local programme evaluations. NESS Synthesis Report 1. Available at: http://www.ness.bbk.ac.uk/documents/synthesisReports/23.pdf Newman, J et al (2004) Public participation and collaborative governance. Journal of Social Policy and Society, 33, pp. 203-223. Peck, E, Towell, D and Gulliver, P (2001) The meanings of culture in health and social care: a case study of the combined Trust in Somerset . Journal of Interprofessional Care, 15(4), pp. 319-327. Rummery, K and Coleman, A (2003) Primary health and social care services in the UK: progress towards partnership? Social Science and Medicine, 56(8), pp. 1773-1782. Rutter, M (2006) Is Sure Start an Effective Preventive Intervention? Child and Adolescent Mental Health, 11(3), pp. 135-141. Stanley, N and Manthorpe, J (2004) The Age of Inquiry: Learning and Blaming in Health and Social Care. New York: Routledge. 1 Footnotes [1] Leathard, A (1994) Going Inter-professional: Working Together for Health and Welfare. London: Routledge, pp. 6-9 [2] Lymbery, M (2006) Untied we stand? Partnership working in health and social care and the role of social work in services for older people. British Journal of Social Work, 36, pp. 1128-1131. [3] Glasby, J and Peck, E (2004) Care Trusts: Partnership Working in Action. Oxford: Radcliffe Publishing, pp. 1-2 [4] Anning, A (2005) Investigating the impact of working in multi- agency service delivery setting in the Uk on early years practitioners beliefs and practices. Journal of Early Childhood Research, 3(1), pp.19-21 [5] Barnes, M, Newman, J and Sullivan, H (2004) Power, participation and political renewal; theoretical and empirical perspectives on public participation under new Labour. Social Politics, 11(2), pp. 267-270. [6] Clarke, J (2005) New Labours citizens: activated, empowered, responsibilized, abandoned? Critical Social Policy, 25, pp. 449-453 [7] Dowling, B, Powell, M, and Glendinning, C (2004) Conceptualising successful partnership. Health and Social Care in the Community, 12(4), pp. 309-312. [8] Hudson, B (2002) Interprofessionality in health and social care: the Achilles heel of partnership? Journal of Interprofessional Care, 16(1), pp. 10-14. [9] Rummery, K and Coleman, A (2003) Primary health and social care services in the UK: progress towards partnership? Social Science and Medicine, 56(8), pp. 1777-1780. [10] Glendinning, C (2002) Partnerships between health and social services: developing a framework for evaluation. Policy and Politics, 30(1), pp. 115-117. [11] Carr, S (2004) Has service user participation made a difference to social care services? London: Social Care institute for Excellence. Available at: http://www.scie.org.uk/publications/positionpapers/pp03.asp [12] Newman, J et al (2004) Public participation and collaborative governance. Journal of Social Policy and Society, 33, pp. 217-220. [13] Peck, E, Towell, D and Gulliver, P (2001) The meanings of culture in health and social care: a case study of the combined Trust in Somerset . Journal of Interprofessional Care, 15(4), pp. 323-325. [14] Balloch, S and Taylor, M (2001) Partnership Working: Policy and Practice. Bristol: The Policy Press, pp. 143-145. [15] Leathard, A (2003) Interprofessional Collaboration: From Policy to Practice in Health and Social Care. New York: Routledge, pp. 102-103 [16] Lewis, J (2001) Older People and the Health–Social Care Boundary in the UK: Half a Century of Hidden Policy Conflict. Social Policy and Administration, 35(4), pp. 343-344. [17] Ham, C (1997) Health Care Reform: Learning from International Experience. Plenary Session I: Reframing Health Care Policies. Available at: http://www.ha.org.hk/archives/hacon97/contents/26.pdf, p. 25 [18] Maddock, S and Morgan, G (1998) Barriers to transformation: Beyond bureaucracy and the market conditions for collaboration in health and social care. International Journal of Public Sector Management, 11(4), pp. 234-235. [19] Gilson, L (2003) Trust and the development of health care as a social institution. Social Science and Medicine, 56(7), pp. 1463-1466. [20] Glass, N (1999) Sure Start: the development of an early intervention programme for young children in the United Kingdom. Children and Society, 13(4), pp. 257-259. [21] DCSF (2008) Sure Start Partnership Work. SureStart Website. Available at: http://www.surestart.gov.uk/stepintolearning/setup/feinvolvement/partnership/ (Accessed 27th December 2008). [22] Myers, P, Barnes, J and Brodie, I (2003) Partnership Working in Sure Start Local Programmes Early findings from local programme evaluations. NESS Synthesis Report 1. Available at: http://www.ness.bbk.ac.uk/documents/synthesisReports/23.pdf [23] Rutter, M (2006) Is Sure Start an Effective Preventive Intervention? Child and Adolescent Mental Health, 11(3), pp. 137-140. [24] Belsky, J et al (2006) Effects of Sure Start local programmes on children and families: early findings from a quasi-experimental, cross sectional study. BMJ, 332, p. 1476. [25] Carpenter, J, Griffin, M and Brown, S (2005) The Impact of Sure Start on Social Services. Durham Centre for Applied Social Research. Available at: http://www.dcsf.gov.uk/research/data/uploadfiles/SSU2005FR015.pdf, pp. 44-48 [26] Glendinning, C, Powell, M A and Rummery, K (2002) Partnerships, New Labour and the Governance of Welfare. Bristol: The Policy Press, pp. 34-36 [27] Hudson, B (1999) Joint commissioning across the primary health care–social care boundary: can it work? Health and Social Care in the Community, 7(5), pp. 363-365. [28] Stanley, N and Manthorpe, J (2004) The Age of Inquiry: Learning and Blaming in Health and Social Care. New York: Routledge, pp. 1-5 [29] Martin, V (2002) Managing Projects in Health and Social Care. New York: Routledge, pp. 180-190

Grandparent and Classroom Clinical Experience Essay

My classroom clinical experience overall was very interesting and educational. Educational in more ways than one, I gained a lot of hands on experience as well learned the basic routine of a nursing and rehabilitation facilities. I was introduced to some really great in the field skills as well some not so great methods of doing these skills. Things were not done to terrible bad just a few skills that I know I learned in class the correct way that should have been implied the correct way at the facility a bit better than they were. Now let’s discuss the wonderful residents that blessed my day and actually made me feel like I had done and accomplished something so absolutely wonderful at the end of the day. These individuals were just as precious as they could be some with great dispositions and some with unknowing dispositions if you will. There was one resident that just really stole my heart but I think she was a nuisance to the other staff there, simply because she was a bit needy or always turning on her light even though you were just in her room. I just melted for her; I felt she just wanted someone to talk to or to just be in the room with her. She seemed to be lonely as well a bit weak and just wanting to feel of importance. So I managed to peek my head in her door whenever I walked by just to say Hello to her. There was one other resident that just absolutely didn’t want to have anything with me the first day of clinicals as to where the next day she just talked and talked like I was one of her kind or something. It is amazing how just getting to know someone just a bit even if it is just seeing them or hearing their voice a few times will let a resident open up. There were a few things I really wished I had all the time of the day to express myself to a few of the staff to maybe let them realize that the residents are just as human as they are and that they are someone’s loved one and needed to be treated as equal as the next. As well they need to treat them like they would their great grandmother or great grandfather or even their mother or father, and some important skills need to be practiced more efficiently such as wiping and cleaning after bowel movements, touching the pillows, covers, faucets, and door knobs with dirty gloves. These two things are so important when it comes to cleanliness and the prevention of spreading germs and should be better practiced. Sometimes I wondered if the staff even washed their hands after they used the restroom. On a much lighter note and off my soapbox clinicals were a great experience and very enjoyable. I did get to actually put some of my skills of what was learned in class to use. I got to experience some good and some bad which was enlightening to help me overall with a better understanding of my skills. My classroom clinical experience overall was very interesting and educational. Educational in more ways than one, I gained a lot of hands on experience as well learned the basic routine of a nursing and rehabilitation facilities. I was introduced to some really great in the field skills as well some not so great methods of doing these skills. Things were not done to terrible bad just a few skills that I know I learned in class the correct way that should have been implied the correct way at the facility a bit better than they were. Now let’s discuss the wonderful residents that blessed my day and actually made me feel like I had done and accomplished something so absolutely wonderful at the end of the day. These individuals were just as precious as they could be some with great dispositions and some with unknowing dispositions if you will. There was one resident that just really stole my heart but I think she was a nuisance to the other staff there, simply because she was a bit needy or always turning on her light even though you were just in her room. I just melted for her; I felt she just wanted someone to talk to or to just be in the room with her. She seemed to be lonely as well a bit weak and just wanting to feel of importance. So I managed to peek my head in her door whenever I walked by just to say Hello to her. There was one other resident that just absolutely didn’t want to have anything with me the first day of clinicals as to where the next day she just talked and talked like I was one of her kind or something. It is amazing how just getting to know someone just a bit even if it is just seeing them or hearing their voice a few times will let a resident open up. There were a few things I really wished I had all the time of the day to express myself to a few of the staff to maybe let them realize that the residents are just as human as they are and that they are someone’s loved one and needed to be treated as equal as the next. As well they need to treat them like they would their great grandmother or great grandfather or even their mother or father, and some important skills need to be practiced more efficiently such as wiping and cleaning after bowel movements, touching the pillows, covers, faucets, and door knobs with dirty gloves. These two things are so important when it comes to cleanliness and the prevention of spreading germs and should be better practiced. Sometimes I wondered if the staff even washed their hands after they used the restroom. On a much lighter note and off my soapbox clinicals were a great experience and very enjoyable. I did get to actually put some of my skills of what was learned in class to use. I got to experience some good and some bad which was enlightening to help me overall with a better understanding of my skills.

Disney Business Plan - 3688 Words

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Fahrenheit 451 The Burning Truth - 1149 Words

Abdulmalik Alnagadi Doctor Clare Little Humanities 142 Aug/7/2014 â€Å"Fahrenheit 451†: The Burning Truth Introduction Fahrenheit 451 is the actual temperature at which paper catches fire. The story by Ray Bradbury represents a social criticism that alarms individuals against the risk of suppressing their feelings due to restrictions. The fascinating story of Bradbury, ‘Fahrenheit 451’ is interestingly well constructed. It can be clearly recognized that the book broadens the idea of a short story that the author wrote entitled â€Å"Bright phoenix. Although the story is considered as a science fiction work, it has led to the significant display of the author’s ability in style and idea writing. Bradbury has successfully applied imagery in ‘Fahrenheit 451’ and has shown how people in the society lead dehumanized and dangerous lives (Hamilton, Tim, and Ray Bradbury 2009). In essence, the use of imagery is strong in ‘Fahrenheit 451’ which seeks to explain how society behaves in circumstances of oppression. The story has successfully applied fiction to show people how oppressive the government is through the process of censorship. It hinders the both originality and liberty of its people. The story’s central idea is that there is a popular fiction that illustrates how the society has successfully installed order at the cost of people’s rights and freedom. Furthermore, the book expresses how risky it is for the government or society to outlaw books just because they provide ideas,Show MoreRelatedMorgan Laplante . Mrs. Rhodes . Pre-Ap English 10 . 131561 Words   |  7 PagesMorgan Laplante Mrs. Rhodes Pre-AP English 10 13 February 2016 Happiness Is Not This A person’s happiness is completely different than that of the person next to them. In Fahrenheit 451, the society is given the idea that happiness is found in the fast life. 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The intellectual metamorphosis that Montag undergoes renders him aware of this fact, making him an incredibly dangerous figure in the society of Fahrenheit 451. Despite Montag’s understanding

Synopsis Of The Speech Announces The Scratchy Pa System

Attention, all higher-ups please report to the meeting hall, announces the scratchy PA system. Juan and Alejandro develop a sly grin and stir up a conversation. Old Paco finally figured how to use that intercom. It ´s a real burden.† Let ´s go get Hector and Adolfo to see what s up. I think I have an idea of what it is. These rumours remind me of grade school, it ´s really getting out of hand. â€Å"Yeah, it’s a joke.† The men casually stroll into the dinky mess hall, which is really more of an empty room with picnic tables. Adolfo is leaning against a scuffed-up wall that emits a pungent odor of rotting meat and old wood. He’s in a slumped position with his grubby hat lazily placed across his forehead and eyes. â€Å"Wake up†¦show more content†¦Ã¢â‚¬Å"I thought we were an elite group of military leaders, not a bunch of chit-chatting slackers! We have a huge crisis on our hands, and it demands our immediate attention!† Bright purple v eins pop out of the General’s head, and his loud steady breathing is the only thing that can be heard throughout the cafeteria. â€Å"There are rumours†¦Ã¢â‚¬  starts the General. â€Å"That Mercenaries are reeking havoc throughout the mountain towns of Chile. No one knows who they are, or where they’re from, but they exist. We are supposed to be the only group that’s dominant, and we need to prove it by finding, and eliminating these abominations. Pack your bags folks, we’re going on an adventure!† General Davola leads the group in front with an immense backpack and a grim face. He can’t get over the fact that his power may be threatened. â€Å"Who would dare go up against me and my troop?† he ponders aloud. Meanwhile, Juan and Alejandro take up the back, behind Hector and Adolfo. â€Å"Do you think Davola will have us do any of his dirty work?† asks Juan. â€Å"We haven’t done anything shady in a while, but I do wonder sometimes which side we are on,† answers Alejandro. â€Å"What do you mean by that?† â€Å"It seems that we do more assignments for criminals, than we do for the actual government.† â€Å"I think you re exaggerating a bit, but money talks, dude. Besides, it’s not like we do anything that can harm Chile itself, we

Employers Get Tough on Health Free Essays

Kayli Tipps Employers Get Tough on Health The article entitled â€Å"Employers Get Tough on Health† is printed by the Chicago Tribune September 24, 2007 and it addresses how some companies in America are now choosing whether you get hired or keep your job based on your personal behavior and lifestyle habits such as smoking or eating high fat meals. In the reading the Article states â€Å"the rules of the work place are changing† and you should be informed of those changes so you can be a likely candidate to get hired if applying for a new job at these companies. I will tell you how they are testing to see if you make â€Å"bad† lifestyle choices and also how it may affect whether you qualify for health insurance or your job at these companies. We will write a custom essay sample on Employers Get Tough on Health or any similar topic only for you Order Now The company known as Weyco Inc. in Michigan is who the article is about. This Company drew national attention in 2005 when it fired four employees who used tobacco. Weyco performs random testing every three months, usually of about 30 workers. The workers are supposed to breath into a breathalyzer-like device that measures carbon-monoxide levels. So if the level is high then they are given a urine test and if they fail they will be dismissed. This is a scary idea to those who might smoke. Also I need to mention that you should say goodbye to the days of high-fat meals because Weyco can also regulate your blood pressure, body mass and glucose levels. The requirements embraced by a growing number of companies are setting privacy aside and raising questions about who will qualify for health insurance and more importantly employment. Like some of the employees you may be wondering if these new rules are illegal. According to Gary Climes, vice president of Meritain Health Michigan, who owns Weyco, stated that the firings do not violate Michigan law and that the 150 employees at the company have accepted the rules. It really comes down to a personal choice as far as do you want to be employed here,† Climes said. Since 2005 when Weyco instituted the wellness policy that includes the smoking ban, health insurance costs have increased by only 2 percent which is below the national average. So you now should be worried because personal behavior and lifestyle habits, those unrelated to work, are now fair game for employers determined to cut health care costs. The Article is very informative and gives detailed reports on the testing and how you could potentially be â€Å"dismissed† if you fail one of the tests. Also the article is expressing to you how you should rethink the junk food you have been eating or the cigarette you are about to smoke. Although thousands of employees have put in place incentives for their workers to live healthier lifestyles, the great numbers of employers have not yet embraced the act to penalize workers who don’t satisfy medical and behavioral rules. Although you should really try to take steps to better yourself and use this article as a little push even if you don’t live in Michigan because punitive measures are gaining a foothold in the workplace. I recommend this article to anyone who is currently looking for a job to get these ideas flowing in your head because even if the company you’re working for isn’t testing you or firing people for smoking you should still be aware that they look at your habits. The most important aspect you should have in the work place in presentation in your effort and in yourself. I found this article very informative because I had no idea that businesses even started testing people to see if they smoke or cared that you smoked at all. Although some things may be out of your immediate control such as high blood pressure and glucose levels, you can take measures to improve your health in the long run with choosing a healthier lifestyle, not only for yourself but for your job. How to cite Employers Get Tough on Health, Essay examples

The Case Study of Jordan Free-Sample for Students-Myassignment

Question: Identify and Justify Nursing Care Assessment with Explanation of Health Care Goals for the Client. Answer: Introduction The paper deals with the case study of Jordan who is diagnosed with cystic fibrosis. It is a genetic disease, which damages the exocrine glands. Due to excess secretion of mucus, pancreatic ducts, bronchi and intestines are blocked and high risk of frequent lung infections (Leung et al. 2015). The family belongs to Shine coast region of Australia. It is a third most populated region in Queensland. This region is known to have highest prevalence of cystic fibrosis. The residents of this region have a low health literacy. Using the five tiers of the socio-ecological framework, the paper discusses the nursing care for the illness and the support needed by the family to address the health needs of Jordan. The paper identifies and justifies the plan of care required by the client. The paper illustrates how the nurse coordinates and delivers the required care keeping in view the health care priority. Case study scenario The paper deals with the case study of Jordan a eleven-year-old girl diagnosed with cystic fibrosis. In the story, the CEO of Cystic Fibrosis, WA Mr. Nigel Baker narrates as to why the story is named 65 roses. He narrated a story of Mary whose son was diagnosed with Cystic fibrosis. While Mary was trying to seek help from her friends and relatives, her son overheard the conversation and thought that his mom was collecting funds for buying 65 roses. Later the story unfolds the illness of Laura. According to her parents, she was diagnosed with the illness when the child was seven week of age. Lauras parents had no awareness of the illness. Lauras father Jason had a traumatic experience earlier. His first cousin passed away at the age of 12 due to Cystic fibrosis. The incident keeps the parents depressed and it has created a black picture of the illness. She is loved by her sister Klara informs that she takes care to keep Jordan away from flu. Another sister, Claudia says that she loves spending time with Jordan. Playing on trampoline and Chasey are her Jordans favourite. She also loves playing with her pet, music and dance. Her father says that since the illnesses have no physical disability she will be like any other normal child and can enjoy her social life. Despite the advancement in the medical field, the parents are worried as the disease decreases the life expectancy. Jordan enjoys the support and special care given by her parents and stays happy. Currently, she is administered with Pancreatic Korean to keep her pancreas functional. Socio-ecological framework The socio-ecological framework of health care intervention is a multi-level approach. The model includes an individual as a core of the model. The four levels of influence on the individual are interpersonal, institutional or organisational, policy and community level (Madan et al. 2014). The framework is developed with the intention to implement the public health activities at these five levels. The framework maximises the synergies of intervention for successful health outcomes. Each of the level is discussed below with the specific health needs of the client and the family. The process of implementing the framework includes making evidence based nursing assessment of Jordan, identify the health care needs and provide the required care using the five tiers in the framework (Betz et al. 2014). Individual level The first tier of the Socio-ecological framework is the individual needs of the illness. It includes the individuals knowledge and attitude towards the illness. It refers to interest of the client in health screening and understanding the risks and benefits of the screening. It also includes approaching the conventional diagnosis and treatment. A nurse pays a vital role in providing the individual with the affordable and convenient treatment source and high quality surveillance (Madan et al. 2014). It was identified from the case study that the patient and the family have active participation in the health care promotion. Jordan is very young and needs to learn about the consequences of the illness. It is identified that Jordans parents want her to have a normal lifestyle as the illness has no phenotypic characteristics. The disease only affects the internal organs of the body. Therefore, it is needed for Jordan and her parents to learn about the health promoting activities that are cost effective and reduce comorbidities. The nursing intervention for Jordan includes education program that helps her better understand the illness and take necessary precautions when in emergency. Jordan will be educated about the nutritional requirements, diet she needs to maintain and on time intake of medicines. It will increase her adherence to the treatment and reduce frequent infections (Tointon and Hunt 2016). Further, she will be taught physical exercises that will improve her lung functions. Yoga and meditation have been found effective in providing relief from symptoms. She will be provided with the instructors for dance and music therapy. These interventions are cost effective and can be implemented in home once trained. It may reduce the comorbidities associated with the disease and improve the life expectancy. A physical exercise increases the immunity and decrease the chance of infection (Radtke et al. 2015). It may reduce the burden of additional financial expenditure. Interpersonal level At the interpersonal level, the health interventions that are effective for preventing the disease and reducing the comorbidities of the illness are provided to the client. These activities or interventions are provided with the aim to invoke behaviour change in the client while overcoming the individual level barriers. The services at this level are intended to affect the social and cultural norms (Cook et al. 2014). Cystic fibrosis is the life threatening disease and the treatment process involves various challenges. Her parents have psychological issues that need to be resolved in order for them to make effective clinical decision for Jordan. They have already experienced black consequences of the illness after the death of Jasons first cousin. Despite the progress in the field of medicine, Klaudia lacks trust in the survival chances of Jordan. Therefore, they need motivation to cope up with the illness and its demands. Further, the family will be provided with the cognitive behavioural interventions. It will help them to make effective decisions in the treatment process of Jordan and believe in the successful health outcome of the illness. These interventions will give them the skills often to care for Jordan. This intervention is effective in helping the clients deal with their thoughts and feelings. These interventions will help the parents to reconstruct their lives and maintain balance between the social, emotional, physical and financial resources. It will also help them to come to terms with the fact that their child may die at a very young age. Cognitive behavioural interventions have been effective in enhancing the interpersonal level (Goldbeck et al. 2014). The family will be provided with the infection control guidelines so that they can stay away from the people infected with the same disease. Organizational level The third tier of the social ecological model is the organizational level where the healthcare professionals, healthcare systems, healthcare plans, health clinics, local health departments and professional organizations are the potential sources at the organizational level. The interventions required at this level comprises of the promotion of the reminder systems for the client and the providers and providing the provider assessment and feedback for the performance (Simplican et al. 2015). Sunshine coast region in Queensland, Australia is the third most populated peri-urban area with dispersed urban growth. There are small hospitals situated in the region with limited facilities. As a result, there is under-staffing and overcrowding at the hospital affecting the healthcare system and quality of care at the region. There is great requirement of nurses and healthcare professionals. In the context of cystic fibrosis, there is need for organizational capacity in terms of organizational support and effective partnership among the doctors and nurses to support the client needs and requirements. A nurse can promote a healthy working environment where their competency and professional role would have an impact on the quality of care to be provided to Jordan. As a nurse, one should fully support the professional role and legitimize their power in increasing the organizational capacity of that area in the healthcare system (McGinnis and Ostrom 2014). At the same time, a nurse al ong with the organization should dedicate to the needs of Jordan and provide her the facilities that she requires while batting with the disease. The nurses should be informed about the health insurances schemes that address cystic fibrosis so that they are able to get financial assistance regarding the treatment and cost of medication. The nurses can also contribute by reaching out to the family of Jordan and helping in an immediate manner are some of the organizational needs that can be fulfilled as a nurse. The school based programs in Jordans school with participant involvement that promotes healthy nutrition and education about cystic fibrosis. Community level The fourth tier under SEM framework is at community level where there is participation of the community level by leveraging resources comprising of health departments, advocacy groups and media that represents the potential sources for communication and community support. The interventions encompass the working of the collaborative and coalitions in promoting awareness among the people of Sunshine coast region along with Jordans family and through conducting educational campaigns. The nurses can collaborate with the peri-tribal health departments in Sunshine coast region that helps to extend services and facilities to Jordans family. People in that region are not aware of the cystic fibrosis condition and the nurses along with the other healthcare professionals should promote health literacy so that the early detection and co-morbidities can be reduced to a larger extent. The nurses can collaborate with the support networks that would be dedicated in providing the direct and indirect services that enhances the life of Jordan in leading a normal life and helps the family in coping with the condition (Sallis and Owen 2015). Nurses along with the community can help to assist Jordans family in providing them services through cystic fibrosis centres that give evidence-based practice for the management and care of Jordan. These centres provide care through the established guidelines that promote and communicate through practice guidelines on all aspects of care. The nurses can also promote adherence to the treatment with the disease. These community centres provide adequate support to the families with cystic fibrosis that are staffed with multidisciplinary care providers like nurses, physicians and other healthcare professionals (Berkes and Ross 2013). Policy level This is the outermost tier in the social ecological model that comprises of activities tat involve interpretation and implementation of the existing policies. The local, state, federal and peri-tribal government agencies support the policies and their promotion in providing assistance to the clients and their families dealing with cystic fibrosis. Effective communication in policy making decisions that addresses the people of Sunshine coast region in coping with the condition. The insurance mandates that are required for the treatment and management of the condition can also be provided by the nurses by working in collaboration with the community members in implementation of policy (Levin et al. 2013). They can also assist in translating the local policies for the community members so that they are able to educate and create awareness about the cystic fibrosis among the public. This is the authoritative decision where environmental change is important that affects the policy decision s. It is important to create sustainable change that targets the interventions and policy making (Ban et al. 2013). Nurses can educate the local officials and community workers about the importance of balanced nutrition and eating vegetables a day. Nurses can support the policies that foster community empowerment through effective partnership and environmental structures that promote healthy education and physical activity. A food policy that can be implemented in the Jordans school that promotes the importance of eating healthy nutrition and children education about the current food systems in peri-urban Sunshine cost region. Moreover, the integration of food policies, local food systems and resilience can support to give sustainable food strategy in the region (Golden et al. 2015). Behaviour support can also be give to the children like Jordan living with cystic fibrosis. The behaviour expectations should be predictable and consistent so that it is helpful in accommodating the stress related to the condition. A health support plan is required for Jordan in conjunction with her family that support the health needs and care information in cystic fibrosis. Nurses can also support by educating in planning support and in areas of personal care, first aid and additional support that ensures continuity of care and education (Eldredge et al. 2016). Conclusion As such, there are no such evidence based practices and behavioural interventions that target the key issues in cystic fibrosis. There is requirement of psychological interventions and evidence based practice for the treatment and management of cystic fibrosis faced by people and their caregivers. The social ecological model addresses the patient health care needs through multi-level approach. It has multiple bands that comprises of individual, interpersonal, organizational, community and policy levels. The model helps to implement the public health activities that help to maximize intervention and provide support to Jordan and her family in dealing with cystic fibrosis. References Ban, N.C., Mills, M., Tam, J., Hicks, C.C., Klain, S., Stoeckl, N., Bottrill, M.C., Levine, J., Pressey, R.L., Satterfield, T. and Chan, K., 2013. A socialecological approach to conservation planning: embedding social considerations.Frontiers in Ecology and the Environment,11(4), pp.194-202. Berkes, F. and Ross, H., 2013. Community resilience: toward an integrated approach.Society Natural Resources,26(1), pp.5-20. Betz, C.L., Ferris, M.E., Woodward, J.F., Okumura, M.J., Jan, S. and Wood, D.L., 2014. The health care transition research consortium health care transition model: a framework for research and practice.Journal of pediatric rehabilitation medicine,7(1), pp.3-15. Cohen-Cymberknoh, M., Shoseyov, D. and Kerem, E., 2014. Standards of care for patients with cystic fibrosis.Cystic Fibrosis,64, p.246. Cook, J.E., Purdie-Vaughns, V., Meyer, I.H. and Busch, J.T., 2014. Intervening within and across levels: A multilevel approach to stigma and public health.Social Science Medicine,103, pp.101-109. Eldredge, L.K.B., Markham, C.M., Kok, G., Ruiter, R.A. and Parcel, G.S., 2016.Planning health promotion programs: an intervention mapping approach. John Wiley Sons. Goldbeck, L., Fidika, A., Herle, M. and Quittner, A.L., 2014. Psychological interventions for individuals with cystic fibrosis and their families.The Cochrane Library. Golden, S.D., McLeroy, K.R., Green, L.W., Earp, J.A.L. and Lieberman, L.D., 2015. Upending the social ecological model to guide health promotion efforts toward policy and environmental change. Leung, D.H., Ye, W., Molleston, J.P., Weymann, A., Ling, S., Paranjape, S.M., Romero, R., Schwarzenberg, S.J., Palermo, J., Alonso, E.M. and Murray, K.F., 2015. Baseline ultrasound and clinical correlates in children with cystic fibrosis.The Journal of pediatrics,167(4), pp.862-868. Levin, S., Xepapadeas, T., Crpin, A.S., Norberg, J., De Zeeuw, A., Folke, C., Hughes, T., Arrow, K., Barrett, S., Daily, G. and Ehrlich, P., 2013. Social-ecological systems as complex adaptive systems: modeling and policy implications.Environment and Development Economics,18(02), pp.111-132 Madan, A.S., Alpern, A.N. and Quittner, A.L., 2014. Transition from paediatric to adult cystic fibrosis care: A developmental framework.Cystic Fibrosis,64(272), pp.00150-6. McGinnis, M. and Ostrom, E., 2014. Social-ecological system framework: initial changes and continuing challenges.Ecology and Society,19(2). Radtke, T., Nolan, S.J., Hebestreit, H. and Kriemler, S., 2015. Physical exercise training for cystic fibrosis.The Cochrane Library. Sallis, J.F. and Owen, N., 2015. Ecological models of health behavior.Health behavior: Theory, research, and practice,5, pp.43-64. Simplican, S.C., Leader, G., Kosciulek, J. and Leahy, M., 2015. Defining social inclusion of people with intellectual and developmental disabilities: An ecological model of social networks and community participation.Research in developmental disabilities,38, pp.18-29. Tointon, K. and Hunt, J., 2016. How holistic nursing can enhance the quality of life of children with cystic fibrosis.Nursing Children and Young People,28(8), pp.22-25.