Chapter 2 Test Political Science Pearson Essay - 987 Words

1) The strength of the economy is directly tied to the monetary value of all goods and services produced in a nation each year, which is called the ________. Gina coefficients for the economy Median household income Gross domestic product Poverty line Mass production factor 2) The degree of ________in the United States is unusually high compared to other developed countries. Religiosity Political idealism Racism Demographic homogeneity Civil liberty 3) Belief in which of the following ideals is part of the core of American political culture? Government intervention Allegiance to parental homeland Caste system Strength in diversity Foreign diplomacy 4) Income inequality has increased significantly in recent†¦show more content†¦Higher unemployment Revolution Political conflict Decreased voter turnout Apathy 16) A majority of Americans identify themselves as being part of the ________. Upper class Political elite Bible belt Proletariat Middle class 17) How do core ideals and shared values, such as liberty and self-government, serve as an important link between the history of the United States and its contemporary experiences? Such values and ideals have prevented the government from infringing on liberty. They remind Americans of the reasons this country was founded .They have kept the country unified since its founding. They have helped America to persevere in every conflict it has been in. They have led America to have the highest rates of equality in the world. 18) Culture refers to ________. Beliefs about a political system A predisposition about participation in a group or a political system Basic values about participating in a society A series of expectations of a political system A way of thinking or a mode of behavior common to a group 19) In which way do Americans best express the essence of the American Dream? Their universal support of limited government Their commitment to welfare programs Their enthusiasm for capitalism By sending humanitarian aid overseas By regularly voting in elections 20) On either end of the political spectrum, voters prefer that elected officials are aligned with ________. Agricultural interests BigShow MoreRelatedHigh School Student Essay20272 Words   |  82 PagesStudents Chapter 3 Learner Diversity: Differences in Today’s Students Chapter 4 Changes in American Society: Their Influences on Today’s Schools ISBN: 0-536-29980-3 Introduction to Teaching: Becoming a Professional, Second Edition, by Donald Kauchak and Paul Eggen Published by Prentice-Hall/Merrill. Copyright  © 2005 by Pearson Education, Inc. ISBN: 0-536-29980-3 Introduction to Teaching: Becoming a Professional, Second Edition, by Donald Kauchak and Paul Eggen Published by Prentice-Hall/MerrillRead MoreExploring Inferential Statistics and Their Discontents2123 Words   |  9 Pages(Zheng Agresti, 2000). 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Effects Of Dieting On Memory Dieting - 1172 Words

Rehan My research topic is the effects of dieting on memory. Dieting plays a major role in almost every humans life. Wanting to become part of the social norm is a goal that most people have trouble achieving. Being skinny is one of those troubles that force people away from the social norm. To become skinny one must work hard at either the gym or even home exercises or just have high metabolism forever. This exercise becomes a problem for the average person. Everyone is so busy with work, it becomes near impossible to be in one hundred percent control of your life. After a long hard day at ones job, working out is usually the last thing on their to do list. But becoming skinny and always on one s mind. So instead of working out, people tend to try looking for easier ways to gain the same rewards as exercising. This search usually leads to people taking dieting supplements, or slim fast drinks to replace their meals. For all easy ways must come at a price or else they would be no rea son for hard paths to be chosen. My research question is whether there is a difference between taking either dieting supplements with no or very low exercise compared to an avid exerciser who just controls his weight from managing food intake. Dieting and working memory: Preoccupying cognitions and the role of the articulatory control process (Shaw, Tiggemann, 2004). The researchers in this study were curious about the cognitive impairment that seemed to be correlated with dieting. 92 femaleShow MoreRelatedDieting On Weight Loss And Weight Management3070 Words   |  13 Pages2015 The Effectiveness of Dieting on Weight Loss and Weight Management Dieting has been a staple in today’s society for as long as we can remember. Everyone wants to be model thin, have the body of a movie star, or have the muscles of a body builder. 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The Day You Were Born Free Essays

The Day You Were Born I was forty-one weeks and one day pregnant, lying in an uncomfortable hospital bed, wearing a hideous pink gown, and counting the minutes until my next contraction. Apparently, you were very comfortable in my tummy because there was no sign of you making your appearance any time soon. I was having plenty of contractions but was not dilating; our doctor was looking for a count of at least 60 on the room monitor, but I was only in the mid-20s. We will write a custom essay sample on The Day You Were Born or any similar topic only for you Order Now Before long she ordered that Pitocin be administered to induce productive labor. It seemed to work– after only twenty minutes, my contractions went from the twenties to the eighties and continued to increase after that. A few more long hours passed. The doctor returned to our room to check on my progress. Surprisingly, after the initial dosage of Pitocin, I had only slightly progressed during the intervening hours. The doctor told me I should have advanced toward your delivery much more than I had and determined that my inability to relax my body was the reason why the process had again been slowed. I was so excited to meet you that I couldn’t help but cry, thinking that you would never show up. A wonderful nurse then came in the room and sat down to talk with us. She assured me that every woman, and every pregnancy, are different. She promised me that I would not leave the hospital without you in my arms. She introduced herself as Nurse Pam, and called herself â€Å"The Pitocin Queen. † She told your Daddy and me all about her days as an Army nurse. We became instant friends. In order to get things moving along a little more quickly, she encouraged me to undergo an epidural to help me relax. Your Daddy was very supportive, holding my hand and reassuring me. Accepting pain medication, he said, did not mean that I was a failure; it just meant that plans had changed. After forty hours of labor, I was willing to try anything to get you to come into the world. After another long hour passed, the anesthesiologist came into our room. Your Nana happened to be downstairs getting coffee, and your Daddy and Aunt Lindsay couldn’t stomach a procedure involving a large needle, so the anesthesiologist ordered everyone but your Mimi to leave. The epidural took only about ten minutes, and between the anxiety and pain from the contractions, I didn’t even feel the needle. I was ordered to lie down and relax so that the medicine could fully take effect and was urged to let the nurses or doctor know if I wasn’t completely numb within a few minutes. About forty-five minutes passed, but I was still able to feel my left leg and move it around. Nurse Pam called the anesthesiologist back in for round two, and that time it finally worked. It was so odd to be lying in bed watching television while your Nana, Aunt Lindsay, Daddy and Mimi giggled about how I couldn’t feel the contractions. We would take turns looking at the monitor and exclaiming, â€Å"Did you feel that one? It was huge! † I had completely relaxed at this point and wasn’t nearly as anxious about the passing time. I was even able to joke with your Daddy, â€Å"Wouldn’t it be crazy if they came back in here and I still haven’t progressed? Looks like we are moving in! † He was happy that I was feeling better, but now he was getting more anxious and ready to meet you. When the doctor came back in to check my progress, we were all happy and relieved to hear that I had progressed to the point where delivery was imminent. The excitement intensified with everyone talking about who you might look like and whose personality you would take after. It was only about one last hour later when I grabbed your Daddy and said, â€Å"Get the doctor– the epidural isn’t working anymore. I feel a lot of pressure. † The doctor returned and checked my progress, and said that the epidural was still working, but that the time for your delivery had finally arrived! The doctor dressed in her gown and gloves and said, â€Å"Go ahead and push when you’re ready! † I grabbed your Daddy’s hand and pushed hard, took a deep breath, and pushed again. The doctor yelled, â€Å"She has black hair! One more push! † I closed my eyes, pushed so hard, and after a big exhale, I heard you scream. That moment the doctor laid you on my chest was indescribable. My heart was pounding and tears were pouring down my face. I couldn’t believe that after waiting forty-one weeks to meet you, you were finally here! Nurse Pam gently took you to bathe, weigh and measure you. Your Daddy and I looked at each other and just smiled. We were both so happy you were finally here with us. Pam called out, â€Å"She’s nine pounds one ounce, and nineteen and a half inches long. She’s a big girl. † She wrapped you up in a blanket and placed you in your Daddy’s arms. His eyes welled up with tears and he immediately fell in love with you. Everyone in the room was staring at your Daddy holding you and your Nana was lots of taking pictures. You had a full head of jet-black hair, dark eyes, ten precious figures and toes and flawless soft skin. You were the most perfect thing we had ever seen. How to cite The Day You Were Born, Essay examples

Accountability of the Anp free essay sample

Over the last few years there has been a precipitous change in the delivery of healthcare within the National Health Service (NHS), which inevitably brought about modification of the nursing role and an adaptation in the professional nursing competencies. It was recognised that vital health improvements that the NHS required could not be made without the advancement of nursing skills and roles (Walsh amp; Crumbie 2003). In the early 1980s the nurse practitioner’s role was first introduced into general practice, the role has now further developed and changed. Advanced Nurse Practitioners (ANPs) are now working in diverse and varied roles within the National Health Service (Crumbie 2008). By accepting new areas of responsibility and accountability requires more from the advanced practitioner than simply a change of uniform and title. There is a need to safeguard the quality in the development and implementation of these roles and continuous evaluation of their success (Whiteing 2008). Since the 1980s there has been considerable amount written in nursing literature regarding the measurement and maintenance of quality nursing care and with the introduction of Clinical Governance (DOH 1998) and the NHS Plan (DOH 2000) the UK government has made it a quality high on the political agenda. The role of advanced nurse practitioner has developed over recent years to provide a high quality and cost effective care, but at times has caused confusion regarding title, professional boundaries and educational obligations which brings about the question of clinical accountability and the advanced nurse practitioner (Griffin amp; Mebly 2005). The Oxford Dictionary (1995) defines the term ‘accountable’ as being ‘responsible; required to account for one’s conduct, and is an integral part of professional practice (NMC 2006b). Accountability can be perceived as being an elevated activity to that of responsibility, as it requires not only designation of who is responsible of an action but also need for the individual who carries out the task is able to give an account, reason and or an explanation for their action. As the enhancement of advanced practice progresses, the ANPs could find themselves in a situation where they are solely responsible for a patient caseload without alternative medical input, although these situations are innovative and unusual Pennel 2008 stresses that these situations exemplifies the level of accountability that could be ut upon the ANP, by performing a role of a medical consultant by maintaining absolute accountability for the patient’s clinical care. Clinical governance requires the ANP to be comprehensible in their judgement and decision-making, yet in some situations this could prove to be complicated for the ANP, since they may be fearful of being held responsible for the outcome of their decision. Currie and Loftus-Hills 2002), however Caulfield (2005) views accountability with a more positive outlook and states: ‘A wider view of accountability is that it is an inherent confidence as a professional that allows a nurse to take pride in being transparent about the way he or she has carried out their practice. This definition reviews accountability as positive element in the development and validation of competent practice. Cornock (2011) also comments that accountability can be perceived as being essential for monitoring when things are going right and therefore necessary to distribute that information for the benefit and to enhance the knowledge of others. Nuttall (1993) verifies that there is a link with accountability and autonomy, and argues that without autonomy the practitioner is unable to be accountable if they are unable to make a decision about their choice of action freely. The Oxford Dictionary (1995) suggests that autonomy gives independence and freedom from control. In order for the ANP to be autonomous they need to have the ownership of all the details and information, though education and communication, and have the authority to act as they see fit with proper mechanisms for measuring the outcomes, by carrying out audits for example. In the framework of the professional role the ANP would seemingly have the authority and autonomy to act in the patient’s best interest, having the ability to explain and justify why, conversely Walsh (2003) maintains that no clinician can be fully completely independent as ANPs work within a team, and alongside the patient’s involvement in the decision-making regarding their care. Consequently the ANP should examine the situation and consider alternative options that may be available, validate their knowledge and understanding of the possible outcomes of these options and decide the best course of action, to which they can justify their actions from their knowledge base (Marks-Maran 1993). ANPs are required to be able to explain the rationale that prompts their actions and the consequences that follow. An accountable ANP should not agree to carry out a task simply because they have been ask by a senior colleague has told them to. Nurses have been encouraged to question and challenge clinical decisions and not just following what is ordered by the doctor (Fletcher amp; Holt 1995), thus guiding professional judgement towards accountability (Watson 1992). In the eyes of the law inexperience is not a defence. If the ANP believes that they are not proficient the skills or ability for a task, at the standard that is required, it is their responsibility to decline the action or to obtain supervision from a senior medical colleague or their mentor (RCN 2010). ANP are accountable to their employers as agreed in their job description/framework and contract (Cox 2010) and is specific to their level of practice to ensure that practitioners are working within boundaries approved by their employers (Walsh 2003). As the working confines between healthcare practitioners modify, with ANPs taking on board several of the tasks formerly assumed to be the work of the doctor, while Health Care Assistants (HCAs) and assistant practitioners perform roles that were customarily carried out by registered nurses, inevitably some confusion arises as staff continue to grasp the effects of these modifications in their role (Mulryan 2009). The established legal advice is that a practitioner would be judged by the standard that are required for the post, for instance if an ANP is carry out a role that would historically have been considered a medical role; taking the patient’s history, carrying out the physical examination of the patient in order to obtain an interim diagnosis of the patient’s condition, and would be critiqued at a standard of a reasonably proficient doctor (RCN 2010). Therefore as the ANP develop the advanced practice of their role it may be prudent to focus on corresponding standards that is required of their medical counterparts. All these modifications continue against the setting of the general public beliefs of health care services and consequently the questions of risk management and legal accountability unavoidably come to pass (Cox 2010). It is reasonable therefore, to conclude that ANPs are personally and professionally accountable for their practice and as per se are obliged to make sure that they have the capability to take on and perform advanced practice actions to the similar paradigm as the person that would usually have been delegated with those actions, such as a doctor (Whiteing 2008), which bring to light the need of the ANPs to practise both within the law and to the same standards as doctors (DH 2002). As the ANP’s role develops into a more complex and demanding expectation, an increase in the amount of activities that were previously performed by the ANP have to be delegated to other members of the health care team. Delegation of such activities may have a legal implication upon the ANP if they inappropriately delegate a task or fail to supervise the delegated task (Whiteing 2008). The ANP should make sure that they are confident in the competencies of the individual who is delegated the task, and also ensure that sufficient supervision is offered to maintain the safety of the patient (Dimond 2003). With these advances the ANPs should reflect upon the professional, ethical and legal implication of their practice (Humphries amp; Masterson 1998). Poyser (1996) noted that with the expansion of advanced practice a greater legal and professional accountability has been distinguished, and therefore a higher level of responsibility is required in conjunction to the mounting complexities of the patient’s healthcare needs (Jones amp; Davies 1999). The Scope of Professional Practice present clear guidelines to those nurses who aspired to develop their role, and made certain that they accepted accountability for their own actions (NMC 2008). The recommendation for the professional and ethical practice of advanced nurse practitioners is the Code of professional conduct (NMC 2008). The essential principles in determining the susceptibility of advanced nurse practitioners are the degree of their self-governance (autonomy), their ability to take responsibility for their own actions (accountability), and their knowledge of the boundaries of their own practice (RCN 2010). For any advanced practice role to be effectively incorporated into a multidisciplinary team, clear and concise boundaries must be approved by the team, particularly by the medical colleagues, who must accept and support the role. By accepting and agreeing of advanced practice roles, members of the multidisciplinary team can understand when the ANP reaches a point that is beyond their area of expertise these colleagues then can understand that it would be professionally appropriate for the ANP to refer onwards to other colleagues, if the ANP believes it necessary (Pennel 2008). The ownership by ANP of credentials, recording their capability to carry out extended nursing duties does not automatically suggest that they are competent in these skills (Crinson 1995); Fletcher and Holt (1995) state, such certificates have ‘never provided blanket immunity from legal liability’. The NMC are also clear on the matter that nurses are personally accountable for their professional conduct (NMC 2002a). Complications may occur if ANPs are unprepared for their scope of practice, with inadequate knowledge and skills to accomplish their role (Whiteing 2008). As a result it is vital for the ANP to have a clear definition of the scope of their working practice. Identification of possibilities and limitations of their practice should also be defined and documented clearly (Furlong amp; Smith 2005) along with advice and from the ANPs designated mentor during clinical supervision sessions. Chalmers and Bond (1997), and Doyal (1998) argue that extended roles that involve high levels of autonomy are deficient in the educational preparation for their practice, Walsh and Crumbie (2003), maintain that there are inconsistencies in the training of practitioners, with some courses involving only a few days of study and others being undertaking their education at a masters level to fulfil their competencies to practice as an ANP. Considerable amount of the uncertainty and ambiguity has resulted from the modernization of delivery of healthcare, and developments of ‘new nursing roles’, Cox 2010 believes that these issues would be reduced or disregarded if the employing organisations and the educational bodies reduced the gap with appropriate standardisation training of ANP. Inappropriate educational preparation, of the ANPs and their employers could be vulnerable to accusations if the educational framework of advanced practice is lacking (Tye 1997). By developing a framework for ANPs, such as, Framework for Advanced Nursing, Midwifery and Allied Health Professional Practice in Wales (NLIAH 2008), gives clarity to what is expected of an advanced practitioner in the terms of defining the role, education, workforce planning, regulation and governance requirements of the ANP in Wales. Nurse educators should be obliged to comprehend the future role of the ANPs in the administration of healthcare, by delivering the correct training to accomplish appropriate preparation, education and demonstrated competence to be practice as a proficient and skilled clinical practitioner (Furlong and Smith 2005). NMC (2007) recommended that educational programmes addressing advanced practice should make precise core and specific competencies for the role of the ANP. Hamric et al. 2000) additional states that master’s degree program for the ANP should include: advanced nursing practice, pharmacology, pathology, physiology, advanced physical assessment skills, research, leadership, quality improvement and case management. The Department of Health (2010) envisage that nurses who are working in an advanced role should complete their education at a Masters level or its equivalent, and the development requirements be identified and supported through ongoing appraisals, performance review in conjunction with a robust clinical supervision framework. A key feature in any education program for advanced nursing practice is that of suitably supervision Dunn (1998) although it is recognized that it is often carried out through personally directed refection it of consequence that the ANP shows that reflective practice has been carried out. Pennel (2008) suggests that it would be responsible practice to seek clinical supervision by the most appropriate senior colleague, for the appropriate situation, so as to maintain safe practice. As well as developing a program that recognizes advanced practice knowledge and skills that are common practice to all ANPs, Furlong and Smith (2005) note that distinguishing the specialist component is essential to provide the clinical expertise for the ANP in their specialty as they are required to implement an advanced level of judgment and decision-making in their clinical environment. Consequently, advanced nursing practice requires a distinctive kind of advanced knowledge, one that is identified as knowing in practice that allows modifications and transformations in order to tackle significant matters that are viewed to be valuable and worthwhile (Callahan 2007). The NHS has historically been regarded as a place of care and security for patients, but in recent years this institution has been stunned by the national and local enquiries of the nursing profession in the clinical environment somewhat lacking with regards patient care (Allan amp; Dennis 2010). Increasing complaints about poor attitudes and the unavailability of nurses to provide essential care of patients may be due to the lack of leadership at the ward level and above (Healthcare Commission 2009, CQC 2010, Cox 2010). According to David Nicholson NHS Chief Executive (2009) leadership is essential in the provision of high quality care and clinical leaders should be supported to drive this transformation both locally and across the NHS organizational boundaries. Dr Peter Carter, RCN General Secretary also noted that senior nurses have a responsibility to oversee patient care on a ward. The author believes that this is also true for the ANP as they need to implement their accountability and to act as role models in terms of the values, attitudes and behavior that are vital to nurses. Local evaluations have highlighted the importance of the ANP in augmenting the responsiveness and the efficiency in the stipulation of healthcare and the overall quality of patient care (RCN 2010). The future delivery of health care is a national in challenge for healthcare leaders, and the role of the ANP as a key player is recognized in the drive for a more effective healthcare through their ability to negotiate matters of health and social wellbeing in a diversity of clinical settings, that offers an opportunity to inaugurate nursing roles that are proficient in delivering, as Lowe et al (2010) explains, â€Å"the most appropriate care, in the most efficient manner and in the most suitable setting. As nursing practice has and continues to change from being task orientated to a team nursing approach that incorporate a holistic framework with the ANP accepting the role as a clinical leader by the very nature of the role. However the role of the ANP in the eyes of some critics is that it has arisen from the reduction in the working hours of junior doctors (Carroll 2002, Smith 2003), and could be argued that the role has been developed out of obligation and not from the necessity of professional autonomy in nursing. Barton (2011) concurs that the reality of reduction of working hours and problems in recruitment and retention of junior doctors, together with the deficiency of continuity due to doctor’s clinical rotation, are well understood and the development of advanced nursing practice has, to some extent, been goaded by these issues, though the nursing profession maintain that the development of advanced practice is of a nursing uniqueness (Hodges 2009, O’Brien et al. 009). Callaghan (2007) argues that ANPs inspire and encourage their team to become proficient and competent in the development of their practice, by sharing their knowledge and expertise rather than allowing habitual nursing practice, by personal, professional leadership in individual decision-making or by involving management teams. The encouragement of innovation and change in practice are fundamental qualities of the ANPs in being efficient and effective clinical leaders (Sofarelli amp; Brown 1998) and is commonly seen in provisions of leading a team or being one of the senior members of the team. This is displayed in decisions related to the priority of care, entrusting responsibilities to team members and the supervision of team members and therefore appropriate delegation of their team. Advanced Nurse Practitioners should able to identify their own and others’ clinical progress needs and take efficient measures to address them. ANPs are expected to have implemented a wide range of educational and developmental opportunities that are presented to achieve their advancement in the role, the Department of Health’s Advanced Level Nursing; A Position Statement (2010) suggests that this is not only carried out through formal education but also from the ANP’s own individual practice and the entities they work with. While is it vital to protect patients and public interest, it is essential to have statutory rights prepared to protect the professional interests of the ANP, and by doing so strengthening the role ANP as an effective clinical leader with self-assurance, mettle and belief in developing their nursing teams (DOH 2010). There is ample literature reviews presented with the confusion surrounding the role of the ANP, Mantzoukas and Watkinson (2006) propose that much of this confusion has been substantiated by the interchange-ability of nursing roles, even when the identical titles are used it does not automatically mean that the comprehension that the preparation and practice performance of the ANP are the same. As a result ANPs need to require their attainment of practice autonomy by having a clear understanding of their professional integrity and professional boundaries, within the multidisciplinary team, and give careful consideration to what applies in their particular role, so attaining their accountability to practice as an advanced nurse practitioner.