Models of Nursing for Safeguarding Vulnerable Adults

Models of Nursing for Safeguarding Vulnerable Adults The articles chosen to be evaluated, compared, analyse and reflected upon are Nursing models and Contemporary Nursing: their development, uses and limitations, Nursing models and contemporary nursing: can they raise standards of care and lastly Safeguarding vulnerable adults. The reasons for selecting the topics above are based on exposure to the subject matter in university and familiarity with the safeguarding vulnerable adults during the many years spent working as a Health Care support worker within the community. Most of all, the ultimate reason choosing these topics is sheer interest in finding out how effective the usage of these integral topics can improve holistic nursing practice and give the service user or patients a better experience. Supporting evidence for this report were sourced from various mediums i.e. Through the internet and from credible websites such as the Royal College of Nursing, Nursing Times and article catalogue banks such as CINHL and Medline. Murphy, F; Williams, A and Pridmore, J (2010) Nursing models and contemporary nursing 1: their development, uses and limitation. Nursing Times 15 June, 2010, vol 106, No 23pp18-20. Pridmore J et al (2010 Nursing models and contemporary nursing 2: can they raise standards of care? Nursing Times 21st June, 2010 Vol 106, Number 24. These articles are suitable for the education, training and informing Healthcare Professionals about the prominence of their field. The articles are presented in a good and coherent fashion, this makes the reading experience enjoyable. The two-part series analyses the worth of nursing models and deliberates whether the essential concepts, principles and ethics about nursing in these models are pertinent to contemporary procedures. This first article provided an outline of nursing models; how and why they were established; and some poignant criticisms. The second article examined the models in the framework of modern nursing practice, with specific attention placed on current initiatives intended to reform nursing and to improve the standards of care. The authors of these articles are experienced and seasoned professionals in their fields of expertise. Fiona Murphy, for example, is a nurse who has held clinical positions as a Sister, staff nurse and clinical teacher in acute hospitals nursing all over the United Kingdom. She has taught and lectured at the University of Swansea since 1992 and worked on a variety of undergraduate and post graduate nursing and midwifery programmes. (Dockerty, 2013) Julia Pridmore, is also a Nurse Lecturer and programme manager for BSc (Hons) Health and Social Care at the University of Swansea. Julia has been a practicing nurse since the 1980s. She specialises on quality improvement, governance and patient safety (Pridmore, 2010). Their experience in practice and teaching combined, validates their knowledge of the subject and also authenticate the issues raised in the articles. The authors, gave a very insightful historical background about the technological boom which triggered the development of nursing models in the early 1960’s in the United States, but it failed to examine the reasons why it took more than a decade for the same to be adopted in the United Kingdom. One could be identified with the difficulty in acclimatizing to an entirely different concept, but the impediment to change as described by (Kenny 1993) ‘reflecting on the approach and attitude towards change and the bureaucratic environment of the NHS, also questioned if models really stood any chance at all’. This statement speaks a lot of volumes but completely void of proofs or facts. The National Health Service have been a driver for change and modification since inception. The Nurses Act of 1949, for example was established to modernise the role of nursing by providing the catalyst for modification to nursing education and training, 1940s and 50s saw nurses uniform b egin to become more standardised, in 1955 the nursing auxiliary or nursing assistant role achieved formal recognition and Enoch Powell’s Hospital Plan recommended that teaching hospitals should act as district general hospitals and that student should be taught where patients required treatment in 1962. Prior to the adaptation of models in the United States the National Health Service was in its twentieth year of reformation, one can conclude Kenny 1993 quote on attitude to change and bureaucracy within the environment of the NHS is possibly a hypothesis. Secondly, there were numerous complications in developing the models, the smallest of which was an absence of a definition of nursing. This led to Henderson’s description being regularly quoted, and it shaped the foundation of vast majority of deliberations. There were also calls to go back to the ideas of Florence Nightingale. Henderson defines both the independent and the co-dependent features of nursing practice, and stipulates the affiliation between nursing and medicine. This difference between independent and co-dependent practice is vital to appreciating the intricacy of nursing and its specific influence inside the multi-disciplinary teams within a health care setting. Nightingale’s emphasis on the advancement of health and healing as separate from the treatment of disease, and the harmony of the individual, well-being and the atmosphere, remain essential to contemporary explanations of nursing. Both philosophies and ideas resounds clearly in the models, a good indication of the advancements and strides made since the days of Florence Nightingale. In hind sight, going back on the ideas to reflect the idle of Florence Nightingale would be a complete retrogression, but rather using models as a framework to guide and reform the delivery of care and will directly improve the experience of the patient thereby affirming the professional outlook of the nurse within the healthcare setting. Betts V; Marks-Maran, D and Morris-Thompson, T (2014) Safeguarding vulnerable adults. Nursing Standard. 28, 38 P37-41. This article is suitable for the teaching, preparation and informing Healthcare Professionals about the importance and efficacy of safeguarding the vulnerable within the confines of the hospital and beyond. The article is presented in clear and comprehensible manner, this makes the reading experience very pleasant. The article examines more or less the matters surrounding safeguarding vulnerable adults, it reviews some of the correlated legislation and literature, and outlines the responsibilities of authorities or those who care for these patient groups. The article reveals how one hospital that is specialised in caring for individuals with early-onset dementia, Huntingdon’s disease and alcohol-related brain damage who need supplementary care, has provided staff with fitting evidence-based facts about safeguarding adults. The authors of this article are knowledgeable and experienced authorities in their fields. Virginia Betts Previously a staff nurse at Forest Hospital, Nottingham and presently health visitor student at Derby University, Diane Marks-Maran is an honorary professor of nursing at Kingston University, London and St George’s, University of London, lastly, Trish Morris-Thompson director of quality and clinical governance at Barchester Healthcare, London. Their involvement in practice and education authenticates their understanding of the theme being examined i.e. Safeguarding Vulnerable Adults and also substantiate the issues raised in the article. This is an evidence based literature which draws lessons and references from current events in Winterbourne View Hospital and Mid Staffordshire NHS Foundation Trust. This article failed to explore in to details the avenues of trainings, retraining, and refresher courses to ensure staff and healthcare professional are constantly reminded of the importance of safeguarding the vulnerable. Although, Nesbit’s warning that no structure or system of safeguarding would be able to pledge with certainty that abuse would certainly not transpire (Nesbit 2013) is completely a valid argument. It also very important to raise, continuous trainings and adequate reminders are the key to keeping this all important subject current and relevant to the healthcare professional. With the view of avoiding a repeat of the happening of Winterbourne View and Mid Staffordshire NHS Foundation Trust, the issue of training, retraining and refresher courses cannot be over emphasised. Research and policy guidance advocates compulsory trainings for care home proprietors and executives in view of safeguarding responsibilities. ‘No secrets’ (DH/Home Office, 2000) also mentioned that all organisations must train all employees and volunteers at all levels of hierarchy within their agencies, organisation or companies, with respect to their responsibilities in the adult safeguarding procedures and processes. Kalaga and Kingston (2007) referred to the commendations of the enquiry into the delivery of services for individuals with learning difficulties at the Cornwall Partnership NHS Trust which specified that the Trust must: ‘as a priority, develop a programme of training, supervision and support for all staff which helps them deliver care in accordance with the principles of the Valuing People strategy’. (CSCI/Healthcare Commission, 2006, p 69) Organisations must ensure a safe environment in which all employees are trained in safeguarding, and a uthorities such as managers, supervisors and even team leaders be responsible for systematic official checks of the organisation’s safeguarding procedures, policies, processes and practices. In essence, the evidence presented for Forest Hospital in Nottingham inaugurated in 2013 to deliver expert care for individuals with early-onset dementia, Huntingdon’s disease and alcohol-related brain injury is exemplary, the institution have gone through a great deal of meticulous planning to encourage the retention of information and training pertaining to safeguarding. All employees new to the establishment obtain an information guide and commence e-learning induction sections on safeguarding vulnerable adults, followed by team deliberations on some of the subjects raised on the materials and guides given, and the sections. Throughout the segments and group studies, employees are familiarised with and well-versed on safeguarding vulnerable adults. Responses, feedbacks and questions are given in writing and verbally from employees and shown that employees who had never worked in care homes or anything similar to care found the training on safeguarding adults educational and easy to comprehend. Employees identified that they valued the chance to utilize the learning tools on safeguarding adults in group discussions. They also mentioned that it was extremely beneficial having a written document to which references could be made when needed. This method of training is entirely innovative and worthy of emulation by every institution and NHS Trusts. The only criticism about the training method in Forest Hospital is the fact the authors provided no detail concerning its frequency. It is vital to note, some of the issues in Mid Staffordshire NHS Trust according to the HealthCare Commission was not due to lack of training but rather lack of adequate training. As a firm believer in learning, unlearn and relearning, training a healthcare professional once or maybe twice in his or her career is not enough. Safeguarding just like manual handling require expiration in its certification. This will enable a continuous assessment of employee knowledge and practical skills with respect to safeguarding thereby delivering exceptional service to the patient. In retrospect, one could say the article on Safeguarding focused mainly on physical abuse by so doing leaving a lot of safeguarding issues unaddressed. Abuse may be physical, psychological, financial or material, sexual, discriminatory, or an act of neglect or an omission to act. For example the involvement of exploitation and mistreatment is likely to have a major impact on a person’s health and wellbeing. By the very nature exploitation and utter abuse of power by one person over another has an enormous impact on a person’s independence and most times depresses their individualities, which are a breach of the rudimentary ethos of the Healthcare profession. Neglect on the other hand, was not mentioned, but it can stop an individual who is reliant on others for their fundamental necessities, exercising choice and control over the basic needs of life and can cause embarrassment, humiliation and loss of self-respect. All vulnerable adults have the right to be assisted to make their own choices and to give or deny consent on whatever they please, be it activities or even services. Consent is a strong sign of a readiness to partake in an activity or to receive a service. It may be gestured, verbal agreement, or in writing. No individual can or should give, or refuse, consent on behalf of a different adult except exceptional provision for specific purposes have been made and it generally by law. The main struggle dealing with abuse of vulnerable adults is knowing that it exists, because it’s multifaceted nature. DeHart et al (2009) cross-examined nursing home employees, policy makers and health care professionals to detect training needs of employees. They discovered that those at risk of abuse were residents who are silent, confused and incapable to communicating or those who have few visitors, as well as those who are non-compliant or with challenging behaviours. They proposed that one of the employees capabilities must be the skill ‘to identify residents’ vulnerabilities that increase the risk of their being mistreated’. A key United Kingdom survey of more than 2000 individuals of age 66 and over living in private accommodations and households discovered a variety of risk factors, precise to the category of abuse: The risk factors for neglect encompassed being female from 85 years of age, in bad health or depression and the prospect of being in receipt of, or in touch with, services. The risk of financial abuse amplified for individual living alone, in receipt of services, in bad or very bad health, older men, and women who were divorced or separated, or lonely. The risk of relational abuse (physical, psychological and sexual abuse combined) was greater in women aged 66–74 (O’Keefe et al, 2007). O’Dowd (2007), in reporting on the above research, recommended the discoveries on risk factors, citing that it should be used by local authorities to observe and act on abuse by directing assistance where it is wanted most. Appointing full-time safeguarding leads or introducing training f or all staff i.e. relevant training for all new staff, from auxiliary to consultant level, as part of its induction programme, and another where training is consolidated at handover times to keep it refreshed and serve as a constant reminder at all time. On the Aspect of Nursing Models, Nurses do require a theoretical framework to serve as a guide and support. This is predominantly so now that we confronted economic, demographic and communal variation that will possibly â€Å"value the nurse out of the market. Devoid of using theory to define what nursing is and does, it would extremely stress-free to demote the role of the Nurse to nothing else but just elementary tasks, when nursing is as a matter of fact, a multifaceted, vibrant and thought-provoking role demanding the mixture of understanding , knowledge, skills, familiarity and theory. The usage of nursing theories such as models assist nurses to make the difference amongst the contributions of the medical, nursing and other healthcare professionals and establish the worth of the nurse. Nurses are acquainted with problem-solving methods such as ASPIRE (Assessment, Systematic nursing diagnosis, Planning, Implementation, Recheck and Evaluation). However, methods like this guides in care planning, they are short on detail on how to do it. For example, a problem-solving procedure is less likely to outline questions needs asking in the course of an assessment or the interventions to be made. Nursing model can drastically improve the methods of assessment and deliver better care. (Barrett et al, 2012) Models can play a variety of roles in the career of the nurse. Take for example, the newly qualified nurse, a model will be a very import framework for the care planning process. A proficient nurse will have the ability cultivate their own diverse model, grounded on the fundamentals of different theories that fits their methodology and framework of care. In conclusion, nursing continue to offer challenging roles in dynamic, evolving healthcare environments. However, the competitive workforce means that in order to first attract and then retain nurses, Authorities in Healthcare needs to ensure that practices are contemporary and innovative. It is also important to recognise that Nurses are part of a broader healthcare team and it is appropriate that to consider and assess the best way to work with other healthcare providers to provide quality patient care now and into the future. Safeguarding adults is everybody’s business. Statutory agencies and all who work with Vulnerable Adults have the responsibility to safeguard the wellbeing and safety of Vulnerable Adults in different ways. â€Å"Safeguarding† when viewed in its wider sense of promoting the safety, wellbeing and opportunities of adults forms part of core business for all statutory agencies, for example, ensuring health and patient safety is the NHS responsibility, promoting independence and wellbeing is the responsibility of Adult Social Care, and protecting people from harm is the responsibility of the Police. For all professionals, â€Å"safeguarding† in its wider sense is part and parcel of everyday working life. However, it also refers to a very specific area of work- the reactive inter-agency response to protect Vulnerable Adults who are at risk of significant harm through abuse by another person or persons. Empowerment and choice need to be at the core of safeguarding policy and practice; this means working to enable adults at risk to recognise and protect themselves from abuse. It also means taking a risk enabling approach within services and ensuring that people who use services have genuine choice both of and within services. Bibliography Dockerty, R. (2013). Swansea nurse lecturer writes ‘Major Works’ book.Swansea University, Swansea nurse lecturer writes ‘Major Works’ book. [Online]. Available at: http://www.swansea.ac.uk/humanandhealthsciences/news-and-events/latest-news/swanseanurselecturerwritesmajorworksbook.php [Accessed: 6 November 2014]. Pridmore, J. (2010). Julia Pridmore.  Nursing Times, Julia Pridmore | Nursing Times. [Online]. Available at: http://www.nursingtimes.net/julia- /148596.publicprofile [Accessed: 6 November 2014]. Choi, N.G. and Mayer, J. (2000) ‘Elder abuse, neglect, and exploitation – risk  factors and prevention strategies’, Journal of Gerontological Social Work, vol 33,  no 2, pp 5–26. DeHart, D., Webb, J. and Cornman, C. (2009) ‘Prevention of elder mistreatment in  nursing homes: competencies for direct-care staff’, Journal of Elder Abuse   Neglect, vol 21, no 4, pp 360–78. Department of Health (2010) Prioritising need in the context of Putting People  First: a whole system approach to eligibility for social care – guidance on eligibility  criteria for adult social care, England 2010, London: Department of Health.

Ethics and Regulation in the Professional Asset Management Industry

Ethics and Regulation in the Professional Asset Management Industry 11 December, 2011 Whenever a person is hired to perform a service or look after the interest of another, the question of rules for interactions and transactions behavior arises. This is particularly important for the financial industry were portfolio managers may be entrusted with portfolio value of trillions of dollars , the inherent risks associated with financial investments and the fact that portfolio managers are often exposed to ethical conflicts. Hence, it is no surprise that the financial industry is highly regulated to ensure that there is a minimum level of acceptable practice. Guidelines are built on two legs – formal legally enforceable regulations and ethical standards. Both follow the overall principle that â€Å"portfolio managers will always act in the best interest of their investors†. Legal regulations are complex often with an interaction between state and federal laws. At the very basic level they establish adequate disclosure of information related to the investment process and provide anti-fraud protections. These cover aspects like documentation, reporting, fairness, timeliness and accuracy of information. At a more complex level, regulations cover specific investments types like for example retirement / pension assets that have different risk management requirements. Following are the principal Securities Laws for the Asset management industry and their primary target user: * Securities Act of 1933 for security issuers * Securities Exchange Act of 1934 for security brokers * Investment Company Act of 1940 for mutual funds Investment Adviser Act of 1940 for advisors and private managers * Employee Retirement Income Security Act (ERISA) for retirement asset managers and fiduciaries * Pension Protection Act of 2006 for pension fund sponsors and managers Several agencies / institutions are responsible to ensure these industry regulations are managed and followed: * SEC – U. S. Securities and Exchange Commission (the main federal agency) * U. S. Department of Labor (pension plans inc luding 401 (k) plans) * NASDR – National Association of Securities Dealer rules * U. S. Commodity and Futures Trading Commission * U. S Internal Revenue Services (tax policies) These financial regulations are the â€Å"1st leg† of regulating investor/agent relationships and they provide the legally binding and enforceable framework of conduct. The â€Å"2nd leg† comprises voluntary ethical behavior standards. They follow the same overall principle of â€Å"investors come first† but describe in much more detail how the clients/investors interest must always take precedence over the interests of investment professionals and their employers. Ethical guidelines are the indispensable as they fill a void space. Policies and regulations may punish illegal behavior but cannot prevent such abuses from happening in the first place. Also while some financial transactions may not have violated any laws but could still be to the disadvantage of investors because of unethical behavior. Thus, Ethical guidelines aim to establish a self-regulating, voluntary behavior to prevent abuses before happening and to provide guidance for aspects of financial transactions not covered by formal policies. Leading institute is the CFA, the Chartered Financial Analysts Institute https://www. cfainstitute. org/Pages/index. aspx, previously AIMR – (Association for Investment Management and Research), which established a code of ethics for its members. Key elements are: * act with integrity, competence, diligence, respect and in an ethical manner. * place integrity of the investment profession and interests of clients above own personal interests. * use reasonable care and exercise independent professional judgment when conducting investment analysis, recommendations and taking investment actions. This ethics code is complemented with precisely defined conduct and actions that are acceptable (or unacceptable). The Centre of Financial Markets Integrity founded by the CFA has created a comprehensive â€Å"Asset Manager Code of Professional Conduct† providing more detailed minimum standards for providing asset management services to clients. These standards extend the rules for individuals to those of entire investments firms. Of note, agents and companies strictly adhering to ethical standards may achieve higher trust and preference ratings from investors as well as employees. Therefore, it is in the own interests of financial institutes and agents to be a CFA member and follow their ethics code. However and despite these wide-ranging regulations in place investors’ interests are not always followed. Two reason fall mostly in two categories 1) Ethical dilemmas: these are situations where the â€Å"investor interest† evaluation is not straight forward, therefore posing an ethical dilemma for the agent. Examples include where an agent may occur expenses for costly company research or other expenses which may not be clearly to the benefit of the client. ) Guidelines must be put into daily practice. A policy by itself is not sufficient to achieve compliance. The responsibility is with the leadership of financial companies by creating a corporate culture that reinforces ethical behavior, by always leading with best example and by establishing a regulatory compliance framework with capability trainings, frequent internal communication, and by stric t enforcement. Closing remarks Much progress has been made in updating and raising the standards of legislation to be more comprehensive and to avoid a repetition of historical financial crisis. However, no matter how detailed regulations may be â€Å"the question really boils down to staying true both the spirit and the letter of the law. † (Carlo V. di Florio) This is the reason why ethical codes such as provided by CPA are a critical complement to legal regulations as they provide behavioral guidelines. In fact, efforts are being made to make the ethical behavior standards legally mandatory. 913 study submitted in 2011 for the Dodd-Frank act as well as FINRA and the code framework itself is in a constant process of updates and expansion (e. . the Shingle theory). This is encouraging and will provide further guidance â€Å"how to put the investors’ interests first†. The investor is playing an important role in the process as well: Being very specific about individual investment priorities, by selecting only CPA proven financial partners and, last not least, by staying in close contact with the agent to ensure the steady flow of information. After all à ¢â‚¬â€œ asset ownership also carries the owner responsibilities. References Brown,C. , & Reilly, F. K. (2009). Investment Analysis and Portfolio Management. (9 ed. ). Mason, OH, Cengage Learning. Carlo V. di Florio, director of the U. S. SEC’s Office of Compliance Inspections and Examinations (OCIE). downloaded on 08 December 2011, http://blogs. cfainstitute. org/marketintegrity/2011/11/30/fatally-flawed-compliance-without-ethics-in-the-investment-industry/ Carlo di Florio, Harvard Law School Forum on Corporate Governance and Financial Regulation, Nov 25-2011, downloaded on 08 December, http://blogs. law. harvard. du/corpgov/2011/11/25/compliance-and-ethics-in-risk-management/ â€Å"913 Study†: Study on Investment Advisers and Broker-Dealers as Required by Section 913 of the Dodd-Frank Wall Street Reform Act (January 2011), downloaded on 8 December 2011 http://www. sec. gov/news/studies/2011/913studyfinal. pdf Jon Stokes â€Å"Fatally Flawed: Compliance without Ethics in the Investment Industry† (30 November 2011)  · Enterprise Risk Management- Integrated Framework, Com mittee of Sponsoring Organizations of the Treadway Commission (September 2004)

Importance of English Education

A language is a systematic means of communication by the use of sounds or conventional symbols. It is the code we all use to express ourselves and communicate to others. It is a communication by word of mouth. Language is something specific to humans, that is to say it is the basic capacity that distinguishes humans from all other living beings. Language therefore remains potentially a communicative medium capable of expressing ideas and concepts as well as moods, feelings and attitudes. In general, the most popular language is English. In this computer age, English is the only language that any one can understand. So to say, it has become as an ideal language for expressing our feelings. As we know that we are living in the world of globalization. English language is a common language and is spoken in many countries. No one denies the importance of English language in the present time as global language. It is clear that the English language has become more dominant around the world. There is no doubt that, the English is language of communication between the people with different cultures . It is also the language of computers that help to communicate with the people around the world through Internet technology and e-mail. One of the main reasons why the English is dominant in the present time is that it is used in the field of education by universities and institutes and, they use it in scientific research. On the other hand, the English is an important requirement in most government jobs and private. English is important because for its use in different fields like: Travel Languages differ from country to country and from region to region. Thus, if we happen to travel to another country, either for business or leisure purpose, we are sure to land ourself into great trouble, in case we are not conversant with the native language. In such circumstances, English becomes a great help for us as it is a global language spoken by more than 900 million people across the globe, either as native language or second language. Familiarity to English can get us to communicate with anyone and everyone where we travel, by easily handling the situation. Education People not only travel to places worldwide for business and pleasure, but they leave their homeland and travel to another country for study purpose as well. Travel to any country on this earth and you would find English as the main medium of teaching, as it is practically impossible for a new person to study in the local language of the country. Most of the universities worldwide include English as one of their major subject. English is the first and foremost criteria whether we are applying for a job or we are seeking admission in a reputed college/university/institution. Hence, education has increased the importance of English to a great extent. Internet Though internet has developed into various other languages, English still remains as the main language for most internet users. Most of the information and websites are available in English only and it becomes very difficult to translate every appropriate page into the language of the concerned country. With the growth of the internet into education and E-commerce, English language is sure to grow. Hence, we can say that English language is the most important language in the world which is used in different fields,in which usage of other language is not only difficult but nerly impossible. So, it is known as universal language that is spoken by people all over the world.

The Postal Service ( Usps ) - 1433 Words

This paper provides documentation published research found online (Internet) and offline (non-Internet), along with face to face interviews (FtF) with employees to the second oldest federal agency the United States Postal Service (USPS). The USPS continues to struggle financially and has not shown a profit since the year of 2007. Congress continues to place pressure to privatize the postal service and to run like any other organization. Unlike other for profit organizations and businesses the USPS receives benefits from Congress such as bailouts when they cannot meet payroll, and are exempt for paying federal and state taxes. On the other side of the coin, the Postal Service must go before Congress with any modifications or adjustments to the way the organization is run and managed. Additionally, any requests must be supported with a host of reports and studies from the Government Accountability Organization (GAO) which can take up to six years for documentation. Mission of the Postal Service â€Å"The Postal Service shall have as its basic function the obligation to provide postal services to bind the Nation together through the personal, educational, literary, and business correspondence of the people. It shall provide prompt, reliable, and efficient services to patrons in all areas and shall render postal services to all communities. The United States Postal Service is an independent establishment of the Executive Branch of the Government of theShow MoreRelatedThe Postal Service ( Usps )1541 Words   |  7 PagesAbstract Since 1971, the U.S. Postal Service (USPS) has been a self-supporting government agency that covers its operating costs with revenues generated through the sales of postage and related products and services. The USPS is experiencing significant financial challenges. After running modest profits from FY2003 through FY2006, the USPS lost $41.1 billion between FY2007 and FY2012. 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