Understand business objectives from an ethical perspective Essay

Understand business objectives from an ethical perspective - Essay Example business objectives are important things that owners can share with their company staff, they are statements that comprise of specific, realistic and measurable goals, which have certain periods that any business has to strive to stick to. In order to achieve its objectives rightly, there are important measures a business has to refer to in its quest to achieve set objectives, these are the business ethics. Business ethics refers to a certain kind of applied or professional ethics, whose role in business is to make an examination of the manner in which moral values are followed in the business environment (Audi 2009 67). It is important that a business, having set its objectives, devise ethical values to govern the manner in which it conducts its internal and external activities in achieving its set objectives. Business ethics defines the manner in which a business treats its staff, manages their affairs and responds to arising issues satisfactorily. At the same time, business ethics plays an important role in the way a business relates with its external environment, it ensures that competition is done in the best interest of all players in the industry. If a business fails to observe business ethics, then it is bound to affect its internal and external business operations including a possible confrontation with its stakeholders. Pfizer being a global company; it has a global vision of researching, manufacturing and delivering medicines for all people around the world. In this understanding, the company has created a statement upon which it operates, that is, â€Å"good health is vital† to all people. It has a major corporate objective of producing medicines that can prevent several diseases, currently; the company is working extensively to produce medicines that can cure and prevent some of the world’s most terminal diseases like Alzheimer’s and cancer among others. Following the need to fulfill a wide range of health needs for people across the world,

Special interest Essay Example | Topics and Well Written Essays - 1250 words

Special interest - Essay Example One kind of an interest group is that which takes the form of political groups; the aim of the creation of this kind of interest group is to influence people in the political arena to create policies that favor the interest of a political interest group. One such interest group is Texas Medical Association, this group is said to be the largest medical association that has been operational for years with the aim of representing over 46,000 physicians and other individuals related to the field of medicine (Newell, 2009, p.92). Interest groups often derive their strength from their membership. Some of the largest and most powerful interest groups in the nation include the American Association of Retired Persons (AARP). This association has a membership of over 32 million persons. With this kind of membership, pushing for championing of certain interest is not very hard. Other equally influential interest groups include the National Rifle Association (NRA), AFL-CIO and American Medical Association (Chapter 11, n.d). The relationship between interest groups and political groups is a very close one and it has been in existence for a very long period of time. Both these groups are defined to conduct separate functions in a particular nation (Bardes, 2012, p.224). A party has the task of ensuring candidates are elected for various public positions after nominating them. On the contrary, interest groups focus on the policy side of the political environment, where they try to influence the policy decision making process. Even though both these groups are defined to have different operational functions, they have a strong relationship which has lasted for quite a long period of time. For example, interest groups such as environmentalists have close ties with a particular state’s democratic political parties. The close alliance

The Ritz Carlton Hotel Company In Jamaica Tourism Essay

The Ritz Carlton Hotel Company In Jamaica Tourism Essay Introduction Executive Summary: Ritz Carlton was founded by Mr. Cesar Ritz who initially worked in finest Hotels and restaurants in Paris. He owned grand Hotel Ritz and within one year he expanded wings in London and opened Hotel Carlton which became Ritz Carlton Hotel Company. He believed in excellent personalized services which satisfied the discerning guest. Ritz Carlton expanded to North America and ownership changed during 1983 to Johnson Company. During 1983 1987 Ritz Carlton expanded domestically and internationally under new ownership.  [i]   During 1997 Marriott International purchased Ritz Carlton and by 2000 it became primarily a management company operating 38 Hotels and resorts worldwide with minority stake in 10 properties and outright ownership of 3 hotels. The company used to obtain management contracts for new hotels and resorts around the world. Over the years hotel conglomerate won acclaimed for its services and had been awarded Best Hotel in Asia Pacific in the eight Business Traveler Asia / Pacific magazine Travel Awards Subscribe Survey and for two consecutive years Best Business Hotel in Malaysia. The Ritz Carlton Hotel Company for the first time now wants to open a hotel in historic Foggy Bottom district of Washington D C in Multi Use facility complex owned by Millennium Partners. The Hospitality Complex is 162 Luxury Condominiums, sports club, splash Spa, three restaurant, and 40,000 square feet of street -level restaurants and retail shops and 300-room hotel. Millennium partners founded in 1990 that set up high end luxury apartments and Lincoln square four building complex in New York was their first project and exhibited their future intensions. Millennium partners ended up in hotel business. In this case study Essence of Ritz-Carlton experience, the Ritz-Carlton selling, how the Ritz-Carlton creates Ladies and Gentlemen in only 7 days. Also McBride, Ritz-Carlton GM, to lengthen the amount of time spent on training hotel employees before hotel opening. McBride should consider a total overhaul of the hotel opening process. Products and Services Ritz-Carlton Hotel Company develops and Operates luxury hotels. Hotels are designed and identified to appeal to and suit the requirements of major customers including meeting event planners, Business travelers and leisure travelers. Ritz- Carlton set out to open any new hotel Ritz-Carlton including detailed analysis of site selection, new product and service development and feasibility study. The detailed analysis also includes target customers, their needs and expectations. The each hotel customized to meet local market demand. Innovation through make use of latest technology for enhancing customer satisfaction level Link restaurant services through internet KobaltExpress.com. It allows customers to decide menus ahead of time and also select the choice of table. Differential aesthetic look and best quality interior was few of the additional features. Core Values Business Model Following are the core values and Business model exist at Ritz Carlton: Core values: Trust, honesty, integrity and commitment. A great emphasizing on human resources, believes it important and biggest assets Foster work environment to fulfill individual aspirations Focus on Service but not sales Guest greets at Airport with mimosas and discount coupons on a silver tray Airport check in concierge Techno savvy to ensure customers needs satisfied Event Planners Ritz -Carlton managed properties for Millennium partners who were one of several hotel owners. Ritz Carlton charged management fees of 3% of total revenue besides wholly owned luxury hotels around the world. The customer segment was Independent travelers and Meeting Event planners. The key success indicators of hotel business were Average Daily Rate and Revenue per Available Room. Independent travelers were influenced through special services like providing discounting coupons at airports, created hotel room at airport and also introduced Technology Butler. The specialized services increased customer convenience and outpaced the competition. The nature of services is perishable and individual travelers are aiding in profitability. The event business / meeting business are growing and desirable for the sustainable profitability. The management contracts tend to meet needs of owners and operators. Quality at Ritz Carlton: Ritz Carlton has a great emphasizing on human resources. Robust HRM practices envisage right people for the right job and inducted to become perfect lady and gentleman. The total quality management philosophy began to permeate the organization. Company focused on new activities and measures including quality standards, continuous improvements for delivering better service quality. New programs designed to meet customer specific need and service quality indicators. The Quality policy believes in Exceeding Standards. Warm and sincere greeting, anticipation and compliances of guest needs and warm good bye are key service steps. Human resources at Ritz Carlton: Human resources is critical element in the process for understanding of the service to be delivered and priorities in doing so, are aligned closely with customers expectations and marketing communications by the organization. For managers, the service climate needs to support and reward employees in their efforts to deliver the service product reliably at the promised standard. The value creation for customer If the customer perceives quality of the service to be higher than the cost incurred, the customer receives value. The greater the difference between the quality of service and the cost, greater will be the satisfaction or dissatisfaction. Ritz Carlton turnover rate was 20% compared to hotel industry average rate of 100%. This exhibits how Ritz Carlton cares about their employees and viewed their employees as one of the important and biggest assets and has passion for the people. Ritz Carlton nurtured and maximizes talent of each individual. Through the extensive formal and informal training employee were prepared to meet current obligations and also higher responsibilities in future. Employees were also trained to meet futuristic obligations and encouraged to cross train and learn about many different aspects. Performance was not only criteria but also managed by the employees themselves. Employees monitoring their own performance and recognized for outstanding work. Staffing: To minimize failure in delivering services, key HRM practices like employee recruitment, selection and training focused and implemented. People having aptitude, talent and attitude to serve people, training schedule made sure to shape out staff for delivering exceptional services. The key of maintaining exceptional service standards was to keep high morale and motivation of each employee. Various tools were used to attract applicants for the various positions include visiting competitors restaurants, advertisement in news papers and visiting hospitality schools. Ritz Carlton job fair was organized for mass recruitment. Aspirants treated well including convenient reaching to destination of job fair, offering snacks and beverages, make them aware about organization. Service Oriented Approach of Ritz-Carlton The customer service oriented approach has three elements: For whom services and products created who will deliver and how will be delivered. Customer Value Customer relationships and customer loyalty Different communication and pricing strategies Assessment of customer satisfaction and complaints Making customer value more tangible People Role of employees in value creation Nature of competencies required to deliver services Empowerment of employees Reduction of stress Operations and Technology Designing processes to create value Design and location of facilities Role of technology Capacity management The Ritz Carlton having different value and philosophy in business which includes and they operate The Credo, The Motto, The Three Steps of Service, Service Values, the 6th Diamond the Employee Promise. The company is engage in the services oriented which have the unique characteristics for providing the services in order to meet the expectation of the customer. Some of the highlights have been captured depicted below:- Excellence in service not in Selling The Ritz-Carlton Philosophy states as they are not in the hotel business. The Ritz-Carlton is selling an experience, and experience that is based on excellence of service. As stated by Schulze, We are not in the hotel business. The hotel business is about selling rooms, selling food, selling the bar. We do those things incidentally, but our business is service. We charge for service. Our commitment to our customers is excellence in service. Their commitment to customers is excellence in service. Service is their profession. The total service oriented approach. The Credo The Ritz-Carlton Hotel is a place where the genuine care and comfort of guests is the highest mission. Pledge to provide the finest personal service and facilities for guests who will always enjoy a warm, relaxed, yet refined ambience. The Ritz-Carlton experience enlivens the senses, instills well-being, and fulfils even the unexpressed wishes and needs of guests. Motto At The Ritz-Carlton Hotel Company, L.L.C., We are Ladies and Gentlemen serving Ladies and Gentlemen. This motto exemplifies the anticipatory service provided by all staff members. Motto of the company, Employee commitment, The credo, employee promises and twenty basics are gold standards and success mantras. Gold standards reinforced on daily basis in order to build the habits of employees to deliver the highest level of services The three steps of service,- A warm and sincere greeting. Use the guests name. Anticipation and fulfillment of each guests needs Fond farewell give a warm good-bye and use the guests name. Service Values: Employees feel proud To Be Ritz-Carlton as they have opportunity to do following which gives them job satisfaction. The Ritz Carlton is known for service excellence and follow following principals to provide excellent service to their customers.. 1. Employee satisfaction. 2. Leadership involvement. 3. Determination, commitment, and accountability. 4. Attend to voice of the customers. 5. Two-way communication. 6. Freedom to act. 7. Employees as ambassadors. 8. Adapt service recovery model (L.A.S.T.: Listen, Apologize, Solve, and Thank You.) 9. Anticipate needs. 10. Scripting to convey the right message  [ii]   The 6th Diamond is Mystique, Emotional Engagement Functional , these all cared by Ritz- Carlton and known 6th Diamond. Employee Promises At The Ritz-Carlton Ladies and Gentlemen are the most important resource in service commitment to guests. By applying the principles of trust, honesty, respect, integrity and commitment, they nurture and maximize talent to the benefit of each individual and the company. The Ritz-Carlton fosters a work environment where diversity is valued, quality of life is enhanced, individual aspirations are fulfilled, and The Ritz-Carlton Mystique is strengthened.  [iii]   Creating Service Oriented culture through orientation Servitisation approach means bundling goods services and makes a integrated package. This approach more focus on associated services than product Four steps in creating servitisation approach:- Knowing your customers Organizing service delivery systems Making sure employees have appropriate skills Employing technology A services discipline is defined by the following main features: The benefits it offers to customers The need to integrate, manage and deliver processes The importance of establishing and maintaining relationships The Ritz-Carlton As a premium hotel whose utmost mission is to provide genuine care and comfort to guests, The Ritz-Carlton pledges to provide the finest personal service and facilities to the guests who will always enjoy a warm, relaxed yet refined ambience.And this objective can only be fulfilled by satisfied and engaged employees. The three goals of Ritz are financial results, customer satisfaction and employee satisfaction. These goals are not exclusive from each other. They are very closely interrelated. Without satisfied and engaged employees, there is no way to achieve excellent financial results and guest satisfaction. To ensure such high service standards, Management team look for people who will fit the existing culture and see the following qualities in the people. People who share the same values and purpose. People who care for and respect others. People who smile naturally. People who seek a long term relationship. People who have talent for the job Process of Ritz to create Ladies and Gentlemen in only 7 days The seven days countdown was formulated for hotel opening process which was refined during in the process of last several years , this was the new employees first encounter with hotel, which started exactly seven days before the grand opening of the hotel. The first two (2) days were devoted to orienting employees to the company culture and values. The next five days were devoted to more skills training and trial runs of service delivery. To ensure that employees are get aligned with organization mission and core values. Trainers from 23 nationalities The orientation process is slow and thorough, and ensures that the employees are aligned with the organizations mission and a great deal of focus is kept on the conveying the values of the organization. The trainers for the orientation program are gathered from 23 different countries, all considered the best of the best in their role within the organization. These trainers are responsible for ensuring that each employee is at the required level or standard in their specific job function at the hotel. Schulze addresses the new team by stating, You are not servants. We are not servants. Our profession is service. We are ladies and gentleman. We are ladies and gentleman and should be respected as such. He conveys a message of unity, a message of equality and team work during his address, and he again insists that We are ladies and gentleman serving ladies and gentleman, as per the Ritz Carlton motto. The Ritz-Carlton employed the Gold Standards to ensure this message was communicated effectively to all employees; the Gold Standard included The Credo, The Three Steps of Service, The Motto, The Employee Promise and the Twenty Basics to ensure employees were focused on the organizations values. Through continuous communication and brain storming session and directives from top to down level and intensive training, skill development and an aligned HRM strategy, within 7 days the Ritz-Carlton managed to create ladies and gentleman out of their employees. The steps for making Ladies and Gentleman Training and daily line-up: During the first two days employees were aware, trained and dipped into the culture and values of the organization and remaining five days devoted to specific skill training and trial runs of service delivery ensuring everything perfect and meeting service standards. The orientation process ensures aligns the worker with the mission of company and ensured service philosophy ingrained in all its employees, they ingrained the message that all employees are in the service business and not the hotel business. The executive team and Human Resources explain The Ritz-Carlton Credo, Employee Promise, and 12 Service Values. After that, they will receive 30 days of training from a certified trainer from the department. On Day 21, new employees are asked to give the management feedback on how they can improve their training program for future training and recertification. In addition, every employee gets a minimum of 130 hours of training every year, which spans training for his or her department, company culture, and language and computer skills. Day 365 is recognition of one year of loyal service and is an opportunity to reinforce the hotels culture. Every employee will also go through annual recertification after they pass written tests, role-play and interviews on culture and skill. Daily line-up is a daily briefing to reiterate the companys standard and convey important business messages. It takes place every morning in each department. While each department may conduct briefings differently, the message they convey is the same worldwide: they will talk about one of the 12 Service Values. Listening and communication: Communication is important and creates abundant opportunities to interact with employees beginning with the interview and continuing through monthly breakfast meetings and his daily rounds of the hotel: Human Resources also holds a monthly feedback session with randomly selected employees for 1 to 1.5 hours to discuss their concerns. Overall, every employee has one opportunity every year to speak with the General Manager or HR Director in private. In addition, the hotel conducts annual employee satisfaction surveys, and on an ongoing basis, collects opinions on employee issues and posts them in public areas identifying those responsible for solving them. The executive team then notes the number of issues solved and measures the satisfaction of the employees. Empowerment and continuous improvement: Employees are also encouraged to be innovative and creative when it comes to improving their jobs. Money is not the key motivator; employees are rewarded for improving the goals measured by guest satisfaction, financial performance and employee satisfaction at year-end. Employees are rewarded and recognized for their outstanding customer service.  [iv]   Information support: Through their numerous interactions with guests throughout their stay like check in, room service, and housekeeping, employees continuously record guest preferences and needs in Guest Preference Forms. Every night, such preferences and needs are entered into The Ritz-Carltons worldwide database Project Mystique, so whenever guests make a reservation at a Ritz-Carlton hotel, their needs and preferences are known and taken care of. Reward and recognition: At The Portman Ritz-Carlton, employees are recognized and rewarded both financially and non-financially. Mark DeCocinis believes if you want your people to be the best, you must pay them top market salaries. While money is not the key motivator, employees are rewarded for improving the goals measured by guest satisfaction, financial performance and employee satisfaction at year end. Employees are rewarded and recognized for their outstanding customer service. Every quarter, a Five-Star Employee Award is granted; with the winner receiving a five-night stay for two at a Ritz-Carlton anywhere in the world, along with round-trip tickets for two and US$500 allowance. At Ritz -Carlton human resources are very well planned they treat with hospitality. As per their President who says you are not servant. We are not servant. Our profession is service. We are ladies and gentleman, just as the guests are whom we respect as ladies and gentleman. If you impart such culture be sure you will create ladies and gentle to serve. Give the respect take the respect, which costs nothing only wins, the heart of the customer who is taking the service will have regards for the service provider. Employee orientation schedule Employee orientation is key part of the training and development process which introduces employees to the jobs, colleagues and organization. Researchers have found that formal orientation can achieve significant cost savings by reducing anxiety of new employees, fostering positive attitudes, job satisfaction and sense of commitment at the start of the employment relationship. The 7 day countdown was a Hallmark of Ritz Carltons well defined hotel opening process which synchronized all steps leading to the opening of a new hotel.  It was Ritz Carltons orientation process aimed at aligning the employee with the vision and mission of the organization. The 7 day orientation process was standardized and ensured that Ritz Carlton has the right employees to support its vision which was Excellent Personalized Service. The seven day countdown was a worldwide best practice for the organization but in our opinion McBride should lengthen the 7 day countdown because of the following reasons: Current difficulty faced in training new hires to meet the high expectation of Ritz Carltons standards in only 7 days. An increase in the training period would help employees understand their role in achieving the key success factors and creating the The Ritz Carlton Mystique. By lengthening the 7 day countdown the service could become flawless which in turn could help translate the 5% dissatisfied customers to satisfied customers. This would result in occupancy going up from 80% to 88% due to increase in satisfaction level translating to $300 million. Extending the 7 day countdown means investing in long standing excellence in areas such as employee orientation and customer oriented training resulting in increased customer engagement and satisfaction. Research on guest-spending patterns indicates that a four percent increase in customer engagement company-wide would generate an extra $40 million in incremental revenue. Employees morale is boosted as they are protected from feeling overwhelmed. A longer employee engagement would also mean further decrease in the annual turnover which stood at 18%. Adults by virtue of having lived longer accumulate greater volume, knowledge and mind-sets. It would help to have more time for the employees to o un-learn and learn new things. Continuous improvement was absolutely critical to keep the commitment to customer for excellence in service and extending the 7 day countdown would help the process. Would help thwart competition from The Four Seasons by offering flawless service which can be achieved by increasing the orientation period. Would help meet the expectations of the Millennium Partners about this hotel offering great great service which means it expected Service par excellence. Thus we believe that Ritz Carlton should therefore increase the length of the orientation to further ingrain service excellence in its new employees which will ensure higher productivity and foster competitiveness. An assessment of 7 days vs 14 days training program 50% occupancy revenue = $5,000,000 Cost of the 7 day training program = $10,00,000 (estimated) 80% occupancy revenue = $8,000,000 Cost of the 14 day training program = $20,00,000 (estimated) Benefit of the program = 3,000,000 Additional Cost = 1000,000 Return On Investment = 300% Every investment including investment for employee training associated with cost and benefit. The cost and benefit mean cost involved in training of employees, direct revenue benefit, intangible benefits. The increase / decrease training schedule also adversely / favorably impact. Ritz Carlton is well known name to the industry and known for service centric approach. Initial Occupancy may not affected by training period but message of customer care approach need to be ingrained. Local culture also affects the training schedule as behavior of individual employees need to framed up in line of the global approach. Change in hotel opening process Change is part of life. World scenario is becoming dynamic and industry is coming up with innovative products to lure customers. In order to stay ahead in competition, Ritz Carlton also need to think differently. The entire training module, customer expectancy needs overhaul of the hotel opening process. The defects need to eliminate within shortest time frame.. Additional training and development will increase the cost but it will build up confidence and set new industry bench mark. Ongoing operation is very different from the opening a new hotel. The opening hotel require two core competencies One is dealing with the development of the site. Human resource processes necessary to get the hotel up running. Ritz-Carlton regarded employees as the cornerstone of its exceptional service culture. The company understood that, as a service organization, the quality of its end product was only as good as the people providing it. Therefore it took care to see that it not only recruited the right kind of employees, but also provided them with the necessary inputs to enable them to provide exceptional service. Although Ritz-Carltons salaries were not significantly higher than those of other comparable organizations in the hospitality industry, the company was a preferred employer because of its organizational culture and the way it treated its employees. Ritz-Carltons organizational culture not only helped the company provide exemplary customer service, but also created an atmosphere where employees felt valued. It is difficult to train new hires to meet the high expectation of the Ritz Carlton service standards in only seven days, but it worked in Ritz Carlton. Training should not be longer which will not be cost effective in the short span of the time. The employees already working should be given chance to in the second opening millennium to avoid taking risk at the opening itself. Recruitment should be done for the Ritz Carlton not for the millennium because the employee can be transferred as per the requirement. The employees of the Millennium partners can be taken for the opening, as the partners employees will feel proud to work jointly as a team. This will give opportunity to the partners employee who knows the brand fame of the Ritz Carlton by giving the Ritz Carlton basics. Ritz-Carlton management takes the following four steps to ensure that employees maintain the companys high standards for quality and service Excellence, as articulated in the Gold Standards: (i) rigorous employee selection process, (ii) employee orientation, (iii) employee training certification, and (iv) continuous coaching. Conclusion: The service industry is becoming more competitive. Global aspirations and technological innovations are challenges for the industry. Customers are loyal to the services rather than company. The services need to revisit and provide latest offers. Worlds best organizations believe in beating their own standards and developing innovating products to serve and win customer hearts. 100 % employee pride Joy, Zero customer difficulty and 100% customer loyalty are performance criteria of performance excellence set by Ritz Carlton Hotels. The road map created for performance excellence through strategic planning, leadership, Human resources, Processes Systems, customer focus, information analysis finally business results. Employees groomed and equipped to exceed (Not meet) customer requirements. Regular updating training needs, deliverance evaluation, PDCA (Plan, Do Check, Act) and Z- back approach; unlearning learning approach aided in meeting industry challenges.

Drugs Essay -- Pharmacokinetics, Lasix, Water Pill

Lasix Pharmacokinetics Lasix is known as the â€Å"water pill† it’s a diuretic administrated orally.(1) The active ingredient of Lasix is furosemide, but also includes a number of inactive ingredients including lactose monohydrate NF, magnesium stearate NF, starch NF, talc USP, and colloidal silicon dioxide NF. (1) The peak effects of furosemide are typically seen within the first hour of two after a dose of the medication. (1). Lasix is prescribed for individuals to treat edema that may arise from congestive heart failure, liver cirrhosis or renal disease. (1) In adults, furosemide may also be taken to treat hypertension itself.(1) Furosemide comes in 20, 40, and 80mg tablets as well as oral suspensions.(2) Furosemide is absorbed rapidly from oral suspension at 50 minutes, and from tablets at 87 minutes.(2) Food may slow down the absorption of the drug and alter the bioavalibitly.(1) Furosemide binds to plasma proteins, albumin being the main plasma protein that furosemide binds to, at 91-99%, and peak plasma concentrations increase with the increase of a single dose.(2) Furosemide is excreted through the urine and the remainder is excreted in the feces. (2) The half-life for furosemide is approximately 2 hours but the diuretic effects last 6-8 hours. (2) Dosage Schedules and Routes of Administration Furosemide is available in tablets, sublingual tablets, oral suspension, and intravenously. (2) The recommended schedule dose for adults for an initial dose is 20 to 80mg. (3) The same dose as well as higher doses may be administered 6 to 8 hours following the previous dose if needed. (2) When titrating doses it may be raised by 20 to 40mg but not within 6 to 8 hours after the initial dose, and this may continue until the desi... ...hat makes the length of time the the medication is active much longer. (1) After opiates bind opiates are bound to the receptor a messanger such as cyclic AMP express the symptoms that are shown.(1) Mechanism of Toxicity Buprenorphine is contraindicated in patients with patients who opiate agnoist hypersensitivity.(1) It has been shown that CNS and repiratory depression macy occur with therapeutic doses of buprenorphine and can increase with ethanol intoxication.(1) Buprenorphine increass the tone and decreases the contractions of smooth muscles of the gastrointestinal tract resulting in constipation.(1) The metabolism of buprenorphine is directed by CYP3A4 isozyme, when administer with protease inhibitors it may decrease the clearance of buprenorphine.(1) This will increase the the levels of the medication in the plasma and can experience toxic effects(1)

Discuss Theories of Communication

P2: Discuss theories of communication. Part A The communication cycle is a commonly used theory of communication. It was first developed by Charles Berner in 1965; it was then modified by Michael Argyle, who was a social psychologist, in 1972. The concept of a ‘communication cycle’ makes it clear that, in order to have effective communication, it must be a two way process. As well as transferring messages to others in a definite, clear way, health care professionals must be able to respond to the verbal feedback as well as the non-verbal feedback.So, effective communication has to involve effort from both participators (both the sender as well as the receiver) in the communication. The communication cycle has six stages. Stage one is when ideas occur, this makes us think and assess the situation that we are in before we start to communicate. We need to think about what we are trying to say, and how to say this in a clear, effective way. Stage two is when the message is c oded and here we have to be aware of the different methods that we can use to send our message.We should try and consider the most effective communication method depending on the situation and the person with whom we will be communicating. Stage three is when the message gets sent. We need to make sure that we have chosen the most effective method of communication, and that we have used this communication method in the most correct way. We should not try and rush the message being sent because that could cause misunderstanding between the two people who are communicating. Stage four is whenever the message gets perceived by the receiver.The service user has to make sense of the message given to them. As health care professionals, we should be aware of the potential difficulties and be aware of how to take steps in order to lessen these difficulties. Stage five is when the message gets decoded. The service user tries to make meaning of what you have just communicated to them. Here, w e have to clarify and check out how much of the information is being understood. This clarification should be carried out on a continual basis, not just at the end of the conversation.Finally, stage six is whenever the message gets understood, and then the receiver of the message then becomes the sender of the new message in the form of feedback. You must allow plenty of time for feedback, remembering that it will be both verbal and nonverbal; this involves listening with your eyes, ears and body language. Part B Mrs Hedges is a resident in a nursing home. Recently, her hearing has declined and she now relies on a hearing aid to enable communication. Three weeks ago, Mrs Hedge’s granddaughter was involved in an accident and since been in hospital.Her family have been reluctant to tell Mrs Hedges of her granddaughter’s condition as they do not want to upset her. Mrs Hedges was used to seeing her granddaughter on a regular basis; she often popped in on her own to spend t ime with her granny. Mrs Hedges has started to worry about her granddaughter and the family have asked that you help them break the news. . â€Å"A relationship without communication will definitely fail. If you attempt to have a relationship without communication, both people involved in the relationship will have different goals and objectives. ANGEL, G, 2010. Title [The importance of the communication cycle]. [16. 10. 12]. Available from World Wide Web : <http://www. helium. com/items/1746915-communication-cycle> The importance of the communication cycle cannot and should not be underestimated. Below, I am going to discuss why I think it is important to follow the communication cycle and why it is important for effective communication. The sender should be aware that the person with whom they will be communicating is hard of hearing, and are wearing a hearing aid.The dispatcher of the communication should be able to select the most effective form of communication in order to communicate the message at hand. The sender must think about how to communicate the message in a sensitive way that the receiver will understand. The communicator should be on the same level as the receiver of the communication; this allows the receiver (Mrs Hedges) to read facial expression and, if possible, lip read. Being on the same level as the receiver of the communication, also allows them to focus and listen more efficiently.The speaker must thoroughly think through what he or she is going to say, and the method in which they want to say it. They must evaluate and decide whether to use verbal or nonverbal communication, or a mix of the two. If they have chosen verbal communication, they must figure out a way to communicate in a non-patronising way that will still be as effective. If nonverbal communication is chosen, the correct method of nonverbal communication should be chosen. Effective communication must happen in order to meet Mrs Hedges’ needs, to help her fe el re assured, safe and secure.In this particular case, I think that a mixture of both verbal and nonverbal communication is requisite. Using speech along with caring and reassuring touch will be effective in making Mrs Hedges feel cared for and safe. The communicator should speak in a normal fashion that Mrs Hedges will not find condescending, but that you speak in a slightly slower pace than usual; this makes your speech clearer. Communicate the message to Mrs Hedges at a time when she is least likely to be tired, as when you are tired, your hearing is decreased anyway.Verbal communication is so important, especially when delivering such a delicate message, so make sure to use simple, short sentences, and make sure that MRs Hedges has understood, you could do this by asking questions such as ‘are you following me? ’ or ‘Do you have any questions, Mrs Hedges? ’. If she hasn’t understood the message, refrain from repeating the same sentence over agai n, instead the sender of the message should try re-phrasing the sentence. Nonverbally, facial expression and hand movements, body language and touch are vital.If Mrs Hedges gets upset, it is important that the communicator re assures her by caring gestures, such as gentle, friendly touch, the carer could put their hand on Mrs Hedge’s shoulder, to comfort her. The carer must be able to communicate effectively to Mrs Hedges so that Mrs Hedges fully understands the message. This is also important as it is useful to know how to effectively communicate so that Mrs Hedges’ needs are met and that she feels safe, secure and re-assured. This will also help her feel valued, and her self-esteem will be boosted by default as the communication is 100% effective.Part C Another theory of communication is Tuckman’s theory of group development. First developed by Bruce Tuckman in 1965, it is one of the more well-known group/team development theories and has been the basis of man y other ideas since its birth. Tuckman’s theory focuses on the way that a team tackles a task from the initial formation of the team right the way through to the completion of the given project. Tuckman’s theory is relevant in particular to team building challenges as each individual phase can affect the completion of the task at hand.Basically, Tuckman's model explains that, as the team develops maturity and ability, the relationships within the team get more established, and the leader changes his or her leadership style, according to the developmental stage of the group. In this group development cycle, there are four main stages although later on, Tuckman added a fifth stage to the cycle (although this is not used by everybody). The first stage, forming, is the stage where the group is put together for the first time, and where all the group members meet one another for the first time, so naturally, this is the most awkward stage of the developmental cycle.The grou p is thought to be at the â€Å"honeymoon stage†- the group members are all naturally shy, and are all aware of their feelings and the feelings of others. In this stage, there is a high dependence on the leader by most of the team members, for guidance and direction. There is little agreement between team members on the aims and purposes of the team, other than what is given by the team leader. Individual roles and responsibilities of team members are somewhat unclear.The leader should be prepared as the team members will have a lot of questions to ask, and the leader will have to be confident so that the team members can feel confident too, and also they will have a sense of security. The second stage, storming, is the stage where the most conflict occurs. The team will begin to gain comfort with one another, and so the team will start to address the task suggesting possible ideas, and different ideas may compete for the favour of the group, and if this is badly managed, it can result in being very destructive for the team.This phase is described as the ‘make or break’ moments for the team, as in the team relationships will either me made or broken. In this stage, it is essential that the team has a strong facilitative leadership in this phase. There is a stronger clarity of purpose, but plenty of uncertainties persist. Cliques and factions form and there might be power struggles within the group. The third stage, Norming, is where the team begins to ‘find their feet’ a bit more.The norming phase is a gradual move towards harmonious team-working. The team becomes more united and begins to agree on rules, purposes, values and aims on which they all agree to operate. In an ideal world, teams will begin to trust themselves more and each member will begin to value the contribution of other team members. In this phase, you will find that the team leader is able to take a step back as individual members become more comfortable with each other and so take on greater responsibility.A potential risk during the norming stage is that the team will become complacent and will lose their creative edge or the motivation that brought them to the team in the first place. The group on a whole is able to make larger decisions, and smaller decisions get delegated to individual team members, adding to the harmony of the group. Outside of the ‘team environment’ the team members may engage in social activities together. The fourth stage, performing, is when the team members are working at their optimum level as a united body.The group can be described as being in ‘flow’ – all of the team members are contributing equally to the team and as a result of this; the team is making excellent progress. When I think of a good team working together as one, I think of the metaphor of a human body; every part of the human body is required for the body to work properly and at optimum level, and this is the same as a team working together. In this stage of group development, each group member can help the other members out by giving them advice, instruction and constructive criticism where necessary.Teams that are performing at optimum level are identified by high independence levels and motivation is evident as well as each team member being highly competent and knowledgeable in the aims they want to achieve, and the main ideas of their team project. Decision making within the team is done as one entity and each team member has a high level of respect for each individual team member. †¦PART D†¦ (TO BE DONE NEXT WEEK) http://www. teambuilding. co. uk/Forming_Storming_Norming_Performing. html http://www. businessballs. com/tuckmanformingstormingnormingperforming. htm Discuss Theories of Communication P2: Discuss theories of communication. Part A The communication cycle is a commonly used theory of communication. It was first developed by Charles Berner in 1965; it was then modified by Michael Argyle, who was a social psychologist, in 1972. The concept of a ‘communication cycle’ makes it clear that, in order to have effective communication, it must be a two way process. As well as transferring messages to others in a definite, clear way, health care professionals must be able to respond to the verbal feedback as well as the non-verbal feedback.So, effective communication has to involve effort from both participators (both the sender as well as the receiver) in the communication. The communication cycle has six stages. Stage one is when ideas occur, this makes us think and assess the situation that we are in before we start to communicate. We need to think about what we are trying to say, and how to say this in a clear, effective way. Stage two is when the message is c oded and here we have to be aware of the different methods that we can use to send our message.We should try and consider the most effective communication method depending on the situation and the person with whom we will be communicating. Stage three is when the message gets sent. We need to make sure that we have chosen the most effective method of communication, and that we have used this communication method in the most correct way. We should not try and rush the message being sent because that could cause misunderstanding between the two people who are communicating. Stage four is whenever the message gets perceived by the receiver.The service user has to make sense of the message given to them. As health care professionals, we should be aware of the potential difficulties and be aware of how to take steps in order to lessen these difficulties. Stage five is when the message gets decoded. The service user tries to make meaning of what you have just communicated to them. Here, w e have to clarify and check out how much of the information is being understood. This clarification should be carried out on a continual basis, not just at the end of the conversation.Finally, stage six is whenever the message gets understood, and then the receiver of the message then becomes the sender of the new message in the form of feedback. You must allow plenty of time for feedback, remembering that it will be both verbal and nonverbal; this involves listening with your eyes, ears and body language. Part B Mrs Hedges is a resident in a nursing home. Recently, her hearing has declined and she now relies on a hearing aid to enable communication. Three weeks ago, Mrs Hedge’s granddaughter was involved in an accident and since been in hospital.Her family have been reluctant to tell Mrs Hedges of her granddaughter’s condition as they do not want to upset her. Mrs Hedges was used to seeing her granddaughter on a regular basis; she often popped in on her own to spend t ime with her granny. Mrs Hedges has started to worry about her granddaughter and the family have asked that you help them break the news. . â€Å"A relationship without communication will definitely fail. If you attempt to have a relationship without communication, both people involved in the relationship will have different goals and objectives. ANGEL, G, 2010. Title [The importance of the communication cycle]. [16. 10. 12]. Available from World Wide Web : <http://www. helium. com/items/1746915-communication-cycle> The importance of the communication cycle cannot and should not be underestimated. Below, I am going to discuss why I think it is important to follow the communication cycle and why it is important for effective communication. The sender should be aware that the person with whom they will be communicating is hard of hearing, and are wearing a hearing aid.The dispatcher of the communication should be able to select the most effective form of communication in order to communicate the message at hand. The sender must think about how to communicate the message in a sensitive way that the receiver will understand. The communicator should be on the same level as the receiver of the communication; this allows the receiver (Mrs Hedges) to read facial expression and, if possible, lip read. Being on the same level as the receiver of the communication, also allows them to focus and listen more efficiently.The speaker must thoroughly think through what he or she is going to say, and the method in which they want to say it. They must evaluate and decide whether to use verbal or nonverbal communication, or a mix of the two. If they have chosen verbal communication, they must figure out a way to communicate in a non-patronising way that will still be as effective. If nonverbal communication is chosen, the correct method of nonverbal communication should be chosen. Effective communication must happen in order to meet Mrs Hedges’ needs, to help her fe el re assured, safe and secure.In this particular case, I think that a mixture of both verbal and nonverbal communication is requisite. Using speech along with caring and reassuring touch will be effective in making Mrs Hedges feel cared for and safe. The communicator should speak in a normal fashion that Mrs Hedges will not find condescending, but that you speak in a slightly slower pace than usual; this makes your speech clearer. Communicate the message to Mrs Hedges at a time when she is least likely to be tired, as when you are tired, your hearing is decreased anyway.Verbal communication is so important, especially when delivering such a delicate message, so make sure to use simple, short sentences, and make sure that MRs Hedges has understood, you could do this by asking questions such as ‘are you following me? ’ or ‘Do you have any questions, Mrs Hedges? ’. If she hasn’t understood the message, refrain from repeating the same sentence over agai n, instead the sender of the message should try re-phrasing the sentence. Nonverbally, facial expression and hand movements, body language and touch are vital.If Mrs Hedges gets upset, it is important that the communicator re assures her by caring gestures, such as gentle, friendly touch, the carer could put their hand on Mrs Hedge’s shoulder, to comfort her. The carer must be able to communicate effectively to Mrs Hedges so that Mrs Hedges fully understands the message. This is also important as it is useful to know how to effectively communicate so that Mrs Hedges’ needs are met and that she feels safe, secure and re-assured. This will also help her feel valued, and her self-esteem will be boosted by default as the communication is 100% effective.Part C Another theory of communication is Tuckman’s theory of group development. First developed by Bruce Tuckman in 1965, it is one of the more well-known group/team development theories and has been the basis of man y other ideas since its birth. Tuckman’s theory focuses on the way that a team tackles a task from the initial formation of the team right the way through to the completion of the given project. Tuckman’s theory is relevant in particular to team building challenges as each individual phase can affect the completion of the task at hand.Basically, Tuckman's model explains that, as the team develops maturity and ability, the relationships within the team get more established, and the leader changes his or her leadership style, according to the developmental stage of the group. In this group development cycle, there are four main stages although later on, Tuckman added a fifth stage to the cycle (although this is not used by everybody). The first stage, forming, is the stage where the group is put together for the first time, and where all the group members meet one another for the first time, so naturally, this is the most awkward stage of the developmental cycle.The grou p is thought to be at the â€Å"honeymoon stage†- the group members are all naturally shy, and are all aware of their feelings and the feelings of others. In this stage, there is a high dependence on the leader by most of the team members, for guidance and direction. There is little agreement between team members on the aims and purposes of the team, other than what is given by the team leader. Individual roles and responsibilities of team members are somewhat unclear.The leader should be prepared as the team members will have a lot of questions to ask, and the leader will have to be confident so that the team members can feel confident too, and also they will have a sense of security. The second stage, storming, is the stage where the most conflict occurs. The team will begin to gain comfort with one another, and so the team will start to address the task suggesting possible ideas, and different ideas may compete for the favour of the group, and if this is badly managed, it can result in being very destructive for the team.This phase is described as the ‘make or break’ moments for the team, as in the team relationships will either me made or broken. In this stage, it is essential that the team has a strong facilitative leadership in this phase. There is a stronger clarity of purpose, but plenty of uncertainties persist. Cliques and factions form and there might be power struggles within the group. The third stage, Norming, is where the team begins to ‘find their feet’ a bit more.The norming phase is a gradual move towards harmonious team-working. The team becomes more united and begins to agree on rules, purposes, values and aims on which they all agree to operate. In an ideal world, teams will begin to trust themselves more and each member will begin to value the contribution of other team members. In this phase, you will find that the team leader is able to take a step back as individual members become more comfortable with each other and so take on greater responsibility.A potential risk during the norming stage is that the team will become complacent and will lose their creative edge or the motivation that brought them to the team in the first place. The group on a whole is able to make larger decisions, and smaller decisions get delegated to individual team members, adding to the harmony of the group. Outside of the ‘team environment’ the team members may engage in social activities together. The fourth stage, performing, is when the team members are working at their optimum level as a united body.The group can be described as being in ‘flow’ – all of the team members are contributing equally to the team and as a result of this; the team is making excellent progress. When I think of a good team working together as one, I think of the metaphor of a human body; every part of the human body is required for the body to work properly and at optimum level, and this is the same as a team working together. In this stage of group development, each group member can help the other members out by giving them advice, instruction and constructive criticism where necessary.Teams that are performing at optimum level are identified by high independence levels and motivation is evident as well as each team member being highly competent and knowledgeable in the aims they want to achieve, and the main ideas of their team project. Decision making within the team is done as one entity and each team member has a high level of respect for each individual team member. †¦PART D†¦ (TO BE DONE NEXT WEEK) http://www. teambuilding. co. uk/Forming_Storming_Norming_Performing. html http://www. businessballs. com/tuckmanformingstormingnormingperforming. htm

Endoscopic Retrograde Cholangio-Pancreatography

Choledocholithiasis (which called bile duct stones or gall bladder stones in the bile duct) is the presence of stones from gall bladder in the common bile duct. Stones usually form in gall bladder but they sometimes pass through the cystic duct into common bile duct. There are many symptoms of gallstone in common bile duct. For example; abdominal pain (in the right upper or middle upper abdomen), fever, jaundice (yellowing of the skin and eyes), loss of appetite, nausea and vomiting and clay-colored stools. So, this condition diagnosed and treated by ERCP. ERCP (Endoscopic retrograde cholangiopancreatography) is a procedure that enables doctor to examine the pancreatic and bile ducts by insert lighted tube which called endoscope (like the thickness of your index finger) is placed through the mouth and into stomach and first part of the small intestine (duodenum) exactly in (ampulla) and passed of cannula (which a small plastic tube) through the endoscope and into this opening with injected contrast material and X-rays are taken to study the common bile duct. Fluoroscopy is a radiographic procedure that provides a dynamic image of the inside of the body frequently after the administration of the contrast media with the use of persistent x-ray beam that passes through the area of interest and later the attenuated beam that come out of the patient is received by a video monitor to view the body part motion in details. The fluoroscopic studies can efficiently detect variety of abnormalities of different body systems such as the skeletal, digestive, cardiovascular, respiratory, reproductive and urinary system. (University of Rochester Medical Center,2018). In this assignment I will discuss about equipment used in ERCP, role of radiographer in ERCP, technical and exposure consideration of ERCP and case study. ? ERCP Equipment ERCP contain endoscopy and fluoroscopy. Fluoroscopy consists of C-arm and monitor. Endoscopy consist of flexible tube which called endoscope with at the end it contain a tiny video camera and light. There is a canal inside components of the scope through which thin instruments are passed and can be poked out the tube's end. These instruments include a catheter, balloon, basket, sphincterotome, biopsy forceps and cytology brush and stents. So, for injecting contrast media into the ducts by used of catheter. Used of balloon is to stretch tight areas of the bile duct or pancreatic duct. Also, for removing and manipulating stones used of basket, and to incise tissue and make the bile duct or pancreatic duct opening larger used of a sphincterotome. Biopsy forceps and cytology brush use to obtain microscopic exam, and use stent to bridge blockages. Other openings allow the doctor to suck out water or air inside digestive system as well as clean the camera lens. Control the movement of the tube by gently pushing and pulling on its outside end is done by the doctor while also steering the inside end with control knobs that the doctor holds in his hand. Video television screen in the procedure room is received images from the endoscope. Also, obtain an x-ray image of the bile duct and pancreatic duct by the fluoroscopy. Role of Radiographer in ERCP:Before examination:First, asked to remove any clothing or jewelry that may get in the way of the body area to be examined and wear gown. Then, check name and an identification number of the patient. Third, prepare the C-arm machine and the monitor. Fourth, positioned on the x-ray table depending on what the doctor want. Fifth, make sure everyone who stays in ERCP room wear lead apron. During examination: Regarding on department's equipment, radiographer may have to stay out in the control panel or may be able to stand in the room to x-ray. stand in the room to x-ray In the latter, it is important to pay close attention so as not to miss cue to x-ray. The doctor will ask the radiographer to x-ray when it is required if screen or spot. Also, the radiographer be attention for doctor and patient condition.After examination:The radiographer save the image and sent it. Make sure the machine is clean. Technical of ERCP:Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that to diagnose and treat diseases regarding to the pancreatobiliary system by used of endoscopy and fluoroscopic imaging. The endoscopic portion of the examination uses endoscope that is passed through the esophagus and stomach and into the second portion of the duodenum. For obtaining high-quality radiographic images and for the prevention of pulmonary aspiration and considered optimal for cannulation of the papilla, so ERCP is performed with the patient in the prone position. But, patients who can not able for prone position for ERCP are often placed in the left lateral decubitus or supine positions.Radiation exposure consideration of ERCP:In ERCP the fluoroscopy time is shorter when ERCP is performed by doctor who has many years experience of done ERCP and carried out a large number of ERCPs in the past year. In general, radiation exposure is higher during therapeutic ERCP than during diagnostic ERCP. Radiation dose to patients during ERCP depends on many factors, and the doctor unable to control some variables which are patient size, procedure type, or fluoroscopic equipment used. In a recent prospective study where ERCP instruments used for example, stent insertion, lithotripsy, needle-knife, biopsies, the use of a guide wire or additional wires other than the standard, a balloon and catheter, that will significantly increase fluoroscopy duration.Patient preparation and care:Before the examination, the stomach should be empty. The patient who does the ERCP must not eat anything after midnight on the evening before the exam. Regarding for examination time, if the procedure is done early in the morning, no drinks must be taken, but if examination is done at noon time, a cup of tea, juice, milk, or coffee can be taken four hours earlier. medications of heart and blood pressure must always be taken with a little amount of water in the early morning. The patient needs to have a companion drive them home after the procedure, since the procedure will require intravenous sedation.To cause relaxation and sleepiness, the patient will be given medications through a vein. Local anesthetic is given to the patient to decrease the gag reflex. Some doctors prefer to give the patients more intravenous medications for sedation, so do not use local anesthetic. This also applies to those patients who cannot tolerate the bitter taste of the local anesthetic or who have a history of allergy to xylocaine and the numbness sensation in the throat. The intravenous medication is given, while the patient is lying on the left side on the X-ray table, and then the instrument is inserted gently through the mouth into the duodenum. The instrument advances through the food passage and not the air passage. It does not interfere with the breathing and gagging is usually prevented or decreased by the medication. After the examination, patients must be observed in the recovery place until most of the effects from the medications have worn off. This sometimes takes one to two hours. Case study:Â   This case study is about 77 years old female patient with H/O common bile duct stones. The condition start 8 months ago by right upper abdominal pain and clay colored stools. The patient came to Royal Hospital and the doctor decided to take x-ray first. So, they found 3 large stones in common bile duct. Then the doctor decided to do ERCP. The ERCP was done in 7/5/2018. The doctor saw a perimapullary diverticulum and with injected contrast through common bile duct, the cholangiogram showed 3 large stones proximally back to back, the balloon was used to remove the stones. However, this patient was uncooperative, so stenting done in long time with use 9cm plastic biliary stent with good bile drainage.

Religion of Anglo Saxons essays

Religion of Anglo Saxons essays The nature of the religion of the Germanic settlers is a very difficult subject, since it has to be pieced together from odd references from classical times and later Christian writings which obviously did not want to promote Pagan beliefs. Many modern historians look at the fact that four days of the week are named after Old Germanic deities, corresponding to four of the deities from later Scandinavian religion and shrug it off as being the same as the religion of the Pagan Vikings. Unfortunately, it is not this simple. Whilst it is true that they share many similarities, this attitude is about as valid as saying the Jewish faith and Christianity are the same thing just because they share the Old Testament. Although both the Early English and Viking religions have the same Germanic root, they were very different, and the Viking version had three more centuries of development than the English one. The early English religion had much in common with pre-Roman Celtic beliefs as well as later Scandinavian ones. Unlike the later Scandinavian religion, the supreme deities in English faith were probably goddesses, not gods. The most important of these was Nerthus, the earth mother (the Harvest Queen of folk tradition). She looked after the fertility and well-being of man and beast. It is unclear whether Frija or Frea is a separate goddess, or just another aspect of Nerthus, but she is usually associated with love, lust, yearning and friendship. Other important Goddesses were Eostre, goddess of the dawn, spring and new life (and whose name is given to the spring festival of the Christian faith - Easter), and Rheda or Hreà °, a wà ¦lcyrie and goddess of the winter. Of the gods of the early English we only know of three: Tir, Woden and Thunor (the Tyr, Oà °in and Thor of Viking mythology). Woden seems to have been the most important of these three since most royal lines traced their descent from him, and he survived the Conversion ...