Media Review Essay Example | Topics and Well Written Essays - 500 words - 1

Media Review - Essay Example ocial policy begun in 2011 through the aid of the digital internet transition who’s aim was to come up with new opportunities that have continually led the innovative forms of investigative journalism. As a result, Ai Media for the past two years have continuously embarked on diligently using the social media (Face Book, Twitter and YouTube) to reach out and share information with regard to the deaf and hearing impaired in the US community. In essence, the company focus more on the disabled persons, and how they should also be given a chance in participating in this company and the products that the company provides. In response, the company continually welcomes feedbacks and suggestions regarding such reactions and comments that are given out by all participants (Flynn 4). Of importance to note is that, Ai-Media has certain principles and guidelines that the company uses in ensuring their media policy remain an efficient tool of communication. To begin with, this social policy ensures that the concept of the community is well understood in terms of giving support to either side (clientele and the company). Secondly, contents found on the social media are friendly to the clientele and further embrace the presence of opinion diversity. This must go in line with the materials that are posted on the social media, the audience involved and the judgement that the company gives. In addition, Ai-Media is conscious and transparent of their intention. Basically, the company is sensitive on placing posts on individual clientele or organisation regarding their nationality, gender, sexual preference, disability and any other related issues. According to Flynn (4), it is worth mentioning that, the social policy must be in a position to assist the concerned persons. In this case, the Ai-Media is mainly concerned with a particular group of people –the disabled (hearing impaired and deaf) thus bringing value as would be expected. In the

Customer Relationship Management (CRM) at Doctors Surgery

Customer Relationship Management (CRM) at Doctors Surgery Proposed Working Title Does Customer Relationship Management (CRM) build stronger bonds with the customers and help provide quality services in a doctors surgery at Camden? - A case study of NHS Research Background and Context I have chosen this topic in order to find out what are the key issues that are important for successfully running a doctors surgery. We have been seeing that there are always patient dissatisfaction and complain about the services, both clinical and non-clinical. Hypothesis The hypotheses that will be tested in this research are as follows: To analyze what aspects of CRM strategies are missing in running this doctors surgery. To identify what benefits can be attained by completely implementing CRM at PPCC To what extent the employees are playing their role according to CRM strategies. To look in various models, strategies, theories and methods that can be used to make the services effective at doctors surgery. Organisation Background – Partnership Primary Care Centre (PPCC) The Surgery has been established in 1973 for the people who are living in the housing. It was named Fairweather House Surgery. Initially it had 250 patients from the housing. Dr. Morris Davies was founder General Practitioner (GP). In 1976, Dr. Diane Rosenthal, Dr. Jonathan Rosenthal, Dr. Enid Greenbury and Dr. Wil Cupola took over from Dr. Morris Davies and this Surgery was under Camden and Islington Primary Care Trust (PCT). In 1976 Camden and Islington PCT allocated more patients and gave a practice boundary that is a catchment area. In 1976, GPs appointed a practice nurse who used to do child immunisation, dressing, and cervical smear. In 1988 Dr. Wil Cupola left the surgery and Dr. Ian Hopkinson joined the surgery as a partner and there were 8 sessions of doctors and 5 sessions of nurses. GPs decided to register more patients and in 2003 total registered patients were 1900. It was difficult to offer more services from the small premise, so GPs had several meeting with the PCT to move to a bigger building. During this time, Camden and Islington PCT divided into two and this surgery came under Islington PCT who decided to move the Surgery in a bigger premises. Meanwhile, one of the local GP died and another GP went for retirement. In 1st October of 2003, Fairweather House Surgery shifted to newly built premises and named the surgery as Partnership Primary Care Centre (PPCC). After moving to this new premise, there are now 16 consulting session of doctors, 10 nurses session and 5 health care assistant sessions. Now the total registered patient is 3300 and growing everyday. (Source: Mr. Rashidul Hasan: Practice Manager and Mrs. Heather Johnson: Ex-Practice Manager at PPCC) Services Offered at PPCC Services that are offered by PPCC are personal doctoring, urgent medical problems, out of hours emergencies, home visits, talking to a doctor or nurse on the telephone, family planning services , antenatal care , child health surveillance, screening and health promotion, travel immunisations advice, sexual health for teenagers adults, quit smoking advice, alcohol advice , advice on drug problems, test results, repeat prescription service, interpreting services, careers needs and special nurse-led clinics available that include asthma/COPD clinics, diabetic clinic, cervical smears, childhood immunisation, family planning, heart disease/stroke prevention, well person checks. (Source: PPCC leaflet) Customer Relationship Management System at PPCC The surgery uses patient data storage system called VISION that is the most popular GP data storage system in the country. It has been maintained by the company called INPS. It holds all the information about the patients who are registered with PPCC. It holds the name, date of birth, address, telephone numbers and obviously the medical information. This system is also linked with the Whittington Hospital in order to receive test results including X-rays that are transferred electronically to the surgery. Rationale for the chosen topic I have selected Customer Relationship Management (CRM) because it is one of the best and most popular methods of developing stronger bonds with customers (in this research my customers are the patients who come to the doctors surgery). It can be said that if there is no patients then there is no need of doctors surgery, that is – no patient, no business. By the implementation of CRM strategies, PPCC can become one of the role model for other doctors practices. Customer satisfaction is the core of any business and when it comes to patients, it is a must. Research Questions- Formulation of researchable questions Like all research, my research also has an objective and to achieve that objective I have prepared a researchable question. The most important question to me is: ‘How effective will be customer relationship management strategies in providing quality services in doctors surgery? I will be focussing on this question through out my analysis of this research. Some of the important concerns that will arise while answering this question are as follows: †¢ What is CRM? †¢ Usage of CRM? †¢ What are the organisational benefits of CRM? †¢ How successful CRM can be in providing quality services? †¢ To what level can customer satisfaction can be achieved? †¢ How the organisation can achieve competitive advantage by CRM? Research Aim The aim of this research is to determine the relationship between the CRM and the quality of services and does it build a stronger bond with customers. Research Objectives The main objective behind this research is to understand and identify the root cause of customer dissatisfaction with the services provided at the doctors surgery. This research will focus on the real life example of a London based doctors surgery called Partnership Primary Care Centre (PPCC). I will discuss about the implementation and benefits of CRM to PPCC. In order to achieve the above aim, the following research objectives have been set: †¢ To understand and identify the root cause of customer dissatisfaction with the services provided by the doctors surgery, †¢ To determine the variable factors that could influence customer satisfaction level, †¢ To determine how CRM can bring a positive change in the quality of service, †¢ To identify how implementation of CRM can benefits PPCC. Literature Review A literature review discusses published information in a particular subject area, and sometimes information in a particular subject area within a certain time period. For the purpose of this research, the literature review is on Customer Relationship Management (CRM). Customer Relationship Management (CRM) The better a business can manage the relationships it has with its customers the more successful it will become. In order to have a better understanding and knowledge about the customers needs and demands, customer relationship management strategies can be used. Customer relationship management (CRM) is not just the application of technology, but is a strategy to learn more about customers needs and behaviours in order to build up stronger relationships with them. As such it is more of a business philosophy than a technical solution to assist in dealing with customers effectively and efficiently. (www.xicom.biz , Accessed: 21/08/09) According to Armstrong and Kotler (2005) customer relationship management (CRM) is managing detailed information about individual customers and carefully managing customer â€Å"touch points† in order to maximize customer loyalty. CRM involves all of the corporate functions (marketing, manufacturing, customer services, field sales, and field service) required to contact customers directly or indirectly. The term â€Å"touch points† is used in CRM to refer to the many ways in which customers and firms interact. (Gray and Byun, 2001) The foundation of customer relationship management CRM is based upon identifying; understanding and being able to provide a better service to customers. CRM allows build a better relationship with customers, improving customer satisfaction and maximising profitability. It is about understanding, anticipating and responding to the exact needs of customers with a constant eye for making the services to them the best it can possibly be. The main target of CRM is to improve long-term growth and profitability through a better understanding of customer behaviour. (Source: www.customerrelationshipmanagementcrmuk.co.uk, Accessed: 21/08/09) CRM consists of three basic components: customer, relationship and management. (Roberts-Witt, 2000) Customer If there is no customer then there will be no profit now or in the future. But a good customer, who provides more profit with less resource, is always scarce because customers are knowledgeable and the competition is fierce. Sometimes it is difficult to distinguish who is the real customer because the buying decision is frequently a collaborative activity among participants of the decision-making process (Wyner, 1999). Information technologies can offer the skills to distinguish and manage customers. CRM can be thought of as a marketing approach that is based on customer information (Wyner, 1999). Relationship The relationship between a company and its customers involves continuous bi-directional communication and interaction. The relationship can be short-term or long-term, continuous or discrete, and repeating or one-time. Relationship can be attitudinal or behavioural. Even though customers have a positive attitude towards the company and its products or services, their buying behaviour is highly situational (Wyner, 1999). Management CRM is not an activity only within a marketing department. Rather it involves continuous corporate change in culture and processes. The customer information collected is transformed into corporate knowledge that leads to activities that take advantage of the information and of market opportunities. CRM required a comprehensive change in the organization and its people (Wyner, 1999). Specific software to support the management process involves: Field Service, E-Commerce Ordering, Self Service Applications, Catalogue Management, Bill Presentation, Marketing Programs, and Analysis Applications. They can be used to take the advantage of CRM, but keeping in mind that CRM is not about just technology but more about quality service. (Source: http://www.tupublicas.com/docs/12-44-15-02-2004-leyva.pdf, Accessed: 17/08/09) The core components of customer relationship management The content of a CRM strategy consists of six mutually dependent criteria (Donaldson and OToole, 2002) Emphasis on quality: if we provide poor service we will lose our customers and ultimately business. The core product alone is no longer sufficient, and service quality is considered as the key to successful business. Measure customer satisfaction but manage customer service: This implies understanding and defining the various benefits that a prospect expects prior to purchase and the management of the gap between expectations and performance after the purchase process. Invest in people: Both internal and external relationships are important. Implementation of a relationship orientation can only come from the people in the organisation understanding the objectives set and meeting the required standards. Maintaining dialogue with customers: Building long-term relationships is the key issue in CRM. Companies that listen and adapt to preferences of individual customers have a higher chance to retain them and make them loyal. Setting realistic targets and assessing performance: Organisations must have an understanding of customer views of the various elements in the offering and the elements important to each individual customer. Relationship-based interfaces: This means being in touch with both internal and external customers in a responsive and flexible manner. In practice, there is a gap between what firms do, what they should do, and what is most desirable to do. The means of communication should be adapted to the needs of the individual customer. (Donaldson and OToole, 2002) Types of Customer Relationship Management There are different variations in CRM approaches and they are all in different software packages focusing on different aspects. Some of the main types of CRM are as follows: Operational CRM Operational CRM is for â€Å"front office business processes. It interactions with customers to gather and stored customer information, so that later staff can retrieve customer information as necessary. The reasons for storing this information are as follows: Managing campaigns Enterprise Marketing Automation Sales Force Automation Sales Management System Analytical CRM Analytical CRM makes strong use of data mining and other techniques to create useful results for decision-making Analytical CRM analyzes customer data for a many reasons and they are: Designing and executing targeted marketing campaigns Designing and executing campaigns, Analyzing customer behavior in order to make decisions relating to products and services Management information system In this stage the importance of fully integrated CRM software becomes most apparent because the more information the analytical software has available for analysis, the better is the predictions and recommendations are. Sales Intelligence CRM Sales Intelligence CRM is more or less like Analytical CRM, but is intended as a more direct sales tool. Features include alerts sent to sales staff regarding: Cross-selling/Up-selling/Switch-selling opportunities Customer drift Sales performance Customer trends Customer margins Customer alignment Campaign Management Campaign management includes elements of Operational and Analytical CRM. The functions include: Target groups formed from the client base according to selected criteria Sending campaign-related material to selected recipients using various channels. Tracking, storing, and analyzing campaign statistics, including tracking responses and analyzing trends Collaborative CRM Collaborative CRM consists of a companys dealings with customers that are handled by various departments within a company, such as sales, technical support and marketing. Staff members from different departments can share information collected when interacting with customers. Collaborative CRMs main focus is to use information collected by all departments to improve the quality of services provided by the company. (Edwards, 2007) Consumer Relationship CRM Consumer Relationship System is mainly for a companys dealing with customers handled by the Consumer Affairs and Customer Relations contact centers within a company. (Source: http://en.wikipedia.org/wiki/Customer_relationship_management, Accessed: 24/08/09) Benefits of Customer Relationship Management Exceptional customer service is about being aware of customer needs and reacting to them effectively. CRM facilitates to understand, anticipate and respond to customers needs in a consistent way, through out the organization. Practicing CRM requires an efficient and integrated internal business system. Many businesses benefit from the organizational discipline CRM imposes, as well as from the technology itself. CRM will help business if we view it as a set of tools that let us do more for, and get more from, our customer. CRM can: Develop better communication channels Collect vital data, like customer details and order histories Create detailed profiles such as customer preferences Deliver instant, company-wide access to customer histories Identify new selling opportunities To better serve customers, organizations must ensure that information can be accessed through one single source throughout the enterprise. (Source: http://www.is4profit.com/business-advice/it-telecoms/crm-customer-relationship-management_2.html, Accessed: 16/08/09) Business benefits of CRM Setting customer relationship management (CRM) solution in practice requires substantial time and expense. However, there are many potential benefits. A major benefit can be the development of better relations with the existing customers that leads to: Increased sales through better timing due to anticipating needs based on historic trends, Identifying needs more effectively by understanding specific customer requirements, Cross-selling of other products by highlighting and suggesting alternatives or enhancements, Identifying which of the customers are profitable and which are not. This can lead to better marketing of the products or services by focusing on: Effective targeted marketing communications aimed specifically at customer needs, A more personal approach and the development of new or improved products and services in order to win more business in the future. Finally this leads to: Enhanced customer satisfaction and retention, ensuring that the good reputation in the marketplace continues to grow, Increased value from existing customers and reduced cost associated with supporting and servicing them, increasing overall efficiency and reducing total cost of sales, Improved profitability by focusing on the most profitable customers and dealing with the unprofitable in more cost effective ways. Once the business starts to look after its existing customers effectively, focus can be shifted on finding new customers and expanding the market. The more we know about our customers, the easier it is to identify new prospects and increase our customer base. (Source: http://www.businesslink.gov.uk/, Accessed: 16/08/09) Customer privacy is an important issue in CRM. CRM deals with large amounts of customer data throughout various touch points and communication means. The personalization process in CRM requires identification of each individual customer and collections of demographic and behavioural data, this is the very information that most customers consider personal and private. The individual organisation gets into an ethical dilemma as it wants to collect as much information as possible about each customer to further its sales. It is a must to have the customer consent to avoid any future problems. Authorized personnel should only have the access to the stored information and data. Drawbacks of CRM As of any other topic there are some negative sides about CRM. According to a research study released in March, 2001 by the Meta Group (cited in Connor 2001), between 55% to 75% of CRM projects fail to meet management objectives. However, research undertaken by CRM Guru (The Blueprint for CRM Success 2002) indicates that the failure rate of CRM projects is 35 %. About 50 % of projects get a payback within 18 months. Research Methodology The two most common methods of data collection for any research are qualitative and quantitative. It is important to define qualitative and quantitative methods. Quantitative data is the term given to data that can be quantified where as qualitative data is the term given to data based on meanings which are expressed through words and language (Anderson, 2004). Both these methods will be used to gather data and information for this research. Interviews will be conducted with the staff members to learn about their ideas and opinions on what they can add to the existing services that they provide. If possible and permitted, then a group of patients will be selected and will be interviewed about what their expectations from the doctors surgery. A questionnaire will be prepared for conducting this research which will be given to the patients who come to take service to the surgery. All these descriptive, exploratory, ethnographic, qualitative and quantitative methods will be used to fulfill the requirements of this research. Data Collection Methods This study draws on both primary and secondary data, such as past customer satisfaction levels, as well as both qualitative and quantitative data. The main focus will be on the qualitative approach as well as observation. This is because my data analysis will be based on words rather than figures. In addition to this, an interview will be conducted on a focused group of patients as primary data source. Primary Data Collection Methods Primary sources are original works of research or raw data without interpretation or pronouncements that represent an official opinion or position. Included among the primary sources are memos, letters, complete interviews or speeches (in audio, video, or written transcript formats), laws, regulations, court decisions or standards, and most government data, including census, economic, and labour data, (Cooper and Schindler, 2003). For the purpose of my research, qualitative method of data collection is more appropriate. Qualitative research is centrally concerned with the understanding rather than the measurement things (Hague Jackson, 1996). Moreover it is believe that qualitative research provides data that is open to interpretation and argue. (Brassington Pettitt, 1996). The search will use a combination of structured and unstructured questionnaires during face-to-face in-depth interview that provide a mixture of closed and open-ended questions for ease and for the acquiring opt imum data. The interviews will be with the parties, the service providers and the service receivers that is the patients. Questionnaire and Interview Questionnaire will be one of the most important approaches that would be used in this research as it provides the simplest and fastest way of primary data collection. A questionnaire will be design to handout to all interviewees and this will give me the data I need to base my theories on. Interviews will be taken to collect data in which selected participants are asked questions in order to find out about their activities, thoughts or feeling about relative issues. The sample size will be 50 plus and of both sexes and of different age groups. Secondary Data Collection Methods Studies made by others for their own purposes represent secondary data, (Cooper and Schindler, 2003). This will include both qualitative and quantitative data as well as descriptive and exploratory research. Books, magazines, articles, journals and other kinds of publications will be used to gather the data. The libraries that will be used for resources are London School of Commerce Library, the British Library, City Business Library and Online Library of University of Phoenix. As this report is a case on NHS (National Health Service), the web sites of the NHS and PPCC will be used to get information about the doctors surgery. The information gathered on the secondary research will be presented in the literature review part of this research. Data Analysis The primary data that will be gathered through questionnaire as a form of quantitative analysis will be analysed by using the Microsoft Excel spread sheet. To have a better understanding of the data, they will be presented in Pie chart and Bar charts. The findings will be also put as percentage of the total sample size. The interview will be analysed as qualitative data as there will be opinions, suggestions and views of the participants. Resource Requirements Some of the expenses that would incur during the primary data collection would be for light refreshments for the interviewees and the expenses for secondary data would be for buying the referral books, magazines, printing and binding of the research. There will be also some additional transportation cost for travelling to the libraries. Time Scale Time is a crucial element for any kind of work and I believe that the dissertation can be completed according to the following time scale. Time Scale Week Activity 1 2 3 4 5 6 7 8 9 10 11 12 Submission of the Proposal Literature Review Interviews Updating Literature Review Data Collections and Questionnaire Data Analysis First draft of dissertation Revising draft Second draft of dissertation Final editing and preparing Final report ready

Calorimeters :: Papers

Calorimeters This is a investigation into how heat transfer is effected when different variables are changed, when boiling water is in a colorimeter. Variables These are the variables which are available for me to change: 1. Different insulators e.g. Foam or Cotton Wool, Polystyrene. 2. The temperature of the water at the start of the experiment. 3. Whether or not the calorimeter has a lid on or not. 4. Different conductors e.g. Copper, Wood, other metals. 5. The amount/Volume of water. Prediction These are my predictions for each variable: 1. Different insulators work better than others. Different insulators will have different effects, because of what they are made of, if the material is a metal, it will conduct the heat, a non-metal will insulate the heat, some better then others. 2. If the starting temperature is higher, then I predict it will be higher at the end too, because the energy lasts longer in the hotter water. 3. If the lid isn't on more heat will be lost, because the heat will rise. 4. Different conductors have different effects too. Some conductors conduct the heat quicker than others. e.g. Copper will transfer the heat quicker than wood. 5. If there is less water there would be a smaller surface area to volume ratio so less water will transfer less heat, and more will enhance the transfer Planning I will investigate different amounts of water and different insulators. I will use these different quantity's of water: à ¢Ã¢â€š ¬Ã‚ ¢ 20cm cubed à ¢Ã¢â€š ¬Ã‚ ¢ 40cm cubed à ¢Ã¢â€š ¬Ã‚ ¢ 60cm cubed à ¢Ã¢â€š ¬Ã‚ ¢ 80cm cubed à ¢Ã¢â€š ¬Ã‚ ¢ 100cm cubed ( I will also change the insulator on this one) Equipment Used I will use the following equipment: à ¢Ã¢â€š ¬Ã‚ ¢ Calorimeter. à ¢Ã¢â€š ¬Ã‚ ¢ Kettle. à ¢Ã¢â€š ¬Ã‚ ¢ Thermometer. à ¢Ã¢â€š ¬Ã‚ ¢ Measuring Cylinder à ¢Ã¢â€š ¬Ã‚ ¢ Insulators (Available insulators e.g. Foam). à ¢Ã¢â€š ¬Ã‚ ¢ Stopwatch. Method I will measure the five different amounts of water and poor them into

Reflective Account Essay

Introduction This assignment will show a detailed account based on an experience in my second year community placement. The framework I shall be using to reflect is Gibbs’ (1988) model of reflection. Within this model are six phases incorporated into a cycle. Each phase will allow me to think systematically about the experience and identify areas where improvement is needed. This reflective account will incorporate the Scottish Patient Safety Programme (SPSP) aim to ‘Prevent Pressure Ulcers’ (SPSP, n.d.a). Pressure ulcers are defined as â€Å"an area of damage to the skin and underlying tissue that is caused by unrelieved pressure, friction and/or sheer forces† (Posnett and Franks, 2008). The SPSP is co-ordinated by Healthcare Improvement Scotland (HIS) and aims to improve patient safety and reduce adverse events. (SPSP. n.d.b). This aim is relevant to the patient involved in this experience as they are a high risk of developing a pressure ulcer therefore preventative measures need to be addressed. To ensure privacy and confidentiality in accordance with the Nursing and Midwifery Council (NMC, 2012a), I have renamed this patient Mathew for the purpose of this assignment. Description Mathew is an 82 year old man who recently suffered a fall within his home and was admitted to hospital with a fractured hip and subsequently had to have a total hip replacement. Mathew was discharged from hospital back to his home with the care of District Nurses visiting him on a daily basis to administer his Clexane injection. Due to Mathew’s injury his mobility has been compromised and has subsequently become incontinent. During our first visit with Mathew my mentor asked me to carry out a ‘Waterlow’ assessment with him. This tool is a scoring system which identifies if a patient is at risk of developing a pressure ulcer (HIS, 2009). As the score was above 10 Mathew was deemed ‘at risk’. Both my Mentor and I discussed with Mathew regarding his risk level, we suggested a pressure†¦ In this assignment, I need to reflect on the situation that taken place during my clinical placement to develop and utilize my interpersonal skills in order to maint ain the therapeutic relationships with my patient. In this reflection,  I am going to use Gibbs (1988) Reflective Cycle. This model is a recognized framework for my reflection. Gibbs (1988) consists of six stages to complete one cycle which is able to improve my nursing practice continuously and learning from the experience for better practice in the future. The cycle starts with a description of the situation, next is to analysis of the feelings, third is an evaluation of the experience, fourth stage is an analysis to make sense of the experience, fifth stage is a conclusion of what else could I have done and final stage is an action plan to prepare if the situation arose again (NHS, 2006). Bairdand Winter (2005, p.156) give some reasons why reflection is require in the reflective practice. They state that a reflect is to generate the practice knowledge, assist an ability to adapt new situations, develop self-esteem and satisfaction as well as to value, develop and professionalizing practice. However, Siviter (2004,p.165) explain that reflection is about gaining self-confidence, identify when to improve, learning from own mistakes and behavior, looking at other people perspectives, being self-aware and improving the future by learning the past. In my context with the patient, it is important for me to improve the therapeutic relationship which is the nurse-patient relationship. In the therapeutic relationship, there is the therapeutic rapport establish from a sense of trust and a mutual understanding exists between a nurse and a patient that build in a special link of the relationship (Harkreader and Hogan, 2004, p.243). (Peplau 1952, citedin Harkreader and Hogan 2004, p.245) note that a good contact in a therapeutic relationship builds trust as well as would raise the patient’s self-esteem which could lead to new personal growth for the patient. Besides, (Ruesch 1961, cited in Arnold and Boggs 2007, p.200) mention the purpose of the therapeutic communication is to improve the patient’s ability to function. So in order to establish a therapeutic nurse-patient interaction, a nurse must show up caring, sincerity, empathy and trustworthiness (Kathol, 2003, p.33). Those attitudes could be expressed by promoting the effective communication and relationships by the implementation of interpersonal skills. Johnson (2008) define the interpersonal skills is the total ability to communicate effectively with other people. Chitty and Black (2007, p.218) mention that communication is the exchange of information, thought and ideas via verbal and non-verbal which both present simultaneously. They explain  that verbal communication is consists of all speech whereas non-verbal communication consists of gestures, postures, facial expressions, tone and level of volume. Thus, in my reflection in this assignment would be discussed on my development of therapeutic relationship in the circumstance of the nurse-patient relationship using the interpersonal skills. My reflection is about one patient whom I code her as Mrs. A, not a real name(Appendix I) to protect the confidentiality of patient’s information (NMC, 2004).In this paragraph I would describe on the event takes place and describe that event during my clinical placement. I was on the female psychiatric ward having a 2 weeks clinical placement for mental health care in semester 3.Generally, there were two separated psychiatric wards which were male psychiatric ward and female psychiatric ward but both wards were sharing the small cafeteria in the area of psychiatric ward. The psychiatric wards were locked up from one main entrance. In the ward, the female psychiatric patients were encouraged to walk out from the female ward and combine with the male psychiatric patients at the small cafet eria during their meal time. During lunch, I noticed one lady was still sitting on her bed. She was Mrs. A, 76 years old been diagnosed a schizophrenia. She was unable to control the muscle also called tremor due to lack of the chemical as she was having a side effect of antipsychotic medication which was a Parkinsonism (Sahelian, 2005). She could not walk herself and need to be assisted if she wanted to stand or walk. So I took the Mrs. A’s lunch meal and fed on the bed. This old lady was unable to feed on her own. So I checked her diet and served her meal. I fed her meal until finished. In this paragraph, I would discuss on my feelings or thinking that took place in the event happened. Before I started to feed her, I introduced myself and approached Mrs. A. So I tried to build a good rapport with her as I do not want her to feel strange as I was not her family members or her relatives. My first approached was to her was to ask whether she wanted or refused to take her lunch. She was on soft diet as she was having a difficulty in swallowing or dysphasia. Then I asked her permission to feed her. She looked at me and looked like blur. In this situation, I showed up my emphatic listening as I put myself in her shoes and assuming I was having a hearing problem. According to Wold (2004, p73) the emphatic listening is about the willingness to understand the other person not just judging the person’s  fact. Then, I touched her shoulder, kept saying, and raise my tone a bit because I was afraid if she had a hearing trouble. At the same time, I did somebody gesturers which could be interpreted an action of eating. I paused, repeated my actions but this time I was using some simple words in the patient dialect. Then she looked at me again and nodded her head. Fortunately the body gesturers also helped me in the conversation with her. In the meantime, I was thinking whether the first language was not her mother tongue but I kept myself communicate verbally with her including using my body gesturers and facial expression. Body gesturers and facial expressions are referred as a non-verbal communication (Funnellet al , 2005, p.443). In my thinking, I needed to speak louder and know more words in her language so that she could understand and interpret of my actions towards her. I thought of the language barrier that breaks our verbal communication. Castledine (2002, p.923) mention that the language barrier arises when there are individuals comes from a different social background use their own slang or phrases in the conversations. Luckily, those particular body gesturers could make her understand that I was going to feed her lunch. During the feeding I maintained the eye contact as I do not want her to feel shy. This is because; my eye contact could show up my interest to help her in feeding. This is supported by Caris-Verhallenet al (1999) which mentioned that the direct of eye contact could express a sense of interesting the person to the other person involves in that communication. In the meantime I communicated with my best with her do that she felt comfortable. As a result, she gave a good cooperation and e njoyed the meal until finished. In my evaluating, I feel I make the right decision to accompany and assist Mrs. A in feeding. Furthermore, I could develop my nurse-patient relationship. Although McCabe (2004, p.44) would describe it as a task-centered communication as one of the element caused the lack communication among nurses, but I think my nurse-patient relationship communication both involved a good patient-centered communication and task-centered communication. In my personal opinion, I attended to Mrs. A as a patient to show my empathy because she was unable to feed herself. It was also as my duty to feed her so that I could make sure the patient get the best care in the ward. So my involvement in this nurse-patient relationship does not only restrict to the task-centered communication because (Burnard 1990, and Stein-Parbury 1993,  cited in McCabe 2002, p.44) define attending as a patient-centered process as wells as to fulfill the basic conditions as a nurse to provide the genuineness, warmth and empath y towards the patient. I was able to improve my non-verbal communication skills in my conversation with her during the feeding. As she was having a hearing problem and could not communicate in the first language properly, so the non-verbal communication plays a role. Caris-Verhallen et al (1999, p.809) state that the non-verbal communication becomes important when communicating with the elderly people who develop a hearing problem. Hollman et al (2005, p31) suggests some effective ways to maximize the communication with hearing impairment people such as always gains the person’s attention before speaking, visible yourself to prevent them feel frighten and try to use some sensitive touch. I feel this is a good experience to me because I learn to develop my non-verbal communication. I used most of the body gesturers because of the language barrier was being a gap in my conversation with Mrs. A. She could speak very limited in the first language so I tried to speak in her dialect. Furthermore, Wold (20 04, p.76) mention that gesturers are one specific type of non-verbal communication intended to express ideas and are useful for people who cannot use much words. However I also used my facial expressions to advise her to finish the meal. It might be not so delicious because she withdraws the meal after few scopes but I smiled and assured Mrs. A that it was good for her health to finish her meal. In addition, the facial expressions are most expressive which are not limited to certain cultural and age barriers (Wold, 2004,p.76). Therefore my facial expression worked out to encourage her to finish the meal. Although I could not explain detail to her about the important nutrition diet that she should take, but I could advocate her to finish the meal served because the meal was prepared according to her condition. In order to analysis of the event, I could evaluate that, my communication skills are very important to provide the best nursing care to Mrs. A. My communication with Mrs. A was the interpersonal communication. This is because the interpersonal communication is a communication which involved of two persons (Funnell et al 2005, p.438). I realized that my nonverbal communication did help me a lot in my duty to provide the nursing care to Mrs. A. Even though she could understand few simple words when I was asking her but I noticed that one of the  problems occurs within the communication was the language barrier. As the patient was not using the official language and the second language, I tried to speak in her language. I still could manage the communication in our conversation. However, it was quite difficult to promote the effective verbal communication with the patient. Besides, White (2005, p.112) recommend that a nurse should learn a few words or phrases in the predominant second language to put a patient at ease for better understanding. Although it was quite difficult but using the nonverbal simultaneously with the verbal communication did encou rage her to speak on her best to make me understand her words. In the event showed that, there was a response from Mrs. A. when I was asking her questions. Funnel et al (2005, p.438) point out that a communication would occur when a person responds to a message received and assigns meaning to it. She nodded her head to assign that she agreed with me. Delaune and Ladner (2002, p.191) explain that the channel is one of the component of the communication process which act as a medium during the message is sent out. In addition, Mrs. A also gave me a feedback that she understood my message by transmitting the message via her body gesturers and eye behavior. Thus I could consider that the communication channels used in my conversation were visual and auditory. Delaune and Ladner (2002, p.191) state a feedback is that the sender receives the information after the receiver react to the message. However, Chitty and Black (2007, p.218) define feedback is a response to a message. In my situation, I was a sender who conveyed the message receiving the information from Mrs. A, the receiver who agreed to take lunch and allow me to feed. Consequently, I could analyze that my communication with Mrs. A involved of five component of communication process which are sender, message, channel, receiver and feedback (Delaune and Ladner, 2002, p.191).In a nutshell, for my reflection of this event explores about on how the communication skills play a role on the nurse-patient relationship in order to deliver the nursing care towards the patient especially the adult. She needed quite some time to adapt the ability changes in her daily activities living where I was trying to help her in feeding. I was concerning my feeling and thoughts during the feeding so that I could improve more skills in my communication. I successfully communicated with her effectively as she enjoyed finishing the meal. So it  is vital to build rapport with her to encourage her ability to speak up ver bally and non-verbal. Moreover, this ability could help her to communicate effectively with other staff nurses. Later, she would not be neglected because of her age or her disability to understand the information given about her treatment.(Hyland and Donaldson 1989, cited in Harrison and Hart 2006 p.22) mention that communication express what the patients think and feel. In order to communicate with adult, it is important to assess her common communication language and her ability to interact in the other languages. As I used some words in her dialect, I essentially encouraged the patient to speak out verbally and communicate non-verbal so that the message could be understood and do not break the nurse-patient communication. In my opinion, I evaluated that it does not a matter whether it was a patient-centered communication or task-centered communication because both communication mentioned by McCabe (2004) actually does involves communication to the patients. So it was not a problem to argue which type of communication involves in my conversation with my patient. After I analyzed the situation, I could conclude that I was be able to know the skills for effective communication with the patient such as approach the patient, asking questions, be an active listening, show my empathy and support the patient emotions (Walsh, 2005, p.34). Actually helping the adult was a good practice in delivering the nursing care among adults. My action plan for the clinical practice in the future, if there were patients that I need to help in feeding or other nursing procedure, I would prepare myself better to handle with the patients who would have some difficulty in communication. This is because, as one of the health care worker, I want the best care for my patients. So in related to deliver the best care to my patients, I need to understand them very well. I have to communicate effectively as this is important to know what they need most during warded under my supervision as a nurse. According to my experience, I knew that communication was the fundamental part to develop a good relationship. Wood (2006, p.13) express that a communication is the key foundation of relationship. Therefore a good communication is essential to get know the patient’s individual health status (Walsh, 2005, p.30). Active listening could distinguish the existence of barrier communication when interactions with the patients. This is because, active listening means listening without  making judgment to listen the patients ’opinions or complaints which give me chances to be in the patients’ perspective(Arnold, 2007, p.201). On the other hand, it also crucial to avoid the barriers occurs in the communication with the patients. I could detect the language barriers by interviewing the patients about their health or asking them if they needed a ny help in their daily activities living. However, I would remind myself for not interfere my communication with barriers such as using the open-ended questions, not attending to non-verbal cues, being criticizing and judging, and interrupting (Funnell et al, 2005, p.453). Walsh (2005, p.31) too summary that making stereotyping and making assumptions about patients, perceptions and first impression of patients, lack awareness of communication skills are the main barriers to communications. I must not judge the patients by making my first impression and assumption about the patients but I have to make patients fee devalued as an individual. I should be capable to respect their fundamental values, beliefs, culture, and individual means of communication (Heath, 2000,p.27). I would be able to know on how to build rapport with the patients. There are eleven ways suggest by Crellin (1998, p.49) which are becomes visible, anticipate needs, be reliable, listening, stay in control, self-disclosure, care for each patient as an individual, use humour when appropriate, educate the patient, give the patient some control, and use gestures to show some supports. This ways could help and give me some guidelines to improve my communication skills with the patients. Another important thing to add on my action plan list is to know which the disabilities of the patients have such as hearing disability, visual impairment and mental disability. Once I could know the disability that a patient has, I could well-prepared my method of communication effectively as Heath(2000, p28) mention that communicating with people who was having some hearing impairment, sight impairment and mental health needs required the particular skills and considerations. Nazarko (2004, p.9) suggest that do not repeat if the person could not understand but try to rephrase and speak a little more slowly when communicating with the hearing difficulties people. Hearing problem commonly occurs among adults because of ageing process (Schofield,2002, p.21). To summarize for my action plan, I would start a communication with a good rapport to know what affects the patients’ ability to communicate well and  to avoid barriers in effective communication in future. In conclusion of my reflective assignment, I mention the model that I chose, Gibbs (1988) Reflective Cycle as my framework of my reflective. I state the reasons why I am choosing the model as well as some discussion on the important of doing reflection in nursing practice. I am able to discuss every stage in the Gibbs (1988) Reflective Cycle about my ability to develop my therapeutic relationship by using my interpersonal skills with one patient for this reflection. Reflection on a Clinical Skill The purpose of this assignment is to reflect upon a clinical skill that I undertook whilst on my second year community placement. I have chosen to use Gibbs (1988) model of reflection. In accordance with the Nursing and Midwifery Council (NMC), The Code of Professional Conduct (2008), confidentiality shall be maintained and all names changed to protect identity. The clinical skill I have chosen to reflect upon during this assignment is the monitoring of capillary blood glucose (CBG). I have chosen this skill as during my previous acute placements as a student I was not permitted to undertake them, and whilst in the community the Primary Care Trust (PCT) allows it. Having yet to develop this skill I thought that by reflecting on carrying it out would help me to gain the knowledge and confidence needed to perform it in the future. According to Siviter (2004) reflection is about gaining confidence, identifying when you could have improved, learning from your mistakes and about your beha viour, viewing yourself as others do, self awareness and changing the future by learning from the past. Description During a routine daily visit with my mentor Jane, a District Nurse, to Nisha, an elderly Asian lady who was Diabetic, Jane asked me whether I would like to take Nishas CBG. As I had only started doing CBGs during this placement I thought it would be a good learning opportunity so I agreed to do it. Jane asked Nisha whether she minded me doing her CBG and although she did not speak very much English she understood and consented for me to do it. I went into the kitchen and washed my hands. I returned to the living room where  Nisha was and asked her whether her hands were clean, to which she answered yes. I then assessed that Nisha was sat down on a low sofa, and thought it best to kneel down and lay my equipment out on the coffee table so that they were all to hand. Once checking that the blood glucose monitor had been calibrated and that the test strips were in date I opened a test strip and placed it into the monitor. I then put on gloves and asked Nisha whether she was comfortable and ready and which finger she wanted me to use, she said yes and held up her right third finger so I got the single use lancet and pricked the side of Nishas finger, disposing of the lancet into the sharps box. The blood came immediately and I applied it to the test strip and waited for the result, in the meantime I held a clean cotton wool ball to Nishas finger to stop the bleeding. I discarded the test strip and my gloves and recorded the CBG.I then washed my hands again. Once we had left Nishas property my mentor commented that I had done very well, but should have asked Nisha to wash her hands before commencing the CBG test. Feelings When Jane, my mentor, first asked me if I wanted to do Nishas CBG I felt slightly nervous as I had only done a few previously and was aware that she would be observing me through the procedure which also gave me reassurance that if I were to do anything wrong she would be there to highlight it. Once Nisha had consented to me doing the CBG I felt pleased that she trusted me to carry out the process, which allayed my nerves. During the procedure I was aware that my mentor was watching me, which once again made me anxious, but she was encouraging me the whole time and totally supportive. When I instantly got blood once pricking Nishas finger I felt a sense of relief that I had done it correctly. Once the whole process was over Nisha held my hand and smiled and in broken English said â€Å"thank you, thank you†, I was humbled by her response as I felt I was just doing my job. Overall I was satisfied with my performance and felt positive that I wouldn’t be so nervous next ti me round. Evaluation On the whole performing this clinical skill went really well, and having not had much practice at doing this particular skill I was glad to have had the  opportunity to do it whilst under direct supervision from my mentor. I think that my communication with Nisha, even though she spoke little English was very good and that I had formed a strong therapeutic relationship with her. I feel that on reflection I should of asked Nisha to wash her hands before the procedure, and that my mentor should have ensured this, to guarantee that the reading was not contaminated. Analysis I will start by looking at the skill and the evidence supporting it. CBG monitoring is part of many diabetics daily routine. If a patient’s CBG goes up (hyperglycaemia) or down (hypoglycaemia) it can cause the patient to become unwell (Baillie, 2009). Dougherty & Lister (2008) state that in the short term CBG monitoring can prevent hypoglycaemia and ketoacidosis and in the long term can considerably lower complications arising that could affect the patient both vascularly and neurally. Patients can control their condition through diet, oral hypoglycaemic agents, insulin therapy or a combination of the above, (Higgins, 2008). By asking Nisha whether she minded me performing the CBG my mentor had gained informed consent in accordance with the NMC (2008), who say that consent must be gained before any treatment is commenced. I washed my hands following the Ayliffe (1978) technique in order to prevent the spread of infection, Pratt et al (2007) state that hands must be decontamina ted between each and every episode of patient care. I asked Nisha whether her hands were clean, as one of the main causes of inaccuracy of CBG readings are fingers that are contaminated with foodstuffs (Alexander et al, 2000). I assessed that Nisha was sat comfortably on a low sofa, Jamieson et al (2007) says to ensure patient comfort and prevent any injury occurring should the patient feel faint during the procedure . I then knelt down and laid my equipment out on the table, as Baillie (2009) suggests that all equipment needed for a procedure should be within easy reach, and avoid any twisting or stooping which could cause me injury, in line with the PCT Moving and Handling Policy and Procedure (2006). I then checked the CBG monitor had been calibrated and that the test strips were in date, to prevent false positive/ negative readings (Hastings, 2009). I then put on my gloves and asked Nisha whether she was ready and which finger she wanted me to use, Jamieson (2007) says  that gloves should be used to prevent the patient and nurse from any potential blood borne infection. The NMC (2008) state that you must allow patients to make decisions about their care, and also that patients should be treated indiv idually and with dignity. Suhonen et al (2007) conclude that individualised patient care leads to positive patient outcomes, such as patient satisfaction, patient autonomy and patients perceptions on health related quality of life. I used both verbal and non-verbal communication, which involved speaking slowly and clearly so that Nisha could understand what I was saying. I also used non-verbal communication through touch, eye contact, facial expressions and body language, (Funnell et al, 2009). I then using a single use lancet, in accordance with PCT (2005) policy on blood glucose monitoring, pricked the side of Nishas right third finger and disposed of the lancet into the sharps box. Baillie (2009) suggests that the third, fourth or fifth finger should be used as the thumb and index finger are important for touch, and to use the side as it is less painful. To prevent injury sharps and unused drugs must be placed in disposal boxes at the point of use, (Dougherty and Lister, 2008). I applied cotton wool to stop any bleeding and then disposed of the test strip and my gloves, washed my hands again using the Ayliffe (1978) technique and recorded my findings. Hastings (2009) recommends applying pressure briefly to the puncture site to prevent painful extravasation of blood into the subcutaneous tissues. The Department of Health (2007) state that to reduce the risk of cross infection any waste must be disposed of appropriately. Flores (2006) maintains that it is important to wash your hands after removing gloves as bacteria can contaminate them through small defects in the gloves or during removal. Records should be completed as soon as possible following an event (NMC, 2008), and as a student all documentation needs to be countersigned (Siviter, 2004). My mentor said that I should have asked Nisha to wash her hands, not if they were clean the rationale being the same as previously stated, (Alexander et al, 2000), and also Cowan (1997) also agreed that patients hands should be washed to ensure a non-contaminated result. Conclusion In conclusion I now appreciate how in depth a â€Å"simple† CBG procedure actually is, when done correctly. I have looked further for evidence stating that patients hands should be washed before the CBG test is performed and realise that I should have asked Nisha to do so as the result could potentially have been wrong. On reflecting on undertaking this skill I have developed my learning of the need to carry out this procedure and the importance of it to a Diabetic. I have also found that following guidelines is vital to accurate results. Action Plan In future when I carry out this procedure I will continue to practice as I have done as long as this is in line with local trust policy and supporting evidence. I will always ensure that the patient washes their hands before commencing the process, as this is what evidence suggests is good practice and also important for an accurate result.

Filipino Traits Essay

Negative, because it arrests or inhibits one’s action. This trait reduces one to smallness or to what Nietzsche calls the â€Å"morality of slaves†, thus congealing the soul of the Filipino and emasculating him, making him timid, meek and weak. Positive, because, it contributes to peace of mind and lack of stress by not even trying to achieve. Ningas-cogon (procrastination) Negative, by all standards, because it begins ardently and dies down as soon as it begins. This trait renders one inactive and unable to initiate things or to persevere. Positive, in a way, because it makes a person non-chalant, detached, indifferent, nonplussed should anything go wrong, and hence conducive to peace and tranquillity. Pakikisama (group loyalty) Negative, because one closes one’s eyes to evils like graft and corruption in order to conserve peace and harmony in a group at the expense of one’s comfort. Positive, because one lives for others; peace or lack of dissension is a constant goal. Patigasan (test of strength) Negative, because it is stubborn and resists all efforts at reconciliation. The trait makes us childish, vindictive, irresponsible, irrational. Actions resulting from this trait are leaving the phone off the hook to get even with one’s party line; stopping the engine of the car to prove that one has the right of way; standing one’s ground until the opposite party loses its patience. Positive, because it is assign that we know our rights and are not easily cowed into submission. It is occidental in spirit, hence in keeping with Nietzsche’s â€Å"will to power.† Bahala na (resignation) Negative, because one leaves everything to chance under the pretext of trusting in Divine providence. This trait is really laziness disguised in religious garb. Positive, because one relies on a superior power rather than on one’s own. It is conducive to humility, modesty, and lack of arrogance. Filipino Traits Kasi (because, i. e., scapegoat) Negative, because one disowns responsibility and makes a scapegoat out of someone or something. One is never to blame; one remains lily white and has a ready alibi for failure. Positive, because one can see both sides of the picture and know exactly where a project failed. One will never suffer from guilt or self-recrimination. Saving Face Negative, because, being closely related to hiya and kasi, it enables a person to shirk responsibility. One is never accountable for anything. Positive, because one’s psyche is saved from undue embarrassment, sleepless nights, remorse of conscience. It saves one from accountability or responsibility. This trait enables one to make a graceful exit from guilt instead of facing the music and owning responsibility for an offense. Sakop (inclusion) Negative, because one never learns to be on one’s own but relies on one’s family and relatives. This trait stunts growth and prevents a person from growing on one’s own. Generating a life of parasitism, this trait is very non-existential. Blaring music, loud tones are a result of this mentality. We wrongly think that all people like the music we play or the stories we tell. This mentality also makes us consider the world as one vast comfort room. Positive, because one cares for the family and clan; one stands or falls with them. This trait makes a person show concern for the family to which he belongs. Maà ±ana or â€Å"Bukas na† (procrastination) Negative, because one constantly postpones action and accomplishes nothing. This aggravates a situation, a problem grows beyond correction, a leak or a small break becomes a gaping hole. This arises from an indolent mentality that a problem will go away by itself. Positive, because one is without stress and tension; one learns to take what comes naturally. Like the Chinese wu-wei, this trait makes one live naturally and without undue artificiality. THE IMPORTANCE OF READING The importance of reading to children cannot be over emphasized. It is also a great way to focus on the family. With that in mind, â€Å"Little Ones Reading Resource† is dedicated to every child and every family out there and to educating us â€Å"big† people about the importance of reading to children and its role in child development. Every child deserves to have a good book read to her. Every child deserves to have good books he can call his very own, stored on his very own book shelf where he can pull them out and â€Å"read† them any time he wants. The importance of reading to children is significant in child development, and reading books to little ones at an early age is essential. In fact, reading childrens stories aloud is one of the most important activities we, as parents, grandparents, teachers, and care-givers, can do for our kids. The importance of reading to children plays out in a myraid of developmental, emotional, and learning issues from bonding and security . . . to learning to read . . . to future success. The best part about reading childrens stories to our little ones is that we can ALL do it! We don’t have to be experts, or rocket scientists, or teachers, or even millionaires to experience the joys of snuggling up with our little ones and enjoying a special story. There is SO MUCH more to reading books to a baby, toddler, preschooler, and school-age child than meets the eye. Isn’t it great to know that something so simple can make such a difference? All children should have good books of their very own, as it is truly a fantastic way to encourage reading. However, we don’t have to think of material things when we think of gifts. The greatest gift we can give our children is the gift of OURSELVES — our time, our talents, our prayers, our thoughts of kindness, and our acts of love and compassion. Any day is a good day to step forward and offer the gift of yourself by reading a book to your little ones! Please come on in and look around and learn about the i mportance of reading to children . . . and let’s start reading together today!