Drunk Driving Do Not Become a Potentional Killer!

Drunk Driving: Do Not Become a Potentional Killer! It is argued whether there is a permissible dose of alcohol, which the driver can get before driving a vehicle. All professional therapists deny the existence of such a dose. Even if a person’s blood contains small amount of alcohol, he or she ceases to perceive the real world in a proper way. When we talk about drivers, they can no longer normally accept moving light sources and determine the distance between riding cars, when under influence of alcoholic beverages. As a result, safety of driving is greatly reduced. If the driver’s blood contains 0,5 0,8 pro mille of alcohol, he or she not only ceases to perceive the distance between moving cars, but also respond to the traffic lights correctly. When the blood alcohol level rises to 0.8 1.2 pro mille, the driver falls into a state of euphoria. As a result, they significantly overestimate their own capabilities and often begin to scorcher. In this case, not only the driver may be seriously damaged, but also other people are exposed to great danger. When the level of alcohol in the driver’s blood reaches 1.2 2.4 pro mille, it is strictly forbidden to sit behind the wheel. There is a strong possibility that during driving an unforgivable error that can cause the most catastrophic consequences can be committed. The point is that such alcohol levels in blood result in inadequate behavior of the driver. It goes without saying that alcohol consuming and driving are incompatible. Even a small dose of alcohol may cause an accident. When it goes to higher dosages, there is no doubt concerning the fact that driving in such a condition is extremely dangerous.

The Treasure Box Is Knowledge, And The Value Is Success...

Introduction A book is a treasure box, the treasure is knowledge, and the value is success and power. Reading is the key that unlocks your access to a wealth of information. With this, one becomes knowledgeable on certain subjects. Knowledge gives you a closer understanding of your situation, which facilities it and gives you control. You gain the power of an ability, which leads to success in the subject. I feel that I must take advantage of the treasures I possess the capability to obtain, seeing as how not everyone has the access I have to them. I have the power to take initiative and learn about any subject I wish. I know I can do anything I set my mind to because I can gain the knowledge required to achieve it. This mindset†¦show more content†¦Reading has given me the opportunity to view the perspectives of different people with different backgrounds from my own, which has led my to question myself on my opinions on the subject. For instance, in Some Things Should Happ en on Soft Pages, Not Cold Metal, Harper Lee expresses that she sees paper books as a better method of obtain information because electronic books are too easy to access. She wrote â€Å"Instant information is not for me. I prefer to search library stacks because when I work to learn something, I remember it† (Lee 1). Harper can be seen having trouble adjusting to the new technologies of this century, choosing to reminisce about the past s lifestyles instead. However, she overlooks the benefits new technology has brought to others. Many people might not have as easy of an access to paper books, something electronic books have helped with. When I was in grade school, I only had access to a few shelves my school called a library and a public library all the way across town, which I could rarely visit. Buying books was immediately a preposterous idea after one look at their price tags. However, I wouldn t be kept away from reading. I found ways to access books online and read th em to my heart s content. Living in a first world country, I was definitely privileged and I can only imagine the circumstances of others not as fortunate. However, as each year we advanceShow MoreRelatedEssay about World of Board Games: Forbidden Island 1807 Words   |  8 PagesAs defined by the creators of the board game, the primary object of Forbidden Island is to, â€Å" . . . work together to keep Forbidden Island from sinking in order to buy enough time to capture its four treasures. Once . . . captured . . . (the team of adventurers) must make it to Fools’ Landing and escape by helicopter to win. 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Power of Substitutes†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 3.2.6.5. Intensity of Rivalry †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 3.2.7. Summary of Industry Analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 3.3.0. Competition Analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 3.3.1. Industry Competitors †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 3.3.2. Rivals Anticipated Strategic Moves†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 3.3.3. Summary of Competitive Analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 3.3.4. Key Success Factors†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 1. 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Assessment and Care Planning Holistic Assessment Free Essays

string(104) " the type of the house she lives in helps to indicate how the patient is going to cope after discharge\." Introduction This essay deals with the holistic assessment of a patient who was admitted onto the medical ward where I undertook my placement. Firstly, the relevant life history of the patient will be briefly explained. Secondly, the Roper, Logan and Tierney model of nursing that was used to assess the care needs of the patient will be discussed, and then the assessment process will be analysed critically. We will write a custom essay sample on Assessment and Care Planning: Holistic Assessment or any similar topic only for you Order Now Identified areas of need will be discussed in relation to the care given and with reference to psychological, social, and biological factors as well as patho-physiology. Furthermore, the role of inter-professional skills in relation to care planning and delivery will be analysed, and finally the care given to the patient will be evaluated. Throughout this assignment, confidentiality will be maintained to a high standard by following the Nursing and Midwifery Council (NMC) Code of Conduct (2008). No information regarding the hospital or ward will be mentioned, in accordance with the Data Protection Act 1998. The pseudonym Kate will be used to maintain the confidentiality of the patient. The Patient Kate, a lady aged 84, was admitted to a medical ward through the Accident and Emergency department. She was admitted with asthma and a chest infection. She presented with severe dyspnoea, wheezing, chest tightness and immobility. Kate is a patient known to suffer from chronic chest infections and asthma, with which she was diagnosed when she was young. She takes regular bronchodilators and corticosteroids in the form of inhalers and tablets. Kate lives on her own in a one bedroom flat. She has a daughter who lives one street away and visits her frequently. Her daughter stated that Kate has a very active social life; she enjoys going out for shopping using a shopping trolley. Assessment of the Patient Assessment Theory In this ward, the Roper, Logan and Tierney model of nursing, which reflects on the twelve activities of living, is used as a base for assessing patients (Alabaster 2011). These activities are â€Å"maintaining safe environment, communication, breathing, eating and drinking, elimination, personal cleansing and dressing, controlling body temperature, mobility, working and playing, sexuality, sleeping, and dying† Holland (2008, p.9). Elkin, Perry and Potter (2007) outlined nursing process as a systematic way to plan and deliver care to the patient. It involves four stages: assessment, planning, implementation and evaluation. Assessment is the first and most critical step of the nursing process, in which the nurse carries out a holistic assessment by collecting all the data about a patient (Alfaro-Lefevre 2010). The nurse uses physical assessment skills to obtain baseline data to manage patients’ problems and to help nurses in the evaluation of care. Data can be collected through observation, physical assessment and by interviewing the patient (Rennie 2009). A complete assessment produces both subjective and objective findings (Wilkinson 2006). Holland (2008) defines subjective data as information given by the patient. It is obtained from the health history and relates to sensations or symptoms, for example pain. Subjective data also includes biographical data such as the name of the patient, address, next of kin, religion etc. Holland defines objective data as observable data, and relates it to signs of the disease. Objective data is obtained from physical examination, for example of blood pressure or urine. Before assessment takes place, the nurse should explain when and why it will be carried out; allow adequate time; attend to the needs of the patient; consider confidentiality; ensure the environment is conducive; and consider the coping patterns of the patient (Jenkins 2008). The nurse should also introduce herself to help reduce anxiety and gain the patient’s confidence. During assessment, the nurse needs to use both verbal and non-verbal communication. Using non-verbal communication means that she should observe the patient, looking at the colour of the skin, the eyes, and taking note of odour and breathing. An accurate assessment enables nursing staff to prioritise a patient’s needs and to deal with the problem immediately it has been identified (Gordon 2008). Documentation is also very important in this process; all information collected has to be recorded either in the patient’s file or electronically (NMC, 2009b). Carrying out the Assessment Kate was allocated a bed within a four-bed female bay. Her daughter was with her at the bedside. Gordon (2008) stated that understanding that any admission to hospital can be frightening for patients and allowing them some time to get used to the environment is important for nursing staff. Kate’s daughter was asked if she could be present while the assessment was carried out, so that she could help with some information, and she agreed. Alfaro-Lefevre (2008) recommended that nursing assessments take place in a separate room, which respects confidentiality, and that the patient be free to participate in the assessment. Although there was a room available, Kate’s daughter said it was fine for the assessment to take place at the bedside because her mother was so restless and just wanted to be next to her. The curtains were pulled around the bed, though William and Wilkins argued that it ensures visual privacy only and not a barrier to sound. NMC (2009a) acknowledges this, along with the need to speak at an appropriate volume when asking for personal details to maintain confidentiality. The assessment form that was used during Kate’s assessment addressed personal details and the twelve activities of living. A moving and handling assessment form was also completed because of her immobility. First, personal details such as name, age, address, nickname, religion, and housing status were recorded. Information was also recorded about any agency involved, along with next of kin and contact details, and details of the general practitioner. Holland (2008) stated that these details should be accurate and legible so that, in case of any concerns about the patient, the next of kin can be contacted easily. The name and age are also vital in order to correctly identify the patient to avoid mistakes. Knowing what type of a job the patient does or the type of the house she lives in helps to indicate how the patient is going to cope after discharge. You read "Assessment and Care Planning: Holistic Assessment" in category "Essay examples" Holland also insisted that religion s hould be known in case the patient would like to have some privacy during prayers, and this should be included in the care plan. The second assessment to be done focused on physical assessment and the activities of living. Barrett, Wilson and Woollands (2009) suggested that when enquiring about the activities of living, two elements should be addressed: usual and current routines. Additionally, identifying a patient’s habits will help in care planning and setting goals. During physical assessment, when objective data was collected, Kate demonstrated laboured and audible breath sounds (wheezing) and breathlessness. Use of accessory muscles and nose flaring was also noted. She was agitated and anxious. Her vital signs were: blood pressure 110/70; pulse 102 beats /min; respirations 26/min; temperature 37.4 degrees Celsius; oxygen saturation 88%; peak flow 100 litres; weight 60kg; and body mass index 21. Taking and recording observations is very important and is the first procedure that student nurses learn to do. These observations are made in order to detect any signs of deterioration or progress in the p atient’s condition (Field and Smith 2008). Carpenito-Moyet (2006) stated that it is important to take the first observations before any medical intervention, in order to assist in the diagnosis and to help assess the effects of treatment. Kate’s initial assessment was carried out in a professional way, taking account of the patient’s particular circumstances, anxieties and wishes. After the baseline observations were taken, the twelve activities of living were analysed and Kate’s needs were identified. Among the needs identified, breathing and personal hygiene (cleansing) will be explored. Identified Care Needs Breathing Wilkinson (2006) states that a nursing diagnosis is an account about the patient’s current health situation. The normal breathing rate in a fit adult is 16-20 respirations/minute, but can go up to 30 due to pain, anxiety, pyrexia, sepsis, sleep and old age (Jenkins 2008). In old people, muscles become less efficient, resulting in increasing efforts to breathe, causing a high respiratory rate. On assessment, Kate’s problem was breathing that resulted in insufficient intake of air, due to asthma. She was wheezing, cyanosed, anxious and had shortness of breath. Wilkinson (2006) explained that a goal statement is a quantifiable and noticeable criterion that can be used for evaluation. The goal statement in this case would be for Kate to maintain normal breathing and to increase air intake. The prescription of care for Kate depended on the assessment, which was achieved by monitoring her breathing rate, rhythm, pattern, and saturation levels. These were documented hourly, comparing the readings with initial readings to determine changes and to report any concerns. The other part of the plan was to give psychological care to Kate by involving her in her care and informing her about the progress, in order to reduce anxiety. Barrett, Wilson and Woollands (2012) stated that it is very important to give psychological care to patients who are dyspnoeic because they panic and become anxious. Checking and recording of breathing rate and pattern is very important because it is the only good way to assess whether this patient is improving or deteriorating, and it can be a very helpful method for nurses to evaluate whether or not the patient is responding to treatment (Jamieson 2007). Mallon (2010) stated that, if the breathing rate is more than 20, it indicates the need for oxygen. Blows (2001), however, argued that this can happen even after doing exercise, not only in people with respiratory problems. Griffin and Potter (2006) stated that, respirations are normally quiet, and therefore if they are audible it indicates respiratory disease. Nurses needs to be aware of these sounds and what they mean, for example a wheezing sound indicates bronchiole constriction. Kate’s breathing was audible and the rate was also above normal and that is why breathing was prioritised as the first need. Oxygen saturation level was also monitored with the use of a pulse oximeter. The normal saturation level is 95-99% (British National Formulary ((BNF)) 2011a). Nevertheless the doctor said that 90-95% was fine for Kate, considering her condition and her age. Kate was started on two litres of oxygen and she maintained her oxygen saturation between 90 and 94%. The peak expiratory flow was monitored and recorded to identify the obstructive pattern of breathing that takes place in asthma (Hilton, 2005). This is another method that is used to assess the effectiveness of the medication (inhalers) the asthmatic patient is taking, and this test should be carried out 20 minutes after medication is administered. It is the Trust’s policy to do hourly observations on patients who have had one, two or three abnormal readings, until readings return to normal. Kate was observed for any blueness in the lips and tongue and for oral mucosa as this could be a sign of cyanosis. All the prescribed nebulisers, inhalers, bronchodilators, corticosteroids, antibiotics and oxygen therapy were administered according to the doctor’s instructions. Bronchodilators are given to dilate the bronchioles constricted due to asthma, and corticosteroids reduce inflammation in the airway (BNF 2011b). Kate was also started on antibiotics to combat the infection because, on auscultation, the doctor found that the chest was not clear. Kate was nursed in an upright position using pillows and a profiling bed in order to increase chest capacity and facilitate easy respiratory function by use of gravity (Brooker and Nicol, 2011). In this position, Kate was comfortable and calm while other vital signs were being checked. Pulse rate and blood pressure were also being checked and recorded because raised pulse can indicate an infection in the blood. Cleansing Due to breathlessness and loss of mobility it was difficulty for Kate to maintain her personal hygiene. Hygiene is the practice of cleanliness that is needed to maintain health, for example bathing, mouth washing and hair washing. The skin is the first line of defence, so it is vital to maintain personal cleansing to protect the inner organs against injuries and infection (Hemming 2010). Field and Smith (2008) stated that personal cleansing also stimulates the body, produces a sense of well-being, and enables nurses to assess the patient holistically. Personal hygiene is particularly important for the elderly because their skin becomes fragile and more prone to breaking down (Holloway and Jones 2005). Therefore this need was very important for Kate; she needed to maintain her hygiene as she used to, before she was ill. The goal for meeting this need was to maintain personal hygiene and comfort. The care plan prescribed involved first gaining consent from Kate, explaining what was going to be done. Hemming (2010) recommended that identifying the patient’s usual habit is very important because each individual has different ideas about hygiene due to age, culture or religion. Identifying usual habits helps individuals to maintain their social life if things are done according to their wishes. Though Hemming said all human beings need personal hygiene, Holland (2008) argued that it is important to ask patients how they feel about being cleaned, especially in private areas. Kate indicated that she didn’t mind being assisted with washing and dressing. She preferred washing daily, shower and a hair wash once a week, and a mouth wash every morning and before going to bed. Kate was assisted with personal care 5-10 minutes after having her medication, especially the nebuliser. Individuals with asthma experience shortness of breath whenever they are physically active (Ritz, Rosenfield and Steptoe 2010). After having medication Kate was able to participate during personal hygiene. According to NMC guidelines on confidentiality (2009a), privacy and dignity should be maintained when giving care to patients. Therefore, whenever Kate was being assisted with personal care, it was ensured that the screens were closed and she was properly covered. Field and Smith (2008) suggested that assisting a patient with personal hygiene is the time that nurses can assess the patient holistically. Since Kate was immobile, it was very important to check her pressure areas for any redness. She was also checked for any pallor, jaundice, cyanosis or dry skin that needed attention. The care was always carried out according to her wishes. The Role of Inter-Professional Skills Considering Kate’s age and condition, she needed multi-professional teamwork. NMC (2008) encourages teamwork to maintain good quality care. Kate was referred to the respiratory nurse who is specialised in helping people with breathing problems. Since Kate was on oxygen since admission, the respiratory nurse taught her the importance of healthy breathing and taught her some breathing exercises to help wean her from oxygen. Kate was also referred to the physiotherapist who did breathing exercises with her. Kate was not able to walk without aid so she was also referred to the occupational therapy department to assess how she was going to manage at home, or if she required aids to help her manage the activities of living. Upon meeting together, all the multi-disciplinary team agreed that Kate needed a care package, as she could no longer live without care. She was referred to social services so that they could assess this aspect of Kate’s future. After one week Kate was medically fit but could not go home because she was waiting for the care package to be ready. Her nurse shared information with the multi-disciplinary team in order to establish continuity of care for Kate. The team prepared for her discharge: the occupational therapy staff went to visit her home to check if there was enough space for her walking frame; social services arranged for a care package; and her nurses referred her to the district nurse to help her with her medication and make sure it did not run out. Outcome Kate responded well to the medication she was prescribed; normal breathing was maintained, her respirations became normal, ranging from 18 to 20 respirations per minute, and her oxygen saturation ranged from 95% to 99%. Kate was able to wash and dress herself with minimal assistance. She was discharged on a continuous care package comprising care three times a day, and the district nurse helped her with the medication to control her asthma. Evaluation The model of the twelve activities of living was followed successfully on the whole. The nurse collected subjective and objective data, allowing a nursing diagnosis to be formulated, goals to be identified and a care plan to be constructed and implemented. Privacy is very important in carrying out assessments, and this was not achieved fully in Kate’s assessment. However, this lower level of privacy has to be balanced against causing anxiety to the patient. Kate’s daughter thought that the bedside assessment would be more comfortable for her mother, and therefore cause least anxiety. This was very important because of the effects of potential panic on breathing; therefore, this was the correct balance to strike. A multi-disciplinary team was involved in meeting Kate’s care goals. This is a good example of the use of inter-professional skills, as a number of different departments were involved in creating and implementing the care plan. However, the system was not as efficient as it should have been: Kate spent unnecessary time in hospital after recovery because the care plan was not yet in place. Assessment can also take a long time, especially with the elderly who are usually slow to respond. Therefore, more time is needed to be sure that the necessary progress has been achieved before taking further steps. However, poor staffing also affects performance in this area, an observation supported by the Royal College of Nursing (2012). In conclusion, the assessment of this patient was completed successfully, and the deviation from best practice recommendations (the lower level of privacy) was justified by the clinical circumstances. Progress from assessment to care goals was good, and at this point an inter-disciplinary team was used successfully. However, the one flaw in this process was delays, caused partly by the difficulties of working across different departments, and partly, it seems, by staff shortages. Reference List Alabaster, C.S (2011) ‘Care and rehabilitation of people with long term conditions’ in Brooker, C. and Nicol, M. (eds) (2011) Alexander’s Nursing Practice (4th ed). London: Churchill Livingstone.. Chapter 32 Alfaro–LeFevre, R. (2008) Critical thinking and clinical judgment: A practical approach to outcome-focused thinking (3rd ed.). St. Louis, MO: Saunders. Barrett, D., Wilson, B. and Woollands, A. (2009) Care Planning: A Guide for Nurses (2nd ed). Harlow: Pearson Education. Chapter 2. Blows, W. T. (2001) The Biological Basis of Nursing: Clinical Observations. London: Routledge. British National Formulary (2011a) Oxygen. London: British Medical Association and the Royal Pharmaceutical Society of Great Britain. British National Formulary (2011b) Corticosteroids. London: British Medical Association and the Royal Pharmaceutical Society of Great Britain. Brooker, C. and Nicol, M. (eds) (2011) Alexander’s Nursing Practice (4th ed). London: Churchill Livingstone. Carpenito-Moyet, L. J. (2006) Handbook of Nursing Diagnosis (11th ed). Philadelphia: Lippincott. Doughty, L. and Lister, S. (eds) (2008) The Royal Marsden Hospital Manual of Clinical Nursing Procedures (student edition) (7th ed). Oxford: Wiley Blackwell. Elkin, M. K., Perry, A. G. and Potter, P. A. (2007). Nursing Interventions and Clinical Skills. Philadelphia: Mosby. Field, L. and Smith, B. (2008). Nursing Care (2nd ed). Harlow: Pearson Education. Gordon, M., (2008). Nursing Assessment and Diagnostic Reasoning. Philadelphia: F.A. Davis company. Griffin, A., Potter, P. (2006) Clinical Nursing Skills and Techniques (6th ed). Philadelphia: Mosby Hemming, L. (2010). ‘Personal Cleansing and Dressing’ in I. Peate (ed) Nursing Care and the Activities of Living. (2nd ed). Oxford: Wiley Blackwell. Chapter 9. Hilton, A. (2003) Fundamental Nursing Skills. London: John Wiley Sons Holland, K., (2008) ‘An introduction to the Roper-Logan-Tierney model for nursing, based on Activities of Living’ in Holland, K., Jenkins, J., Solomon, J. and Whittam, S. (eds). Applying the Roper, Logan and Tierney Model in Practice. London: Churchill Livingstone. Chapter 1, pp.9-10. Holloway, S. and Jones, V. (2005). ‘The importance of skin care and assessment’ in the British Journal of Nursing Dec 2005-Jan 2006 14(22): 1172-6. Jamieson, E. Whyte, L. A. and McCall, J. A. (2002) Clinical Nursing Practices. London: Churchill Livingstone. Jenkins, J., (2008) ‘Breathing’ in Holland, K., Jenkins, J., Solomon, J and Whittan, S. (eds) Applying the Roper, Logan and Tierney Model in Practice. London: Churchill Livingstone. Chapter. 5. Mallon, S. (2010) ‘Breathing’ in I. Peate (ed) Nursing Care and the Activities of Living (2nd ed). Oxford: Wiley Blackwell. Chapter 8. Nursing and Midwifery Council (2008) The Code of Conduct. London: NMC. Available at: http://www.nmc-uk.org/Publications/Standards/The-code/Introduction/ Accessed 24/05/2012 Nursing and Midwifery Council (2009a) The Code of Conduct: Confidentiality. London: NMC. Available at: (http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Confidentiality/) Accessed 24/05/2012 Nursing and Midwifery Council (2009b) Record Keeping: Guidance for Nurses and Midwives. London: NMC. Available at: http://www.nmc-uk.org/Documents/Guidance/nmcGuidanceRecordKeepingGuidanceforNursesandMidwives.pdf Accessed 24/5/2012 Rennie, I. (2009). ‘Exploring approaches to clinical skills development in nursing education’ in Nursing Times 105: 3, 20-22. Available at: http://www.nursingtimes.net/exploring-approaches-to-clinical-skills-development-in-nursing-education/1973990.article Accessed 14/05/2012 Ritz, T., Rosenfield, D. and Steptoe, A. (2010) ‘Physical activity, lung function, and shortness of breath in daily life of asthma patients’ in Chest 138(4), 913-918. Royal College of Nursing (2012) Safe staffing for older people’s wards. Available at: http://www.rcn.org.uk/__data/assets/pdf_file/0010/439399/Safe_staffing_for_older_people_V3.pdf Accessed: 24/05/2012 Wilkinson, J. M. (2006) Nursing Process and Critical Thinking. (4th ed). New Jersey: Pearson Prentice Hall. How to cite Assessment and Care Planning: Holistic Assessment, Essay examples

Attraction and Retention Depends on Business Success

Question: Describe about the Attraction and Retention for Depends on Business Success. Answer: Introduction Success in business depends on attracting and retaining the best talent in place in the present and for the future. It is preferable to look for quality than quantity. An employer should know how to attract great employees and make them stay. Because retention of great talent translates into profits, as these employees love what they are doing and are knowledgeable (Amundson, 2007). All in all, it will result in customer satisfaction and job satisfaction. A lot of companys resources are wasted on the employees inefficient for the job profile a company demands. Attracting here refers to the search of the talented and knowledgeable candidates for the company, and it includes the job analysis, selection, and appointment of the candidate. Retention of an employee means to make the appointed candidate stay in the organization. In this report, both the points are approached and described relevantly (Andersen, 2016). Wal-Mart Stores Inc is a multinational retail company that operates in more than twenty-five countries. It has a chain of discount department stores, hypermarkets, and grocery stores totalling around 11,500 stores spread throughout the world. Walmart is the largest private employer globally with more than two million employees. The Human Resource Management of Walmart has a very critical job and participation in the success of the company. The HRM department of the company aims to maximize the employee performance and ultimately maximizing the sales capacity (Arthur, 2012). The HRM department of Walmart has some major components like human resource planning, job analysis and design in its strategy. With the help of these major components, the HRM department of Walmart develops an adequate workforce through proper job description and specification as per the companys demands. After that a proper attracting applicants process, selection process, appointment process, rejection process, legal compliance, orientation, socialization and strategies to ensure the retaining of efficient employees are taken up by the HRM department (Bell, 2012). Job Analysis and Design of Walmart It is very important for a company to analyze the jobs that company has an opening in. This is done so the advertisement provided in the website should carry all the information required to find the best candidates for the company. For this, the organizational design needs to be understood, and then the job specification will be designed that will be able to find the best candidate for the job (Chi, 2007). Organizational Design- Walmart has a hierarchical functional structure which is implemented in the job design and analysis of the organization by the HRM department of the company. The organizational structure of the company makes it easy to distinguish between the characteristics of each job which is very important to find the correct employee for the job (Edenborough, 2012). They have a clear line of authority, communication, and command in the organizational structure. Though it is sometimes difficult to judge the and clearly define the job because of the changing global demands and the company is still following it traditional organizational structure. This may lead to the uncertainty in job analysis and design (Folsom, 2008). Methods of Job Analysis- the work-oriented and the worker-oriented job analysis are the two methods of job analysis used by Walmart. For the sales positions, the company applies the work-oriented analysis. This method is taken up by the company to provide information about the tasks and results. This method is applied by Walmart in the form of direct observations and interview of the applicants. The HRM department of the company observes the sales personnels activities directly (Han, 2008). To analyze the jobs of team supervisors and leaders, interviews are conducted. This method helps the HRM department of the company to establish expectable job results. When talking about the other method then the worker-oriented method of job analysis provides information on cognitive, perpetual, and interpersonal activities. To analyze the managerial jobs the company uses worker-oriented job analysis method. The company has a specific application of the worker-oriented job analysis method known a s Work Profiling System (WPS) that is designed especially for the managerial positions. The company has divide its job requirements in two parts which in not sufficient to accommodate all types of job opening in the company. Thus, the HRM department should think of some more alternatives for it (Jones, 2010). Job Description- Walmart is the largest retailer in the world with a variety of job descriptions. Its employee turnover is high, especially for the employees working on hourly basis which act as problem for the company (Kenny, 2012). Nevertheless, the companys HRM department uses the variables as criteria for job description, and they are as follows:- Position- the position where the opening has created Function- the function of the employee at that position Duties- duties need to be performed by the employee Performance Standards- standards that the employee should maintain in his performance Job Factors- factors that are required in the job and applicants Job Knowledge- if an employee has knowledge about the job as it will increase the performance of the employee (Koedel Xiang, 2016). Walmart emphasizes on analytical and problem-solving skills, abilities and knowledge for the managerial positions. For sale personnel, Walmart emphasizes on job knowledge and interpersonal skills. Interpersonal skills are very important as per the Walmarts HRM department as they directly communicate with the customers (L, Compton, Morrissey, W.J, Nankervis, 2014). Job Specification- Walmart has a wide collection of job specifications. But, in general, job descriptions divide into two parts essential attributes and desirable attributes. For sales positions, essential attributes are followed, and they are as follows:- Communication skills- this skill is very important because sales personal directly communicates with the customers (Parker, 2007). Business knowledge- an employee should have the knowledge of what business they are entering and going to work in. Products knowledge- Walmarts sells everything from Pin to a Plane there it is important that the employers take all knowledge about the various products sold by the company (Paul, 2014) Throughout the organization, these essential attributes are important for all the sales employees. All these attributes help the employee to deal with the customers, as they are one with whom the customers directly communicate. There are some attributes known as desirable attributes that are preferred by the company but do not make necessary for a sales employee to efficiently fulfil the job (Persky Merriman, 2012). The desirable attributes specified by the company are as follows:- Likable and sociable qualities- to be social and friendly with the customers and make the customer feel happy coming to the stores. Multi-tasking skills- if an employee is multitasking than it will help lot to run the processes of the company (Reed, 2014). Recommendations Walmart has a huge demand of employees with the rate it is increasing its stores. Thus, it is important that the company should have a bit flexible approach in the skills required for the positions in the company. With the changing global demands, the change in the structure of the company is also required, and that will affect the requirements of the job profile that the company wanted. Such changes are to be researched upon by the companys HRM department. Job analysis should be more detailed that emphasizes the exact composition demanded by the companies (Reitz, 2014). Process of Attracting Applicants All the company needs talented and knowledgeable employee working in there company. For attracting such talent companies use various methods. A website portal known as Walmart Careers is used for displaying the jobs available in the company across the world. It displays the opening and the job description (Robichaud, 2014). It also includes the skills and capabilities required for a particular position. One can go on this website and log in as a candidate applying for the job. A candidate has to put in the location and the field in which he wanted a job. If an opening is there then it will display the job description, minimum qualification required, and then the submission of the candidates resume is asked. This is the only method used by Walmart for attracting the applicants to work for the company and it is not sufficient for hiring the best talent for the company as many people are not internet savy (Rose, 2013). Recommendations Walmart is using just a single method of attracting applicants which are insufficient to attract proper talent. Many people do not have access to internet then it will be a lost opportunity for them. Giving a newspaper advertisement with the details about the job can help in attracting knowledgeable and talented people for the job opening (Safdar, Waheed, Rafiq, 2015) The Selection, Recruitment, Appointment and Rejection Process The HRM department of Walmart uses different recruitment sources and methods fitted to various positions in the organization. The retail industry specific criteria are also used by the company in the selection process. The recruitment practices of Walmart are discussed below (Sathya Dr.R.Indradevi, 2012). Walmart Recruitment Practices Recruitment Sources-the HRM department of Walmart uses external and internal recruitment sources for different positions in the company. The focus of the internal recruitment sources is on the current employees. It finds the candidates that are suitable to fulfil the opening or the new position at Walmart. The external recruitment sources are used to find the talent for the company from the labour market. The internal method of recruitment can increase expectations in the employees and if they do not get fulfilled it may affect the morale of the employees (Zhou, 2014). The different types of internal recruitment sources are used by Walmart. The most significant ones are as follows: - Current Employees Trainees Transfers The employees currently working for the company are the recruitment source for the positions like supervisory and managerial positions. The HRM department prefers to promote the hourly based sales employees to managerial positions (Bae, 2011). The HRM department of the company states that more than seventy percent of their managers started as hourly sales employees and now reached this position. For Walmart, their current employees are the biggest source of recruitments. On the job, trainees are also taken as internal recruitment source by the company. A small number of trainees working for the company like in the position in sales and marketing are promoted to take the higher positions in the department they were working in. This saves a lot of time of the company wasted in the talent hunt and training the new employees for the position. When a company takes major changes, then few people can get promoted for a period to fill in the gaps of the workplace, but when these recruitments will be sent back to their old designation then they will lose their morale and some may even feel cheated (Bais, 2012). The Walmart company deals in various fields for them it needs external recruitment source. The following sources are mainly used as the significant sources for the company:- Respondents to job advertisement Campuses Previous applicants. The companys website is the main human portal that is being used as the Walmart external source of recruitments. The job openings are regularly posted on the website. The recruitment source provides the cost benefits to the company. The HRM department is focusing in the campuses of colleges for the recruitment process. The external market increases the cost benefits for the company. There are many applicants that have already applied for the job. The company does not deal with such applicants, and no need of extensive research need to be done (Batistic, 2015). Recruitment Methods- as per the recruitment sources used by the company, the direct and indirect methods are the corresponding recruitment method. Under the direct method, the company directly get in-touch with the prospective employee. Like, occasionally the company goes for the campus selection. The HRM department contacts the students who might want to join the company by applying for the job opening. It is beneficial as it speeds up the recruitment process rather than waiting for the applicants (Cesario, 2015). The method enables the HRM department to apply certain criteria in the selection of students for being contacted. Like, students enrolled in business-related degree programs can be contacted for supervisory or managerial job openings. Though there is a disadvantage also to use the direct method as it limits the potential candidates number (Gberevbie, 2008). When an indirect method is taken for the recruitment, then the aim of HRM department of the company is to reach out to a large population of the worker. And this method is completed by posting an advertisement about the job opening on the website of the company. The majority of Walmart resources are provided to the company by using the indirect method of recruitment. The reach of such indirect method advertisement is on the global basis, thereby creating a large-scale support for the company. Also, using indirect method tend to be cost-effective. The HRM cost is also minimum in case of Walmart, as they place the advertisement on their corporate website (Greenhill, 2010). Selection Process at Walmart Selection Criteria- the job position decides the selection criteria of Walmart. The basic criteria consist of training, and education backgrounds check and checking of any criminal background. For the position of hourly salesman, the company uses knowledge retention and the interpersonal skills. It is very important for the employees to have interpersonal skill for this position (Manson Carr, 2011). This is because the sales personal directly communicates with the customer. Walmarts HRM department also demands skills like problem-solving abilities, and conflict management skills for the position of a supervisor or managerial. They are expected to perform the job of analyzing and solving problems in the workplace (Mishra, 2013). Methods and Techniques- most of the positions, in the Walmart are evaluated using structured interviews and job knowledge evaluation. To determine the details about the applicants perspective and expectations regarding Walmart structured interviews are used. The information collected from the interview helps in determining the person-job and person-organization fit (Ng, 2015). For many positions Walmart uses the personality and situational judgment test. Though theses test are normally used for finding an employee for managerial positions, and especially in the HRM department, finance, and others. The personality test helps the company in deciding whether the candidate can function as per the demand in the companys context and nature of business. The determination of analytical and problem-solving abilities is done through situational judgement tests. These different tests given to candidate ensure the HRM departments approach for the applicants for a position is comprehensive throug hout the Walmarts global structure (Rangriz Pashootanizadeh, 2014). Recommendations More recruitment areas should be established by the HRM department of the company to get the better applicants for the job opening. It is not necessary that the potential candidate is looking at the website of the company when the job opening arises, there using local advertisements methods will help in gaining a good number of potential applicants. College going students have a fresh approach, but they lack in experience and product knowledge, thus, the company will bear the loss while a student will turn into an efficient employee. Once he becomes a professional, he will start searching for better options. Thus filling up of a bond with the students becomes helpful in retaining them for long (Scroggins, 2007). Appointment Process at Walmart A company has a full procedure that it follows to judge the best employee for the company. In Walmart also a well-defined procedure is applied to appoint the best candidate for the company. The companys HRM department shortlist the three best candidates that fulfil the criteria required for the position opened in the company. The three candidates are interviewed by the panel of three and questions related to the job requirement, previous work-experiences, etc. are asked. If a candidate is liked by the panel, then they are given to fill a detailed form where there is a lot of information need to be filled (Yurtseven Halici, 2011). Then the candidate is called for the orientation process. In orientation process, the candidate is showed few videos about the company and the expectation that the company has from the candidate. It is a three days process, and at the end of it, a module test is taken by the candidate that is necessary to be passed (Andersen, 2016). If a candidate fails to clear the module test then the whole process of orientation is repeated to make the applicant familiar with the processes of the company. A training program is held once the candidate clears the module test, and after this, the candidate is signed for the position in the company he is hired for. A written agreement is given to the employee with all the right and benefits mentioned in the agreement regarding the employee (Arthur, 2012). Rejection Process of Walmart The candidates those who are rejected in the online process are being informed by an Email sent through the company website. The people who get selected for the interview but fail to clear it are given a thank you note for taking part in the interview and then asked to leave (Bell, 2012). The documents and information submitted by the candidates rejected by the company HRM department is kept saved in the database of the company. This is done because in future if any candidate applies again then the data regarding the applicant are available to the HRM department of the company and they can decide whether to call the applicant again for the job interview or not (Edenborough, 2012). Legal Framework Every employee has right to know his rights and benefits he is entitled to get from the company. Also, a written document that specifies the appointment of the candidate in the particular company is important for the applicant to get. This legal framework is as per the country where the store is situated. All this is known as the legal framework that is required to be fulfilled on the appointment of the employee. Walmart follows a proper legal framework while appointing the employee for the company (Folsom, 2008). Once the applicant gets finalized by the company he has to sign an agreement with the company, which generalize all the rights and benefits that an employee is liable to. All the facilities given by the company is also mentioned in the agreement like the break time, holidays, sick leave, overtime payment, etc. Walmart follows all the legal procedure framed for the employees as according to the country the store and the job positions. For example, if a candidate is finalized in a store situated in Australia then all the legal papers will be made as per the Fair Work Act of Australia. This is because Fair Wok Act is the legal policy for employees that safeguard the rights and benefits of the employees in Australia (Jones, 2010). Along with this the legal department of the company manages the other compliances also, like work health and safety law obligations. The privacy clause is also added in the employee and employer agreement to safeguard the interest of the company. The Equal Opportunity Act 1984 helps in overseeing the entire recruitment and employment life. If the employee is an immigrant, then that will also be part of the legal framework and then, they will require fulfilling the details of their home country and reasons to come here and working for the company (Kenny, 2012). Recommendations A more detailed legal process is demanded each country, as the company is spread out in about twenty-five countries which make it difficult to follow all the rules of each country. A common agreement with rights and benefits common to all the countries can be asked to be signed at starting of the employment relation. Along with the employees right, the legal document should also display the employers right also (Koedel Xiang, 2016). The Orientation and Socialization Process of Walmart Orientation Process of the Walmart An orientation programs help an individual to understand the company and its goals better. It also helps in familiarizing the new employee with the company. The orientation process in Walmart is of three days. The first two days of the orientation programs is all about filling various papers, watching videos, and learning about Walmart (Parker, 2007). The third and the last day of the orientation program of Walmart are spent on the computers dealing with various module series. These modules are known as CBLs. Each module is about a subject which an employee has to know about. Once all the modules are done, then a quiz on the modules are taken by the employee which has to be passed if an employee fails then he can again try it till the time he gets a pass. After this, a work schedule will be given to employees, and they are to report for it from the next working day (Paul, 2014). Socialization Socialization is very important for both the employees and the organization. Socialization helps the employee to get comfortable and adjusted with the new environment, responsibilities, and people. If an employee get adjusted with his working environment then he will give his hundred percent to the company and ultimately benefits the company (Persky Merriman, 2012). In Walmart, it is the duty of the managers to make the employee comfortable and feel valued for the company. He introduces the company and its members to the new employee and allows him to get familiarize with the various processes of the company. The socialization process is a very formal procedure in Walmart because of the organizational culture of the company. This provides the feeling of authority in the employee and proper and organized working procedures of the organization (Reed, 2014). Recommendations The socialization process in Walmart is very formal which make it difficult for the new employee to understand quickly. It also increases the pressure on the employee. So a bit flexible socialization process will help the employee to get quickly adjusted with the new environment. During socialization process managers should make the employee feel valued and responsible but not pressurized (Reitz, 2014). Walmarts Employee Retention Programs It is a very critical job to retain the talented and efficient employees in the company. Company like Walmart where the number employees are more than two million, then the turnover of the employees is also very high, especially in the hourly sales employees (Robichaud, 2014). To overcome this situation Walmart has come up with the following retention strategies:- Recognition Bonuses Training and development Promotions Academic credit Walmart provides the non-financial recognitions to the excellent employees like top-performing employees of all the stores. As per the business performance the bonuses are decided. Although bonus is generally for the employees working in the managerial positions of the company. To increase the employees morale and to fulfil the needs of the HR of the company, regular training and development is given to the employees as promotions (Rose, 2013). The company has a policy to first recruit the internal candidates to a better position then go looking for the new ones. Thus, in Walmart the hourly sale personal are promoted to supervisory and then to managerial positions of the company. Walmart is in an agreement with American Public University which provides an academic credit to the employees for the work they did at Walmart. This is the best retention strategy that Walmart has applied to retain its employees as it helps an employees to pursue a career and also climb the companys corporat e ladder (Sathya Dr.R.Indradevi, 2012). Recommendations Every individual has a different need therefore a company manager should identify those needs and accordingly give the non-financial or financial help in the form of promotion to the employee; this will help in retaining the employees. More form of promotions and bonuses are required to be applied on more than two million employees of the company.Training and development is good for increasing the morale of the employees but most of them does not take it as the promotion. Thus, it is important to explain them the importance of the training and development in their career (Zhou, 2014). Conclusion For a company its employees are great assets. But in some cases the employees can prove to be a burden for the company. Thus, it is very important to select the best, talented and knowledgeable employees for the company. For this it is very important that the company attracts the most efficient candidates for the company and hire them. The point does not end with hiring the employee, it is very important to retain those employees that are assets to the company. A company has to think carefully and then design the process of hiring personals because mistakes are generally very expensive for the companies. Walmart a well-known company that owns a number of stores throughout the world follows a traditional organizational structure and design and describe the jobs according to it. This is so far working for the company, but with the changing global market and needs for how long it will work cannot be judged. It is better that Walmart should think to expand its idea of hiring employees fo r the company. They should explore more methods of hiring employees along with different criteria and skills in the employees to achieve new success. The HRM department works hard to get the best talent for the company to bring success to the company. To explain the whole process the example of the Walmart and its attracting and retention program is discussed along with some recommendations that can help the company to improve its program and earned better employees for the company and retain them for the companys betterment. 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