Ethical Dilemma On Accepting An Offer

PART A: The CaseJohn is a two year Graduate Engineering Trainee in an Automobile company in India, on a contract binding him to work for 3 more years after the training period. On completion of his training, John gets admission for a PG Program in Management in a reputed Institute. Because of the good impression he had created during training program, the Company grants him special leave with pay for this education. Further CEO personally informs him that his two year education expenses will also be taken by the company. He also expresses his hopes to have him back for a long tenure with the organization.During the last semester of his program, a Multinational Organization in Automobile business offers John a job in their Indian operations, with 6 months intensive job training in Germany. The compensation offered was almost 10 times of what he would be getting in his present employment. . The new organization would also compensate him for whatever he should pay to the present employe r for returning his leave pay, education expenses or liquidated damages as per his original contract. Should John take up the decision of joining the new company?PART B: John should not leave his present company. All employment is a legal bondage, no doubt. But, the relationship of employer employee goes beyond that. The employer places full trust on the employee for a conscientious work performance. ( Heathfield, S. M, 13-04-2009) The employee delivers goods to the best of his abilities. What he is not able to do because of his deficiency in skill, knowledge or even attitude is acceptable, but knowingly withholding performance of a known skill, or causing a deliberate negligence of duty is not pardonable.Legal enforcement always has limitations. Most of the things go by moral bindings in life. Whether it is a family life or work life the element of trust forms the basic ethics of living. John should not let his present employer down. The present employer had gone out of the way to help John in fulfilling his ambition of completing a PG program in Management. In fact, it is this program opportunity had led the way for the new offer from another company. The present employer had not granted him the privileges with a parental attitude.The CEO had specifically called him, offered him the help and expressed his wish that John returns to the company job with added knowledge for a long tenure. John paying back the salaries he had earned during the special leave period or giving back the expenses which the organization had taken for his education, or for that matter sincerely remitting the liquidated damages as per earlier contract, will all belittle the basic value of human gratitude and acknowledgement. (Hunsinger, D. v. D. , 1995, p. 65) The present employer may not be able to sue him for more than what they had expended on John.Their feeling of hurt with this incident, and based on that, their attitude towards employee motivation programs will all shrink, affecti ng the future incumbents to the organization. So, John should not leave the employment and reject the Offer given to him by the multinational company, with ten fold compensation figures. PART C: John should take up the new offer All employment is a legal arrangement. The employer selects the right candidate, pays him a fair compensation and the employee discharges his performance with his utmost faith on his ability.The employee shall not cheat the employer in any of his work related activities. He should be faithful to his employer and work for him with total commitment. He should trust his employer and feel at liberty to ask him to give whatever he thinks right on his part to ask. He should never hesitate to remind him of a privilege or condition that the employer forgets to extend. Likewise, he shall not demand for something which is not due to him. He can always get things clarified wherever he has doubts about his rights. (Assertive Communication, 13-04-2009)Beyond this relatio nship, no employer has right to expect an employee to continue in employment for ever. Mostly conflict of interest arises only when one accepts another employment while at working with one organization disturbing his independence in working with the original organization. (Faculty Guide, 13-04-2009) John’s opportunity is a very rare occurrence. He can not dream of such an offer in the future. He should take it up. Giving up an opportunity, which will benefit him and his family’s prosperity because of increased income will be wrong.,For that matter he might be depriving the benefits to society by not contributing his competence in a wider area of work. Sometimes we confuse morals with ethics. Morals are stated to be selfish too, elsewhere (BrainMeta. Com, 13-042009) All John is expected to do is to go back to his present employer, explain the CEO the situation and his wish to go for the more prosperous job. He should be transparent enough to express his predicament. His taking up the new job is by all means for a large packet of compensation.It also gives him the opportunity in another country with more scope to improve his competence. From what has been his case all along, he is a person thriving for knowledge and this offer carries with it a good training program. He can always be grateful to his present employer on many future occasions, without damage to any of his personal or social values. For instance, there may be scope for him to be a contact to the new employer for the present employer to enter into collaboration arrangements or business arrangements.

GIS – Harrow

For my report I've chosen 4 GIS maps from the Harrow council's official website (to make the results more reliable) that show the differentiation between the standards of living across the London borough of Harrow. The GIS maps that I chose (and copied as evidence) include: population density, life expectancy, street crime, and income levels; I have analysed them and described what the variations in each map are and what they show us. To conclude my report I have compared the variations in all the maps, and described what they show us. This map shows the main wards in the borough of Harrow. Pop. Density This map (see above) shows the population density levels in wards across Harrow. The map shows us that there is a mix of both high and low population density levels across the borough. The north east and west of the borough is the most sparsest, as it's got the lowest amount of people per hectare- 5-less than 40 people and 40-less than 55 High per hectare. Population density levels are more concentrated in the centre of the borough, where wards like Wealdstone, headstone north, Kenton west, and Marlborough are located, with equally high density levels spreading towards the south of the borough-towards the south east, where high pop. density levels are also highly concentrated, Kenton east is situated there. The south west of the borough has more of a mix of pop. density levels, as they're between mostly 40-less than 50 people per hectare, and 83-less than 107 people per hectare. (Wards like Roxbourne, and West Harrow which are situated in the south west of the borough have higher population density levels). Life expectancy This map (see above) shows the life expectancy levels in wards, across Harrow. The map shows us that the life expectancy levels across the borough are generally low- they're mostly around 78.5 years to less than 80 years, and 80 years to less than 81 years. The map shows us that generally the centre of the borough has got the lowest life expectancy levels in the borough, with a life expectancy of 76-less than 78.5 years and 78.5-less than 80 years. The areas with the highest life expectancies in the borough are the far north east where Cannons is located, with a high life expectancy of 81.5-less than 83 years, and the far south east, where Edgware is located, with a life expectancy of 81-less than 81.5 years. In general, I think that the graph shows us that the west-north /west of the borough has got the highest life expectancy, with mostly a life expectancy of 81.5-less than 83 years; the north-west has got a high life expectancy of 81-less than 81.5 years. Street crime-darker area=more street crime This map (see above) shows the levels of street crime in wards, across Harrow. The map shows us that generally, fairly high levels of street crime are quite widely dispersed across the borough, the fact that there is no legend available for this map makes it less reliable. The centre of the borough seems to have the most amount of street crime, as generally, there're darker areas are more concentrated, with Greenhill in the south having the highest level of crime as it is the darkest area. The whole of the eastern section of the borough also seems to have a high indicator for crime levels- where wards like Cannons and Edgware are located, as there're lots of dark areas and they're highly concentrated. The north/ west have got the lowest indicator levels for street crime, as there're a lot of light areas that are fairly highly concentrated, wards like Pinner, Hatch End, Headstone north, and Pinner south are located. Income-darker=less income, lighter=more income. This map (see above) shows us the levels of income in wards, across Harrow. The map shows us that generally fairly low income levels are widely dispersed across the borough, the fact that there is no legend available for this map makes it less reliable. The south of the borough seems to have a lower indicator level for income, as these areas are darker and highly concentrated, where wards like Greenhill, Marlborough, and Kenton are situated. Generally the east of the borough seems to have the low levels of income too (second after the centre). The north west section of the borough seems to have fairly low levels of crime as there are lighter areas, wards like Pinner, Hatch End, Rayners Lane, and Headstone north are located. Conclusion By comparing the 4 variations between the standards of living in Harrow for all 4 of the GIS maps, I have found that in general, the north west of the borough has got the lowest indicators for street crime, and population density, while having the highest indicators for life expectancy, and income. I think this is due to the fact that the categories may be interdependent. I think that because people in the north west generally have a higher income compared to the rest of the borough, so this could've had an impact on the other results from the other categories, e.g. the reason why there is a low indicator for population density in the area could be because the house prices are higher in this area, so people can't really afford to live in this area (as the majority of the rest of the borough seem to generally have a lower income level). Also, the results suggest that street crime levels are generally low in this area because of the low indicator of population density in this area. I have also found that in general, the south/west of the borough has got the highest indicator for population density levels, street crime levels, low income levels, and a low indicator for life expectancy levels. I think that this is due to the fact that the categories may have a correlation. I think that because people in the north west generally have a high indicator for population density levels, as they may have a low income compared to the north west of the borough (which has a high indicator for income), so they can't really afford to live in the north west, this could also be the reason why generally street crime levels are higher in the south east, because of the high indicator for population density. Also, the reason that the area in general has a low indicator for life expectancy may be because of the larger amount of people who live there.

An Operational Analysis of Subway Restaurants

Completed By: Olga Gomez, Nancy Guadron, Paula Clark, and Tyann Peres Completed By: Olga Gomez, Nancy Guadron, Paula Clark, and Tyann Peres An Operational Analysis of Subway Restaurants University of Houston-Downtown MGT 3332 Summer 1 Dr. Steven Coy An Operational Analysis of Subway Restaurants University of Houston-Downtown MGT 3332 Summer 1 Dr. Steven CoyTeam Aces came to an agreement and decided to conduct an operational analysis of various Subway Restaurants throughout the Houston and Katy area. Each team member was charged with the task of visiting a Subway location near their residence. This way each member was given the opportunity to observe the concrete steps required for Subway to complete a service from beginning to end. When you hear the words â€Å"fast food,† you imagine being offered a service in which you are quickly in and out with your order, and nothing else to it.In this instance that is not the case; Subway did not become one of the largest sandwich chains overnight. It has taken years of productiveness from the owners, top managers, employees and each customer of Subway. Throughout this paper we will analyze Subway’s operations by identifying the type of process used and the basic layout of their facilities. We will also provide a detailed service blueprint that will help to get a better understanding of the service process from the beginning, when the customer places an order, to the end, when that paying customer walks out the door with their subway sandwich.After visiting our Subway locations, we will also be able to explain the strengths and weaknesses that we observed from the interaction between employees and customers and the overall Subway experience. One of the locations visited and observed during hours of operations was the Subway restaurant located at 19214 Clay Road, Suite A, Katy TX 77449. This restaurant has been serving the Katy community for approximately ten years. This particular location was observed in or der to help create the service blueprint.The service blueprint lists all of the service functions that are performed and the average time expected to achieve the completion of each function. It begins with the customer’s action; the customer walks into the store and places an order, the employee then acknowledges the customer’s request. This is followed by the customer deciding on the size and type of sandwich they would like made. The Subway employee then begins to prepare the customer’s sandwich with their size and type specifications in mind.At this point, the employee asks the customer to decide on their type of meat and cheese, once the customer communicates this decision, the employee adds the requested meat and cheese. He/she gives the customer the choice of having their sandwich toasted or not. If the customer decides to toast the sandwich the employee then proceeds to put it in the toaster for a minute then moves on to adding the dressings and sauces. I f the customer does not want their sandwich toasted, the employee continues along with the process.The interaction continues with the choosing of any vegetables and final touches which may include adding oil and vinegar or salt and pepper at the customer’s request. Finally, as we approach the end of the service process, the employees wraps the sandwich and offers the customer the option of adding a cookie or the option of making their sandwich purchase as a meal, which would then include chips or a drink for a set additional price. Once the customer has chosen, the employee then collects payment to complete the transaction, and hands the order over to the customer, thus concluding the service process.This entire process happens in between the line of interaction. A line of visibility does exist in all Subway locations, on one side you have the components that are visible to the customer, which include the bread baking and all of the products and produce used to make a Subway sandwich. On the other side of the line of visibility, you have those items not visible to the customers’ eyes, which include the preparation of the bread before baking it, the extra vegetables, meat, and cheeses to be cut and prepped, the chips and drinks used to stock the storefront, as well as the storage of all the other products necessary to perations such as paper products, bags and any office supplies. All of this is required in order to ensure the success of the service process. Even though the customer does not realize what exactly occurs behind the line of visibility, it does not mean they don’t care. Every paying customer hopes and expects that their food is being handled and prepared in the safest and best way possible. This means that employees must be equipped to complete all tasks required in the minimal time possible, while maintaining the utmost standards of sanitary handling and preparation.Please refer to blue print 1 for a visual representation of h ow the actual process explained above works. After getting a closer look at how the service process works by completing the blue print you can see that the employees work diligently to complete the process in less than five minutes. From this you can learn that during peak hours which include lunch and dinner rush, employees work faster than normal to meet the 5 minute process standard. This way may cause a customer to feel rushed.For instance if the employee sees that the customer line has exceeded more than five it begins to rush the process; this causes the customer to make abrupt decisions on what they want in their sandwich. At the same time this can easily cause the employees to make mistakes during the process. For instance they can accidently add the wrong vegetables or sauces simple because they are trying to rush through the process in order to get the customer in and out. This urgency of completing the process faster than usual can turn a customer away.Many paying custome rs like to have the undivided attention of the employees since they do feel like they should get their money’s worth through the service. To help both the employees and customers during this circumstances the manager should ensure the employees that yes you might have to pick up the speed to meet the lunch rush demand; but they will have to be courteous without making the customer feel rushed. ——————————————– [ 1 ]. Subway location 19214 Clay Road, Suite A, Katy TX 77449

Human Rights Essay Example | Topics and Well Written Essays - 1500 words - 2

Human Rights - Essay Example Research by international human rights organizations have described the worst forms of labor abuse and dehumanization among low income earners like domestic and construction workers in the United Arab Emirates. For example, the worst form of exploitation is the â€Å"Kafala† sponsorship program that gives sponsors and employers authority to determine the immigrants’ legal residence (Chalcraft, 2011). According to Sonnez, Apostolopoulos, Tran & Rentrope (2011), employers are given the authority to control migrant workers pay, living conditions, and ability to renew or terminate their contracts without regard to the country’s labor laws. Another form of human right violation is debt bondage and confiscation of passports because migrant workers have been charged high recruitment fees by their home agencies. Violation comes in because the migrants are promised high salaries but on arrival they wages are too low ranging from $175 to $220 per month. A report by Human Rights Watch (2012) indicates that construction workers live in inhumane conditions, with eight to ten laborers sharing a room because of poverty and debt. For instance, they were expected to work for more than 12 hours per day with very few breaks even under extreme heat of the day (Exploited Workers Building Island of Happiness, 2009). The poor wages and increased cases of abuse thrive because of the political environment which has continuously ignored the need for establishing labor unions and enforcing legal action on abusers. Lack of labor unions limits migrants’ choices, rights to expression, ability to seek justice and freedom to move from one employer to another equating the situation to modern day slavery. These limitations have led to increased cases of suicides among immigrants who find themselves in fixed inhumane environment. A 2009 police report indicated that 113 migrants committed suicide with the most victims coming from domestic and

Photographer presentation- Martin Parr PowerPoint Presentation

Photographer - Martin Parr - PowerPoint Presentation Example They clearly reflect on their environment. A good example is shown in his book ‘Signs of the Times: A Portrait of the Nations Tastes’. (1992). He involved pictures of peoples’ homes, and used quotes below the pictures from this book. He has compiled very many photo books, which have taken long time to compile (Parr, 2012, p.78). There are several things that have contributed to his success in the field of photography. Firstly, he always focuses on sets, but not individual images. According to him, none of his individual photos was the favorite. This is because he has ne never focused on individual images, but he thinks of big collections as projects or sets. In a recent interview, Martin Purr said that he stopped focusing on single photos to be able to capture the minds of many people in the internet. Secondly, Martin Purr always adds statements on his photographs about the society. In every picture taken by him, there is a very strong statement that reflects on the society. This makes the photos interesting, funny, and depressing. Of late, he has been able to interject his thoughts and ideas into the photographs. This allows him to express his views about the society and the world at large. This documentary photographer is always obsessive. He includes inspiration and encouragement quotes in the sets of photographs and photo books that he collects. These inspirations add more attention to the viewer especially in the internet. Martin Purr is now at the age of 60s and has not stepped down even one bit. He still fights for popularity and commercial shoots, and this makes him travel the world for the mobilization (Dewi, 2005, p.89). Images taken by Martin Purr are always familiar. In a recent interview he explained that he does not possess a studio. However, he has an office in London but he does not visit the office regularly. He enjoys working at home where he preserves his photo books and other photographic collections. As technology

Sex and Relationship Essay Example | Topics and Well Written Essays - 500 words

Sex and Relationship - Essay Example hese are often no longer connected to how a person is seen in legal or individual terms but some differences still divide people and cause debate where there should be none. Homosexuality or being gay is one such position where unwanted discrimination or even harassment may be conducted against a person. As discussed by the article, relationships between gay individuals should have as much legal value as they hold between straight couples. Denying this right becomes a negative influence on the relationships between gay couples. I feel that such positions are not only harmful for the gay individual against whom they are committed but also against the social setup since they harm the interests of a just and free society. What society needs to create is a legal structure for rights regarding homosexuals because the current situation offers protections to gays only pertaining to their individual rights but does allow them equal rights when it comes to creating a family. Heterosexual couples can adopt children much easier than homosexual couples. The tax/economic benefits given to heterosexual couples are much better than the ones awarded to a homosexual couple (IGLHRC, 2006). Of course, the single cause of the discrimination between the two sets of couples is their personal sexual lives. If our country remains divided on the issue and continues to enforce a pattern of discrimination against homosexual unions in marriage, we would only be reducing our total output as a country. By creating lesser human beings in legal terms and not allowing gay unions in marriage or gay rights as groups of individuals, the law makers of today would create problems for the society of tomorrow. There may not be an armed resistance movement, but the country would certainly be treating some of its citizens as lesser than the others. The Universal Declaration of Human Rights as given by the United Nations declares as its first article that, â€Å"All human beings are born free and equal in

HR hypothetical facts Essay Example | Topics and Well Written Essays - 750 words

HR hypothetical facts - Essay Example In determining whether a worker that provides services to your organization is either an independent contractor or an employee, all information that shows evidence of independence and control degree should be highly considered. The hypothetical facts that show the prove of independence and control are classified into three categories which include type of relationship, behavioral, and financial.Relationship between employee and employer- are there any written types of employee’s benefits or contracts (Fishman, 2014). Will the relationship between an employer and employee continue or end after a while and the services offered very important to the organization. Behavioral- does the organization have the power to control the function of the worker or how he or she carries out his or her duties. Financial- are there aspects of the job of a worker that is controlled by the Human Resource manager? (This includes things such as expense reimbursement and how workers are being paid. T hese are the main facts that the Unemployment Claims Hearing Office should rely on to determine whether John is characterized as either an employee or an independent contractor. Companies must put into consideration all the above mentioned factors when characterizing a worker as either independent contractor or an employee. Some of the factors indicate that a worker should be categorized as an employee while others entail that a worker should be categorized as an independent contractor. The main thing here is to evaluate all the mentioned factors.

Immigration Research Paper Example | Topics and Well Written Essays - 1500 words

Immigration - Research Paper Example It is used to describe certain phenomena that are a common place in the societies. It has been described as ‘the expression of individual social life and thought through language’ (Mangaraj, para.1). Literature then becomes an important tool through which critics in a society can express their criticism on a given social issue. This field of art is important because it touches the lives of individuals, speaks to the individuals, and has universal applications (Lombardi, para.4). Whether one uses poems, drama, narrative tales, and many other genres of literature, the artist always reflects on some life story that has occurred or is likely to be witnessed. Literature and Immigration Immigration refers to the migration of individuals into a given country to be come residents of the country. Several reasons can make individuals to leave their native country to travel to foreign countries. Political upheavals, poor social set-ups, and unfavorable economic conditions are among the major factors that can force an individual out of his native country into a foreign country. This movement of individuals into another country also has challenges for the immigrants. The individuals are forced to adopt the culture of the natives of this destination country. Moreover, the immigrants are often likely to be subject of prejudice and may not enjoy all the fundamental human rights while in the foreign state. Literature has been used to tell of the ugly scenarios that immigrants encounter while in the foreign countries. While they flee their native countries to seek better life (socially, politically, or economically), the immigrants often get other barriers to their anticipated fruitful life. They suffer the consequences of the nearly cut link with their family members back at home. Besides, to minimize the level of prejudice on their children, the immigrants assimilate the children into the foreign culture. One of the literary works that express the challenges of im migration is â€Å"Under the Same Moon,† a movie by Kate Del Castillo. This gives insight into the problems encountered by young children left behind by their parents who have migrated into the US to look for jobs to support their families. Another literary work is a poem â€Å"Immigrants† by Pat Mora. In the poem, Mora describes how the immigrants are obliged to have their children grow completely in the foreign culture so that they can be accepted in the society. Under the Same Moon Under the same Moon is a Mexican-American movie that features a nine-year old Mexican moppet who has been separated from his mother since he was five. In order to provide a better life for her son, the mother, Rosario, migrated illegally to the United States from Mexico. Looking for employment is one of the many reasons that see several immigrants into the United States. Rosario gets a job as a domestic worker in Los Angeles while the nine-year old Carlitos stays with his ageing and ailin g grandmother who eventually passes away (The Internet Movie Database, para.1). Even though they are separated, the mother and son have tried to keep in touch. Rosario and Carlitos have been communicating through phone, his mother using the same pay phone every week (Catsoulis, para.2). This would later enable the boy to locate his mother in Los Angeles. After the death of his grandmother,

DNA Evidence Research Paper Example | Topics and Well Written Essays - 750 words

DNA Evidence - Research Paper Example The research on DNA evidence started showing significant improvement by the 20th century. DNA evidence became widespread and it became a problem-solving tool for immigration disputes, refining the assay, resolving specimen identity, detecting genetic differences and identifying criminals; thus, the need for DNA identity testing became significant. Historically, DNA evidence began in the forensic field when ABO blood group was used as a system in providing evidence of crime issues. Later, the paternity identification that based on serum protein variation became commonly used. However, it was not until when Jeffrey became a pioneer of DNA based identity testing. DNA evidence became common in federal courts, and the first DNA evidence was carried out in the court case of Andrews Vs., Florida in 1988 (Newton, 2008). Many states started adopting DNA evidence in order to identify crime issues as a way of maintaining criminal justice. DNA evidence started evolving as an effective technique of providing proof over crimes issues. It is used up to present in many areas including clinical applications for testing identity, and also solving paternity issues in case of child denial or resolving specimen identity; thus determining the origin of mishandled specimens. The major sources of DNA evidence include semen, bone, blood, skin cells, hair, teeth, urine, tissue, saliva, feces, and vomit. First, blood is one of the main sources of DNA evidence. The substrate in which bloodstain is found can determine the DNA testing; thus providing effective evidence in case of homicide or any other crimes issues. Blood contains some substances that may hamper successful DNA testing process; thus, these substances can be removed through purification methods (Parks, 2010). DNA profiling is the only way through which scientists can be able to stain of a given blood mixture. Through DNA testing, one can be able to determine in case specimen are from the same or different sexes. Semen is anot her source of DNA testing. The semen stains can be analyzed and examined as well as tested through conventional methods in order to provide the required evidence. Sperm cell staining can help in determining in case the stain is the outcome of vaginal drainage. This will enable scientists to determine the rape cases through DNA analysis of semen stains. Moreover, body tissues, saliva and hair roots are among the major sources of DNA evidence. DNA strand isolation from body tissues can help in achieving the intended goals of DNA evidence. DNA survival can be found in teeth or dense bones. The remains of body tissues that have been scattered by either gunshot or trauma can adhere to the bullet; thus, they can sometimes yield sufficient DNA testing. There are some treated tissues by use of the chemical treatment known as formaldehyde and embalming. DNA testing can be successful in both tissues. For instance, a body of a person killed and buried for many years can still yield better resu lts when used in carrying out DNA evidence. Hair roots can be the legitimate source of DNA evidence, but they are not effective in regular forensic use. Saliva can be taken from penile marks, bite marks,  bottles and cigarette butts found in the crime scene. Despite the exciting promise of DNA technology, DNA evidence poses some problems.

Psychology 285 Week 9 Final Essay Example for Free

Psychology 285 Week 9 Final Essay Everyone has asked at point in their lives; who am I? Everyone will go through great lengths to figure out exactly that answer. Because of that no topic in psychology today is more heavily researched than self (Myers, D.G., 2012). These feelings come about for a number of reasons. We develop a number of feelings for reasons that are related to group dynamics, genetics perhaps, and social influence. There are so many influences on the relationships that we develop. Self-concepts There are so many awesome qualities about me I’m honest, very giving, independent and opinionated; however being opinionated can be a blessing and a curse. Growing up I remember being in trouble so much because of my mouth. I was the type of child that needed to get my point across and I was going to get out whatever it was that I needed to say! My mother told me several times lately that she admires my courage when it comes to saying what’s on my mind; she hated it when I was growing up but she respects it now because she holds back a lot afraid to speak up. Knowing that I am extremely opinionated I have to be careful sometimes about the way that I say things to other people. This is because what I say may be without malicious intent however it could come off that way if it’s not carefully expressed! I am so opinionated that I will solicit my opinion to anyone with being asked to solicit it. Especially when it comes to my little sister; she thinks that I’m being hard on her but I tell her all the time; the day I have nothing to say be worried, I talk because I care! This brings me to being such a giving individual I would give my heart if I was able to continue to live. I have given my last to so many and I expect absolutely nothing in return. I have learned that there is no greater lesson in life than the one of being able to give. I am the type of person who will go through my son, daughter, finance and my own closets just to see what they are no longer wearing to give it away to someone else who can actually use it. I want to set great examples to my children I want them to pay if forward too; but I want them to also know the difference between being a giving person and being an idiot! This brings me to my independence in life. I am such a strong minded person, very level headed so I know what I want and I know exactly what I  need to do to get to where I need to be, by myself! My mother loves the independence in me but she hates the reasoning behind why I’m so independent. That reason would be because I don’t want to end up like her she’s so dependent on my stepfat her that she has absolutely nothing on her own! Her first car came from him; the first time she moved into her own place was because of him, the new house the clothes on her back, the shoes on her feet, down to the food she eats. I don’t want that for myself in any way. My fear is that if I allow someone to do anything in any form for me that they will throw it in my face later. While my mother admires this quality about me my fiancà © hates it so much. He’s constantly fighting me not because he has nothing else to do but because he wants to do more. However along with the fear of having what was done thrown in my face another fear is to allow myself to comply with someone else doing something for me and they aren’t able to later than I feel like I set myself up for failure. This aspect of my life is revolved around issues of trust in my opinion. I know that I have trust issues I am always afraid of being hurt in some way whether it be because I was let down or because my heart was broken. My world is great and everything is exactly the way it should be until someone else tries to help. This is what one would call self-serving bias. Self-serving bias plays an extremely major part of mine and anyone else’s life we would all love to believe we’re a super hero all of the time, but when something goes wrong have you ever you ever seen the super hero take the blame? Never that is the sidekick’s job! The concept of self-serving bias has opened my eyes up to taking more responsibility for my own actions and stop using the actions of others to feel better about a situation that has gone wrong. This is why now I feel that I have an internal locus of control I believe that I am what influence the ripple effect of the events of my life. My actions have reaction weather I like the reactions or not they are still because of me and no one else! Attitudes and feelings Confirmation bias influences the perception of yourself and the people around me because we all want what we believe to be true! Take this for example my mother doesn’t very much care for my fiancà © she doesn’t really have a reason, because he does everything that he is supposed to do and more sure we have an argument here and there but to her it’s abusive. So she says  thing like this; â€Å"See I told you he doesn’t care about anyone but himself, look at how he speaks to you he doesn’t care.† I explain to her that it’s unfair to say that about him especially when things were said in the heat of the moment. Confirmation bias can destroy you because you are always looking for the next thing to support your beliefs. My sister thought that her husband was cheating with my cousin, (this was not true) so everything that my brother in law and cousin did together it was inappropriate and because they were sleeping together. I tried so ma ny times to tell her that they weren’t sleeping with one another but she had it in her head that they were so much that she actually pushed them together (self-fulfilling prophecy). She pushed and pushed so much that the untrue theory became true. I was hurt for her when this happened because these beliefs ended up generating their own confirmation. Behaviors influence attitude in so many ways, each day of my life behaviors influence my attitude. My step brother for example to me his behavior is very perverted is says things about my little sisters that he should not referencing the rear ends and other parts of their bodies as well as mine extremely inappropriate this behavior influences my attitude towards him because I don’t trust him as a result, I don’t want him around any of our sisters, or my infant daughter, I don’t even trust him around my son! My attitude toward him is extremely negative and I hate when he’s around. Another way that behavior affect attitude is through imitating your parents because the attitudes and beliefs of your parents have a strong impact on your life later. The topic of exhibiting the behavior of my parents brings me to gender roles. Our gender roles are defined by our own conceptions of being a male or female. Social influence: In certain situations I am willing to conform to a degree, but I am not willing to conform completely for an entire group to make it easier on the group. I enjoy being an individual I never want to blend in with the crowd I always want to stand out. I know this because at work there are so many groups of people who only want to hang out with that group of people they are all so caught up with who’s doing what and why that they completely lose focus of why we are even at work in the first place. I on the other hand  don’t feel that I have the time for that it’s childish so I am all about my work and nothing else! When our Post Master comes around they will all scrabble to go back to work or act as if they are working so that they won’t get into trouble! A person of authority influences obedience because the authority figure has the power to discipline. The foot in the door technique is one that is used in my profession a lot when the new comers come on to the job a co-worker will began to ask for small favors and those small favors turn into large favors. I have used this technique in new relationships to see just how far I can get him to go for me. I will change in the presence of others depending on who the person is if it’s an elder I won’t swear, if it’s a younger group of my peers I will relax more but it really depends on the group. When working with groups there are always slackers in the group they do the least expecting the same amounts of credit. This is something that I have struggled with in school and in work because it’s completely unfair to the group. This is called being lazy and being lazy is completely unattractive. Factors that attract me to someone are whether or not they are intellectually stimulating to me, smart, fun loving, easy going, handsome, tall, and has a great sense of humor. That’s not to say that what’s attractive to me is attractive to the next person. Just because they are attractive doesn’t mean that everything is going to be great there may be some conflict and in resolving conflict you must talk it out, speaking on your concerns and try using the I exercise saying how you feel as oppose to the blame game because no one will be receptive to that!

Role Of Nurse In Breast Cancer Health Promotion Nursing Essay

Role Of Nurse In Breast Cancer Health Promotion Nursing Essay Health promotion has been defined as the process of enabling people to increase control over their health and its detriments and thereby improve their health (WHO 2005). Breast Health Promotion improves understanding and confidence among women. It can help to remove fear of breast cancer and it encourages early diagnosis (Breastcancer care 2008).Health promotion can be performed in various locations. The settings that have received special attention are the community, health care settings, schools and workplaces (Tilford et al 2001). Breast cancer is a disease that affects almost 46,000 women and around 300 men in the United Kingdom every year. One in nine women in the U.K will develop breast cancer at some point in their lifetime (Cancer Research UK 2006). The contents of this assignment will include the importance of health promotion, primary, secondary and tertiary levels in relation to breast cancer, legislation and barriers. Breast cancer is a very frightening word and the detection of it harrowing therefore early detection in order to improve breast cancer outcomes and survival remains the cornerstone of breast cancer control (Anderson et al 2008). Mortality from breast cancer is falling in all age groups and the reasons for this are not certain but early diagnosis through screening and improvements in treatment particularly greater use of adjuvant therapies (e.g. chemotheraphy or radiotherapy) undoubtedly contribute (Petro et al 2000). It is important that women have as much information about the benefits and the risks of potential treatments so that they are able to have an active role in their treatment plans. Treatment should be tailored to individual needs and circumstances (NICE 2009). There are several types of breast cancer which can develop in different parts of the breast and the most common form is ductal breast cancer which develops in the cells that line the breast ducts. Ductal breast cancer accounts for approximately 80% of all cases of breast cancer. (NICE 2002). Breast cancer can spread to different parts of the body such as the bones, lymph nodes and the liver. (NHS Choices 2010). Primary interventions should be considered in the promotion of health in reducing some of the risks of getting breast cancer; these include maintaining a healthy diet (particularly one low in fat but high in fibre and vegetables). A key feature of the governments prevention strategy to reduce early deaths from cancers and coronary heart disease is action to improve diet and nutrition with the introduction of eating 5 A DAY and CHANGE 4 LIFE. Evidence has shown that higher fruit and vegetable consumption can reduce the risk of breast cancer (DH 2000). Being active and undertaking some exercise also reduces the risk and women with higher levels of physical exercise have around 30% lower risk of developing breast cancer than those that are least active. The higher the level of physical activity the lower the risk (Dorn et al 2003). Drinking more than two units of alcohol per day over a number of years can also increase the risk (Macmillan 2008). In order to help promote the governments programmes, it is essential that the nurse has sound knowledge of these plans so that she can raise awareness of health benefits, offer advice and educate patients about all the strategies that they can do to help promote a healthier life. It is very important to become familiar with how the breasts look and feel at different times of the month. The breast awareness 5-point code was introduced as a way of caring for your body and being able to notice any unusual changes in your breasts (Breast Cancer care 2007).The practice nurse will offer guidance to show patients how to examine their breasts or offer a leaflet which contains all the necessary information. School nurses are also helping to promote breast health and breast cancer prevention to young girls across the nation in schools where they talk openly with girls about breast development and the complex health and emotional issues and problems that may occur. The health promotion enables the young girls to face the future with confidence and with knowledge of breast cancer. (Breast cancer 2008). Breast screening is offered to all women between the ages of 50-70 years and they will receive an appointment by letter to attend for breast screening, however, if any unusual changes in the breast are noticed, it is essential that an appointment to see a G.P or the practice nurse is made, where a full examination of the breasts will be given. Reassurance and support will be given by the nurse or G.P and they will try to alleviate some embarrassment by maintaining privacy and dignity by locking the door and by pulling the curtains around (NMC 2008).If the nurse or G.P is uncertain about the problem, or they think that cancer may be present then a referral to a breast specialist for advice or treatment will be necessary. All patients that are referred to a specialist with breast symptoms, even if breast cancer is not suspected should be seen within two weeks of the referral (DH 2007). Diagnosis in the breast clinic at the hospital is made by a triple assessment (clinical assessment, mammography and/ or ultrasound imaging, core biopsy and/ or fine needle aspiration cytology (NICE 2009). The breast cancer nurse will introduce herself and she will explain everything fully to the patient before gaining relevant historical information off them, the nurse will also ask the patient if they have any questions before asking the patient to put on a gown (ensuring dignity and privacy is maintained).The nurse must use sensitivity, empathy and understanding as this can often be emotionally upsetting and distressing for women. The nurse will ensure that prior consent is always gained off the patient (NMC 2008). Screening is carried out by using either ultrasound scans of the breasts or by mammograms which are x-rays that use very low doses of radiation. In some cases women have both of these. A core biopsy may be used to take samples of cells from a lump or area of abnormality in the breast using a needle. This will be sent to the laboratory where it will be studied by a pathologist. The results of these tests can help determine if the lump contains cancerous cells. Local anaesthetic is used in biopsies and the breast may have some bruising or soreness afterwards. The nurse will be on hand to guide the patient through the experience and will offer advice in caring for the area afterwards and she will assist in making follow up appointments and further treatment plans. The nurse will also support the patient by trying to relieve anxieties, offering reassurances and by answering any concerns. Providing information by the nurse alongside all the support can empower the patient to retain or regain control over their lives (DH 2007).Lack of good, sensitive communication skills provokes poor patient care and it costs the NHS greatly in preventable loss of money, time and resour ces (DH 2000). At tertiary level a number of treatments are available for early breast cancer. The patient will become part of a multidisciplinary team and the nurse specialist or consultant will discuss treatment plans with the patient ensuring that the patient is fully aware of what they are being told and that they understand. (Jefford 2002). Breast surgery is often the first treatment for patients with breast cancer and this must be carried out by surgeons with a special interest and training in breast disease (BASO 2009).The nurse plays a vital role in the patients surgical experience and her role is to ensure that the patient is comfortable, pain free and that encouragement is give to promote independence by advising the patient on wound care, maintaining food and nutritional status, mobility, hygiene and the psychological effect that might be experienced. Treatment given after surgery is known as adjuvant treatment and includes radiotherapy, chemotherapy, hormone therapy and targeted (biological) therapy. Understanding the fundamental principles of radiation therapy enables the oncology nurse to provide support both physically and psychologically by offering advice on nutritional needs, areas that may be affected by the treatment, side effects, practical problems such as money difficulties and transportation to the treatment centre. The oncology nurse will also provide strategies to ensure family members and friends are supported. The delivery of chemotherapy is primarily the responsibility of the oncology nurse. The nurse must have sound knowledge of the pharmacology of the drugs used so that errors do not occur and that the patient is well informed of any possible side-effects. Patients can be very poorly because of the side-effects of chemotherapy so it essential that the oncology nurse gives the correct information to the patient and they should be informed and given guidance of who to contact if problems arise. The use of any adjuvant therapy is frightening for most women but nurses can offer practical advice, emotional and physical support and direction throughout the patients journey The nurse will arrange follow-up appointments for any on-going treatments, and they will discuss with the patient where they would like the follow-up to be undertaken (NICE 2009). As a healthcare professional, nurses are sometimes asked about a wide variety of complementary and alternative therapy as some 30% of women diagnosed with breast cancer visit a complementary therapist (Rees et al 2000). Nurses have a duty to be aware of the different types of therapies and in the aspect of health promotion they must be knowledgeable about safety issues, contra-indication and side effects before advising patients about alternative therapy. The nurse must always follow the NMC in working within ones own limits and using practice based evidence to support her actions (NMC 2008). Palliative care offers a support system to help patients live as actively as possible until death. The palliative care nurse will provide relief from pain and she will offer advice on how to deal with symptoms for example vomiting, diarrhoea and fatigue by explaining to the patient how to rest, positioning when resting, how to use relaxation techniques, they will educate the patient about diet and nutrition and how this can help maintain health and well being. If the patient has oral problems then the nurse can advise the patient on alternative foods such as calorie packed drinks. The palliative care nurse will use her knowledge, skills and caring compassion to guide the patient and their family to the end stage of life by communicating with them effectively, supporting emotionally and physically, planning outcomes with the patient as patient choice over place of death should be a priority (NICE 2004), promoting advice on equipment, wound care whilst always focusing on autonomy, just ice and the spiritual needs of the patient. The NHS Breast Screening programme (DH 1988) was first set up and the role of the breast care nurse is invaluable to the patient in providing support for patients by advising the best options in terms of treatment, emotional and psychological support. The nurses are there as a familiar face for the patient and they will continue to be available for the patient for on going advice throughout treatment. The breast care nurse will offer best advice on diet, health and mental well being and she will give guidance and offer literature on issues relating to the patients illness. With the introduction of the NHS Cancer Plan (DH 2000), new funding for cancer services and cancer specialists became available. Nurses working in hospital and community settings help to detect cancer earlier by educating people about diet, health, exercise and raising public awareness by facilitating posters and leaflets around the health departments. Health clinics were set up where patients can attend for check ups, screening and other health related issues. The cancer Reform Strategy (2007) enhances nurses by implementing training initiatives so that nursing staff can become better educated in cancer care, they can spread good practice, have a better understanding of inequalities, have more face to face communication with patients. Nurses are able to promote health awareness and disseminate information down to the people whose health and mental well being matter e.g. advising patients about smoking cessation and raising awareness about other lifestyle factors that contribute to cancer. The Liverpool Care Pathway (LCP) is a framework which allows the caring team to plan care using specific goals, guideline-based interventions and a flow sheet that outlines an expected course of a patients care (Ellershaw 2002). The framework is patient focused so the nurse involved will document a plan of care required that includes comfort measures, anticipatory prescribing and discontinuation of inappropriate interventions. The nurse will work very closely with the patient and family and she will ensure that any religious, cultural or spiritual beliefs are adhered to. The Gold Standards Framework (Thomas 2003) was developed and was aimed at primary care teams including nurses and palliative care nurses to help patients live well until the end of life. It helps the team to focus on promoting the needs of patients, families and carers. The nurse can help to plan good death with the patient and the nurse can offer practical and emotional support which will help to maintain the health of the patient and their loved ones. The nurse will offer advice on claiming benefit and financial support as this may have a detrimental impact on family members, carers and their health if they are worried that they cannot cope financially. The nurse can share knowledge with the multidisciplinary team which will help to maximise patient benefit. (GSF 2006). Communication can be a barrier to effective health promotion especially if the individual cannot understand terminology used by the professional or English is not the first language. Effective communication is central to promoting high-quality care and barriers can be overcome by demonstrating active listening skills, talking to individuals in a manner that they can understand, showing supprt, maintaining realistic hope, taking time to talk to patients, being friendly, open and honest .Demonstrating good body language is also very important and this is one barrier that patients will detect very early on. Many departments and clinical settings now employ interpreters, which is beneficial to the patient whose first language is not English. The use of interpreters improves the quality of care for the patient (Dreger et al 2002). Leaflets containing information are also available in different language for the patient to access. Many individuals are unenlightened to their health needs and they may ignore preventative advice off health care professionals. This barrier can be overcome by educating people about health matters, by having health promotion posters, leaflets and information displayed in public places where people can access them without actually having to make an appointment to see a G.P or practice nurse (unless they want/need to). Lifestyle is a barrier to health promotion. Many people face inequalities such as poor diet, poor health and financial difficulties The Department of Healths healthy eating strategies such as 5 A Day and Change 4 Life have tried to change attitudes and raise awareness about the health benefits of eating fruit and vegetables by introducing it into schools, communication programmes e.g. 5 A Day logo, and ensuring that people can have adequate access to affordable, good quality fruit and vegetables within the local community. (DH 2003). Change4Life (DH 2009) can try to eradicate barriers by promoting healthy eating, having more exercise and living longer to young children with the added participation of other family members. The whole family can work together to initiate a healthy future. Transportation difficulties present barriers for many people as they may find it difficult to access G.P surgeries, health centres or the hospital if they do not have the means to get there. Also if the person has mobility difficulties, attending appointments could prove to be a challenge for them. To encounter this problem health care trusts have provided walk in centres, one stop shops and mobile health units( e.g. for mammogram screening) within communities which are easily accessible , open later and at the weekend. To conclude, it is evident from the information discussed in the assignment that early detection of breast cancer can significantly reduce mortality. The care and treatment of women (and men) with breast cancer has evolved greatly over the last few years and although there is no cure for metastatic breast cancer, evidence has shown that women are able to live longer withy the use of different treatments. Breast screening is very important and evidence shows that the earlier breast cancer is diagnosed and treated, the better the chance of successful treatment. The Governments campaigns such as Breast Awareness, 5 A DAY and ACTIVE 4 LIFE have enriched many peoples lives and by having more accessible clinics, walk in centres and mobile health units all contribute to a healthier, more active lifestyle. Many of the clinics are now nurse led and this has proved to provide a warm, caring and informative environment for patients that attend. Cancer provokes stress, anxiety, fear and anger in patients and nurses on the forefront can attempt to soften these fears by offering psychological and emotional support, guidance and empathy to patients. Caring for patients with breast cancer tests all aspects of holistic nursing care and by having all the necessary skills nurses can build a trusting, therapeutic relationship with the patient which will lessen some worries and anxieties for the patient. Communicating well, providing accurate information, listening and having time for the patient enhances the patient journey. It is essential that autonomy is respected regardless of culture, spiritual or ethnicity differences and that what ever treatment the patient requires is undertaken with the utmost sincerity whilst upholding maximum dignity and privacy for the patient. Lastly, end of life care is now firmly established as an important aspect of care delivery and it is an effective means of improving end-of-life care for all patients. The frameworks allow the patients to have a peaceful and meaningful end to their life.