Friday, August 28, 2020
Microbiology Study Guide Chapter free essay sample
Food Production 1. Lactobacillus, Streptococcus, 2. Saccharomyces cerevisiae B. Oxygen creation C. Nitrogen Fixation D. Disintegration E. Bioremediation F. Anti-infection agents G. Biotechnology and exploration H. Ordinary greenery I. Pathogens (intestinal sickness parasite, E. coli, Salmonella, Clostridium) IV. The Origin of Microorganisms A. Unconstrained Generation returned to 1. Francesco Redi 2. Lazzaro Spallazani 3. Louis Pasteur 4. John Tyndall B. On the off chance that not Spontaneous Generation, at that point what? 1. Ferdinand Cohn 2. Robert Koch Chapter 3: Microscopy Staining I. What would we be able to see with a magnifying instrument? A. Micrometer B. Nanometer II. History of Microscopy A. Robert Hooke B. Anton van Leeuwenhoek III. Standards of Microscopy A. Complete Magnification B. Goals/Resolving power 1. Frequency 2. Numerical opening C. Refraction/Refractive list D. Complexity IV. Light Microscope/Bright field Microscope A. Parts and capacities 1. Oculars 2. Destinations/Revolving nosepiece 3. Stage 4. Condenser Iris stomach 5. Change handles Course, fine, condenser and stage B. Standards of electron microscopy (transmission and examining electron magnifying lens). V. Recoloring Techniques A. Smear Preparation B. Kinds of colors â⬠essential, acidic C. Sorts of Staining Procedures 1. Straightforward recoloring 2. Positive and Negative recoloring 3. Differential recoloring a. Gram stain b. Corrosive quick stain 4. Auxiliary stains a. Container stain b. Endospore stain c. Flagella stain Lecture Chapter 3: Prokaryotic Cell I. Shape: A. Coccus B. Bacillus (pole) C. Coccobacillus D. Vibrio E. Spirillum F. Spirochete II. Courses of action: A. For cocci: 1. Chains or Streptococci game plan 2. Parcels (quadruplicates (4 cells) or 8 cells (Sarcinae)) 3. Bunches or Staphylococci course of action B. For bacilli-Single, sporadic, stacked or binded bars III. Outside Extensions A. Flagella in Gram negative microorganisms 1. Segments â⬠Basal body, Hook, Filament 2. Game plan â⬠(Mono, Lopho, Amphi or Peri) trichous 3. Development â⬠Chemotaxis, Phototaxis, Aerotaxis, Magnetotaxis B. Pivotal fibers (endoflagella) C. Connection pili (Fimbriae) D. Sex pilus IV. Layers/Coverings A. Glycocalyx â⬠Capsule, Slime layer B. Cell Wall â⬠Peptidoglycan, NAG and NAM 1. Gram positive-Teichoic-(TA) and lipoteichoic acids (LTA) 2. Gram negative-external film made of endotoxin - Lipopolysaccharide (LPS), periplasm 3. No cell divider Mycoplasma C. Cytoplasmic (cell) film 1. Segments â⬠Phospholipid bilayer, Fluid Mosaic model 2. Latent vehicle a. Basic dissemination b. Assimilation 1)à Hypertonic 2)à Hypotonic 3)à Isotonic c. Encouraged dissemination 3. Dynamic vehicle a. Significant Facilitator family transporters ââ¬use proton thought process power b. ABC transporters-use ATP as vitality c. Gathering translocation 4. Vitality creation a. Electron Transport chain b. Proton Motive Force V. Inside Structures A. DNA as a Single chromosome in a Nucleoid area B. Plasmids and move of plasmids (conjugation) C. Ribosomes D. Capacity Granules â⬠Glycogen, Volutin, Poly-? - hydroxybutyrate, sulfur E. Gas vacuoles (vesicles) F. Endospores 1. Arrangement of Endospore-sporulation a. Center â⬠Dipicolonic corrosive + Ca2+, DNA proteins b. Center Wall Cortex â⬠peptidoglycan + muramic lactam c. Spore coat â⬠keratin-like protein 2. Germination â⬠Return to Vegetative State 3. Area â⬠terminal, horizontal, focal
Saturday, August 22, 2020
Business External Environmental Assessment Assignment
Business External Environmental Assessment - Assignment Example As per the report discoveries the world of politics is comprised by chose pioneers and the arrangements they present. These arrangements could be planned for controlling business through a scope of business and corporate strategies, altering the tax collection framework, ensuring the earth, and client security. These components are principally constrained by the political class through enactments. Financial condition understands all the variables. Comcast Corporation should consistently filter the monetary condition to check how stable the economy is at some random time. Another part of the financial condition that must be examined is whether dispensable salaries of existing and potential clients is rising or declining. The degree of globalization and rivalry in the telecom and broad communications businesses too should be checked. The degree of rivalry might be checked by deciding whether the piece of the overall industry is developing or shrinking.From this paper it is clear thatâ socio-social parts of nature in which Comcast works involves issues like the populace development pattern and the going with development in the quantity of clients. Generational social mentalities and the societyââ¬â¢s levels of training, wellbeing and social portability additionally impact Comcastââ¬â¢s business choices and industry standing.à These socio-social issues must be investigated after each foreordained time allotments.
US Government essays
US Government expositions In Chapter 1 of the U.S. Government educational plan, we took in a ton about the beginning of what has become our legislature. We learned of John Locke and living in a condition of nature, the reason for government, the state, geographic circulation of intensity, types of government, and the essential ideas of Democracy. We likewise took in a wide assortment of new jargon, which is recorded beneath. Sovereign (ty) direct vote based system government open strategies state Agent popular government turmoil confederation parliamentary government unitary government Nation-state presidential government tyranny implicit agreement The initial phase in shaping government was taken by a man named John Locke. John Locke was an English political rationalist who lived from 1632-1704. (Imagined on blue tab) He had confidence in the normal rights theory, which depended on imagining existence without government. Locke and his kindred rationalists called this living in a condition of nature. Later he, alongside others, made the Social Contract Theory. The individuals of a state would live in a condition of nature until everybody consented to offer up to the state as much force as was expected to frame a legislature. This was shaped by contract. In that agreement the individuals from the state made an administration to execute the forces they had readily allowed to the state. As time advanced different types of government were framed and utilized everywhere throughout the world. The Founding Fathers made a rundown of standards to keep the individuals of the United States free, this was known as the preface to the Constitution and every one of those standards was a reason for having a legislature. (See Preamble under blue tab) The primary rule referenced was to frame a progressively immaculate association. This implies they needed to give the individuals of the United States however much opportunity as could be expected, while having a superior government. The subsequent thought was to set up equity, which ... <!
Friday, August 21, 2020
My Mother - The Greatest Inspiration in My Life :: Personal Narrative
My Mother - The Greatest Inspiration in My Life When asked who their saint is, a great many people react with the name of a competitor or an on-screen character/on-screen character. When asked who my legend is I would need to react with a straightforward three letter word: mother. My mom has been the best motivation in my life and is the primary explanation that I am the place I am and who I am today. Brought up in Richmond, Kentucky, I might want to acquaint you with my mom, Vicki Grant. At present the age of 47, Mom is the most seasoned of three young ladies. At 36 years old, mother chose to return back to school to get her nursing degree. This wasnââ¬â¢t a hard choice for her to make. The April before she selected school my distant grandma died. This significant situation assumed a significant job in momââ¬â¢s returning back to class. She had dealt with my distant grandma for a considerable length of time before she died, and concluded that she needed to have an effect on the lives of geriatrics. While in school, Mom didnââ¬â¢t have it to simple. In addition to the fact that she raised a little girl and deal with a spouse, she needed to manage various misfortunes. These included such things as my dad enduring a coronary failure and proceeding to have a triple by-pass, she herself experienced a crisis medical procedure, which sat her a semester behind, and her dad likewise endured a cardiovascular failure. Mother managed these misfortunes as well as she had the ordinary assignment of things like preparing supper, cleaning the house and raising a family. I donââ¬â¢t know how she oversaw everything, except by one way or another she did. In 1996, my mom moved on from Eastern Kentucky University with a baccalaureate of Nursing. Despite the fact that it took her five years, we were as yet glad for her and all that she had achieved. Today my mother is as yet filling in as a RN. Despite the fact that she simply quit her place of employment at Berea Hospital, where she had been for a long time, she is starting another style of nursing.
Legal Liability in Partnership
Question: Examine the Legal Liability of each of the three Partners of Partnership Business that is Ben, Ann and Mary in the Context of the credit taken from Shady Deals, the New Printing Press, and the Contract with XYZ Ltd. Answer: Legitimate Liability in Partnership: In this we need to examine the lawful obligation of each of the three accomplices of association business that is Ben, Ann and Mary with regards to the advance taken from Shady Deals, the new print machine, and the agreement with XYZ Ltd. Organization Act 1890 manages the association arrangements in UK. Arrangement 5 of Partnership Act 1890 states how accomplices can tie the firm and different accomplices from their activities. According to this Section each accomplice goes about as an operator for both for firm also for his different accomplices for controlling the business carried on by association. Any demonstration done by accomplice identified with business of the firm has capacity to tie the firm and accomplices of the firm. There are a few exemptions to this general principle which express that a demonstration done by accomplice doesn't tie the firm and different accomplices if authority isn't given to the accomplice to follow up for the benefit of the firm for some particular case, and third individual with whom such accomplice is managing realizes that accomplice has no position, or that third individual doesn't trust him to be an accomplice (Partnership Act, 1890). Arrangement 6 of Partnership Act 1890 states that all accomplices of the firm are limited by the demonstrations which are done to carry on the matter of the firm. According to this arrangement any demonstration or instrument which legitimately relates with the business carried on by the association and done or executed for the sake of the firm or if any goal is appeared by that activity or instrument to tie the firm by whatever other individual who is approved and regardless of whether he is accomplice of the firm or not, it is official on all the accomplices of the firm just as firm. It must be noticed that this segment doesn't influence any broad guideline of law which relates with the execution of deeds or any debatable instrument (Partnership Act, 1890). Arrangement 9 of Partnership Act 1890 states the obligation of the accomplices. According to this arrangement each accomplice of the firm is together subject for all obligations and commitments with different accomplices of the firm, and if there should arise an occurrence of Scotland accomplice is additionally severally at risk for all obligations and commitments of the firm which was caused at when individual is accomplice of the firm. If there should arise an occurrence of death of the accomplice his homes are additionally severally at risk for those obligations and commitments caused when he is the accomplice of the firm so far as they stay unsatisfied. In the event of England or Ireland, to the earlier installment of accomplice separate obligations (Partnership Act, 1890). Arrangement 17 of Partnership Act 1890, states the liabilities of approaching and active accomplices of the firm. According to this arrangement any individual who concedes as an accomplice in a current firm doesn't get at risk towards the banks of the firm for any air conditioner which was done before he turned into an accomplice of the firm. Any accomplice of the firm who resigns from a firm doesn't thus stop to be at risk from the obligations and commitments of the firm which are caused before his retirement. Any resigning accomplice might be released from any current liabilities or commitments by an understanding without anyone else or individuals from the firm or leasers, and this understanding can be treated as new constitution between the individuals from the firm and loan bosses. We can comprehend this with the assistance of the case law HURST V BRYK AND OTHERS: HL 30 MAR 2000. For this situation, Hob house L.J. called attention to [1999] Ch. 1, 26B expressed that obligation of Mr. Hurst with the end goal of lease is roundabout, and like some other obligation of the firm this risk is additionally the joint risk of the accomplices of the firm and each accomplice is at risk to pay it. Court consider the Section 9 of the organization Act 1890 in which accomplices are mutually at risk for the obligations of the firm and not severally. With the end goal of risk obligation must be acquired when they are accomplices of the firm (UK parliament, n.d.). Credit taken by Shady Deals: In the current case, from first January 2016 Ben and Ann go into organization as printers, and according to the association understanding executed between the two, any advance taken to carry on the matter of the firm or on the name of the firm should be concurred by the two accomplices. On 1 February 2016, Ann has taken a credit from Shady Deals for sum 100,000 with the end goal of organization at half pace of intrigue. She pays store to purchase new print machine from this cash without educating Ben. For this situation, Ben and Ann both are at risk towards Shady Deals for the measure of 100,000 on the grounds that according to segment 6 of the Act states accomplices are limited by the demonstrations which are done in the interest of the firm and segment 9 of the Act characterizes that each accomplice of the firm is mutually subject for all obligations and commitments with different accomplices of the firm. For this situation Ben abandons first May 2016 to Ann and Mary, and according to Section 17 any accomplice of the firm who resigns from a firm doesn't thusly stop to be subject from the obligations and commitments of the firm which are caused before his retirement. In this manner Ben is at risk towards the Shady arrangements. Area 17 of the Act additionally expresses that any individual who concedes as an accomplice in a current firm doesn't get at risk towards the leasers of the firm for any air conditioner which was done before he turned into an accomplice of the firm, and for this situation Mary joined the firm on first March 2016. Along these lines Mary isn't at risk towards the obscure Deals since this credit is taken before the affirmation of Mary as an accomplice in the firm. The new print machine: In the current case, Ann buy print machine on Credit without illuminating Ben and Section 5 expresses that Acts done by each accomplice to carry on the matter of the firm has capacity to tie the firm and accomplices of the firm. There are a few special cases to this standard which express that a demonstration done by accomplice doesn't tie the firm and accomplices of the firm if accomplice has no position to follow up for the benefit of the firm, and for this situation Ann has no power to done any follow up for the firm. For this situation Ann act without the authority in this way her demonstration doesn't tie different accomplices of the firm just as firm. Ben and Mary are not at risk for new print machine. Agreement with Xyz ltd: For this situation, Ben can't deny his risk towards XYZ according to segment 17 which expresses that any accomplice of the firm who resigns from a firm doesn't therefore stop to be at risk from the obligations and commitments of the firm which are brought about before his retirement. In this way Ben is subject towards the XYZ Ltd. Ben withdraws from first May 2016 to Ann and Mary in this way he is at risk on for the sum which was expected from first February 2016 to 30th April 2016. Ann is obligated for complete sum and Mary is at risk for the obligation which was acquired between first March 2016 to till date and not for any sum which was expected before first March 2016. Private Limited Company in UK lawful Liability of individuals in Private Limited Company: In UK, private Limited Company is that organization which is restricted by offers, and this organization can't exchange their offers overall population. This organization is otherwise called Limited Company, and this organization is most regular sort of organization which is consolidated in (UK organizations constrained, n.d.). Segment 3 of the organizations Act 2006 characterizes that any Company is a restricted organization if constitution of as far as possible the individuals obligation. Organization can be of two kinds either restricted by offers or ensure and if there should arise an occurrence of Private Limited Company is constrained by shares. Organization constrained by shares implies when individuals risk is restricted to that much sum which isn't paid by the individuals on the offers held by them. In the event that, on the off chance that obligation of the individuals isn't constrained, at that point organization is fall under the class of boundless organization (Companies Act, 2006). Segment 4 of the Companies Act 2006, states that a Private Company is any Company which is certainly not an open organization (Companies Act, 2006). Area 59 of the Companies Act 2006 states, that any organization which is Private Limited must utilize restricted or ltd. toward the finish of their organization name, and in the event of Welsh Company its name might be end with cyfyngedig or cyf (Companies Act, 2006). There are some particular organizations which are absolved from this prerequisite, and these organizations are expressed in Section 60 of the Act (Companies Act, 2006). Private restricted Company is an increasingly mind boggling business structure when contrasted with sole dealer and organization. Any organization which is constrained by shares is generally known as Private Limited Company. Organization restricted by shares expresses that risk of individuals is constrained up to their capital speculation. Individuals can't offer portions of private restricted organizations to overall population and these offers can't be exchanged on stock trade. Following are a few attributes of private restricted organization: Private Limited Company can be fused with one part as it were. Risk of individuals in this organization is constrained to the sum which I not paid on shares by individuals. In private constrained organization there is office to give offers to the individuals from the organization, yet shares can't be given to open. Private Limited Companies are isolated from its individuals and it has lawfully unmistakable personality. Organization is overseen by Board of Directors of the Company (UK Companies Limited, n.d.). Following are the benefits of Private Limited Company in UK are: By fusing this organization individuals can ensure individual resources in light of the fact that in Private Limited Company individual resources of individuals and chiefs are not at risk for the obligations and commitments of the organization. In Private Limited Company Liability of individuals are constrained to the complete estimation of unpaid offers. In Private Limited Company can open ledgers, contribute, buy property and so on for the sake of the organization. This structure of business is valid and confided in an
Friday, July 3, 2020
Work book for sh6000 leadership and management in professional contexts - Free Essay Example
Part 1: Management Style Description and feelings This essay aims to reflect on my experience when working with a group of seven students tasked to critically analyse a case study and develop a group presentation. The Gibbs (1988) model of reflection will be used to discuss and analyse the lessons gained from my experience. At the start of our group meeting, a leader was selected and helped the group in planning and implementing the task. However, my experience with the group was marked with difficulties and challenges. In the first stages of our group formation, or the norming stage, we had difficulties meeting as a group due to differences in university schedule. During the meetings, some of the members chose not to participate while others were more demanding and tried to dominate the discussions. The leader tried to create some sense of order in our first meetings and demonstrated the authoritarian leadership style. Throughout our team meetings, some of the members were absent, while others who were present continued to depend on the more dominant members to accomplish the tasks. I was frustrated in the beginning of our meetings and felt that we could have been successful in our presentation if we managed to work more effectively. Our team presentation was not what I expected. I was disappointed with our overall team performance. Discussion and Analysis Management is described as a process where leaders govern and make decision-making within an organisation (Bach and Ellis, 2011). This also involves planning of tasks, organising work, staffing, directing activities and controlling (Belbin, 2010). The main aim of management is for managers to influence or encourage team members to accomplish a task (Belbin, 2010). On reflection, my team leader demonstrated the authoritarian leadership style. This type of leadership is described as one where the leader provides the direction of the team and gives specific instructions and directives on how to achieve the team goal (Daly et al., 2015). An authoritarian leader also supervises the activities of the subordinates and strongly discourages members to validate or question his or her directives (Bach and Elllis, 2011). This type of leadership is appropriate in workplaces where there is a highly-structured setting with routine operations (Bishop, 2009). Autocratic leadership is also favourabl e for activities that are simple and of shorter duration (Marquis and Huston, 2012). On evaluation of my experience in the team, we had very little interaction and cohesion during the first few stages of the team working. According to Tuckmanââ¬â¢s model of team development, there are four stages of group formation (Clark et al., 2007). These include the following: forming, norming, storming and performing. Our lack of cohesion and difficulties in conducting team meetings may reflect the first stage of group formation, which is the establishing stage. In this this step, Clark et al. (2007) has explained that team members are still beginning to form their team roles and tend to be polite and diplomatic. At this stage, a team leader was chosen, who in turn reflected the authoritarian leadership style. Since most team members were reluctant to accept a task, our leader decided to assign team roles and ensured that each team member would attend the team meetings. The leader also s upervised the entire group. On reflection, the authoritarian leadership style was appropriate in the first few stages of our team working since this ensured that tardiness and absenteeism were prevented (Belbin, 2010). Further, the authoritarian leadership style was also appropriate since our assigned task was not complex and was of shorter duration (Bishop, 2009). Our group leader was able to make follow-ups on our assigned task. However, as we progressed towards the second stage, which is the storming stage, conflicts soon arose. There were members who tended to dominate the discussion and did not agree with our leader on our assigned team roles and how the case study should be presented. Although Goodman and Clemow (2010) argue that conflicts in teams are natural and may not always have a negative impact on the function and development of the team, in my experience, the conflicts had negative impact on our team development. Members who disagreed with our team leader on how the case study should be presented chose not to participate in our succeeding meeting and role-playing. Since the authoritarian leadership style was adopted, our team leader did not consider the team memberââ¬â¢s suggestions. Morgan et al. (2015) reiterate that conflicts could help in the development of a team if each team member acknowledges the differences of the team members and learn to adjust to their individual roles. On reflection, most of my team members chose not to adjust to our individual differences. In turn, this created a discordant team, which also reflected on our final presentation. I felt that our presentation was chaotic and reflected poorly on our role as team members. On consideration, our team would have benefitted with the transformational leadership style. This type of leadership encourages members to actively participate in decision-making and is associated with achievement of goals and objectives (Bach and Ellis, 2010). Conclusion The authoritarian leadership style was not the most appropriate style in managing our team since this failed to encourage team members to participate in decision-making. This type of leadership is also not applicable in actual healthcare settings since patient-centred care is promoted and team working and participation highly encouraged. Action Plan When managing a team in the future, I will ensure that I am aware of my own team role. Conflicts should be used to develop and not destroy teams. I will also adopt a leadership style that allows teams members to actively participate in decision-making. Specifically, I will develop the transformational leadership style since this ensures that all members have opportunities to be actively involved and valued during achievement of a task (Bishop, 2009). References: Bach, S. Ellis, P. (2011) Leadership, Management and Team Working in Nursing. Exeter: Learning Matters. Belbin, R. (2010) Management of teams: why they succeed or fall. London: Butterworth-Heinemann. Bishop. V. (2009) Leadership for nursing and allied healthcare professionals. Open University Press: Milton Keynes. Clark, P., Cott, C. Drinka, T. (2007) ââ¬ËTheory and practice in interprofessional ethics: a framework for understanding ethical issues in health care teamsââ¬â¢, Journal of Interprofessional Care, 21(6), pp. 591-603. Daly, J., Speedy, S. Jackson, D. (2015) Leadership and Nursing. Contemporary Perspectives. 2nd ed. Chatswood: Elsevier. Gibbs, G. (1988) Learning by doing: A guide to teaching and learning methods, Oxford: Further Educational Unit, Oxford Polytechnic. Goodman, B. Clemow, R. (2010) Nursing and collaborative practice: A guide to interprofessional learning and working. Exeter: Learning Matters, Ltd. Marquis. B. Huston. C. (2012) Leadership and management tools for the new nurse. A case study approach. Lippincott: Philadelphia. Morgan, S., Pullon, S. McKinlaey, E. (2015) ââ¬ËObservation of interprofessional collaborative practice in primary care teams: An integrative literature reviewââ¬â¢, International Journal of Nursing Studies, doi: 10.1016/j.ijnurstu.2015 03.008 [Online]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25862411 (Accessed: 15 May 2015). Part 2: Leadership, Management and Change Description and Feelings In our team meetings, the concept of change management surfaced since our team leader struggled in influencing team members to assume different team roles. I also realised that I used to complete tasks individually and not as a team. Although I was not the team leader, I also have to learn how to reflect an appropriate leadership style that will be used in future team working. During our team meetings, I was frustrated since we were accomplishing little, but in the end, I felt that I have developed my ability to work in a team. Discussion and Analysis Change is described as a transition that involves movement from the present state of an organisation to a desired, future state (Marquis and Huston, 2012). Changes often occur in healthcare settings and require change management. During the role-play and team meetings, collaborative team working was encouraged to achieve the goals of the team. This represented a change in how I accomplish tasks. From completing assigned tasks individually, I have to learn how to complete tasks as a group. Apart from changes on how to complete tasks, there was also a suggested change on leadership style from authoritarian to the transformational leadership style. On evaluation, change management was necessary in our group since this could have addressed the factors that caused our poor performance and increased the factors that would lead to a successful group performance. Practising change management is crucial since this would help prepare myself in my future role as a registered nurse and as a nurse leader. At least three theories have been proposed in managing change. These include the Plan, Do, Study, Act cycle (PDSA), Kotterââ¬â¢s Model and Lewinââ¬â¢s change model (Bach and Ellis, 2010; Appelbaum et al., 2012; Reed and Card, 2016). The PDSA cycle is often used in the NHS and allows nurse leaders and other healthcare practitioners to create a plan on how to implement a change while the ââ¬Ëdoââ¬â¢ stage constitutes the actual performance of the plan. In the third or ââ¬Ëstudyââ¬â¢ phase, nurse leaders and team members analyse the performance and whether this needs to be enhanced or changed (Reed and Card, 2016). In the ââ¬Ëactââ¬â¢ phase, the proposed changes in the action plan and performance are implemented. The entire process is then repeated until change has been integrated within an organisation. A critique of the PDSA is the difficulty in repeating this cycle, with Reed and Card (2016) noting that only 20% of healthcare groups using PDSA actually repeat the cycle. The applicability of the PDSA is limited with some healthcare settings not benefitting from this type of change management (Taylor et al., 2013). Meanwhile, the Kotter Model of change adopts the top-down approach and is often used in corporate settings (Appelbaum et al., 2012). It is difficult to use this model of change in actual healthcare settings since the NHS encourages all team members and patients to actively participate in planning and implementation of a change initiative (NHS Leadership Academy, 2011). However, a reflection of my own group would show that the Kotter Model of change was demonstrated as our team leader exercised the authoritarian leadership style. The change came from the leader and trickled down to the team members. Finally, the Lewinââ¬â¢s model of change proposes three stages of change: unfreezing, change and refreezing (Gopee and Galloway, 2013). This model is often used in healthcare settings since it takes into account the factors that enable or deter change in actual practice. Force-field analysis is done and factors that enable change are increased while factors that deter change are reduced (Gopee and Galloway, 2013). On reflection, employing this type of change management is crucial in my future role as a registered nurse leading a multidisciplinary team. In the NHS, it is recognised that there are several factors that deter or promote change in practise. For instance, the perception that a proposed change initiative only increases paperwork could deter the uptake of change in practice (Bach and Ellis, 2011). This perception is supported in literature with the Royal College of Nursing (2013) reporting that nurses spend an average of 2.5 million hours per week completing clerical tasks. Hence, I have to be aware of factors that deter or enable change. On reflection, the autocratic leadership style, coupled with the top-down approach to change did not lead to a successful performance of my gr oup. The Lewinââ¬â¢s model of change would have been more appropriate in helping my team members accept their individual roles and in changing their own way of completing tasks. This model would have helped our team leader investigate the factors that lead to poor attendance to our team meetings and the team membersââ¬â¢ refusal to resolve conflicts. Conclusion Effective leadership and change management are crucial when implementing a change initiative and in completing group tasks. Using the Lewinââ¬â¢s model of change would have helped the team leader identify the factors that enable and deter change. Successful use of this model would lead to achievement of the goals of the team. Action Plan I will develop my leadership skills and abilities to carry out Lewinââ¬â¢s change model. I will find opportunities to practice change management skills in my own healthcare setting and report regularly to my mentor and colleagues on my progress. I will ask feedback from my mentor and colleagues if I have achieved leadership and change management skills. References: Appelbaum, S., Habashy, S., Malo, J. Shafiz, H. (2012) ââ¬ËBack to the future: revisiting Kotterââ¬â¢s 1996 change modelââ¬â¢, Journal of Management Development, 31(8), pp. 764-782. Bach, S. Ellis, P. (2011) Leadership, Management and Team Working in Nursing. Exeter: Learning Matters. Gopee, N. Galloway, J. (2013) Leadership and Management in Healthcare. 2nd ed. London: Sage. Marquis. B. Huston. C. (2012) Leadership and management tools for the new nurse. A case study approach. Lippincott: Philadelphia. NHS Leadership Academy (2011) Clinical Leadership Competency Framework. Coventry: NHS Institute for Innovation and Improvement. Reed, J. Card, A. (2016) ââ¬ËThe problem with Plan-do-study-act cyclesââ¬â¢, British Medical Journal Quality and Safety, 25(3), pp. 147-152. Royal College of Nursing (2013) Nurses spend 2.5 million hours a week on paperwork- RCN Survey [Online]. Available at: https://www2.rcn.org.uk/newsevents/press_releases/uk/cries_unheard_-_nurses_still_told_not_to_raise_concerns (Accessed: 10 May, 2017). Taylor, M., McNicholas, C., Nicolay, C., Darzi, A., Bell, D. Reed, J. (2013) ââ¬ËSystematic review of the application of the plan-do-study-act method to improve quality in healthcareââ¬â¢, British Medical Journal Quality and Safety, doi: 10.1136/bmjqs-2013-001862. Part 3: Leadership, Management and Decision Making Description and Feelings In our group work, our team leader did not make a decision to identify the factors that deterred participants from resolving conflicts and adjusting to team roles. There was also no decision to reflect on why team members were reluctant to accept the assigned tasks and the reasons for poor attendance to the team meetings. I felt that these non-decisions heavily influenced our team performance. As a group, we made the erroneous conclusion that our team leader can handle all the required tasks. This group conclusion might have also contributed to our failed group presentation. During our meetings, I was anxious and apprehensive that we were not accomplishing our tasks with the given time frame. Discussion and Analysis The indecision to identify factors that deterred the group from participating in meetings and accepting tasks had a negative impact on our team performance. The ability to make decisions is crucial when completing tasks as a student nurse and in preparation for my role as a registered nurse or a nurse leader. Marriner-Tomey (2009) has argued that decision-making is crucial in healthcare organisations and within teams. In actual healthcare settings, decisions are made constantly and range from decision on whether to admit a patient to decisions on which interventions to use for a specific healthcare condition. These decisions are influenced by legislations, policies, leadership styles and the practice of patient-centred care (NHS Leadership Academy, 2011). On analysis, it is crucial to make decisions within groups. However, it is cautioned that collective decisions might reflect ââ¬Ëgroupthinkââ¬â¢ and lead to failure instead of success (Marriner-Tomey, 2009). The theory of gr oupthink is described as faulty decision made by a group that represents deterioration in reality testing, mental efficiency and moral judgment (Wilcox, 2010). Groups who demonstrate groupthink often do so without realising the impact of their decisions on other groups and in the process, ignore alternatives or actions (Cooke and Young, 2002). It is important to note that groupthink often occurs when members have similar background, when rules for decision-making are not clear and when members do not consider the opinions of others (Wilcox, 2010). In my experience, we were not able to make a decision or demonstrate groupthink despite the similarities of our background. I felt that our lack of cohesion prevented us from also making faulty decisions, which are common when a team ââ¬Ëgroupthinksââ¬â¢. An analysis of our group revealed that we were not able to examine the power relations within the group. Power relations could have an impact on who make the decisions and whethe r these decisions are followed (Bach and Ellis, 2010). Power is described according to who has the formal authority to make decisions for the group and according to who has access to resources (McDonald et al., 2012). Power is also described according to who has less ability to control ideas (McDonald et al., 2012). à In teams, there may be power imbalance especially when professional systems, social and cultural factors reinforce these imbalances (Martin-Rodriguez et al., 2005). This power imbalance may be more evident in hospital settings where medical dominance is seen. For example, medical doctors have traditionally retained their independence and professional autonomy and status when collaborating with other groups of healthcare workers (Hudson, 2002). This may create power imbalance as doctors tend to have more power in decision-making compared to the rest of the group. This is in contrast with what is often seen in community healthcare settings where each member of a health care team tends to share power and make decisions according to what is best for the patient (Hudson, 2002). Meanwhile, Weir-Hughes (2011) asserts that in order for a therapeutic relationship to develop, there is a need to consider the power relationships between healthcare practitioners and patients. It is suggested that power may be used negatively (i.e. through coercion and force) or positively (i.e. through encouragement and empowerment). à On analysis, my ability to understand power relations through my experiences in team working will be essential when caring for actual patients. In our team, power was used negatively since our team leader had to force our team members to accept assignments. However, I realised that in actual settings, it is important to encourage and empower patients and my colleagues to improve patient care. It has been shown that patient empowerment tends to improve the quality of care and patient outcomes (Sullivan and Garland, 2010). On analysis, ther e was power imbalance in our group since the team leader made all the decisions and the top-down approach to change was followed. Conclusion Making decisions is crucial in team working and when caring for patients. However, the ability to make decisions would depend on oneââ¬â¢s power. Those with more access to resources and power have greater ability to influence decisions. In healthcare settings, it is crucial to use power positively and empower patients and other members of the healthcare team to make decisions. Positive use of power is also important in preventing ââ¬Ëgroupthinkââ¬â¢, a phenomenon that tends to result to negative consequences for the group. Action Plan When faced with a similar situation in the future, I will ensure that I actively participate in decision-making. However, I need to empower others and myself to make good decisions. Empowerment is necessary to prevent power imbalance. I will continue to engage in training on how to practice effective leadership and management skills in order to empower others to actively engage in decision-making. References: Bach, S. Ellis, P. (2011) Leadership, Management and Team Working in Nursing. Exeter: Learning Matters. Cooke, M. Young A. (2002) Managing and Implementing Decisions in Healthcare. London: Healthcare Balliere Tindall/RCN. Marriner-Tomey (2009) Guide to Nursing Management and Leadership. St. Louis: Mosby Elsevier. Martin-Rodriguez, L., Beaulieu, M., Dââ¬â¢Amour, D. Ferrada-Videla, M. (2005) ââ¬ËThe determinants of successful collaboration: a review of theoretical and empirical studiesââ¬â¢, Journal of International Care, 19(2), pp. 132-147. McDonald, J., Jayasuriya, R. Harris, M. (2012) ââ¬ËThe influence of power dynamics and trust on multidisciplinary collaboration: a qualitative case study of type 2 diabetes mellitusââ¬â¢, BMC Health Services Research, 12(63). Doi: 10.1186/1472-6963-12-63. NHS Leadership Academy (2011) Clinical Leadership Competency Framework. Coventry: NHS Institute for Innovation and Improvement. Sullivan E., Garland G. (2010)à Practical Leadership and Management in Nursing. Pearson Education, Harlow. Wilcox, C. (2010) Groupthink: An impediment to success. USA: Xlibris Corporation. Part 4: Reflection on Development of Skill Description and Feelings I participated in a second group activity where I was chosen as the leader. In the second group, I was able to practice leadership skills such as effective communication, motivation, change management and integrity. During one of our discussions, I assigned a group member to search for evidence-based interventions for a specific healthcare condition. Following some research, my team member decided to use the case of a real patient to explain the interventions. However, she identified the name of the patient and the context of her care, including the names of the nurses who were involved in her care. I talked to my colleague privately after our discussion and informed her of the NMC (2015) code of conduct on patient autonomy and the need to observe the privacy of the patient. I asked her to use a pseudonym instead when discussing the case of a patient. My colleague accepted my suggestion and protected the identity of the patient during succeeding discussions. On reflection, I felt t hat my decision to inform my colleague on how to discuss patient care was based on the ethics principles of patient autonomy. Discussion and Analysis From my participation in teams/groups throughout the module, I was able to develop effective communication skills. Specifically, I learned how to listen and show compassion to my colleagues and my patients during placement when they converse with me. Kourkouta and Papathanasiou (2014) have emphasised that effective communication skills is crucial in healthcare settings and when working in teams. These communication skills include recognising both verbal and non-verbal messages (Johnston, 2013). Patients who feel that their nurses are listening intently tend to report higher patient satisfaction with the care they receive (Kourkouta and Papathanasiou, 2014). Effective communication skills are also necessary in resolving conflicts in teams and understanding the perspectives of others (Craig and Moore, 2015). In nursing teams or when working with patients, it is recognised that conflicts in ideas also occur. Hence, the ability to communicate effectively and resolve conflicts will be n ecessary in preparing myself in my future role as a registered nurse (Craig and Moore, 2015). Apart from effective communication, I also learned how to motivate my fellow team members. Motivation is crucial in team working since this would help team members to complete tasks. In my experience with my first group, team motivation was not practiced. In contrast, my second team was able to use motivation to help team members accept and carry out tasks. I realised that the main difference was the support that my team members received in the succeeding group. Craig and Moore (2015) state that team support is critical in team working since the absence of support could create dissatisfaction and loss of motivation. In addition to the skills on motivation, I also saw the importance of change management in our team. In my first group, change management was not practised. Managing change is critical in healthcare practice. Thorpe (2015) has stated that planned change, which is described as purposeful, requires collaborative effort and the presence of a change agent. The NMC (2015) has emphasised that nurses must deliver quality care that is based on evidence, suggesting that nurses have to continually update their skills and practice. This also means that changes in practice have to be made. However, in practice, implementing change is challenging. It is suggested that almost 70% of change projects do not succeed (Mitchell, 2013). In my experience with the group, I also realised the necessity of recognising factors that influence or deter change. Mitchell (2013) suggests that advances in science, shortages of the nursing workforce, an ageing population, the need to increase patient satisfaction and rising cost of treatment all influence change. Inappropriate leadership, poor communication and under-motivated staff also deter the uptake of change in practice (Oââ¬â¢Neal and Manley, 2007). In my future practice, I have to identify factors that promote change in p ractice. On reflection, I was not able to promote change in our first group. I could have assisted the team leader in my first group in analysing the factors that deter my colleagues from accepting their assigned tasks. Integrity was also practiced in the succeeding groups that I was involved in. Specifically, power was not misused as all team members in these groups had equal chances to participate in decision-making. In addition, the team leader and group members exercised honesty and transparency in the decisions made. Finally, ethics in decision-making was observed. For instance, all personal information of patients discussed during case studies was not mentioned and patient autonomy was observed. The NMC (2015) has reiterated the importance of protecting the privacy and autonomy of the patients. Conclusion Practising effective leadership skills and ethical decision-making are important when working as teams and in providing quality care to the patients. Inability to work effectively could result to poor performance, which in turn could affect the quality of care that my future patients will receive. Developing these leadership skills early in my undergraduate years would help prepare me in my role as a registered nurse. Action Plan As part of my action plan, I will continue to engage in training on how to develop effective communication skills. Specifically, I will refine my skills on how to show empathy when listening to my patients and colleagues. The ability to demonstrate empathy is crucial since this would help my patients feel that they matter to the team (Fowler, 2015). References: Craig. M. Moore. A. (2015) ââ¬ËProviding support for teams in difficultyââ¬â¢,à Nursing Times.à 111(16), pp. 21 23. Fowler. J. (2015) ââ¬ËWhat makes a good leader?ââ¬â¢,à British Journal of Nursing, 24(11), pp. 598 599. Johnston, B. (2013) ââ¬ËPatient satisfaction and its discontentsââ¬â¢, Journal of the American Medical Association, 173(22), pp. 2025-2026. Kourkouta, L. Papathanasiou, I. (2014) ââ¬ËCommunication in nursing practiceââ¬â¢, Materia Socio Medica, 26(1), pp. 65-67. Mitchell, G. (2013) ââ¬ËSelecting the best theory to implementing planned changeââ¬â¢, Nursing Management, 20(1), pp. 32-37. Nursing and Midwifery Council (NMC, 2015) The Code: Professional Standards of practice and behaviour for nurses and midwives [Online]. Available from: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/revised-new-nmc-code.pdf (Accessed: 12 May, 2015). Oââ¬â¢Neal, H. Manley, K. (2007) ââ¬ËAction planning: making change happen in clinical practiceââ¬â¢, Nursing Standard, 21(35), pp. 35-39. Thorpe. R. (2015) ââ¬ËPlanning a change project in mental health nursingââ¬â¢,à Nursing Standard, 30(1), pp. 38 44.
Tuesday, May 26, 2020
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