The Psychoanalysis Theory

Sigmund Freud’s Psychoanalysis is a theory which tries to discover the connections between the unconscious components of a patient’s mental processes. Freud, a neurologist which has great interests in finding out a treatment for patients with neurotic and hysterical symptoms devised psychoanalysis in Vienna in the 1890s. He called this, â€Å"the hypothesis of unconscious mental activities† (Hook 3). He then developed a method in which talking with the patients is involved. Through this, he found out that the problems of the patients with these kinds of illness stemmed from either repression and/or problems which the patients encountered during childhood. These problems, as Freud believed, lies in the unconscious minds of the persons involved. These problems may not be overtly manifested by the patients, however, in one point in their lives, it will eventually come out. Probably, the main question Freud gives is that, what could possibly have happened during the person’s childhood which affected the way he/she behaves presently? This question is primarily needed for the psychoanalyst to be able to decipher why a certain being acts the way he does. One of the guiding principles of psychoanalysis is the assumption that the problems of the patients in need of psychotherapy lies within the unconscious. This however, was given proof by Freud. According to him, â€Å"the unconscious is the storehouse of instinctual desires, needs, and psychic actions. Also, the unconscious mind acts as a reservoir for repressed memories of traumatic events which continuously influence conscious thoughts and behavior. While past thoughts and memories may be deleted from immediate consciousness, they direct the thoughts and feelings of the individual from the realm of the unconscious†. Through psychoanalysis, these past thoughts and memories which are stored in the unconscious are then unlocked through a process which is called the â€Å"talk therapy†. It is believed that neurotic problems stemmed from the unconscious. These problems, according to Freud, can sometimes manifest themselves in dreams.   The aim, therefore, of psychoanalysis is to bring the repressed memories in the unconscious to the consciousness through a psychoanalytic treatment for it to be addressed accordingly. No matter how successful the movement became, many critics still emerged and deliberately demonstrated their disbelief to the said movement. One of the major critics of Freud’s psychoanalysis is Grà ¼nbaum. In 1986, he said that â€Å"†¦more often than not, they may be the patient's responses to the suggestions and expectations of the analyst† (186).   He is referring to the clinical data gathered by the psychoanalyst. He claims therefore, that psychoanalysis is not reliable because of the fact that most of the patients respond according to what their analysts want to hear. However, if we are going to go through the aim of psychoanalysis, we will find out that Freud was trying to find out â€Å"reasons† rather than â€Å"causes† so therefore, results are technically not important. His main focus was on how the patients will respond to a certain question and how these patients would reason out when given a certain problem. Technically, the procedure is merely a problem solving process. Another critic, Torrey Fuller, considered by some to be a leading American psychiatrist, writing in Witchdoctors and Psychiatrists (1986) stated that psychoanalytic theories have no more scientific basis than the theories of traditional native healers, â€Å"witchdoctors† or modern â€Å"cult† alternatives. In fact, an increasing number of scientists regard psychoanalysis as a pseudoscience (Cioffi, F. 1998). However, this claim by Fuller, was countered by one of the proponents of psychoanalysis by saying that the concepts and theories of psychoanalysis are more akin to the humanities than those of the physica/biological sciences. Therefore, even if they claim that it is not scientific, they cannot push through with that kind of argument. When Freud died, psychoanalysis continued to flourished in its role in solving mysteries with the unconscious. In fact, there emerged the post-freuedian schools which are the Object Relations Theory and the Interpersonal Psychoanalysis. These schools of thought reinforced, in some ways, the psychoanalytic movement proposed by Freud. The Object Relations theory states that the ego-self exist only in relation to objects, be it internal or external. These objects, basically, are said to be formed through interactions with the parents during childhood. According to object-relations theory there are three fundamental â€Å"affects† that can exist between the self and the other; attachment, frustration, and rejection. These â€Å"affects† are considered as the major building blocks of the personality. Therefore, if these affects are triggered, there is the possibility that a change of personality may occur; a changein terms of a person’s perception towards a particular thing or can be a change with regards to a person’s ability to interact with other people. These kinds of changes, as believed by Freudian theorists, may be addressed through psychoanalysis. The Interpersonal Psychoanalysis, on the other hand, states that a patient's interpersonal interactions with others provide insights into the causes and cures of mental disorder. It is believed that patients keep many aspects of interpersonal relationships out of their awareness by selective inattention. The role of psychoanalysis, therefore, is to bring out detailed information from the patient which will lead them to finding out the interpersonal patterns within that patient. In line with the arguments of Freud’s critics, one question that could be raised is that, has psychoanalytic therapy really â€Å"cured† mentally impaired people or are these people just cured because of the fact that they believed that they were cured and not because they really were? There could be a great possibility that people just perceived that he is cured even if he is not. This is one good question that can be addressed with regards to the psychoanalytic process. There were many critics who emerged during the peak of the success of the psychoanalytic movement. Some were for the movement, many were against it. However, it still flourished and up to now, this method is continuously being used. Wholly, Freud’s Psychoanalytic movement has strengths and weaknesses. Probably, part of the strengths of this movement are the facts that clearly, this theory addresses its problem, it can be applied in practical ways and, most importantly, it withstands the test of time. This only means that no matter how many negative criticisms this movement encountered, it is still able to function in such a way that it is being helpful to the society. No matter how many flaws were encountered during the generation of the movement, it is still useful up to this time. In fact, even today, psychoanalysis still remains as a valid option for people who seek help because of mental illness. The movement will continuously flourish because of the fact that it addresses its problems accordingly and it is easy to conduct as long as the involved parties participate accordingly to the process being done. For somebody who whole – heartedly believes in the psychoanalytic movement, it is quite hard to point out certain weaknesses of the movement. However, the only weakness that it might really probably possess is the fact that it might really probably be just giving data which are just interpretations of the analyst which is again, going back to Grà ¼nbaum’s argument, he said that the   patients could probably just saying what the analyst wants to hear. But as stated earlier, Freud’s aim is to find out the â€Å"reasons† and not the â€Å"causes†. The psychoanalytic theory can be considered most useful in addressing problems of patients who are considered mentally impaired. People who undergo Psychoanalysis are people who are emotionally impaired with symptoms like depression or anxiety, loneliness, and incapacity to feel close to anyone. Brain disorders like schizophrenia and autism can be cured through this method as well. However, psychoanalysis would not work with schizophrenics and autistics because such patients ignore their therapist's insights and are resistant to treatment (Dolnick 40). Depression, loneliness, and the incapacity to feel close to anyone, as believed by Freud, to be easily addressed through psychoanalysis, are states wherein a person experiences difficulty in coping up with changes that are constantly happening to his surroundings. He therefore encounters a feeling of being unwanted by the society. With this kind of feeling, the person involved then lacks self esteem which he needs in order for him to get along with the people around him. Freud believed that this kind of problem can be solved if proper interventions will be done and proper techniques of communication will put into practice. This is when the person involved is willing to talk about his problems; the things that makes him think that he is unwanted by other people; the reasons why he is having a hard time coping up with the changes happening around him. Through talking the problem out, the person can now feel that somebody is there to listen to him. This kind of method only works if the person involved is willing enough to disclose himself to another person. Sigmund Freud’s Psychoanalysis is a theory which tries to discover the connections between the unconscious components of a patient’s mental processes. Personally, based on the studies done for this particular topic, I believe that it really is an effective way intervening people with certain problems with their behavior. With the different studies done by Freud, there are ample evidences that conscious thought and behavior are influenced by non-conscious memories and processes. As stated earlier, the psychotherapy could greatly help people with mental and emotional problems by knowing the past events that greatly affects people’s thought and ideas through unlocking the â€Å"unconscious† thereby being able to decipher why a certain person acts the way he does, and thereby addressing the mental problem of the patient. Works Cited Hook, Sidney, ed. Psychoanalysis, Scientific Method, and Philosophy: A Symposium.   New York: New York University Press, 1959. The researcher use data from Psychoanalysis, Scientific Method, and Philosophy: A Symposium to strengthen the topic sentence that Sigmund Freud’s Psychoanalysis is a theory which tries to discover the connections between the unconscious components of a patient’s mental processes. The book talks about Psychoanalysis as a scientific theory and not as a mere philosophical theory, it aims to answer the different questions thrown against the movement. It is through this book that the researcher was able to make strong points against the different debates against the movement. The book also gave enough background about the rise and development of the movement. Freud, Sigmund. An outline of psycho – analysis. New York: W. W. Norton & Company, 1989. The researcher use data from An outline of psycho – analysis to strengthen the topic sentence that Sigmund Freud’s Psychoanalysis is a theory which tries to discover the connections between the unconscious components of a patient’s mental processes. This is a book that focuses on Freud’s psychoanalysis movement. It talks about the fundamentals of psychoanalysis. He marshals here the whole range of psychoanalytic theory and therapy in lucid prose and continues his open-mindedness to new departures. The researcher used the source to describe Psychoanalysis as a whole on the first part of the paper. The researcher also used this to counter some arguments thrown against the movement. Grunbaum, Adolf. The foundations of psychoanalysis. New York: St. Martin’s Press, 1985. The researcher use data from The foundations of psychoanalysis to strengthen the topic sentence that Sigmund Freud’s Psychoanalysis is a theory which tries to discover the connections between the unconscious components of a patient’s mental processes. This is a philosophical critique of the foundations of Sigmund Freud's psychoanalysis. Through this book, Grunbaum was able to state his debates against Freud’s psychoanalysis. The researcher uses the data, to cite an example of debates against the movement. Cioffi, F. Freud and the Question of Pseudoscience. New York: Open Court Publishing Company, 1998. The researcher use data from Freud and the Question of Pseudoscience to strengthen the topic sentence that Sigmund Freud’s Psychoanalysis is a theory which tries to discover the connections between the unconscious components of a patient’s mental processes. The book has shown that psychoanalysis was actually more concrete to humanities rather than the biophysical science. Like a study by Dolnick, cited below, it also discusses debates on the movements, as well as attacks on Freud himself. The researcher was able to get enough background on causes why debates against the movement started. Dolnick, Edward. Madness on the couch: Blaming the victim in the heyday of psychoanalysis. New York: Simon & Chester, 1998. The researcher use data from Madness on the couch: Blaming the victim in the heyday of psychoanalysis to strengthen the topic sentence that Sigmund Freud’s Psychoanalysis is a theory which tries to discover the connections between the unconscious components of a patient’s mental processes. This book focused on the pseudoscientific theories and dangerous practices that emerged and flourished in the wake of World War II as American psychotherapists battled to understand and treat schizophrenia, autism, and obsessive-compulsive disorder. Though unlike Cioffi’s Freud and the question of Pseudoscience, this one strongly emphasize that psychoanalysis did more harm than good to patients. It is through this, that the researcher was able to cite some examples to strengthen. his position with regards to the psychoanalytic movement.

Explore Joe Gargery’s role in Great Expectations Essay

In Great Expectations, Joe acts as a father figure to Pip, when he is in fact his brother-in-law, as Joe married Pip’s sister, Mrs Joe Gargery. We are introduced to Joe as a â€Å"mild, good-natured, sweet-tempered, easy-going, foolish, dear fellow†. Pip describes him as a kind and gentle man, making the reader immediately like him. â€Å"Good-natured† and â€Å"sweet-tempered† give Joe an endearing quality, so the reader is drawn to him. However, â€Å"foolish† introduces a potentially negative side to his character, like he is stupid, although this too could be considered endearing. Perhaps Dickens does this so that we can understand Joe’s actions better, or at least don’t view him too negatively when he can’t protect Pip from Mrs Joe. In contrast to his gentle personality, he is a blacksmith, and therefore a strong man. Pip thinks of him â€Å"like the steam-hammer, that can crush a man or pat an egg shell†. He is likening Joe to a machine in the forge, giving Joe a sense of power. Although, â€Å"crush† is quite a violent word, suggesting Joe to be violent, which he definitely is not. Perhaps Dickens included this detail to make us respect Joe, which is important for later on in the novel, so we don’t just view him as a â€Å"sweet-tempered† man. But there is a sense of this good natured man in the word â€Å"pat†, it could potentially have paternal connotations. Perhaps this links to the image of the egg shell as well, as it is a fragile protector of life. Furthermore Joe could almost be seen as the protector of Pip’s life, as he saves him several times. Also egg shells can be strong, but have weak sides if they are put under stress, just like Joe has a weak side  œ he can’t protect Joe from Mrs Joe Gargery. As well as this, there is the idea that Joe is in control, in the words â€Å"can† and â€Å"or†, he can choose which side of himself to be, strong or gentle. This is a very adult concept, but Joe can sometimes be very childlike. Joe can’t deal with the idea of death, despite being a strong blacksmith. When Pip asks Joe if Miss Havisham died, he eventually replies â€Å"she ain’t living†. This is a very backward way of saying it, a way we don’t normally use, showing Joe’s childish innocence. He avoids the subject of death again, when Pip asks him if he had heard of Magwitch’s death. Even though Joe never knew him personally, he avoids saying the words, instead he says he heard â€Å"something or another in a general way in that direction†. The vagueness of this statement is almost humorous, he can’t even just say â€Å"yes†. Joe is unable to confirm a person’s death, he just brushes over the subject, not fully acknowledging or possibly understanding it, like a child would. Another way Dickens portrays this childishness is through making Joe illiterate. Pip writes him a letter, and all he can read is his name: â€Å"Why, here’s three Js, and three Os, and three J-O, Joes, in it, Pip!† The exclamation mark at the end implies he is excited and proud that he has managed to read, and that he is wanting Pip to recognise his achievement, like a child would want their father too. This childishness makes Joe a lovable character, the reader wants to see him do well. Perhaps it also makes Pip’s behaviour towards him seem worse, from the reader’s perspective, as Joe is such an innocent character. Whilst Joe may not have great knowledge or academic skills, he possesses something most of the other characters don’t have, self-knowledge, he recognises he is illiterate and ‘stupid’. He tells Pip on two separate occasions that he is â€Å"most awful dull†. He is accepting of himself, he knows he is not the cleverest, in fact â€Å"awful† suggests that he thinks he is very stupid. Moreover, â€Å"dull† could imply many things, not only that he is stupid, but also that he isn’t sharp. Perhaps this is a reference to him being a black smith, that he is like one of his hammers, only good for physically things, he’s not sharp witted or clever. â€Å"Dull† could also intimate that he thinks he is boring, perhaps why he struggles to talk to, or be in the presence of people in a higher class to himself, because he considers himself boring and unworthy. But this ‘dullness’ does not stop him from being wise. Throughout the novel, Joe gives Pip many pieces of advice, for example â€Å"if you can’t get to be oncommon through going straight, you’ll never get to do it through going crooked†. Joe, even though he is perhaps the most uneducated character (shown in the wording of the sentence) he can sometimes be the most wise and honourable. Because of this he acts as a hidden role model for Pip. Not only is he honourable and wise, he understands his place: â€Å"I am wrong out of the forge† he tells Pip at their awkward reunion. Dickens suggests (through Joe) that people should stay in their class, and not aspire or try to move up; he argues for social immobility. Joe tells Pip that if he ever came back to the forge he’d â€Å"see Joe the blacksmith, there, at the old anvil, in the old burnt apron, sticking to the old work.† Joe labels himself â€Å"the blacksmith† implying that he believes it is all he is good at. The repetition of â€Å"old† makes him seem experienced, as he has been doing it a long time. There is also the idea that he clings or latches onto his work, in the word â€Å"sticking†, he fixes himself onto it so much that it has become how he defines himself. The fact that he feels himself â€Å"wrong† when not in the forge could be the reason why he can’t talk to Miss Havisham: â€Å"Joe†¦persisted in addressing me.† It is like he cannot deal with the formality of he occasion, as he feels he doesn’t belong there. Dickens humiliates Joe here, presenting him as a shy and awkward character, making the reader sympathise with him. This is another negative quality, helping to balance out the character of Joe. Joe also finds it difficult to deal with Pip when he is a ‘gentleman’. When Pip is ill, and needing Joe’s help, Joe is happy to call him Pip and treat him like he did when he was younger. But as soon as Pip starts getting better and gaining strength, Joe reverts to calling him â€Å"Sir†: â€Å"I shall be happy fur to see you able, sir†. This could show Joe’s insecurity, that when he is no longer sure if Pip needs him, he becomes very polite, and address Pip as if he is in a higher class again. However, Joe does treat everyone equally, for example when Magwitch confesses about stealing the pie, Joe says that whatever he has done, â€Å"we wouldn’t have you starved to death for it, poor miserable fellow-creature.† This shows how Joe views the world, and the people on it, that we are all of the same kind, and all have the same rights. As well as this, â€Å"creature† implies that Joe believes humans are animals, perhaps why he struggles with classes and formalities. This may relate to the fact that Joe never shows a real desire to learn to read or write, because he thinks we are animals that just do physical things, such as make things, like a blacksmith does. â€Å"Poor† also implies that Joe sympathises with the convict, despite knowing it was his own fault that he is in the position he is in, showing that Joe is very forgiving, which the reader respects him for. Joe shows this forgiveness on a number of occasions, for example, when he tells Pip about his abusive father, and how he came after him and his mother. He tells Pip it was because his â€Å"father were that good in his hart that he couldn’t abear to be without us.† One could argue that this was Joe’s innocent view on the world, and that he couldn’t accept that someone would deliberately want to hurt someone else. But, more likely, it is Joe forgiving his father for what he did. Forgiveness (or the lack of it) is a common theme throughout the novel, but Joe seems to be one of the only one who offers it readily. Not only does Joe forgive his father for abusing him, but also Mrs Joe. He tells Pip that she is a â€Å"fine figure of a woman†. This is somewhat ironic as Mrs Joe has no feminine qualities, not even a female name. It also shows Joe’s respect, if not affection, for Mrs Joe, despite her treating him so badly. For example she regularly abuses him: â€Å"she knocked his head for a little while against the wall behind him.† Joe puts up with her, although he could easily fight back. The image if almost comic, especially the phrase â€Å"for a little while†, it makes it sound like she is just casually doing it for the sake of it. It could also link to the phrase ‘knock some sense into him’, perhaps this is what Mrs Joe is trying to do? At any rate Joe is submissive, showing his selflessness, as he lets her do it so she doesn’t hurt Pip as much (as he explains later). The reader pities Joe, as he is such a kind man, married to an abusive woma n, who takes advantage of his kindness. Joe is very loyal to Pip, and is always there when he needs him. One of Joe’s ‘catch-phrases’ is â€Å"ever the best of friends†. â€Å"Ever† shows his loyalty towards Pip, and gives a sense of stability, he gives Pip something to come back to. As if to prove this loyalty, he pays of Pip’s debts. This is such a big gesture as Joe is the poorest of all men. The moral and emotional image of debt appears a lot throughout the novel, perhaps because debt was a personal issue for Dickens. His family were imprisoned for debt, therefore stopping Dickens’ education, and he bailed his father out many times. In the novel, Pip becomes Joe’s debtor, an image of ownership, like Joe owns Pip. One could argue that this was to do with Joe’s insecurity, and that he needs something solid to connect him to Pip. However, throughout the book, Joe has been completely selfless, so this act could just another example of Joe’s kindness. Ther e are also religious overtones to this, he is doing a Christian deed. There are several religious links associated with Joe, for example, Joe takes in Pip a a child â€Å"God bless the poor little child, there’s room for him at the forge.† This could be a reference to the Nativity story, when the innkeepers turn Mary away. Add this to the Christian deeds he does (like paying off Pip’s debt), give Joe an almost saint-like quality. But Dickens needs to balance the character, otherwise we may just view him as a perfect religious figure and would then find it hard to view him as a realistic role model for Pip. So Dickens makes Joe childish, innocent, illiterate and also includes some comedy moments. For example, when Joe has learned to write, he writes a letter to Biddy. Dickens writes this in a very comedic way, possibly overly so. Joe â€Å"constantly dipped his pen into space, and seemed satisfied with the result†, it is almost mocking him. As well as this, it is written like a performance for Pip, but throughout the novel Joe has been the only one who can’t act (e.g. he can’t deal with formal situations and pretend to be something he is not) or pretend. So why does Dickens include these humorous details? Possibly it could be to balance out Joe as a character, for if he was just a religious prophet, he would lose his power in the novel. Or alternatively, it could be to lighten the mood and relieve the tension between Pip and Joe. Or perhaps it is to show Joe fulfilling his mother’s expectations, of Joe being a â€Å"scholar†, to show that it can be done. This may provide hope for the reader, that Pip might be able to fulfill his own expectat ions eventually. Although that wouldn’t explain why it is so over the top. Some characters only see this side of Joe, the awkward, clown-like side. Pip says that Jaggers â€Å"recognised in Joe the village idiot and me his keeper.† Jaggers doesn’t understand Joe, he doesn’t know about Joe’s forgiving, loyal nature, he just sees an â€Å"idiot†. This could be reinforcing our first introduction to Joe, where he is described as foolish. Again this could be to balance the character of Joe, rather then make the reader view him negatively, as we know Joe is a very wise character. Jaggers believes this because Joe cries when he tells him about Pip’s expectations, and has to be comforted by Pip. Joe demonstrates many female tendencies throughout the novel, especially when he is caring for Pip at the end of the book, â€Å"Joe had actually laid his head down on the pillow at my side.† This is ironic considering his strength. Perhaps he is compensating for Mrs Joe’s lack of femininity, or he is filling in the gap left by her death, showing Joe to be a father figure for Pip. Ultimately, Joe is the only true father to Pip, he gives him â€Å"the wealth of his great nature†, which is more than Magwitch ever did. He may not have a lot of money, but he is a true gentleman in character. Ironically, the poorest of all the men is the most gentlemanly. Moreover, Pip eventually comes to realise this: â€Å"there was a simple dignity in him.† Now, whilst he is recognising Joe’s dignity, he doesn’t sound very respectful. The tone sounds quite patronising, and â€Å"simple† implies stupidity. Overall, Joe is the only constant in the book, he can’t act, he can’t pretend to be something he is not, he doesn’t change for anyone – â€Å"whoever came about me, still settled down into Joe.† Even the use of the word â€Å"settled† gives the idea of stability and constants, Joe is always there for Pip. He acts as a role model for Pip, and the other characters, even if they don’t realise it. But he does have his negative qualities, he is childish and awkward. However, this gives him more power in the book, as the reader can relate to him, and not just view him as a religious saint-like figure.

Generation Gap: Mentors and Proteges Essay

When baby boomers reach retirement age; they start mentoring their replacements called generation Xers. Some boomers face difficulties in this process. William Slater; a computer engineer; faced problems while he was participating in his company’s formal mentoring program. One of his students tried to take his place in the organization by reporting negatively about him. Generation Xers even face issues in mentoring programs. Joel Bershok’s mentor dissolved relationship within 3 weeks of mentoring as his mentor did not trust him. This is because new replacements charge less and companies are ready to replace old people with new ones as this helps the company in decreasing cost. This happened with Janet Wheelar as she was replaced by two younger workers. There are beneficial effects of mentoring for the organizations. Mentoring increases employee productivity and job satisfaction. The issue is that many mentoring programs end up in failure due to mismatching of mentors and proteges. On the other hands organizations have benefited from such programs and they have continued using such programs. Mentors should take pride in helping new employees in making their careers. Women are the ones who have gained a lot from mentoring programs and they have reached top level management due to these programs. Knowledge should be passed on. A mentor teaches proteges and then a proteges becomes a mentor and teaches new employees. According to OB literature on Knowledge Management; the experience and the knowledge of the Baby Boomers should be captured and stored so new employees can benefit from that information. This means that Baby Boomers should provide education to new employees so training cost of the organization decreases and performance increases. According to OB literature; performance increases when employees know what they have to do on the job. When employees are able to do their tasks correctly; they gain job satisfaction.

Camera Obscura Edinburgh Essay Example | Topics and Well Written Essays - 1000 words

Camera Obscura Edinburgh - Essay Example These aspects are (1) the visitors’ experience and (2) the visitors’ behavior. Key Words camera obscura, artistic Introduction The Camera Obscura in Edinburgh is one of the most popular tourist attractions in Scotland. The site is frequented by thousands of tourists every year who are eager to see and learn about this artistic marvel (Cooper 2005, p.37). It is a very important feature of Scotland’s tourism industry, and is loved and adored by so many people. Most people love visiting tourist attractions and sites; they love to explore and to take in the wonderful features on offer in not only their countries but other foreign nations as well. However, few people really appreciate these sites. This could be because a majority of them have little grasp of those attractions and therefore are not aware of how to conduct themselves when touring. It is worth noting that if one does not fully understand the history and nature of a particular tourist attraction, it is ve ry difficult to enjoy a visit to that site. At the same time, it is very easy for one to do things that might be considered wrong or inappropriate. Despite this, they cannot be wholly blamed, and this is why tour guides and operators are so important (Huang 2009, p.19). They help visitors to acclimatize themselves to whichever place they are visiting, and in the process improve their experience and allow them to express themselves without any reservations. The Camera Obscura in Edinburgh is an example of a tourist attraction that can do more in order to give its visitors the best possible experience. How to Improve Visitor Behavior Improving Communication (especially informal communication) Visitors always enjoy visits to museums and tourist attractions when they engage in interactive and hands-on exhibitions. These types of exhibitions are usually accompanied by fun, but they are not always accompanied by scientific, cultural or educational enrichment. Visitors often enjoy museum v isits, most visibly to observers, in hands-on and interactive exhibitions (Stine 2009, p.29). Hands-on exhibitions are not necessarily accompanied by educational, cultural or scientific enrichment, although they may be accompanied by having fun. Research carried out over the years has revealed that visitors often miss most of the attitudes and /or ideas that are normally the original objective of museums, exhibition organizers and curators. Museums and tourist sites generally understand and know how to develop the aesthetic, physical and scholarly aspects of spaces. Despite this, the attitudes, learning capabilities, motivations and preconceptions are not well understood. Edinburgh’s Camera Obscura should strive acquire an in-depth knowledge of how visitors learn and behave in leisure-oriented environments. This will allow it to â€Å"read† its visitors and as a result develop a very good understanding of their preferences, how they like to view those preferences and h ow much time they require to view the various attractions within the Camera Obscura (Hall 2009, p.10). It is therefore crucial that any

Affect Social Network and Technology in Our Life Research Paper

Affect Social Network and Technology in Our Life - Research Paper Example In this research text, three articles will be evaluated on their mode of expressing the effects of social networking on our lives in which most of them highlight communication and socializing as being the most affected aspects of human life. Quan-Haase’s (2012) book provides both positive and negative aspects of technology and social networking as they affect human lives. It evaluates both sides of the issue, addressing what technology and social networking adds or deducts from our lives. On the positive note, it states that these two have reduced the social constraints caused by say geography, distance, and schedule in which case they enable the world to function like a small town where talking to anyone around the world is so easy. The internet has become a social tool for communication as there are emails, instant messengers, and distribution lists amongst others. These, unlike the traditional means of communication, enable one to expand their friend circles faster, make coordination easier, bring strangers together and all these come readily at a reduced cost. To support this, she defines a study conducted in Australia which suggested that the people who lived before television was available were less sociabl e. On the other hand, she evaluates the negative aspects of the same, adding that depending on use, these two can be hindrances to socializing. To support her argument, she give examples such as how an adult can spend hours during a weekend sitting down and just scrolling through their computers, consuming time which could have otherwise been used for one on one engagement with real people. They suggest that people should cut down on their use of technology and social networks so that they do not replace what should be done naturally. According to Rozenblum & Bates (2013), social networking and technology have contributed greatly

Does historical and cultural heritage hamper or stimulate foreign real Essay

Does historical and cultural heritage hamper or stimulate foreign real estate investment in historical cities (St Petersburg) - Essay Example op reining horse and across the bridge one can also see the impearl Mariinsky palace made remarkably visible by the gallant anchor and grappling hook themed flag of St Petersburg flying high. The ever spring green Alexander garden which extends for a few miles with the broad river Neva flowing past. These and many other structures and features that characterize the St Petersburg skyline have made it to be one of the top historical tourism cities in Europe (Trachtenberg and Hyman, 1986). There have been numerous tussles between real estate developers and preservationists in this town. This is because a huge part of urban Russia is occupied by concrete apartments designed in the postmodern period with the intention of housing as many tenants as possible to handle the ever-expanding population. In the backdrop of all this, St Petersburg emerges as a jewel set idyllically by the river Neva and sharply contrasting with the nation’s postmodern infrastructure. In the course of them S oviet period it was been relegated to a run-down and neglected town, but it later reclaimed its glory and with this resurrection have come skyrocketing property values. This has resulted to questions of whether the city can survive with its historical significance intact in view of its incredible real estate potential. While UNESCO protects most of the structures for their historical relevance, there have been disputes on whether the real estate in St Petersburg is more beneficial acting as cultural edifice or being developed for the sake of economic growth. The opinion of the Russian government on this matter is not difficult to guess; in 2013, it prepared a draft document for UNESCO that appeared to be the start of a process to remove numerous protected historical sites from the organizations’ protected list of properties. According to Russians opposed to the move, it is a question of reserving the cultural integrity of the city and profiting from the high property values that would

Human Resources Essay Example | Topics and Well Written Essays - 2250 words - 1

Human Resources - Essay Example 13 Marchington, M., Wilkinson, A., and Sargeant, M. 2002. People Management and Development: Human Resource Management at Work. London: CIPD Publishing. 13 Mayock, P. 2011. 28 best practices for hotel operators. [online] Hotel News Now. Available at http://www.hotelnewsnow.com/Article/5800/28-best-practices-for-hotel-operators [Accessed 19 October 2013]. 14 McKay, M. n.d. What Is the HR Business Partner Model? [online] Chron. Available at [Accessed 19 October 2013]. 14 Price Waters Cooper. 2011. Shared service centres: opportunities and challenges in HR transformation. [online] Price Waters Cooper. Available at http://www.pwc.ch/user_content/editor/files/publ_hrs/pwc_shared_service_centres_hr_exec_summ_e.pdf Accessed 19 October 2013]. 14 Reilly, P. 2000. HR Shared Services and the Realignment of HR. [online] IES. Available at [Accessed 19 October 2013]. 14 Reilly, P and Williams, T. 2003. How to Get Best Value from HR: The Shared Services Option. London: Gower Publishing Ltd. 14 Snel l, S and Bohlander, G. ed., 2011. Managing Human Resources. Hampshire: Cengage Learning EMEA. 14 Snider, M. 2003. Compatibility Breeds Success: How to Manage Your Relationship with Your Business Partner. Westport: Greenwood Publishing Group. 15 Storey, J. 2002. Human Resource Management: A Critical Text. Hampshire: Cengage Learning EMEA. 15 University of Michigan. 2013. Administrative Services Transformation Overview Presentation for Shared Services. [online] University of Michigan. Available at: http://ast.umich.edu/pdfs/Awareness-Presentation.pdf [Accessed 19 October 2013]. 15 Wenderoth, M. 2009. Change...On the other hand, when there are challenges facing the human resources department, profitability of the business cannot be guaranteed. Some of the challenges the human resources department can face include tension with the business owners, lack of proper power flow within the department. There are several ways these challenges can be addressed leading to regaining of business pr ofitability and success in its respective sector (Snell and Bohlander, 2011). The Snow mountain hotel has hotels and resorts across America, including Canada, United States, Bermuda, Mexico and Barbados. The hotel’s human resources department is in crisis. The department responsibilities and chores are not well-organized and structured and there has been tension between the owners of the hotel and the human resources management. They have varying perspectives and viewpoints on how the hotel should be run. Business leaders and owners have weight when it comes to making decisions, putting the human resources department between a hard rock and a wall. While they have the strategies on how to do their work, they cannot disregard the instructions from the leaders and owners. This paper will provide a number of propositions on how the human resources management should do to organize the department, agree with the owners and share responsibility. This is a human-resource strategy in which the company leaders and owners work together with the human resources department.

The Effect of Article on the Economy Toulouse Dissertation

The Effect of Article on the Economy Toulouse - Dissertation Example Toulouse, the capital city of the region of Midi-Pyrà ©nà ©es in France, is situated on the Garonne River side, in a plain midway between the Atlantic sea and the Mediterranean Sea. It is at present the fourth biggest city in France. Its international airport is just an hour away from Madrid, a one hour away from Paris and almost one hour and twenty minutes away from London. Airbus has done its best in increasing worldwide marketplace share for airplanes â€Å"Aviation industry is an essential part of the Toulouse economy (Toulouse is the home city of Airbus Industries) but is by no means the only high tech industry located there. The city has become Europe's leading space centre with CNES (French Space Agency), Matra Marconi Space, Alcatel Space Industry and Spot Image among others, all with their head offices around Toulouse† (13th Annual Computer Security Incident Handling Conference 2001). Toulouse has turned out to be a one of the center of spaceflight and aviation t in the past 20 years. In addition to 35,000 city dwellers 400,000 people from other part of the globe work in space industries or civil aviation; EADS/ Airbus is one of the largest employers in the area. This particular metropolis has remained comparatively unchanged in spite of the economic boom. Airbus provides tours with excellent services and facilities; and the tour for about 60 minutes consists of a guide who inform the background of the corporation; the screening of a historical / promotional video, and one can also observe the A380 production line. Airbus played a leading function in guaranteeing the sector elaborate communication and a common position on its various environmental impacts, on the foundation of scientific proof, and on the social and economic advantages it generates. The aim of the study is to identify how airbus has affected the economy of Toulouse since its inception in 1970. Due to the economic effect the industry has brought on Toulouse, this particular city has grown. The main reason for the city having grown is the a result of the aerospace industry, which has had a direct effect on the city of Airbus. Background of the Study: Airbus is a one of the leading aircraft and its producers have clients who focus on profitable know-how, technical leadership, and manufacturing competence which have added to its accomplishments in the industry. It was launched in 1970 as a European grouping of German, French, and later, UK, and Spanish business establishments. Air transport facility plays a key function in the economic growth and social development by addressing the rising demand for worldwide mobility. The advantages of air travel facility are becoming more available, more affordable and more significant to citizens from every economic environment and from every part of the world. The production of airbus is a clever move on the part of the top ranking Europe n ations, to complete with the operations of the US Being. Airbus is a configuration of smaller organizations combined into one large unit. The states that are the main players in Airbus are United Kingdom, Germany, France, and Spain. In recent times, airbus has done very well in increasing worldwide marketplace share for airplanes. Airbus is repeatedly trying to increase its market share by trying to reach out to new emerging marketplaces. These new marketplaces like India and China will play a big position in the future for airbus and boeing. Main industries of Toulouse are electronics, aeronautics, biotechnology, and space and information technology. Toulouse hosts the head office of the Airbus and assembly-lines of various airbuses such as A380, A340, A330 and A320. The others (A380, A32, A319 and A318’s interior furnishing) are in the state of Germany, Hamburg. Airbus intends to reposition Toulouse A 320’s bind assembling location to Hamburg, with A350 and A380 manu facture going in the opposite way, as a division of its Power8 Organization Plan initiated by its ex-CEO Christian Streiff. With the

Can the fund by IMF save the world economy Essay

Can the fund by IMF save the world economy - Essay Example The functions of the IMF are quite broad and it ranges from enhancing monetary cooperation between nations to maintaining an acceptable level of balance of payment. Other functions include promoting stability of exchange rate, ensuring smooth flow of capital and providing funds to nations. Providing financial assistance is one of the major functions of the IMF so that problems relating to balance of payment can be reduced (Weiss, â€Å"International Monetary Fund: Background and Issues for Congress†). Monitoring the fiscal and monetary functions of nations under its membership and technical advice are also functions of the IMF. The purpose of this paper is to highlight the role of IMF in helping to protect the world economy. The paper is divided into five main sections. The chapter of literature review focuses on the key economic theories in explaining the role of the IMF. The methodology chapter briefly discusses the methods of conducting this essay and the section on results provides empirical verification of the ways in which the countries has performed with the help of the funds provided by the IMF. Historically, the mechanism of working of IMF is rooted in the Keynesian macroeconomics. The IMF is essentially a monetary organization that focused on the monetary help to adjust balance of payment of a country. The works of Friedman (1950 cited in Davidson 64) regarding floating exchange rates and monetarism had influenced the functioning of the IMF. Keynes was one of the founding fathers of the IMF and he had applied his countercyclical monetary and fiscal policies to combat unemployment and recessions. However, over the years the functioning of the IMF had changed dramatically with the evolution of the new classical macroeconomic ideas. The proponents of the Keynesian and the post Keynesian theories had suggested that uncontrolled flow of capital makes countries highly vulnerable to events like banking crisis and

Entrepreneurship Business Plan Essay Example | Topics and Well Written Essays - 5000 words

Entrepreneurship Business Plan - Essay Example A wide range of SUVs, small cars, sedans and luxury vehicles will be marketed through the showroom of XXX Automobile. The objective of the business is to become one of the leaders in vehicle retailing market in Geneva. The operations of the business will be performed by an experienced management team. In order to ensure higher productivity, the business will take assistance from advisors and technical experts and thus can help to secure the business from possible risks. The start-up cost of the business is expected to be ? 3,850,000; majority of which will be collected by availing bank loans. The major drivers for success of the business will be quality products with reasonable price and better customer service. XXX Automobile plans to be a start-up car dealership business. XXX Automobile will intend to serve vehicles for middle class and upper class markets. The business is planned to be commenced in the downtown of Geneva in Switzerland City considering the fact that the market of Geneva is untapped and there is high potentiality for car business in that region. People in Switzerland also desire for quality, stylish and world class vehicles. The developed economy of Switzerland along with increasing population and demand of vehicle can increase the probability of success for the business by a considerable extent. The paper describes a detailed business plan for opening vehicle showroom in Geneva city of Switzerland. The objective of the paper is to develop a structured planning for marketing, finance and other significant aspects in order to commence the showroom for demanded vehicles. The paper has also considered the market of automobile along with personnel strategy to conduct the business effectively and ensure profitability. 2.0 Business Description XXX Automobile is expected to be operating as the authorised dealer of Volkswagen Group. The showroom will provide sales and services of new models of Volkswagen. The business will also attempt to procure car s directly from Volkswagen and sell through the showroom to the people of Geneva maintaining a direct supply chain connection with the producer. Therefore, the vision of the business will be to become one of the top-rated Volkswagen dealers in Geneva. The mission of XXX Automobile will be to gain and empower customer loyalty by delivering quality products, services and professional assistance to the customers. The major drivers of the business would be: To manage the threat of other competitors of XXX Automobile through effective advertisements and promotion To deliver products on schedule To control the budget To manage the expenses of business To provide superior customer service To maintain strong network with customers and other business associates 2.1 Business Opportunity The Swiss automobile market has remained resilient throughout the first quarter of 2012 and experienced increase of car registration by 9% than the previous year. The sales of passenger vehicles have demonstra ted strong

Formal Proposal 2 Essay Example | Topics and Well Written Essays - 1500 words

Formal Proposal 2 - Essay Example The data obtained from primary and secondary sources will be analyzed. The study finds that the establishment of an environment which empowers affiliations and networking in the healthcare will facilitate safety and effectiveness to all clinical procedures. Therefore, this system needs to be integrated into all hospital settings.  P.O. Box 25736 Shreveport, LA 71107 Date: October, 12, 2013  I am attaching a proposal for a research paper on the topic of â€Å"Creating an Environment that Empowers Monitoring and Sharing within Hospital Settings† for favor of your consideration and kind approval. I will base my research on an extensive review of the existing literature on the subject as well as ascertain relevant information from a sample population that will include the represent the patients and healthcare staff. In order to attain the objectives of the research, I plan to collect primary data through interviews with nurses and secondary data by means of literature review. T he topic will be of relevance to all hospital settings as well as scholars and academicians in the field of nursing and patient care. I will use the most credible and reliable sources for the research so as to render maximum authenticity to the data. I thank you immensity in anticipation for an opportunity to conduct a study of this nature that can be beneficial to professionals working in this field. Yours sincerely, Porsha Williams Table of Contents Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦1 Research Methodology†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦...3 Solutions and Criteria†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 5 Results†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦7 Analysis and Conclusions†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â ‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.....10 Recommendation†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..12 Reference Page†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 13 Introduction  Medical errors can occur in healthcare settings if proper communication does not occur between patients and nurses as well as other healthcare professionals. The problem I am proposing to solve is that of â€Å"How associations and interacting within clinical milieu impacts patient care and nursing enactment; â€Å"Problem in modifying societal crescendos, lack of cross ethnic understanding harmfully sways patients’ care†. One of the solutions that I recommend is to, â€Å"Embolden associations and interacting transversely diverse groups and sections for purely provided patient maintenance.†  Another solution that I put forward is that of, â€Å"Mentoring and allotment of participations within c linical setting upsurges patients maintenance provision and nursing proficiency† Some of the expected outcomes that I expect when this solutions are implemented well are that the solutions aim at looking at associations and interactions as an imperative contrivance that greatly impacts a safe and effective clinical practice that drives and influences a higher competent nursing care. The criteria that these solutions when affected will put into effective use that of affordability on the side of the patients and the aesthetic values of the nurses. An ethical moral that must be executed by the nurses to guarantee that the patients interrelate with them is

Ronald Reagan and Free

Ronald Reagan and Free Market Economy Essay The real role of government in relation to the economy is much like the role of the captain of a sailboat: If he has rigged the sails correctly, the ship will steer itself.Reagan used supply-side economic policies to change the way the United States looked at the economy. His policies, regardless of standpoint, were a huge change from the prior decades. Reagan promised real change and actually delivered on it.The economic policies of Ronald Reagans administration accomplished the administrations four major policy objectives: reduce the growth of government spending; reduce the marginal tax rates on income from both labor and capital; reduce regulation; and reduce inflation. The United States Federal Government needs to adopt these policies again to get the country out of depression and back on track. Princetons lexical database defines supply-side economics as the school of economic theory that stresses the costs of production as a means of stimulating the economy; advocates policies that raise capital and labor output by increasing the incentive to produce (Princeton). Policies like these were implemented under Ronald Reagan. Critics often called the policies Reaganomics, however, supporters have adopted the term as a positive reference. At this point, the terms are used interchangeably (Uchitelle). Economics stems back to the dawn of centralized currency in the seventh century BC. During the past few hundred years, economics has become an important part of civilization especially since the emergence of the free market economy. The implementation and maintenance of these economies may be more difficult, but the freedom they provide is priceless. The debate of Reaganomics has been present since Reagan began his election campaign. Many criticized his policies and still do today. The debate of supply-side economics is based on whether Reagans policies worked. Statistics show his progress was concrete and undeniable, but still many people remain doubtful, and many others claim that big government should micromanage the economy, at the cost of freedom. The basis of the American economy and ways of thinking, financially, follow the principals of laissez-faire, a term which translates to let it happen. This theory states that government has three roles and only three roles: that a government should protect the peoples right to own property; maintain a stable currency; and provide for the public defense (McFall). That means that government need not be very large. Although some do not agree with these principles, they are the ones the country was founded on. Some believe that the government should interfere with the economy and provide for every individual through programs such as public health care. Those people believe that the wealthy should pay more taxes and the less wealthy should pay less; in other words, the wealthy should be giving away their money to those who do not have as much. They also believe in generally high taxes to pay for the programs they support, which benefit only lower income families. This side is considered the liberal view on the economy and government. Others believe that supply and demand, the free market economy as a whole, will manage itself. The more government interferes, the worse off everyone is. They believe in low taxes and a small government which serves only those three roles of government described under laissez-faire. This is considered the conservative view. Reagan himself held this view. Reagan’s biggest problem, which hurts how supply-side economics is perceived to this day, was his inability to produce a balanced budget within his presidency, to put it frankly, Reagan spent too much money. For any government to work, its spending must balance out with its income. This is also true for people and businesses. If a government spends more than it takes in, it falls into debt. If that problem is not corrected, the deficits begin to add up, increasing the debt. During his campaign, Reagan promised he would cut taxes, get control of government spending, and get government out of the way of American businesses (Second Revolution). Unfortunately, he was only able to deliver on part of his promise. President Reagan did not get government spending under control like the American people wanted. He spent massive amounts of money on defense and created a deficit, the likes of which had not been seen since the Second World War. USA Today published an article in 2004 stating, â€Å"Federal spending as a share of the economy was at about the same level in 1988 as in 1981† (Kirchhoff 2), which shows that although Reagan did not increase spending, he did not decrease it either. Jason Furman, director of the Hamilton Project at Brookings Institution elaborated, â€Å"If you are cutting taxes without offsetting the cuts through reductions in spending, then all you are doing is increasing debt and postponing the taxes† (Uchitelle), which makes perfect sense. If the income of the government is cut, then so must be its expenditure. If Reagan had been able to cut his spending directed towards the military, then his budget deficit would have been cut dramatically. A plan with a defense budget as ridiculous as his would not be even slightly justifiable today; however, the times were different then. It is observed that Reagan ended the Cold War. Without his spending on projects such as the Strategic Defense Initiative, the Cold War could very well be going on today, or worse, it could have gone the way of nuclear warfare. Reagan’s spending, although it was over the top, can be justified. Without it, America, and the rest of the world, might not be standing today. Faced with the Cold War and armed with a love for his country, he was compelled to increase defense spending. Unlike President Jimmy Carter, Reagan was willing to make tough decisions and start progressing towards real peace. At the time Reagan was President, the country was still locked in a Cold War with the Soviet Union. His military spending was very much influenced by this war and the nuclear arms race surrounding it. He took a new, outside-of-the-box approach to the race. Instead of a bigger and better missile, he opted for a missile defense system that would shoot down incoming nuclear threats (Reagan). His actions and others ended the Cold War and the threat of worldwide nuclear annihilation. President Reagans administration turned over record deficits to Presidents Bush and Clinton. Reagans Vice President, George H. W. Bush, shared Reagans views on how to treat an economy and a government; however, President Clinton disagreed and begun reverting the policies of the administration past, under the presumption that the supply-side policies were not working. The truth is they were working, but the excessively poor state of the economy slowed progress and real benefits of Reagans supply-side policies were not seen until well after their implementation. Then, during his presidency, Clinton turned up a budget surplus (Weisenthal). This surplus is thought to be his biggest accomplishment and proof that Reagans take on the economy was not working. This surplus was a curse, not a ray of hope. It ruined any chance the American economy had for returning to a stable state. Clintons administration sucked more money out of the economy than the economy could bear (Weisenthal) and it exacerbated the way of life for every American living in the United States today. Interest rates on personal savings plummeted, household debt soared, and the U.S. trade deficit worsened intensely over the eight years Clinton wreaked havoc in the White House (Weisenthal). Stephanie Kelton, an Economics professor at the University of Missouri claims, we are still suffering the harmful effects of the Clinton budget surpluses, and the data shows that she is correct. Taxes are an extremely controversial issue when it comes to supply-side economics. The premise that lowering taxes increases tax revenue is not the easiest to grasp, especially when the revenue never really comes around. Although the economy was growing vigorously, many claim, the promised boon in tax revenue never materialized (Uchitelle). The left wing media and politicians would like to believe that what followed Clintons actions was, in the words of Gene Sperling, an advisor to both Hillary and Bill, the longest recovery in history (Uchitelle). However, in the years following President Clintons tenure with stagflation at an all-time high and the worst depression since the Great Depression in full swing, it is now apparent that it was not that at all, but instead only economic turmoil in the works. The lack of tax revenue can be explained by the delay caused by the abhorrent state of the economy preceding Reagans presidency. By the time the tax boon was going to come around, the Clinton administration scared the American public back into the old mentality of defensive saving and economic stagflation, especially with the wealthy. However dreary the tax revenue may have seemed, it was still a 5.6% increase over the course of Reagans presidency, according to the White House Office of Management and Budget (Uchitelle). Aside from transfers, such as Social Security payout and dividends from investments, from which most citizens are not receiving income from,wages are the only way for consumers to earn money (Evans). This makes it a very delicate item to tamper with, especially when the government is taking more money out of the pockets of its citizens. President Reagan completely changed the way people think about taxes. Clint Stretch, the national director of tax policy for Deloitte Touche, said, That sense that taxes are tax payers money, rather than a contribution the common good is somehow entitled to, and it couldnt be better said. Tax money is money directly taken from the only income most citizens have−their wages. When people make less money, they spend less money, and the economy tumbles into depression, such as the one currently looming over the United States. Reagan cut taxes dramatically. The top rate in 1980 was 70%, and the rate for a family making $30,000 dollars in income was 37% (Kirchhoff 2). After tax cuts were implemented, the top rate plummeted to just 28% (Kirchhoff 2), leaving consumers more money and leaving businesses and employers more money to hire workers andbegin to move America forward. The logic behind these tax cuts is that workers would have more incentive to get to work, taking home more money for their time and effort, and that it would prompt people to start taking that extra shift or to go and get educated to make even more money. According to Kevin Hassett, director for economic policy studies at the American Enterprise Institute, What really happens is that the economy grows more vigorously when you lower tax rates, (Uchitelle) and that growth triggers more cash to flow through Americas economy and increases tax revenue. The best support for supply-side economics is in the numbers it generates. During the Reagan presidency, 20 million jobs were created (Second). This meant more Americans making money the old-fashioned way:by working hard. Reagan also killed rising inflation. He allowed the central bank to make the tough calls and keep a tight money policy that stabilized the dollar (Kirchhoff 1). If a currency is strong and stable, the economies relying on it will follow the same trend because people feel safe about investing their wealth in it. When the dollar is strong, the economy is strong, but better yet, America is strong. Tight money policies kept the dollar strongby limiting currency printing and raising short-term interest rates to cut inflation from 13.5% in 1980 to 4.1% in 1988. This was key to improving the economy as a whole. Reagan saved America from government control, and turned it around towards the free markets (Kirchhoff 1). The Reagan Foundation describes the situation such that, businesses and entrepreneurs were no longer hassled by their government, or paralyzed by burdensome and unnecessary regulations every time they wanted to expand (Second). As an added benefit, by the time Reaganwas out of office, prime interest rates were back down to 10% in 1988, from 21.5% in 1981 (Second), which allowed business and entrepreneurs to expand their businesses, therefore growing America. Two huge indicators for the immediate state of the economy, the Gross National Product(the total value of goods produced and services provided by a country during one year), and the Dow Jones Industrial Average (the total value of 30 of Americas most successful companies and the most widely cited indicator for the state of the stock market) (Princeton), both experienced incredible growth. GNP grew 26% during the 1980s (Second), and the Dow grew by 11.4% annually (Krantz). Stocks continued to go up after Reagan left office, something which cannot be said for Carter before him, or Clinton after (Krantz). The people saw huge benefits from these policies by the end of the 1980s, even though the government may not have. The net worth of families making $20,000-$50,000 grew by 27% during the implementation of supply-side economic policies (Second). Also relating directly to the people, unemployment went from 7.6% to 5.5% (Second), a number that would be ideal to see today. Of the 20 million jobs created, more than half went to women and the employment of blacks was improved by 25% overall (Second) both of these things being extremely good indicators of the economy and extremely good indicators that supply-side economics work. The economic policies of Ronald Reagans administration accomplished the administrations four major policy objectives: reduce the growth of government spending; reduce the marginal tax rates on income from both labor and capital; reduce regulation; and reduce inflation. The United States Federal Government should to adopt these policies again to get the country out of depression and back on track.High inflation and soaring oil prices gave Reagan the toughest period since World War II (Uchitelle), and he did his best with what he was handed. He pushed for all the right things to fix the economy. He may have spent too much money to truly balance the supply-side economics he was attempting to fulfill, but that should not subtract from the true supply-side theory, which can be proven to work through the data collected during the 1980s under Ronald Reagan. President Reagan set the tone for all Republicans to follow Fellow patriots, this is a call to arms. Do not let America fall any deeper than it already has. Vote for the candidates who support supply-side theory. Vote for those who wish to bring the country up, not sink it down further with stimulus packages and universal health care that the country cannot afford. It is not the duty of the wealthy to support the poor. It is the duty of Americans to exercise their rights to the pursuit of happiness and financial prosperity. Redistribution of wealth carried out by a government that wishes to micromanage the economy through overregulation and taxes is not the answer to the problems the United States faces. Set the sails and let the ship sail itself, because freedom and prosperity do not have to be on opposite ends of the spectrum. Supply-side economics work and they will continue to work in the future. Works Cited Evans, Kim.Major money flows within the U.S. economy. The American Economy. 2011 ed. Detroit: Gale, 2010. Information Plus Reference Series. Gale Opposing Viewpoints In Context. Web. 18 Nov. 2012. Kirchhoff, Sue, and others. Reagan Had Lasting Impact on Worlds Economic Future. USA TODAY. 10 Jun 2004: n.p. SIRS Issues Researcher.Web. 18 Nov 2012. Krantz, Matt.Reagans Stock Success Not Unparalleled, but Try Telling That to Traders. USA TODAY. 10 Jun 2004: n.p. SIRS Issues Researcher.Web. 18 Nov 2012. McFall, Sally. Reaganomics.Economics. Danbury, CT: Grolier Educational, 2002. N. pag.Print. Princeton University About WordNet.WordNet.Princeton University. 2010. http://wordnet.princeton.edu The Second American Revolution: Reaganomics. Reaganfoundation. Ronald Reagan Presidential Foundation and Library, 2010. Web. 18 Nov 2012. Ronald Reagan: Radio Address to the Nation on the Strategic Defense Initiative , July 13, 1985. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ws/?pid=38882. Uchitelle, Louis. A Political Comeback for Supply-Side Doctrine. New York Times (New York, NY). 26 Mar 2008: n.p. SIRS Issues Researcher.Web. 18 Nov 2012. Weisenthal, Joe. The Untold Story Of How Clintons Budget Destroyed The American Economy.Business Insider. Business Insider, 05 Sept. 2012. Web. 05 Dec. 2012.

Independent Practice Issues And Independent Midwifery Nursing Essay

Independent Practice Issues And Independent Midwifery Nursing Essay The founder of modern nursing has rightly quoted that nursing is the care which puts the person in the best possible condition for nature to either restore or preserve health or to prevent or cure injury. Nursing has its own entity and ethics which makes it a profession. In response to the rising health needs, the need for independent nursing is the demand of the hour. This concept is readily formulated and implemented in developed countries. This has helped in meeting the consumers demand for health benefits. During the twentieth century, the nursing profession has undergone immense change. Nursing has progressed from an occupation to a fully licensed profession, with members that provide a broad range of services independently, and in a variety of professional relationships with other providers. This evolution has changed how nurses are educated, clinically prepared, and how they perceive their role. Starting with turn-of-the-century debates concerning the appropriateness of professional nursing practice, registered nurses began assessing not only their licensure status, but their roles related to other professionals. In the early years of the nursing profession, it was generally believed that nurses served and cared for their patients by assisting physicians. However, the perception of nursing often varied dramatically from its practiceThe role of the public health nurse, as it developed earlier in this century, was often independent, with nurses working with families of patients with tuberculosis or other highly contagious diseases and providing a broad range of interventions, both health- and socially-focused. Definition of independent nurse practitioner Wikipedia Definition, An independent Nurse Practitioner(INP) is a registered nurse who has completed specific advanced nursing education (generally a masters degree) and training in the diagnosis and management of common as well as complex medical conditions to provide a broad range of health care services. American Academy of Nurse Practitioners: An Independent Nurse Practitioner is referred as advanced practice nurse has a masters degree in nursing in the specialized area of her/his interest and licensed to practice in her/his state. The International Council of Nurses defines INP: A registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice. PHILOSOPHY OF INP The core philosophy of INP is to provide individuals care to patients of all ages. Its care focuses on patients conditions as well as the effects of illness on the lives of the patients and their families. INPs make prevention, wellness and patient education priorities. This means fewer prescriptions and less expensive treatment. Informing patients of their health care and encouraging them to participate in decisions central to the care In addition to care, INPs conduct research and are often active in patient advocacy activities. Standards required for practice of midwifery Midwifery care is provided by qualified practitioner, who is registered Midwifery care occurs in a safe environment with in context of family, community and system of health care. Midwifery care supports individual rights and self determination with in boundaries of safety. Midwifery care comprises of knowledge, skills and judgment that foster the delivery of safe, satisfying and culturally competent care. Midwifery care based up to knowledge, skills and judgment which are reflected in written practice guidelines. Midwifery care is documented in format that assessable and component. Midwifery care is evaluated acc. to an established prog. For quality management that include a plan to identify and resolves problem. Midwifery practices may be extended beyond the set competences to incorporate new procedures, that improves care for women and their family. HISTORICAL DEVELOPMENT OF INP Nurse practitioners have provided a healthy partnership with their patients for more than 40 years. INP role originated as one strategy to increase access to primary care. The following are brief historical background of INP. The nurse practitioner role had its inception in the mid-1960s in response to a shortage of physicians. The first NP Program was developed as a masters degree curriculum at the University of Colorados School of Nursing in 1965, founded by Loretta C. Ford, a nursing faculty member and Dr. Henry K. Silver, a pediatrician. Programs were developed across the country to provide additional education for experienced nurses to enable them to provide primary health care services to large underserved populations. The first programs were in pediatrics and they soon spread to many other health care specialties. During 1970-1971 Federal Legislation recommended Certificate Programme for nurses to deliver primary health care. Gradually certificate programme shifted to masters degree In response to health care reform in 1990s 3 INPs programmes were developed to meet the demand of primary care services. By 1994, 248 programme centres were developed for INP in US. In 1995, 49000 nurses were employed as INPs. American Academy of Nurse Practitioner in 1993 developed standard and guidelines for practice of INPs which are still followed. Today 200 universities and colleges are offering INP programme all over the world. 70,000 nurses are working as INP in US. Development of Independent nurse practitioner (Independent Nurse Midwifery Practitioner) development in India The Indian Nursing Council (INC), the parent body of the nursing councils in the country, has rolled out an initiative, which is in the early implementation stage, and has been forwarded for approval to the Union Health ministry. Independent nurse practitioners trained in midwifery has been introduced to bring down the high Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in rural areas. The National Population policy 2000 includes reduction of maternal and infant mortality as one of the socio-demographic goals to be achieved by 2010. The single most important way to reduce maternal death in India would be to ensure that a skilledhealth professional is present at every birth. Skilled care during childbirth is important because millions of women and newborns develop serious and hard to predict complications during or immediately after delivery. Skilled health professions such as doctors or nurses who have midwifery skills can recognize these complications and either treat them or refer women to health centers or hospitals immediately if more skilled care is needed. So, in order to ease the impact of the shortage of gynaecologists in community health centres, INC performed a pilot study for the Independent Nurse Practitioner Project in West Bengal at SSKM Hospitals female medical and surgical wards. The project provides an 18 months training in midwifery, besides an additional training in emergency obstetric care to candidates who have completed their BSc in nursing and have two to three years of clinical experience in ob-gyn wards to take care of ANMS in rural sector. These nurses are called independent nurse practitioners as they are trained to prescribe medicines following approved protocols and take decisions independently in absence of gynaecologists. 2 of the 4 trainees have been assigned to a CHC to manage obstetric cases. The results of the pilot study has been submitted to health ministry and the government of India is currently examining the proposal to extend this project all over India. INC is finalising a curriculum with senior obstetrics and gynaecologists for the training of independent nurse practitioner module. Explains T Dileep Kumar, president, INC, In rural areas, though a community health centre should be manned by physician, surgeon, paediatrician and gynaecologist, the community health centre is usually found facing a shortage of gynaecologists. Its in such a scenario, that the role of independent nurse practitioner gains importance, here, Auxiliary midwives are trained. Independent nurse practitioners should be regarded as a part of solution for improving quality, access and cost of care and continuing education. BASIC requirements of Independent nurse midwifery practitioner Becoming Independent nurse midwifery practitioner is one of the important challenges as it needs specialized qualification. The basic requirements are mentioned below: Basic nursing education Registered nurse Advance Nursing Certification (Master Degree in Obstetics and gynaecology nursing) Collaboration with any hospital/agencies for referral and reimbursement Areas of practice Independent nurse midwifery practitioners work in a variety of settings, including: Community Clinics and Health Centres Nurse managed centres private practices (either by themselves or together with a physician), hospitals, nursing homes, birthing centers. Womens Health Clinics Home health care agencies/Home Nursing Schools or colleges based health clinics They often provide care to underserved populations in rural areas or inner-city settings. What Independent nurse midwifery practitioner can do? Midwifery nurse practitioner is a registered professional nurse, with a current license to practice, who is prepared for advanced nursing practice by virtue of knowledge and skills obtained through a post-basic or advanced education program of study acceptable to the State Board of Nurse Examiners. She is prepared to practice in an expanded role to provide primary care to women, to well-woman related to reproductive health, conduct annual gynecological exams, provide education regarding family planning, and provide menopausal care. She provides care in a variety of settings including, but not limited to homes, hospitals, institutions, community agencies, public and private clinics, and private practice. She acts independently and/or in collaboration with other health care professionals to deliver health care services. She conducts comprehensive health assessments aimed at health promotion and disease prevention. She is capable of solo practice with clinically competent skills and are legally approved to provide a defined set of services without assistance or supervision of another professional. Midwifery practitioners are specialists in low-risk pregnancy, childbirth, and postpartum. They generally strive to help women to have a healthy pregnancy and natural birth experience. They are trained to recognize and deal with deviations from the normal. Midwifery nurse practitioners are uniquely qualified to resolve unmet needs in primary health care by serving as an individuals point of first contact with the health care system. This contact provides a personalized, client-oriented, comprehensive continuum of care and integrates all other aspects of health care over a period of time. Their focus of care is on health surveillance (promotion and maintenance of wellness), but it also provides for management of complications in order to maintain continuity. Midwifery practitioners refer women to general practitioners or obstetricians when a pregnant woman requires care beyond the their area of expertise. They are trained to handle certain more difficult deliveries, including breech births, twin births and births where the baby is in a posterior position, using non-invasive techniques. Nurse-midwives work together with OB/GYN doctors. They either consult with or refer to other health care providers in cases that are outside of their experience (for example, high-risk pregnancies and pregnant women who also have a chronic disease). Many studies over the past 20 30 years have shown that nurse-midwives can manage most perinatal (including prenatal, delivery, and postpartum) care, and most of the family planning and gynecological needs of women of all ages. Nurse-midwifery practitioners have improved primary health care services for women in rural and inner-city areas. SCENARIO OF MIDWIFERY IN USA INDEPENDENT MIDWIFERY PRACTICE It is the position of the American College of Nurse-Midwives (ACNM) that midwifery practice is the independent management of womens health care, focusing particularly on common primary care issues, family planning and gynecologic needs of women, pregnancy, childbirth, the postpartum period and care of the newborn. The practice occurs within a health care system that provides for consultation, collaborative management or referral as indicated by the health status of the client. Independent midwifery enables certified nurse-midwives (CNMs) and certified midwives (CMs) to utilize knowledge, skills, judgment, and authority in the provision of primary womens health services while maintaining accountability for the management of patient care in accordance with ACNM Standards for the Practice of Midwifery. Independent practice is not defined by the place of employment, the employee-employer relationship, requirements for physician co-signature, or the method of reimbursement for services. Nor should independent be interpreted to mean alone, as there are clinical situations when any prudent practitioner would seek the assistance of another qualified practitioner. Collaboration is the process whereby health care professionals jointly manage care. The goal of collaboration is to share authority while providing quality care within each individuals professional scope of practice. Successful collaboration is a way of thinking and relating that requires knowledge, open communication, mutual respect, a commitment to providing quality care, trust and the ability to share responsibility. SCENARIO OF MIDWIFERY IN UNITED KINGDOM Independent Midwives UK represent the majority of independent midwives in the UK. The organisation is committed to improving maternity provision for all women in the UK and is working with other support, service and professional groups, including the Government, to achieve that objective. Independent Midwives UK also provides professional advice and mutual support for independent midwives. The former Independent Midwives Assosiation has recently become Independent Midwives UK, an Industrial and Provident Society. The new organisation is a Social Enterprise and with Government support, Independent Midwives UK is working towards making Independent Midwifery available to all women who are entitled to NHS maternity care. Independent Midwife Independent Midwives are fully qualified midwives who have chosen to work outside the NHS in a self employed capacity. Independent midwives fully support the principals of the NHS and are currently working to ensure that all women can access gold standard of care in the future ( LINK). The role of the midwife encompasses the care of women and babies during pregnancy, birth and the early weeks of motherhood. Qualification and regulation of midwives Midwifery is the most securely regulated profession in the UK. All practising midwives must adhere to the Midwives Rules which are enshrined in the 1902 Midwives Act of Parliament and subsequent amendments. All independent midwives have undertaken full midwifery training and are subject to annual supervisory visits and equipment checks. In line with the requirements of our regulatory body, the Nursing and Midwifery Council, we are required to ensure that our clinical practice is up to date and that our actions are within our sphere of competence. Role in emergency conditions There are very few genuine emergencies during childbirth; this is why research has shown that for most women homebirth is at least as safe if not safer than hospital birth. As the experts in childbirth, midwives are trained to recognise any early warning signs that things may not be progressing normally and to take appropriate action. If the unexpected should happen, all midwives are trained in emergency resuscitation of both mothers and babies Independent Midwives carry all the necessary emergency drugs and equipment and these are checked on a yearly basis by a supervisor of midwives. Emergency equipments Independent Midwives carry all the necessary emergency equipment to ensure that if a baby is born needing resuscitation, this can be performed. For example: oxygen, suction, bag and mask. All midwives are trained in emergency resuscitation. Independent Midwives also carry emergency drugs in case a woman is bleeding heavily. They update ourselves on a yearly basis in emergency neonatal resuscitation and many of us have attended emergency skills workshops tailored for independent midwives attending homebirths. It is a requirement that our equipment is checked on a yearly basis by a supervisor of midwives. As Independent Midwives, often working alone and mainly facilitating homebirth, we are very conscious that we need to be completely up to date with all the necessary skills should an emergency occur. Charges for services As Independent Midwives are all self-employed they are all able to choose what they charge. Independent Midwives have to cover all their own costs such as training, equipment and travel. Rates may vary in different areas of the UK; currently a complete package of care will cost you between  £2000 and  £4500 (approx). Most Iindependent Midwives will want to receive payment in full by the time you are 36 weeks pregnant but if you have genuine difficulties in paying please discuss it with your Independent Midwife as most can offer flexible payment plans. Credentials to become a midwife Becoming an independent midwife can seem a daunting challenge but many midwives have taken the leap and few regret doing so. Once a midwife has completed an approved programme of education and is registered with the Nursing and Midwifery Council, (NMC) she/he may practice where ever she/he chooses to in accordance with NMC rules. In the UK that could be in the NHS, the private sector, with an agency  or as an independent self employed midwife. If a midwife chooses to be self employed she is regulated by the NMC midwives rules and standards, and must adhere to the same statutory obligations as an employed midwife. SCENARIO OF MIDWIFERY IN AUSTRALIA Midwives in Private Practice (MIPP) For centuries midwives have worked among their communities providing care to women. Historically midwives have held a philosophy of care based on the belief that pregnancy is, basically, a healthy process and a normal part of life, growth and development. It is this belief that guides the way in which midwives in private practice work. Midwives choosing to work privately, rather than being employed by hospitals and other institutions, do so because it allows them to be flexible about the care they provide. That is, the care offered will be in partnership, directed primarily by the wishes of the women and their families. The private practitioner midwife is able to provide continuity of care to the families who have chosen to use her services. During the pregnancy, the woman and her family develop a friendly supportive relationship with their midwife (in some cases eg homebirth, the care is shared by two midwives). On the day the baby is born the midwife remains with the woman throughout the entire labour. There are no shift changes that require the midwife to leave. During the first week of the babys life the same midwife visits each day until the baby has settled into a feeding pattern and the parents feel confident in caring for their new baby. Some midwives in private practice choose to work in specific areas. For example, some may offer postnatal care, or advice with difficult breastfeeding problems (Lactation Consultants) or Maternal and Child Health (MCHN). In addition, some midwives are skilled and have qualifications in complementary areas such as acupuncture, counselling, naturopathy, chiropractic, massage or homeopathy. The range of services provided: Pre-pregnancy advice Advice about birth options Childbirth education classes Sibling preparation classes Continuous midwifery care during pregnancy Preparation for and attendance at births in an appropriate environment of the parents choice Postnatal care following birth at home, birth centre or hospital Separate postnatal care for women who want private midwifery care for this period only or who are discharged home early from hospital Lactation consultancy Acupuncture and Chiropractic Referral to and advice about other health professionals such as medical and natural health practitioners, eg obstetricians, paediatricians, GPs, chiropractors, osteopaths, naturopaths, homeopaths Some midwives have a special interest and expertise in supporting women in special areas such as vaginal birth after caesarean section (VBAC), breech births, water births and postnatal depression. SCENARIO OF MIDWIFERY IN INDIA Prof. Uma Handa (ex Consultant Midwife, UNICEF) has a BS and an MSc in Nursing with specialization in obstetrics and gynecology. She has worked in the field of nursing since 1974, in nursing educational institutions in both the conventional and distance system, as well as in national and international health agencies. Countries in which she has worked include Sri Lanka, UK, Bangladesh and South Africa (University of Namibia-UNAM). She has received many special awards throughout her career. Umas present goal is to promote independent midwifery practice in India to encourage mothers to go through natural childbirth and so that unnecessary medical and surgical interventions can be prevented. Organizations she is member of: Nursing Research Society of India (Founder), Trained Nurses Association of India (TNAI), White Ribbon Alliance India (WRAI), Society of Midwives, and Executive Committee member Birth India. Issues in independent nurse practice Nursing has been thought to be a part of the medical team where all professionals provide input to build the best care of the patient but now times have changed nurses have developed themselves as independent professionals with a unique body of knowledge. The nurses could not document that they hold a patients medications based on nursing judgment. Such an instance might be when a patient had hypotension from pain medication and thus the morning anti-hypertensive is held. Instead, they need an order from a physician to hold such medication. Further, something like Tylenol on a patients medication record ordered for fever could not be administered by the nurse for a headache if the patient requested it because that would be practicing medicine without a license.   A nurse cannot order a social services consult, flush a urinary catheter should it become clogged, refer a patient for diabetes education, etc., etc., without an order from the supervising physician. Although they were trained to recognize these things, they carried an independent license, sat for an examination to obtain that license, and had years of education. Perhaps nurses really could not do any of these things without a supervising physician to tell them? Physicians, are critical components of the health care team there is no doubt, but why send a nurse to school and give him/her an independent license, scope of practice, and make them answerable to a board of nursing but then limit their usefulness. In the early years of the nursing profession, it was generally believed that nurses served and cared for their patients by assisting physicians. However, the perception of nursing often varied dramatically from its practice. During wars and times of crises, nurses worked with and beside physicians conducting surgical procedures, diagnosing care, and prescribing treatments and drugs. The role of the public health nurse, as it developed earlier in this century, was often independent, with nurses working with families of patients with tuberculosis or other highly contagious diseases and providing a broad range of interventions, both health- and socially-focused. During the twentieth century, the nursing profession has undergone immense change. Nurses have developed themselves as independent professionals with a unique body of knowledge. Nursing has progressed from an occupation to a fully licensed profession, with members that provide a broad range of services independently, and in a variety of professional relationships with other providers. This evolution has changed how nurses are educated, clinically prepared, and how they perceive their role. But, there are certain issues in independent practice: Curriculum for independent nurse practitioner development: Early nurse practitioner training involved nondegree, certificate programs of one year or less. Today the nursing community strongly supports masters degree preparation for entry-level practice. Although the level of education is higher, the focus has remained the same: Nurse practitioner programs emphasize primary care, preventive medicine and patient education. However, physicians offer a different service to patients. With five years of medical education and three years of residency training, their depth of understanding of complex medical problems cannot be equaled by lesser-trained professionals. Prescriptive authority. Nurse practitioners have the authority to prescribe and can write prescriptions (including ones for controlled substances) without any physician involvement. However, some believe that there should be collaborative prescribing agreement between nurse practitioners and physicians. Public view of nursing: Many articles in nursing as early as 1928, speak to the concerns about nurses. Nice girls, dont do nursing!. If you have a strong back and weak mind, be a nurse The publics images of nurses has not essentially changed since nursings inception. In public opinion, nurses are identified as a means for decreasing the cost of health care. She is considered as a highly trained professional who is providing an alternative to the expensive primary care physician. They wonder that can she do anything that a primary care physician can do. They are reluctant to recognize nurse practitioners as primary care providers. Areas of practice: Nonphysician providers have historically thrived in settings where physicians were unavailable places they were unable or unwilling to go, It remains to be seen if independent nurse practitioners will be economically viable in areas of physician oversupply. Quality of care: Many studies show that patients have a high or very high level of satisfaction with NP Services. Regarding measurement of diagnosis, treatment, and patient outcomes, several studies indicate that the quality of care provided by NPs is equal to that of physicians. Cost effective care: Nurse practitioners provide a cost effective care. One study compared the costs of care for two primary care problems and found that the cost of care given by NPs was 20% less than the cost of care given by physicians. At the same time, some argue that, without ready access to supervising physicians, nurse practitioners are likely to order more tests and consultations and be quicker to admit patients to the hospital, thereby driving up health care costs. Insufficient evidence-based practice and nursing research There is a need of promotion of evidence-based practice and nursing research so that with a sound knowledge base, the nurses will be able to function more independently. Establishment of policies on the use of evidence in practice is required. Nurses with a Masters degree should be encouraged to provide evidence, read nursing research and use evidence to improve or change nursing practices. An academic atmosphere should be created in the workplace. An information system and library should be provided. Multidisciplinary research should be encouraged. At the hospital, there should be a person who is responsible for nursing research activity including fund seeking for research and building of research network. Nurse educators should develop a short-course training on evidence-base and research or to supervise research activity. Resources such as journals and books can be shared. Joint research between nurse educators and clinical staff should be encouraged to strengthen the capacity of both groups and improve education and practice. The INC can be a part of nursing research development. The INC should set nursing research priorities in collaboration with nursing and non-nursing organizations to provide research funds and promote nursing activities for policy formulation. Establishment of a nursing research information system is encouraged to monitor research work, areas of research and researchers. Dissemination of nursing research and models for best practices should be established. Need for establishment of a continuing nursing education system Continuing education is an informal study or activity to gain knowledge and learn about new technology. Lifelong education is essential for self-development, knowledge-building and learning. Continuing education stimulates nurses to keep up with new knowledge and technology, to increase their skills and competency, and to be able to contribute to the health care team. The existing continuing nursing education programmes should be strengthened or new units established. The appointment of responsible persons for continuing education activity is needed. Continuing education programmes should get approval from the INC so that nurses can develop increased competency to work independently. Need to establish a quality assurance system for the nursing service A quality assurance system comprises vision, mission, objectives, strategic and operational plans, nursing service activity, nursing manpower management, roles and responsibilities, nursing standards, nursing indicators, nursing research, nursing administration and management, resource allocation and financial support. The objective of this system will be to ensure quality care and nursing outcomes as expected by clients (less suffering, shorter duration of hospital stay, and reduction of health care costs, infection, complications and mortality), and according to professional standards. It also indicates the commitment of the care provider towards providing the best care to consumers. Successful development and implementation of the system depends on the commitment of nursing leaders, hospital administrators, mutual goal-setting, participation of all personnel in the process, continuous quality improvement and good communication. The role of the INC in regulating nursing practice should be strengthened by amending the Nursing Act to include maintaining of registration of qualified nurses, renewal of licence, and setting up a nursing service and nursing education accrediting system. If possible, a hospital QA system should have nursing as an integral part and involves nurses in a surveyor team. Thus, this will help ensure the quality of services provided by independent practitioners Lack of involvement of nurses in health and nursing policy formulation and planning There is insufficient involvement of nurses in healt