Physical Observed Assessment Analysis

Physical Observed Assessment Analysis COMMUNICATION Any form of interaction is done through communication as a skill. To human interaction it is pivotal. Communication is a process which enables people to relate with those around them and to make concerns and needs know very well indeed. Communication can be verbal and non- verbal.Peate (2005) states that non- verbal communication reinforces a verbally communicated message. Building an important sustaining relationships with a patient, eye contact, smiling, touching, head nodding and leaning forward all these are recommended and have been seen as more helpful in communicating with patients on non-verbal communication. These are the signs and symbols we use, they have powerful impact in interpreting and sharing the meanings of messages. Non-judgemental interactions are focused on therapeutic communication, helps settle emotional conflicts and supports heart to heart talks allowing a patient to feel safe and free to share their true feelings, fears, values, hopes and ideas. This can result in healing benefits. According to Crawford et al (2006), communication is central and powerful, it helps not damage a patient’s life. Other important attributes of communication are listening and acknowledgeing.These are also essential because they raise the self –esteem of patients, thereby paving way for a therapeutic relationship. All details that could identify any person, clinical placement or trust have been changed to protect confidentiality, in line with The Nursing and Midwifery Council (NMC) Code of Professional Conduct, Performance and Ethics (2008) the name used will be Mr. Smith. This assignment is going to be discussed about a physical observed assessment which was observed during practice at placement. Mr. Smith came in with different medical history problems. The reason why he was admitted in hospital is because he had eye condition two months ago. On assessment, Mr. Smith was coughing, wheezy and dyspnoeic with shallow breathing accompanied by the use of accessory muscles. His hands were clammy. Mr. Smith said that he did not want to be in hospital, was tough and appeared very anxious during assessment. Touch was the Communication tools which was used to assess him during the period he was admitted in the ward. He could not see the nurse when she was talking to him because of his vision lost. Mr. Smith suffers with an eye condition. This is a condition somewhere the optic nerve is injured next to the idea of where it will opt out. With this kind of condition that Mr. Smith has, when trying to communicate with Mr. Smith you must attempt to be at the similar eye level as him, continually examine to find if he is able to comprehend you or not.so that you will be able to achieve Mr. Smith’s courtesy and to keep his attention during the discussion, the use of touch is vital. Establishing the health care needs, when a patient is admitted an assessment has to be done. Assessment is one of the greatest vital jobs any qualified workers can agree to. If it is done systematically by using the range of skills that is required, it can show to be most actual and authorising knowledge for everybody anxious. But it requires to be completed appropriately and to the best of your capability. Before arriving at any decision MDT has work and achieve their set of goals effectively, communication has to take place at all levels across the various discipline.NMC (2008) specifies that nurses should make patients their first concern and treat them with compassion maintaining the individual aspects, NMC (2011) sees communication as an important skill that complements the proficiencies that nurses are required to accomplish. Mr. Smith’s nurse has made a plan. A plan was a session which lasts 30minutes and allowed me to observe my mentor what she has been doing with Mr. Smith. When someone is sensitive to touch, they are many signs that will indicate. Facial expression, a bite reflex or grinding teeth are most visible when touching someone. The procedure which was used by the nurse reduced the relieves reaction. She started by touching Mr. Smith’s hands then slowly moving them up his arms final on his shoulders, she clarified this was beneficial to the patient, slowly developed the use of being touched. She then engaged both hands on the side of Mr. Smith’s face slightly and started with the movements. The reason she did this was because she wanted to warm up Mr. Smith’s face muscles. The nurse now provided Mr. Smith some facial languages to attempt and transport out such as sulking, pleasure, irritation, surprise and grief. Furthermore make sure they are agreed out correctly with sufficient of time, as if they are hurried they will not be achieved correctly. (Timby 2005) indicated that touch is the best potent non-verbal message techinique.It is a caring and calming hint shows the patients that the nurse helps. Remain confident to practice touch in this technique only if there is non –violent to patients. However( Holey and Matthews 2013) stated that touch is a cultural ,some patients prefer that you not touch them except for treatment purpose, Many feel that touch is a medical setting signals that something disagreeable is about to happen. If you feel the patient is friendly, offer a comforting touch when nothing offensive or painful is planned. ( Kowalski 2008) suggest that before touch as a means of giving concern and compassion, defined by seeing the client whether your touch is wanted without consent agreed touching implies a certain understanding and creates power to the one who is touching over the one who is touched. There are many plans needs to be considered when communicating with a lost vision clients (Mr. Smith). It is vital to make face to face with Mr. Smith when communicating with him, if required, bow or be seated down so you remain on level where he can see you eye to eye and he can also hear your voice. (Timby ,2005) stated that eye to eye communication means eyeing straight into the eye of the other person .Absence of eye interaction has a number of meanings among cultures. Do not speak to him when you are not standing in front of him where cannot see or hear you clearly or do not go missing while cooperating. With Mr. Smith’s condition you have to speak with a tone voice since he has a vision condition. There signs that can encourage Mr. Smith toward communicate such as touching overall comments and using his title before introduction into general discussions can help Mr. Smith to feel more relaxed to be involved in a discussion. To keep a flowing discussion the healthcare professional are required to use inquiries, encouragements and investigations as required (Stretch, 2006). During clinical placement mentor investigated the patient, Mr. Smith assisting him by giving him a cup of tea, the nurse asked him if he would like a cup of tea.’Mr. Smith frustrated to say coffee, vocal, keeping a flowing discussion and prompts and inquiries. The point to which we trust on non- vocal signs for example; face appearance, body actions, or sign, to maintain our verbal production is not regularly fully familiar. The patient who is very unpleasant, or in discomfort might discover these nonverbal signs difficult to produce. The nurse’s duty is to attempt to talk this with Mr. Smith and his family to look at likely choices for avoiding this possible failure in communication. Where verbal communication is condensed through someone who cannot talk very well or intellectual changes, the non-verbal position can deliver a different and actual main approach of both meaning receiving and giving. There are changed channels in which personal communication can be conserved. Maintaining social communication, this benefits to maintain Mr. Smith’s self-esteem. Always try to save speaking, Mr. Smith might discover some of the non-verbal movements helpful and many are understood. Use touch carefully, it is clear that Mr. Smith relaxes at comfort as soon as touch is complex even if it a finger on his shoulders. Inspire efforts to communicate and deliver other types of encouragement with Mr. Smith, touch feeling, face to face languages, body posture, space and equal amongst vulnerable and nurse Barriers such as term practice, phrases, images and knowledge styles have an effect. Semantic obstacles perform a massive part in the program of message from the nurses to the clients or the added method round. Arguments may have a unlike significance even communicating in not in different languages. Therefore while trying to communicate with Mr. Smith these features must be extremely measured earlier, for example no judge mental. Thompson (2003) stated that a barrier gesture is any action, behavior or physical arrangement that discourages the other person from feeling comfortable, thereby reducing their ability to communicate positively and effectively. However Trevithick (2005) suggests that one of the skills which occasionally works to help unlock someone’s barrier gestures is called a mirroring.Mr.Smith use to sit up in bed with his arms locked, if his vision was good mirroring would have been an good idea to him. For example if they are sitting with arms firmly crossed, you do the same for a while that is if their vision is clear, but this would be a disadvantage to him because the vision condition he has. However, the vision is not clear enough you have to talk to them, slowly they begin to unfold your arms, and you may find that they copy your actions and begin visibly to relax especially to those who can see you. It is worth an occasional try, but it needs to be done marginally, and there is no promise that it works. However active listening can be used as well. Docherty and McCallum (2009) states that ‘Active listening’ ensures that everything that a person is trying to say is fully received and understood by the listeners. This will include trying to comprehend not just what the person is saying with their chosen words, but what some of their underlying thoughts and feelings are that may be taken as much by what they do not say and by their body language, as by the words they use. Trevithick (2005) suggest that ‘Active listening’ is often used by helping professionals to highlight the significance of the movement. Furthermore Crawford et al (2006) states that sometimes patients just need you to be there, quiet and listening and this can also be achieved using the acronym SOLER.Consequently, a good listener will always pay attention to non-verbal cues too and this encourages the patients to open up giving more information and expressing their concerns. From this it can be deducted that respect is given to a patient’s contribution best when they are listened too. Active listening has several layers to it, it is only hearing the words which are being spoken by people. It is easier than done, which is why such an importance is laid upon it as a core communication skill. The listening skills we need will vary according to the setting of the tasks. For an example, if you are a nurse you may need to produce vital information about a patient’s symptoms in order to reach a correct opinion. This example illustrate the complication of the listing task. The common subject, however, the type of question that can be used in active listening. There are grouped together into two categories which is Open questions and closed questions.Open questions are used when you want to help someone to ‘open up’ about themselves, or to give you some insights into how they feeling or to explore a situation in more depth. When Mr. Smith has been assessed by the nurse on the time he came in hospital. She asked him with her manner voice and she was speaking slowly in order for the patient to hear her well and clearly. Her tone voice overwhelmed Mr. Smith and he then explained his situation to the nurse more deeply, so this helped the nurse to get more information from her patient because he was talking about the topic to the nurse. Open questions do not allow a straightforward ‘yes’ or ‘no’ response, but it will invite the patients to talk about the topic like what Mr. Smith did to my mentor. Not everyone will feel able to open up’ easily and share their deep thoughts and feelings. Some people needs to go step by step and to be led by interviewer until they gain confidence to go deeper. This is why closed questions also have an important role to play. Closed questions invite a straightforward ‘yes’ or ‘no’ answer, they are necessary in gathering factual information in as straightforward a way as possible. This questions can give a message to the interviewee that you are in charge, know what you are doing and where you are going, and that they can put their confidence in you. In this case it is not that open questions are good and closed questions are bad, it is a gross magnification. Each of these two has it ‘s own part to play in a well-balanced effective interview, and it is up to you to judge which will be most suitable and real as the interview explains. Conclusion However, communication is certainly a principle commanding for the real caring. Performance and communication of caring and capability at this time have a main effect on the ability of patients and relations to adjust the update, reflect choices, and adjust to anything deceptions forward. If the update is depressed the right touch, appearance, and compassionate kind terms constantly displays a change. The main ideas that have been debated in this assignment are that of the significance of communicating in nursing and how nurses can progress their communication skills and keep their competence. We must deliver complete care for our patients and the objective is to listen to the person and offer them with concerned understanding. REFERENCES Lee Thayer, (2011). COMMUNICATION A Pocket Oracle for Leaders. 1st ed. Xlibris Corporation: e.g. Houghton Mifflin. Nursing and midwifery council.(2011).guidance on professional conduct for nursing and midwifery students. Retrieved from http://www.nmc-uk.org Timby, B. K. (2005). Fundamental nursing skills and concepts. (9th ed). London, United Kingdom: Williams Wilkins

Southwest Internal Analysis

Southwest Airlines Internal Analysis Introduction This internal business analysis is on Southwest Airlines, which was founded in 1967 by Rollin King and Herb Kelleher. The main focus for Southwest Airlines was to provide low cost flights for their customers, and also have exceptional customer satisfaction. Southwest is a leading airline company that continues to do well in an industry that has been historically challenging. For instance, in the span of two years (2005-2007) five major airlines have filed for bankruptcy.The challenges are great in the airline industry, because competitors are trying to imitate the â€Å"low-cost† offering of Southwest. Many companies have tried to do what Southwest has done, and many have failed to stay in business. Surprisingly, many of those companies were started by ex-employees of Southwest. Southwest currently has a profitability record for the past thirty six years, which is spectacular in such a challenging industry. Herb Kelleher has be en replaced by Gary C. Kelly, as the president when he resigned in May of 2008.Southwest is in the process of expanding the locations they serve so that they can increase market share, and also find ways to cut costs without losing their quality. In order for southwest to continue their consecutive financial success there is a necessity for excellence in the execution process of their strategy. Business Level Strategy The business level strategy (BLS) that Southwest focuses on is Cost Leadership. They are the leading airline in the United States for providing low-cost fares to their broad customer base.Southwest has found innovative ways to reduce cost within their cost structure enabling them to offer lower fares than competitors and still maintain a profit. One way that has helped Southwest save time and money is their standardization of their airline fleet. This tactic is known as the â€Å"one-model-fleet† by the airline. Having a single airplane model in a fleet has allo wed Southwest to â€Å"lower inventory, record keeping and maintenance costs, and it minimizes the number of technical manuals, tools and spare parts. † Another methodology that has layed an important role in their thirty six years of profitability is their fuel hedging practices they’ve practiced since the late nineties. This tactic has saved the company millions of dollars, and in 2007 alone has saved the company 727 million dollars. Another cost saving measure that Southwest has implemented is the use of blended winglets on all of their 737-700’s models. This change is supposed to improve performance by extending the airplanes range, saving fuel, and lowering engine maintenance costs and reducing takeoff noise. More recently, Southwest began to use EcoPower engine wash services.This is going to allow Southwest to save an estimated $20 million dollars in fuel costs. All of these tactics by Southwest are designed to save on expenses that they incur doing busine ss. Many airlines cut cost by laying off employees, but Southwest has established a â€Å"no layoff policy† that is currently still in effect. This shows how committed the company is to their employees, and how they are an integral part of their business. Resources Southwest has plenty of resources that have contributed to their success as an airline company. Their intangible resources have created their competitive advantage in relation to their competitors.The reason for that is the simple fact that their tangible resources are not difficult to replicate. It’s the technique that Southwest uses to connect their resources that has enabled them to be successful in the airline industry. Their tangible and intangible resources are as follows: Tangible: The main tangible resources that Southwest has are its training center, employees, headquarter facility, acquisitions, partnerships, take off and landing spots, frequent flyer reward program, self-service check-in kiosks, a nd their fleet aircrafts.In 1986, Southwest opened a multi-million dollar training center for their flight crews. As all businesses, employees are necessary if you’re conducting business on a large scale. The connection between Southwest and its customers are their employees, which makes the employees role that much more important. Although, the employees are tangible, the culture of the employees is intangible aspect that has been difficult for competitors to imitate. The training center for their employees was an investment Southwest made early on knowing its importance to the long term success for the company.The headquarters for Southwest is another tangible resource, which is located in Dallas. The headquarter similar to many other companies allow top management to effectively communicate the organizational goals of the company. Acquisitions and partnerships that Southwest has completed throughout their duration allow the company to expand their services to more than 64 cities in the United States, and obtain more take-off and landing spots. The frequent flyer program is another tangible resource that Southwest possesses, but interestingly has not had a major impact on Southwest’s bottom line.With the help of IBM, Southwest was able to offer about 250 self-service check-in kiosks. The reason for having the kiosks for their customers was to reduce the amount of time the customers spend in line and to improve the airport experience. In the very beginning, Southwest only had 3 Boeings in their lineup but now they have more than 243 aircrafts in their lineup. Intangible: The main intangible resources that Southwest has are its brand, unique culture, and reputation. Southwest has a brand that is known widely when referencing the airplane industry.The brand that they represent is one that is reliable, convenient, employee centered, customer oriented, and at the same time providing a low cost alternative to their customers. This has helped dramatic ally in their formation of their culture, because even in the beginning their main focus has been on its employees. Southwest has a culture that is unmatched in the industry, and one of the main reasons they have been wildly successful in a challenging environment. Early on Southwest made the decision to sell one of their airplanes rather than laying off their employees to show their loyalty to its employees.All of these factors have enabled the company to maintain a reputation that is respected among the industry. The reputation that they have has enabled them to reap the benefits of being recognized as a leader in the industry. For example, Southwest has earned several Triple Crown awards, which is an award for having the best on-time record, best baggage handling, and fewest customer complaints. Outcomes from Combinations of the Criteria for Sustainable Competitive Advantage: Is the Resource of Capability Valuable? | Is the Resource or Capability Rare? | Is the Resource or Capabi lity Costly to imitate? Is the Resource or Capability Nonsubstitutable? | Competitive Consequences| Performance Implications| No| No| No| No| Competitive disadvantage| Below-average returns| Yes| No| No| Yes/No| Competitive parity| Average returns| Yes| Yes| No| Yes/No| Temporary competitive advantage| Average returns to above-average returns| Yes| Yes| Yes| Yes/No| Sustainable competitive advantage| Above-average returns| Result from the chart: Capabilities The capabilities of Southwest Airlines are the origin of the firm’s ability to create a competitive advantage over other airlines in industry.Southwest focuses on three main functional areas within the organization, which are management, human resources, and marketing. Management The management capabilities of Southwest Airlines are the main reason why the company has been so profitable, utilizing an effective low cost organizational structure throughout the entirety of the company. Using only one type of plane fleet, the Boeing 737 series, which allows minimizing inventory and resources needed for training, maintenance, parts, and is also a very reliable plane.This helps in the quick turnaround times at the gates, which keeps more planes in the air at any given point in time. In the 1990’s Southwest employed an aggressive fuel hedging tactic saving the company millions of dollars in hard times, while still being able to provide low ticket prices to consumers. Another important area management focuses on is the management of human resources that emphasis both employees and customer alike. Human Resources Focusing on customer service, Southwest Airlines opened a multi-million dollar training facility for its flight crews in 1986.The heart of this training facility is to promote human capitol and share knowledge throughout company. By focusing first on their own employees, southwest can ensure that the employees will then focus on the customer. Through motivation and empowerment in the training of its employees, Southwest can provide customers a comfortable experience while retaining employees and making it hard for competitors imitate. This is proven with its Triple Crown Award for best on-time record, best baggage handling, and least customer complaints. MarketingOne way to promote value and differentiate itself from competitors is Southwest’s humorous advertisements. Exercising the LUV ticker symbol, Southwest promotes its customer driven services and prices. While in the late 1980’s Southwest started a rewards program that has retained loyal customers, but has not been proven successful for leisure travelers. With the low cost abilities, timeliness flights, rewards, and focus on the customer, Southwest Airlines has carried out an exceptional marketing strategy. Core Competencies Employee LoyaltyWithin the first two years of operation Southwest suffered huge losses and had to make some major financial decisions. These decisions lead to the selling off an aircraft and keep all of the employees created the â€Å"no lay off policy†. Then in 1973 Southwest was one of the first companies to incorporate profit sharing where employees owned at least 8% of the company stock. This leads to higher employee satisfaction, retention rate, and increases the want for the company to do well, this way the employees focus more on creating value for the customer.Management Skills Southwest Airlines management has tailored numerous sets of activities around a low cost structure creating value for the customer. With short domestic, point-to-point flights, no additional in flight features and no seat reservations allows for a short turnaround time, which makes for less crowded airports and maximizes flight time. Along with fuel hedging and low maintenance costs, the design of these best-fit activities show that the excellent management skills are a core competency that creates a competitive advantage over other airlines.Conclusion Through the inte rtwining of its resources, Southwest Airlines has created a unique set of capabilities and competencies that has continuously allowed successful implementation of its business level strategy. With a focus on low-cost leadership and customer service, Southwest Airlines creates value with reliable on-time departures and a unique company culture. This provides a sustainable competitive advantage that is hard for competitors to imitate and provides a string foundation for Southwest Airlines’ future success.

Psychoanalytic Critique on the Black Swan

How does the main character deal with her id ego and superego? Which part of the subconscious seems to dominate? I believe Ninas Id is the dominant because she constantly in the movie is doing what she can to satisfy what she wants she does what she’s told to do to get it and be able to do it correctly. How does the relationship she has with other people? Does there seem to be a childhood trauma or a childhood experience that has occurred?She isn’t really able to have relationships with other people she doesn’t even have a good relationship with her mom I feel like she’s still some sort of child on the inside like a teen rebelling. I think this is probably because she didn’t really communicate with her mom as a child or have a dad around. What in the protagonist’s past has triggered her to be the way she is in her relationships now? I think Nina was probably isolated as a child that’s why she doesn’t really have that many relati onships as an adult.She still lives with her mom, which shows she doesn’t really know how to deal with regular daily things on her own. What does the protagonist dream about? What is the first thing she thinks about when she wakes up? What does this tell us about her? She had a sexual dream where she was receiving from lily. She believed it actually happened until lily tells her she left right after and didn’t stay the night. I think this shows that she was receiving love in a different way then she receives it from her mom since she doest really have any relationships like a boyfriend and friendships.What core issues does the character have and where do you think they come from? I think these issues come from her childhood she obviously grew up without a dad and her mom shows how overprotecting she is with her. She does have a habit of scratching herself when something seems to overwhelm her. What are the fears of our protagonist and why? The fears Nina has are not be ing perfect and not playing the role she was given. And she fought for. She always wanted everything perfect.I think she’s probably scared of herself as well since she scratches her self without realizing it most of the times. What are her desires and how do they affect her subconscious? I think her desires are to be the best at ballet and being the swan queen she wants to finish on top beating everyone else. Well throughout the movie this was what she wanted and she didn’t want lily to take that from her mainly. Which she thought was better and maybe she wanted to be more like lily since she saw how carefree she was unlike her.How does the characters sexuality affect how people view her and why? Since Nina was a virgin she was viewed as innocent the goody goody ballerina. After her sexual dream I viewed her a little different as in she wanted to receive love in a different way then her mom she wanted to maybe break out of the shell she was in. What types of defense me chanisms do they use and what are they trying to repress? She constantly has to cut her nails because she scratches herself I think she uses this as a defense mechanism to avoid having herself having to deal with the other problems around her.

African Americans And The Civil War - 2096 Words

During the Civil War, Georgia seceded from the United States and joined the Confederacy. In 1865, the Confederacy collapsed and the Civil War came to an end. Following the Civil War, the city of Atlanta was destroyed. Despite the political and socioeconomic struggles during the Reconstruction Era, Atlanta began rebuilding and became an up-and-coming metropolitan city where both whites and African-Americans could live together, â€Å"The white man and the negro have lived together in this city more peacefully and in better spirit than in any other city, in either the North or South.† As Atlanta’s economy was growing, so was its population. Atlanta began to experience a high influx of African-American migrants from surrounding states, and an increase in tensions between whites and African-Americans began to grow. As African-Americans obtained rights, competition amongst whites and blacks increased and tensions only further escalated between the two groups. In September of 1906, the racial hostility between whites and African-Americans resulted in a violent race riot. Although Atlanta was once the city where whites and blacks could live together in racial harmony, the Atlanta Race Riots of 1906 changed the relationship between the two groups. By the late nineteenth century, Atlanta had rebuilt its economy and became the center of the economic boom in the South. Atlanta’s population in 1880 was 89,000 and by 1900 the population increased to 150,000. In 1880, there wereShow MoreRelatedAfrican Americans And The Civil War1076 Words   |  5 Pages Throughout history African Americans have had is bad in the United States. First they went through slavery which lasted about two hundred year and was ended around the Civil War which was in the 1860s-1870s. 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