How to make an essay
Wednesday, September 2, 2020
The Agricultural Adjustment Act :: essays research papers
The Agricultural Adjustment Act à à à à à During World War I, Englandââ¬â¢s rural economy was severely harmed. This burden for the English was a gift to American ranchers. Since the creation of the consolidate, and different other mechanical reaping machines, American ranchers could build their harvest yield. Thus they could send out the additional yields to England for more cash. When England recovered financially, American ranchers couldn't discover any fares for their yields. As they kept on creating beyond what the American individuals could devour, the costs of agrarian products drastically dropped. By the 1930ââ¬â¢s numerous ranchers were in genuine need of help, with substantial homestead advances and home loans hanging over their headââ¬â¢s. Nothing had been done to help the farmerââ¬â¢s during The Hoover Administration. So in 1933 as a major aspect of Rooseveltââ¬â¢s New Deal, the Secretary of Agriculture, Henry Wallace contrived an arrangement to confine creation and increment costs. W hich came to be known as the Agricultural Adjustment Act of 1933, otherwise called the AAA. The AAA was built up on May 12, 1933 it was the New Deal thought to help ranchers during the Great Depression. It was the main far reaching exertion to raise and settle ranch costs and pay. The law made and approved the Agricultural Adjustment Administration to: Enter into deliberate understandings to pay ranchers to diminish creation of fundamental wares ( cotton, wheat, corn, rice, tobacco, pigs, milk, etc..), to make propelled installments to ranchers who put away yields on the homestead, make promoting understandings among ranchers and agents, and to exact preparing expenses to pay for creation modifications and market advancement. Fundamentally the AAA paid ranchers to devastate their yields and domesticated animals as a byproduct of money. In 1933 alone cotton ranchers were paid $100 million to furrow over their cotton crop. 6,000,000 piglets were butchered by the legislature after they got them from ranchers. The meat was canned and given to individuals without occupations. All together for this new bill to work there should have been cash to pay the ranchers, this cash originated from the organizations that purchased ranch items as duties. While it appeared to be a smart thought to repay ranchers to slice on harvests to bringing down the excess and lift the economy, The Supreme Court found the Act illegal in 1936.
Saturday, August 22, 2020
Navigating controversial topics in the workplace
Exploring dubious subjects in the working environment As a rule, the vast majority realize that discussions that dunk into governmental issues, religion, or close connections are ideal to stay away from in proficient settings. However in the current political atmosphere, no-no points are getting increasingly hard to abstain from, making individuals share more assessments and exercise much less restriction and protection in the workplace.Regardless of who brings hot catch issues into the discussion, itââ¬â¢s in every case best to be set up to manage them without saying something embarrassing or insulting someone.à Here are a few hints on the most proficient method to keep it tasteful (and keep yourself in the clear) when debate emerges at work.Always follow the rules.Your organization more likely than not has a few arrangements set up in regards to strict or political articulation. You probably won't be permitted to hang up a battle catch or guard sticker in your work space, for example, or enliven your work area with anything a coll eague may esteem hostile. Take a speedy look at the representative handbook once in a while to ensure youââ¬â¢re shading between the lines.Listen, grin, and keep quiet.Its more difficult than one might expect, yet in the event that the discussion around you turns warmed, its frequently best to simply kick back and take in the assessments of everybody around you. In the event that you accomplish more tuning in than chatting by and large, at that point you have less chances to state something youââ¬â¢ll lament or that will get you in trouble.Unless youre in a circumstance where a genuine wrong or treachery is occurring, in the event that you wind up needing to state something-and asking yourself Is this alright to state?- odds are you ought to most likely hold that idea and keep it to yourself.Document wrongdoings.If you have an associate (or chief!) whoââ¬â¢s regurgitating hostile editorial or tormenting you or another person or, more terrible, taking part in loathe discours e then youââ¬â¢re going to need to construct a case before you do anything or snitch. Have something unmistakable you can present to HR if that turns into your best alternative. Casing your interests regarding defending the soundness of the organization and culture.If youre upset, say something.Rather than making suppositions or jumping to determinations about a personââ¬â¢s character, once in a while itââ¬â¢s better to simply be forthcoming and straight to the point with a collaborator who has insulted you. This doesnââ¬â¢t mean leveling allegations. It implies moving toward that individual deferentially with an olive branch and an opportunity to talk things through. Dont denounce clarify. Explain to the person in question why youre upset. Having the certainty to do this in any case is a precarious aptitude to ace, however this can be very successful in killing an in any case loaded situation.Own your mistakes.If youââ¬â¢re the one creation individuals awkward even i nadvertently own ready, assume liability, apologize, and change your conduct. In any case your activity may wind up on the line. Keep in mind, youââ¬â¢re by all account not the only one in the workplace whose conclusions and sentiments matter.The base lineIf a discussion emerges and you have energetic emotions, definitely, shout out. In any case, in the event that you do, keep your tone and language as expert as could reasonably be expected. Attempt to diffuse instead of blame. Pose inquiries as opposed to attesting solid articulations. Keep a receptive outlook and your feelings at a level its conceivable to be both enthusiastic and well mannered.
Friday, August 21, 2020
Definition Essay - Art and Excellence :: Expository Definition Essays
Definition Essay - Art and Excellence Workmanship is the reason I get up toward the beginning of the day, however my definition closes there, ya know, it doesnââ¬â¢t appear to be reasonable that Iââ¬â¢m living for something I canââ¬â¢t even characterize, and there you are in that spot meanwhile. ââ¬Ani DiFranco, ââ¬Å"Out of Habit,â⬠Living in Clip Craftsmanship is by all accounts such a widely inclusive word it resists definition. The craftsman Ani DiFranco conspicuously says in her music that she can't characterize workmanship in spite of the fact that it is personally and enthusiastically integrated with her life and relational connections. Ani Difranco is a craftsman, however for what reason would she say she is a craftsman? Shouldn't something be said about her and her music make her a craftsman? What makes her music workmanship? What is the distinction between this endeavor and that of being a world-class physicist? Was Einstein not a genuine craftsman? Is material science not a craftsmanship? In the event that it is a workmanship, is it craftsmanship? At the point when one endeavors to examine and characterize workmanship, these sorts of inquiries definitely emerge, making any target thought of what craftsmanship is exceedingly hard to decide. Truth be told, we find that almost everyone has their own one of a kind origin ation of craftsmanship. Obviously, it might be contended that everyone likewise has their own extraordinary origination of a spoon or some other thought, however workmanship appears something far beyond this. The inconceivable profundity, wealth, and intricacy of craftsmanship don't just take into consideration, however appear to require the heap originations of workmanship we find in our general surroundings. I accept the level to which anything can be viewed as craftsmanship relies upon the degree of inventiveness, capability, adequacy, and other such relative attributes giving chances to the incredible execution or amazing imagination we ordinarily partner with workmanship. To start clarifying what is implied by artââ¬â¢s dependence on relative attributes, let us break down the word profound. How would we realize when something is profound? Would it be advisable for us to consider anyone of water more prominent than four creeps inside and out profound and anything less profound shallow? It appears to be genuinely clear that the word profundity alludes exclusively to relative marvels. Profound is a genuinely straightforward property to which we change from shallow at some subjectively and moderately characterized level on the inclination of profundity.
Wednesday, May 27, 2020
Does a High PSAT Score Mean that Youll Ace the SAT
Warning: A top score on the PSAT doesnââ¬â¢t guarantee anything. Man, what a feeling. You take the PSAT at the start of junior year and have a higher score than almost anybody you know. Youââ¬â¢re set, right? In the clear. Donââ¬â¢t even have to worry about the SATââ¬âitââ¬â¢s pretty much the same thing right? Alright, so this doesnââ¬â¢t happen to everybody. After all, only 10% of students can be in the 90th percentile. Thatââ¬â¢s how it works. But letââ¬â¢s say this is you, just as it was me: youââ¬â¢ve confirmed that youââ¬â¢re a good test-taker and you know your stuff, and youââ¬â¢re ready to wash your hands of the whole thing. Stop there. Donââ¬â¢t get cocky; itââ¬â¢s not that simple. Even if you already know everything you need to know about the PSAT vs the SAT, a top score on the PSAT doesnââ¬â¢t guarantee anything. Yes, if you did well, youââ¬â¢ll probably do well on the SAT, too. But itââ¬â¢s not a sure thing, and this isnââ¬â¢t worth gambling over. SAT scores fluctuate, sometimes by a hundred points or more, and the less experience you have with the test, the more likely that thereââ¬â¢s going to be some inconsistency. Besides that, your reach schools might be looking for scores that are already on level with your PSAT score as it is, even if it is high. And if your PSAT scores drop jaws but your goal schools are only modest, then itââ¬â¢s time to start looking at even higher-tier schools: ivy leagues tend to look pretty good on resumes, and youââ¬â¢ve just shown that your test-taking skills, at least, might be up to snuff. And if you do decide to go for the gold and apply to the best-ranked schools, then you might need to do some serious test prep to seal the deal, rather than gambling based on your PSAT score. Take a look at Harvard SAT scores, for example: 75 percent of students score over 2100. (If we compare that to the PSAT, thatââ¬â¢s around a 200 composite score.) The story isnââ¬â¢t so different with Yale SAT scores, either; top schools expect top scores. Are you absolutely certain youââ¬â¢re going to score that high? If you arenââ¬â¢tââ¬âand who is?ââ¬âthen yeah, you might want to study for the SAT. Itââ¬â¢s a lot of work to take on when youââ¬â¢ve already got classes, extra-curriculars, and a life, but whatever you can make time for is worth it if it brings you closer to your dream school. All that being said, I want to make it clear that I donââ¬â¢t recommend serious prep for everybody. If youââ¬â¢re absolutely sure that any and every school you want to apply to has average SAT scores much lower than what youââ¬â¢re expecting based on your PSAT, then there are probably other things you should be focusing on. Your test scores are only part of the package, and if theyââ¬â¢re already the strongest part by far, then you shouldnââ¬â¢t spend too much time and energy on them, of course. But be careful not to write those scores off, either. This post was written by Lucas Verney-Fink, resident SAT expert at Magoosh. For more advice on SAT prep, check out Magooshââ¬â¢s SAT blog.
Saturday, May 16, 2020
Abraham Lincoln And The American Civil War - 1758 Words
Per a cited resource (http://www.history.com/this-day-in-history/president-lincoln-dies) Abraham Lincoln our 16th president of the Unite States of America was fatally shot on April 14, 1865 in the back of the head in the Presidential box at Fordââ¬â¢s Theater in Washington D.C. but, actually passed away at 7:22 a.m. the next day. Lincoln was taken to a home across the street, where he died, from the bullet wound he inflicted the night before. Lincoln survived nine hours after his assassination took place making him the first President to get assassinated in the United States of America. By well-known actor also affiliated with The Confederate Party John Wilkes Booth. His death came six days after Confederate General Robert E. Lee surrendered his army at Appomattox, ending the American Civil War. Booth, who despite his Confederate sympathies resided in the north, while his initially plot was to capture President Lincoln and take him to Richmond, the Confederate capital. Howbeit, on March 20, 1865, the day of the planned kidnapping, the president failed to show up at attended spot where Booth and his six fellow conspirators waited and were unsuccessful. Although a couple of weeks later, Richmond fell to Union forces. In April, with Confederate armies near collapse across the South, Booth hatched a desperate plan to save the Confederacy. After obtaining information that President Lincoln was to attend Laura Keeneââ¬â¢s performance in Our American Cousin at Fordââ¬â¢s Theater on April 14,Show MoreRelatedAbraham Lincoln And The American Civil War1322 Words à |à 6 Pagesaccredited to Abraham Lincoln, but he was not always the complete abolitionist as he is commonly portrayed. The ââ¬Å"house dividedâ⬠, as Lincoln depicted it in his famous ââ¬Å"House Dividedâ⬠speech, of the United States during the Civil War was not always led towards the freedom of all mankind and there is sufficient evidence to support this claim. The sixteenth president of the United States is most commonly remembered for inducing the courage and determination to end the American Civil War with the EmancipationRead MoreAbraham Lincoln : The American Civil War1756 Words à |à 8 PagesAbraham Lincoln is often regarded as a resilient individual who triumphed over adversity during one of the most turbulent times in Unites States history: the American Civil War. Traits that are often attributed to him are honesty, charisma, a silver tongue, and a sense of equality. Lincoln achieved notoriety not only with his exceptional delivery of famous speeches, such as the Lincoln-Douglas debates, but also with the lesser known interactions, conversations and daily activities with common peopleRead MoreAbraham Lincoln, Slavery and the American Civil War Essay1716 Words à |à 7 Pagesinvestigation will analyze how Abraham Lincolns view on slavery reflected during and after the American Civil War from 1861 to 1865. To analyze exactly how Lincolns position on slaver y affected the war overall, this investigation looks at Lincolns moral and religious views as well as his social and political views. Two main sources were used, both dealing with events relevant to his political career and his roots in his career and other important issues including slavery. Lincoln by David Herbert DonaldRead MoreEssay The American Civil War: Abraham Lincoln754 Words à |à 4 PagesCan you imagine what it was like to be president during the Civil War? To have so many people looking up to you? So much pressure on your shoulder? Than imagine Abraham Lincoln. This self-educated president dealt with all this, successfully, as our leader during the Civil War. Lincoln was born on February 12, 1809 in Hardin County, Kentucky. He only had 3 short periods of formal schooling throughout his childhood, as he had to work constantly to support his family. When he was slightly older, heRead MoreAbraham Lincoln and the Fourth Estate: The White House and the Press During the American Civil War by Richard Carwardine565 Words à |à 3 PagesIn ââ¬Å"Abraham Lincoln and the Fourth Estate: The White House and the Press during the American Civil Warâ⬠Richard Carwardine discusses the incredible increase in the Pressââ¬â¢ contribution to the American Civil War. Carwardine explains Abraham Lincolnââ¬â¢s role with the media and his use of newspapers as political weaponry from before the election and into his presidency. This topic is significant because it illustrates Abraham Lincolnââ¬â¢s intelligence and strengths as a president during the Civil War. TheRead MoreEssay on Abraham Lincoln - the Greatest President1069 Words à |à 5 PagesA braham Lincoln There have been forty four U.S. presidents over the past two hundred and twenty years. What president has served the best for our country? None other than Abraham Lincoln. Abraham Lincoln is the greatest president ever because he did great things such as ending slavery, getting the us through the Civil War, and helped our country a lot. The American Civil War was a war between the Southern states and the Confederate states. Abraham Lincoln was not very prepared for the war militarilyRead MoreAbraham Lincoln : An Influential President1572 Words à |à 7 PagesAbraham Lincoln: An Influential President When you hear the name Abraham Lincoln, what is the first thing that comes to your mind? Do you think of a tall, slender man with an enormous top hat? Do you think of his devotion to the abolition of slavery? Abraham Lincoln contributed to more than one can imagine. He was the president of the United States during a time of colossal distress, the Civil War, and he paved the way for a great number of changes. Abraham Lincoln was a powerful figure whoRead MoreLincoln s Impact On The Civil War1542 Words à |à 7 PagesAbraham Lincoln Research Paper Who was the Greatest President that ever lived! Abraham Lincoln. Abraham Lincoln was a very well respected man at an early age. He worked hard most of his life and worked hard in law, and as a president to keep our nation in one during the Civil War. He had the mindset to get where he needed to go. He lived a long and resentful life full of problems that he fixed. Lincolnââ¬â¢s early life, Lincoln enters presidency, Lincolnââ¬â¢s impact on the Civil War as a president, Lincolnââ¬â¢sRead MoreLincoln s Impact On The Civil War1564 Words à |à 7 Pages Abraham Lincoln Research Paper During the Civil War, was Abraham Lincoln the cause or the cure? Abraham Lincoln, the man that hit right path toward life while earning respect. He worked hard most of his life and at law, and as a president to keep our nation in one during the Civil War. He had the mindset to get where he needed to go. He lived a long and resentful life full of problems that he fixed. Lincolnââ¬â¢s early life, Lincoln enters presidency, Lincolnââ¬â¢s impact on the Civil War as a presidentRead MoreThe War Between The North And The South993 Words à |à 4 PagesFive years American had their own bloodshed between the North and the South. There is many reason into why the United States had a war between the North and the South. The United States was divided depending on location and personal sentiments. People in the United States sometimes think that this war was only fought over slavery, but there was many reason in why the Union and the Confederate States of America fought. The war was fo ught on many reason such as the idea of slavery, statesââ¬â¢ rights
Wednesday, May 6, 2020
The Goal Of Healing Homes - 1621 Words
The goal of healing homes is to develop and foster nurturing Hispanic adoptive and foster homes that responds to the cultural, emotional, and behavioral needs of at-risk Hispanic youths in the foster care system. Rooted in the belief that every child walks their own path and has the ability to reach full potential, Healing Homes focuses on a curriculum that teaches parents and caregivers how to be better listeners and supportive parents and enables children to improve. According to Dettlaf Rycraft (2010), ââ¬Å"immigrant Latino children and families represent the largest and fastest-growing population in the United States, and thus require the attention of child welfare systems and the development of evidence-based practices designed to respond to the unique needs of this population.â⬠Theme I: Cultural Competence ââ¬Å"Child welfare agencies in the U.S. are seeking to respond to the need for linguistically and culturally responsive services for children of immigrants and their families as the population continues to growâ⬠(Johnson, 2007). In a study conducted by Brown, Sintzel, Arnault, George (2009), the researched explored how important it is to understand how cultural values, beliefs and traditions of foster parents are related to placement success because a substantial proportion of children in care come from culturally diverse backgrounds. The study consisted of telephone interviews to participants (foster parents) by the researchers compared against literature reviews.Show MoreRelatedThe Heartsong Center For Healing And Awakening964 Words à |à 4 PagesHeartsong Center for Healing and Awakeningââ¬â¢s Mission is to be the #1 retailer of in the spiritual transformation and natural self-healing health industry in Southern California. Its goal is to offer eastern methodologies and modern day application of quantum physics and neuroscience.at a discounted price, provide prompt and outstanding customer service through its knowledgeable staff. Keys to Success Some keys to success in the industry for the Heartsong Center for Healing and Awakening is directlyRead MoreReflective Paper : Healing Justice1392 Words à |à 6 Pages Reflective Paper: Healing Justice As per viewing the video ââ¬Å"Healing Justiceâ⬠they interaction between the punishment justice system and the healing system have two very distinct opinion and methods. The first nation view if someone changes their ways negatively they cause find their way back. As far as the legal justice system they believe, ââ¬Å"if you did the crime you do the timeâ⬠. In order to be able to have a full understanding of why the aboriginal push the issue of a holistââ¬â¢s justice, we firstRead MoreHolistic Core Values Of Holistic Nursing1707 Words à |à 7 PagesHolistic Core Values Holistic nursing care involves treating the patient mind and body, as well as providing comfort through prayer. The overall ideal goal of providing holistic care is treating the patient as a whole. There are certain standards and guideline designed by the American Holistic Nursing Association in which establish the core values of holistic nursing (Frisch, 2001, p. 1). This paper will discuss the core value number three: holistic communication, therapeutic environment and culturalRead MoreAn Article On His Theory Using Prayer And Scripture1018 Words à |à 5 Pageson recognition of mental events in the present moment and the second is involves adapting to openness and acceptance. Yang-Tang(2007) model combines prayer and scripture to help patienceââ¬â¢s heal from their problems. The goal is to help patients to feel whole and experience healing through God. All patients sign an consent form to agree to this form of treatment. Yang-Tan (2007) has used this method for over 25 years, in different therapeutic settings as well as bible colleges. The method includesRead MoreWhat Is Gap Analysis? Registered Nurses Of Ontario ( Rnao )1535 Words à |à 7 Pagesââ¬Å"underestimatedâ⬠wound and a common acute injury seen in the elderly. Skin tears are wounds that often pose significant challenges for the resident who sustain the injury and the Interprofessional team involved, to progress the injury towards healing as stated by (Manning Chrisakis). The RNAO Gap Analysis Assessment and Management of Stage 1 to 1V Pressure Ulcer, Revision 2007, (Ontario, The RNAO Gap Analysis Assessment and Management of Stage 1 to !V Pressure Ulcer,) Work sheet wasRead MoreEducation Plan For A Care For Diabetic Pat Patients Who Have Foot Ulcers Essay1505 Words à |à 7 Pagespatient will be able to verbally state nutritional components that positively effect wound healing. An outline for my education is as follows: â⬠¢ If you have any pain in the wound, acetaminophen (Tylenol) can help take the edge off. Especially in the initial stages, it is recommended to take Tylenol around the clock, as directed on the bottle, to keep the pain under control. â⬠¢ You will most likely go home with a prescription for antibiotics, it is important that you take them around the same timeRead MoreThe Alternative Treatment Of Wilderness Therapy861 Words à |à 4 PagesWhen a parent has a teenager who is struggling with addiction it can be overwhelming. There are many different treatment and therapy options. There are options such as inpatient and outpatient homes. Outpatient therapy treatment may not be enough for those who are heavily addicted and some inpatient programs can last anywhere from up to six to twelve months. Wilderness therapy proves to be a positive alternative treatment in rehabilitating adolescents. Wilderness Therapy is a more successful meansRead MoreHolistic And Holistic Nursing Care Essay1327 Words à |à 6 Pages Holistic Nursing Care Norma Valdez-Rosa South University Online Complementary Alternative Methods Introduction Holistic nursing is defined as ââ¬Å"all nursing practice that has healing the whole person as its goalâ⬠(Dossey, 2012). Holistic nursing does not replace medicinal practice; rather, it incorporates the whole patient into the nursing care plan with the outcome being that of a healthier patient. Holistic Nurse Self-Care is the most important core value of the Holistic NursingRead MoreTruth, Reconciliation, Healing : A Curriculum1478 Words à |à 6 PagesReconciliation, Healing: A curriculum Joshua Lorenz Vancouver Island University Abstract This paper brings together the two perspectives of residential school abuse and the viewpoint of healing. Intergenerational effects have been created due to residential school and have devastating impacts on Aboriginal communities. This paper explores how a school curriculum would help spread awareness of the wrongs committed against Aboriginal communities and how we can set the path for healing. Read MoreMarketing Analysis : The Marketing Industry, The Target Market, And What The Competitors Offer935 Words à |à 4 Pagesinformation about the local and nationwide competitors will provide an understanding of the sustainable advantages our company has over its competitors. Integrative Touch for Kids (ITK) is a nonprofit organization and its goal is to aid children through their major programs like the Healing Retreat, and Hospital Heroes. As consultants, it is critical to utilize this research in order to better understand ITKââ¬â¢s core values in order to act accordingly. Industry Overview This nonprofit company can be classified
Tuesday, May 5, 2020
Health Ethics Dignity and Human Rights- myassignmenthelp.com
Question: Discuss about theHealth Ethicsfor Dignity and Human Rights. Answer: Introduction: Nurses working in health care setting are often confronted by daily ethical challenges in the delivery of care. According to the professional and ethical code of conduct in nursing practice, nurses are often required to uphold the moral values and principle to create an environment of trust with patients and avoid ethical conflicts. Adherence to ethical code of nursing practice is also necessary to develop trust with patient. However, nurses often face ethical challenges in the provision of care (Ulrich et al., 2010, pp. 2510-2519). To understand the kind of ethical issues experienced by nurses in daily practice, the report mainly analyzes the experience of Camillas, a nurse while working on a surgical unit with Sam, a 21 year old man with acute abdominal pain. Based on the identification of ethical issues in the scenario, further discussion is presented with support from several ethical theory, ethical principles values, professional code of ethics. It also provides recommendation about the strategies that nurse can employ to overcome the ethical challenges in the care process. Identification of ethical issues at stake: 100 words approx The nurse Camilla faced challenges in completing the vital sign assessment process for Sam because he was very aggressive and resistive during the procedure. Sam was also verbally abusing Camilla and pulling out the IV cannula. The medical team had ordered that physical restraints be applied on Sam, however as Camilla was worried this might cause further harm to patient, she took advice from the nurse-in charge Julia regarding the issue. Julia also favored medical teams order and asked Camilla to focus on other patient and apply physical constraint on him. The main ethical dilemma in the case scenario is the conflict between the ethical principle of beneficence and non-maleficence. According to the principle of non-maleficence, (avoid unnecessary harm to patients or other during care), the action of physical restraint was justified. However, due to the use of physical restraint, there is high possibility of patient being more aggressive and harming himself and others. Hence, the use of physical restraint is in violation of the ethical principle of beneficence (promote well-being of patient) (Luk et al., 2014). It is an ethical decide for Camilla to decide whether priority should be given to non-maleficence principle or beneficence of patients and she should go ahead with physical restraint for Sam or not. Ethical perspective on the issue: The above dilemma of exercising physical constrain on Sam is an ethical dilemma for the nurse, Camilla. Physical restraint is defined as the use of any device or equipment around the patients body to deliberately control their free movement. This type of constraints is mainly applied for older patients with functional disabilities or patients with cognitive disturbance or behavioral problem (Heeren et al., 2014). Use of physical restraint was proposed for Sam considering his aggressive behavior and past medical history of multiple hospital admissions for drug related psychosis. However, use of physical restraint is considered as an ethical issue for nurses because of the physical risk to patient. For example, physical restraint is associated with physical harm to patients such as bruises, increased agitation, undernutrition and many others. It increases the chance of conflict for nurse because use of physical constraint does not meet therapeutic needs of patients (Hofmann Hahn, 2014 ). Hence, reconsidering the need for physical constraint is necessary for nurses because of the chances of harm for patient. Considering the requirements of ethical justice in using physical constraint is also necessary for nurse according to the virtue theory. The Virtue theory emphasizes on the individual character of the person on ethical thinking. This means that while doing professional duty to achieve good consequences for any person, the character traits of a person must be analyzed (Bell, Dyck Neubert, 2017). Hence, the virtue theory mainly supports the fact that universal principles cannot be applied in all moral situations and impact of any actions must be evaluated on the basis of individual character of patient. Therefore, Camillas worry for safety of patient is justified according to the virtue theory because physical constraint may further cause harm to Sam. However, the medical team and the nurse leaders decision to proceed with physical restraint seem to go with the deontological theory. This is because deontology theory judges the morality of an action based on established rules and the n urse leader may justify her action by stating that it is a usual norm to use physical restraint on patient who is aggressive (Lazar 2017). Use of deontological theory is not favored for moral decision making in Camillas case because such theory lacks justified decision making and has many risk and uncertainty with the decision. Alternative perspective: The ethical issue in using physical constraint for Sam can also be explained by the ethical principle of beneficence. According to the ethical principle of beneficence in nursing practice, the nursing action must be such that it promotes well-being for patien. In accordance with this principle, a nurse has the responsibility to prevent harm in patient and defend the rights of other by analyzing the benefits against possible risk of an action. Hence, Camillas action of clarifying the use of physical restraint for Sam is a morally sound action by her because she weighed the intervention against harm for patient. Moghadam, Khoshknab Pazargadi, (2014) also supported the fact that although physical restraint is used to manage maladaptive behavior and reduce aggression, however negative effects of aggression such as stimulation of aggression and damage to therapeutical relationship with patient is also a possibility. Hence, instead of physical restraint, the medical team could have also a dvised the nurse to use other interventions like giving antipsychotic drugs like Olanzapine to patient to manage aggression. This intervention can reduce aggression in patient as well as promote safety of patient and other staffs (Gobbi, Comai, Debonnel, 2014). According to the value of humaneness too, the act of using physical restraint is not ethical action as it violates equal treatment and cause physical risk and injury to patient (Brophy et al., 2016). In addition, medical teams decision of ordering physical constraints is also a disrespectful action as all patients irrespective of their illness deserves to be cared with dignity and respect. Restraint is seriously detrimental to the dignity of patient and is considered to reflect therapeutic practice (Petrini, 2013). Hence, another ethical perspective to the Camillas scenarios is that ethical challenges are present in the case study due to the conflict between divergent values and value of respectfulness for patients. Discussion of ethical issues from the perceptive of: The requirement to respect human dignity and human right Apart from the clinical responsibility of caring for patient, nurses also have the obligation to comply with human rights and human dignity in practice setting. According to ANA Position Statement (2017), nurse must always advocate for human rights protection and respect inherent dignity, worth and human rights of all individuals. According to this action, the nurse must always refuse a practice that would negatively influence the quality of care and leaded to human rights violation. In the case scenario of Camilla too, the medical teams order of applying physical constraint on Sam is a situation of human rights violation. Physical restraint by the use of device to restrict movement of patients strips them of all dignity and right to be involved in treatment. However, using this strategy to control aggressive and uncooperative patient is an indication that health staffs lack training to work with such patient. Hence, to protect harm to patient, the nurse Camilla must analyze the acti on on ground of human rights and human dignity and take the step to deny such practice. This is within the provision of nursing practice. In addition, she can also take alternative option possible to minimize negative ethical consequence and harm to patient. your future professions codes of ethics/ professional conduct professional standards According to the Code of Ethics for Nurses in Australia, they must value access to quality nursing care for all people. In the context of valuing quality nursing care for all people, it means that nurse must accept their moral and legal responsibilities to provide safe and competent care and have all the right to question any nursing intervention that is potentially unethical or illegal (Code of Ethics for Nurses in Australia, 2017). In this context, it can be said that the nursing intervention of using physical restraint for Sam is an unethical issue as it will lead to harm for patient and violate the requirements for safe and competent care. There are high chances of patient safety related issues in using physical restraint as it will increase agitation, cause skin injuries or restrict circulation and lead to self-harm consequences (Hughes Lane, 2016). Hence, according to the code of ethics, Camilla has all the rights to question such treatment and consider the safety of patient a bove all things. Another important value statement of the Code of ethics is that nurses must value kindness and respect for self and others. According to this statement, the nurse have the obligation to respect and preserved the dignity of people by practicing kindness and recognizing vulnerability of the patient (Code of Ethics for Nurses in Australia, 2017). From this perspective too, the act of using physical restraint is an ethical issue as it will give feelings of disrespect to Sam and it will be harsh method of nursing care. According to Mhler Meyer, (2014), nurse often decide in favor of using restraint when they are in doubt and lack skills to handle aggressive patient. They also use strategies to cope with negative feelings of patients. For Camilla, using other intervention will save her from ethical issues while on duty. The principles of health care ethics The principle of health care ethics is mainly centered around the factor of autonomy, beneficence, non-maleficence and justice to ensure optimal safety and care for patient. Autonomy is related to giving right to patient to take part in decision making for treatment options. Beneficence is the responsibility to put best effort for the benefit of patient and non-maleficence is related to ultimate goal of causing no harm to patient during the care process. The principle of justice demand elements of fairness in all kinds of decision making (Holmes, 2016). By comparing and evaluating the Camillas experience based on the principle of health care ethics, it can be said no principle of ethics is followed in going forward with physical restraint. Firstly, principle of autonomy will be violated because the medical team has not taken consent from Sams relative while deciding to use physical restraint. Secondly, beneficence principle is violated because physical restraint is not a therapeutic care option and develops negative feelings and behavior in patient such as isolation, resentment and aggression. Justice is also denied because according to human rights principle, no person has the right to be restricted and all must be treated equally. Proposal for professional practice Based on the identification of several negative ethical implication for Camilla in using physical restraint for Sam, the recommendation for nurses like Camilla is that they must first identify the goal of the health care intervention and its benefit for patient. According to medical teams order, physical restraint is necessary to save others from harm. However, as the nursing care is mainly centered around the patient related outcome, Camilla must also weigh the benefits and risk of physical restraint for Sam. Considering his mental condition, if using physical restraint is a necessity, then she must follow ethical process of taking consent from patient or his family members to make them aware of the need for such act. This will prevent any future issue in the future. However, as there is many evidence to provide harm and negative experience for patients is using physical restraint, Camilla must also identify other alternative intervention physical restraint is associated with increa sed risk of injury to both hospital staffs as well as patients. For example de-escalation technique can be used to avert violence and regain calmness of patient. However, as this requires complete verbal and non verbal communication skills by nurse, Camilla can also consider pharmacological treatment option to control aggression in patient (Spencer Johnson, 2016). This will ensure that fairness is maintained in decision making and patient dignity and respect is preserved during the delivery of care. Conclusion: The essay summarized the ethical issue faced by Camilla in applying physical restraint and likelihood of ethical implications in practice due to risk of harm to patient and violation of dignity and respect of patient. Considering the risk of harm and negative consequences of physical restraint for patient, it can be said that the use of physical restraint is not effective nursing intervention. This is explained with support from ethical theory, principles of ethics in health care and code of ethics for nursing practice. The main recommendation for professional practice in dealing with such scenario is that benefits and risk of physical constraint must be weight for patient and ethical process must be followed in implementing it such as taking informed consent and using least restrictive methods to minimize injury in patient. It is also proposed to find alternative interventions to curb the practice of using physical restraint for mentally aggressive patient. Reference ANA Position Statement (2017). The Nurses Role in Ethics and Human Rights: Protecting and Promoting Individual Worth, Dignity, and Human Rights in Practice Settings. Retrieved 23 October 2017, from https://www.nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Ethics-Position-Statements/NursesRole-EthicsHumanRights-PositionStatement.pdf Brophy, L. M., Roper, C. E., Hamilton, B. E., Tellez, J. J., McSherry, B. M. (2016). Consumers and their supporters perspectives on poor practice and the use of seclusion and restraint in mental health settings: results from Australian focus groups.International journal of mental health systems,10(1), 6. Code of Ethics for Nurses in Australia. (2017). Retrieved 24 October 2017, from https://file:///C:/Users/User00/Downloads/5_New-Code-of-Ethics-for-Nurses-August-2008.PDF Gobbi, G., Comai, S., Debonnel, G. (2014). Effects of quetiapine and olanzapine in patients with psychosis and violent behavior: a pilot randomized, open-label, comparative study.Neuropsychiatric disease and treatment,10, 757. Heeren, P., Van de Water, G., De Paepe, L., Boonen, S., Vleugels, A., Milisen, K. (2014). Staffing levels and the use of physical restraints in nursing homes: a multicenter study.Journal of gerontological nursing,40(12), 48-54. Hofmann, H., Hahn, S. (2014). Characteristics of nursing home residents and physical restraint: a systematic literature review.Journal of clinical nursing,23(21-22), 3012-3024. Holmes, D. (2016).Critical interventions in the ethics of healthcare: Challenging the principle of autonomy in bioethics. Routledge. Hughes, L., Lane, P. (2016). Use of physical restraint: ethical, legal and political issues.Learning Disability Practice,19(4), 23. Lazar, S., 2017. Deontological Decision Theory and Agent-Centered Options.Ethics,127(3), pp.579-609. Moghadam, M. F., Khoshknab, M. F., Pazargadi, M. (2014). Psychiatric Nurses Perceptions about physical restraint; a qualitative study.International journal of community based nursing and midwifery,2(1), 20. Mhler, R., Meyer, G. (2014). Attitudes of nurses towards the use of physical restraints in geriatric care: a systematic review of qualitative and quantitative studies.International journal of nursing studies,51(2), 274-288. Petrini, C. (2013). Ethical considerations for evaluating the issue of physical restraint in psychiatry.Annali dell'Istituto Superiore di Sanit,49(3), 281-285. Luk, E., Sneyers, B., Rose, L., Perreault, M. M., Williamson, D. R., Mehta, S., ... Burry, L. (2014). Predictors of physical restraint use in Canadian intensive care units.Critical Care,18(2), R46. Bell, G. G., Dyck, B., Neubert, M. J. (2017). Ethical leadership, virtue theory, and generic strategies.Radical Thoughts on Ethical Leadership, 113. Spencer, S., Johnson, P. (2016). De?escalation techniques for managing aggression.The Cochrane Library. Ulrich, C. M., Taylor, C., Soeken, K., ODonnell, P., Farrar, A., Danis, M., Grady, C. (2010). Everyday ethics: ethical issues and stress in nursing practice.Journal of advanced nursing,66(11), 2510-2519.
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