Short Story Responses free essay sample

Katherine Mansfield’s short story The Fly challenges the average reader to rise out of their comfort zone, and confront the prospect of losing a loved one. Mansfield was herself affected by the grief of losing a sibling to premature death, and cleverly crafted a tale of a middle aged businessman who went into sadness and depression when a chance remark by a colleague reminded him of the death of his son. The remedy came from a lowly member of the animal world – a fly. Animal instincts drove it to struggle again and again to survive drowning in an inkblot, just as we all must when faced with grief. While we would all like to be blissfully unaware that our elder loved ones will die, and we will have to go on, The Fly ‘s protagonist faces a more extreme situation, the loss of a younger family member, no less, the only son on whom the father had placed so many hopes and expectations. We will write a custom essay sample on Short Story Responses or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page While the son isn’t actually in the story, he is one of an interesting array of characters who provokes the internal conflict in the protagonist. The elderly co-worker is an effective foil, not only in the sense that he make the comment that reminds the protagonist of his son, but also in that, as a living, doddering geriatric, he is a complete contrast to the young son, thus underlining the cruelty of death at such a young age. The choice of a third person limited narrator allowed for both detached narration and revealment of the protagonist’s inner sufferings. Mansfield wrote, â€Å"It had been a terrible shock to him when old Woodfield sprung that remark on him about the son’s grave† as well as â€Å"My son! † groaned the boss. In the past†¦ he had only to say those words to be overcome by †¦ a violent fit of weeping. † This effectively reveals the suffering caused by grief, and the need for people to persist if they are to deal with it. The episodic structure of the plot line, with the fly continuing to fight through crisis after crisis, in a struggle to survive, serves as a lesson from the animal kingdom to humans that we must persist to survive the adversities that life throws up, such as grief. Mansfield’s unique context of having lost a younger sibling at an early age, shared through her cleverly told short story, confronts average readers with the prospect that they will have to struggle through dealing with the grief associated with the death of loved ones. Short Story and Novel Sample essay response to novel done by Mr Carbon in 30 minutes On Going Bovine by Libba Bray Why did I ever walk past the display shelf in the library that had the novel Going Bovine by Libba Bray on it. I had to read it, and it was 480 pages! First there was the picture of a cow walking with a garden gnome under its â€Å"arm. † Then there was the blurb promising a road trip across America – I’m a sucker for journey settings. Then there was the advertised combination of characters – Cameron, a punk angel, a video gaming dwarf and a garden gnome that is really a Norse god. You don’t get that sort of thing every day. What I ended up with was a cross between a teenage version of Jack Kerouac’s On The Road and Love Story, that schmaltzy 70s movie where the young man dies of a lingering disease but everyone learns a lot more about love and life. I think Libba Bray actually rammed every theme or issue that had been in the ‘papers in the last month into her novel. Cameron had contracted BCG, that’s Mad Cow Disease, and the whole road trip major action of the novel actually never happens beyond his medication and sickness affected hospital bed. The whole fantasy in Cameron’s mind that we readers are treated to is his imaginary search to find Dr X who has the cure for his sickness, which in his imaginings is dark matter brought down to Earth by Dr X’s dimension travellings. Cameron actually finds Dr X, but because the genius is bitter and still mourning the death of his own wife, he won’t help unless Cameron can convince him with what he has learned on his travels. Cameron can only share that â€Å"to love is to live, and to live is to love. † For a teenage readership to realise that, in the end, life is about love is trite and pure schmaltz, but, never the less, extremely worthwhile. Interspersed with the road trip setting were times when Cameron was apparently sleeping or unconscious, and he was back at his hospital bed in the company of his family. This structure made it clear that the most important thing in life is the love of family. The climax of the novel is an amazing conversation between Cameron and an alter ego self from his fantasy. Essentially, this other Cameron tells Cameron, â€Å"it sucks, but the truth is sometimes the people you love die, and there is nothing you can do about it. † This is wonderful realisation for a teenage readership that probably thinks it is immortal and that their loved ones will always be there for them At the start of the novel, Cameron was of course obsessed with the love interest, the best looking girl in school, and true to stereotype, in his fantasy, he loses his virginity to her before the novel ends. The interesting part is the contrast through the character of an angel who cares for and guides Cameron to his death, and makes love to him along the way. There are obvious implications for the nature of true love and commitment in relationships. Libba Bray wants to push the politically correct line of complete acceptance, including through the foil character Gonzo, but do you think including a gay Mexican dwarf is a bit too much. I mean, he covers all bases, except maybe if he was an environmentally friendly whale at the same time. I feel Bray is out of her depth when it comes to writing through the persona of a teenage boy. The vernacular humour is a feature of the entertainment of the novel, but times such as using the expression nuclear in dialogue to satirise teenage life is just one example of where she lacks credibility. I couldn’t put Going Bovine down, and the novel goes a long way to engaging teenagers with the realities of death and the importance of love. Perhaps in Bray’s range of issues and engaging style she tries for too much. .

Peter Browns The World of Late Antiquity essays

Peter Browns The World of Late Antiquity essays Peter Browns The World of Late Antiquity The Late Antique period is recognized from AD 150 to 750. For many historians, the central focus of this era revolves around decline and fall; however, this is not the case for Peter Brown, author of 1971s The World of Late Antiquity. Brown saw the Late Antique period as a study of social and cultural changes. Instead of focusing merely on the declines of empires, like many of his contemporaries, Brown goes deeper with his research to describe the Late Antique period as an era in which the most deep rooted of ancient institutions disappeared for all time (p.9). By 476, the Roman Empire had vanished from Western Europe, and by 655, the Persian Empire had disappeared from the Near East. What makes Brown unique in his portrayal of the era is that instead of studying just the cause and effect of the civilizations downfall, he examines the changes that occurred and mens reaction to them. By doing so, Brown is able to show his purpose for writing the book. He believed there were t oo many books concerning just the downfalls of the era, and wanted people to know that the period was also one of outstanding new beginnings. Brown also wanted to show that the Late Antique period defined the far-reaching impact of both Christianity on Europe, and Islam on the Near East. His thesis centers around social and cultural changes and specifically states: I hope that the reader will put it down with some idea of how, and even why, the Late Antique world came to differ from classical civilization, and of how the headlong changes of this period, in turn, determined the varying evolution of western Europe, of eastern Europe and of the Near East (p.7). The World of Late Antiquity is organized into two parts titled the Late Roman Revolution and Divergent Legacies. Part one, the Late Roman Revolution, is divided into two chapters, society and rel...

Entry into Foreign Market Essay Example | Topics and Well Written Essays - 1500 words - 2

Entry into Foreign Market - Essay Example Despite Cameron International Corporation’s involvement in other developed nations, the company’s production and innovative approaches towards development of oil extraction equipment may hinder the desired success if it fails to establish the actual needs of the oil drilling industry in Myanmar. The risk involved in the company’s strategic entry in foreign markets is the lack of research and development programs to establish the unseen barriers, and the dependence on its large capital base for diversification of investments (Griese, 2004). Certainly, the risks of production that prompted to the explosion of BP oil rig revealed technological failures thus; the company’s profitability should not serve to guarantee success in Myanmar since technological breakdowns might lead to expulsion and exploitation from the mining industry (Crouch & Maclean, 2011). Arguably, the institutional risks present in the oil extraction corporation serve as deterrence to success in entering the Myanmar oil industry. The institutional risks born to the multinational corporation are; financial, human resources, and the corporate social responsibility practices (Meyer, 2010). However, the management is certain of prosperity in the market due to its capital amount set aside for the investment. VRIO analysis to determine the existence of support to entry VRIO analysis in Cameron Corporation establishes a strategic scheme towards the global market approach. Firms draw their market entry strategies to reflect their vision statements and determine the success of objectives upon any of the corporation’s segments. Ideally, VRIO abbreviations denote value, rarity, imitating or counterfeiting, and organization’s competitiveness in guaranteeing profound market entry variables (Griese, 2004). As an organization, Cameron International boasts over its business success in the continued production of oil services and equipment. The sectoral approach in the ene rgy production industry enables the CAM Corporation of continued innovation of ideal equipment in correlation to the raising performance together that seeks to denote its essential need to deliver value to the mining companies in order to become the global market leader in supplying valves and fittings in subsea oil wells. Secondly, the company asserts that its segment strategy is to enable corporations and countries to meet their energy services needs (Duncan, 2009). CAM targets those companies that operate in petroleum and natural gas exploration and extraction. Due to the strategic involvement in the energy industry, the company is arguably a leader in the production and marketing of pressure control equipment critical for competent oil and natural gas extraction programs. The company’s underlying strengths of rich history in production of valves used in exploration sites in over 300 countries acquaint vast opportunities towards success in its bid to enter the Myanmar oil industry. CAM competes with FMC Technologies and National-Oilwell Varco as the market challenger and market follower respectively (Lincoln, 2007). Therefore, the VRIO analysis declares proficient support in CAM’s entry in the Myanmar oil production industr

Linguistics essay 2 Example | Topics and Well Written Essays - 750 words

Linguistics 2 - Essay Example he basis for such concepts as ‘melting pot’ and ‘ethnocentricity’, where it was considered possible that all newcomers would blend into the existing society. Bennett (1993) believes that this does not work and that applying one’s own perspective is the source of ongoing conflict everywhere. Empathy, however, approaches communication from a point of ‘difference’ (Bennett 1998, p. 203), acknowledging that everyone is different from the other, from a multitude of angles and that only by acknowledging and valuing this difference, real communication can be achieved. In other words, empathy assumes the perspective of the other. Bennett (1998 p. 209) proposes 6 steps to achieving empathy, including acknowledging that there is difference, based on self-understanding, on temporarily suspending this self and allowing empathy with the other to take place. This can be achieved through what Bennett calls guided imagination an emphatic experience, re-establishing self once the period of empathy has finished. As you have made us aware, you are planning a strike in the near future, with the aim of obtaining an increase in wages. From our initial discussions, we now both are aware that we are different in our approaches to this problem. As you are now aware that the Chinese workers are not favour of this move and we are entering into this correspondence with the aim of arriving at a compromise acceptable to both parties. This may perhaps be more successful, if we understand the reasons for each other’s position. Therefore, we would first like to explain the motivation behind our move to forego higher wages. To begin with, we would like you to understand that, like you, most of the Chinese men working here have left everything behind to follow their dream of a better life for their families in California. While the railroads were being built, employment was good and we did well, but once they were finished, there was little chance that there would be further

Compare and contrast both caracter sarzan the mad man and sarzan the Essay

Compare and contrast both caracter sarzan the mad man and sarzan the prisoner - Essay Example So, a stranger to the land of Africa should not question or comment unfavorably on the age-old traditions. Keita returns to his village after completing his duty with the army, and stays to build a road. He strongly criticizes the superstitious practices of the people like sacrificing animals, and is not tired of repeatedly telling them that it is the practice of the savages. He is disgusted with such cruel practices. Overwhelmed by his re-exposure to traditions, he goes crazy and looks like the possessed individual. The local people call him â€Å"Sarzan†. For his act of disrespect to traditions he must get punishment. Kieth’s outlook had broadened, as he was the part of the French Army and seen action in many places of the world. When he returns to his native village, he is quite unhappy to accept the ways of the people sticking to traditions and follow them unquestioningly. No one is willing to accept his reformation processes and unable to bear their stout resistanc e Keita loses his mental balance. In that tradition-bound world it was no ordinary sin to take a stand against the old tribal gods and customs. The spirits of the ancestors will not condone the serious lapse on his part. The local people are not willing to accept him as the normal human being. He is an individual who has lost senses—a mad man according to them.

Impact of Aphasia on Health and Well-being

Impact of Aphasia on Health and Well-being Abstract This discussion paper considers the impact of aphasia on health and well-being, and following an in-depth exploration of relevant literature, provides suggestions for appropriate nursing interventions in respect of this relatively common condition following stroke. The introduction states that effective communication is essential to holistic care and positive outcomes for individuals affected by aphasia. However, when verbal communication is absent, nurses fail to adequately utilise alternative strategies so that the standard of nurse/patient communication is frequently poor. The discussion introduces the Theory of Human Scale Development. This theory emphasises that quality of life depends as much upon self-actualisation and relation-building as on physical health. The theory is used as a framework within the discussion in order to highlight the significance of communication to quality of life, and how its loss has profound psychological and social consequences. By utilising the theory, the discussion demonstrates that nursing care delivery must address loss of self-actualisation and relationship-building abilities, as well as physiological communication skills. The discussion reflects upon how aphasia results in loss of self, and how the situation is exacerbated by inadequate healthcare communication strategies such as nurse-controlled conversation, talking-over, and elderspeak. Suggestions are offered regarding more appropriate strategies. Efficacy of family input is considered; nursing competence regarding language practice therapies is discussed, and the quest approach is explored. Next, the discussion reflects upon the impact of aphasia on relationships. Aphasia denies access to support networks and results in isolation, stress, and loneliness. The individuals predicament is worsened by negative nursing responses such as communication filtering and avoidance tactics. The discussion reflects upon positive nursing strategies, which alleviate effects of aphasia on individuals social health. Concept analysis and self-awareness exercises as methods of enhancing compassion skills are explored. The social model of disability is discussed in order to highlight the benefits to individuals of environmental adaptations. Also, the social benefits of aphasia-group affiliation are discussed. The discussion concludes by emphasising that fundamental human needs involve social and psychological as well as physical aspects. Nursing interventions must therefore address all needs in order to provide holistic care in its fullest sense. Key Words Aphasia: nursing: relationships: self: Theory of Human Scale Development Summary Statements What is already known about this topic Good communication between nurses and patients is essential to the provision of quality healthcare that protects patients rights, autonomy and choice. Aphasia compromises nurse/patient communication leading to discrimination in health services, suboptimal care, poor long-term outcomes, and restricted rights. Communication difficulties faced by individuals with aphasia risks loss of self, and diminishes the beneficial impact of social integration on health. What this paper adds The multifarious impact of aphasia on the lives of individuals with the condition must be recognised and acknowledged by nurses. During their day-to-day nursing activities, nurses can facilitate the immediate communication needs of individuals with aphasia. Nurses can initiate aphasic individuals abilities to function independently and autonomously in the wider world via supporting the maintenance of personal identity and social integration. Introduction It has long been acknowledged and purported that good communication is essential to the provision of quality healthcare as it is integral to effective clinical assessment, health promotion, and patient choice and autonomy. Models of communication and research studies (Peplau, 1952; Fosbinder, 1994; Charlton et al, 2008) suggest that care delivery and health outcomes are improved when nurses use communication as a reciprocal interaction to express concern and commitment, and in return invite trust and human connection. These texts demonstrate that proficient interpersonal skills transform patients from objective clinical tasks to individuals meriting empathic, holistic care. However, because most communication strategies depend upon speech, the expediency of interpersonal relationships becomes severely compromised for individuals who experience aphasia as a consequence of stroke. Indeed, although the World Health Organisations (2001) definition of communication impairment encompasses verbal, non-verbal and graphic abilities, Finke et als (2008) systematic review finds that nurses continue to focus on stroke patients inadequate ability to verbally meet communication needs. Non-verbal messages are assigned a secondary, supporting role, and are therefore not adequately exploited as legitimate alternative strategies. The subsequent poor standard of professional/patient communication, described as appalling in the United Kingdoms National Sentinel Stroke Audit (Intercollegiate Stroke Working Party, 2009, p.12) has serious ramifications. O Halloran et als (2008) literature review suggests that health professionals inability or unwillingness to effectively enga ge with individuals affected by aphasia leads to discrimination in stroke services, suboptimal care, poor long-term outcomes, and restricted rights. Theory of Human Scale Development To avoid the suboptimal care of patients with aphasia, nurses must realise the necessity of effective communication to health and well-being. If nurses are to be motivated to explore, improve and exploit communication strategies as therapeutic tools, they must, in the first instance, understand the devastating impact of aphasia on quality of life. An analysis of aphasia in relation to the Theory of Human-Scale Development (Max-Neef et al, 1991) helps to illustrate its effect on the individual. According to the Theory of Human-Scale Development, quality of life depends upon the satisfaction of nine classes of interrelated ontological fundamental human needs (figure 1). Of these, only subsistence relates to physical health, the others being concerned with psychological and social issues associated with the sense of self and relationships. Because quality of life correlates with the number of satisfied needs, if a synergic satisfier (one satisfier that satisfies multiple needs) such as the ability to fluently verbally communicate, is removed, the impact on life quality is devastating (figure 2). Charmaz (1983; 1995; 1999) symbolic interactionist perspective reaches similar conclusions. These grounded theory studies of chronic illness demonstrate that the self is developed and maintained via self-actualisation and social relationships. Where illness reduces individuals participation in society, and prompts negative reactions from others, feelings of discreditation and loneline ss follow. Individuals beliefs that they are encumbrances on society rather than valuable contributors, lead to suffering and the loss of self. It is essential, therefore, that rehabilitative therapies should result in a synergic effect so that self, relationships, and thus quality of life are improved and maintained to the highest possible level (figure 2). However, many individuals with aphasia bemoan the fact that health professionals consistently focus on physical, biomedical definitions which view the condition as synonymous with physiological stroke events, rather than separate aphasia disability experiences (Liechty and Heinzekehr, 2007; Shadden et al, 2008; Wertheimer, 2008). This leads to the dismissal of psychological and social aspects of communication impairment and a thwarting of attempts to address them. Thus, the biomedical perspective, which defines aphasia as an inability to use or comprehend language as a consequence of injury to the cerebral cortex, results in the comment, I have aphasia, generating the response, You mean you had a stroke (Liechty and Heinzekehr, 2007, p.316). But, as Liechtys autobiographical account illustrates, aphasia is not an objective condition but a subjective reality, and focusing on the physiological brain damage both de-emphasises the pain that aphasia causes and denies the continual struggl es faced (p.316). Liechtys experience suggests that a psychosocial definition is more appropriate to describe the full extent of the consequences of aphasia to the individual. Sundin et als (2000) wider definition describes the condition as a defect in the use of language which causes extensive damage to psychological and social well-being resulting in isolation and depression. This study suggests that understanding the meaning of the illness for the individual rather than concentrating on the underlying physical causes, is the true initiator of holistic healing. O Halloran et al (2008) agree. This systematic review proposes that a biomedical perspective impoverishes care delivery because attributing communication breakdown to the disease process reduces nurses responsibility and motivation to develop ongoing communication strategies. The review suggests that a psychosocial perspective where nurses view communication impairment as an illness experience as well as a medical phenomenon, promotes the ide a that difficulties result from impaired interaction between nurse and patient. This increases nurses feelings of responsibility to overcome communication barriers and seek out the individual behind the disease. It is apparent, then, that reference to the Theory of Human-Scale Development helps to illustrate how a professional attitude which attempts to satisfy all fundamental human needs, not just the physical need of subsistence, subsequently leads to richer, more meaningful outcomes. Although fundamental human needs are to an extent, interrelated (figure 1), they are broadly split into three categories. The discussion paper will explore the impact of aphasia by focusing on self-actualisation and relationship needs. Self-Actualisation Needs Impact of Aphasia on the Self Rogers (1967) personality theory states that self-concept and self-perception are fundamental components of personal identity. He proposes that because life-meaning and behaviour are essentially purposeful, individuals require freedom to make choices, and create and develop their own personalities, in order to construct a valid presence in the world. Of course, language is the core of this process of self-construction. Without language, the ability to narrate lived experiences is lost. The individual cannot inform the world who and what he/she is, or understand who and what others are, hence is unable to find an appropriate place in the scheme of things. Shaddens (2005) literature review describes this predicament as identity theft, a state of affairs in which individuals with aphasia are ignored and invisible. However, Kagans (1995) masking of competence model refutes this, proposing that the individual is transformed rather than rendered invisible by aphasia. The model states that because communication impairment makes it difficult to perceive the individuals functional mind, it becomes difficult to envisage capacity. With capacity hidden, the individual is transformed from a person to a mere physical presence and is often viewed as a burden with little social value. According to Charmaz (1983), witnessing ones former self-image crumbling away is itself a fundamental form of suffering (p.168). Time and again, autobiographical narratives refer to the pain experienced when the self is reduced by an assumption that language loss is synonymous with the loss of intellectual and cognitive abilities (Neal, 1988; Bauby, 2008; Liechty and H einzekehr, 2007). Bauby (2008) summarises the feeling thus, [They] left no doubt that henceforth I belonged on a vegetable stall and not to the human race (p.90). Buber (1958) refers to this objectivising of people as an I-It relationship (as oppose to an I-Thou relationship defined by its reciprocal and mutually respectful nature). Aphasia renders the establishment of a nurse/patient I-Thou therapeutic relationship particularly challenging, because sharing and understanding become difficult to achieve. Unfortunately, this often results in I-It communication within the healthcare arena, which in nursing, is intrinsic to detached task-orientated care. According to Gordon et al (2008), this denies individuals with aphasia the freedom to control and direct their own lives. Gordon et als (2008) observational study concludes that staff control conversations and focus dialogue on their own nursing-task goals. The studys use of conversation analysis demonstrates that patients rarely initiate conversations and therefore have little influence over topics. In addition, due to heavy reliance on the sequential context of dialogue in order to maximise unde rstanding, individuals with aphasia find it difficult to alter the course of conversation to suit their requirements. Such asymmetrical, task-orientated communication is neither therapeutic or responsive to holistic needs. This results in a reduction of the self and a denial of individuals rights to participate in their own care or in the creation of their own future. According to Wertheimer (2008), curbing the freedom to express the self commonly leads to feelings of entrapment. Wertheimers (2008) detailed analysis of post-subarachnoid haemorrhage experiences suggests that language difficulties and loss of control during hospitalisation contribute to depression, and dreams and hallucinations, which frequently involve images of imprisonment and dictatorial authoritarianism. The negative impact of nurse-controlled conversation is exacerbated further by persistent occurrences of talking over patients. Flegels (2008) short article acts as a reminder that talking over is unethical because it contradicts health professionals codes of conduct that stipulate patient autonomy is paramount during care delivery. Quoting Kants (1785) argument that autonomy depends upon the hypothesis that all individuals have unconditional worth, Flegel (2008) believes that talking over signifies to patients that their presence is of no consequence and therefore they are not autonomous. Elderspeak also diminishes autonomy. This speech style is generally used as a means to communicate with elderly patients, but research confirms that it is commonly used by nurses when encountering individuals with physical, cognitive and communication disabilities (Kemper et al, 1998; Williams et al 2004; Melton and Shadden, 2005). Williams et al (2004) describe elderspeak as a demeaning mode of communication similar to baby talk that features exaggerated, simplified, repetitive language. Because elderspeak stereotypes elderly and disabled patients as incompetent and incapable, individual potential and progress may be ignored, thus reducing control and the sense of self even further. Reactions to Loss of Self Unsurprisingly, individuals with aphasia struggle to instigate the fight to rescue the self, and often surrender to discreditation. Charmaz (1983) explanation that self-concept depends upon reflected images of the self by others is confirmed by Simmons-Mackie and Damico (2008). This study of communication therapy sessions suggests that external negative responses to individuals with aphasia leads to internal negative perceptions of the self and a silencing of the voice. Poor nurse communication techniques based on task-orientated conversation, elderspeak and talking over compound this internalisation process. According to Ryan et als (1986) seminal literature review and subsequent theory of dependency over-accommodation, implications of incompetence and diminished capacity which arise from such condescending speech styles lower individuals confidence and self-esteem. This increases dependency and passive acceptance of care, and consequently promotes feelings of worthlessness and powe rlessness. Parr et al (2003) agree. This literature review reports that individuals faced with inadequate communication attempts of service providers, feel so diminished that they often apologise for their own existence. By reflecting on the impact of aphasia on self-actualisation needs, it seems that the nursing role in care delivery should involve supporting the individual to both recover the pre-aphasic self and connect this self to the new disabled identity. In order to achieve this, the nurse must firstly get to know the patient as a person, then secondly, empower that person to regain the creativity, confidence and freedom required to control his/her own life. Nursing Implications Use of Family Liaschenko and Fisher (1999) identify person knowledge as integral to the establishment of effective therapeutic communication and holistic care. The acquisition of this knowledge involves knowing the patients private biography with a view to revealing the unique individual. Where aphasia inhibits direct verbal interaction between nurse and patient, family and friends can relay information and re-construct much history, therefore contributing to the satisfaction of a range of fundamental human needs. According to Williams and Davis (2004), this indirect narrative is invaluable as it allows the nurse to participate in individualised communication when speaking directly to the patient. This deters any tendency for task-focused interaction or elderspeak, which in turn, reinforces the individuals sense of self. There are barriers to implementing such interaction however. Paradoxically, despite, for example, British Government calls for improved professional/patient/carer communication (Intercollegiate Stroke Working Party, 2009), some studies report that nurses efforts to personalise care by informal chat with patients and families are thwarted by sociopolitical systems that prioritise task completion over person knowledge. (McCabe, 2004; Speed and Luker, 2004). Also, Fairburns (1994) study of attitudes to visiting hours reports that nurses often feel patients and relatives resent staff presence as an intrusion upon their private time together. Perhaps the use of patient diaries can help overcome these barriers. Combes (2005) introduction of diaries in the intensive care setting demonstrates that by encouraging families to produce ongoing written narratives, which are left at the patients bedside, readily accessible relevant information concerning what is significant and individual to the patient is made available. This data can be utilised and built upon in later nurse/patient interactions. Research into the use of diaries in aphasia care should therefore be undertaken. Families are also useful when nurses are trying to ascertain the individual with aphasias immediate concerns and opinions. Goodwins (1995) well-cited case study illustrates that needs are more easily interpreted when relatives, familiar with the individuals gestures, facial expressions and idiosyncrasies, and who share common social contexts with him/her, are on hand to translate. Indeed, Finke et als (2008) systematic review finds that, where nurses are prepared to ask families for suggestions, or written directives, regarding the meanings of the individuals non-verbal strategies, communication is much more efficacious. In terms of advocacy, Hedberg et als (2008) study of multi-disciplinary care-planning meetings demonstrates that an in-depth knowledge of the individual with aphasias life and views, equips family members to act as advocates in the negotiation of care needs and future plans. The research therefore concludes that nurses require training in how best to involve relatives in the decision-making process in order to ensure individual needs remain salient. While the recommendation to involve families in the communication process is essentially sound, much of the proposing nursing literature quoted above nevertheless fails to fully explore the potential risks to patient autonomy of relying heavily on alliances with relatives. Translation literature (Englund-Dimitrova, 1997; Bradby, 2001; Leininger and McFarland, 2002) confirms that any form of interpretation via a third person amplifies the chances of misinterpretation. However, the risk is further heightened by relatives conscious or subconscious propensity to distort, omit or add to the patients messages and opinions in order to address their own concerns. Shadden et als (2008) review of autobiographical narratives reports that, while the well-being of patients is the central concern of most families, disability caused by stroke has a significant negative impact on the lives of all close family members. This may result in the interpretation of aphasic communication being influenced by the intermediarys own slanted perspectives. Thus, relatives feelings of guilt, fear, stress, and fatigue may filter out some of the true messages that the individual with aphasia is trying to express. Ryan et al (1986) offers a more cynical consequence to family advocacy by suggesting that it may undermine the individuals power to control situations, and can even disguise the sense of self by recreating and redefining elements of the individuals history, personality and wishes during the advocacy process. Hence, although it is helpful to use family knowledge to obtain patient information, nurses must recognise that individuals needs may not be adequately supplied by biased intermediaries. Nurses must therefore be able to use their own disinterested objective strategies to reach an understanding of the individual with aphasias meaning. Nursing Implications Competence Theory and research which explores the meaning of caring (Halldorsdottir and Hamrin, 1997; Brilowski and Wendler, 2005; Chang et al, 2005) states that a fundamental strategy when nursing any illness is the alleviation of the patients fear that nothing can be done to treat the condition. This literature reveals that while patients appreciate expressive caring behaviours, competence when performing instrumental therapies, is considered imperative to a secure caring base. As Halldorsdottir and Hamrin (1997) assert, caring without competence is meaningless (p.123). It is apparent that in aphasia, where preservation of the self is at stake, the nurse needs to convey competence and confidence in attitude and execution of language practice therapies, so that the individual with aphasia feels secure in the knowledge that recovery of identity is possible and in hand. Nystroms (2009) phenomenological study of interviews and biographies finds that such provision of security via nursing competence encourages patient hope, motivation, and fighting spirit (p.2509). Finke et al (2008) believes that nursing competence in language practice therapy requires training in basic speech therapy, familiarity with augmentative and alternative communication, and regular consultations with speech and language therapists. However, currently, none of these schemes are widely implemented. Hemsley et al (2001) suggests this is due to individual and organisational attitude barriers, which view specialised communication techniques as both too time-consuming and beyond the remit of nurses. Finke et al (2008), proposes that time and resources spent on enhancing nurses communication competence may prove more efficient than relying on minimal task-orientated interactions. This is because ineffective interactions are at high risk of misinterpretation, ineffective at meeting individual needs, result in frustration, fear and despondency, and may contribute to depression. Also, Nystrom (2009) finds that extended time periods required for personal care support, provide ideal opportunities for skilled practitioners to simultaneously offer language practice (thus reducing rehabilitation time and resources), while allaying patient fears. A participant in the research is quoted thus, One nurse talked to me while helping me to eat and get dressed†¦that made me feel calm and secure (pp.2507-8). Nursing Implications Quest Approach Aphasia traps individuals in the present. Struggling to express details of past achievements, individuals situations are worsened by an inability to shape the future. In effect, individuals have lost both identity, and the freedom and creativity to restore it. They have lost their place in the world. Nystrom (2009) believes that the optimal method of regaining place is to defer to individuals pre-stroke identities. An awareness of individuals previous competencies, allows the nurse to personalise language practice, communication strategies and conversation by basing subject matters on familiar contexts of family, work, interests, and achievements. This enables individuals with aphasia to grasp meanings more easily, but it also helps to maintain a sense of the old valued, accomplished self, thus providing a structure on which to base rehabilitation goals. This method, defined by Moss et al (2004) as a restitution approach, is fundamentally flawed because it overlooks the fact that for many individuals, aphasia remains a permanent disability. Preoccupation with the old self could therefore lead to a painful mourning for what is lost. It could even exacerbate feelings of worthlessness by highlighting comparisons between past abilities and present inabilities. Moss et als (2004) exploration of online illness narratives purports that a quest approach is more psychologically healthy. Here, individuals are encouraged to accept their changed circumstances, and envisage and create a different future. For the nurse, this involves using the individuals history, not as a source of goals, but a source of interests on which new modified goals can be built. This requires strong multi-disciplinary co-ordination skills to bring patient, nurse, speech therapist and occupational therapist together in order to fully explore interests, resources, potential and progress. Furthermore, according to Vickery et als (2009) quantitative analysis of self-esteem scales, the nurse must kindly but firmly guide individuals to a realisation of their limitations so that the risk of disappointment is reduced. However, simultaneously, the nurse should demonstrate motivating and commendatory attitudes that elicit a sense of pride from individuals in their gains and success es, which ultimately increases confidence, self-worth and a sense of freedom. Relationship Needs Impact of Aphasia on Relationships Berkman et als (2000) review of social integration theory demonstrates that relationships and affiliations are formidable influences on physical and psychological health. The study explains that relationships provide informational, instrumental (practical), appraisal (decision-making) and emotional support, as well as opportunities for social engagement. All these aspects are essential to the endorsement of meaningful roles, the reinforcement of participation and belonging, and the promotion of affection and pleasure. Charmaz (1983; 1999) reiterates that these factors add to the sense of self as a valuable entity. Any process or condition which leads to alienation, separation or disconnectedness from society, adversely impacts on mental well-being and mortality (figure 2). Generative studies by Durkheim (1952) and Bowlby (1991) suggest that relationships serve to buffer detrimental influences of stressful events. These texts illustrate that when consistent, reliable relationships are absent or damaged, psychological stability is weakened and the risk of depression increases. Berkmans (1988) hypothesis takes this concept further by suggesting that social isolation is itself a chronic stressor resulting in persistent heightened hypothalamic-pituitary-adrenal (HPA) axis responses which consequently accelerate physiologic aging and functional decline. Because conversation is pivotal to interaction and relationship building, aphasia inhibits individuals from exploiting the health benefits of social integration. Pound et al (2006) believe that conversation is primarily transactional, enabling individuals to participate within a supportive society consisting of mutually supportive relationships. Aphasia therefore, results in an inability to access support strategies resulting in isolation and stress. For example, appraisal support is compromised because individuals with aphasia are unable to talk problems over with friends. Likewise, informational and instrumental support may be inaccessible if individuals cannot express their opinions and needs, nor comprehend disseminated messages. While Laver (1975) acknowledges the transactional element of conversation, he also emphasises its interactional nature, which allows the development of social connections. He explains that it is a bonding ritual, which explores and categorises social position, conveys intimacy, conspiracy, affection and belonging, and as such, its loss can lead to a devastating sense of loneliness. For individuals with aphasia, whose health is already severely impaired by stroke, it is imperative that nurses are able to support the relationship-building process, and hence, diminish risks of further health problems associated with social isolation. Ramos (1992) research concludes that this is best achieved by establishing reciprocal or connected nurse-patient relationships which involve the development of emotional and cognitive bonds that persuade the individual to feel the nurse is taking on part of the burden (p.503). Reciprocation also encourages nurses to perceive coping with illness as a shared responsibility. Pound et al (2006) agree, stating that if professionals acknowledge patients are not solo performers, but part of a company of players (p.18), then this idea of joint responsibility is accentuated. However, poor therapeutic relationship development in aphasia remains a common problem. Perhaps this can be explained by Hindles (2003) suggestion that any phenomenon, which undermines nurses competence as communicators, leads to the implementation of communication filter barriers, such as rationalisation and projection. Sundin et al (2000) believe aphasia is a relationship leveller because both nurse and individual with aphasia have difficulty being understood by, and understanding, each other. This situation is uncomfortable for nurses working in a healthcare social construction that is founded upon competency achievement and proficient practice. Balandin et als research (2007) validates this idea. This small qualitative study finds that the undermining of competence and power results in rationalisation and projection in the form of defensive attitudes such as its not my job or the patient doesnt need to communicate (p.58). These avoidance tactics have been so widespread that Stock well (1972) included individuals with aphasia in her list of unpopular patients. Reactions to Diminished Relationships Charmaz (1983) research, confirmed by Davidson et als (2008) case study, reveals how unwillingness or inability of family, friends and professionals to establish effective relationships with individuals affected by aphasia leads to feelings of rejection. This in turn erodes patients perseverance to pursue support and comfort, often resulting in retreat and the seeking of solitude. Lyon (1998) refers to this behaviour as constructive because it provides a protective cocoon (p.12) in which individuals can rest and quietly contemplate their situation. Likewise, Shadden et al (2008) believe solitude-seeking is beneficial as it allows individuals to recapture the self which appears to bolster self-esteem. The authors quote from a patient interv

Employee Empowerment in Flat Organizations Essay -- Employment Custome

Employee Empowerment in Flat Organizations A flat organization is a culture of ownership and partnership, it is an organization that uses teams to increase efficiency, responsiveness and flexibility. The focus is on customer satisfaction, work is directly connected, to customer processes. Employees in a flat organization know the business, they have been delegated the power to think for the whole company. Flat organizations are giving lower management more responsibilities; they are expected to make more decisions to integral operations. Good decision-making is a balance between getting most of what we want with as little risk as possible. It means that we use the right processes that encourage participation while keeping the focus on the decisions at hand. Every organization has decisions that need to be made daily. Organizational performance is largely dependent upon the decision-making processes that a particular organization uses. Having good decision making skills allows us to make the decision with a degree of confidence and efficiency. Employees at all levels will be able to make decisions with greater confidence if they have processes. Processes provide clarity to think through the recommendation and the process to make coherent decisions. Processes improve our ability to think clearly and a company that adopts a common decision making process improves the outcome and efficiency of decisions made. A process will map out how to plan, frame and resea...