What Is Global Civil Society What Are The Compacting Perspectives On Essay

What Is Global Civil Society What Are The Compacting Perspectives On Global Civil Society - Essay Example According to Keane (2003, 54) the civil society is developing and becoming increasingly visible; though its implications to the age-old political arrangement are not quite clear. The civil society remains a complex expedition of a vague and politically disputed phenomenon. The utter heterogeneity of collections, activities, along with networks that constitute global civil culture nonprofits, trade, social pressure groups, sightseers, academics, performers, cultural recitalists, ethnic as well as linguistic associations, among many others poses the risk of making the expression an explanation of everything and naught. Keane even so insists that this expansive thunder does without a doubt function as a civilization or a ‘civilization of civilization’ having rules along with customs of conduct (Keane, 2003, 56). The author acknowledges, though, that global civil civilization is still an embryonic, open-ended community sphere whose aptitude to become more autonomous, better incorporated into authority institutions, and endowed with collective values determines its significance. Global civil society implies the cluster of civil entities across the world operating parallel to government establishment and governed by a code of conduct primarily based on the respect and the pursuit for common objectives (Kaldor et al, 2006, 43). The global aspect denotes the aspect of beyond borders whereby the organizations operate within established national boundaries. Common objectives, structure and operations acts as the basis of it’s uniformity with similar organizations in other countries is. Hence, civil society is a global movement that describes civil constituents of the same calibre spread all over the world having different titles, names and description but sharing similar characteristics, structures, ideals, concepts and practices. Civil society organizations unite in their pursuit for egalitarian ideals of freedom and emancipation. Just like democracy , the original perception of civil society was as a western conception whose sole aim was to spread western ideals in the rest of the world. In as much as such perspectives will always prevail, civil society has outlived its western connotation and translated into a global civilization movement that is well conversant with respective needs of the countries of operation. The structure and conceptual framework may remain western but the implication, scope and application is more of a global phenomenon. Background Civil society is the field external to family, the state, as well as the market in which people connect to advance universal interests. It is from time to time considered to comprise of the family in addition to the private area and then regarded to as the "third subdivision" of society, dissimilar from government as well as business (Chandler & Baker, 2005, 69). Civil society can be broadly described as the cumulative of non-governmental associations and institutions that re present interests along with will of society or entities and organizations in a civilization, which are autonomous to the government. Sometimes the expression is used in the supplementary general sagacity of "the constituents† such as autonomy of speech, a self-governing judiciary, among others that constitute a democratic culture. The expression entered civic discourse in America in the 1980s. The phrase was, however, previously developed in the 18th century, attributed to Adam Ferguson, the "founder of contemporary sociology", and applied in the designation of his thesis on

Communication in the workplace Case Study Example | Topics and Well Written Essays - 750 words

Communication in the workplace - Case Study Example Communication can be defined as information transfer to receiver from sender under the condition of transmitted message being thoroughly understood by receiver. Business communication can be internal or external but in this study internal organizational communication shall be highlighted. Communication is ever changing and dynamic. It can be categorized into transmission of verbal and non-verbal messages. Trade union is representatives of employees and they should be able to effectively communicate their issues to management. Bad communication between top management and trade union in Maestro Fits has resulted into workplace conflict. The issue started off in 15th November when management had taken decision to close internal restaurant. 30th November had been decided as the closing date. However trade union president sent a letter to top management on 28th requesting shift in the date. The reason behind this was three employees were working there on a part-time basis. Top management replied that trade union would be given responsibility of structuring a business plan for the new restaurant and forming a new worker’s group. Since business plan was not developed by trade union so worker’s group proposed an idea of donating 2 convertible marks by employees per day. A voting poll was organized by trade union where 325 employees supported the donation idea, 188 were against it and 186 employees did not cast any vote. The results were then forwarded to working group stating that trade union shall not insist restaurant formation due to less than 50% of employees in favor of the idea (Ferrante, 2010). On the other hand, top management already had taken decision regarding decrease in employee’s salaries. This decision came into existence on 10th December 2013. The major reason behind this was lack of financial support due to no new business contracts. Trade union strictly opposed this decision. This case study problem clearly reveals

Interventions Against Burnout in Mental Health Nursing

Interventions Against Burnout in Mental Health Nursing Are educational interventions effective in reducing the incidence of burnout among mental health nurses? A critical review of the literature Abstract Background There is much evidence to link burnout with mental health nursing, but limited empirical evidence that examines the impact of educational interventions on the incidence of burnout in mental health nurses. Aim The aim of this literature review was to critically evaluate the literature relating to educational interventions associated with burnout in mental health nursing using selective and comparative analysis Method The search strategy involved the use of several electronic databases, and a library search to access relevant journals. Search terms and inclusion/ exclusion criteria are identified. Evaluative criteria (Price 2003) were applied to a critical analysis of the literature. Findings There is limited empirical research in this area; some of it is predictive rather than evaluative. Conclusions Despite the paucity of information, there are some strong arguments for the use of educational interventions to reduce the incidence of burnout in mental health nurses. There are implications for further research to be carried out in this area. Background Burnout is defined as a state of emotional exhaustion, accompanied by a sense of low self- worth (Peveler et al 2000), lack of motivation and a physical as well as emotional, sense of ill- health (Malach-Pines 2005). It tends to involve an insidious process of cumulative stress (Morrisette 2002a). Burnout is most often associated with human- service (helping) professions (Ekstedt and Fagerberg 2005) and frequently, it is those who have a high level of commitment to their work, who are most at risk (van Dierendonck D et al 2005). There is much evidence within the literature that links mental health nursing with burnout ( Barling 2001; Coffey 1999; Duquette et al 1994; Edwards et al 2000; Fagin et al 1995; Happell et al 2003; Harper and Minghella 1997; Kipping 2000; Prosser et al 1999a; Onyett 1997; Wykes et al 1997). Although burnout is associated with different types of nursing (Nolan and Smojkis 2003); mental health nurses in particular, are reported to be at high risk (Nolan et al 1999; Thomsen et al 1999a). Suggested reasons for this high level of vulnerability to stress and burnout are that the profession attracts people who have a predisposition to mental health difficulties themselves (Guppy and Gutteridge 1991) and that working with people with severe mental illness is so stressful that a degree of transference can occur between the patient and health professional (particularly if the latter is inexperienced) (McLeod 1997). The stressors associated with mental health nursing are further compounded if certain factors are present, such as low self- esteem; conflicting demands of home- life, inadequate coping mechanisms (Thomsen et al 1999b) and a lack of job satisfaction, which is especially associated with hospital, rather than community nurses (Prosser et al 1999b). Many sources propose that burnout is preventable (Burnard P 1999; Figley C 2002; Jones 2003 ; Morrisette 2002b; Taormina and Law 2000). It is important therefore, to raise awareness of prevention strategies. It is possible that these could be incorporated into educational programmes and it is suggested that failure to do so can result in informally learned negative behaviours leading to maladaptive coping strategies (Thompson 2003). Aim The aim of this literature review is to critically evaluate the literature relating to educational interventions associated with burnout in mental health nursing using selective and comparative analysis. Method The search strategy involved the use of the Athens Access Management System in order to access such databases as The British Nursing Index, CINAHL, the Cochrane library, Evidence- based medicine (EBM) reviews, Embase psychiatry, internurse.com, Medline, Ovid, PsycINFO, Pubmed, ScienceDirect and TRIP database. The University library was also used in order to conduct a hand search of such relevant journals as The Journal of Psychiatric and Mental Health Nursing; The International Journal of Mental Health Nursing; Mental Health Nursing; Journal of Psychosocial Nursing and Mental Health Services, Journal of Advanced Nursing; International Journal of Nursing Studies; Nurse Researcher and Nursing Research. The search terms and keywords used were: ‘burnout’ and ‘stress’ in combination with ‘mental health nursing’; ‘mental health nurses’; ‘nurses’ ‘education’; ‘nurse education’; ‘training’ (as it was found that this word was used quite a lot within the literature) and ‘prevention’. The search process highlighted the search terms that were most effective in accessing the relevant information using trial and error; otherwise referred to as a process of screening (Fink 2005a) The inclusion criteria were: papers dating back to 1990, the rationale being that a lot of work on burnout was conducted during the 1990’s; some of it in relation to mental health nursing, which is still being cited by published authors; research articles addressing the concepts of ‘stress’ and ‘burnout’ as they relate to ‘mental health nursing’; research articles linking ‘burnout’ with ‘nursing’, ‘prevention’ and ‘education’ as there is limited specific information on educational interventions to prevent burnout in mental health nursing, therefore some transferable principles were applied. For the same reason (shortage of specific information) research articles from other countries were not excluded. Both quantitative and qualitative studies were included. Exclusion criteria were any papers published before 1990; any articles not written in the English language; any articles not specifically addressing stress and burnout and articles about stress and burnout that are not related to nursing. Evaluative criteria adapted from the framework developed by Price (2003) were broadly applied to a critical analysis of the literature. These criteria are: Do the papers address my question? Is the content accessible and comprehensible? Are the research results valid, reliable and authentic? Are there any gaps within the literature and Are there any competing perspectives/ contradictions within the literature? These criteria were supplemented by selective reference to sampling techniques used, strengths and weaknesses of the research designs, methods of data collection and analysis, ethical aspects and presentation issues (Fink 2005b). Findings A recurring theme that emerged from the literature in relation to burnout within the helping professions is the concept of emotional labour, and that education and training can help to make people more aware of this phenomenon and to develop strategies to manage it. Emotional labour is a form of dissonance when the practitioner feels under pressure not to display the emotions which are engendered by the nature of their work (Brotheridge and Grandey 2002). There are two levels of emotional labour; surface or deep acting (Ashkanasy et al 2006). Surface acting is when the practitioner adopts a behaviour that belies their true emotions whereas deep acting is when they struggle to feel the emotion that is expected of them. Mann and Cowburn (2005) conducted a study that aimed to increase understanding about the links between components of emotional labour and stress in mental health nursing. 35 mental health nurses completed questionnaires which yielded information relating to 122 nurse- patient interactions. Three different published research instruments were integrated into the questionnaire; the Emotional Labour Scale, the Emotional Labour Inventory (both of which related more directly to nurse- patient interactions) and the Daily Stress inventory which addressed more general areas of stress. The use of tried- and- tested research instruments helps to ensure validity and reliability of the findings. Published research tools have often been refined several times, with the need to have excellent reliability and validity (Giles 2002). The data was analysed by using Pearsons correlations and multiple regression techniques. The researchers concluded that emotional labour is positively correlated with both the stress that arises from interactions with patients, as well as other sources of stress; that the impact of emotional labour is dependent upon the intensity of the interaction and the range of emotions experienced throughout the interaction, and that surface acting is a more important predictor of emotional labour than deep acting. Only one psychiatric unit was involved in the study with a relatively low response rate of 29%; low response rates can introduce bias and uncertainty into a study (Smeeth 2002). What constitutes a satisfactory response rate varies according to the nature of the research, however a 60% response rate might be considered to be ‘good’, and a 50% response rate to be adequate (Sim and Wright 2000); although many researchers accept that any response rate over 40% can yield meaningful results. The authors acknowledge that generalisability of the results is limited. Interestingly it was the non- cooperation of the unit in general that adversely af fected the response rate because of a lack of flexibility regarding access to respondents which influenced the methodology, in that it was not possible to obtain qualitative data relating to the lived experiences of mental health nurses in relation to emotional labour which might have been more meaningful, and an unwillingness to allow the researchers to follow- up non- responders. There is an implication here for nurses to become more research aware and for healthcare organisations to promote and support research- mindedness. The discussion and conclusion are interesting and relevant to the link between education and burnout in relation to mental health nursing. While acknowledging the limitations of the study, the authors do however stress that the findings have important implications for nurse education in that skills training for performing emotional work should be given a higher priority; that an increased focus be placed on facilitating self- awareness skills to enable mental health nurses to become more introspective about their feelings, so that they can develop effective techniques for dealing with them. However this study does not have the scope to be able to empirically demonstrate that educational interventions are effective in preventing burnout. The value of developing new educational strategies in relation to addressing emotional labour (in addition to other issues) for student mental health nurses was more clearly demonstrated by Turner et al (2004). The purpose of the study was to evaluate a pilot client attachment scheme for student mental health nurses. The rationale for client attachment is that it enables students to form therapeutic relationships with individual clients. This type of educational experience differs from the more traditional route of progressing through different placements. The methodology involved the use of semi- structured interviews to gain the perspectives of students (12), their supervisors (22) and clients (2). Although this is a small sample, the design was qualitative and a depth of meaningful information was obtainable, particularly from the students and the supervisors. The data was organised using thematic analysis, although this was not possible with the client data as there were only two clients and although they gave very positive feedback, the amount of information was very limited. Service user involvement in mental health research is a relatively new and developing concept (Telford and Faulkner 2004). This study is relevant to the discussion because it highlighted that different educational approaches can more effectively promote reflective skills among mental health nurses, which in turn can provide a tool for dealing with emotional labour. The researcher’s literature review revealed that many mental health student nurses report sources of stress as including not feeling part of a team, and dealing with distressing incidents involving clients. These factors lead to emotional containment, causing reduced motivation and increased stress. The client attachment scheme goes some way to addressing these issues by providing more continuity and increased supervision for mental health student nurses. Although the scope and generalisability of this study is limit ed, it flags up important indicators for changes to be made to the student nurse curriculum that will provide students with the skills to recognise and deal with, emotional labour, which should impact upon more effective stress management and prevention of burnout. Another study which concludes that changes should be made to the mental health student nurse curriculum in relation to stress management was conducted by Kilfedder et al (2001). They contend that previous studies on burnout in nursing contain several methodological inadequacies, and so set out to design a more theoretical study. The study sample was drawn from nurses employed in a Scottish National Health Service (NHS) Trust which provided both acute and continuing care mental health services in both hospital and community settings. 510 nurses returned questionnaires (a response rate of 48.8%). A total of 12 published measures were used, together with one purpose- designed measure which related to non- occupational stressors. The others related to such aspects as social support, occupational stress, burnout and coping strategies. As previously highlighted, the use of published measures can enhance reliability and validity. A range of statistical tests were used to analyse the data. H igh levels of emotional exhaustion, depersonalisation and burnout were reported and low levels of personal accomplishment. The researchers concluded that not only should a core part of the nursing curriculum be devoted to stress management and coping skills, but also that management training should incorporate leadership skills that facilitate stress management and that all nurses should be provided with training that equips them to develop coping mechanisms. Education is very much seen by the researchers as an essential part of a comprehensive approach to prevention, which should be emphasised more than the current tendency towards ‘picking up the pieces’ after the event. This study is quite complex which tends to affect its accessibility, however its findings have important implications for stress management in mental health nurses. Sharkey and Sharples (2003) evaluated a learning pack on risk management, developed for use with clinical mental health teams with emphasis on the impact the pack had on team members’ stress. The learning pack was made up of six sections, each one corresponding with a facilitator- led workshop. Participants were expected to carry out some reading and learning activities between workshops. Interestingly the authors identify two aspects of risk management that are potential stressors; the potential risks of the job such as dealing with violence and having to get to grips with the concept of risk management as a relatively new concept, and the systems involved. The researchers adopted a quasi- experimental approach, using pre and post measures, taken eight weeks before and after the learning intervention, in order to be able to measure any change in relation to work- related stress among the participants, as a result of following the educational programme. The researchers highlig hted difficulties with not being able to conduct a controlled experiment which might have affected the outcome, as it was not possible to be certain that any change was attributable to the educational intervention, as opposed to other factors. Sampling was self- selective which might also have affected the findings, as having volunteered; the participants indicated a level of motivation which could have impacted on the effectiveness of the learning programme. The sample (42) was drawn from two mental health locality teams, which included mental health nurses. The pre and post measures used were the Occupational Stress Indicator and the Healthcare- related Work Pressure Scale. Again, these are tried and tested published instruments, the use of which should contribute to the validity and reliability of the findings. These yield quantitative data which was analysed using descriptive statistics, the paired t -test and the Wilcoxon signed rank test. Once again, it might have been of valu e to combine qualitative with quantitative measures, in order to gain an understanding of the participants’ experience of stress; qualitative methods allow researchers to overcome the assumptions inherent in fixed- choice questionnaires, although these also have their value for example, in relation to information about prevalence (Cummings and Galambos 2004). All 42 participants completed the pre measures( although only 32 started the programme and 27 completed it) together with the post measures. It would have been interesting to identify why almost half of the original sample did not complete the programme; whether workload and/ or stress issues contributed to this level of attrition. However it was suggested that quite intensive time commitment was required to complete the programme which might have been an inhibitory factor and there could be implications for redesigning the programme so that it can be accessed more flexibly by participants. Responses were not broken down into professional groups- this also might have yielded some important differences. In relation to the Occupational Stress Indicator, comparing pre and post scores indicated that there was a general decrease in many sources of stress. Interestingly lower means at post measures were observed for the ‘job satisfaction’ subscale which indicated reduced satisfaction. The researchers suggest that this could be due to increased knowledge and expectations as a result of the learning intervention; whether this development could be a source of stress in itself is not speculated upon even though different studies have reported a relationship between stress and reduced job satisfaction (Koslowsky 1998). Scores for the Healthcare- related work pressure scale all show a lowering of item means at post measure. Overall the researchers concluded that the learning intervention brought about positive changes in relation to the work- related stress of the participants; in some cases the i mpact was significant. It is suggested that the ways in which educational interventions can bring about change is by enabling participants to gain knowledge and skills within the ‘safe’ environment of the classroom. A positive outcome of this study is that the learning pack has been modified, following feedback from the pre and post measures together with evaluations from the participants, and is now in use. Ewers et al (2002) evaluated the effect of Psychosocial Intervention Training (PSI), using a controlled experiment, in reducing burnout rates in mental health nurses working in secure units, having identified that this group is particularly at risk of developing clinical burnout syndrome. The hypothesis was that if nurses gained a better understanding of clients’ illnesses and develop more skills to be able to help clients, then they would experience lower levels of burnout within their clinical roles. A self- selecting sample of 20 volunteered to do the PSI course, but these met pre- set inclusion criteria and represented all grades of staff and all wards. 10 subjects were allocated to the experimental PSI group and 10 to the waiting list control group. Baseline measures of knowledge were taken, using a 30- item multiple choice questionnaire which had been used in previous studies; of attitudes, using a measure developed by one of the researchers and of burnout, using the Mas lach Burnout Inventory. It was not clarified whether the attitude measure had been tested for reliability and validity, whereas the other two measures are tried and tested. The experimental group received 20 days of PSI training. On completion of the course all subjects were asked to complete the measure of knowledge, attitudes and burnout. The facilitator had previously received advanced training in PSIs. The course includes both practical and theoretical assessment components and a minimum attendance of 80% was required. The data was analysed using Fisher Exact tests and t tests. The results showed that there was a significant difference in the knowledge scores for each group, with an increase in the knowledge of the experimental group. The same applied to the measurement of attitudes, which it is assumed (although not made clear by the authors) refers to an increase in positive attitudes for the experimental group. Again, the same applied to the burnout measure; this time the res ults are expressed more clearly in that the experimental group had moved in a positive direction along the subscales measured by the Maslach Burnout Inventory. The limitations of this study are that the results might not be generalisable to other units; as only one unit was involved in the study wherein specific factors might exist that contribute to the development of burnout. As with the previous study, the self- selecting nature of the participants might indicate that they were more highly motivated and more responsive to change. However, while acknowledging the methodological weaknesses, the researchers conclude that the significantly positive changes in knowledge, attitudes and burnout measures of participants within the experimental group are indicative of the value of educational interventions in reducing the incidence of burnout among mental health nurses working within secure units. Ho (2007) describes a study which explored the value and meaning of a psychodynamic work discussion for mental health nurses, which is described as a method of working, learning and development in professional practice. A work discussion group can enable psychological and emotional containment for mental health nurses which can impact upon the prevention of burnout. While the work discussion group is a means of learning in itself, education about the psychodynamic processes involved is also necessary in order to unlock the potential of the group. A qualitative design was used in order to be able to explore the feelings, experiences and perceptions of the participants, which seems highly appropriate within a study of this kind. Data was collected from a focus group of 6 mental health nurses ranging from staff nurse to ward manager level. This is quite a small sample, however this is often more acceptable within qualitative research as depth rather than breadth of information is being sought. It is generally considered that the ideal composition of a focus group is between 6-12 people, however when the nature of the subject could be emotionally charged or sensitive, it is preferable to limit the size of the group to 5 or 6 (Polit and Beck 2004). The data was analysed using Bulmer’s framework, a technique derived from grounded theory in order to define meaning through focus groups. This article is quite complex but comprehension has been facilitated by the presentation, in tables and boxes, of the categories and themes within which the discussion was structured. The purpose of the focus group (which was not immediately made clear) was not to act as a work discussion group but to explore the potential for its value with mental health nurses, and the group appeared to be generally responsive to the concept. The author concludes that mental health nurses could benefit from this approach, but would need encouragement and education and that the use of the work d iscussion group could be integrated into nurse education. The researcher acknowledges that the potential use of this approach needs to be explored further, with larger samples from a wider area. Lee (2005) evaluated the effectiveness of a stress management training intervention for care assistants working in a residential home for the elderly; many of whom had dementia, having cited research which links caring for people with dementia with work- related stress. The study took place within one residential home. The training consisted of a three- day programme that aimed to create and maintain an effective work environment by managing stress and stressful situations. The researcher provides an outline of the course content but does not state how many participants there were or how she measured the effectiveness of the programme, despite including sections headed ‘methods’ and ‘findings’. She reports that the stress management training reduced the care assistants’ levels of stress and improved their ability to cope with potentially stressful situations. She also concluded that the age or experience of the care assistants did not have an impact o n their stress levels or coping ability, which did not concur with the findings of a different study. This is a poorly written research article; the lack of detail reduces its value. However given the paucity of research related to educational interventions for mental health workers, it still adds to the existing body of knowledge. An interesting development is that the researcher subsequently contacted 21 residential homes and found that only 3 provided training interventions related to stress management. Conclusions An extensive review of the literature has revealed that there are gaps in the literature relating to educational interventions to reduce the incidence of burnout in mental health nurses; this finding is supported in a review by Edwards and Burnard (2003), who concluded that while there is evidence that stress is a problem for mental health nurses, research on interventions to address this, is insufficient. Many articles on this subject are literature reviews, drawing on broad- based research in related areas, with a definite lack of empirical studies, and these reviews have not been included here. It has been necessary to include studies which predict that educational interventions will reduce the incidence of burnout in mental health nurses as well as those which evaluate existing interventions (which are very few). There are implications for further research into this important area. However there are some interesting and valuable conclusions that can be drawn from the existing lit erature. A synthesis of this review of the literature yields the following outcomes: There is a link between emotional labour and burnout, and adopting strategies (including educational) to enable mental health nurses to recognise and deal with emotional labour (including self- awareness and reflective skills) should impact upon the prevention of burnout. Educational interventions aimed at reducing the incidence of burnout should take place both within pre registration programmes and as part of continuing professional development (CPD). Educational interventions are an important part of a comprehensive strategy to reduce the incidence of burnout among mental health nurses. As well as focussing on stress management, educational interventions can also be used to enhance knowledge and skills (relating to for example, risk management and helping skills) which in turn, positively impact upon stress levels and coping skills. A range of educational approaches should be explored in relation to stress management, allowing for innovation and flexibility, to facilitate access for mental health nurses, who may feel inhibited by such factors as shift patterns, workload or lack of resources References Ashkanasy N, Zerbe W and Hartel E. Emotions in the Work Place: Research, Theory, and Practice. Quorum/ Greenwood. 2000. p. 16 Barling J. Drowning not waving: burnout and mental health nursing. Contemporary Nurse. 11(2-3) 2001 pp. 247-59. Brotheridge C and Grandey Emotional Labour and Burnout: comparing two perspectives of ‘people work’. Journal of Vocational Behaviour. 60 pp. 17-39. Burnard P Practical counselling and helping. Routledge. 1999. p. 115 Coffey M . Stress and burnout in forensic community mental health nurses: an investigation of its causes and effects. Journal of Psychiatric and Mental Health Nursing 6(6) 1999. p. 433 Cummings S and Galambos C. Diversity and Aging in the Social Environment. Haworth press. 2004. p. 157. Duquette A, Kerouac S, Sandhu BK, Beaudet L. Factors related to nursing burnout: a review of empirical knowledge. Issues in Mental Health Nursing. 15(4) 1994 pp.337-58. Ewers P, Bradshaw T, McGovern J and Ewers B. Does training in psychosocial interventions reduce burnout rates in forensic nurses? Journal of Advanced Nursing 2002 37(5) pp. 470-476. Malach-Pines A. The Burnout Measure, Short Version. International Journal of Stress Management. Volume 12(1) 2005. pp. 78-88 Mann S and Cowburn J. Emotional labour and stress within mental health nursing. Journal of Psychiatric Mental Health Nursing. 12(2) 2000 pp.154-162, Nolan P, Dallender J, Soares J, Thomsen S and Arnetz B. Violence in mental health care: the experiences of mental health nurses and psychiatrists. Journal of Advanced Nursing 30(4) 1999. p. 934 Nolan P and Smojkis M. The mental health of Nurses in the UK. Advances in Psychiatric Treatment. 9. 2003. pp. 374-379. Prosser D, Johnson S, Kuipers E, Dunn G, Szmukler G, Reid Y, Bebbington P and Thornicroft G Mental health, burnout and job satisfaction in a longitudinal study of mental health staff. Social Psychiatry and Psychiatric Epidemiology. 34 (6). 1999. pp. 295-300. Sharkey S and Sharples A. The impact on work-related stress of mental health teams following team-based learning on clinical risk management. Journal of Psychiatric Mental Health Nursing. 2003 10(1) pp. 73-81 Sim J and Wright C. Research in Health Care: Concepts, Designs and Methods. Nelson Thornes 2000. p. 359. Smeeth L. Improving the response rates to questionnaires. BMJ 324 2002 pp. 1168-1169 Taormina R and Law C. Approaches to preventing burnout: the effects of personal stress management and organizational socialization. Journal of Nursing Management 8(2) 2000, pp. 89-99 Telford R and Faulkner A. Learning about service user involvement in mental health research. Journal of Mental Health. 13(6) pp. 549- 559. Thompson T. Handbook of health communication. Lawrence Erlbaum Associates. 2003. p. 356. Thomsen S, Soares, J, Nolan P, Dallender J and Arnetz B. Feelings of Professional Fulfilment and Exhaustion in Mental Health Personnel: The Importance of Organisational and Individual Factors. Psychotherapy and Psychosomatics 68 1999 pp.157-164 Turner L, Callaghan P, Eales S and Park A. Evaluating the introduction of a pilot clien

A Mind Full, a World Shattered :: Personal Narrative Writing

A Mind Full, a World Shattered At the end of a long road one will look back and ponder the experiences that time has moved along the path. There is no doubt I am leaving high-school a different person and I doubt there are few ideas that I once held that have remained the same. At times I miss the simple lessons, the easy test, the mindless homework assignments. I wasn't sure what I expected in high-school, but I am leaving with a mind full, and at times, a world shattered. I'm not sure education meant much to me when I began this path. Perhaps it meant a little more when I had to work for the knowledge I chose to keep or dismiss. I have come to realize that high-school was no more than life lessons, ways to cope, how to deal with people, and a way to test my boundaries mentally and emotionally. It took me awhile to realize that those test given prove nothing, those papers written in structured form prove little else than the thesis statement on the paper topic demanded by teachers. As I look back I can say I will take this with me: Understanding who I am is understanding what I have learned, what I have failed at, what I have questioned, and what I believe. I have learned to distrust words but adore their depth. I have learned to follow directions and to break the rules. I have learned that teachers are just people, with their own minds and beliefs that, in some way, have infiltrated the class room and what I have been taught. At times this has been a tremendous gift, other times a great tragedy. I have learned that a brilliant person is not one who can memorize facts or maintain a high GPA. I have learned grades do not reflect who I am and my abilities. Grades are only maintained to because people are afraid to just "be" and just "learn." I have realized that grades and competition may be the system used to induce hard work and dedication, but I also know that there are better ways because the system fails on a moment to moment basis. I have realized the most important people of this world are not those walking around with the most money or graduating from the best high-schools.

Rebuttal on Mark Twain’s the World Is Not Civilized Essay

Mark Twain says that the human race I cruel, and uncivilized. Unlike the animals, humans have the ability to care for those who are weak, sick, and otherwise unfortunate. In the wild if an animal is sick or weak, they are abandoned by their own species and are, ultimately, a source of food for another. The wounded are killed without a hesitation. Man has compassion, not only for our species but for the others. There are many organizations that are created to help people in need. There is the Red Cross that steps in during an emergency to provide shelter, blood and food to those who need it. There are homeless shelters that take in the homeless to shelter them from the elements. There are soup-kitchens that feed the homeless. There are children’s homes that provide a safe place for orphaned or abandoned children to grow up. There is Breast Cancer Awareness, AIDS foundations, and a society to end world hunger. All of these organizations are founded to help someone or something that is in need. Twain says â€Å"I was aware that many men who have accumulated more millions of money than they can ever use have shown a rabid hunger for more, and have not scrupled to cheat the ignorant and the helpless out of their poor servings in order to partially appease that appetite†. Even though it may be true that rich men want to get richer, the wealthy people are the ones that are most charitable. Bill Gates and Warren Buffett, two of the richest men in America, give millions of dollars annually to various foundations and charities that help people all over the world Man also helps the animals. There are many organizations that help animals and the planet. Some of those include PETA and Green Peace. We even try to help the earth. New inventions are being created just to help the earth. They start business just to keep specific animals from going extinct. We share and support other countries. When the hurricane in Haiti happened people helped. Resources were given because of the generosity of man. When countries are in need they are helped. When the flood came to Tennessee the people gave some time for community service. Some people that didn’t get hit by the flood could have done nothing but they decided to help others. Man created governments to stop the fighting. Laws were created in order to have a calm and safe environment. Man Negotiates to prevent wars and battles from happening. We also come up with compromise and treaties in order to get peace. For example the Treaty of Versailles was ratified after negotiating and finally coming to a compromise. We don’t just go ahead and fight who ever walk across our territories like the lions.

Donald Trump’s Presidency

Donald Trump's presidency has brought a lot of controversy with it. His constant tweeting, his blunt statements, and his act-now-think-later mentality have earned him both praise and criticism since the moment he announced he would run for United States President. One act that has stirred up a lot of mixed emotions is President Trump's announcement of a ban that would prevent transgender individuals from serving in the military. This ban, which was first announced via President Trump's twitter account in late July, will override an Obama-era plan that was previously in place specifically to allow transgender individuals to serve in the military (Davis, 2017). Perhaps what is the most frustrating development of this ban for many people is the fact that it was revealed shortly after President Trump declared his great respect for members of the LGBT community and intentions to protect their individual rights and freedoms during his presidential campaign. While many have cited discrimination as the reason behind this act, President Trump and his staff have ensured the public that this ban is purely for national security reasons, and he wanted to assure the LGBT community that this is not a betrayal (Cooper, 2017). This ban has been a hotly debated topic for quite a while. While both the Trump administration, supporters of the ban, and those opposed to the ban all have valid arguments, anyone who is willing to fight and die for his or her country and its freedoms should have the opportunity to do so. This statement holds especially true for Americans because the United States was founded on this very principle. While the military shouldn't pay for gender reassignment surgeries and treatments, recruitment options should be open to all Americans, including transgender individuals. There are many reasons why this is acceptable, including the fact that transgender people are already serving in the military, transgender individuals provide little to no disruption of military activities, and the transgender ban is currently being scrutinized in court for its constitutionality. Taking all of this into consideration, it's hard to see a reason why transgender individuals shouldn't be allowed to fight for the freedom our country provides. It's difficult to argue that transgender individuals shouldn't be allowed in the military simply because there are already transgender people serving in the military today. In fact, as of 2016, there are an estimated 6,630 actively serving transgender individuals in the military and anywhere from 2,030 to 7,160 individuals serving in reserves. Along with these numbers, an estimated 150,000 transgender individuals have served since the year 2012, which is about 21% of all transgender adults in the United States according to UCLA researchers. In contrast, only 10% of the general non-transgender population has served (Hamblin, 2017). The fact that a higher percentage of transgender individuals has served in the United States military compared to those who do not identify as transgender should serve as an eye-opener to many. After all, active military service poses many risks, especially during times of conflict or war. In fact, several American and British armed forces members in Afghanistan were asked about the threats that they faced. The statistics, which are represented by the above image, are quite shocking. Roughly half of all individuals interviewed said that they saw at least one person killed while actively serving. One in every six people witnessed a close friend being injured or killed. One in four were injured by an IED, three in four experienced long-range attacks with rockets or mortars, and half had been attacked at close range with machine guns (Gee, 2017). The point of these statistics is that serving in the United States military can be dangerous, and if such a high percentage of transgender adults are willing to serve in the United States military and risk injury, they shouldn't be denied the ability to do so. The decision to serve in the United States Military should be respected regardless of any drama created by gender. Along with the fact that transgender Americans have already proved that they are willing to make the same sacrifices as their military comrades, a large majority of transgender individuals cause little to no disruption of military activity while serving. In fact, as far as disruption of military activity is concerned, transgender individuals who could possibly be disrupting military activity by getting reassignment surgery account for less than 1% of all available members. The actual number of all individuals estimated to have surgical treatments while actively serving was between 25 and 130 individuals – hardly enough to cause any meaningful hindrance to military activities (PBS, 2017). In regards to this same issue of military disruption, eighteen other countries were examined in a study to determine if transgender service members cause any noticeable problems. Overall, the study â€Å"didn't find any readiness or cohesion implications† involving transgender individuals. Many countries revealed concerns about bullying issues at one point, but it was later determined that simple policy changes were able to deal with this issue (PBS, 2017). If other countries are able to work around the minor ‘difficulties' that transgender individuals may pose, then why can't the United States as well? Surely if this situation is able to work for other countries, it can for Americans as well. Along with this information, President Trump's proposed ban has received legal criticism as well. There are concerns that this ban would violate the Constitutional rights of those individuals affected by the ban. One example of the legal obstacles that this ban has faced occurred in August of 2017. Two gay rights groups filed a lawsuit to ‘ban' the ban before it could be instated. This lawsuit was filed on behalf of five transgender women who are openly and actively serving in the military, for they feel strongly that this ban would violate their constitutional rights (Cooper, 2017). Although the lawsuit itself wasn't the cause, the individuals who filed the suit earned at least a temporary victory in late October, for the ban was temporarily blocked in court by a federal judge (Kheel, 2017). This same judge responsible for the blockage was quoted saying that the ban â€Å"does not appear to be supported by any facts.† Along with this, another federal judge reviewed this ban in court and halted the ban altogether (Marimow, 2017). He stated that active-duty transgender service men and women already suffer harmful consequences because of the president's policy. Some examples of said consequences include being set apart as inherently unfit, facing the threat of discharge, the inability to move ahead with long-term medical plans, and the inability to commission as an officer.Due to these two federal court rulings, it is clear that there is much to be concerned about regarding the legality of the ban. A third court case was carried out with the National Center for Lesbian Rights (NLCR) and the GLBTQ Legal Advocates ; Defenders (GLAD) as the plaintiffs. They argued that the ban violates the Fifth Amendment rights of all transgender service members, and they pushed for the removal of the ban on funds for gender reassignment surgery (which accompanied the transgender ban). Judge Colleen Kollar-Kotelly presided over the court. After the case ended, she wrote a 76-page memo emphasizing the fact that the plaintiffs' Fifth Amendment claim is a strong one that will prove difficult to refute once it reaches the Supreme Court. The fact that this ban has been heavily criticized, and in some cases acted upon, by not one, not two, but three highly-esteemed judges only serves to prove that this ban is in violation of the Fifth Amendment and is highly discriminatory against transgender individuals who are only trying to serve their country. This ban has only encountered setback after setback in court, yet the Secretary of Defense is still being pressured to produce a plan for both carrying out the ban and dealing with currently enlisted transgender individuals. Although President Trump is still pushing for action to be taken, the ban is still being processed through the courts as an appeal is being sought after due to the decisions made from past cases (Lopez, 2017). Although there are many ‘arguments' out there that support the idea of a United States Military with a transgender ban, they lack substantial evidence, and the evidence that is presented is far from accurate in most cases. President Trump's two main reasons for the ban, disruption of military service and health and medical costs, are easily discredited when all of the facts are lined out.In regards to ‘disruption of services,' it's clear to see why this isn't a legitimate issue for the United States Military. First of all, there is roughly, on estimate, a total of 13,500 transgender individuals serving actively, in the reserves, or in the National Guard. Of these 13,500 transgender individuals, only an estimated 25-130 active members will ever undergo long-term surgical treatments that would cause disruption while serving. These numbers, compared with the estimated 1,281,900 total of all active service member, along with the 801,200 estimated to be in reserve, account for far less than even one percent of the military's total service members (PBS, 2017). So, assuming that the highest estimate of 130 military members undergo surgical treatment while serving, an extremely insignificant fraction of all military members would be incapable of carrying out military duties while recovering. This accounts for .0015% of all available ‘manpower' at any given time for the military (PBS, 2017). That percentage is hardly worthy of being referred to as a ‘disruption.' The second main ‘reason' behind this ban is the potential costs. The President and his staff worry that the medical treatments and surgeries that transgender individuals require is an expensive and unnecessary cost to the United States Military budget. While gender reassignments and other surgeries are certainly expensive, as stated in the previous paragraph, only about 25-130 individuals will even have the operation done (PBS, 2017), and the military has historically not been required to pay for these surgeries unless they are proven medically necessary on a case-by-case basis. Along with this information, a study in The New England Journal of Medicine in 2015 found that the total costs for these surgeries and treatments would amount to somewhere between 4.2-5.6 million dollars, or roughly ten percent of the annual military healthcare budget. For those that think this is a large amount of money, the annual amount of taxpayer dollars spent on medication for erectile dysfunction alone is over ten times this amount at 84 million dollars annually. Claiming that transgender medical costs are expensive and unnecessary is plain wrong. While not all treatments are medically ‘necessary,' several treatments are. Denying transgender individuals from serving in the military due to medical costs would be the equivalent of denying a diabetic the ability to serve; it makes no sense. President Trump has made a lot of changes since he was elected into Presidency. While his decisions usually at least make some sense, the transgender military ban makes no sense at all. His two main reasons for this ban, which were potential disruption of military activity and medical costs, are backed by little to no evidence, and his ban is coming across as discriminatory both in the public eye and in court so far. Transgender individuals should not be denied the right to serve because they have been allowed to serve (not openly) for several years with little to no problem, they don't cause any disruption or hindrance to military activity, and the ban itself is being reviewed for its potential violation of the Fifth Amendment and discrimination against transgender individuals. All of this effort for a ban that isn't necessary should be spent on something more useful to America.