Professional Boundaries in Nursing

Professional Boundaries in Nursing The scope of work of Assistant Medical Officer is very clearly governed by the Board of Medical Assistants which was comes under the preview formed under Malaysian Medical Assistant Act (Act 180), AMO takes the oath of Medical Assistant Code of conduct which serves as an ethical guide map to morally binds steer AMO to its rules and responsibilities. It is therefore the responsibility and morale duty of every Assistant Medical Officer to uphold the medical ethics with professionalism and honor. At no other circumstances AMO are allowed to carry out other work outside the specified prescribed boundaries. However in reality AMO in my clinical set up does lots of duties actually falls under the scope of other professional such as doctor, psychology counselor and dietitian. While it feels good that as an AMO, we can perform many works normally done by other professions however it is not without possible legal implications. Boundaries are an imaginary line that separates the duties of a pa rticular professional from the others. Boundary is the ability to know where one ends and where another person begins. Professional boundaries are important because they define the limits and responsibilities of the professional with whom we interact in the workplace. When workplace boundaries are clearly defined, the organization can function more efficiently because redundant work assignments are eliminated.improve this rational it is because health professional have specilised skills and high quality pt care is a collaboration of skills the optimum benefit of the pt outcome. When everyone in an organization is made aware who is responsible for what, healthier workplace environments are created. Crossing borders No professionalism by AMO No collective power Criss crossing of professional boundaries is the norms of today s chores especially working in Haemodialysis Centre .AMO in Haemodialysis Centre especially in my state is working under a great stress. duress and precarious role. Currently, AMo provide care for 000 dialysis care pt over 19 centre through the state requiring close mentoring and care. In Haemodialysis lots of duties specify critical procedures e.g performed by AMO are not legally sanctioned covered under MA act. These porecedures are carried out on the instructions of Renal specialist who by hirechrichal position of power who acts like Kings control the strings where AMO forced to puppet without questions. Being in this precarious position, AMO professional are extremely vulnerable, as if everything goes well, we will get just get condescending a pat at the back, but when something goes wrong support strings are quickly cut and one get ostracized for breach of professional boundaries. Officers nowadays in Haemodilysis centres are not only to ensure that patients comes for three times dialysis treatment, patients gets adequate dialysis treatment but also to carry out mentorship, the staff as a mentor and the patients as the mentee. Through this the Renal doctors expects nurses and AMO to functions as mini-doctors, i.e the mentor are to know the day to day medical conditions, nutritional conditions, medications and blood parameters of their patients. They are expected to know how to make adjustment to tritrate patients medications and dialysis treatment and also to make referral to renal specialist when necessary as there is no. The ironiny is there is no Renal specialist /doctors through the 18 other rural regionla dialysis centres but a total 12 specilaist conviently stationed in urban hospital in the state`s city. Failure of the mentor to make proper mentorship and care of their patients, the mentor will be scolded admonlished by the doctors and if the mentor dis agree question their role with this ruling, they will be asked to leave of the Haemodialysis Centre. Thus a profession dictated by others without voice of empowerment over a long term cannot mature professionally (RRRRR) and it is for this reason that I have chosen this topic to explore and expose the various flaw, the impact and the possible remedy to our health care system. Lain lain u buat sendirilah Nowadays the public or consumers are more knowledgeable, educated and know their rights, medical knowledge can now be easily accessed right at the comforts of their home via internet and as a results any wrong practices will be subject the AMO and nurses to litigations. It is therefore no surprising that patients are more knowledgeable, than the nurses. As a result they have a higher expectation to receive a good quality of health care and thus push the AMO and Nurses to a stressful situation. Although the AMO and Nurses are capable performing the job but with thoughts of professionalism hanging on their heads they feel that patients are not getting the best professional treatment. Though AMO tried everything possible in order to meet the demand of the patient, but sometime patient are not satisfied as they prefer doctors to AMO/Nurses in terms of prescribing medications and blood test and hence AMO and nurses continue to be yelled. (Vondras et al, 2004).These things make the AMO fee l uneasy as at one point they want to be obedient subordinates but at the same time feel that unprofessionalism is practice. And so the AMO/Nurses works about like headless chicken doing their work without much thinking. I feel that Innocent Nurses and AMO are the most vulnerable groups in the medical professions as they can be force by their superior to carry out jobs which is not in their list of jobs descriptions .However in the last line of the list of jobs descriptions, it states that, to carry out orders or instructions as ordered by a higher authority from time to time . I personally feel that this statement has been long abused by higher authorities such as doctors as this controversial statement is deemed to be a license for doctors and higher authorities to compel the nurses and Assistant Medical Officer to carry out clinical or non clinical activities. Somehow the order of carrying out a mini-doctors job which is a vertical substitution with controversial permissions, are reluctantly carried out by the Nurses and AMO because of the unavailability of Renal specialized doctors and moreover if they dont do the job then the patient will suffer and may even cost the patient life. The mentors wh ich is working under stressed however carry out their jobs minus their heart and with frustrations and they may eventually burnt out, Curci, Linda. (2004) Therefore the Associations of Dialysis for Medical Assistant and Nurses (ADMAN) must stand up and issue a strong collective voice to protects the AMO/Nurses from this continuous exploitations. .However the more important questions is, are the nurses or AMO adequately protected from the law when carrying out certain task which may be a risky procedure and may have a medico-legal implications? The Medical Assistant Board has underline codes of Ethics and professional conduct of AMO which must be observed by all Assistant Medical Officer As not all AMO task are specified, I wonder if the ministry of health will go all the way to protect her staff in the case of law suits. The experience faced by AMO and Nurses is therefore akin to force labor. This abuse is therefore professionally wrong as it lays the major platform of destroying the medical support industry. As a protective strategy in the medical profession, doctors have given the nurses low regard therefore making them to have low self esteem towards their profession and assume subordinate perspectives (Fritz, 2008, p. 82) However jobs which are not listed in the main AMO jobs descriptions are Credentialed and privileged. It is therefore important that all terms and conditions of the process of credentialing and privileging must be observed and documented in order to comply the requirement of credentialing and privileging. How To Document on Credentialing and Privileging Applications. Available at : http://www.ashp.org/s_ashp/docs/files/SCSS_HowtoCredPrivdoc.pdf accessed 30 September 2010 . While credentialing is the process of obtaining, verifying and assessing the qualifications of a healthcare practitioner and to provide patient care services privileging is the process used to identify, document, and approve the specific procedures and treatments that may be performed in a specific setting. Privileges are granted based on the findings of the credentialing function and should only be granted for services that are currently offered by the hospital. Available at : http://knol.google.com/k/kathy-matzka/credentialing-and-privileging/3ep8m4hgro5l7/1# accessed 30 September 2010. The noble mission of ministry of health Malaysia is to lead and inspire through excellence in medical device regulatory system., to influence change and forge partnership that ensure public health and safety, to ensure that only high quality, effective and safe medical devices are available in Malaysia, to encourage and support the innovation and development of technology in medical device industry.( Medical Device Bureau Ministry of Health, Malaysia ). And in Nursing, professional boundaries simply means to establish the immediate legislations and requirements that differentiate the nurses and doctors scope of works (Ruth Constance ,2008, p. 39). Nursing profession is born out of ethics and desire to ensure that high levels of purity and integrity of life is observed (Barbara Lynn, 2008, p. 109). When there is lack of clear definition of specific boundaries in terms of specialization, the doctors are considered to have more impact in treatment of the patients than the nurses (Anne, 2008, p. 277). Nurses are not allowed to challenge any of the surgeons decisions but just to follow instructions as the surgeons finish the patients operations within short periods and then leave the nurses to carry out nursing care of the patient (Fritz, 2008, p. 82). Besides being a clear generalization, assumption, deliberate or unintentional underrating of the nurses profession, it is a clear indicator of torn delineations that lacks clear outlining for harmonious operations (Bessie Huston, 2008, pp. 752-753).Nurses are therefore required to assume their major activities when they are away irrespective of the main reason (Ruth Constance, 2008, p. 40). With lack of proper institution for defining the boundaries, the nurses are consumed in their calm built nature of service towards humanity (Colyer, 2004, pp. 408-104) .Using strong legislative framework and policy guidelines, nursing should be guarded like other professions and define the required relationship with the doctors in their areas of work (Bridgit, 2008, p. 569). When there is a criss crossings violations by doctor intrusions they allow do but wont empower you. Surface icing doctors may need AMO/Nurses helps but in reality they dont allow the AMO/Nurses to practice outside making the AMO/Nurses only the tool of convenience .However If everybody wants their own border of practice, everything have to wait for the doctors thereby causing a mark increase of public complaints. Therefore care should now be multi-taskings and coordinating care . Why I do cross boundaries, I do for the following reasons :- Because I am facing the patients If I dont do the public will complaints Critical to do patient will do Sometimes expatriate doctor with questionable qualifications patients may die but if my mother or relatives I want them to do it correctly. What happen if I do then Patient recovered really well I will save reputations of the my hospital Pat on the back from the doctor however it not done openly However patient will not be happy . But what happen if there is a complications when I do it then I will be Trying to be smart Trying to be a doctor Model for crossings borders Counsellings deepressed patients suicidal Anne, M. (2008) Advanced Practice Nursing: Essential Knowledge for the Profession. New Jersey: Jones Bartlett Publishers Barbara, M. Lynn, K. (2008) Holistic Nursing: A Handbook for Practice. New Jersey: Jones Bartlett Publishers. Credentialing and Privileging? Available at : http://www.ashp.org/s_ashp/docs/files/SCSS_HowtoCredPrivdoc.pdf accessed 30 September 2010 Colyer, H. M .(2004) The Construction and Development of Health Professionals: where will it end?, Journal of Advanced Nursing, 48 (4), pp. 406-412. Fritz, A. (2008) Physicians at War: The Dual-Loyalties Challenge. Miami: Springer Publishing Press. How To Document on Credentialing and Privileging Applications. Available at : http://www.ashp.org/s_ashp/docs/files/SCSS_HowtoCredPrivdoc.pdf accessed 30 September 2010 Medical Device Bureau Ministry of Health, Malaysia http://www.mdb.gov.my/mdb/index.php?option=com_contenttask=viewid=62Itemid=113 Ruth, F. Constance, J. (2008) Fundamentals of Nursing: Human Health and Function. San Francisco: Lippincott Williams Wilkins. Curci, Linda. (2004). Burnout. http://www.counseling.caltech.edu/articles/burnout.html. Life Positive. 2000. Stress at workplace. http://www.lifepositive.com/Mind/psychology/stress/stress-at- work.asp#causesofworkplacestress

The Internet And Social Media

The Internet And Social Media Self-esteem is all about how a person views themselves. When a person has a healthy sense of self, they respect themselves and they possess the courage to try different experiences even if it means that they might fail. A positive sense of self is driven to make healthy decisions and does not search for negative influences to pattern after. Low self-esteem is the complete opposite; it entails feelings of loneliness and self-hate. Low self-esteem is a serious problem for many young people; they often feel that they are undesirable and not worthy of having long lasting friendships or love interest. These feelings are a normal part of adolescence but, children who have low self-esteem find that negative thoughts and feelings of self-loathing dont seem to disappear. A child who has a normal and healthy sense of self has the ability to overcome these feelings or find ways to cope with them. Children with low self-esteem often cant summons the energy to channel positive thoughts and feelin gs. To combat this problem, teens will search for things that will make them feel complete. According to (Bessie`re, Seay, Kiesler, 2007; Wan Chiou, 2006), feelings of inadequacy and meekness often leads young people to prolonged use of the Internet. Children with low self-esteem also feel that the important adults in their lives, constantly judge them on their performances in school and in other social situations. They feel a need for acceptance and love from their parents, peers and community. The Internet and Social media sites also provide children the opportunity to fill the void of despair by choosing negative and harmful role models to pattern themselves after. These role models become important to them, they feel a need to nurture them and allow them to grow. Many times, these characters are more important than actual face to face communication with peers and family. Internet addiction in this case is characterized as a child or young adult spending excessive amounts of time and energy on the internet or on social media sites. The child will often find himself visiting sites; posting pictures and communicating all day long, while neglecting their daily responsibilities and routines. Instead of having normal peer relationships and interactions, the child seeks; people to chat with on-line. Greenfield (1999) found that young people, who use chat-rooms in a marked degree, make up a large group of compulsive Internet users. For these participators, chat rooms and Social media sites become their primary outlet for interactions; relationship building and the fulfillment of social needs. These children often miss the opportunity to make friends in the real world because they start to believe that the people they meet on line can be trusted with personal information. Polls taken on students found that Seventy-two percent of school age range youth has adm itted to using internet chat rooms in excess on a daily basis. Young (1997) found that children lose out on peer interactions and academic opportunities due to compulsive internet use. Egger (1996), found eight prevalent indications of Internet addiction: 1. the child seems to overlook time spent when on line, 2. the child gets angry when he is asked to end Internet time. 3. The child steals time on the internet without parental permission, 4. The child exhibits a loss of interest in daily activities or relationships, 5. Child seems depressed and despondent when they are not on-line, 6. Child checks e-mails and Social Media accounts constantly, 7. The child seeks out friends on-line and forms new relationships and 8. The child uses chat identification names while off-line. A child can also find themselves developing addictive patterns like; checking media sites or entering chat rooms. On the Internet; a child who is normally shy and reserved, can create a whole new image and personality by joining on-line chat rooms. In a groundbreaking article, Rheingold (1996) argued that internet chat rooms and Social media sites are places that a child can act out a part in a role of their choosing. The child can create their own reality, while hiding behind a computer terminal. In these social media rooms, the child feels the freedom to re-create himself into the person he wishes to be. This gives the child the power to control his state of being. Instead of feeling powerless and non-existent, the child has the confidence that he never had before. On-line friendships in Social media sites become more important than actual relationships with family members and peers. This is why it is so easy for the child to become addicted to Social media; they seem to be a safe harbor for anyone who feels lonely and powerless. There are many popular sites that children use in order to chat with others; many times these sites condone sexually explicit behavior and messages. These sites have a large adolescent following; they offer the chance to chat with peers and create web pages that can be suggestive and inappropriate. Many children often feel free enough to explore their sexuality and desires without anyone knowing who they are. Arisoy and Davis (2009, 2001) states that despite the fact that overuse of Social media and Internet sites are seen as productive and gratifying to the user; it is actually an unhealthy way of coping with feelings of inadequacy. Facebook and MySpace are very popular Social media sites that teens with low self-esteem frequent. These sites are among the most popular social networking sites that children frequent today; with millions of teen followers (most under the age of 15). These sites allow the users to update their status as many times as they would like without fear of being reprimanded for inappropriate language or content. Lampe (2006) argued that the dominant reason why Social media sites exist is to bridge friends and family together; in spite of distance and time constraints. But what happens when these sites are abused by teens? These sites then become addictive and harmful to the user and can ultimately cause the child to perform poorly in school and in life. The allure to these sites seems to be the fact that children can create the self-image they always wanted to have. They can create an identity that mirrors the self-image they wish to have; while inviting the same peers who tease them to be friends with them. The child feels that the friends made on line are true and loyal. The child feels a sense of excitement and joy when their peers desire to view their page; this is seen as acceptance-even if the child is being deceptive. Children with self-image issues are given the platform to voice concerns and maybe turn the tables on awkward situations. Many children will hide behind Social media sites in order to empower themselves-sometimes in negative ways. Another effect that the internet has on self-esteem is cyber bullying. Cyber bullying entails using the internet or other electronic devises to harass or intimidate another person. Cyber bullying occurs when a child or group of children flood the internet or other electronic devises with negative images; slurs or rumors about fellow classmates of peers. Analysis establishes that cyber bullying causes both boys and girls feelings of exasperation, sadness, and desperation. Girls tend to respond with discontent but boys are preoccupied with feelings of possible revenge and score settling by the bully. This negative behavior has become a national problem; it is among the leading cause of teen suicide and school violence. Cyber bullies have many excuses as to why they harass their peers. Some say that they do it to get back at them for some wrong doing; another cyber bully says they did it because the class mate dressed and acted differently from other students. Children who have low self -esteem and are bullied feel unsafe in their surroundings. They feel that wherever they are, they can be touched by vicious and unfounded rumors on the Internet or physically harmed by the people who started the rumors. Children in this situation may feel too intimidated to tell a parent, family member or community leader. There is an unspoken rule that children in schools across the country follow; the no snitching or tattling rule. It often does not matter if the child is threatened or harmed in front of hundreds of their peers, that child feels that they cant tell. If they are brave enough to tell, the child will most certainly face retaliation and social humiliation by not only the bully but their friends also. These feelings of helplessness and confusion often lead the victim to either take their own life or the lives of the bully or other innocent people. Kessel (2012) stated that many victims of cyber bullying dealt with feelings of emotional distress; these feelings lead to depression, self-mutilation and or suicide. Pedophilia and predatory stalkers are also contributors to self-esteem and the Internet. In this case, children are preyed on while on certain Social media sites with the assumption that they are reaching out to young people their own age; but police reports and news articles paint a different picture. In the last few years; reports have invaded the news about the dangers of frequenting sites that have a large youth following. Pedophiles and stalkers prey on the young and naÃÆ'Â ¯ve; they use and contact children through their social media pages with false identities and backgrounds. The perpetrator is only chatting with the child in order to gain their trust and to acquire their personal information. After the offender gains that childs trust; they offer to meet them face to face with the promise of sex, drugs or some type of adventure. Often; these children are found sexually abused, psychologically scared or even worse- deceased. According to Melody (2007), in standard, there ar e three elements of staking: 1. there has to be a continuous sequence of unwanted behavior displayed by the stalker to the victim; 2. The stalker has to have made a threat toward the victim; 3. The victim has to have experienced a sense of uneasiness or danger as a result of the stalker. Recently, Facebook and other sites have promised to clean up its content by going in and deleting the member pages that contain explicit and suggestive language and content. They also vowed to delete the pages of children who post personal information such as; phone numbers, addresses and names of schools. Facebook and other sites only agreed to do this after a group of angry parents and educators called attention to the threat against our youth. Spitzberg and Hoobler (2002) argued that with the influx of Social media sites and other forms of technology, stalkers and pedophiles have better access to their victims. It is imperative that parents become active participants in spreading the word about the dangers of excessive internet use. Another link to self-esteem and internet use is negative body image. Teens are often ambushed with some type of media which includes circulars, videos, radio and Internet sites. Many young people and teens spend large amounts of time searching on fashion sites for the latest trend and fad diet. Children can spend hours in their rooms on various sites researching pictures of the perfect nose; eyes; stomach and behind. Many times these images are photo shopped and doctored to be flawless; the children feel that these images are real and should be aspired to. Young people with low self-esteem feel that their bodies are ugly and flawed so they are in search of what will make them feel whole. Many young women find themselves eager to have reconstructive surgeries done on their bodies due to these feelings. The Internet fuels these feelings of self-hate by encouraging young women and sometimes boys to fixate on images and celebrities body parts that they deem as attainable. The more these images are downloaded; more time consuming it becomes for the adolescent; this causes them to loose themselves in a world of unhealthy and detrimental thoughts. This time could be better spent interacting with peers and forming; lasting relationships outside of the home. Park (2005) suggests that the issues teens face with body image has taken an upturn with the surge in popularity of the Internet and Social media sites. There are many strategies parents can use in order to build higher self-esteem in children: parents need to create an open dialogue with children about their feelings and social interactions. Children who are disheartened feel that they have little chance to be successful in life. By opening the lines of communication; the child can express emotions and work out any aggression they might feel. This also gives the parent a better understanding on how to help the child through difficult times. Adults should show genuine care and concern toward the child and their particular issues; this will break down the wall of uncertainty and lack of trust between parent and child. Children can feel betrayed and angry when they sense that the parent is humoring them or being condescending; these feelings might lead the child to mistrust the parent and shut down. These assumptions could also lead the child to feel that their parents dont have their best interest at heart. To ensure that the child is not made to feel embarrassed or shunned, parents should think before they engage in an open dialogue. It is a good idea that parents establish an environment of optimism and concern about life and its ups and downs; be honest enough to tell them that we all face disappointments and hardships but stress the importance of not giving up. Have faith in the child/young person and display it- let the child know that they make a difference in the world. Dispense praise and positive assessment; chil dren feel their self-worth is contingent on how their peers view of them. To help reassure the child a parent can acknowledge when they attempt a hard task then, praise them for having had the courage to try. Learn to acknowledge what a child is feeling by asking them to identify their feelings. Parents of young children can even have a feelings chart hung in sight; with the proper title under each emotion. When the young child cant express their emotion in words, they can point to an emotion that best describes them. This will give the child the assurance that they are heard and understood by the parent while the parent teaches the names of the emotions and the best ways child how to handle them. Parents should also try to focus on the positive actions of the child instead of the negative ones so the child will feel confident and empowered instead of degraded and singled-out. Children love to imitate or follow after adults so it is important to allow children to see you take chances and step outside the norm. This action sends a clear message to the child; If I am brave enough to try, you can do it also. Encourage your child to use the creativity they possess; if they like to draw or paint, enroll them in an art class and participate. Lastly; trust that your child can handle making their own decisions; start with small issues then work up to large ones but keep the lines of communicati on open. For example; allow the child to choose their wardrobe for school. If there are questionable choices made, use that situation to positively discuss it. As time goes on, both sides will learn to compromise and talk out larger issues. Parents can also get children involved in activities away from home and the computer. Engaging in physical activity helps to stimulate the mind; build muscles and allows opportunities for positive social interactions. There are many strategies parents can use in order to combat excessive Internet usage in children. 1. Parents need to inform themselves about the internet and chat rooms; parents are not aware that their children are addicted to the internet because they know so little about it. Parents should ask their children to help them navigate through some of the social media sites. Allow them to assume the role of teacher while the parent praises them of their knowledge and understanding of the sites. This will make the child feel easier about sharing this information and create an opening for questions and answers. 2. Take a computer literacy class. If parents are not comfortable with asking their child to show them how to navigate the web, they can sign up for free classes. Places like the public library and community centers offer free or reduced priced classes that will teach the basics of computer usage. 3. Computers should reside in an open space in the home. This way; the child will not lock himself away in a room or spend enormous hours surfing unknown and unsafe sites. If the entire family has access to the computer, the child does not have the privacy to sneak away and use the computer inappropriately. 4. Adults also need to monitor childrens use of the internet. The child should not spend more than two hours a day on the Internet with each hour broken into half an hour intervals. By allowing children to use the internet in intervals, we give them an opportunity to explore other talents and interests that might not be utilized while on-line. 5. Parents should become detectives. Parents can log on and create their own page in a site that a child frequents; this way the parent will find out the types of conversations that takes place. Some may find this as intrusive but in some cases; it has to be done to save a childs life. 6. When choosing data plans for cell phones or other devises, limit the time and sites that the child can visit. There are many applications that can be downloaded on the phone to ensure the safety of youth and teens. Technology can be wonderful and beneficial if we learn to use it properly. In an effort to combat cyber bullying and online harassment it is a good idea to get teachers and school administrators involved. Some students are more comfortable confiding in teachers or counselors about cyber bullying rather than talking to their parents. They may feel that the teacher has a better understanding of these issues because they understand teens better. While in school, teachers should: 1. Discuss Internet safety and proper usage of cell phones and other devises. 2. Facilitate open dialogues in class about the dangers and warning signs if cyber bullying. 3. Give students the strategies to combat cyber bullying like; reporting it right away and keep personal business and information off the Internet. 4. Lastly, make an effort to let the student know that you are available to assist them with the issue. Parents can also turn to churches for seminars and small group discussions about self-esteem and internet use. Parents can play a role in self-esteem building by treating the child with respect and love, seriously listening to their views and opinions. Most importantly, parents have to remember that self-esteem is paramount in every childs development. When the child sees that this issue is important to you; they will take notice and start talk about their concerns. Now that we have identified the link between internet addiction and self-esteem, parents must be proactive and get involved with their children and their activities. Parents have to be able to recognize the signs of low self-esteem and be ready to help the child cope with their feelings. Parents have to be the childs first resource when their feelings and emotions seem to go awry. In order to be this resource, they have to become familiar with various strategies and plans that will aid the child. Parents should be prepared to notice the signs of low self-esteem and be willing to seek outside help. The Internet and other technologies have indeed changed our lives in meaningful and substantial ways; this why we have to help our children understand and assume the responsibilities of it.

Conventional Plastic Films vs Sustainable Films Essay -- Environment,

Sustainability has become and important issue in the world as the Green Movement continues to gain popularity. One area where research is being conducted to find a more sustainable production process is plastic films. Plastic films are defined as a packaging material, usually less than ten mils (a mil is 0.001 inch) in thickness, with an average of 0.7–1.5 mils, that can be used as a bag or wrapper. They are composed of a broad range of materials, which can be simple or complex depending on what a particular product or package demands (Osborn & Jenkins, 1992). There are two main categories of films used in packaging, conventional films and sustainable films. Conventional plastic films are much more widely used and have a larger market than sustainable films. The film can be made with different resins, each of which have unique structures and are ideal for specific applications. The films can be clear or colored, printed or plain, single- or multilayered and are often combined with other materials such as aluminum and paper. Examples of plastic films usages include Ziploc bags, trash bags, grocery sacks, drycleaner bags, and plastic wrap. The only common characteristic of all plastic conventional film is that it is flexible in nature. The most common resin used to create these plastic film packages is low-density polyethylene (LDPE). As a film LDPE has decent clarity, is a good moisture and gas barrier, and it can be heat sealed while retaining its strength and flexibility. Polypropylene (PP) is also a common resin used to create plastic film. It has an excellent moisture barrier, good transparency, gloss, and tensile strength. The PP resin also has a high melting point, which makes it appropriate for packages that need to be st... ...petroleum, which has been around for significantly longer and has a strong hold on the market. As sustainability continues to become an emerging concern for consumers bio-plastics will grow in importance in the packaging industry. Similar to auto companies who are searching for alternative sources of energy for automobiles, chemical companies are searching for alternatives to manufacture of plastic materials (Perkins & Lindsay, 2011). We have a limited supply of fossil fuels and ate the rate plastic products such as film are being produced and consumed each year, it is hard to say how long they will last. Bio-plastics currently represent only a small fraction of the emerging area of sustainable development, but their usage is growing. There is great potential for bio-plastics as replacements for the less-sustainable fossil fuel based plastics used in plastic film.

Hindu women Essay -- essays research papers

Throughout history, there have been many different aspects that have been looked at in all culture ways . Many researcher’s have studied the history and the lifestyle of the different societies and particular cultural norms. This information is gathered from media, weather be it through internet, newspaper, television or simply history books as educational informers. Although these are the most common bases for societal general knowledge, in the inner truth occurs within the inner realms of particular societal. We as Americans sometimes fund the ways in which many of these cultures do things different, weird, or crazy. They are for us to look forage deeper into these different aspects but sometimes many of us choose to just believe the contrary, the truth that is tainted and not rooted within history. One of these mistakenly miscnceived cultures is the Hindu Culture. Americans may not see things in our cullture the way others do in their own private communities. In our societ y, women are beginning to get respect for the things they do and they are being looked at in the same way that men are, in various occupations. In the Hindu culture this is quiet the opposite, their society views women the same way a any other society would view those in the lower social aspects. This suppressing and inferorating view has had a large impact on their society, economically, as well as politically. The women in this culturl are looked upon as being something great, according to their cultural and religious believes. This aspect of Hindu society is the only that has had credit to the respect and value of women, where if compared to the status of women in other societies. Though the women are vied very highly by the gods, they are viewed from a society with a caste system. India like any other society is divided into different classes. The classes are division is marked by wealth and production industries. The adjoining part of the society is ruled by higher authority. Women are a large of this particular society. They are subjected to agricultural and exploitation by the men who rule them. The women in these particular communities have many duties that come with being a part of that society. â€Å" The chief duty of a women is to maintain her Pativrata Dharma. To a women there is no higher duty than service of her husband. She should worship him daily† (Shivanada, 1963). Women... ...ntirely socialized and restricted to their family-kin community. Tremendous effort has been to ignite, for they have come a long way from the beginning, hoping to see a fair end. As an American women in a westernized culture, one sometime takes the freedom given for granted, not realizing that there are women out there that have to fight for things that they want in life. True, we do choose to go out and get an education, but we should sometimes stop and think what things would be like if we were not able to even try to get an education. Education is given abundantly, there is equal opportunities in exchange for self enhancement, to think that all these rights can be taken away, not only paints a painful life but gives one a glimpse into the lives of the Hind women who had to endure such mistreatments. The Hindu women have lived under the incubation of powerful men, who have no regard to their equality nor their intelligence and capability. These women have not just fulfilled a dream but have economically, politically, and socially, broken the barrier as well as the stereotype that they may no amount to anything. They have taken that initiative, and made it i nto something great.

Theodore Roethke Essay -- modern American poetry

Theodore Roethke â€Å"Roethke was a great poet, the successor to Frost and Stevens in modern American poetry, and it is the measure of his greatness that his work repays detailed examination† (Parini 1). Theodore Roethke was a romantic who wrote in a variety of styles throughout his long successful career. However, it was not the form of his verse that was important, but the message being delivered and the overall theme of the work. Roethke was a deep thinker and often pondered about and reflected on his life. This introspection was the topic of much of his poetry. His analysis of his self and his emotional experiences are often expressed in his verse. According to Ralph J. Mills Jr., â€Å"this self interest was the primary matter of artistic exploration and knowledge, an interest which endows the poems with a sense of personal urgency, even necessity† (Contemporary Authors 476). Roethke was born in 1908 in Saginaw, Michigan to Otto Roethke and Helen Huebner. He demonstrated early promise in a Red Cross campaign speech as a high school freshman. This speech was translated into twenty-six different languages and showed that he had talent and potential even at a young age. He graduated magna cum laude from the University of Michigan in 1929, and was pressured to move on to law school by family members. However, he was not interested in law and dropped out in order to take graduate courses in literature at Harvard University. Allan Seager concluded, â€Å"it was more than an unsuppressible awareness of life that led him to choose poetry as a career† (Contemporary Authors 475). He took up various teaching positions afterwards at colleges including Lafayette College, Pennsylvania State University, Bennington College, and final... ...uminaries who had an effect on his writing were Leonie Adams, Emily Dickinson, Rolfe Humphries, Stanley Kunitz, and Emily Wylie (1). â€Å"At the University of Washington, Roethke found talented protà ©gà ©s in Carolyn Kizer, David Wagoner, and James Wright† (Kalaidjian 2). He is well known for his influence on this subsequent generation of award-winning poets. Works Cited Parini, J. â€Å"Roethke, Theodore.† Chambers Biographical Dictionary. Ed. Melanie Perry. New York: Larousse Kingfisher Chambers Inc, 1997: 1584. â€Å"Roethke, Theodore.† Encarta 2002. CD-ROM. Redmond, WA: Microsoft 2002. â€Å"Roethke, Theodore (Huebner).† Contemporary Authors. Volumes 81-84. Ed. Francis Carol Locher. Detroit: Gale Research Company, 1979: 475-479. â€Å"Theodore Roethke’s Life and Career.† Walter Kalaidjian. 1999.

A Game of Thrones Chapter Thirty-five

Eddard He found Littlefinger in the brothel's common room, chatting amiably with a tall, elegant woman who wore a feathered gown over skin as black as ink. By the hearth, Heward and a buxom wench were playing at forfeits. From the look of it, he'd lost his belt, his cloak, his mail shirt, and his right boot so far, while the girl had been forced to unbutton her shift to the waist. Jory Cassel stood beside a rain-streaked window with a wry smile on his face, watching Heward turn over tiles and enjoying the view. Ned paused at the foot of the stair and pulled on his gloves. â€Å"It's time we took our leave. My business here is done.† Heward lurched to his feet, hurriedly gathering up his things. â€Å"As you will, my lord,† Jory said. â€Å"I'll help Wyl bring round the horses.† He strode to the door. Littlefinger took his time saying his farewells. He kissed the black woman's hand, whispered some joke that made her laugh aloud, and sauntered over to Ned. â€Å"Your business,† he said lightly, â€Å"or Robert's? They say the Hand dreams the king's dreams, speaks with the king's voice, and rules with the king's sword. Does that also mean you fuck with the king's—† â€Å"Lord Baelish,† Ned interrupted, â€Å"you presume too much. I am not ungrateful for your help. It might have taken us years to find this brothel without you. That does not mean I intend to endure your mockery. And I am no longer the King's Hand.† â€Å"The direwolf must be a prickly beast,† said Littlefinger with a sharp twist of his mouth. A warm rain was pelting down from a starless black sky as they walked to the stables. Ned drew up the hood of his cloak. Jory brought out his horse. Young Wyl came right behind him, leading Littlefinger's mare with one hand while the other fumbled with his belt and the lacings of his trousers. A barefoot whore leaned out of the stable door, giggling at him. â€Å"Will we be going back to the castle now, my lord?† Jory asked. Ned nodded and swung into the saddle. Littlefinger mounted up beside him. Jory and the others followed. â€Å"Chataya runs a choice establishment,† Littlefinger said as they rode. â€Å"I've half a mind to buy it. Brothels are a much sounder investment than ships, I've found. Whores seldom sink, and when they are boarded by pirates, why, the pirates pay good coin like everyone else.† Lord Petyr chuckled at his own wit. Ned let him prattle on. After a time, he quieted and they rode in silence. The streets of King's Landing were dark and deserted. The rain had driven everyone under their roofs. It beat down on Ned's head, warm as blood and relentless as old guilts. Fat drops of water ran down his face. â€Å"Robert will never keep to one bed,† Lyanna had told him at Winterfell, on the night long ago when their father had promised her hand to the young Lord of Storm's End. â€Å"I hear he has gotten a child on some girl in the Vale.† Ned had held the babe in his arms; he could scarcely deny her, nor would he lie to his sister, but he had assured her that what Robert did before their betrothal was of no matter, that he was a good man and true who would love her with all his heart. Lyanna had only smiled. â€Å"Love is sweet, dearest Ned, but it cannot change a man's nature.† The girl had been so young Ned had not dared to ask her age. No doubt she'd been a virgin; the better brothels could always find a virgin, if the purse was fat enough. She had light red hair and a powdering of freckles across the bridge of her nose, and when she slipped free a breast to give her nipple to the babe, he saw that her bosom was freckled as well. â€Å"I named her Barra,† she said as the child nursed. â€Å"She looks so like him, does she not, milord? She has his nose, and his hair . . . â€Å" â€Å"She does.† Eddard Stark had touched the baby's fine, dark hair. It flowed through his fingers like black silk. Robert's firstborn had had the same fine hair, he seemed to recall. â€Å"Tell him that when you see him, milord, as it . . . as it please you. Tell him how beautiful she is.† â€Å"I will,† Ned had promised her. That was his curse. Robert would swear undying love and forget them before evenfall, but Ned Stark kept his vows. He thought of the promises he'd made Lyanna as she lay dying, and the price he'd paid to keep them. â€Å"And tell him I've not been with no one else. I swear it, milord, by the old gods and new. Chataya said I could have half a year, for the baby, and for hoping he'd come back. So you'll tell him I'm waiting, won't you? I don't want no jewels or nothing, just him. He was always good to me, truly.† Good to you, Ned thought hollowly. â€Å"I will tell him, child, and I promise you, Barra shall not go wanting.† She had smiled then, a smile so tremulous and sweet that it cut the heart out of him. Riding through the rainy night, Ned saw Jon Snow's face in front of him, so like a younger version of his own. If the gods frowned so on bastards, he thought dully, why did they fill men with such lusts? â€Å"Lord Baelish, what do you know of Robert's bastards?† â€Å"Well, he has more than you, for a start.† â€Å"How many?† Littlefinger shrugged. Rivulets of moisture twisted down the back of his cloak. â€Å"Does it matter? If you bed enough women, some will give you presents, and His Grace has never been shy on that count. I know he's acknowledged that boy at Storm's End, the one he fathered the night Lord Stannis wed. He could hardly do otherwise. The mother was a Florent, niece to the Lady Selyse, one of her bedmaids. Renly says that Robert carried the girl upstairs during the feast, and broke in the wedding bed while Stannis and his bride were still dancing. Lord Stannis seemed to think that was a blot on the honor of his wife's House, so when the boy was born, he shipped him off to Renly.† He gave Ned a sideways glance. â€Å"I've also heard whispers that Robert got a pair of twins on a serving wench at Casterly Rock, three years ago when he went west for Lord Tywin's tourney. Cersei had the babes killed, and sold the mother to a passing slaver. Too much an affront to Lannister pride, that close to home.† Ned Stark grimaced. Ugly tales like that were told of every great lord in the realm. He could believe it of Cersei Lannister readily enough . . . but would the king stand by and let it happen? The Robert he had known would not have, but the Robert he had known had never been so practiced at shutting his eyes to things he did not wish to see. â€Å"Why would Jon Arryn take a sudden interest in the king's baseborn children?† The short man gave a sodden shrug. â€Å"He was the King's Hand. Doubtless Robert asked him to see that they were provided for.† Ned was soaked through to the bone, and his soul had grown cold. â€Å"It had to be more than that, or why kill him?† Littlefinger shook the rain from his hair and laughed. â€Å"Now I see. Lord Arryn learned that His Grace had filled the bellies of some whores and fishwives, and for that he had to be silenced. Small wonder. Allow a man like that to live, and next he's like to blurt out that the sun rises in the east.† There was no answer Ned Stark could give to that but a frown. For the first time in years, he found himself remembering Rhaegar Targaryen. He wondered if Rhaegar had frequented brothels; somehow he thought not. The rain was falling harder now, stinging the eyes and drumming against the ground. Rivers of black water were running down the hill when Jory called out, â€Å"My lord,† his voice hoarse with alarm. And in an instant, the street was full of soldiers. Ned glimpsed ringmail over leather, gauntlets and greaves, steel helms with golden lions on the crests. Their cloaks clung to their backs, sodden with rain. He had no time to count, but there were ten at least, a line of them, on foot, blocking the street, with longswords and iron-tipped spears. â€Å"Behind!† he heard Wyl cry, and when he turned his horse, there were more in back of them, cutting off their retreat. Jory's sword came singing from its scabbard. â€Å"Make way or die!† â€Å"The wolves are howling,† their leader said. Ned could see rain running down his face. â€Å"Such a small pack, though.† Littlefinger walked his horse forward, step by careful step. â€Å"What is the meaning of this? This is the Hand of the King.† â€Å"He was the Hand of the King.† The mud muffled the hooves of the blood bay stallion. The line parted before him. On a golden breastplate, the lion of Lannister roared its defiance. â€Å"Now, if truth be told, I'm not sure what he is.† â€Å"Lannister, this is madness,† Littlefinger said. â€Å"Let us pass. We are expected back at the castle. What do you think you're doing?† â€Å"He knows what he's doing,† Ned said calmly. Jaime Lannister smiled. â€Å"Quite true. I'm looking for my brother. You remember my brother, don't you, Lord Stark? He was with us at Winterfell. Fair-haired, mismatched eyes, sharp of tongue. A short man.† â€Å"I remember him well,† Ned replied. â€Å"It would seem he has met some trouble on the road. My lord father is quite vexed. You would not perchance have any notion of who might have wished my brother ill, would you?† â€Å"Your brother has been taken at my command, to answer for his crimes,† Ned Stark said. Littlefinger groaned in dismay. â€Å"My lords—† Ser Jaime ripped his longsword from its sheath and urged his stallion forward. â€Å"Show me your steel, Lord Eddard. I'll butcher you like Aerys if I must, but I'd sooner you died with a blade in your hand.† He gave Littlefinger a cool, contemptuous glance. â€Å"Lord Baelish, I'd leave here in some haste if I did not care to get bloodstains on my costly clothing.† Littlefinger did not need to be urged. â€Å"I will bring the City Watch,† he promised Ned. The Lannister line parted to let him through, and closed behind him. Littlefinger put his heels to his mare and vanished around a corner. Ned's men had drawn their swords, but they were three against twenty. Eyes watched from nearby windows and doors, but no one was about to intervene. His party was mounted, the Lannisters on foot save for Jaime himself. A charge might win them free, but it seemed to Eddard Stark that they had a surer, safer tactic. â€Å"Kill me,† he warned the Kingslayer, â€Å"and Catelyn will most certainly slay Tyrion.† Jaime Lannister poked at Ned's chest with the gilded sword that had sipped the blood of the last of the Dragonkings. â€Å"Would she? The noble Catelyn Tully of Riverrun murder a hostage? I think . . . not.† He sighed. â€Å"But I am not willing to chance my brother's life on a woman's honor.† Jaime slid the golden sword into its sheath. â€Å"So I suppose I'll let you run back to Robert to tell him how I frightened you. I wonder if he'll care.† Jaime pushed his wet hair back with his fingers and wheeled his horse around. When he was beyond the line of swordsmen, he glanced back at his captain. â€Å"Tregar, see that no harm comes to Lord Stark.† â€Å"As you say, m'lord.† â€Å"Still . . . we wouldn't want him to leave here entirely unchastened, so†Ã¢â‚¬â€through the night and the rain, he glimpsed the white of Jaime's smile—†kill his men.† â€Å"No!† Ned Stark screamed, clawing for his sword. Jaime was already cantering off down the street as he heard Wyl shout. Men closed from both sides. Ned rode one down, cutting at phantoms in red cloaks who gave way before him. Jory Cassel put his heels into his mount and charged. A steel-shod hoof caught a Lannister guardsman in the face with a sickening crunch. A second man reeled away and for an instant Jory was free. Wyl cursed as they pulled him off his dying horse, swords slashing in the rain. Ned galloped to him, bringing his longsword down on Tregar's helm. The jolt of impact made him grit his teeth. Tregar stumbled to his knees, his lion crest sheared in half, blood running down his face. Heward was hacking at the hands that had seized his bridle when a spear caught him in the belly. Suddenly Jory was back among them, a red rain flying from his sword. â€Å"No!† Ned shouted. â€Å"Jory, away!† Ned's horse slipped under him and came crashing down in th e mud. There was a moment of blinding pain and the taste of blood in his mouth. He saw them cut the legs from Jory's mount and drag him to the earth, swords rising and failing as they closed in around him. When Ned's horse lurched back to its feet, he tried to rise, only to fall again, choking on his scream. He could see the splintered bone poking through his calf. It was the last thing he saw for a time. The rain came down and down and down. When he opened his eyes again, Lord Eddard Stark was alone with his dead. His horse moved closer, caught the rank scent of blood, and galloped away. Ned began to drag himself through the mud, gritting his teeth at the agony in his leg. It seemed to take years. Faces watched from candlelit windows, and people began to emerge from alleys and doors, but no one moved to help. Littlefinger and the City Watch found him there in the street, cradling Jory Cassel's body in his arms. Somewhere the gold cloaks found a litter, but the trip back to the castle was a blur of agony, and Ned lost consciousness more than once. He remembered seeing the Red Keep looming ahead of him in the first grey light of dawn. The rain had darkened the pale pink stone of the massive walls to the color of blood. Then Grand Maester Pycelle was looming over him, holding a cup, whispering, â€Å"Drink, my lord. Here. The milk of the poppy, for your pain.† He remembered swallowing, and Pycelle was telling someone to heat the wine to boiling and fetch him clean silk, and that was the last he knew.

Professional Action Plan Essay

I am a firm believer that in order to best choose what to do with your life, you must first know who you are in life. Self-awareness can help create a happy, balanced, and fulfilled existence on a personal and professional level. This can equate to success on both sides of the spectrum. HCS/449, Health Care Capstone has helped me understand this statistic more clearly and it will be etched in my psyche for years to come. I will aim to expand on this knowledge of self and how I may effectively convey it to the world around me; specifically the world of health care on a management level. I am a: hard worker, high performer, fast past learner, self-starter, team player, and work well under pressure. I am a motivator by choice and possess keen communication skills. I was lastly employed in the health care industry in 2010, to pursuit a BSHA and will return to the industry as a more valuable asset. My extreme passion is sometimes misread as aggression and I am strategically learning to control my passion to fit my environment. The objective of this essay is to answer: what my professional goals are, what job I plan to have in the health care sector, what skills I currently have for this job, which skills I need to change or alter, my plan for ultimately achieving my professional goals, what professional organizations can help me achieve these goals, and what benefit does the career action plan outline? Professional Goals The health care industry is one of the world’s largest and fastest-growing industries. I am eager to return back to it, for it is one that I love.† Employment of medical and health services managers is expected to grow by 22 percent from 2010 to 2020, faster than the average for all occupations.†(Bureau of Labor Statistics, 2012) At a minimum I seek to obtain a career in health care administration on a management level and ultimately work my way towards executive leadership. My sights are set high because I would like to make a difference in the industry and I feel that I am highly capable of being a good steward in the capacity that I seek to serve. Job Interests There are so many jobs that interest me in the health care industry on a management level. Medical and health services managers also called healthcare executives or healthcare administrators, plan, direct, and coordinate medical and health services. They might manage an entire facility or specialize in managing a specific clinical area or department, or manage a medical practice for a group of physicians. As healthcare changes, medical and health services managers must be able to adapt to changes in laws, regulations, and technology. Upon conducting an assessment of self, I realized that I enjoy making a positive difference in the life of others , being a voice of reason, and an advocate for identified much needed change. That result has led me to the decision of wanting to be a source of knowledge and advocate within the health care industry, taking on a managerial role in any aspect to make a difference. I would like to take on an active role of accountability and assist in bringing about positive change for the consumers and stakeholders alike. Accountability is defined as â€Å"the act of accepting ownership for the results or the lack thereof† (Sullivan & Decker, 2005, p. 144). † Accountability in health care encompasses the procedures and processes by which health care leadership justifies and takes responsibility for its activities such as achieving various organizational goals. Health care providers and officials are constantly striving to improve quality and efficiency in health care by using performance management systems and quality improvement initiatives. Creating and maintaining a culture of accountability in health care is important because accountability is the reason for measuring and improving performance towards the aim of rendering quality, efficient health care.† (O’Hagan & Persaud, 2009) Skills I have a broad range of health care services skills afforded to me by the United States Air Force with a job occupation of 4A071, Health Services Management Craftsman. â€Å"The occupation description from service file for 4A071: Manages health services activities. Plans, develops, manages, and performs health services activities. General Duties and Responsibilities: Performs resource management functions.† (Verification of Military Experience and Training, 2010) I have been trained to perform duties in support of patient services activities to include: admission and disposition procedures, outpatient and inpatient records functions, medical terminology, inpatient unit administration, appointment booking systems, managed care programs, third party liability, medical air evacuation of patients, and information management skills to name a few. In addition I have management and supervisory experience in each capacity. All of my previous skills go hand in hand with the information being afforded to me in the University of Phoenix, BSHA program. Needed Skills Medical and health services managers typically need at least a bachelor’s degree to enter the occupation. Prospective medical and health services managers have a bachelor’s degree in health administration. These programs prepare students for higher level management jobs than programs that graduate students with other degrees. In addition to education other needed qualities consist of: analytical skills, communication skills, interpersonal skills, problem-solving skills, technical skills, and be detail oriented. I truly feel that I possess these much needed skills and excel at them although there is always room for improvement on every level. The only credential I seem to lack is a BSHA in hand. However, I am well on my way to achieving this personal and professional goal that I have chosen and set for myself. My expected time of graduation is May 2013. Ultimate Plan My plan for ultimately achieving my professional goal is to complete the BSHA program at University of Phoenix and be able to meet the minimum education requirements of qualifying to become a health care manager. I will continue on with my education and pursue a MHA to bring about more opportunities and expand my health care knowledge because I feel that it is necessary to advance. I would like to remain current with policies, procedures, and health care laws to bring my best into any organization that affords me the opportunity to be a part of their establishment. I will also seek out professional organizations that can help me achieve my professional goals by way of networking and mentorship. Partnerships are vital in succeeding in the health care industry and I understand that now. I am now curious about joining the American Council for Health Care Executives (ACHE). I think this organization could definitely help me in achieving my professional goals. I think I would also be a valuable asset to their professional organization as well. Action Plan Outline Initially, I was perturbed by the idea of having to complete a career action plan outline, but in all honest it helped. It served as a writing guide and helped shape what I wanted to say. It also served as some sort of SWOT analysis. It highlighted my strengths, weaknesses, opportunities, and threats to selecting a career that I identified as seeming right for me. Conclusion This assignment was highly effective. My career goals have been set and my career action plan is complete. I know what I have done, what I can do, what I want to do, and what I need to do. I have been equipped with the necessary tools and knowledge of making my dreams a reality. I have some immediate goals, and some long term goals. They are all a work in progress but well within reach. Achievement starts with me. References Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2012-13 Edition, Medical and Health Services Managers, on the Internet at http://www.bls.gov/ooh/management/medical-and-health-services-managers.htm (visited August 13, 2013). DD Form 2586 (2010) Verification of Military Experience and Training O’Hagan J. & Persaud D. (2009) Creating a Culture of Accountability in Health Care Retrieved from http://www.nursingcenter.com/lnc/static?pageid=935642 Sullivan, E. & Decker, P. (2005). Effective leadership and management in nursing (6th ed.). Upper Saddle River, NJ: Pearson.