“Early Bird” or “Second Mouse” Essay

â€Å"The early bird may get the worm, but the second mouse gets the cheese.† Decide which of the strategies (â€Å"early bird† or â€Å"second mouse†) is the most effective in your life as a student and life in general. The early bird may get the worm, but the second mouse gets the cheese was first recorded in 1605 in William Camden’s book of proverbs and has remained part of the misplaced work ethic ever since. The early bird gets the worm meaning it is best to start the day early and also not procrastinate on things. ‘But the second mouse gets the cheese’ meaning the first mouse got killed in the mousetrap and so you got rewarded for starting late or procrastinating. So let the other eager person screw up and then learn from their failure and then reap the reward. I am neutrally in this option. If the early bird gets the worm, then how can it be that the second mouse gets the cheese? If we need to motivate our staff to get up and get started, then we might want to state that the early bird get the worm, so let’s get up and get going so as to get there early before anyone else. On the other hand, if the competition has come out with something quicker than we have, then in order to get everyone on point we might say, â€Å"The second mouse gets the cheese.† In other words, if we build upon the original idea that may have been invented first, then we can build something bigger and better. â€Å" The early bird may get the worm† meanings that success comes to those who prepare well and put in effort. Preparation is the cost you need to pay in order to be truly rewarded. You can’t just jump in the ring and expect to win the fight without having first learned how to box and prepare your body for the required endurance. From the moment of birth till death, we work very hard to succeed. In childhood, we learn how to walk and communicate with others though persistence and willingness. Throughout our adolescence, we study hard to achieve good marks and to get a proper job. For example as I am a student, it is best to study early and in small increments well before the test. Do not cram the night before the exam is the best advice for me from my secondary school teacher that make me successfully went into university. However, â€Å"second mouse† is another effective strategies in my life as a student and life in general. Sometimes in life it is smart to learn from the risks that others take and the mistakes they make. The dead mouse in the trap saw the cheese and went for it. Did not work. But the second mouse, though still cautious, was in the enviable position of reaping the reward with no risk. We are all human, therefore we all make mistakes, but the one thing that comes out of these mistakes is we usually learn a lesson. Making mistakes is human nature, none of us are exempt. That is even true in writing this paper, I will have to write many drafts without errors, and to meet what I feel is right. It will only be natural for me to make these mistakes. But, just as in making errors on this paper and making the corrections, making mistakes in life and correcting those makes for a better human being. We need to be smart so that we will be the â€Å"second mouse that get the cheese but not the first mouse that in the trap.

Care Delivery & Management Essay

The purpose of this assignment is to reflect upon my personal and professional development. It will consider the quality of the care I provided, the skills I developed in my specialist placement, plus my learning since the commencement of my nurse training. Personal learning and self-reflection will be identified. I shall be using Gibbs (1988) Reflective Cycle to consider my practice. Gibbs (1988) Reflective Cycle looks at six aspects which include the following; what happened, what were my thoughts and feelings, what was good or bad about the experience, what sense can I make out of the situation, what else could I have done and if it arose again what would I do? Findings will be supported or contrasted by relevant literature. A conclusion will be offered to evaluate findings. I shall also include an action plan, which will address future professional and personal development needs and any factors that may help or hinder this. I will also consider why I have selected these issues fo r my action plan, what my goals are and how I aim to achieve them. At the beginning of my nurse training we were asked to write on a piece of piece what our definition of nursing was. I wrote ‘It’s about being human’. At the time these words were based on my gut feeling and personal belief. Now, two and a half years later, I would write the same thing, but this time my definition would be based on the skills, knowledge and experiences I feel privileged and grateful to have had during my training and not just on gut feeling and personal belief. How does this knowledge impact on me in terms of practice? I can now put my definition of nursing into a framework and relate the theory of it to practice, for example I can identify when I am actively undertaking anxiety management with a patient. This is quite an achievement for me. What else have I learnt? I have gained knowledge of illnesses and understand how bio-psycho-social aspects of mental illness impact on the individual, their family and their life. I have also developed a good basic knowledge of practical skills such as: counselling, anxiety management, assessment, nursing and communication models, problem-solving and psychotherapy. This knowledge and development of practical skills has enabled my self confidence and self esteem to grow. What things have had the most influence on my personal and professional learning? These things are what ‘It’s about being human’ means to me as a nurse. They include a humanistic care philosophy. Evidence suggests that patients have found the humanistic care philosophy to be positive and helpful to their well-being (Beech, Norman 1995.) Humanistic care believes in; developing trust, the nurse-patient relationship, using the self as a therapeutic tool, spending time to ‘be with’ and ‘do with’ the patient (Hanson 2000,) patient empowerment, the patient as an equal partners in their care (Department Of Health 1999,) respect for the patient’s uniqueness, recognition of the patient as an expert on themselves (Nelson-Jones 1982, Playle 1995, Horsfall 1997). Equally important to me is person-centred care, Roger’s (1961) unconditional positive regard, warmth, genuineness and empathy, recognition of counter-transference, self-reflect ion and self-awareness. I was on placement with Liaison Psychiatry also known as Deliberate Self Harm. The team consisted of my mentor and myself. In this placement we would assess patients who had deliberately self harmed. Patients would be referred via A&E only. We would see patients whilst they were still in A&E or after they had been transferred to hospital wards for medical treatment for their injuries etc. We would only see patients once they were medically fit to have a psychiatric assessment. The purpose of the assessment was to find out what was happening for the individual and see if we could offer any help via mental health services to the individual, this is done via implementing ‘APIE’ the nursing process (Hargreaves 1975). The main focus was to consider what degree of risk we felt the patient was in. Therefore we needed to establish what the individuals intent was at the time of the deliberate self harm, and if suicidal, whether they still had suicidal intent after the incident. We also held a weekly counselling clinic. I considered Gibbs (1988) Reflective Cycle. How did I feel about this placement? At first I was apprehensive as to how I would feel dealing with patients who do not necessarily want to live. I belong to a profession that saves lives, so I felt an inner conflict. This is an anxiety that is recognised in most nurses (Whitworth 1984). In my first few weeks I felt distressed by the traumatic events that these patients were experiencing. I felt guilty that I have a family who love me, a fulfilling career, a lovely home and no debts, then each day I talk to people who may have no home, no money, no one to love them and no employment. It was hard for me to make sense of these things when life circumstances, such as class, status, wealth, education and employment create unfairness. I felt a desire to help try and improve the quality of these patients’ situations. Midence (1996) has identified that these feelings are a normal response when dealing with others less fortunate that oursel ves. Patients’ who attempt suicide have lost hope (Beck 1986). I felt more settled and positive once I was able to make sense of the situation (Gibbs 1988). I realised that could help by listening to these patient’s and help to restore hope, develop problem solving ideas to tackle some of their problems or referring them to gain the emotional help and support they needed from appropriate mental health services. Patients find help with problem solving extremely valuable and can help them feel able to cope (McLaughlin 1999). Generally, after most assessments, I learnt that listening, giving emotional support and problem solving helped restore enough hope in the previously suicidal patient enable them to feel safe from future self harm. In only a handful of cases did my mentor and I need to admit patients to any inpatient facility under the Mental Health Act (1983). This was because they still felt at risk of future self-harm. Through using Gibbs (1988) Reflective Cycle to consider my special placement area I feel I have been able to change my nursing practice in a positive way, initially from feeling anxious, guilty and helpless when dealing with suicidal patients to feeling useful, constructive and positive. I’ve learnt that by confronting my own feelings of guilt and discomfort I was able to help in a very positive, practical, constructive and empowering way. My mentor identified that one of my strengths is that I can generally combine common sense, logic and practicality in terms of risk assessment and problem solving and still build up a sensitive and caring, therapeutic relationship when dealing with patients whose circumstances are in crisis and complicated and they themselves are emotionally and mentally vulnerable. Nurses not only need good communication skills (Faulkner 1998) but they also need to have an environment conductive to open communication (Wilkinson 1992). Social barriers such as environment, structure or cultural aspects of healthcare can inhibit the application of communication skills (Chambers 2002) Utilising Gibbs (19988) Reflective Model, in retrospect; I feel our interview with some patients could have been done differently. On occasions when my mentor and I were in the A & E department the two rooms that we had available for our use were occasionally both in use. This meant that we would conduct our assessment interviews in the Plaster Room, if it was empty. This room was where medical patients would have plaster-casts applied. This was a very clinical room. However, due to limited room availability this was sometimes the only option we had at the time, it was not a welcoming or appropriate setting and would not have helped patients feel relaxed or valued. In reflection, I believe it was actually demeaning as we were asking patients who had attempted suicide to sit on a hard chair in a clinical workroom and share their despair with us. I am sad that this happened and I feel as though we were giving the patients the impression that a cold clinical work room is all they were worth. If this arose again (Gibbs 1988) I would suggest to my mentor that we wait for one of our allocated rooms to become available, where the rooms were relaxing, with soft armchairs and a feeling of comfort. Using Gibbs (1988) Reflective Model I shall describe a situation with a patient to highlight my learning. What happened (Gibbs 1988)? Neil had been bought to A&E by his son after he made an attempt to take his own life. His son explained that Neil’s wife had terminal cancer and had died the day before. Neil was unable to engage in conversation other that to repeat over and over again â€Å"I don’t want to live without my wife.† However the more disturbed and difficult to communicate a patient is the less interaction they receive therapeutic or otherwise from nursing staff (Cormack 1976, Poole, Sanson-Fisher, Thompson 1981, Robinson 1996a, 1996b). I found this too be true in Neil’s situation as some A & E nurses did not wish to approach him because of his disturbed state and unresponsiveness to verbal cues. What were my thoughts and feeling (Gibbs 1988)? After spending twenty minutes in the assessment interview Neil had remained unresponsive to our approaches and had remained distressed, distant and uncommunicative for the entire time. I had past experience of recent bereavement within my immediate family and I realised that counter-transference was at play and was a reason for my strong emotional reaction to Neil’s distress resulting in me having an overwhelming desire to ease his suffering. Even though another part of me understood the need for him to experience this extreme pain as a normal part of grieving. What was good or bad about the experience (Gibbs 1988)? This was not a good experience for me because as a compassionate person, I found it extremely hard to suppress my own feelings of wanting to protect him from such devastating distress, although I recognised that I was over-identifying with him due to my own grief. I considered that he might have been embarrassed by the emotional state he was in and his inability to control his grief; he could not speak, maintain eye contact or even physically stand. What sense could I make of the situation (Gibbs 1988)? We adjourned for a few minutes so that my mentor and I could assess the situation. I thought it might be appropriate to utilise Heron’s Six Category Intervention Analysis (1975) cathartic intervention as a therapeutic strategy to enable the patient to release emotional tension such as grief, anger, despair and anxiety by helping to (Chambers 1990). I hoped it would facilitate the opportunity for Neil to open up and express his full feelings in a safe and supportive environment. I initially planned to sit quietly with him and briefly put a reassuring hand on either his hand, arm or shoulder. My mentor supported this action. I was aware that I ran a risk of misinterpretation by choosing therapeutic touch. Therapeutic touch may be criticised because it is open to misinterpretation by the patient and abuse of power by staff. The patient may view holding another’s hand as a sexual advance, violation or abuse, so nurses should always consider patient consent, appropriateness, context and boundaries. Clause 2.4 of the Nursing and Midwifery Council (2002) Code Of Professional Conduct says that at all times healthcare professionals must maintain appropriate boundaries with patients and all aspects of care must be relevant to their needs. Therapeutic touch appeared acceptable given his situation and seemed appropriate to the context it would be performed in, given that my mentor would supervise me. As per Gibbs (1988) Reflective Cycle I considered what else I could have done especially if the situation arose again and mentor not been there. I would may have chosen to utilise Hanson’s (2000) approach of ‘being with’ whereby I use therapeutic use of self through the sharing of one’s own presence, and not involved any form of touch, avoiding any misinterpretation or breach of boundaries. I was anxious because I felt concerned that my nursing skills would be inadequate to address his needs due to his acutely distressed state. In reflection my mentor helped me acknowledge that this was about my own anxiety rather than being accurately reflective of my nursing ability. I approached Neil and explained that if it was acceptable with him I would like to sit quietly with him so that he was not alone in his distress. â€Å"It is likely that the nursing process is therapeutic when nurse and patient can come to know and to respect each other, as persons who are alike and yet different, as persons who share in the solution of problems† (Peplau 1988). I gently placed my hand onto his. Neil reacted by given the impression that he physically disintegrated, he become extremely distressed and crying loudly, squeezing my hand tightly. This continued for several minutes. Neil became calmer and started to talk about his situation. This was a good outcome. I was able to utilise Herons (1975) cathartic strategy with positive effect via empathising with Neil’s situation and using myself as a therapeutic tool through the use of touch, thus enabling Neil to express his emotions and activate a nurse-patient relationship. Studies have shown that nurses can express compassion and empathy through touch, using themselves as a therapeutic tool (Routasalo 1999, Scholes 1996) and this has a cathartic value, enabling the patient to express their feelings more easily (Leslie Baillie 1996). The therapeutic value of non-verbal communication and its harmfulness is overlooked (Salvage 1990). Attitudes are evident in the way we interact with others and can create atmospheres that make patient care uncomfortable (Hinchcliff, Norman, Schoeber 1998) On one occasion, one nurse privately referred to Neil as a â€Å"wimp† because he was having difficulty coping with the death of his wife. I wondered whether her body language had transmitted her bad attitude towards Neil, contributing to his distress and difficulties in communicating with staff. Again using Gibbs (1988) Reflective Cycle, I shall provide another example to highlight my learning in practice. What happened (Gibbs 1988)? Cycle On one occasion my mentor and I received a phone call from A & E asking us to review an 18-year-old girl called Emma who had taken an overdose. They said she was medically fit to be assessed. When we arrived they claimed that she was pretending to still feel unwell and described her as â€Å"milking it†. We found her to be vomiting and discovered she had been left in a bed in the corridor of A & E for 8 hours. McAllister (2001) found that patients who had self-harmed were ignored, had exceptionally long waits and suffered judgemental comments. What were my thoughts and feelings (Gibbs 1988)? I felt very angry towards A & E staff as I felt that she was being unfairly treated because she had caused harm to herself, she had been labelled as a troublemaker by staff and I do not believe she had received good quality care. Emma explained that in the last month her father had died, she had miscarried her baby, discovered that her partner was having an affair, and she had been made redundant leaving her with debts that she couldn’t pay. As I looked at her, I saw a vulnerable young woman at the end of her tether. I felt saddened and disappointed by the judgemental attitudes of the A & E staff who had not even taken the time to talk to Emma or ask her why she had taken an overdose, instead they describe her as an â€Å"immature and attention seeking kid†. As per Gibbs (1988) Reflective Cycle, I felt this was a very bad experience of poor care, bad attitudes and unacceptable moral judgement being made by A & E staff. Cohen (1996) and Nettleton (1995) identify that social status; age, gender, race and class contribute to stereotyping and judgemental attitudes. I noticed that people who self-harmed were judged differently dependent upon their age and the younger they were the worse the attitude of A and E staff. Interestingly ageism towards youth is an area that I could find no research on. I believe ageism towards younger people is overlooked and is really only identified in the elderly. During the assessment I was aware of how my physical presence can impact on the care given. However, I have learnt about the importance of considering how one can communicate to the patient via body language. By attending to patients in a non-verbal or physical way it is another method of saying, â€Å"I’m interested, I’m listening and I care.† To do this during Emma’s assessment I utilised Egan’s (1982) acronym S.O.L.A.R. This meant that I sat facing Emma Squarely, with an Open posture, Leaning towards her, whilst making Eye contact and Relaxing myself, to give her the feeling of my willingness to help. This client centred care recognises her equality in the nurse-patient relationship. What sense did I make of the situation (Gibbs 1988)? I was very unhappy about the attitude of A & E staff but recognised that they had a lack of understanding and knowledge. In one study looking at self-harm admissions it was discovered that patients who deliberately self-harm are often deemed as unpopular patients, being labelled and judged as time wasters by A & E staff. Apparently 55% of general nurses perceived these patients as attention seekers and disliked working with them, 64% found it frustrating, 20% found it depressing and almost a third found it uncomfortable (Sidley, Renton 1996). What else could I have done (Gibbs 1988) After reflecting upon the experience with my mentor, I was able to realise that part of my role is to act as a representative for mental health. If this happened again what would I do (Gibbs 1988)? If staff were to make judgemental comments again it is part of my role to educate and inform them so they can have a positive understanding of the needs of the mental health patient and learn to address any judgemental comments made. This is a view supported by Johnstone (1997), who says that if we are made aware of our actions when we are judging and labelling people it is our responsibility to correct this. Medical staff need to be aware of mental health promotion, and need further training and education in respects of helping to care for and understand of this vulnerable patient group (Hawton 2000). This is a view supported by the Department of Health (DOH 1999a) who have recommended closer liaison between mental health and A & E services in an effort to address the poor understanding and negative attitudes of A & E staff. I have also learnt that I must look at both sides of each situation and should show more understanding towards the A & E staff’s feelings, as they are often confronted with shocking and distressing acts of self infliction which can make them feel despair, helpless and unskilled to deal with these sort of patient. I believe nurses negative attitudes develop because we all intuitively apply own our values and views to everyday situations, people, experiences and interactions. It may be the staff member’s own coping mechanism to keep their distance from the patient or to label them as attention seeking in order to make sense of the situation for themselves. This is a view supported by Johnstone (1997). In reflection, following the assessment and planning of care for Emma my mentor and I reflected upon the care I provided for her. I recognised that I felt nervous because it was my first experience of conducting an assessment. Having my mentor there to observe me made me feel secure because I trusted my mentor and could rely on her expertise to ensure that I provided safe practice for Emma. However, I still felt anxious as I was faced with an unknown situation. This made me realise how difficult and intimidating the assessment process may have felt to Emma. I had the security of feeling safe in the relationship with my mentor. Emma didn’t know either of us. This highlighted the huge value of the nurse-patient relationship and how the importance of utilising Rogers (1961) theory of client-centred care involving unconditional positive regard, warmth, genuineness and empathy towards patients. My mentor said that I provided evidence based care and I appeared to have a good humanistic approach, sensitively providing client centred care. She joked that I was so keen to ‘get it right’ that I was practically sat on Emma’s knee in my efforts to non-verbally show to Emma that I was attentive and listening to her. I think that whilst this was a joke, I will endeavour to continue to be keen but will relax a bit more, hopefully as I gain more experience myself. I will also use the insight and understanding from these experiences to benefit my future practise and the care I provide for patients. Boyd & Fales (1983) suggest, â€Å"Reflective learning is the process of internally examining an issue of concern, triggered by an experience, which creates and clarifies meaning in terms of self, and which results in a changed conceptual perspective.† Self-reflection helps the practitioner find practice-based answers to problems that require more than the application of theory (Schon 1983). I have discovered this to be true, especially in mental health nursing where problem solving may be in the realm of religious, spiritual or cultural beliefs, emotional or intuitive feelings, ethics and moral ideals, which sometimes cannot be theorised. With one patient I couldn’t understand his unwillingness to engage in therapy even though he turned up for a weekly appointment. Once I reflected on this with my mentor I realised that I was not considering his strict religious and cultural background, which complicated his care. I realised that I had been completely ignorant of his needs and had in-fact lacked self-awareness otherwise I would have recognised these issues sooner. According to Kemmis (1995) a benefit of self-reflection is that it helps practitioners become ‘aware of their unawareness’. I have learnt that there are barriers to reflection. On occasions after seeing a patient my mentor may interpret events in a slightly different way to myself. Newell (1992) and Jones (1995) criticize the idea of reflection arguing that it is a flawed process due to inaccurate recall memory and hindsight bias. Another criticism of refection is that it aims to theorise actions in hindsight therefore devaluing the skill of responding intuitively to a patient (Richardson 1995). I considered that my thought to hold Neil’s hand may have been intuitive but because we must use evidence based practice and appropriate frameworks of care, I theorised my care and utilised Heron’s (1975) framework. I believe self-reflection helps me to become self-aware. Self-awareness is achieved when the student acknowledges there own personal characteristics, including values, attitudes, prejudices, beliefs, assumptions, feelings, counter-transferences, personal motives and needs, competencies, skills and limitations. When they become aware of these things and the impact they have on the therapeutic communication and relationship with the patient then they become self-aware (Cook 1999). I have learnt through these experiences that reflection can be a painful experience as I have recognised my own imperfections and bias. I have felt angry with general nursing staffs attitudes towards mental health patients and have now been able to realise that this emotion is unhelpful and instead I should be more tolerant and understanding and help them to understand the patients needs. It is also difficult especially if one is experiencing strong emotions such as anger, frustration and grief (Rich 1995). At times I have over-identified with my patients and personalised their situation to similar situations of my own. This is known as counter-transference and has blinded my ability to address their care needs. Counter-transference is the healthcare professionals emotional reaction to the patient, it is constantly present in every interaction and it strongly influences the therapeutic relationship, but is often not reflected upon (Slipp 2000). Counter-transference can be defined as negative as it can create disruptive feelings in the clinician, causing misguided values and bias (Pearson 2001). I have learnt that it is crucial for me to consider how my reactions to a patient’s problem can impact on the care I provide. Whilst I endeavour to always give 100% best and unbiased care to each patient, I have realised I respond more favourably to patients that I like or identify with. For example I was extremely compassionate and biased towards both Emma and Neil and I feel that my personal life experiences influenced me because I could really empathise with them both. However, I realised that I am only human and that as long as I recognise the impact of counter-transference then I can use it positively as my self awareness of the fact that the process is occurring will enable me to address and challenge my own thoughts, feelings and responses. To conclude, I have been able to highlight my learning over the last two and a half years, both personally and professionally. This has enabled me to look at the areas that I am good at and the areas that I can improve on. I have been able to look at the quality of the care I have given patients and considered what I have achieved, how I felt, how I could have done things better, what was successful and unsuccessful, what issues influenced me and what understanding I had of the experience. I have also been able to recognise my role as a representative for mental health nursing and how I can promote it to other healthcare professionals. I have also identified the value of the role of my mentor in helping me to develop as a nurse. I will use the insight and understanding from these experiences to benefit my future practice and the care I provide for patients. ACTION PLAN Word Count 1086 What are my goals? My mentor and I discussed the areas that I want to improve on. We identified that my stronger points are common sense, logical approach and practical ability in terms of things like risk assessing and problem solving. I am also competent in the building of a therapeutic relationship, utilising a humanistic care philosophy, person centre approach, empathy, genuineness, unconditional positive regard and honest. I also have a good knowledge in respect of mental health promotion, anxiety management, basic counselling skills, understanding of the fundamentals associated with nursing, assessment and communication models and the basic principles of psychotherapy. I feel I have come a long way in two and a half years and have accomplished a lot. However, there are areas that I recognise that I can improve on and I am happy that I can address these as I hope this will improve my learning, skills and competency as a nurse in the future, providing better patient care. The areas I need to gain more knowledge and experience of include: understanding the religious, cultural and spiritual needs of the patient and how this impacts on their care and quality of life, recognising and working with counter transference and my tendency to feel the need to over protect patients as this does not help the patient to utilise choice, be responsible for themselves or empower themselves. I want to continue developing my own self awareness through self reflection. Finally I wish to develop my academic abilities and to train further so that I have more knowledge. Why have I chosen these issues? I have chosen to improve my knowledge and understanding of patients religious, cultural and spiritual needs and how this impacts on their care and quality of life, because by doing this I hope to be able to address their needs holistically. To successfully undertake a thorough assessment the healthcare practitioner needs to identify the holistic needs of the patient, failure to do so would neglect the patients physical, psycho-social and spiritual needs (Stuart and Sundeen 1997.) At present I feel I am unable to fully comprehend or provide best care as I feel I lack the skills and knowledge to do so. I also wish to further consider the impact of counter transference and my tendency to feel the need to over protect patients. I feel that if I gain more understanding and recognition of how counter-transference can change my reaction to a patient then I will be able to address it and have more control and choice over my nursing and my responses. In practice, I have experienced strong emotional reactions to some patient’s, perhaps because I could identify with some of their issues. However, this can result in my wanting to over protect them, which may disempower them, and this is unhelpful. Different characteristic in patients can influence the emotional reaction of the nurse (Holmquist 1998). I need to be able to recognise these characteristics in the patient and be self aware of the way I am responding. I want to continue developing my own self-awareness through self-reflection, as I will need to be able to exercise autonomous and expert judgement as a qualified nurse. The ability to use self-reflection as a learning tool to becoming self-aware will help me achieve this. This is a view supported by (Wong 1995). Boud, Keogh & Walker (1995) believe self reflection is an important human activity, essential for personal development as well as for the professional development of the nurse. By being able to mull over my experiences will help me challenge my beliefs and behaviour as an individual and a nurse. Finally I wish to develop my academic abilities and to train further so that I have more nursing knowledge. Experience alone is not the key to learning (Boud et al 1985). I wish to gain further qualifications so that I may further my career and knowledge, as this will provide a sense of achievement and fulfilment for me. How am I going to achieve my goals? I intend to develop my portfolio and keep an open reflective diary (Richardson 1995) to show evidence of my learning and prepare for my PREPP. Portfolios are seen as a collection of information and evidence used to summarize what has been learnt from prior experience and opportunities (Knapp 1975), and acknowledges professional and personal development, knowledge and competence, providing nurses with evidence of their eligibility for re-registration every three years (NMC 2002). I believe maintaining my portfolio helps with one’s self-assessment and will help me to develop my strengths, plus identify and critically evaluate my weaker areas, this is a view supported by Garside (1990). However in contrast Miller & Daloz (1989) suggest there is no evidence to suggest that self assessment contributes to enhance self awareness. A barrier to one’s ability to self-reflect may be time constraints and socio-economic factors such as high staff and management turnover, low staff morale and staff illness (Bailey 1995) I hope to overcome this by being a supportive team member to my colleagues and maintaining a positive mental attitude. I am happy to work on my portfolio and diary in my own time as I think it is a valuable learning tool. I will use my preceptorship, learning in practice, observation in practice and clinical supervision to help achieve my goals. Reflection on action is considered to be an essential part of clinical supervision (Scanlon & Weir 1997). I will continue to use Gibbs (1988) Reflective Model to help me develop my learning through reflection. I will need to feel confident that by sharing my portfolio, diary, reflection or seeking advice via preceptorship and supervision that this will not reflect negatively on me and effect my ability to feel able to trust my mentor. Students and staff sometimes feel unable to fully express themselves or belittled by the power relationship if supervision is not in a trusting relationship feeling it could be open to bias, personality clashes, counter-transference or could disadvantage them in terms of career development (Richardson 1995 Jones 2001). However, good clinical supervision enables nurses to feel better supported, contributing to safer and more effective nursing (Teasdale 2001, Jones A 2001). I hope to continue with life long learning and would like to be able to study for a degree in nursing. I shall do this by apply for funding once I am employed and hope that whoever my employers are they will support me in my goal to become better qualified. 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Newell R (1992) Anxiety, Accuracy And Reflection; The Limits Of Professional Development, Journal Of Advanced Nursing, Vol 17, 1326-1333 Nursing and Midwifery Council (2002) Code Of Professional Conduct, London, NMC Pearson L (2001) The Clinician-Patient Experience: Understanding Transference And Counter-transference, The Nurse Practitioner, The American Journal Of Primary Health Care, Vol 26 (6) 2001 Peplau H (1988) Interpersonal Relations In Nursing, London, MacMillan Press Poole AD, Sanson-Fisher RW, Thompson V (1981) Observations On The Behaviour Of Patients In A State Mental Hospital And A General Hospital Psychiatric Unit: A Comparative Study, Behaviour Research And Therapy, 19, 125-134 Playle J (1995) Humanism And Positivism In Nursing; Contradictions And Conflicts, Journal Of Advance Nursing, 22, 979-984 Rich A (1995) Reflection And Critical Incident Analysis, Journal Of Advanced Nursing, Vol 22 (6) 1050-1057 Richardson R (1995) Humpty Dumpty- Reflection And Reflective Nursing Practice, Journal Of Advanced Nursing, Vol 21, 1044-1050 Robinson D (1996a) Measuring Psychiatric Nursing Interventions: How Much Care Is Individualised, Nursing Times Research, 1, 1, 13-21 Robinson D (1996b) Observing And Describing Nursing Interactions, Nursing Standard, 13, 8, 34-38 Rogers C (1961) On Becoming A Person, London, Constable Routasalo P (1999) Physical Touch In Nursing Studies: A Literature Review, Journal Of Advanced Nursing, 30, 4, 843-850 Savage J (1990) The Theory And Practice Of The New Nursing, Nursing Times Occasional Paper, 86, (4) 42-45 Scholes J (1996) Therapeutic Use Of Self: How The Critical care Nurse Uses Self To The Patients Therapeutic Benefit, Nursing In Critical Care, 1, 60-66 Schon D (1983) The Reflective Practitioner, London, Temple-Smith Scanlon C & Weir W S (1997) Learning From Practice? 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Narrative Essay- the Crucible Abigail Williams

Before the accusations: Dear Diary, I hate Elizabeth by heart. I am calling for revenge, oh God please hear me. And if God is not willing to fulfill my desire I will have to use other aid. I cannot stand the hurt in my bleeding heart anymore. John, oh John, it would be easier if you left your wife and flower out the purity of our love with me. We could leave; go to a place where we will be satisfied for the rest of our lives. But you broke my heart. I tried to couple with you. I still remember my accelerated heartbeat when our bodies came closer; you should have kissed me.But you did not. Instead, you do not want to know anything about me. I truly thought that you would fall in my arms. And I did not feel guilty about our forbidden love for one breath of my life. I would do it again, just for you John, for our love. I never felt such true love in my life. I never had a mother who would love me no matter what happens. You were the only light in my life. And this light disappeared when you decided to turn your back on me. You cannot resist me, I know that. You still love me, you have to love me, and I am the only one for you.So I will do whatever it takes to reunite with you again. I do not care about Elizabeth or her devilishly children, they should burn in hell. Oh yes, Elizabeth, you honest, well-behaved holy woman, you will perceive my choler. You will regret dismissing me. I am not the one to blame for the emptiness in your marriage. Besides I am the one of us two who makes him blessed to be a member of this world. I have a plan. I shall not rest until I receive what I deserve. People may die. But there is a price for every purchase in this world. In my case it is the craving for revenge.Revenge, revenge, you are sweet bitter. I need to make sacrifices. Witchcraft is the problem’s solution. Tituba will help me. She is from the Barbados and she is informed about other spirits. We used to meet in the woods. We dance. Sometimes we get naked. Last time we drank chicken blood in order to kill Elizabeth Proctor. I think Parris saw us dancing in the woods. Betty is not doing well. But I do not care about her state. If she says a word about us drinking blood I will kill her. I already warned her. She will listen, she is bright. All the other maids do not mind to manipulate Salem.It is a game. We will never give up because we started it. I am awfully enthused to see Elizabeth hang. Proctor is clever. He will know that I am behind all this mystic witchcraft. Maybe then he will know how important he is to me. Some people are going to die. I think we are going to name 19 people in the court. Mary Warren is a good girl, too good. She might tell the truth about everything. I need to be prepared. She will not be the one to destroy my genius plan. I already put too much effort in it. No one can stop me. No one can stop the girls from Salem. We are born to be successful.We are born to get what we want. We will kill inhabitants of Salem. We will be the winners of this game I write the rules. I am the leader. After the witch trials: Dear Diary, John is dead. I never wanted him to die. I loved him too much. He is gone now. He will never come back. I offered him to leave with me, I had the money but he did not want to be with me. He did not want me, Abigail Williams. I miss him; I miss his warm hands and his soft skin. I miss how he looked at me. Elizabeth it is your entire fault. You should have died. Why him and not you? I tried my best.I pointed at innocent people. Innocent people hanged because of us. We killed them. We had to kill them. They had to die. I enjoyed the relieving moment when someone was hanged. It felt right. I felt euphoric. They were the zenith of my life. I knew that Mary Warren would act Puritan. She is just like Elizabeth. I hate her. The Court did not believe her. We were too strong. She was too weak, poor girl. She was sweating like a hounded pig when the judge was questioning her. She needs to learn how to lie. When she knew that the judges would not believe her she gave up and came to our safe side.But now John is dead because of her. I am selfish. I take my life over his and I do not regret it. John had his chance to come with me. It was his choice to hang. I want to live and I will. I will find another man, a better man who appreciates my effort and love. I will be happy and blessed. Until then I will do everything to hide the truth from the light. Salem will never be clever enough to hunt the actual witches of the town. We are responsible for the death of 19 human lives. We are beasts. Try to catch us. The game goes on.

As the Federal government comes to terms with large budget deficits, Essay

As the Federal government comes to terms with large budget deficits, what will be the effect on the American economy - Essay Example Paying down the debt too fast or too far could result in the deflationary effects on the economy due to the paradox of saving. A debt that grows too far or too fast, especially if held by foreign nationals, has the effect of weakening the dollar against foreign currencies and could potentially lead to hyperinflation and economic collapse. The budget deficits that are currently in effect are not a matter of how large they are, but are more a concern of what the money is spent on. Spending more than the federal tax revenues take in has the capacity to fuel the economy or leave it in a state of debt with little or no return. For every tax dollar spent there is an opportunity cost. When tax dollars are borrowed to build roads or bridges, the money goes into the hands of employment and suppliers. This money is then recycled through the economy by the working class buying consumer goods. This stimulates the economy and provides jobs for autoworkers, carpet layers, and appliance salesmen who again recycle the money. However, if the money is spent on the design and testing of complex weapons system most of the money ends up draining the available pool of talented engineers and provides no commercial benefit (Nimroody and Hartung). Spending the money wisely can fuel the economy or be an opportunity lost. While excessive government spending, and especially wasteful disregard, may seem to be an excessive opportunity cost, the consequences may be more dire than one might expect. Adam Smith introduced capitalism to the invisible hand concept, which states that people will pursue their own self-interests, which â€Å"will ultimately benefit everyone, including the unintended. He continues by saying that any interference by government is almost certain to be injurious to the invisible hand concept† (Palmer 22). From Smith’s viewpoint of the invisible hand, all taxation contracts the economy, even when necessary. When the government runs up

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Strabucks Case Essay Example | Topics and Well Written Essays - 2500 words

Strabucks Case - Essay Example Simply, there are no unimportant customers. However, before drawing any recommendations, a careful analysis of the situation should be made. Especially I would like to focus on the three key points in the whole story. First, final costs of settling the issue with the dissatisfied customer, who went on anti-Starbucks ad campaign, are much greater than the initial costs of satisfying the client, who returned his defective cappuccino maker. Second, during the investigation of the case by Starbucks the customer was disturbed so many times, that his dissatisfaction had grown greatly, almost turning into aggression. He had to tell his story to every manager he talked to, and had to face several weak attempts of compromising before his demands were satisfied. Third, problems with Starbucks coffee makers did truly happen. It can be concluded from a wave of phone calls on the phone line established by the furious customer. "Upon the first advertisement's appearance, Dorosin received a "ton of calls." He said he had received thousands of calls, from customers, competitors and employees who felt Starbucks misrepresented themselves to the public." (Barr et al 1998) Therefore, Starbucks did perform badly. In fact the customer was so upset, that this issue has overgrown the simple financial compensation. What he though Starbucks should do is to apologize. The point is in moral compensation, not just financial. This fact is supported by $20,000 spent by client on the case: "He set up a toll-free line with six telephones installed in his small scuba shop and hired extra employees to answer the calls. In one year he received about 6,000 responses. His total estimated outlay: $20,000." (Kalis and Leaf 1999) The media attention to the situation made the position of Starbucks even more complicated. Now let us turn to Starbucks profile and background. The company has been developing rapidly since 1988, offering various coffee drinks and beverages, operating through its own stores. The company's competitive advantage was based on three whales: highly differentiated offers, suitable position of its stores, and a great attention paid to customers. "Customer service was a key ingredient to Starbucks' success. One of the five guiding principles of the company was 'Develop enthusiastically satisfied customers all of the time.'" (Barr et al 1998) It was the reason people preferred the large corporation offering rather expensive beverages to tiny comfortable cafes. In the light of this strategy a weak decision of replacing Dorosin's and his friend's machines with two new ones at a cost of $270 instead of top-of-the-line cappuccino maker priced $2500 and apology looked very bad. From the external viewpoint it looks like, not only the company has failed to deliver its services to customer on the proper level of quality, but also tried to pinch pennies on the compensation. After all, what is one top-of-the-line machine to Starbucks in compare to its brand image Nothing. If given a decent amount of attention from the Starbucks' management the issue would have been resolved without unnecessary noise in the media. The hysteria raised by press was even more uncomfortable, because Starbucks experienced another problem: the company was accused in the elimination of local coffee businesses throughout the country, which could not match to the corporation. "'I like supporting a local business,' says Conrick, a

Analysing legal issue on Gun Control in Canada Essay

Analysing legal issue on Gun Control in Canada - Essay Example 2 An audit by the Auditor General of Canada in 2002 further showed that the Department of Justice estimated the cost of the gun registry program would rise significantly by 2004-2005, costing more than $1 billion while gun registration fees amounted to about $140 million in fees, 2 though no significant benefit of the gun control program is recognized. According to John Lott and Eli Lehrer since the start of the new gun control program, crime rate in Canada has increased.3 The Canadian government also recently admitted it could not identify a single violent crime that had been solved through the process.3 Canadian Alliance Party critic Gary Breitkreuz says the current firearms law should emphasize on harsher punishment for those who use weapons in the commission of a crime.2 Bob Runciman called for the program to be put on hold while describing it as a waste of taxpayers' money.2 The Justice Department's statistics that claim Firearms Act and gun registrations are on the increase are irrelevant, since criminals don't sign up for licenses. From statistics compiled from the registration program it is clear that even though rural Canada has by far the majority of firearms, it still recorded the least amount of crimi

Intermediate Microeconomic problem set section A & B Coursework

Intermediate Microeconomic problem set section A & B - Coursework Example It is only possible to have dominant strategy equilibrium as Nash equilibrium, and not Nash equilibrium as dominant strategy. A dominant strategy is a special case of Nash equilibrium since there can be a tie of the strategies made by the players, therefore, resulting in Nash equilibrium. At that point, no player is capable of making any move since any move made by any player makes them worse off. They can only make a move if the dominant player makes a move (Kelly, 2003). 5. What are production externalities and how can they be eliminated through a merger? Explain, also with the aid of an example illustrated by a diagram. Production externalities are costs or benefits to a party other than the producer. Production externalities can either be positive or negative. Positive production externalities are the benefits that ensue from production or the construction of a production unit in a place. The benefits are to the society. These benefits result from production externalities that co me about as a result of production by companies and industries. The costs that come about as a result of production sum up to negative production externalities. ... Industries emit harmful gases into the atmosphere through the various processes of production. Such gases pollute the environment and more so, the air people breathe. This results in respiratory diseases when inhaled and also destroys the ozone layer leading to changes in climate. Setting up of industries also involved creating space trough cutting down of trees. Planting and having such trees takes ages and this is a cost to the society. Another externality is that traffic jams ensue as industries take up more space for industrial construction. Positive production externalities are the benefits to other third parties other than the producer. Such benefits are enjoyed by third parties. The producer does not enjoy them. An example is where producers provide jobs to the community in which it is set up and provides sponsorships and produce quality and safe products to the society. Have to be charged for emission of gases or harmful substances into the environment. They also pay for poll ution permits in order to produce. Industries also pay taxes to the government which acts as a revenue. While society benefits from this, it is a cost to the producer. A merger is where industries come together and represent both industries as one. For example, when there is a fishing firm a manufacturing industry that emits sewerage to the water that the fish firm depends on. The fish firm may decide to buy the manufacturing firm so it becomes one company, so that it is able to control the pollution of the water resource. Thus, by merging the two industries, the costs of the production externality are controlled and reduced (Quiggin and Chambers, 2001). S=maginal social costs(MSC) S=marginal private costs (MPC) Price P* P B D=marginal social benefits (MSB) Q* Q Quantity The difference

Understanding & Managing Organisations Essay Example | Topics and Well Written Essays - 3000 words

Understanding & Managing Organisations - Essay Example Understanding and Managing Organisations As such, human resource (HR) has to find means wherein the management of people becomes the foundation for the success of the organisation (Boxall & Purcell 2003). In this regard, this study will look into HRM, its meaning and functions and on how strategic HRM becomes an essential development in the field. From this perspective, the study will focus on five aspects of HRM, namely, resourcing, employee engagement, job design, employee development and leadership. This is undertaken with the purpose of gaining more insight and better understanding of HRM. The paper will be having the following structure. The first section will deal with the nature of HRM. This will provide the framework in which the five related functions of HRM are appreciated. The second part will deal with some questions pertinent to the five aspects of HRM, which is the focus of the study. This is essential as it affords a way wherein some concerns relevant to these five functions may be clarified. Finally, the thi rd part will be the conclusion. In the end, it is the aim of the writer to be able to produce a clearer vision of the relationship between organisational behaviour and HRM. HRM: Its Nature and Definition Before, HRM has been concerned with administrative functions in people management. However, with developments in technology, HRM administrative functions are no longer its main concern, but it is now focused on coming up with strategies that position the right staff in the right job at the appropriate time and carrying out task effectively. (Lawler & Morhman 2003). As such, human resource management is â€Å"strategic and coherent approach to the management of an organization’s most valued assets – the people working there who individually and collectively contribute to the achievement of its objectives† (Armstrong 2006, p 2). Observable in the definition is the notion that people are considered to be as the â€Å"most valued assets of the organisation†, this position breaks from the traditional perception that employees are deemed as costs rather than assets. This is a significant condition because there are some who are claiming that there is a difference between HRM and human capital management (HCM) and that the main difference between the two is the actual practise (Armstrong 2006). It is contended that HRM also sees personnel as assets, however, since they have several concerns, only a few of HR people admits in implementing the philosophy and belief system underlying HCM (Armstrong 2006). On the other HCM uses measurable data to come up with policies, strategies and programmes that will help the management develop the right training, learning and opportunities that will further improve the employees. Nonetheless, although the discourse regarding the difference between HRM and HCM is continuing, what is necessary is that HRM and HCM may be combined in order to with better HR policies, strategies and programmes that best suit t he needs and goals of both employees and the organisation. With people as valuable assets as its ethos, HR works within a system wherein there is a clear HR philosophy that serves as a guide to managing people. It also has to have clear HR strategies that will lead HRM to its goals and vision. Likewise, it has to have HR policies that will set as the standard in addressing HR concerns while HR procedures are necessary concrete methods or processes adopted by the organisation as it implements HR policies. At the same time, there are

Human Resource Management (Strategic Perspectives) Essay

Human Resource Management (Strategic Perspectives) - Essay Example It is, therefore, imperative that call centre employees be exceedingly well-trained in order to ensure, not just the provision of quality service but that the call centre communicate a positive image of the corporation itself. Upon consideration of the importance of call centres, the decision to outsource appears quite monumental as, indeed, it is. Cost considerations, however, firmly establish it as a practical decision. Therefore, prior to outsourcing its call centre operations to India, ABC Incorporated need have a thorough understanding of HR outsourcing, its associate management models, be cognizant of the advantages and disadvantages of such a step and realise the cross-national and cross-cultural challenges which confront such a step in order to best manage them. This report will do just that. The report will commence with an overview of the definition of both outsourcing and HRO. Both these definitions are important for two reasons. In the first place, they give us a solid understanding of the advantages of outsourcing specified HR functions. In the second place, they give us an insight into the ways and means by which the disadvantages associate with HRO may best be managed and contained. Outsourcing: A New Definition for a Historic Phenomenon While popularly perceived of as a new phenomenon for which globalisation is held responsible, Domberger (2005) contends that outsourcing, as contracting, is a historical practice, solidly grounded in economic imperative and principle. As defined by Domberger (2005), outsourcing is best understood as a form of extra-contracting whereby, to reduce overall operational and manufacturing costs and maximise efficiency, firms and manufacturers have, traditionally and historically, contracting out specific steps in the work process. Referring to Adam Smith as the first to theorise this phenomenon, Domberger (2005) borrows the British economist's famous rural-urban example. Instead of rural areas embarking on activities which were not supported by heir environment, such as manufacturing, they focus on the agricultural activities supported by their environ; urban areas, instead of seeking to grow the raw material required for the manufacture of finished products, purchased the aforementioned from the rural areas. Rural and urban areas, thus, entered into an economically co-dependant and cooperative relationship, based on specialisation (Domberger, 2005). Specialisation, insofar as it involved the exploitation of labour tale nt and competencies from without the immediate geographic area, is the basis upon which outsourcing is founded. Domberger (2005) as may be deduced from the above, defines outsourcing as contracting based on specialisation and motivated by such economic imperatives as the exigencies of reducing cost and improving quality in order to remain competitive. Within the context of this definition, outsourcing is hardly a new phenomenon, but a

Project Management Essay Example | Topics and Well Written Essays - 2500 words - 4

Project Management - Essay Example On the sparc.airtime.co.uk website, a Software Project Manager is defined as a person with "the role with total responsibility for all the software activities for a project (CSCI). The Software Project Manager is the individual the Program Manager deals with in terms of software commitments and who controls all the software resources for a project. The Software Project Manager may have the responsibility for multiple software projects." (www.sparc.airtime.co.uk, 2006) By understanding what the project management position being advertised is in relation to the definitions of what that job is ensures that both the advertiser and the applicant are under the same understanding of what both are looking for. Sometimes the jobs that are being advertised are vague with respect to what the job scope is and many times this is done for a reason Many of the job advertisements reviewed from both online newspapers (Times) and internet searches were indeed different in what they wanted applicants to see. The different scopes of the descriptions tend to either be too vague and the job description is meant to either weed out those who the company does not want to have apply, or, keep their true job requirements a closely guarded secret. One of the many tactics that employers tend to do is to ensure that competitors are not finding out what the job is in entirety, especially if they are not going through a placement agency, to ensure they do not phish for information about future projects. As many employers look to recruitment agencies to find their next employees, one of the problems that come from that route is that the agencies do not provide complete details about the job as they want a face to face interview before the applicant even goes before the customer. The job of the recruitment agent is to ensure that the customer is in fact getting the right candidate for the job, and, for the position of a project manager the customer can ill-afford the trouble of interviewing substandard applicants. Advertised Positions for Project Manager - Good and Bad The search for this type of position was actually quite easy and circumspect in what the different employers classified as a project manager, as it would appear many of them leaned more to a Directorship position. In one advertisement for a web project manager through a recruitment agency, the position called for Detailed understanding of web projects & implementation methodologies; An understanding of commercial and account strategies with the ability to tailor implementation and wider delivery processes to meet stakeholder requirements; General knowledge of HTML, design/graphic production software packages (e.g. PhotoShop, Dreamweaver) and familiarity with other web technologies Understanding of web development and design tools; Appreciation of other web technologies; Ability to lead cross-functional team of designers, developers and other staff; Client management skills for project reporting, conflict management and general engagement; Strong project estimating skills; Strong project planning and project management abilities with skills in

Greek Mythology and Heracles Family Essay Example for Free

Greek Mythology and Heracles Family Essay The Greek heroes Heracles, Jason, Perseus and Theseus are all intriguing characters of Greek mythology. They each portray many different qualities and compare and contrast each other. For example the fact that Heracles was constantly a target of Hera and Theseus a target of Medea links them as characters. Also, Heracles frees Theseus from the chair of forgetfulness which also makes them similar. Even further, Perseus is from the city of Argos which happens to be where Heracles’ family is from as well. Another similarity between Heracles and Theseus is that they attack the Amazons together and both tend to rid the lands of certain monsters. Heracles also worked together in the Argonaut crew with Jason. All these heroes also tend to share great physical strengths and capabilities to defeat their enemies. These four heroes also differ from each other. Jason seemed to be portrayed as somewhat of a weaker character and Perseus seemed to receive much more help from gods and goddesses, even by Heracles, more than the other heroes did. It may have been because they favored him more. Another distinguishing feature is that Heracles was an average human being before he became immortal. As far as how each hero handles their quests, all four of them seem to mentally be prepared for each quest. They tend to each focus on the task at hand. For example, Heracles labors to catch a deer that is lightning fast; he perseveres for a year before he catches it. They all seem to show dedication and patience to each mission. However unlike Theseus who picks more dangerous routes, maybe for more of a mental challenge, Perseus does not seem to be as mentally focused but more on the physical side of things. Perseus is more physical and does not have to use as much intellectual thinking because he is gifted by nymphs and gods that give him the right tools to succeed on his quest. Heracles stands out as a physical hero since the day he was born by having to fight off the snakes that Hera sent his way and the fact that most of the twelve labors were aimed for his failure yet he succeeds. Another impressive success was the cleaning of the Augean stables by means of diverting 2 rivers. Each of these four heroes has honorable qualities that drives them in their quests and make them compare and contrast to each other.

Amendment to Controlled Substances Act: Hydrocodone

Amendment to Controlled Substances Act: Hydrocodone H.R. 1285: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone a Schedule II Drug Jill Garreth Abstract This paper describes H.R. 1285, a bill proposed to amend the Controlled Substances Act to make any substance containing hydrocodone a Schedule II drug. It explores the historical, sociocultural, ethical, economic and the political/legislative environment in which the bill was introduced. Some of the difficulties encountered include the bill being referred to the House Committee of Judiciary and the House Committee of Energy and Commerce (H.R. 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone A Schedule II Drug, 2013). Since being referred to both committees, there has been no further action taken on this bill by Congress (H.R. 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone A Schedule II Drug, 2013). Stakeholders in the passage of this bill include physicians, pharmacists, advanced practice nurses, patients and long term care (LTC) facilities. The likelihood that H.R. 1285 will pass is very small due to the fact that the Drug Enforcement Agency (DEA) recently made a ruling that changed hydrocodone to a schedule II drug (Drug Enforcement Administration, 2014). Because of the DEA’s actions, it seems unnecessary to push forward with H.R. 1285. Keywords: hydrocodone, schedule II drugs, controlled substances, DEA H.R. 1285: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone a Schedule II Drug Introduction H. R. 1285 is a bill introduced March 20, 2013 to amend the Controlled Substances Act to make any substance containing hydrocodone a Schedule II drug (H.R. 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone A Schedule II Drug, 2013). H.R. 1285 â€Å"amends the Controlled Substances Act to remove dihydrocodeinone (hydrocodone) from classification as a schedule III controlled substance. Directs the Attorney General to immediately allow manufacturers and distributors to store hydrocodone compound products in accordance with the physical security requirements for schedule III, IV, and V controlled substances for three years beginning on the date enactment of this Act. Requires the Comptroller General to submit a report on the reclassification of hydrocodone products under this Act, including: (1) an assessment of the degree to which the reclassification of such products under this Act impacts the ability of patients with legitimate m edical needs, particularly those in rural areas and nursing home facilities, to access adequate pain management; and (2) recommendations necessary to address any issues relating to patient access to adequate pain management† (H.R. 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone A Schedule II Drug, 2013). H.R. 1285 is a piece of legislation that could directly affect the prescriptive authority of an advanced practice nurse (DEA Issues Info, 2012). Some states only allow an advanced practice nurse the authority to write prescriptions for drugs rated Schedule III and below and because of that, H.R. 1285 has the potential to affect advanced practice nurses in at least nine states (DEA Issues Info, 2012). Environment Historical Title 21 of the United States Code Controlled Substances Act classifies drugs based on three criteria (U.S. Code: Title 21-Food and Drugs, 2012). The criteria used to determine the schedule of the drug is the potential for abuse of the drug, whether the drug has an acceptable medical purpose and the type of dependence the drug may perpetuate (U.S. Code: Title 21-Food and Drugs, 2012). Between 2004 and 2009 products containing hydrocodone had an increase in demand of approximately 125% (Drug-Related Hospital Emergency Room Visits, 2011). Florida Congressman Vern Buchanan introduced this bill to help combat the growing prescription drug epidemic in his home state of Florida and wants to make hydrocodone combination products more difficult to obtain and prescribe (Congressman Vern Buchanan representing Florida, 2014). Sociocultural There are more than just health concerns that have brought this issue to forefront. There have been many studies done that show a direct link to drug abuse and crime. According to the Bureau of Justice, 30% of offenders in state detention facilities stated that they would likely commit crimes in order to get money for drugs (Bureau of Justice Statistics, 2004). In Florida, at least 7 people die daily from prescription drug overdoses (Congressman Vern Buchanan representing Florida, 2014) and at least 75 people die daily nationwide (Drug Enforcement Administration, 2014). Crime and drug overdoses are just a few of the sociocultural considerations that caused Congressman Buchanan to introduce H.R. 1285. Ethical One ethical implication that pushes H.R. 1285 to the forefront of legislation is that because hydrocodone is a prescription medication, prescribers have an ethical responsibility to assist in combatting the misuse and abuse of this drug (Hamburg, 2014). H.R. 1285 is not designed to make it more difficult for patients with a legitimate need to obtain the medication but it is designed to assist the providers in making better educated decisions when prescribing medications that have such a high potential for abuse (Drug Enforcement Administration, 2014). Economic Economic factors that have made this issue important is not necessarily related to the cost of the drug but the cost of the effects of abuse of the drug. â€Å"Prescription opioid abuse costs were about $55.7 billion in 2007. Of this amount, 46% was attributable to workplace costs (e.g., lost productivity), 45% to healthcare costs (e.g., abuse treatment), and 9% to criminal justice costs† (Centers for Disease Control, 2014). In 2010 there were 49 million uninsured people in the United States (US Census Bureau, 2011). Rising healthcare costs and uninsured people need to be a consideration when legislators review H.R. 1285. Political/Legislative H.R. 1285 has been assigned to the House Committee on Energy and Commerce and the House Committee on Judiciary (H.R. 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone A Schedule II Drug, 2013). The House Committee on Energy and Commerce has the responsibility of reviewing the Food and Drug Administration’s (FDA) ability to establish the effectiveness and safety of prescription and over-the-counter (OTC) drugs in the United States (Longest Jr., 2010). The House Committee on Judiciary has jurisdiction over revision to existing codes so it has an important role regarding amending the existing drug scheduling (United States House of Representatives Judiciary Committee, 2014). Despite the fact that both committees have a Republican majority, there has still been no movement on this bill. Difficulties Encountered H.R. 1285 was introduced on March 20, 2013 by Florida Republican Representative Vern Buchanan (H.R. 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone A Schedule II Drug, 2013). This bill has 54 co-sponsors of which 32 are Republican and 22 are Democrat (H.R. 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone a Schedule II Drug, 2013). H.R. 1285 has been referred to the House Committee of Judiciary and the House Committee of Energy and Commerce and the committee chair makes the determination on whether the bill moves forward (H.R. 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone A Schedule II Drug, 2013). One difficulty noted in regards to H.R. 1285 is the fact that there has been no action taken since its introduction to Congress. There is no optimistic timeline to predict if H.R. 1285 is going to be passed. Speaking pess imistically, H.R. 1285 will not pass at all. As of October 6, 2014 a Drug Enforcement Administration’s (DEA) ruling took effect that is essentially in the same spirit as H.R. 1285 (Drug Enforcement Administration, 2014). This ruling reschedules hydrocodone from a schedule III drug to a schedule II drug (Drug Enforcement Administration, 2014). Since the DEA has already changed the schedule of hydrocodone and it has already been implemented, there is no need for further movement of H.R. 1285. Stakeholders in the passage of H.R. 1285 include physicians, pharmacists, advanced practice nurses, long term care (LTC) facilities and patients. LTC facilities have been especially vocal on this topic due to the fact they believe that any further regulation or change in the scheduling of certain narcotics will have a negative effect on patients in their facilities and the ease in which these patients will have access to them (Garrison Mitty, 2010). Nurses who work in these types of facil ities are encouraging others to join professional organizations and write to their legislators to make their voices heard (Garrison Mitty, 2010). Effects Some positive effects of H.R. 1285 are increased awareness for prescribers of the dangers of opioid dependence related to hydrocodone and a decrease in â€Å"doctor shopping† related to the tighter regulation and monitoring of hydrocodone (Phillips, 2013). Negatives of H.R. 1285 include increased difficulty for patients in LTC facilities to access physicians and obtain prescriptions needed to adequately address their pain needs (Garrison Mitty, 2010). Because of the tighter prescriber restrictions related to refills and the types of prescriptions accepted, those who reside in LTC facilities could have to wait longer to receive refills on much needed pain medication (Garrison Mitty, 2010). International The U.K. has similar problems to the U.S. when it comes to prescription drug abuse (Weisburg et al., 2014). The U.K. has the Health Act of 2006 which created Accountable Officers that track and audit the prescriptions written (Weisburg et al., 2014). The U.K. also has trialed a real-time monitoring system to be able to monitor irregular prescribing practices for certain drugs (Weisburg et al., 2014). Although it was only a trial of a computerized system, it showed great promise in assisting real-time monitoring of prescriptions written. Change to the Bill As with anything, there are always improvements that could be made. One way to refine H.R. 1285 is to implement mandatory education for prescribers. Requiring education in areas of opioid pain management, pain management alternatives and safe prescribing practices is one way that could improve policy outcomes (Weisburg et al., 2014). Another improvement that could be made is by establishing a universal standard to pain management and the dispensing of medication because by using a universal standard, improved outcomes can be expected (Gourlay et al., 2005). Another way to improve H.R. 1285 would be to include a plan to implement a national prescription drug monitoring program (PDMP) (Drug Enforcement Administration, 2014). Many states already have a PDMP in place but it only monitors statewide activity (Drug Enforcement Administration, 2014). In order for a PDMP to be effective, it would need to be nationwide and offer up to date information (Drug Enforcement Administration, 2014). Conclusions H.R. 1285 is a bill introduced to Congress to change the schedule of hydrocodone from a schedule III to a schedule II drug. Congressman Vern Buchanan introduced this bill because of the growing drug epidemic he witnessed in his home state of Florida (Congressman Vern Buchanan representing Florida, 2014). He describes seeing more pain management clinics that dispense prescriptions for drugs than McDonald’s restaurants (Congressman Vern Buchanan representing Florida, 2014). Although H.R. 1285 was referred to two separate committees, the likelihood that the bill will be passed is very slim. There has been no further action taken on the bill by either committee. Prescribers, patients and LTC facilities have a stake in whether or not H.R. 1285 passes. All have concerns regarding difficulty in prescribing medication to those who truly need it and maintaining access for the patients who are living in a LTC facilities. Due to the recent ruling of the DEA that changed hydrocodone conta ining products from a schedule III drug to a schedule II drug, it seems unnecessary for H.R. 1285 to move forward (Drug Enforcement Administration, 2014). References Bureau of Justice Statistics 2004 Bureau of Justice StatisticsBureau of Justice Statistics (2004). Bureau of Justice Statistics. Retrieved October 6, 2014, from http://www.bjs.gov 201410091059041289595843 Centers for Disease Control 2014 Prescription Drug Overdose in the United States: Fact SheetCenters for Disease Control (2014, July 3). Prescription Drug Overdose in the United States: Fact Sheet. Retrieved from http://www.cdc.gov 20141009115559483260035 Congressman Vern Buchanan representing Florida 2014 Congressman Vern Buchanan representing FloridaCongressman Vern Buchanan representing Florida (2014). Congressman Vern Buchanan representing Florida. Retrieved from http://www.buchanan.house.gov 201410091015471184166312 DEA Issues Info 2012 American Association of Nurse PractitionersDEA Issues Info (2012, June). American Association of Nurse Practitioners. Retrieved from http://www.aanp.org 20141008133918138817310 Drug Enforcement Administration 2014 Schedules of Controlled Substances: Rescheduling of hydrocodone combination products from Schedule III to Schedule IIDrug Enforcement Administration (2014, August 22). Schedules of Controlled Substances: Rescheduling of hydrocodone combination products from Schedule III to Schedule II. Retrieved October 7, 2014, from http://federalregister.gov/a/2014-19922 20141009113706118370533 Drug-Related Hospital Emergency Room Visits 2011 National Institue of Drug AbuseDrug-Related Hospital Emergency Room Visits (2011). National Institute of Drug Abuse. Retrieved October 1, 2014, from http://www.drugabuse.gov 20141008130227593245745 Garrison K Mitty E 2010 Pain management and the U.S. Department of Justice.Garrison, K., Mitty, E. (2010). Pain management and the U.S. Department of Justice. Geriatric Nursing, 31(3), 214-219. 20141009140312276748895 Gourlay D Heit H Almahrezi A 2005 Universal precautions in pain medicine: A rational approach to the treatment of chronic pain.Gourlay, D., Heit, H., Almahrezi, A. (2005). Universal precautions in pain medicine: A rational approach to the treatment of chronic pain. American Academy of Pain Medicine, 6(2), 107-112. 201410091514541512988925 Hamburg M A 20140403 FDA Commissioner Margaret A. Hamburg statement on prescription opioid abuseHamburg, M. A. (2014, April 3). FDA Commissioner Margaret A. Hamburg statement on prescription opioid abuse. Retrieved October 7, 2014, from http://www.fda.gov 20141009112410159525513 HR 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone A Schedule II Drug 2013H.R. 1285-113th Congress: To Amend the Controlled Substances Act to Make Any Substance Containing Hydrocodone A Schedule II Drug (2013). Retrieved from http://www.govtrack.us 20141008132123465403199 Longest B B 2010 Health policymaking in the United StatesLongest Jr., B. B. (2010). Health policymaking in the United States (5th ed.). Chicago, IL: Health Administration Press. 201410091217191092675209 Phillips J 2013 Prescription drug abuse: problem, policies and implications.Phillips, J. (2013). Prescription drug abuse: problem, policies and implications. Nursing Outlook, 61, 78-84. 201410091423161519538522 United States House of Representatives Judiciary Committee 2014 United States House of Representatives Judiciary CommitteeUnited States House of Representatives Judiciary Committee (2014). United States House of Representatives Judiciary Committee. Retrieved from http://www.judiciary.house.gov 201410091227131141156554 US Census Bureau 2011 Overview of Uninsured in the United States: A study of the 2011 current population surveyUS Census Bureau (2011, September). Overview of Uninsured in the United States: A study of the 2011 current population survey. Retrieved October 8, 2014, from http://hhs.gov 201410091201171076915503 US Code: Title 21-Food and Drugs 2012 Legal Information InstituteU.S. Code: Title 21-Food and Drugs (2012, January 14). Legal Information Institute. Retrieved from http://www.law.cornell.edu 20141008143645967177272 Weisburg D Becker W Fiellin D Stannard C 2014 Prescription opioid misuse in the United States and the United Kingdom: Cautionary lessons.Weisburg, D., Becker, W., Fiellin, D., Stannard, C. (2014). Prescription opioid misuse in the United States and the United Kingdom: Cautionary lessons. International Journal of Drug Policy, 20141009144237381562709

Police And The Use Of Force Shakoya

Police And The Use Of Force Shakoya There have been several issues concerning the policies that underline the use of force within the field of law enforcement. Favorable opinions, negative objections, and indecisive feelings about the use of force have varied throughout the public as well as within the criminal justice system when it comes to this policy. For a number of years, it has been extremely difficult in determining the proper definition of what is considered to be the use of force or the proper use of force, especially in regards to law enforcement. Ironically, there have been dozens of studies on police and the use of force and research concluded that there is no single accepted definition. Must police use force? Not only should the answer to this question include the circumstances surrounding the situation but it should also include the amount of force able to be used in each unique situation. This question will especially benefit a police officer when determining the amount of force that should be exerted on criminal suspects. Overall, in order for one to fully understand the various definitions of use of force, one must be able to appreciate the background, causes, and ways to reduce the use of force. The basic problem is the lack of routine, national systems for collecting data on incidents in which police use force during the normal course of duty and on the extent of excessive force. Literature Review The term, use of force, describes a right of an individual or authority to settle conflicts or prevent certain actions by applying measures to either: dissuade another party from a particular course of action, or physically intervene to stop them (Burke, 2005). The authority of the police to use force represents one of the most misunderstood powers granted to representatives of government. Use of force from a law enforcement perspective is using any means necessary to bring a volatile situation to a more manageable and/or resolved state. Adler (2007) found as leading police historians have demonstrated, early law enforcers worked in a hostile environment. Established during an era of soaring violence, when riots were commonplace and when social divisions cleaved cities into competing neighborhoods, American policemen, in Chicago and elsewhere, faced a daunting task. They were expected to maintain order, yet they lacked legitimacy and remained shackled to a partisan, often corrupt, institutional structure in which they were encouraged to use their influence and muscle for overtly political tasks, such as safeguarding their patrons and quelling labor unrest. All the while, American law enforcers battled to command respect and to control the streets. Types of Force The officer has a range of force options from which to choose. For instance, police officers are authorized to use both psychological and physical force to apprehend criminals and solve crimes. Sometimes, the mere presence of the police officer is enough control. At other times, verbal commands are needed. The compliance hold (physical force) is the next stage of control, followed by the use of non-lethal weapons such as the baton or chemical spray. Lastly, a police officer may resort to the use of deadly force, which by all means should try to be avoided unless deemed necessary (Douthit, 1975). It is widely regarded that the police in any given society have a difficult job to fulfill. Dealing with criminals and placing themselves in harms way on a day to day basis is definitely an admirable calling. Although seen as difficult, there is an underlying sentiment in the general public that the job of law enforcement officers is relatively straightforward. Police are faced with tough moral decisions daily. They are to decide when and how to act when presented with violations of the law. They are given the use of force as a means of crime prevention but often times the very usage of this force is questioned and sometimes, deemed unnecessary or excessive (Engel,1997). When the use of force exceeds that which is necessary to accomplish their lawful purpose, or when their purpose is not lawful apprehension or self-defense but, rather personal retaliation, it is defined as excessive use of force and is unethical and illegal (Pollock, 2010). The Bureau of Justice Statistics (BJS) in Data Collection on Police Use of Force, states that à ¢Ã¢â€š ¬Ã‚ ¦the legal test of excessive forceà ¢Ã¢â€š ¬Ã‚ ¦is whether the police officer reasonably believed that such force was necessary to accomplish a legitimate police purposeà ¢Ã¢â€š ¬Ã‚ ¦ However, there are no universally accepted definitions of reasonable and necessary because the terms are subjective. A court in one jurisdiction may define reasonable or necessary differently than a court in a second jurisdiction. More to the point is an understanding of the improper use of force, which can be divided into two categories: unnecessary and excessive. The unnecessary use of force would be the application of force where there is no justification for its use, while an excessive use of force would be the application of more force than required where use of force is necessary (U.S. Dept of Justice, 2008). An excessive amount of force can range from a severe man handling during arrest that seems or is unnecessary to excessive use of non-lethal force. The use of non-lethal force can sometimes be considered excessive, when the uses of chemical spray, bean bag guns, or tasers, are over used to resolve a problem (McDonald,2003). However, since they are non-lethal they can be seen as reasonable use of force. Therefore, the amount of force a policeman uses does not solely depend on himself but his or her discretion. Adams (1995), states that defining excessive force in order to understand and control is not a simple matter. Every situation that possibly involves the use of force is unique. Situations may be similar or seem to mirror one another but no situation is the same. By situations varying from the differences in people, regions, beliefs, and backgrounds to tailor a particular definition, or create certain guidelines for the use of force is difficult. The dilemma, according to Rahtz (2 003), is the lack of a clear agreement on what constitutes legitimate use of force. The public, as well as the police, understand that in some situations, force is not only necessary and unavoidable, but is required, if serious injury, death or destruction of property is to be avoided (Buker,2007). However, police officers must learn to use force lawfully. You cannot use lethal force at will or use force when it is not permissible. The idea and ability of managing force by police officers is directly related to establishing responsibility and accountability to encourage the use of reasonable force (Ng, 2009). Some people believe police should not have the power to use force, no matter what the situation. They believe everything can be solved along peaceful terms in which no one can be injured or killed (Ng, 2009). Police are allowed to use force during the course of their daily activities. Force can be used to make arrests, maintain order, or keep the peace. The important thing is that the police officer is able to gain control of the situation. How the officer gains control is left up to his or her judgment: In other words, an officer most often attempts to take control of a confrontation by defining the situation (Alpert, Smith, 1994). Causes A major cause of overuse of force, possibly leading to police brutality is the belief that police officers are soldiers in a war on crime. The war mentality says it is okay to do certain things that would not be allowed under normal conditions. Police adopt this mentality because of citizens, whose fear of crime has reached an all-time high, and because of politicians, who publicize the notion that tough cops prevent crime (Albert, Smith, 1994). Harmon (2008), indicates Haduring an arrest, an officer might give verbal commands to a suspect to stop, to keep his hands visible, to turn around and place his hands against the wall, to submit to a pat-down, to put his hands behind his back for handcuffing, to come along to the car, to get in, to get booked at the station. Most suspects are compliant and require no more than a guiding arm, but those who refuse or resist, and occasionally those who do not, may provoke a forcible response. Subjects of police uses of force often respond with a llegations of law enforcement brutality. Sometimes these allegations are baseless, a product of misunderstanding what might justify lawful force or of false accusation (Matthew, 2006). Other times they represent a just demand for recognition and redress for damaged bodies and spirits. Clearly, when the law confronts claims under these statutes that an officer used too much force during an arrest, the central question for federal liability is what constitutes constitutionally excessive force under the Eighth Amendment; the Eighth Amendment of the U.S. Constitution enforce cruel and unusual punishment (Matthew, 2006). In our society, police are in a very precarious situation when it comes to the amount of force they can apply when dealing with a civilian suspect. Whether it be physical force, persuasion, or coercion; they must use discretion when deciding what course of action best suits the situation (Douthit, 1975). Discretion is the authority to make decisions without reference to specific rules or facts, using instead ones own judgment; allows for individualization and informality in the administration of justice (Buker, 2005). This gives the police leeway as to when force is necessary and when it is not, within certain guidelines. For instance, a policeman cannot beat up a man for robbing a store. But, if the robber battered someone in the process of the robbery the policeman could. He could do this because there was a clear threat of danger to himself or to another officer or human being. Police must take the precise course of action to fit the time, because if they are too lenient or to for ceful, even when dealing with the pettiest things, they can be chastised by superiors and the public. The force the police use should not exceed the threat of force that could be applied on them by someone else. As one can see in the many case histories the excessive use of force is very rarely punished on legal terms (Matthew, 2006). The police nearly always get exonerated from the charged placed on them, even though substantial evidence may be in the prosecutions favor. Why is this? Being that the police enforce the law, they become analogous with the law (Adams, 1995). When officers are placed in situations where excessive force can be used, they use this knowledge of past precedent to get away with their excessive aggression. The 1991 beating of California motorist Rodney King will have an impact on law enforcement for years to come. The videotape of the horrifying beating, broadcast nationwide, resulted in public outrage over police brutality. The broadcasting showed three Los Angeles police officers beating with metal batons, kicking and stomping on a seemingly defenseless African American male as their supervisor watched (Gray, 2006). Regardless of the videotape, a jury in Simi Valley concluded that the evidence was not adequate to convict these officers. Everyone seemed to believe that the police used excessive force in arresting King. This case caused a special commission to investigate whether brutality was widespread within the police department. Police departments across the country likewise reviewed their own policies on excessive force. Despite these efforts, citizen complaints about police brutality have increased since the Rodney King beating. Where an officers initial use of force is provoked and lawful, the line between a legal arrest and an unlawful deprivation of civil rights within the aggravated assault guidelines is relatively thin. The line between reasonable force and a criminal excessive force beating is thin indeed. There is no middle ground, no buffer zone. Its either reasonable or criminal. One extra baton strike, shove or control holds can make the difference between an officer doing his job and being sent to prison (Johnson, 2007). Ways to Reduce Use of Force In order to reduce the improper and excessive use of force, the law must be enforced in its totality. Police must not be able to get away with the use of excessive force on undeserving offenders. Police who commit this crime should be prosecuted to the fullest extent of the law. They should be made as examples, so this crime does not happen in the future (Alpert, Smith, 1994). It is not a question of should or whether, but when and how much. Guidelines define when deadly force should be used: The use of such force is prescribed by state and federal statutes. In an effort to curb the discretionary power used by police, there is a set of written procedures (Burns, Crawford, 1998). Providing a framework for police to follow is one method employed to try and counteract individual decision making by trying to prevent officers from deviating from procedure. Another method used to control police more thoroughly is the creation of watchdog units within the department. Often times, this comes in the form of an internal affairs office. This is a department within a police department which is strictly in existence to ensure that police are acting responsibly and also to investigate any allegations against officers that may arise. The Continuum Scale is believed to be one of the most efficient sources used to ensure the appropriate amount of force is used. A use of force continuum is a standard that provides law enforcement officials security guards with guidelines as to how much force may be used against a resisting subject in a given situation. In certain ways it is similar to the military rules of engagement. It was designed as a general guide to using force in a confrontation or arrest situation and to make sure police officers use the appropriate level of force necessary in the performance of their duties (Burns, Crawford, 2009). The scale will assist officers in applying the law and departmental policy in use of force situations, documenting the use of force, and presenting testimony in a court proceeding. The purpose of these models is to clarify, both for officers and citizens, the complex subject of use of force by law officers. Implementation With pertinent criticisms of the use of force by law enforcement, there has been a development of a Police Training Model to assist with attempting to reduce the use of force by police officers. For instance, as of 1999, the COPS Office provided funding to PERF and the Reno (Nevada) Police Department to develop an alternative national model for training new officers that would incorporate community policing and problem-based learning techniques. The resulting Police Training Officer (PTO) Program addresses the traditional duties of policing in the context of specific neighborhood problems and includes several segments on the use of force. The PTO Program is an alternative to the 30-year-old San Jose Field Training Officer (FTO) Program. Many agencies are using the outlines of the PTO Program to develop their own in-house programs adapted to their particular needs (US. Dept of Justice, 2008). Methodology The literature is in general agreement that police are in a very precarious situation when it comes to the amount of force they can apply when dealing with a civilian suspect. There is no clear definition of use of force because the terms are subjective. The methodology used in this research was a qualitative approach. Many early studies utilized official report statistics to measure the outcome of the variables use of force and excessive use of force. Contacts between Police and the Public, a 1999 BJS report, estimated that less than half of 1 percent of an estimated 44 million people who had face-to-face contact with a police officer were threatened with or actually experienced force. Other studies report similar statistics. It is these few situations, however, that attract public attention. Robert K. Olsen, former Minneapolis Police Chief and Past President, Police Executive Research Forum (PERF), early in 2004 called the use of force the single most volatile issue facing police departments. He noted that just one use of force incident can dramatically alter the stability of a police department and its relationship with a community (U. S. Dept of Justice, 2008). Also, according to International Association of Chiefs of Police (2001), one of the most publicly debated aspects of police use of excessive force during the last year, is the racial characteristic of participants in use of force encounters. There were 8,148 reported incidents of police use of force in which the contributors (police departments) included racial descriptions for officers and suspects. Of this total, 39% involved white officers using force on white subjects, 44% involved white officers using force on African American subjects, 7% involved African American officers using force on African American subjects and 3.4% involved African American officers using force on white subjects. Overall, police department policies can have a significant impact on how force is used in street-level encounters, says a 2003 study by the Community Relations Services of the U.S. Department of Justice, Principles of Good Policing: Avoiding Violence Between Police and Citizens. The BJS Data Collection statistics reported, stresses the need for police executives to improve training of recruits and police officers on the use of force and the techniques for minimizing its application. It also so stresses the need to reduce the negative perception of police officers and the use of force within the publics opinion (U.S. Dept of Justice, 2008). Limitations Several key points could have been operationalized differently. For instance, every day, law enforcement officers face danger while carrying out their responsibilities. When dealing with a dangerous or unpredictable situation, police officers usually have very little time to assess it and determine the proper response. It is evident that the proper training as well as other guidelines can enable the officer to react properly to the threat or possible threat and respond with the appropriate tactics to address the situation, possibly including some level of force, if necessary, given the circumstances (U.S. Dept of Justice, 2008). The need for improved data collection systems can also be justified by considering the legal liabilities that law enforcement agencies have with their use of force, from both lethal and less-than-lethal weapons. The research conducted over the last 30 years on police use of force consistently calls for improved data collection at the local and national level. Conclusion In short, the purpose of this study was to determine the meaning of use of force, who can use force when and how much. The term of use of force describes a right of an individual or authority to settle conflicts or prevent certain actions by applying measures to either: dissuade another party from a particular course of action, or physically intervene to stop them (Buker, 2005). A major cause for police use of force is the belief that police officers are solders in a war on crime. The continuum scale is one of the most effective sources use to ensure the appropriate amount of force is being used. All in all, one may view the use of force as a glass half empty, and some view the glass half full, which simply states it all depends on how you look at the situation. Works Cited Adams, K. (1995). Measuring the prevalence of police abuse of force. In W.A. Geller and H. Toch (Eds.), And Justice for All: Understanding and Controlling Police Abuse of Force. Washington, DC: Police Executive Research Forum. Adler, J. (2007). Shoot to Kill: The Use of Deadly Force by the Chicago Police, 1875-1920. Journal of Interdisciplinary History, 38(2), 233-254. Retrieved August 26, 2009, from Academic Search Complete database. Alpert, S. (1994). How Reasonable is the Resonable Man. Journal of Criminal Law and Criminology . Buker, H. (2005). Understanding Police Use of Force / Understanding Police Use of Force: Officers, Suspects and Reciprocity / Into the Killing Zone: A Cops Eye View of Deadly Force. International Journal of Police Science Management, 7(3), 208-217. Retrieved August 24, 2009, from Academic Search Complete database Douthit, N. (2003). Enforcement and non-enforcement roles in policing. Journal of Police Science and Administratin , 339. Engel, R. (2008). Revisiting Critical Issues in Police Use of Force. Criminology and Public Policy , 557-561. Gray, M. (2006, October). The L.A. Riots:15 years after Rodney King. Time . International Association of Chiefs of Police. (2001). Police Use Of Force In America. Retrieved July 6, 2005, from www.theiacp.org/documents/pdts/publication/Pol. Matthew, A. (2006). Understanding Police Use of Force:Officers Suspects and Reciprocity. Comteporary Sociology , 69-71. McDonald, J. (2003). Police Use of Force: Examining the Relationship between Calls for Service and the Balance of Police Force and Suspect Resistance. Journal of Criminal Justice , 119-127. Ng, N. (2009). Rules for the Use of Force. International Peace Operations , 39-42. Rahtz, H. (2003) Understanding Police Use of Force. Criminal Justice Press: New York