Tuesday, December 31, 2019
Mispronunciation Definition and Examples in English
Mispronunciation is the act or habit of pronouncing a word in a way that is regarded as nonstandard, unconventional, or faulty. Words and names are sometimes deliberately mispronounced for comic or malicious purposes. The traditional term for incorrect pronunciation is cacoepy (the opposite of orthoepy, the customary pronunciation of a word). Because the pronunciation of a word or name is often determined by dialectal or regional conventions (which may vary widely), most contemporary linguists avoid the terms correct or incorrect in reference to pronunciation. Examples of Mispronunciationà The word I had used to describe the Liberal lust for power was insatiable, which I mispronounced as insat-eye-able. To this day, I cringe in embarrassment as I reflect upon the gentle public correction by Governor General Bob Higgins and the look of undisguised dismay on the face of Prime Minister Murray.(Brian Mulroney, Memoirs. McClelland Stewart, 2007)I had to mock her Australian accent, and she had to mock my American one, because she looked at me and my mouth and saw the corollary of what I saw, and we fought violently over how to spell aluminum, which she pronounced aluminium, and when she ran off into the bamboo and came back shaking a British dictionary that spelled it her way, I was utterly defeated.(Jane Alison, The Sisters Antipodes. Houghton Mifflin Harcourt, 2009) Local Pronunciations One thing visitors will notice in the Ozarks is the odd pronunciation of certain words. If youre used to hearing the state pronounced Mis-sour-EE, you may be surprised to hear some natives say Mis-sour-AH. Bolivar, Missouri, is BAWL-i-var, while out on the edge of the Ozarks, Nevada, Missouri, is Ne-VAY-da, and nearby El Dorado Springs is El Dor-AY-duh.(Fodors Essential USA, ed. by Michael Nalepa and Paul Eisenberg. Random House, 2008)If its the first Sunday in April, its Brougham Horse Trials. Thats Brougham pronounced broom. We have a tradition for odd pronunciation in Cumbria; its why Torpenhow is pronounced not tor-pen-how but Trappenna. I know. I cant work that one out either.(Jackie Moffa, Shipwrecked. Bantam, 2006) Exercise: Is There a Right Way to Say It? Think of some words that have more than one common pronunciation (coupon, pajamas, apricot, economic). Practice transcribing by writing each pronunciation in phonemic transcription. After you have done the transcription, discuss the varying pronunciations and the characteristics you associate with each pronunciation. What factors (age, race, gender, class, ethnicity, education, etc.) correlate with each pronunciation, and why do you think you have those associations? Are there some words for which you adopt the pronunciation of the person youre speaking with?(Kristin Denham and Anne Lobeck, Linguistics for Everyone: An Introduction, 2nd ed. Wadsworth, 2013) Mispronunciations in Language Acquisition One very productive approach to the language of under-fives especially is to study apparent mispronunciations. These can appear to be idiosyncratic mistakes but, as with inflectional errors, many children display similar patterns, and they are considered to be part of normative development unless they persist for too long.(Alison Wray and Aileen Bloomer, Projects in Linguistics and Language Studies, 3rd ed. Routledge, 2013) Mispronunciations in English Language Learning (ELL) First is the foreign accent factor: ELLs may mispronounce a word because some of the sounds do not exist in their first language and they have not learned to say them in English, or because the letters they are trying to pronounce map to different sounds in their native language.(Kristin Lems, Leah D. Miller, and Tenena M. Soro, Teaching Reading to English Language Learners: Insights from Linguistics. Guilford Press, 2010) Speech Perception In speech perception, listeners focus attention on the sounds of speech and notice phonetic details about pronunciation that are often not noticed at all in normal speech communication. For example, listeners will often not hear, or not seem to hear, a speech error or deliberate mispronunciation in ordinary conversation, but will notice those same errors when instructed to listen for mispronunciations (see Cole, 1973). . . .[S]peech perception [is] a phonetic mode of listening in which we focus on the sounds of speech rather than the words.(Keith Johnson, Acoustic and Auditory Phonetics, 3rd ed. Wiley-Blackwell, 2012) A Word That Cant Be Mispronounced Banal is a word of many pronunciations, each of which has its outspoken and often intractable proponents. Though it may pain some to hear it, let the record show that BAY-nul is the variant preferred by most authorities (including me). . . .Opdycke (1939) says banal may be pronounced [BAY-nul] or [buh-NAL) (riming with a pal), or [buh-NAHL] (riming with a doll), or [BAN-ul] (riming with flannel). It is, therefore, one of the few words in English that would appear to be impossible of mispronunciation. . . .Although BAY-nul is probably the dominant pronunciation in American speech, buh-NAL is a close runner-up and may eventually lead the pack. Four of the six major current American dictionaries now list buh-NAL first.(Charles Harrington Elster, The Big Book of Beastly Mispronunciations: The Complete Opinionated Guide for the Careful Speaker. Houghton Mifflin, 2005) Deliberate Mispronunciations As well as making history, [Winston] Churchill also wrote it. His deep historical sense was evident in his many books and in his brilliant speeches in which he used his speech impediment to great effect. One example was his deliberate mispronunciation of the word Nazi, with a long a and a soft z, in order to show his contempt for the movement to which it referred.(Michael Lynch, Access to History: Britain 1900-51. Hodder, 2008)Singapore culture may be considered pro-West in many ways. This pro-West attitude is implied in the Singlish word cheena, which is a deliberate mispronunciation of China. It is an adjective used to describe anything that is considered Chinese and old-fashioned (e.g. so/very cheena). The word can be used to describe the way a person looks or does things.(Jock O. Wong, The Culture of Singapore English. Cambridge University Press, 2014) Mock Spanish and the Mispronunciation of Spanish Loan Words [T]he sociolinguist Fernando Peà ±alosa (1981), working in southern California, identified the racist functions of hyper anglicization and bold mispronunciation of Spanish loan words as long ago as the 1970s. Spanish speakers object to the use of offensive words like caca and cojones in public English, and many also object to the ungrammaticality of expressions like No problemo, and misspellings like Grassy-Ass as showing disrespect for the language...Bold mispronunciation . . . yields bilingual puns like Fleas Navidad, which shows up every year on humorous Christmas cards with pictures of dogs, and that hardy perennial Moo-cho with a picture of a cow. The opposite treatment is Much Grass from Muchas gracias.(Jane H. Hill, The Everyday Language of White Racism. Wiley-Blackwell, 2008) The Lighter Side of Mispronunciation Ann Perkins: Seniors can get pretty ornery.Andy Dwyer: I think thats pronounced horny.(Rashida Jones and Chris Pratt in Sex Education. Parks and Recreation, October 2012) Donald Maclean: Hullo.Melinda: Hi. Youre English.Donald Maclean: Does it show?Melinda: You say hello with the letter u where the letter e oughta be.Donald Maclean: Well, youre American.Melinda: You noticed.Donald Maclean: You say hello with the letter i where the e and the l and the l and the o ought to be. . . . I hate America.Melinda: Are you gonna tell me why?Donald Maclean: For the way you treat workers, the way you treat black people, the way you appropriate, mispronounce and generally mutilate perfectly good English words. Cigarette?(Rupert Penry-Jones and Anna-Louise Plowman in Cambridge Spies, 2003)
Monday, December 23, 2019
American History Quiz - 645 Words
Q1. Assess both Patriot and British strengths and weaknesses when the Revolution began. How did the United States win the War against such a powerful adversary? Without the benefit of hindsight, one might be tempted to draw the conclusion that the American army was foolish to rebel against the British: the British army was the best trained, best equipped, and most professional army in the world. The Royal Navy was, at the time of the American Revolution, the undisputed ruler of the High Seas (Tubbs 2009). In contrast, the American army was poorly supplied, insufficiently trained (initially), and inconsistently paid and the colonies lacked a centralized government at the time (Tubbs 2009). However, the American army had the advantage of knowing the territory and even more important the loyalty of the majority of the populace (Tubbs 2009). The British government had been behaving in a belligerent and insensitive manner towards the colonists, raising the ire even of formerly loyal subjects of the crown living in the Americas. The British soldiers, in contrast, fought largely out of duty versus personal conviction. The Americans also had the advantage of foreign support, specifically the financial support of France (Faragher, Buhle, Czitrom, Armitage, 2009). And just as importantly, they had the leadership of General George Washington, who made several decisive moves which resulted in a victory for the colonists. Had General Washington not attacked the Hessians atShow MoreRelatedQuestions On People Of The U.s. Essay1016 Words à |à 5 PagesPractice Quiz #3 People of the U.S. to 1877 Chapters 9,10 ( Americaââ¬â¢s History, 8th ed, Volume 1) Directions: Please read the questions and answers carefully. Students need to print out the following practice quiz and circle the BEST response with blue or black ink pen. 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Sunday, December 15, 2019
Three really is a crowd Free Essays
string(53) " cheek I suddenly realise how much I have hurt nick\." ââ¬Å"Would you like some pretzels with your wine.â⬠The airhostess said, I never drink when I fly but in this case I need a drink to steady my nerves I have called my old friend Lauren to see if she knows where nick is living now and I am in luck she had just seen nick. ââ¬Å"How was he?â⬠I asked impatiently ââ¬Å"He was kind of distant, not his usual laid back self. We will write a custom essay sample on Three really is a crowd or any similar topic only for you Order Now Why are you asking about nick you never want to talk about him what has happened?â⬠Lauren sounded concerned. I couldnââ¬â¢t keep secrets from Lauren she was my oldest friend and my rock when things go wrong. I had to tell her so for the next half an hour I poured my heart out I told her everything about Pierre and nick and the engagement ring. â⬠Well he sounded really upset now I know why, what are you going to do.â⬠She sounded genuinely sorry for me. â⬠I am just going to turn up at his flat and try to talk him round I love him Lauren, it has always been him I was happy with Pierre sure, but he was always in the back of my mind.â⬠I am never one to pour out my heart but I couldnââ¬â¢t help myself. Lauren offered me her spare bedroom to stay at her house, which is less than a mile away from nicks so it would be perfect. I wake up as I look out the window and can just see the sky through all the buildings there is a deep blue sky just like the day me and nick went on a weekend away the sky was like that all weekend I canââ¬â¢t help but smile at all the good memories of me and nick. The time at the new years the night nick and me first got together ââ¬Ë I was all alone no one to kiss at midnight 4,3,2 I am going to look like such an idiot 1 nick suddenly appears from no where and kisses me a real kiss I had never been kissed the way he kissed me.ââ¬â¢ There it is that all to familiar feeling when I think of me and nick. Later that day I was in the local cafà ¯Ã ¿Ã ½, all of a sudden Lauren made excuses for herself and left quickly as I watched her leave my eyes wandered to the bar where nick was sitting I nearly spilled my coke I hadnââ¬â¢t even noticed him come in. What should I do I didnââ¬â¢t want to talk to him here and now I wanted to be alone with him I couldnââ¬â¢t just chicken out not after giving up my relationship with Pierre and possibly my dream job. All of a sudden with out any notice nick turns his head he sees me I donââ¬â¢t know what to do I end up sitting their like an idiot pretending not to notice him. To my surprise nick gets up and walks out. I nearly burst into tears I knew that I hurt nick but I didnââ¬â¢t think he could not even bare to look at me anymore. When I get back to Laurens I tell her everything she has a great idea â⬠How about I ring nick and ask him if he wants some company tonight you turn up instead of me and explain how you love him.â⬠She was the best friend a girl could have I agreed to the idea. In the taxi on the way to nicks house I couldnââ¬â¢t help but feel sick with nerves the way he had just blanked me as if he didnââ¬â¢t even know me as if I meant nothing to him as if nothing had never happened between us I know I hurt him but he is the man I love, I would give up the whole world for him. It takes me what 10 to15 minuets to knock on the door suddenly my phone rings I open my bag in such a hurry everything falls out onto the floor. I hear the latch on the door turning I look up to see nick staring down at me, I wonder is he going to slam the door in my face but to my surprise he bends down and starts picking all the contents of my handbag up as he passes it to me our eyes meet he holds my glance I canââ¬â¢t breath thinking what I have done to this man how I lied to him how I hurt him so much. â⬠We better go inside.â⬠He finally says he hands my bag to me and opens the door letting me in. why is he being so cool about all this, what happened today in the cafà ¯Ã ¿Ã ½? His flat is so nice his shinny leather sofa and his modern art that is so cool and laid back like himself, they say peopleââ¬â¢s house tells you most things about them when nick came to my flat their were dark lies in all of Pierreââ¬â¢s stuff. ââ¬Å"Nick I am so sorry I came here to explain everything!â⬠I sound desperate but I canââ¬â¢t help it. ââ¬Å"You hurt me.â⬠â⬠I know I was just starting to get my life on track after I left you and then you walk back into my life and my whole world turns upside down and with one look at you I fall completely head over heels in love with you.â⬠Nick says nothing he just stares at the floor he canââ¬â¢t even bare to look at me. ââ¬Å"I didnââ¬â¢t want to tell you about Pierre I knew it would wreck all our chances together.â⬠â⬠So you just lied to me, as if I meant nothing to you.â⬠He sounds hurt ââ¬Å"You know I donââ¬â¢t think you are nothing I think you are everything. I would never intentionally hurt you.â⬠A tear rolls down my cheek I suddenly realise how much I have hurt nick. You read "Three really is a crowd" in category "Papers" ââ¬Å"I should leave.â⬠I go to get up and leave to my surprise nick jumps up he reaches for my arm to stop me ââ¬Å"Why are you going?â⬠He almost sounds desperate like I did earlier. â⬠I donââ¬â¢t know I donââ¬â¢t see how I can undo what I have done and it is like a knife through my heart seeing the pain in your eyes the pain I have caused and it is in your eyes now as I try helplessly to try and explain what I have done to you.â⬠I can hardly see nick through tears. Nick reaches up and wipes my tears away, why is he being so nice I donââ¬â¢t understand. â⬠I love you Sarah even if you lied and even if you left me to go to nice I will always love you.â⬠â⬠But can you forgive me?â⬠Nick letââ¬â¢s go of me he sits down on his cool leather sofa he puts his head in his hands. â⬠Let me explain myself, you see I had left you behind it took me at least a year to get over you, then one day Pierre walked into my office he was the new guy he was so gorgeous and charming.â⬠â⬠Do I really have to hear about you and Pierre.â⬠He says almost in disgust, am I digging myself a hole but I have to tell him everything. â⬠Just listen to me no more lies, I never thought I would find love again it wasnââ¬â¢t the love we shared but my life had to go on me and Pierre were happy the night before I saw you he proposed if I had known I was going to see you again I would have called everything off right then and there but I thought I was never going to see you again I thought you had moved on and made a new life of your own.â⬠I was trying my best to make nick see that I didnââ¬â¢t purposely try to hurt him. â⬠I understood all that, I just canââ¬â¢t understand why you lied cause I asked you if you had a boyfriend and you lied straight to my face, I actually remember seeing the ring on your finger and thinking nothing of it thinking that it was your right hand or something.â⬠He looked so tiered and fed up. â⬠Did you take the ring off?â⬠he asks, I canââ¬â¢t lie to him not now even as much as Iââ¬â¢d like to I just canââ¬â¢t. â⬠Yes but again I can explain you asked me if I had a boyfriend so I took the ring off hoping you hadnââ¬â¢t already noticed, I know you want to know why because I love you and wanted to seeâ⬠¦Ã¢â¬ I canââ¬â¢t get out the words and when I do they sound all wrong. â⬠To see what?â⬠he is starting to get annoyed ââ¬Å"To see if we ever had a chance together.â⬠I am nearly in tears again â⬠Donââ¬â¢t cry please.â⬠He sounds concerned â⬠How can I not cry I am trying to undo the mess I have done, I have said I am sorry I canââ¬â¢t say anymore I have described the way I feel, but I now am asking you what you think!â⬠I canââ¬â¢t help but ask I know it sounds selfish but I am giving loads and getting nothing back this was it truth time when I had to know what my future with nick was going to be. â⬠I said earlier that I still love you.â⬠He seems kind of distance not to sure of what he is saying. â⬠But can you forgive me nick I need to know.â⬠I have to know I canââ¬â¢t bare it; nick is the type of guy not to let you know what he is thinking even if I know him as well as I do. â⬠I forgive you, but you have hurt me.â⬠I nearly burst into tears with happiness, we both catch each others gaze and in those blue eyes my happiness is restored. Nick stands up he comes right up to me and wraps those warm and protective arms around me. ââ¬ËRing, ringââ¬â¢ nicks phone is ringing, I canââ¬â¢t believe it who could it be, it is nearly half ten at night. â⬠Who could that be?â⬠I have to ask â⬠I donââ¬â¢t know.â⬠ââ¬ËRing, ringââ¬â¢ â⬠Arenââ¬â¢t you going to answer it then.â⬠Nick walks over and picks up his phone to see who is calling; to my surprise he switches his phone off without even answering it. â⬠Who was it?â⬠â⬠Oh no-one, I have more important stuff here and now.â⬠Nick takes me by the hand and sits me down on the sofa, I am expecting him to sit next to me, to my horror he gets down on one knee and produces this jewellery box, he opens it and in there is the most perfect ring in the world. â⬠I know it isnââ¬â¢t the size of Pierreââ¬â¢s ringâ⬠¦Ã¢â¬ â⬠No, no it is perfect.â⬠â⬠I think you know the question I am going to ask but I am going to ask it anyway, Sarah will you marry me.â⬠I look down into those perfect blue eyes. â⬠I think you know the answer, yes.â⬠I shout it so loud, nick puts the ring on my finger, then jumps up and lifts me up spinning me around he starts to slow down just as he is putting me on the floor he leans in and kisses me a real kiss a nick kiss, my nick. I later discovered that nick had bought the ring in nice and had come for a job interview so he could live with me in nice. I canââ¬â¢t wait to tell Lauren I am so excited, I walk back to Laurens it is such a clear and perfect night the stars are so bright and clear. â⬠Lauren you will never guess what has happened!â⬠I feel like I canââ¬â¢t get the words out fast enough. â⬠What?â⬠she sounds confused and worried â⬠Are you alright?â⬠â⬠I am the best, you know how I was going to nicks, well when I got there my phone rang and he opened the door and I was scramblingâ⬠¦Ã¢â¬ â⬠So you and nick got back together then.â⬠She sounds weird and not her usual self. â⬠Not only that he asked me to marry him.â⬠I have to scream â⬠No way, oh my god I donââ¬â¢t believe it!â⬠she sounds so surprised â⬠I think I am going to bed.â⬠She says, what the hell I wanted to stay up most of the night planning it. â⬠Oh what, donââ¬â¢t you want to help me with ideas.â⬠â⬠No I am so tired, but we will talk in the morning.â⬠She gives me a faded smile and goes off to bed. I canââ¬â¢t possibly sleep now so I deicide to go back to nicks. I donââ¬â¢t bother to buzz because someone is coming out of the building, as I reach out to knock on nicks door it opens and out walks Lauren in tears. â⬠What the hell are you doing here and why are you crying.â⬠I say confused. â⬠Lauren wait I can explainâ⬠¦Ã¢â¬ nick walks out after Lauren but stops dead when he seeââ¬â¢s me. â⬠Lauren what is the matter.â⬠I look at nick for an answer but he is staring at the ground, what is going on? I want to know I thought she said she was going to bed. â⬠Why donââ¬â¢t you let nick explain, let nick explain everything.â⬠Lauren runs off in tears. I have no idea what is going on â⬠Nick what the hell is going on, why is Lauren crying, why was she even here?â⬠I donââ¬â¢t understand any of this. â⬠We need to talk, lets go inside.â⬠Nick walks into the flat I follow behind him, when I get into his flat there is a smashed glass on the floor. â⬠What has happened let me clear it up.â⬠I walk over to clear it up â⬠Just leave it, I need to tell you something.â⬠He sounds guilty and worried. â⬠Nick what is going on, first Lauren comes out of your flat crying then there is a smashed glass on the floor and now you are looking guilty and asking to talk to Me.â⬠am I being paranoid? â⬠You might want to sit down I have to tell you something.â⬠â⬠What nick tell me now donââ¬â¢t give me all this crap about sitting down tell me.â⬠â⬠Lauren was crying because she didnââ¬â¢t want you and me to get married.â⬠â⬠What, why?â⬠I donââ¬â¢t understand. â⬠Because she loves me.â⬠I donââ¬â¢t believe it he doesnââ¬â¢t look like he is lying I look into his eyes he is telling the truth nick never lies not to me. Suddenly it all makes sense when nick walked into the cafà ¯Ã ¿Ã ½ this morning how Lauren walked out and why she didnââ¬â¢t want to talk about my wedding plans. â⬠Why would she be in love with you?â⬠I canââ¬â¢t believe I am asking this and I try to not to sound like I want to know but the question has to be asked. â⬠Because, we had a thing!â⬠â⬠What do you mean a thing?â⬠he better not be saying what I think he is saying. â⬠Me and Lauren together.â⬠â⬠Youââ¬â¢re not giving me enough information, what the hell are you trying to say here?â⬠I canââ¬â¢t believe what he is trying to tell me. â⬠Me and Lauren we had a thing together, right after you left.â⬠â⬠I donââ¬â¢t believe what you are saying, how long for?â⬠I feel like I want to scream. Nick whispers something but I canââ¬â¢t quite here him. â⬠Donââ¬â¢t whisper I need to hear this.â⬠â⬠Two years the same time as you and Pierre were together.â⬠â⬠Pierre you didnââ¬â¢t even know, whereas my best friend.â⬠â⬠You slept with my best friend, donââ¬â¢t even try to get out of it and you leave me standing on the prom in nice crying my eyes out because I got engaged while you are sleeping with my best friend who I have known and trusted for over ten years.â⬠I am nearly in tears and I feel pathetic but I am angry, angry at being so stupid not to see it and angry at nick for making me feel bad and guilty when he has been doing exactly the same but worse. â⬠Iââ¬â¢m sorry, I can explain give me a chance like I gave you a chance earlier.â⬠He sounds desperate and upset. I look over to him he has tears in those big blue eyes he stands up and walks over to me. â⬠You had gone and Lauren understood what I was going through so we became friends and one night we got really really drunk and one thing led to anotherâ⬠¦Ã¢â¬ ââ¬Å"So you slept together at least me and Pierre were in a stable relationship.â⬠I am so mad I am crying in anger. Nick reaches out to wipe my tears away but I push his hand away. â⬠Donââ¬â¢t touch me, how could you and you blamed me for getting engaged and you, you wereâ⬠¦Ã¢â¬ I canââ¬â¢t even say the words; suddenly a thought comes into my head. â⬠Wait a minute when I spoke to Lauren on the phone last night on the plane she said that she had seen you in the last twenty four hours that means you slept with Lauren after you had seen me didnââ¬â¢t you.â⬠I am really crying now. â⬠Didnââ¬â¢t you!!!â⬠I scream at him he looks up with tears in his eyes and nods his head. â⬠You bastard.â⬠I run over to him and hit him again and again I am like those sad and depressed woman in the movies but I canââ¬â¢t help it nick is holding me down and trying to hug me. â⬠Get off me.â⬠I am crying so so much, I can smell nick his gorgeous smell, nick is still trying to hug me I give up we just stand there holding each other for what seems like hours after a while nick speaks. ââ¬Å"Let me explain just give me that much of a chance.â⬠He sounds like he is crying I look up to see that he is, I nod and sit down on the sofa to listen I donââ¬â¢t want to hear this but I want to know I have to know. â⬠You had just gone and Lauren was there the first time we slept together we were drunk, then it became a regular thing.â⬠I look away as tears spill out my eyes I canââ¬â¢t take it but Iââ¬â¢ve got to know, nick lifts my head up and looks me right in the eyes, he is nearly crying as well. â⬠I knew I couldnââ¬â¢t have you, so Lauren was the closest thing to you, what me and Lauren had was like a drop in the ocean compared to us, Lauren was growing more and more attached but all I wanted was you, before I knew it me and Lauren had been doing it for two years and she just wasnââ¬â¢t you so I decided to come and get you when I got there you were with Pierre.â⬠He gets up and walks into the kitchen, I follow him when I get into the kitchen he has his back to me I swear he just wiped a tear away from his eye he turns to me and looks into my eyes. â⬠Sarah I love you.â⬠â⬠But can I forgive you?â⬠â⬠That is up to you, what me and Lauren did is horrible and I will never forgive myself.â⬠â⬠I donââ¬â¢t know I have to think this through until then I think you should have this.â⬠I slide off mine and nicks engagement ring I reach out to give it to him but he refuses to take it so I put it on the granite worktop and leave. Where should I go I canââ¬â¢t go to Laurens I defiantly canââ¬â¢t go to nicks. ââ¬ËKnock knockââ¬â¢ it is taking ages for them to answer after what seems like hours later the door opens. â⬠Mum!â⬠I burst into tears â⬠Sarah what has happened come in what has happened.â⬠So I tell her everything right from the start the two engagement rings, Pierre, nice, Lauren and nick. By the time my story has finished it is beginning to get light. â⬠What should I do mum I donââ¬â¢t know what to do.â⬠â⬠First you should get some sleep then we will talk about it.â⬠She smiles at me. It is weird sleeping in my old room so many times I cried myself to sleep in this bed, when dad left, when granddad died, when I failed my GCSEââ¬â¢s, the night before I left for nice and left nick behind. I get up to the smell of home when I go downstairs mum is sitting in her usual spot I remember as I child whenever she had to think something through she would sit their and no one was allowed to disturb her for hours. â⬠Hey how did you sleep?â⬠She pats the spot next to her I go and sit with her. â⬠Not well, I kept thinking about nick and how he is, I did try to stop thinking about him but he just kept coming back into my mind.â⬠ââ¬Å"I know sweetie it is horrible.â⬠â⬠What should I do mum?â⬠â⬠My advice is, Lauren is the main one to blame I am not saying nick is innocent in all this but he was looking for a replacement of you, whereas Lauren knew full well what she was doing and lied to you every time she spoke to you.â⬠â⬠Still I donââ¬â¢t know what to do.â⬠â⬠Go and talk to nick and if you love him give it one last try I am not saying it will be easy.â⬠So I took mums advice. I press the buzzer outside nicks flat, so many things are running through my head I donââ¬â¢t know what is going to happen I donââ¬â¢t even know weather to forgive him or weather I can forgive him. â⬠Helloâ⬠â⬠Itââ¬â¢s me, can I talk to you.â⬠He buzzes me in without saying another word, when the lift doors open he is standing by his door wearing boxers and a t-shirt. â⬠I was asleep I wasnââ¬â¢t expecting you to come back.â⬠He looks really tiered and upset I canââ¬â¢t look him straight in the eyes just yet. â⬠You better come in.â⬠he walks in leaving the door open behind him when I come into the flat I find him in his bedroom sitting on the end of the bed, he looks up at me â⬠I didnââ¬â¢t get much sleep after you left I obviously feel asleep, how have you been?â⬠he looks concerned â⬠I didnââ¬â¢t sleep much every time I tried to sleep I just kept thinking about you.â⬠I look at nick and ask myself how can I still love him after what he is done to me and if I was being honest with myself I donââ¬â¢t actually know the answer. â⬠Can I ask you one thing?â⬠I say curiously â⬠Anything but are you sure you want to hear it?â⬠â⬠It isnââ¬â¢t about you and Lauren.â⬠I say â⬠Ok then what is it?â⬠he looked surprised did he want me to ask about him and Lauren or was their more he hadnââ¬â¢t told me, that he had left out hoping I wouldnââ¬â¢t know maybe I was just being paranoid it was hard to tell this whole lie was so unexpected. â⬠If you were sleeping with Laurenâ⬠¦Ã¢â¬ nick looks away ashamed â⬠When you came to nice and found out about me and Pierre how come you were so mean to me when you were doing the same with Lauren?â⬠it is a harsh question but it has to be asked. â⬠Because you obviously had strong feelings for Pierre, I donââ¬â¢t know maybe the thought of you even liking someone else also maybe the fact that you lied to me.â⬠He sounds annoyed at that. How can he be annoyed at me I didnââ¬â¢t sleep his best friend did I? â⬠Why are you getting annoyed at me for lying.â⬠I sound like a spoilt child ââ¬Å"I donââ¬â¢t know?â⬠â⬠Well I suggest you find out, youââ¬â¢re the one who told me after I agreed to marry you.â⬠â⬠Youââ¬â¢re the one who let me find out when your fiancà ¯Ã ¿Ã ½ turned up when I was topless just about to kiss you.â⬠Nick stands up, I canââ¬â¢t believe him. â⬠Oh that is low even for someone that sleeps with my best friend when he says he was madly in love with me.â⬠I say spitefully â⬠Donââ¬â¢t you dare for a second say I wasnââ¬â¢t in love with you.â⬠â⬠So why didnââ¬â¢t you come and get me?â⬠â⬠I did.â⬠â⬠What three years later, three years to late.â⬠I am shouting now thank god it is the middle of the day and not the night. â⬠What did you expect me to come after you?â⬠â⬠Yes.â⬠I say almost in a whisper, Nicks face instantly changes â⬠What?â⬠â⬠Yes, I wanted you to come and get me but you never showed up.â⬠Nick comes closer to me â⬠I never knew.â⬠â⬠You didnââ¬â¢t have to know were werenââ¬â¢t supposed to know.â⬠I turn away from nick, I have come here to try and sort things out and end up saying things that were just stupid thoughts ages ago and they donââ¬â¢t even help now. I canââ¬â¢t think of anything to say and nick is just looking at me, I seriously have no idea what to do I want to tell him so much I love him but I just canââ¬â¢t not now. I look at nick hard to see what he is thinking looking into his eyes I just canââ¬â¢t work it out. Suddenly I thought crosses my mind. â⬠I need to go.â⬠â⬠What, why I thought we need to talk.â⬠Does he think this is it. â⬠I have to speak to Lauren see what she has to say and pick up my stuff.â⬠â⬠Why are you going, are you coming back.â⬠â⬠I donââ¬â¢t know, I just have to talk to her to see what she has to say about all of this.â⬠I leave the flat as I am pressing the bottom for the lift door to close nick suddenly comes out of his flat and holds the lift door open. â⬠Promise you will come back and talk to me.â⬠He says I donââ¬â¢t know what to say I have to hear Laurens side of the story before I make any decisions. â⬠Even if you canââ¬â¢t forgive me at least come and say goodbye.â⬠I nod and nick lets go of the lift door I look at him as the door closes I look at his light brown ruffled hair, his perfectly tanned skin, his strong hands, and those perfect sea blue eyes. I really donââ¬â¢t want to see or hear Laurens side of the story but it has to be done; I suppose I owe it to our friendship or something like that. I donââ¬â¢t bother to knock or buzz because being one of her oldest friends I have a key it is, seeing as it is a Sunday she is sure to be in. when I walk in she turns around and smiles â⬠Sarah where have you been did you stop over at nicks.â⬠She winks at me, Why is she acting normal when she knows what is going on. â⬠Isnââ¬â¢t that more your style!â⬠I know I sound like a fifteen year old but before I can stop myself I have said it. Lauren sighs â⬠So he told youâ⬠â⬠Well what did you expect him to do not tell me?â⬠â⬠Oh I donââ¬â¢t know, I didnââ¬â¢t expect you to even come after him.â⬠â⬠What you knew.â⬠â⬠Of course, all of a sudden I was dumped for you.â⬠now she sounds like a fifthteen year old â⬠Lauren you can try to match you and nick to me and nick but as nick said your relationship was like a drop in the ocean compared to ours. So donââ¬â¢t you dare compare, I am here for one thing only and that is to hear your pathetic excuse of a side of the story.â⬠I have to stay strong and not cry I try to remember revenge is a dish best served cold, cold like Laurens heart has to be. â⬠Sarah donââ¬â¢t be like this.â⬠She sounds desperate â⬠So come on then I want to get this over with lets here it from start to finish the whole feeble excuse for an affair.â⬠ââ¬Å"Sarah donââ¬â¢t be like this.â⬠â⬠Why not.â⬠I shout at her I hate being like this but I am so mad at her. ââ¬Å"Ok, Iââ¬â¢ll tell you just after you left nick was really upset so I went round to cheer him up and we got really really drunk and ended up in bed together and from then it become a regular thing.â⬠She looks away ashamed of herself exactly like Nick. â⬠So what is your excuse then nick had a reasonable one.â⬠I ask impatiently â⬠What I just told you about me and nick.â⬠â⬠No you told me what happened I want an excuse for sleeping with my ex boyfriend when you knew I still liked him.â⬠I know I am being really unfair on her but she deserves it. â⬠You knew I always liked nick I knew he was just using me because he couldnââ¬â¢t have you.â⬠â⬠Is that it.â⬠I say in disgust â⬠Is that your excuse cause if it was I wasnââ¬â¢t buying it.â⬠I shake my head at her and walk into my room get my stuff and go to leave as I am getting to the door Lauren runs after me. â⬠You left nick it was over canââ¬â¢t you let someone else have him I shouldnââ¬â¢t be ashamed of what we had or still have.â⬠â⬠What do you mean still have?â⬠â⬠He told me he loved me.â⬠She says looking pleased with herself, I look at her with tears in my eyes. â⬠How could you Lauren I thought you were my best friend and your just a desperate â⬠¦Ã¢â¬ I stop myself â⬠Go on Sarah itââ¬â¢s not like you to not finish saying what you like.â⬠Lauren says sneering at me. â⬠I wouldnââ¬â¢t want to waste my breath.â⬠I walk out leaving her standing there. When I am outside Laurens I am trying to get a taxi as I begin to give up and start walking a taxi slows down inside it is nick he opens the window and tells me to get in. â⬠Where to then?â⬠The taxi driver asks, I look at nick for an answer â⬠Just drive us around for a while we need to have a talk without one of us running away.â⬠The taxi driver grunts a bit before agreeing and we start to drive nick leans over and closes the hatch. â⬠Nick what are you doing here?â⬠I ask â⬠I never trusted Lauren, I had to come and get you so she doesnââ¬â¢t feed you a pack of lies.â⬠I say nothing and just stay silent â⬠Well come on then tell me what she said I know she has said something.â⬠How can he tell that by just looking at me. I canââ¬â¢t stand this I need more time to think so I reach over and open the hatch and tell the taxi driver to stop. â⬠She said you loved her.â⬠I say as I scramble out of the taxi with my bags I begin to walk off all I can hear is Nick shouting my name. ââ¬Å"Sarah wait.â⬠He shouts from somewhere behind me â⬠Just leave me alone!â⬠I shout back people are stating to stare but I donââ¬â¢t care. Nick is right behind me when he catches up with me he stops me and spins me round so I am facing him I didnââ¬â¢t realise he was so close to me he is right behind me. â⬠I donââ¬â¢t love Lauren I never have I like her but I would never love her.â⬠â⬠So why did you tell her that you did?â⬠I look up at nick he is not going to reply so I carry on talking. â⬠I can take the fact that you have been sleeping with her for the past two years but telling her you love her when you say you love me, I am sick of this Nick all the lies and dirty little secrets.â⬠I look across the street at all the people walking in and out of the shops. â⬠Did you tell Pierre you love him?â⬠nick asks â⬠Of course I did.â⬠I reply, this is it right here me and nick standing in the middle of a busy London street this is when I realise the future. â⬠It looks like we are both in love.â⬠I say to nick, he begins to smile I raise my hand for a taxi â⬠But it looks like we are in love with the wrong people.â⬠I say as tears spill out of my eyes I reach up and kiss nick on the head â⬠Goodbye nick.â⬠I get in the taxi â⬠Heathrow airport please.â⬠I can hardly see nick through tears â⬠Sarah donââ¬â¢t do this I love you.â⬠Nick shouts from the pavement I canââ¬â¢t bear to look at nick â⬠Just drive please,â⬠I say my voice wobbling cause I am crying so much. This has to be the hardest thing to do; all I can see is nicks face when I got in the taxi the way he looked at me. I am sitting at gate waiting to be called wondering if I am doing the right thing. â⬠Could people sitting in business class please come to the desk with your boarding cards and passports ready.â⬠The airhostess was saying into the microphone this was it all over again leaving nick but this time it felt a hundred times worse. I have to do this I am strong enough to do this I know I am. So why am I still sitting here? I get up and walk over to the airhostess giving her my boarding pass and passport, she smiles brightly at me all I can manage is a brief smile I feel so rude but I am not in the mood to be polite. She hands my passport back and lets me through to go down to plane my stilettos are killing me and all I want to do is kick them off and run, run into nicks arms and forget all my troubles but I just canââ¬â¢t not now not ever again. As I reach the aeroplane I am almost in tears again luckily no one has noticed, I get on to the plane and into my seat all I can think about is nick nothing else everything around me seems to remind me of nick like the guy sitting next to me got out his briefcase and I happened to notice his card that clearly explained that he was a lawyer like nick and the lady in front of me asking for a martin without the olive just like nick would ask, I keep telling myself I am being paranoid. After what feels like days I am home. I open all the windows in my flat to let out all the heat it is nearly midnight and still boiling, I try to get some sleep but just canââ¬â¢t I keep thinking about nick and wondering what he is doing. I decide that I am not going to sleep at all and end up watching dirty dancing the best romantic film if only love could really be that simple even though her dad doesnââ¬â¢t like them together he accepts it in the end and they dirty dance dance together. I wouldnââ¬â¢t normally cry at the end but after everything that has happened I canââ¬â¢t help but cry. I end up falling asleep in front of the TV all I can see in my dreams is nick screaming my name but none one can hear him I wake up to the my phone ringing no wait not the phone the door bell I look up at the clock it is 3.30 who on earth could it be. I stagger to the door still half asleep yawning I open the door and standing in a white checked shirt and jeans is nick. I canââ¬â¢t speak I donââ¬â¢t know what to say I look around for a conversation starter and end up catching sight of myself in a mirror I look terrible I am wearing and oversized t-shirt and bed socks my hair is all messed up. I look up at nick and he is just looking into my eyes. â⬠I have been shouting your name for ages havenââ¬â¢t you heard me?â⬠he says in a gentle voice. â⬠I was asleep, sorry.â⬠Why am I apologising he shouldnââ¬â¢t be here. â⬠Nick why are you here?â⬠I ask â⬠Because I am not going to let it end like this.â⬠Nick walks into my apartment and sits down on the sofa, I close the door behind him and end up sitting on my dinning room table cause my apartment is open plan you donââ¬â¢t have to sit on one particular chair I can sit anywhere. â⬠Do you want anything to drink?â⬠I ask politely â⬠No, I want you.â⬠I have no idea how to reply to that so I just end up sitting their not being able to think of anything to say luckily I donââ¬â¢t have to say anything. â⬠I know you donââ¬â¢t want it to end like this, and I am not going to let it end like this.â⬠â⬠How do you know what I want?â⬠I ask getting angry ââ¬Å"Because I love you and if you love someone you know every little thing about them.â⬠â⬠Like what?â⬠I ask ââ¬Å"Like the way they take their coffee, their shoe size, what their favourite movie is or when they are lying or unsure about something.â⬠â⬠So do you know all of that?â⬠I challenge him â⬠You donââ¬â¢t like coffee or tea, your shoe size is 6 which you hate cause you think it is to big, your favourite movie is dirty dancing probably cause of Patrick Swayze and I do know when you are lying cause I knew the minuet after you left that you were lying.â⬠I get out and walk on to the balcony I donââ¬â¢t know what to say? By this time nick has followed me. â⬠I love this view.â⬠Nicks say looking out on to the sea and the moon. â⬠You have seen it before.â⬠â⬠True but I didnââ¬â¢t pay much attention to it last time all of my attention was you, it looks like you have done really well for yourself.â⬠â⬠Well running a billion euro cosmetic company does have its upsides.â⬠I laugh nicks says nothing and just smiles How to cite Three really is a crowd, Papers
Saturday, December 7, 2019
Vegetarianism and the Other Weight Problem free essay sample
The first argument is one appealing to the interests that humans have in conserving food resources.He starts out by giving figures to illustrate the American overabundance of food as many American households are throwing out garbage about ten percent of the food they buy every day. As he states, it is immoral to buy and waste food; it is practical and reasonable for us to shop more carefully, buy somewhat less, not waste the food surplus and give extra money to buy food for starving people in order to help relieve famine. Rachels admits that shipments of food alone will not solve the problems of famine; however, there is no conclusive evidence that the situation is hopeless.In fact, there have been positive improvements in certain countries. He believes that combining short-term famine relief efforts and long-range population control programs can considerably reduce the tragedy of starvation. Another matter that he discusses is the inefficiency of the grain growing process as a large percentage of grain produced in the United States is fed to animals raised for slaughter. We will write a custom essay sample on Vegetarianism and the Other Weight Problem or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page If this massive quantity of grain currently fed to livestock were consumed directly by people, a great number of people could be fed.We are indeed wasting a great deal of grain in this manner; instead we can totally eat portion of the grain and use the rest to relieve hunger His second argument is appealing directly to the interests of the animals themselves. Cruelty to animals must be opposed because it directly makes animals suffer and has ancillary effects on humans. As a part the meat production process, immoral practices of cruelty are adopted because of their efficiency and low cost. The suffering of animals who are raised and laughtered for food is not justified, since it is not necessary for us to eat animals to get the nutrition we need. We treat animals cruelly simply just to serve our trivial enjoyment of taste. In addition, Rachels asserts that it is impossible to treat the animals decently yet still produce a sufficient amount of meat. According to him, the humane production of millions of pounds of meat would be so costly that it would force most of us to become vegetarians, as most of us would not have the resources to be able to afford much meat.In response to the question that: ââ¬Å"if meat could be produced humanely, without mistreating the animals prior to eating them painlessly, would there be anything wrong with it ? â⬠(Rachels 372), he argues that human being the subjects of biographical and not merely biological lives is what qualifies humans for rights; however, the animals with which we are most familiar are subjects of biographical lives and if we have the right to life on the basis of having a life, then those animals have rights to life as well. Thus, even if the farming practices are completely humane, killing the animals is still immoral.There are millions of vegetarians already, there is already less cruelty than there would be otherwise, so little effect does not equate none. He uses the analogy of slavery to retort to the objection as knowing that one have little effect on slave trade if one does not own slave would not mitigate the moral culpability for owning slave. Like owning slaves, if the cruelty of factory farming is immoral, it is ââ¬Å"his duty, at least, to wash his hands of it, and if he gives it no thought longer, not to give it practically his supportâ⬠.Therefore, we ought to be vegetarian All in all, through these two arguments, James Rachels discusses the immorality of meat eating due to the valuable protein it wastes, along with the enormous suffering it causes to animals and he argues for a moral duty to be vegetarian. Rachels, James. Vegetarianism and the Other Weight Problem. 367-73. Print.
Friday, November 29, 2019
Well Done State a Problem Essay - Sample Essay
I have often wondered whether the United States has an obligation to get involved in the internal conflicts of other countries. When does the power to intervene become an obligation to act? I gained some insight into this dilemma when a small part of the Bosnian war spilled into my home last year.During the height of the Bosnian conflict, my family was informed that twenty Bosnian students were airlifted out of the mountains surrounding Sarajevo. A relief organization called Bridge for Humanity sought families in the United States that would take in these Muslim teenagers for the school year. The need was urgent because the U.S. government would not let them board planes until homes had been found.My parents and I spent at least a week contemplating whether we should offer. At first I resisted, fearing the obligations that I would be forced to undertake. I knew it would be my job to help this visitor integrate with the students at our school and to look out for him in social situatio ns. Eventually, my parents agreed, but they left the final decision to me. The deciding factor was my parents reminder of the six-million people who were killed in World War II. Many of these Jews, gypsies, and other undesirables had tried to flee Germany and Eastern Europe, but found no country that would accept them. Being Jewish, I found it easy to imagine how desperate I would have been in the same situation, needing someone to rescue me. The choice was made.Emir arrived last October with one small bag. He told us that he had crawled out of Sarajevo through a narrow tunnel leading to the mountains beyond the city. He crawled for many hours in this hot confined space, terrified of being caught and shot by the Serbs. I doubt that Emir looked back during this journey. The building where he had once lived had been blown up months before. He survived in cellars, with little food, and electricity for only five hours each week. Behind Emir, the bombs fell on his city every day.When Emi r arrived at my house, for the first day he could not stop smiling. He appeared jovial and appreciative of the United States and of my family. Soon, however, it became clear that Emir had not escaped Bosnia completely. His inner rage began to emerge. His hatred of the Serbs permeated his thoughts and judgments. Eventually, he began to hate the United States too. To Emir, Americas failure to prevent Serbian atrocities made it evil. He found it reprehensible that some Americans opposed sending troops to defend the Bosnian minorities. He hated Americans that would not risk their lives to save his people.The six months that Emir lived in my home are the most difficult that I can remember. Many nights I would stay up very late talking to him about his negative attitude toward the United States. As he attacked our society, I found myself becoming defensive, then angry. When my mother found butcher knives hidden in his drawers, anger turned to fear. I began to understand the depth of the t rauma Emir had experienced in Bosnia, even as I pulled away from him. I discovered some limits to what I could give.It is now six months later. I have learned that the casualties of war cannot be measured merely by life and death. Those who survive may live with pain, and those who try to help may feel its repercussions. This experience brought a new dimension to my life, as well as a new appreciation of my advantages in the United States. As we are a privileged nation, I feel we have an obligation to aid both oppressed and impoverished countries. There are risks, there are rewards, and there are degrees of failure. Sometimes those we help may hate us for being less than they imagined. But because we did not look away when we were needed and had something to give, we have lived up to our moral obligation.
Monday, November 25, 2019
Hitlers Mistakes essays
Hitler's Mistakes essays The true nature of a mans ability and worthiness is assessed not only by his triumphs but also his failures. Quite often all that is achieved may suddenly be overshadowed by dark clouds of fallacy, occurring lightning fast, and having thunderous repercussions. Through either ineptness, deficiency in character, or just plain bad luck stemming from uncontrollable events, failure is as inevitable as death and occasionally may lead to this unfortunate ending. Adolf Hitler regarded as a man who almost had world domination in the grasp of his ironclad fist, let it slip through his fingers with a compound of irreparable and unjustifiable mistakes which ultimately cost him the war and his life. Within various arenas around the world, he continuously obliterated all hope the Third Reich had on winning the war and expanding its empire permanently. Key blunders, which were detrimental and caused Hitlers downfall, include the hesitation at Dunkirk, the indecision to wage against Great Brita in, and the betrayal of Russia. The disappointment at Dunkirk, although its affects were not felt suddenly, was distinctly the afternoon that Hitler lost the war. British and French officials noticing the devastating force Germany was becoming after recent victories in Poland and the mutual non-aggression pact signed with military mass Russia, proclaimed war against their sworn enemy. France was amply prepared for their neighbouring rival, protecting their borders with the Maginot Line a series of concrete structures costing France $ 1 billion and consuming over 26 million cubic feet of cement. In an outstanding strategic move, the German generals anticipated the resistance that would be encountered in a foreshadowed attack, and made their way through the Ardennes Forest, thought by the French to be impenetrable, especially by armour units. The swift declaration of B...
Friday, November 22, 2019
Collapse by Jared Diamond Essay Example | Topics and Well Written Essays - 1250 words
Collapse by Jared Diamond - Essay Example All these societies have experienced different climatic, environmental, economic, and technological conditions. How the success or failure of these societies depends on these conditions and how these societies have responded to the changed condition is what the book is all about. The root problem, according to the author, in all but one of these factors leading to collapse is overpopulation. The factor of accidentally or intentionally introducing non-native species to a region has nothing to do with overpopulation. However Diamond feels that environmental damage alone is not a major factor responsible for all collapses. For instance in the collapse of the Soviet Union and the destruction of Carthage by Rome in 146 BC, it was military or economic factors alone that were responsible. Part One describes the environment prevailing in the US state of Montana. It attempts to give a human face to the interaction between society and the environment by focussing on the lives of several individuals. Part Two describes societies that have collapsed.Here Diamond considers the five factors that may affect society, namely climatic change, environmental damage, hostile neighbors and trade partners and lastly the societys responses to the problems caused by the environment. The Greenland Norse : Causes of collapse include climate change, hostile neighbours, environmental damage, loss of trading partners and also because of the unwillingness to change when confronted with social collapse At the end of Part Two Diamond discusses the success stories of three regions, namely the Pacific island of Tikopia, the agricultural success of central New Guinea and the success of forest management in Japan. Diamond describes the terrible situations in Haiti and Rwanda. He also portrays the contemporary Third World where societies have failed because of overpopulation and depletion of environmental resources He is worried about rising mega
Wednesday, November 20, 2019
Just War Doctrine Essay Example | Topics and Well Written Essays - 250 words
Just War Doctrine - Essay Example In this direction, Orend, Brian (2008) argues that ââ¬Å"just war theory is probably the most influential perspective on the ethics of war and peace.â⬠This means that the talk of just war raises a lot of questions on ethics and morality. Many researchers and theorist have therefore propounded a lot of ideas and theories on just war. One of such is the ââ¬Ëconsequentialistââ¬â¢ moral dynamic for intelligence operations introduced by Arrigo. The Arrigo Paper and believers of it thereof raise a lot of issues of when human source intelligence, counterintelligence, or covert operations pass the ââ¬Å"moral divideâ⬠and violate the Just War doctrine. As an expectation of civilians from the military, wars should be started by causes and causes should be found through intelligence. For this reason, a justified war comes with a justifiable cause and for that matter, a justifiable intelligence. It is therefore important that ââ¬Å"a doctrine of just war should coordinate wi th a doctrine of just intelligence, especially for human source intelligence, counterintelligence, and covert operationsâ⬠(Arrigo, 2001).
Monday, November 18, 2019
PROMOTING RECOVERY WORKING WITH COMPLEX NEEDS Essay
PROMOTING RECOVERY WORKING WITH COMPLEX NEEDS - Essay Example An increasing number of people in this group also have problems with substance misuse, often resulting in contact with the criminal justice system. These problems often interact and can appear intractable. Recent years have seen a paradigm shift in mental health, from a focus on illness and disability towards the promotion of recovery and social inclusion (Repper and Perkins, 2003). Underpinned by a stress vulnerability model of mental health problems (Zubin and Spring, 2004, 105; Nuechterlein, 2004, 300), a range of psychosocial interventions (PSI) can be used to enable service users to build on strengths and develop skills in order to manage their own mental health more effectively. This in turn can facilitate attainment by service users of socially valued roles and relationships taken for granted by most people. One of the available interventions is a structured approach to the prevention of relapse, developed by Birchwood and colleagues (Birchwood et al, 2000, 5), building on the early work of Herz and Melville (2006) and Birchwood himself (Birchwood et al, 2000, 652). This work had demonstrated that it was possible to predict relapse in psychosis on the basis of recognition of early warning signs. The intervention incorporates a strong educative element. This aims to increase understanding of the typically episodic nature of psychosis and to enhance service users' self-efficacy in relation to the management of their mental health. A Cochrane Review (Pekkala and Merinder, 2002) concluded that psychological education significantly reduces relapse rates, increases compliance with medication, and may have a positive effect on a person's well being. To deliver the relapse prevention intervention effectively calls for the use of a set of specialist knowledge and skills, in addition to general mental health nursing skills. Aims Our primary aim was to enhance the quality of service provided to users of the inpatient areas of the local mental health rehabilitation service by making the relapse prevention intervention available routinely and sustainably. An essential interim aim was to equip the multidisciplinary team with the knowledge, skills and confidence required to deliver the intervention effectively. To address these aims and evaluate whether they were achieved, we developed a project plan in six stages. In the event, workers from community settings also sought out the training, and so the original scope of the project was broadened to include all areas of the mental health rehabilitation service. This paper will focus on the aspects of the project relating to service users. Intervention The project was jointly led by the clinical nurse leader of the mental health rehabilitation services and a lecturer practitioner. At the outset we sought guidance from the Trust's research and development coordinator as to whether we should seek ethical approval for our planned project. The advice received was that the project represented service audi t/evaluation rather than research and, as such, ethical approval was not required. We began by attending clinical meetings at which we described our plans and encouraged discussion and questions by the multidisciplinary team. We refined a previously developed two-day training programme in order to meet the needs of a multidisciplinary group
Saturday, November 16, 2019
Causes and Impacts of disruptive Behavior (DB) in Healthcare
Causes and Impacts of disruptive Behavior (DB) in Healthcare Introduction Persons may be fascinated to study and work in the nursing occupation because it is trustworthy and esteemed; though, the reputation of nursing is at risk as nurses are vulnerable to violence at their work more than other professions (Carter 2000 cited in Norris 2003). Indeed, nursing profession is four times more dangerous than most other careers (Gallant, R 2008). Nurses deliver care for displeased patients and families, whether they are mentally or emotionally ill, or they are offenders. They also need to deal with staffs and other healthcare members within the organization who evoke distress and nervousness. Lateral violence (LV) in health organizations has come to be so widespread and troublesome that it has gained the concern of the policy makers, managers and the healthcare organizations. During the past years LV has gained special attention in organization research. According to National Council on Compensation Insurance (NCCI) in 2006, 60% of workplace assaults are presented and intensified in health organizations, social facilities, and personal care employments. Investigators have reported alarming findings about the negative consequences related to disruptive behavior (DB) for the individuals, the health organizations, and the patients. As for the impacts on the organization, DB has been reported to be associated with higher turnover and intent to quit the organization, higher absenteeism, and decreased commitment and productivity (Hoel, Einarsen Cooper 2003). In addition, victim bullying has been reported to experience stress, job dissatisfaction, psychological and physical illness, and possible expulsion from the Job (Hoel Cooper 2000, Keashly Jagatic 2003 cited in Hoel et al. 2003, Vartia 2001) while patient bullying has been reported to result in reduced s afety and quality of care (reference). Although LV is considered a global epidemic (International council of nursing (ICN) (2007) and has long been a concern among healthcare providers, it has frequently gone uninhibited, or even pernicious, accepted as part of the organization. Thus, leaving these behaviors unaddressed, health organization quietly maintained and reinforced them. Fortunately, DB has lately come under better scrutiny. The American Medical Association (AMA) (2002) has commented: Personal conduct, whether verbal or physical, that affects or that potentially may affect patient care negatively constitutes DBs. The American Association of Critical Care Nurses (AACN) in 2005 has noted that the presence of DB is negatively impacting the collaboration among healthcare workers, which is principal to instituting and supporting a productive work environment. Furthermore, Alspach (2007) stated that LV in nursing is insidious, costly, disgusting and affects patient care. These behaviors urge TJC in 2008 to warrant the healthcare organizations of the safety risk caused by intimidating behaviors and asked them to increase their awareness of the individuals and organizational risk resulting from these behaviors. Those exposed to DB can live through stress, frustration, and psychomatic disorders. Sadly, Griffin (2004) found that 60 % of newly appointed nurses quit their work within six months of service upon exposure to LV, 20% leave the nursing profession forever. While, Veltman (2007) stated that DBs pushed the nurses to leave a particular job, and this drain on resources further affect patient care. In order to address this threat TJC (2009) introduced a leadership standard requiring that facilities looking for accreditation must formulate policies to tackle DBs in healthcare organizations. Now all Healthcare givers should be charged with understanding and addressing this needed culture change within health organizations. In this paper, the causes and impacts of DB for both patients and healthcare workers will be reviewed. Strategies to address and combat DBs among healthcare givers will be discussed. LV, DB and bullying are the terms that I will be using throughout this assignment. Laying the foundation Several terms have been used in nursing research to describe the negative behaviors of nurses in health services. These include LV, bullying, relational aggression, intimidation, horizontal hostility, horizontal violence, sabotage, verbal abuse, psychological abuse, oppression and interactive workplace trauma. (Alspach 2007,Dellasega 2009,Longo Sherman 2007, Lutgen-Sandivk 2007, Rocker 2008,Rowell 2005, Rosenstein ODaniel 2008, Stanley 2007, The Joint Commission(TJC) 2008) . Griffin (2004) identified the most common ten features of DB in the nursing literature (Duffy1995; Farrell1997, 1999, McCall 1996, cited in Stanley 2007): non-verbal innuendo, verbal affront, undermining activities, withholding information, sabotage, infighting, scapegoating, backstabbing, failure to respect privacy, and broken confidences. These kinds of DBs may be perpetuated by healthcare providers, patients or their families. High jobs pressure such as nursing tends to create stresses that are often released when further stressors are added. The discharge of the unbearable stress can result in LV. Irrespective of the initiating stress, no one merits to be abused. When LV erupts, everyone is influenced (Rowel 2010).Some researchers argued that nurses are an oppressed group who intern contributes to the oppressive behaviors indicative of LV (Stanley et al. 2007). Moreover, oppression, vulgarity, and sexual harassment are key elements of LV (Lutgen-Sandivk 2006). But these issues are not the only means that DB may manifest itself in personal communications. Norris (2010) added that hostility may take the form of apparent detesting, patronizing language, annoyance with questions from neophyte nurses or unlicensed employees, disparaging, impoliteness, concealing information, and even temper tantrums. DB is used to depict the workplace negative behaviors that may affect the health status of patient (TJC 2008). Dellasega (2009) refers LV to the act of intimidating, degrading that result in physical, psychological or emotional injury on a colleague or group while Rosenstein and QDaniel (2008) described LV as any unsuitable conduct, conflict, or confrontation ranging from verbal abuse to bodily or sexual harassment. According to Piper (2003) DB is any aggressive behavior that may endanger the stability of patient, unit, and the ability of the organization to achieve its mission. The ICN (2007) defined bullying as a behavior that dishonors, demeans, or otherwise shows disrespect for the dignity and value of an individual. Habitually, the fundamental cause of DP turns around communication mishaps (Ratner 2006, cited in Rowel 2010) or intentional obnoxious behaviors. Sheridan-Leos (2008) stated that the term LV has been used for more than 25 years in the nursing literature and described it as an act of antagonism that occurs between nursing colleagues within an organizational hierarchy. DB may be obvious or subtle. Farrell (2001, cited by Leiper 2005) uses the terms active or passive to categorize DP while the TJC uses the terms overt or covert. Active or overt actions range from intimidating body language designed to discomfort another or others to overtly criticizing a colleague in the presence of others, shouting at others and even physical attack (Leiper 2005, Longo Sherman 2007). Passive, covert aggression may take the form of gossiping, cover-up information needed to perform the job, or demonstrating unhelpful approaches during routine doings. Griffin (2004) found that many experienced nurses are not acquainted with the term LV and thought new nurses were making up the term. Likewise, many forms of DB may be so delicate that certain actions are considered nothing more than a personality conflict between two persons. Jackson (2002) contends that DB is an axiomatic phenomenon in health organizations and is recognized by many organizational cultures as a part of doing business. However, when asked precisely about personal experiences with DB, most healthcare providers confess that they know it when they see it, and many acknowledge exposure to some sort of experience with it during their professional life (Alspach, 2007). Owing to the seriousness and continuity of the side effects of LV on patient outcomes, a great attention has been paid to this topic in the literature. Here are some examples of reported cases: In a study conducted by the joint program and reported by the international council of nurses (ICN) (2007).Researchers found that the most common forms of LV are Verbal abuse, bullying and sexual harassment where verbal abuse ranks the highest among them. Verbal abuse had been experienced by 39.5% in Brazil, 32.2% in Bulgaria, in Portugal, 52% in the health center complex and 27.4%in the hospitals, 40.9% in Lebanon, and up to 67% in Australia. Additionally, bullying has been suffered by 30.9% in Bulgaria, 20.6% in South Africa, 10.7% in Thailand, in Portugal ,23% in the health center complex and 16.5% in the hospital, 22.1% in Lebanon, 10.5% in Australia and 15.2% in Brazil. Furthermore, sexual harassment impacted 64% in India, 90% in Israel and 56% in Japan, 69% for the UK, 48% in Ireland and 76% in the US. The Institute of Safe Medication Practice (ISMP) surveyed over 2000 healthcare providers in 2004 including nurses (1565), pharmacists (354), and others (176) and reported that 88% of the surveyed staff suffered bullying by other workers in the form of haughty language or voice intonation. 87% felt impatience when questioned and 79% were unwilling or refuse to respond to questions or telephone calls. The Nursing journal website (2006) asked guests in the last 6 months have you observed any nurse dealing inappropriately with others? 55% of all visitors claimed yes. This was demonstrated by a survey administered in 2007 to 663 nurses; 46% informed that LV was very serious or somewhat serious issue in their healthcare area and 65% reported witnessing DB repeatedly (Stanley 2007). Ulrich (2006) surveyed 4000 nurses; 18% reported verbal abuse from another nurse, while 25% of all participants rated the quality of teamwork and communication with other nurses as fair or poor. A minor study in Boston (2001) involving 26 new graduate nurses reported that 96% of respondents had seen LV during their first year of work, 46% stated that the act was against them. Acts of LV included being set them up to fail with an unreasonable assignment, sabotage, undermining, or not being available (Griffin 2004). According to a survey written by the Workplace Bullying Institute in 2010 and commissioned by Zogby International survey (2010), an estimated 35% of the U.S. workforce has been bullied at workplace; 62% of bullies are men; 58% of targets are women,68%of bullying is same-gender harassment; an additional 15% witness it. Half of all Americans have directly experienced it. Simultaneously, 50% of targets and witnesses never report the incident (silent epidemic). Leymanns (1993, cited in Einarsen1999) asserts that four elements are noticeable in prompting bullying at workplace: (1) lacks of work design, (2) deficits in leadership performance, (3) a socially visible status of the victim, and (4) reduced ethical standards in the working department. Einarsen et al. (2003) designed a workplace bullying framework; which gives an overview of how factors on different levels may interact at different stages in the multifaceted bullying process. This framework calls the attention not only to individual factors (in victims and perpetrators) but also to contextual, organizational and social factors. Salin (2003b) adapted this framework (Fig. 2), which builds and argues a planned adjustment of the framework by constructing on organizational factors of intimidation and its tolerance/intolerance by using terms such as enabling/disabling factors (Fig. 3). The Problem A survey conducted by TJC (2008) involving 4350 healthcare providers revealed that 77% witnessed DP by doctors and 65% by nurses. These behaviors are frequently demonstrated by professionals in positions of power and include unwillingness or rejection to answer questions; return telephone calls or pagers; patronizing language or voice intonation, and impatience with questions. In response to these events, TJC (2008) issued a patient safety alert affirming that the existence of threatening and unapproachable behaviors weakens the effectiveness of teamwork, erodes professional behaviors, and creates an unhealthy work environment. This sort of toxic environment can lead to malpractice risk (Rosenstein and ODaniel 2005, Morrissey 2003, ISMP 2008), patient dissatisfaction and to preventable adverse outcomes, (Rosenstein and ODaniel 2005, Gerardi 2008, Ransom and Neff et al 2000), increase cost of care, (Gerardi 2008, Ransom and Neff et al 2000) and causes competent clinicians, administrators and managers to look for new workplaces in more professional settings. Lutgen-Sandvik (2009) stated that nurses employed in a toxic, threatening environment often dread going to work and many face the day with feelings of impending doom. Recurrent exposure to bullying headed some nurses to retreat into silence, which led to disruption in communication and teamwork. Furtherm ore, continuous bullying may alter nurses self-confidence, initiativity and innovation resulting in psychological and occupational impairment (WBI 2003). All of these factors combine their effects to disrupt the stability of employees, the organization, and the patients safety. Unfortunately, there is no research study in the United Arab Emirates (UAE) handling the issues of LV except for a minor one conducted in Saqr Hospital in Ras Al Khaimah. The executive director stated that DB by physicians, including Sexual harassment and verbal abuse is a major cause of nurses stress and dissatisfaction at the hospital. Such abuse pushes the nurses to turnover (Zain 2010). Moreover, unhealthy nurses-physicians rapport and authority abuse by the doctors have contributed to nurse turnover in the UAE (khaleej, T 2009).The absence of studies involving the whole emirates does not mean that the problem does not exist. Based on my observation as part of the healthcare system, many nurses especially Asians suffer from different kinds of hostility from physicians, superiors, peers, patients and their families in their work. This hostility take the form of shouting, oral degrading expressions, oral ironic remarks, raised eyebrow, unflattering face gestures, apparent detesting , and sexual harassment. Literature Review History The notion of LV is not a new phenomenon. Horty (1985, cited by Piper 2003) defined the disruptive doctor as as a very clinically competent to the extent of considering himself as the most experienced in the healthcare organization. The troublesome physician is naturally very tough to contact and hence argumentative and antagonistic. In the 1990s, DBs by doctors began to be labeled in the literature as a form of physician impairment (Piper 2003). Gawande (2000) revealed in his article When Good Doctors Go Bad how the medical community was not set to suitably address physicians DB. Rosenstein et al. (2002) found out that lack of physician awareness, appreciation, value, and respect for nurses were serving to fuel the countrywide nursing shortage, profoundly impacting job satisfaction and morale for nurses. So what motivates TJC to ask the medical community to act against violence after two decades? Researchers agree that two milestone matters brought the dispute of LV to the front (Lu tgen-Sandivk 2007, Rocker 2008, Rosenstein ODaniel 2008, Seidel, 2006). The Institute of Medicine (lOM) published in 1999, To Err is Human. The report determined that medical errors cause between 44,000-98000 deaths yearly- more than result from vehicle accidents, breast cancer or AIDS (Baker 2009). The report emphasized the necessity to consider organizational resources and human factors that harmfully influenced patient care (Rosenstein ODaniel 2008). The risk of a nursing shortage. Aiken et al. (2001) found in his global study in a sample of 43,329 nurses that job dissatisfaction was highest in the USA (41%) followed by Scotland (38%), England (36%), Canada (33%) and Germany (17%). More striking, however, was that 27-54% of nurses less than 30 years of age intended to quit within 12 months of data collection in all countries. The U.S.A had a shortage of 150,000 nurses and that number is expected to reach 800,000 by the year 2020 (Childers 2005). Consequently, the nurses will be incapable to meet the forthcoming patients needs if this continues. One reason of turnover is the frustration caused by DBs. Rosenstein et al. (2002) noted that nurse-physician relationship is the key element for retaining nurses. Rosenstein surveyed 2562 from 142 hospitals from 11 Voluntary Hospital Association regions. The sample included 389 physicians, 1615 nurses and 104 senior level executives. More than 90% informed witnessing DB by physician and over 33% of nurses tend to turnover. Using a scale of 1-10 to identify the level of nurses satisfaction and moral; LV ranks pretty high (8.01) Figure 4 Theoretical Framework Rowell (2010) suggested five theories about LV. (See Appendix I). Causes of LV Physicians related Several researchers stated that the physicians training at the hospitals make them vulnerable to DB (Kuhn 2006, Rosenstein ODaniel, 2008). During their training; doctors learned to think individualistically and to become accountable for their activities. This mentality promotes self-reliance, self-sufficiency and an autocratic, bullying conduct which is the antithesis of teamwork (Rosenstein et aI. 2002). According to Kuhn (2006), the absence of quality control starting in university and it is nearly difficult to be fired from internship. This leads the physicians to see themselves as the so-called captain of the ship but possibly do not have the necessary skills to keep it right. This also produces a hierarchal model of healthcare which builds passive roles for nurses and other subordinates (Rosenstein ODaniel 2008) Piper (2003) found that DB is usually demonstrated by excellent clinicians who are accepted by their patients and the society. As they habitually have a notable record of accomplishments; victims may be unwilling to intervene considering the behavior as an exceptional one. Moreover, Piper stated that hospital managers who are supposed to implement the policies are confronted with the challenge of whether to ignore the behavior, or take a difficult decision of firing a great physician who shows too much enthusiasm. According to Rosenstein ODaniel (2008) some hospital directors are disinclined from averting the aggressive attitudes of the physicians because they are not hospital employees and willingly admit their patients to the hospital and thus considered a source of organizational income. Growing external forces such as governmental supervision, pressures for more productivity, managed care restrictions, lower payment, and increasing liability risk cause disruptive physician behavior (Rosenstein et al. 2002). Practicing physicians are overwhelmed with paperwork. As a result, demoralization, and anger will develop leading to oppressive conducts. Another likely cause is the stress inherent in todays medical environment such as mental exhaustion and environmental stressors experienced by physicians lead them to commit medical errors (Kuhn 2006). Staff related The oppression theory will be applied to understand the nurse-to-nurse aggression. Healthcare institutions are controlled by the administrators and physicians who use their authority to rule subordinates. It is obvious that when any oppressed group recognizes that it is not possible to direct its power upward, the group then places their powerlessness and frustration on one another. These peer-to-peer hostilities, which reduce self-esteem, are called LV (Sheriden-Leos2008, Griffin 2004, Leiper 2005). Dunn (2003) confirmed in a study involving 500 nurses in the operating theater that the great numbers of nurses were verbally attacked by the surgeons. This sort of offensive abuse led the oppressed group to develop personal characteristic such as disunity and inability to oppose the physicians because of their positions, authority and ability to revenge from the nurses. Rowell (2005) estimated that 81% of oppressors are bosses, 14% peers, and 5% lower rank staff. Referring to Griffin (2 004) this form of oppression causes the nurses to feel helpless, disrespected and self-loathing. Stanley and Martin (2007) have suggested an applied model of oppressed group behavior to demonstrate how LV seems to manifest itself in the workstation (Fig. 4).It also useful in predicting nurses retention and satisfaction. Gender is another factor. Many studies revealed that females are more susceptible to LV than males. Dunn (2003) rationalized that women tend to suppress their feelings of bitterness. In addition, women are habitually considered inferior to men within society in general and healthcare organization in specific. Accordingly, it is not astonishing to see recurrent acts of sabotage in the nursing as 90% of nurses are females. Leiper (2005) has a parallel opinion and said that females generally underestimate their efforts and have lesser self-esteem than males so they can be irritated more easily and have a predisposition to yell at others. Dellasega (2009) concluded that males express their anger more frequent with bodily violence and this is usually accepted and women exhibited it through character insult, mortification, disloyalty and rejection. ISMP (2004) surveyed 2095 nurses (86% female and 14 % male) and found that DB was nearly equal. Thomas (2003) agrees with this finding. Not all Researchers support the oppression theory as the mechanism for DBs. Ratner (2006) view the oppression theory as condescending to nurses, making them appear as the powerless victim. Another standpoint suggests that organizational cultures, sustained struggles for authority, inconsistent work standards and management styles results in LV (Hallberg 2007). Further organizational causes include shortage, work overload, lack of administrative support, relations among groups, and organizational reform (Rocker 2008). Patient/Family related Patient or family members with a history of DB should be considered at high risk for becoming violent. Violence results from those who are frustrated, rampant, mentally ill, and substance abuser. Finally, LV is not frequently reported by victims and therefore run unaddressed. Fear of revenge, the stigma related to blowing the whistle on a peer, a wide-ranging averseness to oppose an oppressor (TJC 2008), the status quo, lack of confidentiality, lack of administrative support, and lack of awareness or reluctance among doctors to change inhibit the reporting (Rosenstein et aI. 2002). Similar to other kinds of mistreatment, staff violence is repeatedly viewed as an isolated matter and individuals are occasionally unwilling to talk about it (Gammons 2006). On several occasions, LV is not informed because it isnt identified. Some practitioners doubt that bullying has happened except when somebody shouts or uses attacking language (Beyea 2004). Forms and Manifestations OF LV: (see Appendix II) Effects of LV on: Nursing workforce, Organization and Patient The Nursing workforce Defamation of professional dignity, stress, anxiety, frustration, and anger (Rosenstein ODaniel 2008), sleeping disorders, reduced self-esteem, low morale, disconnectedness from their colleagues, depression, apathy, and excessive sick leave (Alspach 2007, Longo Sherman 2007), Suicide attempt (Griffin, 2004). According to the WBI, 45% of respondents had stress-related health problems which include debilitating anxiety, panic attacks, clinical depression (39%), and even post-traumatic stress. Not astonishingly, the adverse effects of LV are not only restricted to the targets. Co-workers witnessing LV report stress and job dissatisfaction. Witnesses who never report are confused how to stop assailant. Unluckily, their silence often leads them to despair and turnover (Lutgen-Sandvik 2007). Healthcare Organization Manifestations include: increased patient illnesses, increased healthcare costs, unplanned absences, law suits (Rowell 2005), malpractice risks (TJC 2008) and turnover (Rosenstein QDaniel 2008, Griffin 2004). Rocker (2008) states that between one third and one half of all work related absences and illnesses are a result of office bullying. According Yamada (2009) some victims pursue compensation or disability benefits as they are no more able to endure work stress and intimidation. Along with Stanley (2010) the overall increase in nurses turnover induced by LV from 2002 to 2007 is 32%. Turnover costs the organization per RN for 2007 $82,000 88,000. Additional costs are decreased productivity and loss of experienced and knowledgeable nurses. Malpractice of physicians and other healthcare providers, which is estimated at 4-6%, has a vast impact on organizational costs. Patients and families detect aggressive work environments (TJC 2008) and are ready to sue when they are faced with arrogant or insensitive behavior from healthcare workers (Aleccia 2008 as cited by TJC 2008). The Patient Rosenstein (2008) surveyed 4530 participants from 102 USA organizations from 2004-2007. The survey questions were intended to assess the respondents perception of the link between DB and patient care. The links were as follow: 66% adverse events, 71% medical errors, 53% compromises in safety, 72% detrimental impacts on quality of care, 25% patient mortality,18% were aware of a specific adverse event, 75% of them believe that the adverse event could have been prevented. According to Dunn (2003) some nurses may control patients by putting off their response to the patients needs- pain medicines, etc. Displeased nurses can also keep patients family uninformed about the patients health status or not support them when needed. Stanley (2010) reported that 1.5 million patients are harmed by medication errors yearly. DISCUSSION In todays sophisticated healthcare setting, each system brings particular skills to patients care. Whether the clinician is a nurse, or any other healthcare workers; each has a unique set of expertise and acquaintance that enable them to view the patient from a particular standpoint. Each field is taking care of the patient at distinctive times and intervals of the day. The doctor visits the patient one or two times a day for 15-20 minutes whereas the nurse employs several successive hours bedside his patient. Therefore, the nurse is the first one who detects and attends the alteration in patients status, not the physician. The patient and the efficacy of the healthcare team are dependent on each other to thoroughly and assertively communicate the changes in the health status of the patient. Unhappily; DB hinders this communication process which affects patients outcomes. It is of merit to mention that the international picture of LV is no difference from UAE.I have been working in the clinical setting for 16 years in different hospitals as a nurse and in a health institution as a teacher and clinical instructor. I have been exposed to and witnessed many episodes of Dbs. For example, I remember a situation when the head nurse asked the Surgeon whether he wants to start the patient on diet or continue keeping him nothing by mouth. The doctor replied in an offensive manner; give him Shoes. The head nurse asked him to write this in the order sheet. Sadly but true, the doctor did it without giving consideration to anything. The nurses felt that they were disrespected and were frustrated because of the recurrent response from the administration when DB is reported as status quo. That instance happened before 9 years but this troublesome situation impacted my psychological status that I recall it as if it occurred yesterday. Another incident, Though I do no t like to recall it, but its profound effect keeps it all the time in my imagination when the nurse came to the nursing counter crying once an aged patient got the money from his pocket and asked her to satiate his sexual desire. Furthermore, nurse on nurse aggression is also clear and take different forms ranging from verbal and non-verbal attack such as intentional rolling of eyes, folding arms, gazing into space when communication is being attempted, backbiting, withholding informationà ¢Ã¢â ¬Ã ¦etc. to physical assault such as pushing each other. These DB extended also to the patient particularly the dependent and the unconscious patients who were insulted either by bad words or inappropriate care. The negative effect of these DBs was manifested by medical errors, reduced patient safety and care, decreased performance and productivity, frustration, dissatisfaction, turnover, and poor hospital reputation. Although these are merely anecdotal notes, there are comparable events recognized in the research. Rosenstein ODaniel (2006) presented selected comments acquired from a survey of 4530 healthcare providers. They include terms such as RN did not call doctor about change in patients health status because the doctor had a history of abusive behavior and particular surgeons give the impression that they have the right to be impolite and verbally offensive. It is hard to maintain a high level of performance when repetitively scared of being yelled at (Rosenstein ODaniel2006). Unhappily, DB is not solely restricted to doctors. Rosensteins survey data supports the issue that DB spread to other non-physicians employees. Remarks include; DB from nurses is much more upsetting. I expect it from the surgeons but not from my peers and please realize that most stress is from RN managers, not MDs. According to Rosenstein ODaniel (2008), the most common situation that triggered DP by doctors, as conveyed by nurses, was calling physicians to report a decline in the patients condition. This shows a failure in communication that ought to bring dreadful results on the patient. For instance, if the physicians order is inaccurate or not clear. The nurse many not carry out the order until clarified by doctor. If the nurse is anxious about making a telephone to the doctor due to fear of an annoyed eruption, she might postpone the call or make another work around by evading the doctor entirely and including another party. If there is inaccurate order of medicine, this situa tion can be revealed in various ways, all with awful outcomes for the patient. Primarily, the issue will not be verbalized as the practitioner did not desire to confront the stellar reputation of the doctor or because they were demoralized by previous behavior (ISMP 2008). Consequently, the incorrect medicine will be given. If the nurse calls the doctor and feels that the physician is irritated, the incorrect medicine can still be given and secondary repercussions such as being unable to correct the order in the future can result. Unfortunately, several nursing staff has to live with the guilt of a serious error because they did not follow up on a questioned situation (ISMP 2008). The negative outcomes of such an error can result in stress and frustration for all involved and thus can bring about DB. Limitations Workplace LV is a complicated issue. A diversity of expressions is used to reveal similar behaviors .Although they possess distinctive meanings, the terms are frequently used interchangeably in the nursing literature. There are also a many workplace abuse that might be categorized as DB. First, the paper has focus merely on psychological and/or verbal abuse and not physical or sexual harassment. Second, the majority of literature focuses on LV in nursing profession in particular and to a certain degree
Wednesday, November 13, 2019
LAN networking :: essays research papers
If you want to add additional computers to your network in the future, all you need are more Network Interface Cards and 10BaseT cables. Simply plug the new network cards(s) into your computer an run a cable form the card to one of the hubââ¬â¢s open ports. For even greater expandability, the hub can be joined, or uplinked, to other hubs. If you look closely at the front of the hub, you will see a port marked Uplink. To uplink a hub, simply insert a standard, straight-through 10BaseT cable between the Workgroup Hubââ¬â¢s Uplink port and any of another hubââ¬â¢s regular 10BaseT ports. A maximum of three hubs can be connected together. For example, like most hubs, a 5-Port Hubââ¬â¢s port number 5 and Uplink port are joined internally. This means that when port 5 is in use, the uplink port cannot be used, and vice-versa. If you plan on using the uplink port, youââ¬â¢ll need to disconnect any cables that are connected to port 5. Setting up your network cardââ¬â¢s software involves installing a network driver onto your computer. The driver will allow the card to communicate with your Network Operating System (NOS). Software package. Some of these NOS include Windows for Workgroups, Windows 95/98, Windows NT, and Novell. All the network cards that you buy should come with a 3.5â⬠software disk where it includes drivers for different NOS. They should also have instructions on how to install them, but this hand out will help you understand and teach you how to install drivers. After installing your network card hardware in your computer, follow the instructions below to install the cardââ¬â¢s software. 1.à à à à à Install the network card hardware if you havenââ¬â¢t already 2.à à à à à Start up your computer and Windows 95/98. 3.à à à à à Windows 95/98 will automatically detect the presence of your network card hardware in your computer. à à à à à If Windows 95/98 goes immediately to the windows desktop, and does not display a new hardware detected message. Go to my computer > control panel > system > device manager tab > select the network adapter and remove it from the list > restart computer and you should get a windows asking for drivers. Important: When you reboot Windows 95/98 may ask you for the Operating System CD ROM. Please provide them as necessary. 4. Windows 95/98 will detect your network card and display a â⬠New Hardware Foundâ⬠window as shown bellow 5. Put your 3.5â⬠in drive A with the network card drivers that came with the it.
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