The Importance of Leadership in Nursing - Free Essay Example

Sample details Pages: 7 Words: 2195 Downloads: 1 Date added: 2017/06/26 Category Medicine Essay Type Analytical essay Did you like this example? Nursing example essay The importance of leadership is now widely recognised as a key part of overall effective healthcare, and nursing leadership is a crucial part of this as nurses are now the single largest healthcare discipline (Swearingen, 2009). The findings of the Francis Report (2013) raised major questions into the leadership and organisational culture which allowed hundreds of patients to die or come to harm and further found that the wards in Mid Staffordshire, where the worst failures of care were found were the ones that lacked strong and caring leadership, highlighting the crucial role of nurses in leadership. Research into nursing leadership has shown that a culture of good leadership within healthcare is linked to improved patient outcomes, increased job satisfaction, and lower staff turnover rates (MacPhee, 2012). Don’t waste time! Our writers will create an original "The Importance of Leadership in Nursing" essay for you Create order Although the NHS currently faces many challenges such as financial constraints and a growing elderly population, leadership cannot be viewed as an optional role. Previous research by Swearingen (2009) has suggested that educational programmes for nurses do not fully prepare them for leadership roles, and this gap between the demands of clinical roles and adequate educational preparation can result in ineffective leadership in nursing (Feather, 2009). It is important to recognise the critical role that nurses and nurse leaders play in establishing leadership for patient care and the overall culture within which they work (Feather, 2009). Themes explored in this essay will include defining leadership, leadership in nursing, factors that contribute to nursing leadership, and leadership preparation as part of nursing education. What is leadership and culture? Leadership can mean many different things and has clearly evolved in meaning over time (Brady, 2010). Common qualities associated with leadership are influence, innovation, autocracy, and influence (Brady, 2010, Cummings, 2010). A key factor which has remained part of leadership during its evolution has been the ideas that leadership can involve the influence of behaviours, feelings, and actions of other people (Malloy, 2010). Culture is different, and refers to the implicit assumptions that each member of a group or organisation perceives and reacts to different things (Malloy, 2010). Culture is often regarded as a good reflection of what an organisation values most: if compassion and safety are highly regarded, staff will assimilate this (Hutchinson, 2012). Interactions by leaders at all levels of an organisation have been identified as the most important aspect/component of establishing and maintaining a culture of leadership (Malloy, 2010, Hutchinson, 2012). The most senior lev el of leadership within NHS trusts often comes from the board of directors, who have overall responsibility for the overall leadership strategy (Brady. 2010). Nursing leadership Although there are many research articles and books about leadership and management, there has been relatively little research until recently into what nursing leadership entails. Cummings (2008) found that perceptions of nursing leadership were different from general leadership because it placed a greater emphasis on nurses taking responsibility for and improving and influencing the practice environment. Brady (2010) reported that anytime a nurse had recognised authority, they were providing leadership to others. By this argument, student nurses are leaders to their patients, a staff nurse is a leader to student nurses and patients, and the leader to all team members is seen in the ward manager (Brady 2010, Sanderson, 2011). It is also important to distinguish between a manager and a leader (Brady 2010, Sanderson, 2011). Mangers are seen to be those who administer, maintain, and control, whereas leaders are those who are seen to innovate, develop, and inspire (Sanderson, 2011). Wh ilst there is obvious need for managers within the health service, it is vital to realise that there is a clear distinction in the roles of managers and leaders (Sanderson, 2011), and that there are areas where these roles may not overlap (Sanderson, 2011). One of the key challenges facing the NHS is to nurture a culture which allows the delivery of high quality healthcare (MacPhee, 2012) and one of the most influential factors which can impact the delivery of quality patient care is leadership: ensuring there is a clear distinction between management and leadership, and that leaders are equipped with the necessary tools to inspire others to follow their example (Jackson, 2009). Factors which contribute to nursing leadership The systematic review by Cummings (2008) demonstrated that research into nursing leadership falls into two categories à ¢Ã¢â€š ¬Ã¢â‚¬Å" studies of the practices and actions of nursing leaders including the impact of differing healthcare settings, and the effects of different educational backgrounds of nurse leaders. The conclusion from the systematic review by Cummings (2008) suggests that leadership from nurses can be developed by a stronger emphasis placed on leadership in education, and by modelling leadership styles on those which have been seen to be successful in the workplace. Several studies also highlighted personal characteristics which were deemed to promote leadership qualities, such as openness and the motivation to lead others (Jackson, 2009, Brady 2010, Sanderson, 2011). Marriner (2009) also showed that contrary to popular belief, age, experience, and gender did not seem important factors when considering the effectiveness of leadership, and that interpersonal skill s were more important than financial or administrative skills. However this focus on financial and managerial skills seems to suggest an overlap between management and leadership, which has previously been shown to be two different areas (Richardson, 2010, MacPhee, 2012). They also showed that leadership was perceived to be less effective when leaders had less contact with those delivering care, highlighting the importance of nurses on the ward to also be effective leaders (Richardson, 2010, MacPhee, 2012). The emphasis which has been placed on interpersonal skills and relationships between healthcare workers is strongly suggestive that this is an important leadership skill, and could be a key part of leadership development programmes (Malloy, 2010). A recent review of the role of emotional intelligence and nursing leadership highlights the need for emotional intelligence in effective leaders and has been shown to be highly influential on healthcare cultures (Hutchinson, 2012). A lthough the impact of these factors can suggest how best to promote leadership in nursing, it is clear that a thorough understanding and overview of their interactions are needed to fully understand their effectiveness. Sorensen (2008) suggested that these effects can also be promoted through educational programmes, particularly at undergraduate level. Education It is clear that leadership is considered to be fundamental to nursing, and that nurses are now expected to act as leaders across a wide variety of settings (Richardson, 2010). If nurses are expected to undertake such roles it is important that they are adequately trained and prepared for this (Sanderson, 2011). Studies have found that many undergraduate nursing courses now view organisation and management to be fundamental parts of autonomous nursing practice, and it is widely part of the curriculum (Richardson, 2010, Sanderson, 2011). However it is unclear what is actually taught, and much of the content appears to be focused on the transition period from student to qualified nurse (Sanderson, 2011). However it seems that current expectations of leadership within the NHS are not suitable to be taught as isolated elements within the curriculum, and should instead be embraced throughout training and beyond (Richardson, 2010, Sanderson, 2011). The development of leadership skills sh ould also be continued through a nurses career to continually promote the importance of leadership, and to develop newly-qualified nurses into role models for others (Jackson, 2009). Collective leadership In collective leadership there are both individual and collective levels of accountability and responsibility (Cummings, 2008). There is a strong emphasis on regular reflective practice which has been shown to improve the standard of care given by nurses, and strives to make continuous improvement a habit of all within the organisation (Cummings, 2008, Cummings, 2010). This is in contrast to a command and control style of leadership, which displaces responsibility onto individuals and leads to a culture of fear of failure rather than a desire to improve (Feather, 2009). Leadership comes from both the leaders themselves and from the relationships among them and with other members of staff. Key to leadership is also the idea of followership à ¢Ã¢â€š ¬Ã¢â‚¬Å" that everyone supports each other to deliver high quality care and that the success of the organisation is the responsibility of all (Hutchinson, 2012). It is important to recognise that good leadership does not happen by chance , and that collective leadership is the result of consciously and purposefully identifying the skills and behaviours needed at an individual and organisational level to create the desired culture (Hutchinson, 2012). This is in contrast to more traditional leadership development work, which has focused on developing individual capacity whilst neglecting the need for developing collective capability (Cummings, 208, Cummings, 2010). This style of leadership has been linked to poorer patient outcomes, decreased levels of job satisfaction, and higher levels of staff turnover (Sorensen, 2008). The challenge of recruiting and retaining leaders at all levels must be recognised, as there is need for clinical leadership at every level (Cummings, 2010). Research has shown that where leaders and relationships between leaders are well developed, there is an increased quality of care due to all staff working towards the same goals and a well-established culture of caring (Sanderson, 2011). In addition to this, there is also an increasing drive to form leadership partnerships with patients (Sanderson, 2011, Hutchinson, 2012). Collective leadership with those receiving care functions in a similar way to multidisciplinary team working as this style of leadership with patients needs a redeployment of both power and decision making in addition to a change in thinking about who should be included in the collective leadership community (Hutchinson, 2012). Several authors (Cummings, 2008, Jackson, 2009, Malloy, 2010) recommended that NHS leaders should work with those seen as patient leaders to facilitate the changes outlined in the Francis Inquiry report (2013).   There have been frequent reports that staff working in healthcare settings are often overwhelmed by the workloads required and are unsure of their priorities, sometimes because there are too many priorities identified by senior managers (Cummings, 2008). This can result in stress and poor quality care for patie nts (Cummings, 2008, Cummings, 2010). Whilst mission statements about efficient and high quality care can be helpful for staff, they are only helpful when translated into objectives for individuals (Jackson, 2009). Establishing and maintaining cultures of high-quality care relies on continual learning and improvements in patient care from all members of staff, and thus taking responsibility for improving quality (Jackson, 2009, MacPhee, 2010).   Where there is a well-established mentality of collective leadership, all staff members are more likely to work together to solve problems, to ensure that the quality of care remains high, and to work towards innovation (MacPhee, 2012). Conclusion The importance of effective leadership to the provision of good quality care is firmly established, as is the central role that leadership plays in nursing (Cummings, 2008). It is now also clear that leadership should be found at all levels from board to ward and it seems obvious that the development of leadership skills for nurses should begin when training commences and should be something which is honed and developed throughout a nursing career (Feather, 2009). For health care organisations to provide patients with good quality healthcare there must be a culture that allows sustained high quality care at multiple levels (Francis Report, 2013). These cultures must concentrate on the delivery of high quality, safe health care and enable staff to do their jobs effectively (Jackson, 2009, Francis Report, 2013). Part of this is ensuring that there is a strong connection to the shared purpose regardless of the individuals role within the system and that collaboration across profession al boundaries is easily achieved (Cummings, 2010). Nurses can be a key part of this by using collective leadership to establish a culture where all staff take responsibility for high quality care and all are accountable (Malloy, 2010). This may require a shift in mentality of the way many see leadership à ¢Ã¢â€š ¬Ã¢â‚¬Å" from seeing leadership as a command-and-control approach, to seeing leadership as the responsibility of all and working together as a team to work across organisations and other boundaries in the best interests of the patient (Brady, 2010). References Brady, P. (2010). The influence of nursing leadership on nurse performance: a systematic literature review. Journal of Nursing Management, 18(4), pp.425-439. Cummings, G. (2008). Factors contributing to nursing leadership: a systematic review. Journal of Health Services Research and Policy, 13(4), pp.240-248. Cummings, G. (2010). The contribution of hospital nursing leadership styles to 30-day patient mortality. Nursing Research, 59(5), pp.331-339. Feather, R. (2009). Emotional intelligence in relation to nursing leadership: does it matter? Journal of Nursing Management ¸ 17(3), pp.376-382. Hutchinson, M. (2012). Transformational leadership in nursing: towards a more critical interpretation. Nursing Inquiry, 20(1), pp.11-22. Jackson, J. (2009). Patterns of knowing: proposing a theory for nursing leadership. Nursing Economics, 27(1), pp.149-159. MacPhee, M. (2012). An empowerment framework for nursing leadership development: supporting evidence. Journal of A dvanced Nursing, 68(1), pp.159-169. Malloy, T. (2010). Nursing leadership style and psychosocial work environment. Journal of Nursing Management, 18(6), pp.715-725. Marriner, A. (2009). Nursing leadership and management effects work environments. Journal of Nursing Management, 17(1), pp.15-25. The Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: executive summary. London: Stationery Office (Chair: R Francis). Richardson, A. (2010). Patient safety: a literature review on the impact of nursing empowerment, leadership, and collaboration. International Nursing Review, 57(1), pp.12-21. Sandstrom, B. (2011). Promoting the implementation of evidence-based practice: a literature review focusing on the role of nursing leadership. Worldviews on Evidence-Based Nursing, 8(4), pp.212-223. Sorensen, R. (2008). Beyond profession: nursing leadership in contemporary healthcare. Journal of Nursing Manag ement, 16(5), pp.535-544. Swearingen, S. (2009). A journey to leadership: dsigning a nursing leadership development program. The Journal of Continuing Education in Nursing, 40(3), pp.113-114.

The Odyssey By Bernard Evslin - 910 Words

Greek Gods are known for, helping and fighting others, but is that really true, and do we really know their stories? In the book â€Å"Theseus† by Bernard Evslin, Theseus is a young man that lives a boring life, until one day, a seagull told him that Poseidon was Theseus’s father, and he wanted to find him. Theseus overcomes various obstacles, he finally reaches Athen and finds his father king Aegeus. Later on Aegeus ask Theseus’s to go on an important journey. Meanwhile, another, epic poem is The Odyssey by Homer. After ten years of the Fall of Troy, Odysseus was disregarding to the gods, and the gods were flustered that they set Odysseus and his men off course to where the cyclops lived. But luckily, Odyssey trick the cyclops into being†¦show more content†¦He welcomed the dangers that lay in wait. ‘The more, the better,’ he thought ‘Where there’s danger. There’s glory. Why I shall be disappointed if I am not attackedâ €™(Evslin 156). Theseus wants to take risks, and so he is using the habits of mind taking responsible risk from the habits of mind. Theseus ventures out even though he might put himself in danger. Taking responsible risk means that he wants to do things that might be dangerous but is worth it. Theseus wants to venture out to find his father, even though he is going to danger himself. Although many people are faced with life threatening problems, Odysseus will always try his best to get him out of a situation, by creating imagining, and innovating. The cyclops captures Odysseus and his men and was going to eat them. But luckily, Odysseus had a plan to escape from the cyclops by making the cyclops drunk. So later on Odysseus obtains some wine from his ship and says to the cyclops â€Å"Cyclops, try some wine. Here’s liquor to wash down your scrape of men†(Homer 9. 904). He wants to trick the cyclops into getting intoxicated so they could escape and return to his land. Odysseus was using something from the habits of mind and that is creating, imagining and innovating. Odysseus is smart to trick the cyclops and escape. He knew that if the cyclops was intoxicated the cyclops would not pay attention to Odysseus and his men, and they could escape. Using

Globalization of Healthcare free essay sample

However, one could draw conclusion, using Hill, Charles W. L. (2011), that several mitigating factors have enabled not only the globalization of marketable production-based goods, but also of service-related industries such as legal services and using medical diagnostics as well as surgical procedures; the case makes a compelling, if somewhat incomplete, case for globalization based upon factors such as cost reduction and improved quality of care; however, further research supports the case study’s findings. Facilitating Developments Factors such as a perceived shortage of qualified cardiologists to meet a rising demand for services is a possible explanation. Although, in the Time Magazine article by Brill, Steven (2013, March 4), he exposed the widespread practice of ordering medically unnecessary CT scans. Statistics show that the use of CT scans alone has more than quadrupled in recent decades, many times to ward off a possible malpractice lawsuit, but oftentimes to drive up profits. The demand for more skilled physicians to interpret results may be genuine, yet it is exacerbated by profit-driven hospitals eager to pay for expensive equipment within a short time. As surmised by Hill, Charles W. L. (2011), making much-needed care more accessible and affordable certainly makes outsourcing to less costly, but equally skilled, physicians in Mexico, India, and Singapore more attractive. Additionally, escalating costs of health care in the U. S. (driven mainly by hospital / pharmaceutical profits as our country’s sixth largest economy), nd technological innovations, which would allow efficient use of â€Å"outsourcing,† both contribute to the globalization of health care. As stated by Hill, Charles W. L. (2011), the assigned case cites U. S. surgical costs in the hundreds of thousands for surgeries such as hip and bypass surgeries while those same surgeries, with travel expenses included, cost much less when outsourced. Furthermore, technological advancements in the past several decades have greatly increased efficiencies with immense cost-saving and life-saving benefits. Per Hill, Charles W. L. (2011), a great argument can be made for outsourcing diagnostics to the other side of the world; while American doctors are asleep, Indian counterparts can be hard at work interpreting films or CTs, readying the results for swift treatment the next day. One of the most important factors supporting globalization, however, is the pushback of insurance companies and uninsured / underinsured consumers in an effort to reign in costs and create a more competitive health care economy. In a Time Magazine article by Brill, Steven (2013, March 4, the investigative journalist and author published several startling facts: Americans pay more per person for health care than Denmark, Australia, Japan, and Spain, yet our life expectancy is lower; we are number 50th in infant mortality, and 69% of American citizens who’ve experienced medically-related bankruptcy â€Å"were insured at the time of their filing,† meaning insurance failed to protect other valuable assets in a time of major illness or injury (p. 29). I surmised from Hill, Charles W. L. (2011) that it is no wonder that American employers, together with large insurance carriers such as Aetna, now encourage its health insurance customers to seek treatment abroad in order to reduce costs. Who Benefits? Who Loses? Given the spiraling costs of U. S. healthcare, many entities seek to benefit. Americans currently insured or underinsured will be encouraged by insurance carriers to seek treatment abroad to reduce costs, thereby saving potential out-of-pocket expenses once an insurance cap has been reached, reducing medical bankruptcy. American businesses may be able to take advantage of premium reductions offered by insurance companies should their employees agree to globalized care for major medical procedures or serious conditions which require single treatments or procedures; follow-up could be maintained in stateside facilities while the bulk of surgical procedure costs are reduced without sacrificing quality of care. Employees receiving better care will be a more productive asset to their employers. U. S. mployers, citizens, and insurance companies all stand something to gain, but it should also be noted that developing countries will also benefit; an increasing demand for their services will not only assist in honing their skills, but will also bolster their country’s economy, standard of living, and GDP. Other developing countries will also benefit as they will have more medical options as well as training centers to foster their own medical communities, thereby improving world health. The largest potential losers are still the uninsured with no obvious means to pay for out-of-pocket procedures, in spite of deep discounts. The case, Hill, Charles W. L. (2011), makes a vague reference to â€Å"recent legislation†, which one can assume refers to the â€Å"Affordable Care Act,† designed to bring coverage to millions more uninsured; however, affordability will still be an issue for privately insured/underinsured patients, according to Steven Brill, who exposed the â€Å"Chargemaster,† a driving force behind escalating healthcare costs in the U. S. It is an exhaustive list at each U. S. hospital, a listing of hospital services and corresponding charges, each charge bearing no relation to actual costs; every hospital sets the prices of its own Chargemaster; no hospital’s pricing schedule resembles that of another, nor do they seem to be based on anything objective, such as actual cost According to Brill, Steven (2013, March 4). hospitals, non-profit ones especially, have built in astronomic profits for basic procedures, laboratory tests, and have been caught padding bills which Medicare would never pay, but which are still submitted to insurance companies and private citizens after receiving treatment† (p. 22). As concluded by Brill, Steven (2013, March 4), because there is no current legislative oversight reducing what hospitals can charge those who aren’t on government-subsidized healthcare, hospitals do not participate in free-market, capitalized-based competition with one another, nor are they transpar ent about the basis for their charges. For these reasons, hospitals themselves stand to lose a great deal; they could see their profits erode as more savvy insurance agencies, employers, and citizens seek out a global market which is competitive and fair. Risks of Health Care Globalization One obvious risk of globalization is to the U. S. health care market and the arrogance fostered by the lack of regulation. Once again, U. S. hospitals are not transparent about how charges are determined as they bear little relation to actual costs. For example, according to Brill, Steven (2013, March 4), excerpts were used from actual hospital invoices; free from price regulations, patients are routinely charged $18 each for diabetes test strips (consumers can purchase for 55 cents each), $24 for a niacin tablet (in drug stores for about a nickel a piece) and CT scans for $6,538 (Medicare would pay that same hospital $825 for three scans based on actual costs). As stated by Hill, Charles W. L. (2011): Should U. S. hospitals be required to reign in domestic costs and succumb to regulation to remain competitive globally? Or do we hope that globalization alone levels the playing field? If they outsource services to India or Singapore for diagnostics, would U. S. hospitals or physicians ethically pass on those cost savings to patients or insurers? Or simply pad their profit margins? And although the text does assert studies which demonstrate quality care is already available in Mexico, India, and Singapore. (p. 42) There are dangers inherent in rapidly expanding where U. S. insurers send patients; subpar facilities may be utilized in order to curb costs; regulation and oversight must be included to facilitate safe, responsible implementation of health care, both home and abroad. Is Globalization Worthwhile? For many reasons previously discussed, globalization of healthcare, with proper oversight and some crucial regulation, is a breakthrough. No longer would patients or insurance companies (only Medicare is immune) be forced to pay exorbitant â€Å"Chargemaster† rates for U. S. healthcare, which has already been proven to be lacking in many areas. No longer would patients view treatment options as limited by geography; the increasing hospital conglomerates in the U. S. which are systematically reducing competition, would have genuine global competition. For the first time since Medicare’s inception, there’s a genuine opportunity to stem the tide of skyrocketing medical costs, increase care efficiency, and foster real competition for complacent domestic health care providers who’ve long viewed their services as geographical monopolies: for too long health care has been exclusive to an area, much like utilities such as water and pow er, but without any legislative oversight necessary to protect the American people from abusive costs. As asserted in the expansive article by, Brill, Steven (2013, March 4). , â€Å"if you are confused by the notion that those least able to pay are the ones singled out to pay the highest rates, welcome to the American medical marketplace† (p. 22). Globalized health care may be the cure for what ails us. References Brill, Steven (2013, March 4). Bitter Pill: How outrageous pricing and egregious profits are destroying our health care. Times, 181, 16-55. Hill, Charles W. L. (2011). International Business (9th Edition). McGraw Hill Irwin.

Value-based Pricing for New Software Products free essay sample

Pricing methods such as flat price, tiered pricing, MIPS-based, usage-based, per user, per seat, and pay as you go, are often tactical in nature and easily matched by competitors, which can undermine profitability by accelerating the commoditization process. Conversely, a value-based approach charges a price based on the customer’s perceived value of the benefits received. Value-based pricing methodologies can be used to estimate the market value of new software concepts at various stages of the development process in addition to pricing new products for launch.This paper describes a value-based approach to pricing that is dependent on the firm’s commitment to invest in the development of its long-term â€Å"pricing capital. † This investment in methodologies, infrastructure, and processes to create, measure, analyze, and capture customer value is the key to successful long-term pricing strategy. No tool in the marketing toolbox can increase sales or destroy dema nd more quickly than pricing strategy. We will write a custom essay sample on Value-based Pricing for New Software Products or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The pricing decision is one of the most critical decisions that a firm can make in the launch of a product.Managers in the software industry have traditionally developed their pricing strategies by overemphasizing cost-related criteria at the expense of focusing on the value of the product to the customer. Cost-based pricing strategies are focused on short-term value to the vendor. Conversely, value-based pricing is based on the customer’s perception of the value of the product, not on product costs (see Figure 1). Value-based pricing strategies are focused on creating long-term value for the customer.From a marketing perspective, the goal of pricing strategy is to assign a price that is the monetary equivalent of the value the customer perceives in the product while meeting profit and return on investment goals [37]. This paper posits the view that traditional cost-based approaches to software pricing are short-term, tactical in nature, and place the interests of the seller over the interests of the buyer. Conversely, pricing approaches based on customers’ perceptions of value are strategic and long-term in nature since they are focused on capturing unique value from each market segment through the pricing mechanism.

Intrusive Misuse of Colons

Intrusive Misuse of Colons Intrusive Misuse of Colons Intrusive Misuse of Colons By Mark Nichol Writers often mistakenly introduce intrusive â€Å"colonization† where it is not necessarily. In each of the following examples, as explained in the discussion, the colon is superfluous. 1. Smith was invited to give the presentation: â€Å"Global Development and Global Practices.† â€Å"The presentation† and the title of the presentation are appositive- one is equivalent to the other, just as in â€Å"global-development expert John Smith,† the person’s description and his name are appositive- and no intervening punctuation is necessary: â€Å"Smith was invited to give the presentation â€Å"Global Development and Global Practices.† (If the presentation previously was alluded to and is now being specified, set the title off from the first part of the sentence with a comma: â€Å"Smith was invited to give the presentation, â€Å"Global Development and Global Practices,† but otherwise do not replace the colon with a comma. Also, if the wording is â€Å"Smith was invited to give a presentation on the topic of . . .,† the description of the topic is just that- a description- and should be lowercase and not enclosed in quotation marks. 2. An effective compliance program will include: governance and management oversight, policies and procedures, training, monitoring, quality control, and independent audit. When include or includes (or â€Å"consist/consists of† or a similar word) precedes a list, a colon is superfluous, just as it would be between any verb and any single noun or noun phrase associated with the verb. This is true whether the information is presented as an in-line list (meaning that it is integrated into the sentence, as here) or it is formatted vertically, one item on a line, whether as is or set off with bullets or numbers: â€Å"An effective compliance program will include governance and management oversight, policies and procedures, training, monitoring, quality control, and independent audit.† (An exception is if what precedes the list is an independent clause, such as â€Å"An effective compliance program will include the following.†) 3. Management is secure in the knowledge that it: has considered all plausible scenarios, understands the organization’s breakpoint in the event of extreme scenarios, and has effective contingency-response plans in place. The point of the previous example is true regardless of whether a verb precedes the colon or, because each item in the in-line or vertical list begins with a verb, the colon follows a word representing another part of speech; the fact that a sentence is more extensive and complex than if it had essentially a one-item list (for example, â€Å"Management is secure in the knowledge that it has considered all plausible scenarios†) is irrelevant: â€Å"Management is secure in the knowledge that it has considered all plausible scenarios, understands the organization’s breakpoint in the event of extreme scenarios, and has effective contingency-response plans in place.† Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Punctuation category, check our popular posts, or choose a related post below:What Does [sic] Mean?The Writing ProcessWriting a Thank You Note

Eight exciting careers for the world traveler

Eight exciting careers for the world traveler Working eight hours every day behind a desk isn’t for everyone. If you love traveling and are tired of spending all your paid time off and hard-earned money on only traveling once or twice a year, consider finding a job that gives you the freedom to travel the world. Here are eight jobs for the world traveler:1. Cruise line workerCruise ship jobs are a travel lover’s dream gig. You get paid to travel the world and interact with people of different cultural backgrounds. As if that doesn’t sound amazing enough, you’ll receive free food and accommodation while collecting a salary.These floating resorts offer plenty of opportunities for individuals of all backgrounds. You can be a restaurant server, a cook, bartender, an entertainment director or a performer in the cruise’s entertainment lineup.2. International tour guideBecoming a tour manager or a tour guide is one of the most rewarding and exciting ways to travel the world. You get to learn about the history and culture of different countries while sharing your love of travel with like-minded individuals.Wherever you want to go, there are plenty of travel destinations that are always in need of friendly, knowledgeable guides. With tour guiding, you’ll get to travel to fabulous vacation spots while getting paid. What’s more, if you’re good at it, you may get good tips, making your salary very competitive.3. Travel agentIn the age of the Internet where you can easily search and book flights and vacation packages online, you may think that the professional travel agent is a dead career. While it’s predicted that there will be a decline in this job over the next decade, it’s still a rewarding occupation for travel lovers.Travel agents work with resorts, cruise lines, airlines, and rental companies to secure travel arrangements for their clients. This means you’ll regularly go on free trips to luxury resorts sponsored by resorts or travel co mpanies. The nice thing about becoming a travel agent is that you don’t have to pass an exam to prove that you know your stuff. While there are no real required skills, it’s useful to know basic things like geography and history and stay on top of the latest news at different destinations.4. TEFL teacherTeaching English abroad is just as rewarding for you as it is for your students. You’ll get to help students acquire one of the most sought-after skills in the world (speaking English) while immersing yourself in the country’s culture.Jobs are in abundance, but you may need a bachelor’s degree, TEFL training, TEFL certification, and some teaching experience. If you’re thinking about what countries to teach English abroad, Thailand is one of the most popular TEFL destinations you may want to consider. Other top TEFL teaching destinations to consider are Vietnam, Korea, Japan, Dubai, and Taiwan.5. Au pairBeing an au pair is one of the oldest an d most famous travel jobs. If you work well with children, consider taking up an au pair job. An au pair works for a host family in a foreign country and provides childcare services. Alongside childcare, you may help out with light household chores.You’ll receive free board and lodging as well as pocket money. Although the salary may be relatively low, you’ll get to immerse yourself in another culture as an extended member of the host family.6. PhotographerIf you’re skilled with a camera, you can turn your photographs into cash while traveling the world. As a travel photographer, you’ll be required to capture a variety of sites and events including destination hotels and resorts, outdoor adventures, scenery, cultures, local events, and customs.You can choose to become a full-time photographer and work for a company or as a freelancer. Either way, you will travel the world while making money.7. Website designerWe live in an exciting time where anyone can m ake a living online. Becoming a web designer is one of the occupations with oodles of potential and scope for employment. And, starting your web design journey in the field is easy – just choose a development specialization like JavaScript frameworks, HTML or CSS, get essential coding skills and launch an online portfolio.8. Flight attendantThis is the most obvious jobs that involve travelling the world. It doesn’t require a degree but the requirements may vary from one airline to another. Most major airlines require prior customer service experience and a certification from a relevant aviation agency. Some airlines may require you to be able to stand on your feet for extended periods of time and reach the overhead bins.Worth mentioning is that the work isn’t easy and the hours are frequently erratic. However, you’ll get the opportunity to travel around the world. Plus, you’ll get free or discounted flights for you and your family.These eight jobs will enable you to explore the world while making money and building your career. Just be sure to choose one that’s fit for you.About the Author: Riya is an inspired writer writing in several areas of expertise. With spending her years working marketing communication, Riya is delighted to work with aspiring small business owners. Connect with Riya on Twitter, @sanderriya.

Current Trends in Health Care in USA Essay Example | Topics and Well Written Essays - 1250 words

Current Trends in Health Care in USA - Essay Example t of heart diseases it has been reported that 476,009 Americans under 85 died of cancer compared with 450,637 who died of heart disease as per the American Cancer Society’s annual statistical report of 2002. (â€Å"Cancer now top killer of younger Americans†, 2005) Almost one third of the cancer cases traces back to smoking while other are associated with obesity, poor diet and lack of exercise. There have been premature deaths caused by cancer, which arises from radioactive and carcinogenic materials in the surroundings. Unsafe products like hair dyes, food additives, cosmetics and marketed medicines manufactured for quick profits are associated with problems like cancer. The increased consumption of junk food is a major cause. Indiscretion in sexual life and keeping multiple partners are one of the major causes. Considering the variations among gender, Centers For Disease Control And Prevention reports that in 2003, prostate cancer (150 per 100,000) have been highest in men among the other types while breast cancer (119 per 100,000) have occupied the highest rate among the other types in women. Hepatitis B and C cause liver cancer; cervical cancer has been due to human papillomavirus while mainly H. pylori bacteria cause stomach cancer. AIDS related cancer is due to the HIV infection. Most of these cases are preventable through timely prediction, diagnosis and preventive measures through vaccines. (â€Å"Cancer now top killer of younger Americans†, 2005) The other most common types of cancer prevailing among both men and women are Lung and Colorectal cancer. The incidence of cancer is also highest among the blacks or the Afro Americans. Most of these people opt for the western treatment of cancer involving chemotherapy and surgery rather than any traditional methods. The reasons are basically that the process of opting for these drugs and chemicals is faster and easier than the slow progress of traditional methods. Lack of adequate information and knowledge