Monday, January 27, 2020

Discussing and comparing the Tyler model

Discussing and comparing the Tyler model In this essay I will be discussing and comparing the Tyler model and Knowles model for Adult Learners. This can be seen in section one where the comparison and contrasting of the two models will be established in order to get a better understanding. In section two I will choose one of the two models that are most appropriate for a learning context. The conclusion will consist of a summary of the key points established throughout this paper. Section One Tyler was very much linked with curriculum theory, development, educational assessment and evaluation. In education individuals regard Tyler as the father of behavioral objectives. This form of approach puts much more importance on the needs of the learner. There are similarities between Tylers and that of the andragogical model as they both relate specifically to the individuals self direction and their experience. Tyler regularly used this in learning to be a development during which an individual attains new patterns of behaviour. He had four basic questions regarding to learning: What educational purposes should the school seek to attain? What educational experiences can be provided that are likely to attain these purposes? How can these educational experiences be effectively organized? How can we determine whether these purposes are being attained? (Boone, pp.26) The previous questions are now well known in adult education. Knowledge of the psychology of learning helps set bounds on what can be learned within the given time and the current environment of the organization (Boone. Pp. 26). Tyler thought that the makeup of a schools curriculum had to relate to three main factors that together form the elements of an individuals education experience. First off would be the nature of the individual learner, which may include the individuals developmental factors, their learner interests/needs and also their life experiences. Second would involve the individuals values and aims of society, which may include values and attitudes. The last being knowledge of the subject matter. What the learner believes to be worthy and usable knowledge. In answering the four questions and in designing learning experience for students, curriculum developers had to establish judgments through the three factors. He believed that when setting educational objectives, pro grammers should take into consideration the learners, society, philosophical considerations within the institution conducting the program, the intellectual climate of society and experts in the subject (Bye Reich, pp. 181). The assumptions of this model are that all learning can be measured in terms of changing behaviours. One of the most frequently offered criticisms of programs of professional preparation by graduates who subsequently inhabit the real world of practice is that such programs are strong on theory but weak on practical application (Brookfield, pp. 201). Knowles is regarded as a central figure in US adult education in the second half of the twentieth century. The programming model is structured on his andragogical philosophy, where one assumes that adults move toward self-direction. By doing this use their experience as a learning resource, then are ready to learn in accordance with socio-developmental tasks and desire immediate application of learning. Knowles believes that the adult learner brings life experiences to learning, incorporating and complementing the cognitive abilities of Piagets adolescent. As the individual matures: his/her self-concept moves from dependency to self-direction he/she accumulates a growing reservoir of experiences that becomes a resource for learning his/her learning readiness becomes increasingly oriented to the tasks of various social roles his/her time perspective changes from one of postponed knowledge application to immediate application his/her orientation to learning shifts from subject-centered to problem-centered (http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/teachtip/knowles.htm ) Knowles believes that adults should have developed mature understanding of themselves, able to understand their needs, motivations, interests and goals. Individuals should be able to look at themselves objectively and maturely. They should accept themselves and respect themselves for what they are, while striving to become better. Adult learners should develop an attitude of acceptance, love, and respect toward others. This is the attitude on which all human relations depend. They must learn to distinguish between people and ideas, and to challenge ideas without threatening people. Ideally, this attitude will go beyond acceptance, love, and respect, to empathy and the sincere desire to help others. Knowles was convinced that adults learned differently to children and that this provided the basis for a distinctive field of enquiry. His earlier work on informal adult education had highlighted some elements of process and setting (http://www.infed.org/thinkers/et-knowl.htm ). In doing t his Knowles cam to the conclusions about the shape and direction of adult education. According to Knowles andragogy model the key points are: Adults move towards self-direction Adults use experience as a learning resource Adults are ready to learn in accordance with socio developmental tasks Adults devise immediate application of learning (Bye Reich 2003, p182) The two models are very different to one another when compared. Tylers objective model requires no prior knowledge of the content being taught whilst Knowles institutional model requires some prior knowledge from the adult learner. This prior knowledge helps motivates the learning to participate more in the learning process which results to further /advances in knowledge of the topic being taught. The learner is seen as an empty vessel in Tylers model. The individual is more dependent on the teacher in learning new things within the learning environment. This is entirely opposite to Knowles model, as the learner seeks growth in knowledge. Section Two My goal in this section is to apply Tylers model with TAFEs Business Management course. Central to Tylers model is effectively organizing the learning activities. He believes in three criterias that are required in building organized learning experiences. These are continuity, sequence and integration. Business Management mirrors Tylers model by creating active learning experiences in a content area that is otherwise found boring. Having identified a number of learning activities, the teacher challenges students in active learning with writing assignments, group presentations, group quizzes, a written financial project, individual and group participation and a final exam. The process of assessment is critical to Tylers model and begins with the objectives of the educational program. The lecturer will be required to establish the point of the assessment by answering questions such as what is the purpose of this assessment, what do you want it for? With an online syllabus, students can prepare for the various methods of assessment. Mid semester evaluations provide valuable feedback on learning activities. A final evaluation of 2009 present important feedback for course revision. As a result, the following semester group learning activities were increased from 10% to 40% of the course content. Other feedback found that students desire for more review time and that the instructions progressed too quickly. Due to time limitations, the lecturer incorporated additional non-graded assignments as group presentations. By doing this the curriculum and instruction assessment helped better achieve the defined outcomes of improving critical thinking, communication and analytical skills. A final exam also helps evaluate the learning objectives and integration of knowledge. Tyler and TAFEs Business Management have comparable strategies for designing curriculum and instruction. Tyler states, Education is a process of changing the behaviour patterns of people. TAFE uses assessme nts to achieve the defined learning objectives and promotes participation from individuals through interesting activities. They both value the individual learner. Conclusion Education either functions as an instrument which is used to facilitate the integration of generations into the logic of the present system and bring about conformity to it, or it becomes the practice of freedom, the means by which men and women deal critically and creatively with reality and discover how to participate in the transformation of their world (Freire, Pedagogy of the Oppressed, 1970) By using a combination of adult learner techniques and strategies, educators can create training experiences that will enhance the learning of participants. When an individual is put into positive learning experience that follows andragogy process that has been presented above, they are more likely to retain what they have learned and apply it in their work environment.

Sunday, January 19, 2020

Our Time Machine :: essays research papers

Our Time Machine H.G. Wells once wrote a novel called The Time Machine, it was published in 1895. This exciting little adventure featured a device that had power over time. Who knew that in 2001 we too would have such a device? One invention that has made it evident that we have reached the twenty first century is named Tivo. With this, one has the ability to pause, fast forward, and essentially tamper with live television. This gadget is, in a sense an actual time machine. We’re living in an age where the word digital seems to come into play with every new invention. Digital technology includes all types of electronic applications that use information in the form of numeric code. This information is usually in something called a binary code—that is, code that can be represented by strings of only two numeric characters. These characters are usually 0 and 1. Devices that process and use digital information include personal computers, calculators, automobiles, traffic light controllers, compact disc players, cellular telephones, communications satellites, and now Tivo. Most of the information we sense is analog in nature—that is, it varies constantly, and an infinite number of values can be assigned to the information. For example, the brightness of a light bulb dimmed gradually from on to off could be considered analog information. This infinite number of brightnesses can be broken up into ranges. If the possible brightnesses are broken into two ranges, then the values 0 and 1 can hold digital information relating to the brightness of the bulb. However, each of the two digits still represents a countless number of analog values. The ranges of brightnesses can be divided again and again, until there are thousands of ranges of values, each of which can be represented by a numerical value. Once analog information has been broken up into digital information, it is impossible to perfectly reverse the process and re-create all of the possible analog signals from the corresponding digital signals. This is why most analog signals are represented by a great number of digital information levels. For example, the sound stored as digital information on a CD is broken down into 65,536 levels. A CD player translates the digital information into analog information so that a speaker can convert it into sound waves. Some devices process digital information using a tiny computer called a microprocessor. It performs calculations on digital information and then makes decisions based on the results.

Saturday, January 11, 2020

Qualified nurse during a clinical placement Essay

Decision making essay Decision making is important to nurses in today’s society, ( Thompson et al 2002) as a number of policy and professional imperatives mean that nurses have to worry about the decisions they make and the way in which they make them. The government has produced several policy initiatives (DOH 1989, 1993a, 1993b 1913c,1994, 1995, 1996a, 1996b,1997, 2000, 2000) which have led to the creation of an evidence based health care culture ( Mulhall & Le May 1999). Thompson et al (2002) believe that poor decision making will no longer be acceptable, the government aim to examine professional performances and the outcome of clinical decision making for the first time. Evidence based practice will no longer be an optional extra but a requirement of all health care professionals. The aim of this essay is to analyse and evaluate a decision made by a nurse in a community practice. The author will highlight why she chooses the particular issue and how it is important to nursing. The author will provide an overview of two general approaches to decision making, rational and phenomenological, by evaluating and analyzing them. The author will consider decision making theories, and try to apply them to the decision making process witnessed in her community placement. She then aims to show, how they should or could have been used as an aid in effective decision making. She will also consider influencing factors that effected the decision making process. A pseudonym is used throughout the essay to protect the patient’s identity, as stated in NMC (2002) code of professional conduct section 5. The patient chosen for the purpose of this essay will be referred to as Jo. Jo is 53 year old women who suffer with rheumatoid arthritis. This also resulted in Jo having bilateral hip replacements. Jo is on steroid treatment, which leads to thinning of the skin and susceptibility to trauma (Mallet and Dougherty 2001). Jo lives with her husband and two grown up  sons. Jo was refereed to the district nurse on her discharge from hospital following her second hip replacement. The initial referral was to check the surgical wound. However on arrival it was pointed out by Jo that she had a skin tear on her left shin that wasn’t healing. The district nurse performed an assessment and concluded the wound was a venous leg ulcer as it had been present for 6 weeks. The district nurses used Sorbisan and Telfa to dress the wound. Twice weekly visits were carried out to Joe for a further 4 weeks, and it became obvious that the ulcer was not improving. The district nurse had to make a decis ion on what care to provide. The decision was to try another dressing Aticoat which is impregnated with silver, and not to refer the patient to the leg ulcer clinic at the local hospital. The district nurse involved with Jo’s care was a G grade nurse and in charge of a community practice that had 3 other nurses working in it. The author decided to focus on this particular decision, as she was influenced by the amount of evidence based research available on the issue, and how the district nurse chose to ignore the evidence, and made a decision on the basis of personal knowledge. The author visited a leg ulcer clinic while on her community placement, and asked the expert nurses running the clinical at what stage they would like to see patients referred to them. She was told if a wound wasn’t healing after 4 weeks the patient should be referred, this information was passed on to the district nurse and ignored. The district nurses felt that if he referred all his patients after 4 weeks the leg ulcer clinic at the hospital wouldn’t be able to cope. In doing this he chooses to ignore the expert advice. I found this very frustrating and interesting, and as Scott (2004) said we ought to promote good and not cause harm, in Jo’s case, the action of not referring her to the appropriate expert nurse could be seen as prolonging healing thus causing her harm. I decided to investigate further what issues led to him making his decision. To achieve excellence in care nurses need to base there decision on evidence based care (Parahoo 2002). There is no shortage of research on wound care  and the management of venous leg ulcers. However because research is based mostly on opinions or experience, hence the development of guidelines and protocols that have practical use is difficult (Leaper et al 2004). There are many sources of evidence, Journal; the Cochran Library database relevant to wound care, however there is so much information it would be difficult for nurses to know where to start. Evidence suggest the management of patients with venous leg ulcers is fragmented and poorly managed ( Carrington 1999). Vowden (1997) agrees and suggests healing rates are poor and treatment costs are high, this could be as a result of nurses not referring patients to appropriate experts for assessment and using expensive, inappropriate dressings such as aticoat, which is impregnated with silver. Although there is evidence to suggest that dressing impregnated in silver and sorbisan are highly effective in heavily exudating wound (Leaper et al 2003& BNF (2004) Jo’s ulcer was shallow and not heavily exudating. The evidence for the care of venous leg ulcers strongly points to the uses of 4 layer bandaging. This is demonstrated in Allen and Nelson (1996) work, they found that healing rates improved for patients who  attended a leg ulcer clinic and had 4 layer bandaging applied. This is also backed up by evidence printed by the RCN(`1998), and Research carried out by Nelson (1996), which suggests that between 40 and 80% of leg ulcers heal with the application of compression bandaging. Jo had suffered with her leg ulcer for 10 weeks before a decision was made by the District nurse to change the dressing from Sorbisan to Aticaoat. The use evidence based care, provides the foundation for evidence based practice ( Harding et al 2002), the ulcer healing rate and outcome for Jo could have been improved by a quick referral to the leg ulcer clinic, as this is seen as the most effective way to treat leg ulcers ( Musgrove and Woodham 1995). One of the reasons the district nurse was hesitant about referring Jo to the ulcer clinic, was that he felt compression banging is uncomfortable and requires a strict regime (House 1996), and his experience patients didn’t often comply. However Jo was not offered the choice. Taylor (1996) believes that communication with patients is crucial to compliance, he suggest by educating patients it will enable them to understand the importance of the compression and assist patient to comply to treatment. Patients need to be given the option of whether they are involved in the decision making process. In Jo’s case the district nurse made the decisions, he didn’t explain alternative treatments to Jo, or explain the 4 layer bandaging to her. In the authors opinion the patient was not given an informed choice. There is a professional responsibility to obtain informed consent from patients before a nursing care procedure is carried out (Cable 2003, Averyard 2000, NMC 2002). The ethical issue of informed consent came essentially from the Nuremberg Code (1947)  as a result of human experimentation in world war two. This was aimed specifically at humans involved in medical research, however consent is now applied to nursing clinical procedures (General Medical Council 1988). There is increasing evidence to suggest that well-informed patients manage their health and treatment better, this enables them to feel in control of there illness (Ogden 2001) and have better psychological outcomes (Gibson 2001). Although Gibson (2001) argues that knowledge alone does not change health outcomes for patients, to allow Jo to give informed consent she would need information that was relevant to her condition and treatment. Jo is an intelligent women and giving her a choice of treatment would have protected her autonomy (Edwards 1996) and individual rights (Caress 2003), however Jo was not offered a choice in treatment, and alternatives were not discussed. The district nurse made a decision and applied the treatment. In doing this the district nurse used his power to manipulate Jo into accepting the treatment the he wanted to give. Giving restricted information the nurse restricted the patient’s choices to secure her compliance (Lukes 1974). The district nurses actions went against advocating the government Expert Patient Policy (DOH 2000), which highlights the need for changes in society that mean individuals expect to have choices, and be involved in decision  making (Kenney 2003). Although Jo gave consent for the treatment given, she did not, in the author’s opinion, give informed consent. Decision making can be divided into two groups, decision making from a rationalist perspective and from a phenomenological perspective ( Tanner 1987). Rational  decision making is a step by step approach that follows a logical course, and clearly definable stages (Harbison 1991), taking into account obvious starting points and objectives, assessment tools, policies and protocols. It gives clear predictable outcomes and is process driven. Rational decision making works, on the basis that when a problem arises, the decision maker agrees a definition of the problem and  discovers all the possible solutions, matches the problem with the recourses and chooses a solution that best matches the problem, and then implement solution  ( Harbison 1991).This approach fits in well with the current trend towards research and evidence based care (Harbison 1991). Using the rational approach to decision making, makes assumptions that all decision makers will take into consideration all possible options and consequences, in light of a thorough understanding of a situation. However in practice this approach would be influenced by time constraints, habit and routine, and Harbison (1991) argues that sensitivity could be lost when following a rational approach. Using Phenomenological process in decision making can be seen as a subjective individual approach (Easen et al 1996). This approach takes into account nurses opinions and views, for this reason as discussed by Thompson (1999) it can create bias, as it is based on experienced expert knowledge. Using expert clinical reasoning the nurses draws on a deep understanding of the patient situation and holistic care needs. Intuition is a quality that  nurses have traditionally valued (Trueman 2003), however with the development of evidence based care it is now seen be some to be unreliable, unscientific and unsuitable for nursing practice (Trueman 2003). Intuition has been criticised for not being able to provide a rational for the decision made,  however Benner (1984) believes intuition is understands without a rational. Benner (1984) argues that during a long nursing career, nurses can gain a great deal of knowledge and skill practice, this leads to them being intuitive about the decisions they make. Intuition is not something that is measurable according to Benner (1984), it is developed through experience, expertise and knowledge, along with personal awareness and personality. McCutcheon and Pincombe (2001) also believe that there are benefits derived from intuition in practice, such as enhanced clinical judgment and effective decision making. Although Cioffi (1997) argues that holistic patient assessment and improving nurse-patient relationships are being undermined by a drive for evidence based care. Intuition has been identified as a useful tool as nurses can analysis the situation as a whole rather that a series of tasks (McCutcheon and Pinchcombe 2001). Both the phenomenological and rational decision making theories have a number of strengths and limitations. McKenna (1997) argues that knowledge can only become known by others if it is shared knowledge and communicated to others. McKenna (1997) suggests this causes a problem for the phenomenological model it is almost impossible to communicate something which is intangible, and which the practitioner is unable to express. Using a mixture of both theories can create a holistic and well documented procedure. Lauri and Saklantera (1995) using a factor analytical approach found evidence that both Benners (1984) intuitive model, and the hypothico- deductive approach of information processing, had a degree of analytical usefulness in explains the decision making of nurses. The implications were that both had something to offer and neither is often a single solution to explain decision making in  practice. Using a decision making model such as Carroll and Johnston (1990) would have enabled the district nurse to reflect and evaluate the effectiveness of the care delivered. Carroll and Johnston (1990) outline seven stages of temporal decision making, and acknowledged that these stages may not simply be followed through there sequence, but the nurse can backtrack at any stage. The first two stages of recognition and formulation involves the examination and classification of the situation by the district nurse. During a home visit the community nurse may be confronted with a range of patient problems (Bryans and McIntosh 1996). Some of these are discrete and easily recognised, while others are likely to dependent upon various circumstances in the patients life, which are likely to remain hidden unless they are explored by the nurse (Bryans and McIntosh 1996). In view of the fact that patient and nurses are strangers to each other, Thompson et al (2002) believe this exploration must be skillfully negotiated by the community nurses, if nurses appropriately identify needs, and thus begin the process of addressing these needs and planning suitable care. If this part of the assessment had been undertaken effectively by the district nurse, the patient may not have suffered for a long period with the leg ulcer. Bryans and McIntosh (1996) suggest this phase of decision making is generally less conscious and deliberate, and more difficult to articulate, than subsequent phases. Although Elstein et al (1978) suggest this a very important part of decision making it often gets neglected. Many decision making models start with an assessment phase such as Walsh (1998)  nursing process, which has four stages of decision making, assessment, planning, implementation and evaluation. If the assessment carried out by the District nurse is poor then the rest of the planning and care delivered will be poor. It has been highlighted in many publications Lait & Smith (1998), Lawrence (1998), Thompson (1999) that a holistic assessment is needed in the care of patients with leg ulcers. Holistic assessments help to identify underlying pathology, and ensure correct diagnosis (Moffat & O’Hara 1995). However the way each individual nurse views the wound will depend on there experience and whether they have come across a similar situation before (Thompson et al 2002). Walsh (1998) highlights the need for a goal to measure against in the assessment phase. In Jo’s case the tool used, could have been a wound chart. A wound chart was however was not used, so on subsequent visits the nurse’s used there own judgment on whether the wound had changed. It was however difficult to clearly classify the wound, a point highlighted by Flanagan (1997) who warns wound classification can lead to inconsistencies in care. Different nurses visited each time making it difficult to provide continuity of care. The district nurse had defined the objective, which was to treat the leg ulcer. However the planning phase of Walsh (1998) model was not implemented, the nurse did not consider an alternative as identified as important in Schaefer (1974) theory. The best outcome, in the district nurses view, was considered although not in an evidence based way. Carroll and Johnson (1990) refer to the common sense view of decision making, in  stages 3,4, and 5, alternative generation, information search and judgment or choice. These three stages can be associated with problem solving approaches and with hypothetic deductive models such as Dowie & Elstien (1988). Hypothetic deductive  method could have been used to identified what was going on with the wound e.g. blood test could have been taken to test for clotting factors, a Doppler could have been used to test for circulation. However nurses can’t always wait for a lab test to give a hypothesis so the district nurse then drew on his experience. However using reflection in action (Schon 1983) and taking into consideration of the added problem of Jo being on steroids, he could have put these things into action to help create an evidence based care plan. Carroll and Johnston (1990) usefully includes decision making and subsequent (stages 6, 7) action and feedback. The inclusion of action and feedback in models of decision making has particle relevance to Jo’s community nursing assessment, because her assessment was continuous in nature ( Cowley et al (1994). If the district nurses had utilized the information properly the outcome for Jo may have been more successful. The best outcome for the patient depends on the patient’s response to treatment the nurse’s intervention and appropriate use of information gained from the evaluation (Luker and Kenrick 1992). District nurses need to be flexible in providing care in patients own homes, because of the sheer diversity of home environments and lifestyles of there patients. Luker & Kenrick (1992) believe that community nurses have there own personally owned knowledge that they find difficult to describe. Benner (1984) would describe this as intuition. However many influencing factors are involved with the nurses decision making, the district nurse that treated Jo had 20 years experience, but in the authors opinion had not used reflective and evidence based practice. The use of reflection enables nurses to learn from there experience and build up an expert knowledge base. However if you don’t learn from your mistakes it doesn’t make you an expert. 02971588 11 Experience doesn’t always equal expertise. If you are a ineffective nurse to start with you may always be a ineffective nurse. The district nurse involved with Jo’s case didn’t seem to reflect upon his actions and learn from practice but just performed a task. As long as the patient was being visited twice a week it didn’t seem to matter how long the wound took to heal, as Thompson et al (2002) suggest 20 years experience may be no more than one years experience repeated 20 times. According to Walsh and ford (1990) there is a need for assertiveness and this  was sadly lacking. Walsh & Ford (1990) argues the lack in assertiveness may be generated from being a mainly female profession, and Corbetta (2003) suggests women that work tend to be judged as inferior. However the district nurse involved in this decision making essay was a man, so I would question whether social conditioning had rubbed of on him. The district nurse seemed to resist altering his practice as directed by the ulcer clinic, it was almost as if he had ownership of the patient’s problem and care, and he saw it as a failure if he had to refer the patient on to a specialist service. It is the resistance to change practice that is cited by several authors (Gould 1986, O’Conner 1993, Koh 1993) as major influence inhibiting the introduction of research into practice. However Parahoo (2002) suggests to change the way nurses work, using evidence based practice, nurses need to think about what they do, how they relate to the people they care for and generally stimulate a more reflecting and questioning attitude. Reading research articles can generate a reflective approach (Parahoo 2002) although the author is aware that changing practices based on one research article is unsafe. Nurse managers have an important role in coordinated efforts, aimed at providing effective evidence based care. Although not all nurses are inclined towards academic work (Jootun 2003), the district nurse was the manager so without him being aware and appreciative of nursing research his team of community nurses provided an inadequate service. However as Sleep (1992) states it is unfair and unrealistic for educational programmes to place upon practitioners the burden of introducing research into the workplace, unless the climate prevailing in both service and management spheres is receptive to change. The organisation needs to facilitate changes in nursing to allow the professional as a whole to practice evidence based care (Parahoo 2002). The district nurse worked in a small isolated practice and his priority seemed to be the setting up of new PCT policies. Patients with leg ulcers were almost in the way. If the district nurse had a positive attitude towards research and regularly read research articles on wound care, which as Gould (2001) suggest are available in digestible form, the  care provided would have been evidence based effective care. Recommendations Joint education and clinical career pathways are needed to close the theory practice gap. Many nurses working in small practices are not getting the education they need to prove the government with a highly effective and trained workforce. Many organizations within the NHS are busy and overworked. The time is not available for them to update their knowledge and training. To help nurses who work in isolated community practices the setting up of groups or research meetings could enable them to keep up to date with relevant research, and would enable the effective utilisation of research findings. Nurses can also be encouraged to use expert nurses that are available at many hospitals and PCT. The use of computer networks and interactive software and research newsletters could also aid in the implementation of research practice. Evaluation Carroll & Johnston (1990) provide a framework for decision making, the author feels if the district nurse had used such a framework the care delivered to Jo could have been more effective and evidence based. The District Nurse didn’t evaluate or reflect on the care he delivered. Using decision making model such as Carroll and Johnston (1990) and Walsh (1998) nursing process, the nurse could have delivered evidence based reflective care. Models such as these are used as a guideline to nursing procedures, if they are followed it ensures that patients get best care and that nurses don’t become complacent in the care they deliver, but use a systematic approach alongside there  experiences and expertise Conclusion Intuition has been identified as a useful tool that needs to be recognised within nursing, however a need for a ration approach along side it is necessary. This will enable nurses to provide evidence based care with clear rationales. There are many aspects of nursing that cannot be subjected to measurement, and intuition is one of them, and so is caring. To ignore intuition as a nursing skill would be to deny the patient of truly holistic care. 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Nursing Standard. 18, 24, 73-77. Luker, K. A. & Kenrick M. (1992) An expiratory study of the sources of influence on the clinical decision of community nurses. Journal of Advanced Nursing 17, 682-691 Lukes, S. (1974) Power: A Radical View. London: Macmillan. Mallet, J. Dougherty, L. (2001) Manual of Clinical Nursing Procedures fifth edition Blackwell Science. London. McCutcheon, H. Pinchombe, J. (2001) Intuition: an important tool in the practice of nursing, Journal of Advanced Nursing 35 (3) 342-348. McKenna, H. (1997) Nursing Theories and Models. Routledge, London. Moffat, C. OHara, L. (1995) Fundamentals in clinical practice. Journal of Community Nursing 9, 9, 10-16. Mulhall, A. Le May, A. (1999) Nursing research: Dissemination and implementation. London: Churchill Livingstone. Musgrove, E. Woodham , C. (1995) Fundamentals in clinical practice. Journal of Community Nursing 9(9), 10-15. Nelson, E. A. (1996) Compression Bandaging in the treatment of venous leg ulcers. 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Friday, January 3, 2020

Maritime Consultative Organization - Free Essay Example

Sample details Pages: 4 Words: 1063 Downloads: 1 Date added: 2017/06/26 Category Law Essay Type Narrative essay Did you like this example? United Nations Portal Formely Inter-Governmental Maritime Consultative Organization The International Maritime Organization (IMO), formerly known as the Inter-Governmental Maritime Consultative Organization (IMCO), was established in Geneva in 1948,[1] and came into force ten years later, meeting for the first time in 1959. The IMCO name was changed to IMO in 1982.[2] Headquartered in London, United Kingdom, the IMO is a specialized agency of the United Nations with 168 Member States and three Associate Members.[2] The IMOs primary purpose is to develop and maintain a comprehensive regulatory framework for shipping and its remit today includes safety, environmental concerns, legal matters, technical co-operation, maritime security and the efficiency of shipping. IMO is governed by an Assembly of members and is financially administered by a Council of members elected from the Assembly. Don’t waste time! Our writers will create an original "Maritime Consultative Organization" essay for you Create order The work of IMO is conducted through five committees and these are supported by technical subcommittees. Member organizations of the UN organizational family may observe the proceedings of the IMO. Observer status is granted to qualified non-governmental organizations. The IMO is supported by a permanent secretariat of employees who are representative of its members. The secretariat is composed of a Secretary-General who is periodically elected by the Assembly, and various divisions such as those for marine safety, environmental protection, and a conference section. History IMCO was formed to fulfill a desire to bring the regulation of the safety of shipping into an international framework, for which the creation of the United Nations provided an opportunity. Hitherto such international conventions had been initiated piecemeal, notably the Safety of Life at Sea Convention (SOLAS), first adopted in 1914 following the Titanic disaster.[2] IMCOs first task was to update that Convention; the resulting 1960 Convention was subsequently recast and updated in 1974 and it is that Convention that has been subsequently modified and updated to adapt to changes in safety requirements and technology. When IMCO began its operations in 1958 certain other pre-existing instruments were brought under its aegis, most notable the International Convention for the Prevention of Pollution of the Sea by Oil (OILPOL) 1954. Throughout its existence IMCO, renamed the IMO in 1982, has continued to produce new and updated instruments across a wide range of maritime issues cover ing not only safety of life and marine pollution but also encompassing safe navigation, search and rescue, wreck removal, tonnage measurement, liability and compensation, ship recycling, the training and certification of seafarers, and piracy. More recently SOLAS has been amended to bring an increased focus on maritime security through the International Ship and Port Facility Security Code (ISPS) and the IMO has increased its focus on air emissions from ships. Legal instruments IMO is the source of approximately 60 legal instruments that guide the regulatory development of its member states to improve safety at sea, facilitate trade among seafaring states and protect the maritime environment. The most well known is the International Convention for the Safety of Life at Sea (SOLAS). IMO regularly enacts regulations, which are broadly enforced by national and local maritime authorities in member countries, such as the International Regulations for Preventing Collisions at Sea (COLREG). The IMO has also enacted a Port State Control (PSC) authority, allowing domestic maritime authorities such as coast guards to inspect foreign-flag ships calling at ports of the many port states. Memoranda of Understanding (protocols) were signed by some countries unifying Port State Control procedures among the signatories. Current issues Recent initiatives at the IMO have included amendments to SOLAS, which upgraded fire protection standards on passenger ships, the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers (STCW) which establishes basic requirements on training, certification and watchkeeping for seafarers and to the Convention on the Prevention of Maritime Pollution (MARPOL 73/78), which required double hulls on all tankers. In December 2002, new amendments to the 1974 SOLAS Convention were enacted. These amendments gave rise to the International Ship and Port Facility Security (ISPS) Code, which went into effect on 1 July 2004. The concept of the code is to provide layered and redundant defenses against smuggling, terrorism, piracy, stowaways, etc. The ISPS Code required most ships and port facilities engaged in international trade to establish and maintain strict security procedures as specified in ship and port specific Ship Security Plans and Port Facili ty Security Plans. The IMO is also responsible for publishing the International Code of Signals for use between merchant and naval vessels. The First Intersessional Meeting of IMOs Working Group on Greenhouse Gas Emissions from Ships took place in Oslo, Norway (23-27 June, 2008), tasked with developing the technical basis for the reduction mechanisms that may form part of a future IMO regime to control greenhouse gas emissions from international shipping, and a draft of the actual reduction mechanisms themselves, for further consideration by IMOs Marine Environment Protection Committee (MEPC). [3] The IMO has also served as a key partner and enabler of U.S. international and interagency efforts to establish Maritime Domain Awareness. Member states The list of member and associate member states is followed by the year of joining the IMO.[4] Country Year Albania 1993 Algeria 1963 Angola 1977 Antigua and Barbuda 1986 Argentina 1953 Australia 1952 Austria 1975 Azerbaijan 1995 Bahamas 1976 Bahrain 1976 Bangladesh 1976 Barbados 1970 Belgium 1951 Belize 1990 Benin 1980 Bolivia 1987 Bosnia and Herzegovina 1993 Brazil 1963 Brunei 1984 Bulgaria 1960 Burma 1951 Cambodia 1961 Cameroon 1961 Canada 1948 Cape Verde 1976 Chile 1972 China 1973 Colombia 1974 Comoros 2001 Congo 1975 Cook Islands 2008 Costa Rica 1981 Cocirc;te dIvoire 1960 Croatia 1992 Cuba 1966 Cyprus 1973 Czech Republic 1993 Democratic Republic of the Congo 1973[5] Denmark 1959 Djibouti 1979 Dominica 1979 Dominican Republic 1953 Ecuador 1956 Egypt 1958 El Salvador 1981 Equatorial Guinea 1972 Eritrea 1993 Estonia 1992 Ethiopia 1975 Fiji 1983 Finland 1959 France 1952 Gabon 1976 Gambia 1979 Georgia 1993 Germany 1959 Ghana 1959 Greece 1958 Grenada 1998 Guatemala 1983 Guinea 1975 Guinea-Bissau 1977 Guyana 1980 Haiti 1953 Honduras 1954 Hungary 1970 Iceland 1960 India 1959 Indonesia 1961 Iran 1958 Iraq 1973 Ireland 1951 Israel 1952 Italy 1957 Jamaica 1976 Japan 1958 Jordan 1973 Kazakhstan 1994 Kenya 1973 Kiribati 2003 Kuwait 1960 Latvia 1993 Lebanon 1966 Liberia 1959 Libya 1970 Lithuania 1995 Luxembourg 1991 Madagascar 1961 Malawi 1989 Malaysia 1971 Maldives 1967 Malta 1966 Marshall Islands 1998 Mauritania 1961 Mauritius 1978 Mexico 1954 Moldova 2001 Monaco 1989 Mongolia 1996 Monten egro 2006 Morocco 1962 Mozambique 1979 Namibia 1994 Nepal 1979 Netherlands 1949 New Zealand 1960 Nicaragua 1982 Nigeria 1962 North Korea 1986 Norway 1958 Oman 1974 Pakistan 1958 Panama 1958 Papua New Guinea 1976 Paraguay 1993 Peru 1968 Philippines 1964 Poland 1960 Portugal 1976 Qatar 1977 Macedonia 1993 Romania 1965 Russia 1958 Saint Kitts and Nevis 2001 Saint Lucia 1980 Saint Vincent and the Grenadines 1981 Samoa 1996 San Marino 2002 Satilde;o Tomeacute; and Priacute;ncipe 1990 Saudi Arabia 1969 Senegal 1960 Serbia 2000 Seychelles 1978 Sierra Leone 1973 Singapore 1966 Slovakia 1993 Slovenia 1993 Solomon Islands 1988 Somalia 1978 South Africa 1995 South Korea 1962 Spain 1962 Sri Lanka 1972 Sudan 1974 Suriname 1976 Sweden 1959 Switzerland 1955 Syria 1963 Tanzania 1974 Thailand 1973 Timor-Leste 2005 Togo 1983 Tonga 2000 Trinidad and Tobago 1965 Tunisia 1963 Turkey 1958 Turkmenistan 1993 Tuvalu 2004 Ukraine 1994 United Arab Emirates 1980 United Kingdom 1949 United States 1950 Uruguay 1968 Vanuatu 1986 Venezuela 1975 Vietnam 1984 Yemen 1979 Zimbabwe 2005 Associate members Country Year Hong Kong, China 1967 Macau, China 1990 Faroe Islands, Denmark 2002