Charlotte Perkins Gilman—The Yellow Wallpaper

 Use the questions to guide your responses. Each response area should be fully developed as if you were going to use that category for your own literary analysis. Setting Setting is a desсrіption of where and when the story takes place. In a short story there are fewer settings compared to a novel. The time is more limited. Ask yourself the following questions:Study the time period, which is also part of the setting, and ask yourself the following: When was the story written? Does it take place in the present, the past, or the future? How does the time period affect the language, atmosphere or social circumstances of the short story? Characterization deals with how the characters in the story are described. In short stories there are usually fewer characters compared to a novel. They usually focus on one central character or protagonist. Ask yourself the following: Who is the main character? Are the main character and other characters described through dialogue – by the way they speak (dialect or slang for instance)? Has the author described the characters by physical appearance, thoughts and feelings, and interaction (the way they act towards others)? The theme is the main idea, lesson, or message in the short story. It may be an abstract idea about the human condition, society, or life. Ask yourself: How is the theme expressed? Are any elements repeated and therefore suggest a theme? Is there more than one theme? no need for references just answer questions as they apply to the story in a couple paragraphs here is the story′s link https://www.gutenberg.org/files/1952/1952-h/1952-h.htm

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The Yellow Wallpaper Analysis

The Yellow Wallpaper is a short story that was written in 1952, and the setting of the story takes place in the period that it was written. The time of the setting of the story affects how the characters address each other. She has no right to argue with her husband for the female narrator, and she needs to keep him happy by doing things that he wishes. To this end, she even pretends to improve while her condition is worsening to make her husband happy. On the other hand, the narrator’s husband addresses her as his inferior. His language, such as calling her his blessed little goose and his treatment towards her, indicates that he takes her likes a child instead of an adult. The atmosphere of the story combines a big room and restriction to indicate emptiness and loneliness in life. During the story, a rich man could afford a big house for his family, but due to the time that the story was set and the society’s perceptions towards women, he had to isolate her in a big empty room for his rest cure. When the story was set, women were thought to lack abilities, and thus the time of the setting led to the isolation of the narrator. 

This short story’s protagonist is an unnamed narrator who tells the audience about her story to madness through her diary. The main characters, especially John, are depicted according to the way they address other characters. John, in various circumstances, ignores what the narrator tells him and forces his opinion on her. t5he author mostly bases her description of the characters on their interactions. Mainly the interaction between the narrator and her husband as she undergoes her rest cure. 

The story’s main theme is the subordination of women in the 1950s, which was common, and was it not for the madness that the narrator undergoes at the end of the story. The whole story would have seemed like a usual occurrence to an audience of the time. Women’s subordination was the societal expectation of women, which required women always to obey their husbands no matter what. The theme is indicated in the various suggestions that the narrator gives to her husband, who responds by discrediting them without any consideration. She has no option but to accept the rest cure, which her husband insists will do her good while she knows it’s destroying her but has no way to prove it to her husband. Other key themes of the story include the need for self-expression and the dangers of the rest cure. 

Injury Risk Related to environment

 

 

The Risk for Injury related to Environmental Conditions

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The Risk for Injury related to Environmental Conditions

Community health helps to enhance, maintain, improve, and protect different population groups’ health status within specific communities. (Lehman and Sanders, 2007). Primary healthcare programs and solutions help to reduce risk factors and increase health promotion and prevention. There are multiple health problems affecting individuals within specific communities based on the location and population within a particular community. The health problem identified in the community assessment is the increased risk for injuries related to environmental conditions. More specifically, the community does not have sidewalks to enable citizens to walk around town safely. Individuals, especially children and senior citizens, experience increased falls and accidents due to weak and frail bodies and inadequate strength. This activity aims to communicate with adults about the issue, suggest a health promotion program to address the problem, and determine how to evaluate that program’s success in promoting the community’s overall health. 

Health Promotion Program

Senior citizens are the most affected by the lack of sidewalks within a community, leading to more individuals experiencing falls and injuries when visiting walking in town. Providing adequate transportation services for senior citizens would be a better and improved way to help them get around town quickly and efficiently (Sylvestre, Christopher, and Marcie, 2006). Accessible transportation is essential in ensuring access to vital services such as grocery shopping and medical care. In essence, this program will also help sick and injured individuals get to the medical facilities without experiencing problems that could damage their existing health problems. Part of aging well involves individuals being able to interact with other people in the community. Thus, the availability of accessible transportation means allows older people to live independently within a community, prevent loneliness and isolation and minimizes the need for long-term care placement. In other words, it improves their social, psychological, and emotional lives. Many senior citizens do not drive and rely on family and friends for transportation. Nonetheless, these individuals are not always available, and older people must find resources such as public transportation as it is a vital support service that acts as their only connection to the people in the community and the outside world. 

In this case, the transportation program will provide door to door services and fixed-route with scheduled time and services. It will help senior citizens move around town as well as go back home easily and safely. Door-to-door services will require individuals to give notice on their intent to ride on a bus from one specific location to another, while fixed-route services will take passengers from specific stops at different locations. Ridesharing programs would help senior citizens avoid falls and related injuries on the road and improve their health by enabling them to visit senior centres and adult daycare and attend their health-related appointments. 

If approved, this program will be funded by the local government and other charitable groups within the community. More importantly, it is cost-effective as it involves developing transportation services that can be used by all individuals in the community. The government will provide two minibuses to help individuals move around town more efficiently at all times. It will focus on senior citizens in the whole community rather than just one individual.

Evaluation

The program’s success will be determined by the number of senior citizens who go to the hospital from injuries from walking around town in the next three months. A reduced number of senior citizens taken to the hospital due to falls and related injuries when in town means that the program effectively reduces the risks of injuries related to environmental conditions. Also, improved health outcomes and overall well-being among the older populations will show the program’s effectiveness. It will take about three months to achieve change in behavior among all senior citizens as individuals accept and adapt to the new transportation program.

Literature Review

According to Gorman, Jones, and Turner (2019), the aging population increases globally. Thus, the provision of accessible and safe transportation services remains a top concern for older individuals, health care providers, caregivers, and overall communities where they live (Meyers, 2019). Accessible public transportation services are crucial as they allow older individuals to live independently. Many senior citizens choose to age in their homes and communities. According to Meyers (2019), successful community living for older people requires access to medical care and other essential services, such as transportation to go to and from town. 

 The study by Shrestha et al. (2018) supports the health promotion program by suggesting that accessible transportation helps older individuals to go shopping, attend their health care appoints, or even got to work. According to the article, the natural aging process is characterized by physiological issues and changes that may profoundly affect mobility. Thus, they get into accidents and fall easily if they do not have proper support. As older individuals today become more active than before, public transport would play a critical role in maintaining their lifestyle even when they cannot drive. Fundamentally, implementing an adequate and accessible public transportation program and services as a health promotion program will profoundly increase older individuals’ quality of health and life by reducing falls, promote their sense of freedom, and enhance their independence.

 

References

Gorman, M., Jones, S., & Turner, J. (2019). Older People, Mobility, and Transport in Low-and Middle-Income Countries: A Review of the Research. Sustainability11(21), 6157.

Meyers, G. (2019, December 9). Transportation challenges for the elderly. SendaRide – Safe.Secure.Stat. https://www.sendaride.com/2019/12/09/transportation-challenges-for-the-elderly/

Lehmann, U., & Sanders, D. (2007). Community health workers: what do we know about them. The state of the evidence on programs, activities, costs, and impact on health outcomes of using community health workers. Geneva: World Health Organization, 1-42.

Shrestha, B. P., Millonig, A., Hounsell, N. B., & Mcdonald, M. (2017). Review of public transport needs of older people in European context. Journal of population ageing10(4), 343-361.

Sylvestre, G., Christopher, G., & Snyder, M. (2006). The mobility needs and transportation issues of the aging population in rural Manitoba.

Price-Value Relationship

Price-Value Relationship

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Price-Value Relationship

Previously, the value of a product determined its price. In this line, customers would look at the product’s qualities, such as the quality of material making a piece of clothing, to determine what it should cost. However, things have changed, and the price of a product is determining its value. Therefore, when a customer steps into a supermarket, for example, he/she doesn’t go for the product that has the highest quality; many don’t even know these qualities anyway, they just look at the price tags, and the most expensive product has the highest value (Serwetz, 2020). The concept of price-determining the value of a product is true and has been the main way consumers have been using to select products when purchasing. The concept is true for companies such as Gucci, which make elegant products have always put a higher price on their goods, and many people do not care about the quality of their goods; having a Gucci expensive shoe is all that matters. Despite the competition from other cheaper products from places like China, Gucci continues to prevail by selling expensive products that consumers believe are worth the price.

TJX retailers have survived the price-value problem that has bankrupted other brands. Their price level is lower than that of other retailers such as Macy’s, but they have been consistent in their pricing, and customers have trusted the value of their goods based on the price (Serwetz, 2020). If TJX continues with the success, it should never try to restructure their price-value relationship. Brooks Brothers messed with their price-value relationship when they lowered the price of their shirts. If Brooks Brothers are to survive, they need to redesign their shirts and tag high prices, making consumers believe that the shirts are worth that price. Macy’s have also messed with the price-value relationship by lowering the price creating a mentality that the product will be cheaper tomorrow than it is today. Macy’s have lost their customers’ trust, and to regain it, they need consistency in their prices as all their customers need an assurance that their products are worth that price. Neiman Marcus has taken a similar route to that taken by Macy’s, which will have fatal results if they do not change. All their products have a 50% discount, and with the current price-value relationship, this strategy does not work. If they are to escape their downfall, they need to make customers believe that their products are worth the price they have tagged.

As a consumer, the price determines the value of the product I purchase; if it’s expensive, it’s good and original. I trust the seller’s prices as a determinant of the values that they sell, and this has, in many circumstances, helped me get better products. If the use of price to determine the value of a product is anything to go by, the statement cheap is expensive would serve me as a customer right, which would be a breakthrough in my purchasing strategy. 

 

References

Serwetz, M. (2020, June 22). Not understanding the relationship between price and value can be (Is, was) lethal. I, Sourcerer Business & Marketing Community. https://www.isourcerer.com/2020/06/not-understanding-relationship-between.html

 

Democratic and Authoritarian Political Systems

Democratic and Authoritarian Political Systems

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Democratic and Authoritarian Political Systems

Politics usually have a great impact on people and the country at the meso level. The type of political system implemented in a country greatly influences how the state or government controls the individuals. Some of the main political systems include democratic and authoritarian styles. In a democratic political system, the government and politics’ power emanates from that specific country’s citizens. For a country to fully implement a democratic political system, it must meet and follow certain criteria. A democratic political system provides freedom of speech, press, and religion to all its citizens. Here, the system respects the basic individual liberties and freedom of expression of ideas and opinions (Ahlers and Stichweh, 2019). Secondly, in such a system, the majority rule with minority rights. In democratic countries, the citizens accept decisions and rules developed by majority voters in a free election. It also provides ways in which minorities can voice their opinions and rights. Thirdly, a democratic political system includes different leaders from different political backgrounds (Nwogu, 2015). In this case, it allows many different individuals to compete for leadership positions. Lastly, it allows free-competitive elections, and the leaders elected to lead the country must abide by the rule of law. In other words, democratic countries are governed by laws that apply to both citizens and leaders. The degree to which a country meets the above criteria is how it implements a successful democratic political system. Examples of democratic countries include France, Great Britain, the United States, and Japan.

On the other hand, an authoritarian political system is different and follows different concepts and perceptions from those used in democratic countries. In democratic political systems, the citizens profoundly participate in the governing of a nation. However, in the authoritarian system, only one leader or a small group of leaders has real power to govern that specific nation. Authoritarian governments allow individuals to participate in elections and is in contact with the citizens. However, citizens cannot control or voice their views about how they are ruled (Glasius, 2018). Typically, in an authoritarian system, the citizens do not have a free choice. Rather, the leaders decide what people can or cannot do or have. People become subjects that must obey instead of participating in government decisions. Unlike in democratic governance, the authoritarian system denies individuals the freedoms of press, speech, and religion (Ahlers and Stichweh, 2019). It also does not follow the majority rule or protect the rights of the minorities. Its leaders mostly include military officials and aristocratic families, including kings, military leaders, presidents, or prime ministers. Some of the countries that exercise this system include Myanmar, China, Cuba, and Iran.

 

Response to Videos

There are different types of economies. The video “What is Marxism?” (8-Bit Philosophy, 2014) shows the concepts supported and promoted by Karl Max, a German philosopher, and poet. According to the video, Marx supported an economy that is not driven by money and does not have class divisions. An economy where people give according to their abilities and take based on their needs. Fundamentally, he supported a communist economy, claiming that it was not only possible but also inevitable. Marx believed that it is not a conflict of ideas that propels history, but rather, conflicts of individuals’ relation to material wealth that will bring history to its end (0:46). The rapid increase of population led to the concept of capitalism to meet the needs of all individuals. 

Nevertheless, according to Marx, capitalism brings various issues to individuals and societies, including the fact that it alienates individuals from the fruit of their labor. Individuals are paid a certain wage to work. However, the products they make are not for themselves but are sold to other people (8-Bit Philosophy, 2:12). Capitalism also alienates individuals from each other. Workers that work and produce efficiently are influenced and driven to compete with other employees for their job, turning individual against each other. Thirdly, it alienates individuals from their nature. Creation is a crucial aspect of people’s lives. However, because individuals make items that have no personal investment, their lives and work become a burden.

As capitalism continues to evolve, the gap between the rich or the elite class and the poor increases. Capitalism developed because of human frailty, institutional failures, obsession with a false theory, and toxic cultures and beliefs in some countries, such as the Americans’ belief in homeownership. It was also caused by the failure of policy in financial institutions where there was many regulations in the wrong sectors. Nonetheless, over the years, capitalism has led to more issues, as illustrated by David Harvey in the RSA Animate (Harvey, 2010). In essence, capitalism has also led to wage regression and boom and bust economic cycles in different geographical locations. Here, capitalism does not solve financial problems; rather, it moves them around geographically, from one nation to another. The increased accumulation of profits for some individuals has led to greed. Greed among business people lacks up wealth among the wealthy, leading to an increased gap between the rich and the poor (Harvey, 9:14). The rich get richer while the poor get poorer. Currently, capitalism has been implemented globally, which means that different individuals from different regions experience all the above issues. Governments and organizations should find better economic systems that would bring profits and promote the well-being of all individuals and communities.

 

References

Ahlers, A. L., & Stichweh, R. (2019). The Bipolarity of Democracy and Authoritarianism: Value Patterns, Inclusion Roles and Forms of Internal Differentiation of Political Systems. Sociologia & Antropologia9(3), 819-846.

8-Bit Philosophy. (2014). What is Marxism? (Karl Marx + Super Mario Bros.) [Video]. YouTube. https://www.youtube.com/watch?v=Vz3eOb6Yl1s&feature=emb

Glasius, M. (2018). What authoritarianism is… and is not: a practice perspective. International Affairs94(3), 515-533.

Harvey, D. (2010). RSA ANIMATE: Crises of Capitalism [Video]. YouTube. https://www.youtube.com/watch?v=qOP2V_np2c0&feature=emb

Nwogu, G. A. I. (2015). Democracy: Its Meaning and Dissenting Opinions of the Political Class in Nigeria: A Philosophical Approach. Journal of Education and Practice6(4), 131-142.

Harriet Tubman analysis

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Harriet Tubman

Harriet Tubman is an American icon who was enslaved and rose to become the leader of the Underground Railroad, which facilitated many slaves to gain liberty before the civil war began. She was a nurse who also acted as the Union’s spy while a bounty on her head had been placed (Krasner 2). Harriet was born in 1820 and worked as a cook before being rented as a muskrat traps setter. At the age of twelve, she began her quest for justice, but this led to a head injury due to heavy weight that was thrown at her but intended to hit another fugitive (Mcelya 1). The traumatic head injury made her dizzy and hypersomnia. She began to have strange visions and elaborate dreams and believed that they were from God. Religious background and the experience led her to be religiously devout. Harriet was a major activist for the suffrage of women movement. She was married to John Tubman, who was a free black man and acquired his second name. 

Since Harriet got a head injury, she never regained normal health. This led to a major sickness in 1849, which rendered her useless as a slave, and her master could not get a buyer for her. She was discontented to learn of her master trying to sell her and continuous enslaving her relatives further (Larson 7). After the death of Edward Brodess, his wife wanted to sell Tubman and her relatives, but she decided to liberate herself. She believed that it was either liberty or death for her to be free despite persuasion from her husband. Harriet managed to escape together with her brothers in the same year she got sick. Her escape was hardly noticed by Brodess’s wife Eliza for two weeks (Whitehead 3). Eliza decided to offer a $100 bounty for every escapee and posted it on the Cambridge Democrat. Following the bounty, her brothers decided to return, and this forced Tubman to return with them. 

Tubman did not stay long before she planned and executed another escape alone. She informed her mother of her planned escape through an encoded message in the form of a song. She escaped using the Underground Railroad route, which is not exactly known. This route network had been well established by other free and enslaved black people, white abolitionists, and other people who fought for the rights of others. The Quakers were dominant members of the Underground Railroad movement in Maryland (Broyld 7). It is believed that from Maryland, Tubman traveled through Preston close to Poplar Neck and then headed to Pennsylvania through Delaware. Through the journey, she traveled at night and followed the North Star as the direction guider. This enabled her to hide from the slave catchers who hunted for escaped fugitives and collected their bounties. To ensure protection, the conductors of the movement had to use deception techniques so as not to be recognized (Clinton 30). One would be given some chores so as to appear as to be working for a certain family during the day and at night be transferred to another household using a cart. 

While in Philadelphia in 1850, the U.S. Congress approved the fugitive slave law, which advocated for a hefty punishment for those slaves that escaped. The law enforcers in all States were forced to assist in capturing the escapees. This made it difficult for Harriet Tubman to remain free. Following notice on the sale of her niece and her two children, Tubman hid in Baltimore with her brother-in-law Tom Tubman. Her niece Kessiah and the children managed to escape with the help of John Bowley using a canoe to Baltimore, where they reunited with Tubman (Larson 14). In 1851, she returned to Maryland and escaped with her brother Moses and two other men. When she traveled to Dorchester County to meet her husband, she learned that he had married another woman. Tubman tried to persuade them to follow her, but they refused to claim that they were comfortable with their lives (Whitehead 4). John Tubman was later killed sixteen years later due to a confrontation with a white man. 

By December of 1851, Tubman managed to escape with eleven fugitives and headed north. The Fugitive Law of 1851 had made life unbearable for the escaped fugitives, and the only option was to escape. Evidence indicates that Tubman and the eleven fugitives visited Fredrick Douglass, who was an abolitionist and a former slave (Clinton 32). Tubman’s continuous assistance for the escape of slaves gave her more confidence to continue with the work she had started. The returns to Maryland led to saving another seventy slaves over a period of eleven years. It is believed that this took thirteen returns to achieve. Approximately another sixty slaves managed to escape northwards without Tubman, but they were given instructions by her (Broyld 7). She managed to lead a group of eight fugitives harbored by her father when she learned of the possibility of his arrest. Her efforts to assist slaves into freedom from the whites earned her the nickname ‘Moses’, comparing her to the biblical Moses, who assisted the people of Israel in gaining freedom from the Egyptians. 

Achieving such tremendous and noble tasks was not easy for Tubman as there was a bounty on her head. It took a lot of determination and courage to carry out the plans. She came up with an ingenious plan that worked marvelously. Every time she had to escape with the slaves, it had to be during the winter season. During this time, it was cold, and people had to stay at home (Calkhoven 15). Also, the nights are longer and the day time shorter. Therefore it would be easier for her to flee unnoticed at night and travel for long hours the night with the fugitives. She always made early contact with the slaves, and the escape would be conducted on Saturday evening. This was because the runaways were not printed on weekends and had to wait until Monday (Hobson 6). This would give them ample time to be far from the bounty hunters. The art of subterfuge played a major role in hiding the slaves. They would pretend to carry out normal errands and thus go unnoticed as escapees. 

Tubman was a staunch religious believer and used her visions to guide her and the others as they escaped. She altered songs to inform the fugitives when it was safe and unsafe in their journey. Due to the success achieved, more slaves believed opted to follow her (Krasner 112). She used to carry a revolver, which offered security and never feared using it when required. It is believed that the revolver was also used to threaten any slave who would try to return back or escape. Due to her methods of escaping with the slaves, the slaveholders did not know that it was Tubman who was responsible as she was considered disabled due to the head injury (Broyld 2). They thought that there was a white abolitionist who lured the slaves to himself from the region. When they came to realize it was Tubman, a huge bounty of about $40,000 was given for her in 1868. 

Tubman met John Brown, an abolitionist, in 1858, and the two believed to have a divine calling. Brown believed that slavery would only be abolished by the use of violence, while Tubman advocated for peaceful means. However, she decided to support his ideology of direct action. Brown sourced support from activists, abolitionists, and fugitives to form a movement that would attack the slave masters (Clinton 65). He met with Chatham Ontario and gave him his plan. The plan was leaked, forcing Brown to change it. Tubman offered invaluable strategies adding them to the plan. However, the plan failed, and Brown was arrested, convicted for treason and hanged. Tubman considered his death as worth more than a hundred living men who were not resisting slavery (Calkhoven 20). Brown’s resistance gave many slaves and abolitionists the courage to fight more for freedom. 

In 1861, the American civil war began, and this was an opportunity for Tubman to help in ending slavery. Due to the help that slaves got from the army, Tubman felt that the Union Army would be the solution to slavery. She wanted to assist the Union with her expertise and thus became a spy (Larson 14). She joined other abolitionists, where she was able to assist more fugitives. The Union’s generals, such as Benjamin Butler and David Hunter, supported the abolition of slavery and ordered the freeing of contrabands in the regions. Former slaves joined the army regiment and thus empowered the black community in the fight against enslavement (Hobson 4). At Port Royal, while an abolitionist and a spy, Tubman became a nurse where she made concoctions of traditional plants for the treatment of dysentery and smallpox. 

In 1863, Tubman led an army assault. She then joined Montgomery at the Combahee River and raided plantations using steamboats (Krasner 121). They managed to destroy properties worth thousands of dollars using fire and also seize food. When the slaves in the area saw this, they ran towards the boats together with their belongings and children (Calkhoven 24). Over seven hundred and fifty slaves gained freedom during that raid, and Tubman was hailed for the work. She continued to work with the Union Army until 1865, when she went back home. In 1869 she was involved in an argument with a train conductor. The conductor wanted her to move to the baggage car, but she refused as she had papers allowing her to be in the half-price area. The conductor was assisted by two other white passengers and got Tubman into the baggage section. Her hand got broken, and this act of defiance has been hailed since then (Broyld 11). She spent the rest of her life with her family in Auburn. 

Harriet Tubman played a major role in the abolishment of slavery in the Northern region of America. She used to be a slave but got injured on the head and could not be sold as a slave. The injury gave her visions, which she believed were from God. She managed to escape and began her journey as a freedom fighter for people of color who had been enslaved. Through many returns to Maryland, she managed to escape with more fugitives to freedom despite having a bounty on her head. She met with many abolitionists and planned more for the fight for the end of slavery. When she joined the Union army, she led an attack that saw over 750 slaves were rescued. Her works are remembered today in American history as an icon. In her old age, she advocated for women’s suffrage as she believed that women had equal rights to vote as men. Suffragist activism earned her more admiration in America.

 

Works Cited

Broyld, D. J. “Harriet Tubman: Transnationalism And The Land Of A Queen In The Late Antebellum”. Meridians, vol 12, no. 2, 2014, pp. 78-98. Duke University Press, doi:10.2979/meridians.12.2.78.

Calkhoven, L. Harriet Tubman: Leading the way to freedom. Sterling Publishing Company, 2008.

Clinton, C. Harriet Tubman: The road to freedom. Little Brown & Company, 2004.

Hobson, J. “Harriet Tubman”. Meridians, vol 12, no. 2, 2014, pp. 1-8. Duke University Press, doi:10.2979/meridians.12.2.1.

Krasner, B. Harriet Tubman: Abolitionist and conductor of the Underground Railroad. Encyclopaedia Britannica, 2017.

Larson, K. C. “Harriet Ross Tubman Timeline”. Meridians, vol 12, no. 2, 2014, pp. 9-27. Duke University Press, doi:10.2979/meridians.12.2.9.

Mcelya, M. “:Harriet Tubman: Myth, Memory, And History”. The American Historical Review, vol 113, no. 4, 2008, pp. 1163-1163. Oxford University Press (OUP), doi:10.1086/ahr.113.4.1163.

Whitehead, K. W. “Harriet Tubman”. Meridians, vol 12, no. 2, 2014, pp. 156-160. Duke University Press, doi:10.2979/meridians.12.2.156.

Nursing leadership and Management

 Attached below is a copy of the rubric and instruction for this paper. In this paper My change project for this assignment is staffing ratios in hospital. Follow instruction and connect how better staffing ratios for nurse can lead to positive outcome.

Answer

Donabedian Model Framework 

Figure 1: Donabedian Model Framework 

Source: Donabedian (2005)

The Donabedian Model Framework is essential for improvement projects to have an outcome, process, structure, and balancing measures (Donabedian, 2005). The outcome reflects on the impact of change on a patient while the process demonstrates on systems and processes involved to achieve the desired outcome. The structure demonstrates on input measures such as staff to patient ratios. Balancing measures reflect on the consequences of the change.                                                                         

 

Plan for change Using the PDSA cycle

Figure 2: PDSA cycle

Figure 3: Implementing the PDSA cycle (Source: www.ihi.org)

A Plan, Do, Study, Act (PDSA) cycle is used to test the changes experienced on a small scale and building on what has been learned from the test cycles in a structured way before the changes are implemented (Improving Health and Health Care Worldwide, n.d.). The author states that the process enables the hospital stakeholders to ensure that the change is safe and less disruptive for staff and the patients.

The first step in the PDSA circle is to Plan. The hospital needs to define the objective, questions, and predictions. Data collection through the questionnaire can answer the necessary questions for the change to be tested or implemented. The second step is Do. The data is collected and analyzed before carrying out the change. Study is the third step. The collected information before and after the change is analyzed and compared to predictions. The fourth step is the Act. In this step, the next circle is planned for, or full implementation takes place.

Aims Statements from the health care provider

To improve staffing ratios for nurses for a positive outcome. This will be achieved by;

  • Developing a formal plan for staffing nurses.
  • Collecting data on underlying courses to reduce turn over.
  • Consulting the staff nurses on a safe nurse to patient ratios.

In order to know if the change is an improvement, the outcomes need to be measured, such as the provision of better care. Other positive results are reduced waiting time, improved care services and treatment, and less time to undergo transfer or discharge. The change will be measured using HCAHPS Scores.  

Figure 4: HCAHPS Score of Staffing outcome

 

References

Donabedian, A (2005) Evaluating the Quality of Medical Care, The Milbank Quarterly, 83(4):691-729

(n.d.). Improving Health and Health Care Worldwide | IHI – Institute for Healthcare Improvement. https://www.ihi.org

current events

 

The global pandemic has been a challenge to several countries across the globe. Regarding the news article posted by Minyvonne Burke, she claims that over the past few months after the World Health Organization (WHO) declared the Corona Virus a global pandemic, with millions of cases Covid-19. Simultaneously, the third wave hit massively, prompting the CDC (Center for Disease Control and Prevention) to take action. Moreover, Burke claims that the country has recorded more than 200,000 coronavirus cases over the last twenty-four hours, which brought the number to 12,002,863, with a total number of deaths of 255,567 (Burke 2020). He further states that the numbers are likely to rise. 

In a bid to contain the global pandemic, Burke notes that several governors have added masks’ measures and tightened the rule on attending social gatherings. The news item depicts clear that the new measures came after the stay after the issue to stay at home was ordered, which had been invalidated by the Supreme Court. At least six governors issued their opinions concerning the spread of the global pandemic. The six governors, including Tony Evers urged the Americans to take the virus seriously and work together in fighting the virus.  Moreover, the governors urged the Americans to reconsider traveling for the thanksgiving event, which will result in thousands of citizens contracting the dreaded virus.

The Covid-19 has impacted the usual ways of doing business. Businesses are significantly affected, leading to some of them completely shutting down. The economic concepts, such as value, scarcity, supply and demand, costs and benefits, and incentives, among others, are significantly affected in one way or another. The concept of the world having scarce resources leading to business owners on constant decision making. With the emergence of covid-19, several businesses were shut down, causing products to be scarce as the public is in constant demand for them. Since the United States banned Flights from major producing countries such as China, businesses need products from other countries to shut down. Since the United States economy is led by a constant demand and supply chain, most businesses’ closure due to Covid-19 has put a significant setback to the demand and supply chain economic concepts. Enterprises are currently redefining their way of conducting business. Some of them did not incorporate change strategy, which leads them to make losses instead of profits, consequently causing the company to shut down promptly.  The closure of such businesses causes massive unemployment that significantly impacts the United States’ economy. Since most firms have closed down, the firms’ values have tremendously dropped down, causing a negative impact on the economical concept (Hossain, 2020). The government’s straining orders have also affected different firms produces products for public consumptions.   

According to the article (Burke, 2020), the governors urged Americans to observe the health regulations that will contain the virus’s spread. In a bid to stop the virus, the governors have set out measures that ensure that the general public is safe and are not at risk of contracting the dreaded virus. I want to support the opinion since it has affected all classes of people, including us. We should join hands in the wake of the virus to reduce the mortality of the virus. By working together, the American economy will regain, and people will continue living their everyday lives.

 

References

Burke, M. (2020, November 21). U.S. records over 12 million cases of coronavirus. NBC News. https://www.nbcnews.com/news/us-news/u-s-records-over-12-million-cases-coronavirus-n1248511 

Hossain, M. (2020). The effect of the Covid-19 on sharing economy activities. Journal of Cleaner Production, 124782.

Eternal Truths and Ethical Dilemma in Nursing 

Argumentative Term paper about Blessed Augustine of Hippo

 Word Document onlyDouble Spaced12 pt New Roman FtConcise, Cogent argument.* Must enclose FootnotesEX:Cyndi Browning, Readings for Ethics. Vintage, Revised edition, 2013. Page 23-25Paper should have:1. Introduction2. Summarize the key concepts (at least one, no more then three)3. Include accurate citations

Answer

Eternal Truths and Ethical Dilemma in Nursing 

St. Augustine of Hipp’s philosophical work was a straddle between the ancient Greek philosophers and the medieval Christians in Europe. At Milan, he was involved in Neo-Platonism, and he gained interest in the teachings of Bishop Ambrose of Milan. After conversion into Christianity, he got baptized and denounced worldly desires. He had a challenge with Neo-Platonism and Christianity virtues. In AD 396, he became a bishop at Hippo. It is believed that his works were more religious-based than philosophical. According to him, discussing philosophical issues was meant for interested academics and focused on the attainment of beatitude and blessedness. Augustine was concerned with how people understand the eternal truths of the universe as provided by Neo-Platonists and Plato (Chroust, 2017). This term paper provides arguments of Augustine on eternal truths and the ethical dilemmas in nursing. 

Augustine provided an argument that was meant to counter skeptics that stated that there was no knowledge that is at all possible. According to him, there are many things that we know to be true and cannot be said to be a lie. To support his argument, he gave several examples of how knowledge is possible (Qvigstad & Bordo, 2016). The law of non-contradiction states that if something is true, then the opposite cannot be true at the same time. He also argued about the existence of a person on the basis of “if I err, I exist. Every person knows that he or she exists, and this is true and cannot be argued about it (Lazier & Gaul, 2011). Cognition about the existence of you is true knowledge, according to Augustine. Another argument is that appearance cannot be falsified as it is infallibly known how everything appears. For instance, the shape of an object can be described in the same manner by different people on the basis of its appearance. How they judge the object beyond what seems to be the case is what leads to the aspect of falsehood. 

Doubting is an indication that there is a truth on one side of the argument. Skeptics rely on doubts, and this means that there is a true side of the story. Also, in mathematics and geometry, there are truths that are used, and it cannot be doubted about that (Qvigstad & Bordo, 2016). For instance, if a distance is ten meters, that cannot be a lie. Lastly, Augustine argued about real existence and abstract principles. He argued that people know of abstract concepts that are generated from general ideas. However, people also know of existing real concepts such as natural phenomena (Chroust, 2017). We know that the sun rises every day even when there are clouds all day, and this cannot be refuted even if it were to be argued that what we experience is a dream or a vision in our mind, our existence and being alive is undoubtedly true. 

Augustine acknowledges that the senses can sometimes have erred in our judgment of the truth. For instance, a straight stick appears to be bent when placed in water. It can be argued that it is bent based on what we can see, but this is not true in reality (Lazier & Gaul, 2011). The senses do not deliver the truth entirely correctly, as tis the case for mathematical and geometrical outcomes. However, this is not to say that senses are wrong all the time. According to the Plutonic argument, different people have different senses, and this leads to uncertainty in the truth of knowledge based on sense (Chroust, 2017). Eternal truth and the existing knowledge about it are relatively different, and it is difficult to account for both. It is not possible for the sensible world to provide us with truths and immutable ideas. The mind and soul are mutable despite being considered immortal. 

The existence of diseases is true, and this cannot be contradicted otherwise. Nurses cannot assume that there are no diseases. Since the knowledge about the existence of diseases is real, the opposite of this cannot be true. Nurses must learn about diseases and the management practices that are required. However, there are cases where the management of a disease requires nurses to improvise on the basis of abstract ideas (Clement, 2016). This raises an ethical dilemma as it is a requirement to adhere to the set protocols. Before making a conclusive diagnosis of a patient, a nurse requires to make several assumptions of the possible disease. Augustine acknowledged that skepticism indicates some truth. In nursing, a nurse has to be skeptical about a patient’s condition, and this prompts him or her to seek the truth. Lack of skepticism raises ethical dilemmas due to the possibility of issuance of wrong treatments. 

In nursing, sense does not necessarily provide the truth about a patient. Relying on senses could result in losing a patient due to the wrong diagnosis of the situation. This is similar to the bent stick in the water. When a patient in the ward is calm and appears relaxed, the nurse may assume that he is recovering. In reality, the patient could be severely sick, and the body has become numb as it may be realized upon testing. It is ethically right to ensure that every patient is checked and evaluated regardless of outward appearance (Davis et al., 2010). However, this does not mean that senses are wrong all the time in practice. When a patient who was not talking much is seen talking with others, laughing, and walking around, this is an indication of recovery.  

From Augustine’s arguments, it is true that we live and die. Everyone is entitled to live and die under natural circumstances. Through reasoning, we can determine what is true and what is false, but this is not enough to seek eternal truth.  Nurses work to save lives and meet every patient’s wants. In eternal truth, the nurse understands that there is a life that needs to be preserved (Davis et al., 2010).  However, how to save it relies on the knowledge gained in school and in the field.  Meeting the needs of patients is considered to be ethically right. However, nurses are faced with an ethical dilemma when faced with a case where a patient wants to die due to suffering. When the patient with a killer disease asks the nurse to end his life, the nurse is in a dilemma of saving a life and ending it. It is unprofessional, and the ethics of care conflicts with the requirements of the patient (Clement, 2016). The nurse knows that her action to meet the want of the patient will result in the loss of life, and this cannot be contradicted to be false. 

In conclusion, Augustine’s philosophical work on eternal truth tries to contradict beliefs from real knowledge. There exists reality around us, and this cannot be assumed to be false. In the nursing practice, there are ethical dilemmas that face nurses as they take care of the patients in relation to Augustine’s argument. Nurses must use real knowledge and not beliefs so as to avoid dilemmas. However, there are instances where they are at a fix in determining what to do. Professionalism requires nurses to handle cases ethically.

 

References

Chroust, A. (2017). The fundamental ideas in St. Augustine’s philosophy of law. Augustine and Modern Law, 171-193. https://doi.org/10.4324/9781315096735-9

Clement, I. (2016). Ethical dilemma. Textbook on Professional Trends and Adjustments in Nursing, 65-65. https://doi.org/10.5005/jp/books/12786_10

Davis, A. J., Fowler, M. D., Aroskar, M. A., & Fowler, D. (2010). Ethical dilemmas & nursing practice. Prentice Hall.

Lazier, J., & Gaul, B. (2011). The cogito arguments of Descartes and Augustine. Just the Arguments, 131-136. https://doi.org/10.1002/9781444344431.ch35

Qvigstad, J. F., & Bordo, M. (2016). On learning from history: Truths and eternal truths. On Central Banking, 124-155. https://doi.org/10.1017/cbo9781316584682.007

Development of the European Union

European Management and Business Strategy

Topic 1: The Development of the EU
Assess the extent to which integration in the European Union has been economic. Why has economic
policy played such an important role in the development of the EU?

Formalia:
Minimum 2000 Words – Max 2050 words This excludes words used as part of tables, graphs, appendices,
the bibliography, cover, and table of contents.

The essay should focus on answering the discussion question by providing a summary of the key issues and
wherever appropriate providing your insights and recommendations.
The work must be typed doubled-spaced. Marks will be deducted where the word requirement is not
adhered to.
It is important that you carefully reference your sources so that there are clear distinctions between your
thoughts and those expressed by others. You should follow the Harvard referencing style which can be
accessed through the Word References tab.
While appendices provide greater flexibility for you to illustrate your points, this does not mean they
should be used as a method to circumvent the word limit. Appendices must be referred to in the work;
your mark will suffer if you do not refer to them.
We require a formal word count of the main body of text at the end of the paper before the bibliography
and appendices. You can use the Word Count feature in Word that is found on the Review tab.

Evidence of a well-planned, organized and structured piece of work including clear conclusions and
recommendations.
Appropriate content and coherence: relevance of the context to the questions set; has the assignment
questions been squarely and clearly answered? To what extent does the content develop coherent themes
of argument in answering the questions?
Analytical standard: emphasis on analysis rather than repeating descriptive details; application of
theoretical concepts and techniques, demonstration of analytical learning.
Presentation: use of essay format, use of diagrams and visual aids, quality of academic writing and the use
of English. Proper referencing and use of bibliography.
Full details of all published or unpublished books, articles, pamphlets, reports or papers used must be
included in a bibliography at the end of the paper.

 

Answer

Development of the European Union

The European Union (EU) consists of 27 members from Europe. The origin of the organisation is traced in the 1950s between European steel and coal communities who were in constant wars. It is a political and economic union where it has developed an internal market for various goods and services through the standardised laws and regulations among the members (Chalmers, Davies and Monti 2019). The policies of the organisation are about free movement of goods, people, capital and services among the member states. Member countries maintain standard guidelines in the trade, agriculture and fishing sector to enhance the common objective of free movement. There has also been the enactment of legal laws for the administration of justice to home affairs. There is no restriction on travelling, making it easier for the flow of people among the member countries. 

In 1992 a monetary union was established which came into existence in 2002, the monetary Union aimed to improve the trade policies of the movement and the usage of a common currency. The monetary Union consists of 19 member states. With time other countries have been able to join the organisation like the 2009 Lisbon treaty, which was amendments to the European Union constitution to allow members to join. European Union is represented to the World Trade Organization (WTO), which promotes economic and trade growth (Richardson 2015).  EU has played an essential role in improving the financial states of the member countries and also the nominal gross domestic product (GDP). Member states have lower inflation rates which are enhanced by free movement across the borders. 

Economic policies have played an important role in the development of European Union because there was partisan support brought about by the policies put in place. Prior to the formation of EU partisan support was associated with political but with the formation of the EU, partisan support was achieved through the economic policies. The market and price stability was the main objective of the formation of the Union which was achieved through sound economic policy (Braniff 2011). The economic policies that were put in place enabled more countries to joining strengthening the Union. It is through the policies that we see more countries participate in free trade. The policies were important to minimize the trade wars that could arise, for example, wars that were early witnessed in the steel and coal region.

Policies of the European Union

European Union is commonly characterised by its single internal market which was among the main objectives during formation. The internal market involves free movement of capital, goods people and services in the members’ states. Also, there is the customs union which requires the implementation of standard external tariffs. When the goods are already circulated in the market, they are not subjected to discriminatory taxes, custom duties and import quotas. The legislation and policies are well articulated in the constitution, and this enhances the trade relationships between countries (El-Agraa 2011). The free movement on capital targets on more manageable investment in share capital and also buying of properties in other countries. Free movement of people means that there is reduced administrative requirements on the boarders; hence people can work and live freely in other countries. 

 Various policies help in governing and ensuring that the objectives of the organisation are made. The policies are in line with the goals of each member state. In the movement, there is a policy on the economic empowerment of member countries. The monetary policy aims at stabilising the use of Euro. With the help of a common currency, there is completion among the companies. The European Central Bank regulates the interest rates applied by all financial institutions in the member countries. The standard interest rates will be easier for companies that need financial assistance to access with the same rates in different countries. The bank also regulates the inflation and exchange rates which means there are no additional costs incurred when doing transactions in other member countries. The European Central Bank, through the Union, pays member states subsidies on development projects intending to improve the living standards of the people and also the economic value of the state.

There is enhanced financial supervision in the Union.  There are three authorises governing the supervision aspect they are; European Securities and Market Authority, European Banking Authority and European Insurance and Occupational Pensions Authority. These authorities can check on the financial obligations of the members. The securities exchange board is responsible for supervising the aspects of the capital and securities performance on the market. The authority also oversees that all the companies participating in the market are treated equally and doing the right businesses. Through this board, there has been improved and secure trading of securities (Maudos and de Guevara 2015.). The Insurance and Occupational Pensions Authority has been on the frontline on fighting for better laws about the occupation. Different occupations have been recognised in member states. Also, there has been the application of standard procedures and rates when pensions are applied—the European Risk Systematic Board, which analyses risks in the markets and advice on the way forward. There has been excellent economic stability since risks are analysed, and internal controls are put in place to minimise the occurrence.

The Union is concerned with the industry and entrepreneurship among the members. There has been an emphasis on the need for industry development and also encouraging the growth of Small and Medium-sized Enterprises (SME). With the growth of digital industries across the members, there will be enhanced trade relationships. There have been programmes that have developed to aid in the establishment and functioning of the SMEs. Through SMEs, there has been increased economic growth and innovation. There have been policies which encourage the operation of small and medium-sized enterprises (Cini and Borragán 2019). With the right economic systems already put in place, many SMEs have been formed. There has been an immense improvement in innovation and also the digital economy. Many enterprises have been able to embrace the digital economy since its cost-effective.

The agricultural policy is critical in the European Union. This is evident by the passing of the Common Agricultural Policy (CAP). The policy focuses on the increasing food certainty to the members, increasing agricultural production and also improving the living standards of the farmers. The policy too focused on stabilising the farming markets and ensuring fair prices for both farmers and consumers. The policy also looks on ways of minimising on overproduction of agricultural products so that the supply does not exceed the demand. The policy allows subsidies and direct monetary aid to be offered to cut the cost experienced by the farmers (Richardson 2015). For example, farmers in less fertile areas are given financial assistance to support their cattle rearing compared to farmers from the productive areas in central Europe. Good packaging has seen many consumers be satisfied and happy for the example Finland people are delighted when they see food packaged in Finnish even if it was imported from other EU member countries.

There has been a policy on the infrastructure whereby the organisation is working on improving the inter-country transport system through the Trans-European Networks (TEN). There have been various projects to improve the infrastructure coverage in the Union they include, Brenner Base Tunnel and the Strait of Messina Bridge. There has been a notable improvement on the railway, roads, harbours and airports in the member countries. Also, the synchronising of the railway network by the European Railway Traffic Management System (ERTMS) has enhanced security and efficiency of railway services to the people (Dall’Erba and Fang 2017). With developments in the infrastructure across the countries, there has been ease of accessibility to different parts. Perishable agricultural products can be transported promptly to reach the consumers in time. Good infrastructure has enhanced the operation and movement of goods across the borders.

The policy on security has been emphasised by the members, which focuses on the internal matters of Europe. There is a standard enforcement agency called Europol, which allows police authorities among member states to cooperate and solve crimes affecting the region (Kaczorowska-Ireland 2016.). Europol focuses on international crimes like illegal immigration, drug trafficking and money laundering. The cooperation between law enforcement authorities like judges and prosecutors has led to improved justice delivery and also saves time. The presence of rapid forces to help when there are an emergency or terror attacks as helped in mitigating difficult situations among members. There is a possibility of formation of common security across the member countries of the 

Union.

An acceptable policy on labour force has been a good relationship between member states. With the development experienced in world trade, the economic recession, there has been an increase in the unemployment cases (El-Agraa 2011). The Unions seeks to keep jobs for its people and find more jobs to cushion the shortage. There is an excellent investment in the education system and research in forecasting any changes in the economy in the forcible future. The Union offers grants to education and research to make it easier to access education systems for better service delivery. During the economic recession, there are subsidies granted to building offering large scale jobs. With better terms on the labour policy, there is the easy availability of the services which has common laws across member countries.  

Impact of the European Union

The European Union has played a significant role in the development and growth of the world economy since it is the second contributor to the world economic income. The Union has brought about the economic development of the member countries. The member countries have had a significant improvement in the national per capita income and the national gross domestic product, which has enhanced development of other sectors in the country (Chalmers, Davies and Monti 2019). With no application of trade tariffs on goods and services, also the free movement of people, capital, goods and services, there has been an improvement in economic growth. Trade tariffs increase the cost of imported goods which, when used in production it increases the cost of production, making the price to go high. The EU has no tariffs on the goods; hence the cost of production will be cheaper.

There is the growth of small and medium-sized enterprises. The Union has a strategy that helps in the development of SMEs, especially in developing member countries. Growth of SMEs help in reducing unemployment and also plays an essential role in inflation (Wallace, Pollack, Roederer-Rynning and Young 2020). The Union gives subsidies and direct monetary aid to countries so that they can develop the SMEs system. The development of SMEs has had an increase in innovation and inventories in the economic world. Through SMEs, the tax base of the country is increased hand also it encourages competition from peer companies. Small and medium-sized enterprises adapt fast to the changing economic situations; hence they are suitable for financial cushioning during the recession. 

There is a reduction in financial market risk. The use of common currency by members has led to reduced risks in currency exchange fluctuations. The use of different currencies is associated with fluctuations in the exchange process. Business loses money since there is value difference and the exchange rates change from day to day (Cini and Borragán, 2019). The EU central bank is instrumental in tracing the interest rates applied by financial institutions. The use of similar interest rates across member countries has helped businesses to access financial loans in different countries. Availability of financial loans has helped in the expansion of other companies leading to economic growth in the country.

There has been enhanced unity among the member countries. The union advocates for co-existence and harmony among the member countries in the Union. The joint police cooperation among member states has helped in fighting injustice and crimes. This has reduced the rate of crimes and fostering unity (Maudos and de Guevara 2015). The Union states that there should be no conflict in the affiliate countries, making it clear on the importance of unity.  It has discouraged inequality by stopping rich nations like Germany and France in controlling the affairs of developing countries. Each country has a say in the matters concerning the Union and economic empowerment.

The Union has experienced various setbacks in its functioning. With free movement of goods services people and capital, countries have little power on either to agree or not (Braniff 2011). This has reduced the economic powers of the state in implementing the regulations that favour them. The rules set for members are hard to achieve; for example, Iceland could not join fishing trade due to the regulations set.

Another challenge is the restriction of members by regulations and laws stipulated in the Union. With such laws, the powers and responsibilities of affiliated members are limited. Countries are not able to fully utilise their economic capabilities. Also, the rules make it hard for members who want to exit voluntarily from the Union. For example, in 2016, after the United Kingdom referendum, they decided to leave the Union. Still, they had to sign an agreement for the successful exit, which will be effective from January 2021 (Leruth, Gänzle and Trondal 2019). Considering all the formalities and regulations set, it becomes tough for and time-consuming for a country to exit the organisation.

In conclusion, the European Union has played a vital role in the economic growth of the member countries and the world at large. There has been immense growth in the financial and banking sectors since the Euro is the second traded currency after the Dollar. The Union has enhanced unity among the affiliates and non-member countries (Dall’Erba and Fang 2017). The trade tariffs, which was not applied to goods, led to lower prices of goods encouraging consumption. The policies that were put in place by the Union like the agricultural policy led to sufficient production of food commodities. Through the Union there was market stability and also prices due to free movement. The European Union was able to achieve its set objectives.

 

                                       

 

                                       References 

Braniff, M., 2011. Integrating the Balkans: Conflict Resolution and the Impact of European Union Expansion. IB Tauris,

Chalmers, D., Davies, G. and Monti, G., 2019. European union law. Cambridge university press.

Cini, M. and Borragán, N.P.S., 2019. European union politics. Oxford University Press, USA.

Dall’Erba, S. and Fang, F., 2017. Meta-analysis of the impact of European Union Structural Funds on regional growth. Regional Studies51(6), pp.822-832.

El-Agraa, A.M., 2011. The European Union: economics and policies. Cambridge University Press.

Kaczorowska-Ireland, A., 2016. European union law. Routledge.

Leruth, B., Gänzle, S. and Trondal, J., 2019. Exploring Differentiated Disintegration in a PostBrexit European Union. JCMS: Journal of common market studies57(5), pp.1013-1030.

Maudos, J. and de Guevara, J.F., 2015. The economic impact of European financial integration: The importance of the banking union. The Spanish Review of Financial Economics13(1), pp.11-19.

Richardson, J., 2015. European Union: power and policy-making. Routledge.

Wallace, H., Pollack, M.A., Roederer-Rynning, C. and Young, A.R. eds., 2020. Policy-making in the European Union. Oxford University Press, USA.

Data Security in Health Care Organizations

 Scenario You are the Chief Executive Officer [CEO] of a health services organization. This organization has inpatient and outpatient facilities, home healthcare services, and other services that meet your patient population’s needs. It also has a world-renowned AIDS treatment center. The organization has always enjoyed an excellent reputation and its quality of care is known to be excellent. Unfortunately, your organization has recently been featured in every media vehicle known to man. The reason: Someone downloaded the names of 4,000 HIV+ patients seen in your HIV clinic and posted the list on the Internet. The Board of Trustees is furious and wants to fire you. You have been able to convince them that they need to keep you as CEO to fix this major crisis. You hire a computer security consultant who comes into your organization, disguised as a nurse manager. After three days, she comes to you with the following report. Nurses log in to the computer system with their passwords and then walk away, leaving the system open and running. • Dr. Jones leaves his password taped to his PC on a piece of paper. • Fax machines and printers are in open rooms without locks. • One password can access the entire database in the hospital including human resources. • There are no programs reminding staff to change their passwords on a regular basis. • She pretended to forget her password and other nurses gave her their password. • She requested sensitive patient files and staff provided her with the files without question Assignment Requirements Your paper should be clear, concise, and 4 double-spaced pages (excluding a title page and a reference page) in 12-font. Only the first 4 pages of your assignment will be graded, so it is important to be concise in your writing and remain on-topic. You do not need to provide an abstract or describe any of the details of the scenario provided above. You must address the following: • A brief assessment of the problems that your organization faces from a ‘big picture’ health care management point of view. This should be a high-level overview of the category/categories of problems that your organization currently faces. (1-page maximum) • An overview of key laws, regulations, and guidelines that are relevant to the scenario. Be sure to support your assessment with examples of why you believe each law, regulation, and/or guideline is relevant. (1-page maximum) • The identification of 2 similar situations that have occurred within the health care industry in recent years. A brief explanation of how the identified organizations handled the crisis and an assessment of whether this approach would work for your organization. (1-page maximum) • An explanation of how your organization could best handle this crisis. (1-page maximum) You are required to: • Utilize a minimum of four references. Resources used to support your findings should use a variety of information types including interviews, expert opinions, journal articles, and newspaper articles. • Provide a reference list in APA format. • Use in-text citations in APA format.

Answer

Data Security in Health Care Organizations

Key Management Issues at the Organization

In consideration of the scenario described, the organization is experiencing various management problems. Issues within the current complex healthcare system include regulatory changes, system inefficiencies, coding updates, security issues, and disruptive technology. Among these, issues related to technology are most common in the current technologically-led society. Medical and technology advancements and innovations have enabled radical service delivery advancements in health care settings. Nonetheless, while organizations experience growth, they are also experiencing a lot of issues because of technology. As the organization’s Chief Executive Officer, I find that though information technology helps solve various healthcare management issues, it also brings security to patient protection laws. Over the past few years, there have been increased cyber attacks on information technology systems in health care organizations, leading to data breaches of patients’ personal information and health records. According to Hayes (2015), data breaches experienced from 2009 to 2015, compromised 135 million patient health records, which led to an estimated cost of about $50.6 billion. 

The organization currently experiences technological issues from a data breach where someone downloaded the names of 4,000 HIV + patients from our hospitals’ HIV clinic and then uploaded it on the internet. Technology innovations allow health care providers to use cloud storage services to store medical files allowing quick and efficient access from any location. Other management issues within the organization are improper employee training about security and the need to protect customer information, contributing to data breaches. It is crucial to note that some health records are compromised due to malicious software and activities, but a large portion of it is due to the staff’s unintentional disclosures. Here, the staff, including doctors and nurses, give out their passwords without questioning the person’s intentions in the system.

Key Laws, Regulations, and Guidelines related to data breaches in Healthcare

Legally, the obligations for responding and managing data breaches involving healthcare-related data in the United States include laws such as the federal Health Insurance Portability and Accountability Act (HIPAA) and its Breach Notification Rule. Also, the Federal Trade Commission’s (FTC) Health Breach Notification Rule and applicable state law include the Personal Information Protection Act (PIPA). According to HIPAA laws, covered entities should ensure adequate storage, transfer, and management of patient health records (PHI) (Snells, 2017). It drives covered entities first to identify the breach’s source and notify individuals whose information has been affected or their data have been acquired, accessed, used, or disclosed. The FTC law applies to foreign and domestic healthcare organizations in the U.S., and it helps PHR related entities, vendors of personal records, and third-party service providers to manage and lawfully deal with data breaches. 

PIPA provides laws that guide how organizations should respond to data breaches. These laws only apply to data collectors and not to any health organization under HIPAA. Data collectors refer to companies that collect, manage, disseminate, and deal with personal information such as names, medical information, email addresses. It ensures that the collectors encrypt and protect individuals’ data, including that of patients. Lord (2020) provides guidelines and tips on how health care organizations can protect their patients’ information and reduce and prevent data breaches. Lord (2020) encourages health organizations to follow HIPAA laws and other regulations concerning data breaches, educate staff about IT-related security issues, restrict access to sensitive patients’ data, encrypt data systems, use off-site data backup servers and conduct regular risk assessments.

Data Breach Cases

As technology advances, health care organizations experience severe consequences of incorporating current and advanced technology. According to Davis (2019), in 2018 alone, 25 million patient health records were compromised in 503 breaches, three times more than experienced in 2017. In 2019, over 25 million patient records were breached. Healthcare organizations have experienced massive data breaches, which increases the risk of exposure to patients’ health and personal data in various facilities. For instance, in July 2018, an authorized third-party gained access to Navicent Health through an employee database and hosted email accounts leading to a breach of data of over 278,000 patients. The organization launched an investigation into the breach to determine how to improve security in the facility. It notified patients about the breach eight months later, which is against the HIPAA laws. HIPAA requires health providers to notify patients 60 days after the breach. This would not be a good approach to deal with a data breach, especially when it involves patients’ health records. 

Also, UConn Health centre experienced a data breach, potentially compromising the personal and health data of approximately 326,629 patients. Some employees became victims of phishing attacks, which led to the data breach. In February 2019, the company also discovered a hacker trying to access employee email, but it immediately secured the accounts. Assessing risks and securing accounts and computer systems greatly helped the company solve the crisis and prevent more data bleach events. The approaches would effectively work for our organization to reduce data breaches.

How to Handle Data Breaches

Data breaches are quite common in health care organizations as hackers try to gain access to hospitals’ mainframes and database systems holding patients’ information and health records. As we try to solve the organization’s crisis (Jelen, 2018), I would recommend we use specific strategies to manage the issue. First, I would recommend we assess the damage caused by the breach to the organization. This would help the management know how the attack happened and how to prevent it. Secondly, we should notify the individuals affected or whose data has been compromised. It is not only ethical but also follows the regulations in the HIPAA laws. We will notify the patients through phone calls, direct messages, and emails. Thirdly, we will conduct a security audit or assessment. Here, we will conduct a thorough assessment of the organization’s current computer systems, which will help prepare future recovery plans. We will then update our recovery based on the assessment results to solve the current data bleach and prepare for future cyberattacks. 

Fundamentally, the human resource department and the IT Department will organize training programs for nurses, doctors, and support staff members about data breaching and other security issues and concerns caused by technology currently. The human elements remain one of the largest security threats in all sectors, especially the health care sector (Lord, 2020). Human negligence and error can lead to expensive and disastrous outcomes for an organization. They will be taught the importance of keeping their passwords safe, not revealing them to other individuals, and shutting the systems down after closing them. The organization will develop a program to remind employees to change their passwords weekly or monthly. Fundamentally, security awareness training will provide employees with sufficient knowledge to make smart decisions and apply appropriate approaches and caution when managing patients’ data.

 

References

Davis, J. (2019, August 2). The ten most significant healthcare data breaches of 2019, so far

Hayes, T. (2015) Are Electronic Medical Records Worth the Costs of Implementation? American Action Forum. Retrieved from: https://www.americanactionforum.org/research/are-electronic-medical-records-worth-the-costs-of-implementation/

HealthITSecurity. https://healthitsecurity.com/news/the-10-biggest-healthcare-data-breaches-of-2019-so-far

Jelen, S. (2018, November 27). Top 5 ways to handle a data breach. The World’s Largest Repository of Historical DNS data. https://securitytrails.com/blog/top-5-ways-handle-data-breach

Lord, N. (2018, September 12). Healthcare cybersecurity: Tips for securing private health data. Digital Guardian. https://digitalguardian.com/blog/healthcare-cybersecurity-tips-securing-private-health-data

Snell, E. (2017, January 6). State data breach notification laws critical to healthcare Orgs. HealthITSecurity. https://healthitsecurity.com/features/state-data-breach-notification-laws-critical-to-healthcare-orgs