Writing a analytical essay
Topic Ideas For Research Paper
Thursday, August 27, 2020
Online Mba Programs Versus Traditional Bricks and Mortar
Online MBA Programs versus webpage hand Programs Andrew Cortez Ashford Managerial Marketing BUS 620 Sharif Muhammad October 23, 2011 Online MBA Programs versus website Programs With joblessness rates at a record-breaking high joined with the expanding costs related with conventional physical schools, online training is by a wide margin one of the quickest developing and flourishing businesses. As more youthful understudies are endeavoring to seek after conventional advanced education, they are understanding that the expenses are expanding every day, except the projects are longer in span and frequently not a superior instruction than the online line programs. The individuals who have lost their positions and need an edge over other jobless applicants are finding that a B. A degree alone is regularly insufficient and that in certainty a MBA degree could enormously improve their odds as being all the more speaking to businesses who have barely any employments to offer to a staggering number of candidates. The individuals who do have occupations are frequently worried about the steadiness of that activity and this gathering is likewise is additionally looking towards those higher degreeââ¬â¢s as to stay serious and feasible for their present employments or for future employments that may offer them greater dependability. This gathering commonly has high work requests and thus, they need to gauge their alternatives with regards to coming back to class to acquire that MBA. The quantity of school level separation learning classes offered online keeps on expanding as they offer more noteworthy planning adaptability to understudies, they advance to understudies who like to work freely, and permit universities to build enlistment without building new study halls (Werhner, 2010, p. 310). Seeing completely what your objectives are, just as what confines you may have will assist with deciding the correct heading for an understudy. The accompanying will incorporate a showcasing plan that will help with exhibiting the upsides of examining an online MBA program as a practical and favored option in contrast to an on location MBA Program. 1. Organization Overview: San Diego Higher Education (SDHE) is an on the web, revenue driven Company that centers around online training with the reason serving its understudies as a suitable technique for acquiring a MBA degree by means of electronic courses through an authorize college. With the SDHE online MBA program, you can have the right stuff and experience you have to build your odds for progress by taking on the most mind boggling influential positions. SDHE has been helping San Diego occupants in getting a MBA degree utilizing the online medium since 2007. The organization had at first focused on low pay as well as jobless people, yet it has extended its contributions with the aim to develop towards all sections. Past down to earth abilities, the program is additionally intended to cultivate thought authority, development, and corporate social duty on a global, multicultural scale; SDHE is headquartered in San Diego California. Key Leaders of the organization: Tanner C. Senior member CEO â⬠¢ Jeffery S. Anderson-CFO â⬠¢ Scott R. Howard-COO â⬠¢ Andrew Cortez-CMO Key Service Offerings: Online MBA programs with a specialization in Finance, Healthcare Marketing, Project Management, Human Resources, Information Technology, Global Management and Accounting. 2. Official Summary of Marketing Plan: As the economy has kept on declining and joblessness has kept on expanding, the requirement for moderate and open online instructive alternatives have expanded. The utilization of on-line instructional conveyance strategies by non-conventional grown-up students keeps on developing as mechanical and cultural changes have empowered and energized this development. The reason for this advertising plan is to audit late promoting systems as for how grown-ups learn and tie that procedure into a conversation dependent on a survey of the appropriateness of, fulfillment with, and inclination towards on-line guidance among grown-ups. A few territories for development are found and suggestions are given dependent on these audits (McGlone, 2011, p. 1-9). It is normal that our promoting endeavors need realignment as to turn out to be progressively applicable to a wide range of understudies. Where as our underlying promoting plan was restricted, the market has since totally opened up and we currently are in a position extend our contributions to bigger crowd. We will propose to re-mark and divert our SDHE as to interest an a lot more extensive segment section. A definitive objective is to persuade potential understudies that SDHE is a practical advanced education foundation that surpasses the contributions of our rivals while keeping up a lower cost for a MBA degree. Our specialty is that we are in truth a littler organization and can in this way offer a more redone program in which understudies don't feel as if they are only a wellspring of income for our organization; they will feel as if they are getting basic and open administrations that they won't get from the bigger establishments. 1. Depiction of Target Market: Demographic Segment: Male/Females between the ages of 22-45+ who have an understudy certificate, salary 35K-80K every year. Psychographic Segment: Looking towards people who originate from businesses that have been generally affected by economy, for example, land, banking, development. , retail, home improvement, pharmaceuticals, promoting, PDA, and car enterprises (Rampell, 2009). Geographic Segment: Target for this specific advertising plan ought to incorporate California, Nevada, Florida, Arizona, Idaho and Louisiana as these states have been hit hardest by the downturn (Kiser, 2010). Out of these states we have to take a gander at explicit socioeconomics of these states as to guarantee that they are in arrangement with our Demographic Segment, on the off chance that they might be killed. . Portrayal of Competitors: University of Phoenix: The University of Phoenix is authorize by The Higher Learning Commission and is an individual from the North Central Association-access to grounds based and online libraries; scholarly exhorting; coaching; mentoring; money related guide office-MBA (fixations include: Accounting, e-Business, Global Management, Health Care Management, Human Resource Management, Marketing, Technology Management); joint MS in Nursing with MBA in Health Care Management. Each University of Phoenix personnel must have a Masters or Doctorate qualification. No homeroom participation, the educational program is totally on the web. Strayer University: Strayer University is certify by the Middle States Commission on Higher Education-access to grounds based and online libraries; profession advancement help; scholarly exhorting; coaching; money related guide prompting MBA (accessible fixations: Acquisition, Human Resource Management, Management, Marketing, Supply Chain Management). Dough puncher on the web: Pastry specialist College is authorize by the Higher Learning Commission and is an individual from the North Central Association through Baker College-access to grounds based and online libraries; profession guiding and arrangement help; scholarly prompting MBA (accessible focuses: Accounting, Computer Information Systems, Finance, General Business, Health Care Management, Human Resource Management, Industrial Management, International Business, Leadership Studies, Marketing) Columbia Southern University: Separation Education Training Council (DETC) â⬠Online library with day in and day out bookkeeper administrations, scholarly and money related guide exhorting, and understudy administrations General fixation, discretionary focuses (E-Business and Technology, Finance, Health Management, Hospitality and Tourism, Human Resource Management, International Management, Marketing, Project Management, Public Administration, Sport Management). 3. 0 Description of Product or Services: SDHESââ¬â¢S MBA program refines the current aptitudes that the understudies as of now groups. Through our one of a kind multi month program understudies can finish the whole program and gain their MBA. The program will give a strong comprehension in every aspect of business, from the essentials to specializations in Finance, Healthcare Marketing, Project Management, Human Resources, Information Technology, Global Management and Accounting. The specializations will offer understudies the chance to develop their insight by concentrating on their particular regions of intrigue. The whole program is on the web and understudies are intended for the bustling calendars of its understudies. . Advertising Budget: This specific spending plan is for a year re-dispatch and re-marking of its present contributions as to extend our present client base. The sum required for this is $960K and the separate of costs is as per the following: â⬠¢ $120K-Website update to incorporate modern and current usefulness. â⬠¢ $600k-Media to incorporate web based life crusade (Banner promotions/emai l impacts/pamphlets) to relate with Billboard, TV and print include. â⬠¢ $120K-Marketing things to incorporate flyers, embeds, deals pamphlets and misc. ollateral as regarded per area. â⬠¢ $60K-PR to incorporate official statements, open appearances and so on â⬠¢ $60K-Outreach to nearby business, to incorporate work organizations. Effort will be a more grass attaches way to deal with explicit networks. 5. Depiction and Location: Online scholastics can open itself to an a lot bigger market section as the virtual homerooms are a lot bigger than a customary study hall. Since the MBA program would be totally online it is accessible to anybody with the innovation of a PC and network access. Web/site look are the key areas where potential understudies will at first search for our item; this is the reason such a large amount of the spending will be spent on web composition and usefulness. Appropriation channels, for example, face book and Google standards will be utilized. Road groups will be utilized at exchange fairs, shows and occupation fairs. We will likewise offer bigger companies motivating forces to post data on their interior sites publicizing instructive assets to their employeeââ¬â¢s. Shopping center Media will likewise be utilized to publicize; bigger provincial shopping centers can have u
Saturday, August 22, 2020
Sociolgical Imagination
Sociological Imagination Sociological Imagination can be characterized as the capacity to see a distinction in individuals because of their social conditions, how their ââ¬Å"social norms,â⬠impact their lives. Here and there these circumstances can prompt a result and it gives you an understanding with regards to why things happen the manner in which they do. You comprehend what makes drove that particular result. Fundamentally, you comprehend people groups lives since you can perceive how the result impacts their lives and the individuals around them.Having a comprehension of sociological creative mind helps in the field of humanism since it alps you have an alternate point of view on people groups lives. I began dating a person toward the start of my senior year of secondary school. Not long after, we become indivisible. It didn't take extremely yearn for me to think I was infatuated. At the point when I sensed that it was the ideal time, we chose to engage in sexual relatio ns. I never imagined that I would get pregnant the first run through on the grounds that we were sheltered, and I was on anti-conception medication. Luckily, I didn't. As the months went on we would chance not utilizing insurance and I was still not getting pregnant.Stupidly, I thought well perhaps I Just can not get pregnant since it has not transpired at this point. After about a time of dating, I missed my contraception for seven days. Around two months after that I become extremely ill and can not hold any food down. My grandma takes me to the specialist and I will always remember that second when the specialist returned and said the words I figured I could never hear. I was pregnant. My sister had gotten pregnant while she was still in secondary school, so my mom truly relied upon me to be the girl that completed school and afterward began my very own existence. She was so baffled in me.But the remainder of my family seen it as typical that I had gotten pregnant at 18. A large number of my cousins began a family as opposed to setting off for college. 9 out of 11 of my cousins were high schooler guardians. Alongside the more youthful age, my grandparents, aunties, and uncles likewise began their families early. While I didn't intentionally attempt to begin a family at my age, my family didn't consider it to be an awful thing. My beau ventured up in this circumstance and chose right off the bat that he was not going to resemble each other youthful father and run off. He has changed all aspects of his life to give our child the best life quite a while prior getting hitched at an extremely youthful age was socially adequate, presently it is ethically off-base in numerous ultras. Since young ladies were hitched at a youthful age, teenager pregnancy was acknowledged, too. In this age high schooler pregnancy is still Just as basic as it was at that point, yet without the young ladies being hitched or even seeing someone. ââ¬Å"1 . 3 out of 10 adolescent America n young ladies will get pregnant in any event once before back 20. That is almost 750,000 high schooler pregnancies consistently. 3. Under 2 percent of youngster mothers acquire a higher education by age 30. 5. The United States has one of the most noteworthy youngster pregnancy rates in the western industrialized world. 10.Almost 50% of youngsters have never thought about how pregnancy would influence their lives. (The National Campaign to Prevent Teen and Unplanned Pregnancy) Due to youngster pregnancy rates being so high, Americans need to figure out how to acknowledge and adjust to this being another custom. ââ¬Å"Based on a youngster study his association led in 2009, a greater part (eighty-seven percent) of adolescents who watched the MAT show 16 and Pregnant detailed that they felt the show exhibited to them the genuine hardships that high school pregnancy can bring to the two young ladies and young men. Interestingly, not many (seventeen percent) felt the show really celebr ated high schooler pregnancy. (Silvers) These demonstrates help to show the battles that all he little youngsters featuring in them face. By putting their accounts out there they are assisting with lessening high schooler pregnancy rates. Despite the fact that there are shows to help attempt to lessen youngster pregnancy, there are additionally films and shows that make being explicitly dynamic teenagers look ââ¬Å"cool,â⬠or ââ¬Å"popular. â⬠Many motion pictures show the virgin being ridiculed for not being explicitly dynamic. Making sex look fun or cool outcomes in adolescents having intercourse, which may prompt high schooler pregnancy. The social standard for youngsters is to graduate secondary school, head off to college, get a vocation, and start their very own existence.
Friday, August 21, 2020
An Alabama Payday Loan Company Employee Accused of Identity Theft - OppLoans
An Alabama Payday Loan Company Employee Accused of Identity Theft - OppLoans An Alabama Payday Loan Company Employee Accused of Identity Theft An Alabama Payday Loan Company Employee Accused of Identity TheftInside Subprime: Oct 29, 2018By Grace AustinAn Alabama payday loan company employee is being accused of identity theft and forgery, among other charges, after stealing customersâ information.Always Money employee Dominque Banks, 33, was booked at the county jail in late October. Police say there have been at least three victims of her crimes, and they believe there might be a fourth, according to a Huntsville, Alabama-based TV station.Police say Banks stole old customer data to pay off loans and write new ones, pocketing the cash. That included forging signatures on the loan applications. Police say she stole just under $3,000 from customers.Officials say they were tipped off because payments stopped on the loans.Always Money told WHNT in Huntsville that an internal investigation led to the police investigation and subsequent charges. The payday loan firm claims they spoke to the victims and contacted police right awa y about Banksâ potential fraud.Since payday loan providers donât require a lot of information for their applications, itâs easier for thieves to steal customerâs identity. And payday loan firms have found a comfortable home in Huntsville, where Banksâ fraud took place. The city was home to 747 licensed payday lenders in 2016.In addition to Alabama, payday loans are also legal in the region including in South Carolina, due to loopholes in the laws, and Mississippi, which is the poorest state in the country.Visit OppLoans on YouTube | Facebook | Twitter | LinkedIn
Monday, May 25, 2020
How to Make Polite Requests in Spanish
Telling someone what to do can sound rude or impolite. So in Spanish, just as in English, there are a variety of ways of asking people to do something or of making what might be called mellow commands. For example, in English, instead of telling someone, give me a cup of coffee, it would be far more polite to say something like I would like a cup of coffee. Add a please to that with a friendly tone of voice, and nobody will be able to call you rude! Following are some of the most common ways of making polite requests, the equivalent of something such as I would like, in Spanish. Any of these ways will likely be understood wherever you go in the Spanish-speaking world, although usage varies with region. Querer (I Would Like) Although it may seem grammatically illogical, the imperfect subjunctive form of querer (usually translated in this context as I would like), quisiera, is a common colloquial way of stating wishes and making polite requests. The normal sequence of tenses applies, so when quisiera is followed by a conjugated verb, the following verb must be in an imperfect subjunctive form. Other forms of querer including the present and conditional tenses also can be used in either statement or question form. Quisiera unas manzanas. (I would like some apples.)Quisiera comer ahora. (I would like to eat now.)Quisiera que salieras. (I would like you to leave.)Quiero dos manzanas. (I want two apples.)Quiero comer ahora. (I want to eat now.)Quiero que salgas. (I want you to leave.)à ¿Quieres darme dos manzanas? (Do you want to give me two apples?)à ¿Querrà as darme dos manzanas? (Would you like to give me two apples?) Gustarà a in the Conditional Form The verb gustar (which can be translated as to be pleasing) can similarly be used in the conditional form, gustarà a, to make gently worded requests. Me gustarà a que estudiaras. (I would like you to study.)Me gustarà a que ambos observasen el comportamiento de su hijo. (I would like both of you to observe the behavior of your son.)Me gustarà an dos manzanas. (I would like two apples.)à ¿Te gustarà a darme dos manzanas? (Would you like to give me two apples?) Note how in the first two examples the second verb (the one after gustarà a) is translated as an infinitive in English. Poder (To Be Able) This verb meaning to be able or the auxiliary verb can can be used as a question in the conditional or imperfect indicative tense. à ¿Podrà as darme dos manzanas? (Could you give me two apples?) A Ver Si as a Gentle Request The phrase a ver si, sometimes misspelled as haber si, which is identical in pronunciation, can be used to form the gentlest of requests. Although it is close in meaning to the English lets see if, it can be translated in a variety of ways. A ver si estudias mà ¡s. (Perhaps you could study more.)A ver si comamos juntos un dà a. (Lets eat together some day.)A ver si tocas el piano. (Lets see if you can play the piano.) Saying Please The most common ways of saying please are the adverbial phrase por favor and the verb phrase hà ¡game el favor de (literally, do me the favor of). Although you are unlikely to be criticized for overusing por favor, its usage does vary with region. In some areas, its use is expected, while in others it might not commonly be used when asking someone to do something that he or she is expected to do, as when ordering a meal from a restaurant server. And remember, ââ¬â¹too, that tone of voice can have as much to do with how a request is received as its grammatical form can. Por favor usually is placed after a request, although it can also come before: Otra taza de tà ©, por favor. (Another cup of tea, please.)Quisiera un mapa, por favor. (I would like a map, please.)Por favor, no dejes escribirme. (Please, dont quit writing to me.)
Thursday, May 14, 2020
Critical Analysis of Wilfred Owenââ¬â¢s ââ¬ÅDulce Et Decorum Estââ¬Â...
Critical Analysis of Wilfred Owenââ¬â¢s ââ¬Å"Dulce et Decorum Estâ⬠Wilfred Owenââ¬â¢s poem ââ¬Å"Dulce et Decorum Estâ⬠, is a powerful poem with graphical lifelike images on the reality of war. It is blatantly apparent that the author was a soldier who experienced some of the most gruesome images of war. His choice of words, diction, tone, syntax, and metaphorââ¬â¢s paint a vivid picture in a brilliant poem. His choice for the poemââ¬â¢s name is ironical in itself. The entire phrase is ââ¬Å"Dulce et Decorum Est Pro patria moriâ⬠, which basically translates to ââ¬Å"It is sweet and fitting to die for oneââ¬â¢s countryâ⬠. This was a common theme told to young soldiers during the First World War. The phrase itself came from a Roman poet named Horace. The argumentative claimâ⬠¦show more contentâ⬠¦Wilfred Owen utilizes informal diction within this poem, his choice of words and jargon is keenly apparent with readers of military knowl edge and experience. His use of syntax and tone distinctly put the reader in the middle of crisis: Gas! GAS! Quick, boys! ââ¬â As ecstasy of fumbling, Fitting the clumsy helmets just in time, (Meyer 886) These few lines completely change the feeling of following battle weary soldiers marching to the rear, to complete chaos of the moment. The reader can feel the adrenaline rush through them as they picture young soldiers donning their chemical warfare gear while under attack. This gives the readers the impression of panic and urgency, even though they were exhausted. Equipping their gear ââ¬Å"clumsyâ⬠distinguishes that the soldiers cannot put their gear on quick enough, helps to portray the urgency of the moment. Wilfred Owen leaves nothing to the imagination of the reader. He clearly explains that war is not ââ¬Å"sweetâ⬠and shows the graphic nature instead by painting a gruesome display of death. He explicitly demonstrates through vivid images and carefully chosen words to articulate the horrors of war: And watch the white eyes writhing in his face, His hanging face, like a devilââ¬â¢s sick of sin, If you could hear, at every jolt, the blood Come gargling from the froth-corrupted lungs (Meyer 887) The reader receives a distinct mental image of one of the soldiers dying a slow and painful horrible death. These wordsShow MoreRelatedWilfred Owen : The Greatest English Poet During The First World War Poem Summary1358 Words à |à 6 PagesDulce Et Decorum Est Wilfred Owen Wilfred Owen is recognized as the greatest English poet during the First World War. Wilfred Owen notable poems contains the lives and historical records. He wrote out of his intense personal experience as a soldier and wrote with unrivalled power of the physical, moral and psychological trauma of the First World War. From the early age of nineteen, Wilfred Owen wanted to become a poet and immersed himself in poetry, being specially impressed by KeatsRead MoreAnalysis Of Wilfred Owen s Poem Dulce Et Decorum Est1692 Words à |à 7 Pagesweekââ¬â¢s poetry type, American slam and we are now studying Protest and Resistance poetry. The protest poem ââ¬ËDulce et Decorum Estââ¬â¢, written by Wilfred Owen, challenges the dominant World War One ideologies of militarism and nationalism. You will find that this poem is a great example as it defies the dominant values and beliefs of war in Britain. Wilfred Owen Letââ¬â¢s discuss the poet. Wilfred Owen was one of the leading voices of the first world war. In January 1917, Owen was deployed but he was innocent
Wednesday, May 6, 2020
Sexism in Susan Glaspells A Jury of Her Peers Essay
In Susan Glaspellââ¬â¢s ââ¬Å"A Jury of Her Peers,â⬠Minnie Foster is accused of killing her husband. This accusation forces Mrs. Peters to choose between the law and her inner feelings. Her husband is the sheriff of Dickenson County, Iowa. It has always been a small, quiet town where nothing really happens. Mrs. Peters is faced with an internal struggle. On one side, she is married to the law and on the other side she understands what Minnie has been through. Her husband used to mentally abuse her to the point where she is now basically secluded from everyone and everything in the world. Mr. Hale even makes the comment, ââ¬Å"Though I said at the same time that I didnââ¬â¢t know as what his wife wanted made much difference to Johnâ⬠(260). Theâ⬠¦show more contentâ⬠¦The worst part of it all is that she had a little pet bird that she treated like her own child and John Wright has killed by wringing its neck. She has nothing to love or care for and defi nitely has no one to love and care for her in the way she so desperately needs. When John Wright kills her only friend that brings her happiness, her little bird, she has to kill him. Minnie always had friends and loved life until this man kept her away from it. Minnie has every right in the world to kill her husband. Glaspell also gives the impression that all men are jerks. For example, the men constantly make fun of the women and put them down for everything they do or do not do. In the beginning of the story the men complained of ââ¬Å"dirty towelsâ⬠when Minnie is in jail and has not even been home to clean up (264). Even though many men may be like that, not all men are. These types of men are the ones who give the rest of the gender a bad name. Glaspell was not at fault by making some men look bad, but she could have put at least one man in the story who was kind and understanding. In the story, she makes every man look like a jerk. By doing that, Glaspell basically says that is how all men are and that they cannot and will not be sensitive or be able to understand women in any way, shape or form. She is wrong. She does not give men enough credit. There are plenty of men who are sensitive and Glaspell refuses to show that side of the male gender. Mrs.Show MoreRelatedSusan Glaspell s A Jury Of Her Peers1408 Words à |à 6 PagesGrowing up in Iowa in the 1800s and 1900s, Susan Glaspell took inspiration for many of her stories from personal experiences. As a former courthouse reporter herself, Glaspellââ¬â¢s short story ââ¬Å"A Jury of Her Peersâ⬠is based largely on her involvement with a murder case and a kitchen she recalled investigating. ââ¬Å"A Jury of Her Peers,â⬠a rendition of her early play, Trifles, focuses on the homicide of an abusive husband by his wife. While the men investigating the case overlook the various signs of abuseRead MoreSusan Glaspell s Jury Of Her Peers1841 Words à |à 8 PagesName: ZaZa Horton Professor: Leblanc Course: Anicent Woman in Greece 20 April 2015 Susan Glaspellââ¬â¢s ââ¬Å"Jury of Her Peersâ⬠ââ¬Å"Jury of Her Peersâ⬠is a short story that revolves around the strange death of john wright. It is a piece of work that exposes sexism on women. Women have been categorized for some time now based on their gender and not on ability and skills. They have always fell at the short end of the stick when compare against men. Nevertheless, there were many similarities as well as
Tuesday, May 5, 2020
Professional Nursing for IMG Orientation Program -MyAssignmenthelp
Question: Discuss about theProfessional Nursing for IMG Orientation Program. Answer: I had attended the program called the Centralised IMG Orientation Program - Hitting the Ground Running. This program was conducted for about two days. The first day had two important sessions. The first session was based on the orientation to the Australian Healthcare system. Some of the main components are structure and funding, Medicare Australia, department of veterans affairs as well as many others. The second section mainly composed of the different legal frameworks present in the healthcare sectors of Australia and the different legal obligations that are present in the different domains of healthcare. Responsibilities regarding child care and adolescent autonomy, maintenance of confidentially were discussed in details to nursing students ("HITTING THE GROUND RUNNING (HTGR) CENTRALISED IMG ORIENTATION PROGRAM 2"). The day two mainly comprised of providing live examples as well as detailed discussion on the topics of communication and maintenance of cultural safety. Respect and competence were also explained to be important part of the nursing practice. These came under section 3. The section 4 mainly comprised of nursing practice in relation to Indigenous Australians giving them detailed insights about their culture and their health requirements. HITTING THE GROUND RUNNING (HTGR) CENTRALISED IMG ORIENTATION PROGRAM 2 Day Program had helped me recollect the entire important moral and ethical virtues that a nurse need to follow in my nursing practice within only two days programs. It was a two day program but I got the scope to develop a large amount of knowledge that I can apply in my regular practice which will enhance my reputation as well as my confidence as a skilled caregiver. The communication program helped me develop my listening and feedback giving skills as I always found me poor in these domains in my regular student life and also in my internship sessions. Moreover the program gave us much new information about how to enhance cultural safety. I used to be a culturally bias human being but this program showed me how I could overcome my biasness. Therefore it was really helpful for me. Huge amount of information about aboriginal health and their likes and dislikes also helped me to be prepared when I will attend su ch patients during my employment years. Fat embolism syndrome is a disorder that often occurs in a patient who has experienced fracture. In this type of disorder, it is usually seen that embolic fat micro globules enter into different small blood vessels of the lungs as well as other sites. This results in the occurrence of endothelial damage and causes different types of respiratory failures. These may be acute respiratory distress syndrome called the ARDS or may be cerebral dysfunction or might cause a petechail rash. It becomes difficult to diagnose and therefore the nurses have to be very careful in handling such issues if this arise (Blokhuish, Pape Frolke, 2017). The patient who is present in the healthcare setting has also undergone such symptoms after a shaft and femur fracture. Aetiology of the disorder mainly involves closed fractures which produce more emboli than open fractures. Long bones, pelvis and ribs cause more emboli. Intramedullary nailing of long bones, knee as well as hip replacements also results in embolism due to severe trauma. Therefore, after the nurse diagnoses that the chest pain in the patient is due to the fat embolism syndrome due to the traumatic injury of fracture in thighbone, she must immediately take necessary steps. The main management of Fat embolism syndrome is supportive. The nurse should primarily ensure that she is helping the patients to initiate good arterial oxygenation. The main rationale behind the initiation of arterial oxygenation is that high flow rate of oxygen helps in the maintenance of the arterial oxygen tension in the normal range. The second step that the nurse should initiate is the control as well as the restriction of the fluid intake as well as the use of diuretics (Sengupta et al., 2016). These will in turn help in the minimization of fluid accumulation in the lungs. This should be continued as long as circulation is maintained. The third intervention that the nurse should monitor is the maintenance of intravascular volume. This is important because it can result in the exacerbation of the lung injury that is mainly caused by the disorder. The fourth intervention that the nurse should consider is the recommendation of the use of albumen for volume resuscitation. This wou ld be in addition to the balanced electrolyte solution maintenance in the patient. The main rationale behind this intervention is that it would not only restore the volume of blood but at the same time would help in the binding of the fatty acids (Ahmazdai et al., 2014). This will in turn decrease the extent to which the lung has been injured. The nurse should maintain hemodynamic stability, proper administration of blood products, proper hydration and others. Moreover the nurse should also take necessary steps for prophylaxis of stress related gastrointestinal bleeding as well as deep venous thrombosis. The nurse should also know that mechanical ventilation as well as positive end-expiratory pressure (PEEP) are significant in the maintenance of arterial oxygenation. Often drugs were frequently used by nurses like ethanol to reduce the function of lipolysis, use of dextrose for reduction of fatty acid mobilization and heparin anticoagulation. However recently, drugs are rarely used as the benefits have not yet been proven. All these are preventive in nature. Corticosteroids also reduce the risk of mobilization of fats by 78% but evidences are not strong (Hammer et al., 2015). Often certain situations arise in a practice setting where a nurse needs to attend more than one patient at a time. At such a situation, it becomes extremely important for the nurse to prioritize the tasks according to the threat level of the patients (Kashyap et al., 2013). This requires the nurse in critical analyzing skills as well as expertise and experiences to handle such crucial moments with skill and rapidity (Levy, 2015). While analyzing the patients, the nurse should immediately develop the idea that who was the most vulnerable person within the next few minutes. After critically analyzing the situation, it was found that the patient with asthma is most vulnerable. This is because he was experiencing tightness of muscles mainly due to the response of the cholinergic receptors. This mainly results from limiting of exchange of gases over the lungs (Gullach et al., 2015). As a result blood cannot carry any oxygen to different parts of the body leading to death of the patient. Hence, the nurse should first try to attend this patient and stabilize the condition by proper intervention. The next patient that the nurse should attend is the patient of another nurse who is suffering from acute pain. Often there are many instances of heart attack, stroke and many other threats and disorders that may result from acute pain. As the patients is not getting any relief from any sort of other narcotic analgesics, endone is provided to the patient for getting relief from acute to moderate healthcare (Athanasou, 2016). The nurse has to maintain the principle where she has to provide such a care to a patient who relieves them from pain and provide a better quality life (Charles et al., 2015). Hence to avoid any other side effects, this patient is attended second. The third patent who needs to be attended is the patient who was having IV infusion therapy. The alarm had just started ringing signifying that the electrolyte balance is gradually come to an end. This states that there has been a small amount of time which the nurse could have taken to attend to more severe cases. After attending both the cases, she should immediately refill the IV infusion pump so that before the homeostatic balance as well as the electrolyte balance is maintained (Jones Vaidya, 2014). This needs to be attended before the electrolyte balance falls (Zhou et al., 2014). Although the time required for the balance to be lost from the body is above an hour and hence the nurse could easily attend the other two sever cases. The next patient that should be attend is the patient who had stroke two weeks back and is at high risk of fall due to his left hemoplegia. He has the urgency to attend the ensuite for bowel purposes. Although, it an extremely important physiological process that he needs to conduct, he is not at least at a life threatening process that may claim his life (RFurness Callaghan, 2015). Hence, although it may create huge unpleasure moments, but it can be handled and managed if attained in the fourth position after attending more severe patients. The next patient that the nurse should attend is the patient whose blood glucose level is to be assessed. It is a very important task and the breakfast would be provided within 10 minutes. However in need to attend severe cases, his breakfast can be delayed by 10 more minutes within which the blood glucose assessment would be done after attending the other patients (Chamberlain et al., 2016). Hence, this patients is least vulnerable to harmful risks and therefore can be attended in the last. The colleague who was performing the dressing of the wound was initially following the correct procedure. Melolin is a low adherent absorbent dressing material that is mainly used for the management of different types of light to moderately exuding wound. These mainly involve clean sutured wounds, minor burns, abrasions as well as lacerations. In the case study, it was also seen that the wound of the patient had almost dried up and only a small part was moist. Therefore application of melolin was exactly a right decision for the patient. As it was wound this was almost dry and very lightly-exudating, melolin would have been brought the best effect to the wound. The nurse in this selection of intervention initial seemed to be properly educated and had good skill and knowledge. However the situation turned towards a negative side, when her activity revealed a negative aspect about her sense of maintenance of hygiene. The professional codes of conduct instruct a nurse and midwife to fol low safe practices that will assure the best health to the patients. Moreover, the theory of beneficence for the nurses always state that the nurse should offer practices that will be the best intervention to the patient making the patient come back to normal lives. Another nursing theory that every nurses should follow is the practice of non-maleficence. This theory usually guides the nurse to conduct her practices in a way that prevents any short of negative influences on the patients. In other words, it means that the nurses should never take any steps that would harm the patients (Dougerty Listener. 2015). However, none of the theories were applied by the nurse and she also did not follow the professional codes of conduct. The standard one of the professional codes of conduct states that every nurse should practice in a safe as well as in a competent manner. The standard two of the codes states that the nurses activity should remain in accordance with each and every standard of their nursing profession as well as of the broader healthcare system where they are employed. Both the standards assure that a nurse should develop skills and knowledge which will help them to be responsibly treats the patients in ways which are not only competent but also assures safety of the patient. In the present scenario, the nurse did not follow proper hygienic procedures that ensure safe practice. It was seen that although the dressing material fell on the bed, she did not dispose it (El- Soussi Asfour, 2017). Instead she applied it to the wound, stating that the part would be applied to the dried part. She applied the rationale that as that part of the wound had become dried, it would never create any sort of infection. However, she completely lacked education about proper hygiene that should have been maintained by tem to avoid any sort of hospital acquired infection. Such infections result in increasing the chances of burden of diseases on the patient making his stay lo nger at the hospitals. Out of the two types of wounds like the traumatic wounds and the surgical wounds, surgical wounds are those acute wounds which need to be closed with sutures, adhesives as well as staples. For patient in the case study had wounds from where suture was removed and therefore need to be dressed properly with melolin dressing which is a low adherent dressing material. he main standard principles that she needs to educate about to practice best practices regarding the wound management is that she should maintain proper hospital environment hygiene, hand hygiene, safe use of sharp objects and their proper disposal, proper hygiene maintenance with equipments of wound care, use of personal protective equipment as well as maintenance of set of principles for asespsis (Lewis et al., 2015). With assigning proper strategies for light, moderate or heavily exudating wounds, the nurse can assure fast recovery. However, the nurse in this case has not maintained the hygiene principles by picking up t he dressing form the bed of the patients which might contain microorganisms harmful for his wounds. The causality that the nurse showed in her profession by stating that infected melolin of applied t the dried area stating that it would be safe was totally unethical and harmful for the health of the patient. as a nurse she is assigned with the duty of providing the best care to patients ad her profession does not allow this type of risk taking attitudes. This is totally immoral and the nurse who was asked for help should enlighten the other nurse making her realize the correct procedure and principles of wound management. The other nurse would advice her to follow te professional codes f conduct, and evidence based searches to develop her practices in wound management. She should never compromise with the health of the patient and must be very careful while handling such risky situations of wound management with proper principles and guidelines. Researchers have even stated that the part of the dressings which is cut and kept inside the sterile wrapper may get colonized by bacteria and hence this practice becomes unsuitable for later use (Kashyap et al., 2013). Similarly, the dressing which is not directly applied after opening and has fallen on somewhere may get colonized by bacteria. Application of such dressing is harmful and may affect quality life. References: "HITTING THE GROUND RUNNING (HTGR) CENTRALISED IMG ORIENTATION PROGRAM 2".Pmcv.Com.Au, 2017, https://www.pmcv.com.au/computer-matching-service/resources/1016-htgr-program-sessions/file. Ahmadzai, H., Campbell, S., Archis, C., Clark, W. A. (2014). Fat embolism syndrome following percutaneous vertebroplasty: a case report.The Spine Journal,14(4), e1-e5. Athanasou, J. A. (2016). Chronic Pain. InEncountering Personal Injury(pp. 69-78). SensePublishers. Blokhuis, T. J., Pape, H. C., Frlke, J. P. (2017). Timing of definitive fixation of major long bone fractures: Can fat embolism syndrome be prevented?.Injury. Chamberlain, J. J., Rhinehart, A. S., Shaefer, C. F., Neuman, A. (2016). Diagnosis and Management of Diabetes: Synopsis of the 2016 American Diabetes Association Standards of Medical Care in DiabetesSynopsis of the 2016 ADA Standards of Medical Care in Diabetes.Annals of internal medicine,164(8), 542-552. Charles, B., Hardy, J., Anderson, H., Tapuni, A., George, R., Norris, R. (2014). Should the dosage of controlled-release oxycodone in advanced cancer be modified on the basis of patient characteristics?.Supportive Care in Cancer,22(2), 325-330. Dougherty, L., Lister, S. (2015).The Royal Marsden manual of clinical nursing procedures. John Wiley Sons. El-Soussi, A. H., Asfour, H. I. (2017). A return to the basics; nurses practices and knowledge about interventional patient hygiene in critical care units.Intensive and Critical Care Nursing,40, 11-17. Furness, J. B., Callaghan, B. (2015). Output Report: Bowel Project, Animal proof of principle. Gullach, A. J., Risgaard, B., Lynge, T. H., Jabbari, R., Glinge, C., Hauns, S., ... Tfelt-Hansen, J. (2015). Sudden death in young persons with uncontrolled asthma-a nationwide cohort study in Denmark.BMC pulmonary medicine,15(1), 35. Hammer, S., Kroft, L. J., Hidalgo, A. L., Leta, R., de Roos, A. (2015). Chest CT examinations in patients presenting with acute chest pain: a pictorial review.Insights into imaging,6(6), 719-728. Jones, A. G., Vaidya, B. (2014). Preoperative Endocrine Function and Fluid Electrolyte Balance. Inpituitary apoplexy(pp. 95-105). Springer Berlin Heidelberg. Kashyap, S. R., Bhatt, D. L., Wolski, K., Watanabe, R. M., Abdul-Ghani, M., Abood, B., ... Kirwan, J. P. (2013). Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes.Diabetes care,36(8), 2175-2182. Levy, M. L. (2015). The national review of asthma deaths: what did we learn and what needs to change?.Breathe,11(1), 14. Lewis, S. L., Maltas, J., Dirksen, S. R., Bucher, L. (2015).Study guide for medical-surgical nursing: Assessment and management of clinical problems. Elsevier Health Sciences. Sengupta, R., Veljanovski, J., Sudasena, D., Michaels, A., Jain, T., Rahman, M., DiGiovine, B. (2016). The Devastating Pulmonary Complications Of Sickle Cell Disease: Fat Emboli Associated Acute Chest Syndrome Mimicking Massive Pulmonary Embolism. InB54. CASE REPORTS IN THE PULMONARY CIRCULATION(pp. A3942-A3942). American Thoracic Society. Zhou, F., Peng, Z. Y., Bishop, J. V., Cove, M. E., Singbartl, K., Kellum, J. A. (2014). Effects of fluid resuscitation with 0.9% saline versus a balanced electrolyte solution on acute kidney injury in a rat model of sepsis.Critical care medicine,42(4), e270.
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