Plastic Surgery Essay Example for Free

Plastic Surgery Essay Research Paper Outline Plastic Surgery Section Specialties Recruiting and Retention Fund November 6, 2012 Attn: Mr. Eric J. Harris, Q.C. From: Stan Valnicek, MD, Section Head – Plastic Surgery Dear Mr. Harris Thank you for taking the time to review our submission for the SRRF. We have tried to organize it into logical sections representing the issues that we face as a Section. Our argument is based on data from the following sources: 1. Canadian Institute for Health Information http://www.cihi.ca 2. Medical Services Plan (MSP) BC Payment Information 2010/11 report (Latest) 3. Survey of our section membership – October 2012 (83% response rate) i I have included the raw data in the appendix to this submission. We have tried to use the latest available data sets from sources independent to our section in order be fair and accurate in our claims. I am happy to provide all additional documentation and supporting evidence for items in this submission as required. The goal of this submission is to protect the provision of public hospital based plastic surgery services in the province of BC. Recent media attention in the Vancouver Sun has brought light to the long waits our patients face in the public system: http://www.vancouversun.com/health/Operation+Delayed/7494235/story.html Part of the public issue relates to limited hospital resources in the BC public health care system. Barriers to recruitment are primarily driven by availability of OR time and the willingness of Health Authorities to provide the necessary resources for new surgeons. Low remuneration does affect recruitment in areas of the province that are chronically unde rserviced since competitive rural opportunities exist across Canada even when major urban areas are well staffed. Our main issue as a section is retention of surgeons within the public system and this is primarily driven by significant intra and inter-provincial income discrepancies that put us near the bottom of all surgical specialties. Research Paper Outline 0. Definition of Plastic Surgery Plastic surgery is a misunderstood specialty and it is surprising to us how pervasive the misconceptions are among not just the public but also our colleagues in the medical profession. Media portrayals of cosmetic surgery have led to unfortunate distortions and harmful attitudes, which over the years have had significant negative impact on our profession and particularly on remuneration for public work. Plastic surgery as a specialty grew out of the need to address the management of complex wound healing issues in patients with severe burns, spinal cord injuries, major trauma or defects caused by the extirpation of cancers. This is still the core of our profession today. One hundred years ago skin grafting did not exist and even moderate burns were fatal or led to severe contractures and lifelong disability. Patients who had breasts or parts of their face removed spent their remaining lives disfigured and often shunned. Spinal cord injured patients lived with massive bedsores severely restricting their mobility and independence. Children born with congenital anomalies such as facial clefts were ostracized or worse. Those of us who carry out missions to the third world see the effects on patients and families in regions where plastic surgical care is not readily available. Plastic surgeons have also been pioneers in tissue transplantation, wound healing, nerve regeneration and tissue engineering. Rebuilding form and function has led to the development of entirely new areas such as hand and wrist surgery, facial trauma surgery, craniofacial surgery, microsurgery and skin cancer management. In the province of BC our plastic surgery section provides the majority of care in the following areas: Disease and injury to hand and wrist Disease and injury to the face Burns Congenital defects of the upper extremity or face Reconstruction for defects from cancer ablation Pressure sores in spinal cord injured or systemically ill patients Complex wounds Severe infections including necrotizing fasciitis Primary cancers of skin and soft tissue Microsurgical reattachment of amputated limbs or body parts (scalp, ear etc.) Microsurgical transplantation of tissue Gender reassignment surgery We are also the 3rd or 4th busiest surgical service (out of 10) in terms of emergency surgery due to our coverage of the majority of hand, wrist and facial injuries. ii Research Paper Outline I. Recruitment and Retention A: Demographics iii Prior to presenting our data, I would like to clarify some of the underlying demographic variables. We presently recognize a total of 81 BC plastic surgeons (defined as those with Canadian certification through the RCPS(C) or international equivalent) within our Section in BC. Some of these are part-time, semi-retired or in primarily private practice. These serve an estimated 2012 BC population of 4.5 million (Statscan 1). In order to determine â€Å"full time† practitioners, the Medical Services Commission (MSC) defines a cut off for low billings. This changes yearly and is currently set at $82,100 annual MSP billings or less. With this metric our numbers drop to 52 active surgeons for the last year data was available (2010/11)2. Government (MSP) plastic surgery census data differs slightly as they include anyone who â€Å"bills† primarily out of our section of the fee schedule as a â€Å"Plastic Surgeon†. There are about 3-5 of these physicians and may include Orthopedic surgeons with a primary hand surgery practice or temporary locums. For the purposes of this submission, we will use the most current MSP data sets for the following reasons: they are readily available to the BCMA and to each section. the BCMA uses them for their own calculations and allocations any allocated funds rightfully benefit physicians billing out of the plastic surgery section of the fee guide 1 2 http://www.statcan.gc.ca/ig-gi/pop-bc-eng.htm Medical Services Plan (MSP) BC Payment Information 2010/11 report attached Research Paper Outline B: Plastic Surgery Manpower in BC over past 5 years iv If one looks at the numbers from the MSP dataset for the last six years, our growth as a section seems significant. I have compared us to all other surgical specialties (9 sections) and medical specialties (18 sections). It would appear that the total number of BC plastic surgeons grew rapidly for 3 years with a leveling off in the last two. 3 18% 16% 14% 12% 10% 20% Plastic Surgery Anaesthesia 8% 6% 4% 2% 0% Other surgical specialties Medical Specialties Chart 1: 6 Year Trend in BC Physician Manpower over 2005/06 Baseline looking at total physician numbers per category 3 Medical Services Plan (MSP) BC Payment Information 2010/11 report attached Research Paper Outline v When one applies the semi-retired/part-time payment cutoff (set by MSP) to determine the trend in â€Å"full time† plastic surgeons, the numbers change dramatically. Here the data shows that despite an increase in anesthetists, medical specialists and other surgical specialties overall, the number of full time BC plastic surgeons has dropped in the last 6 years. 20% Plastic Surgery 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 Anaesthesia 15% 10% 5% 0% Chart 2: 6 Year Trend in BC Physician Manpower over 2005/06 Baseline looking at full time physician numbers per category -10% -5% Other surgical specialties Medical Specialties The MSP billing data shows that despite a 17% increase in the number of plastic surgeons in the province over 6 years, the number who bill over a minimum cut-off and would be considered full time has dropped 7%. This trend is in stark contrast to the growth of other specialty groups in BC. The population of BC from the 2006 to the 2011 census grew from 4.1 million to 4.4 million for a 9% increase. Another way of looking at the data shows that in 2005/06 only 19% of BC plastic surgeons were billing under the $82,100 cutoff while in 2010/11 the proportion had grown to 35%. The impact of this on public access to plastic surgical care is enormous. Research Paper Outline C) Manpower issues related to recruitment and retirement vi Our UBC Medical School has a training program for plastic surgeons. We traditionally produce 2-3 graduates a year. Given a population of 80 surgeons and a career span of 30-35 years one would anticipate needing 2-3 new surgeons each year in BC. The majority (88%) of UBC graduates stay in the province (based on a review of all graduates since 1971) and this is reflected in the rise in total plastic surgeons in BC over the past 5 years. A recent survey of our BC section membership (86% response rate) shows 55% feel their hospital is understaffed for plastics and a further 8.6% call their situation severely depleted. A full 70% of respondents would like to recruit one or more plastic surgeons to their community in the next 3 years. The top three barriers to recruitment were OR availability, cooperation of the Health Authority and low MSP remuneration compared to other provinces. Only 17% felt that availability of suitable candidates was an issue for recruitment. The important question is this: Why has the number of full time plastic surgeons dropped over the recent 5 year period as shown in Charts 1 and 2 despite growth in all other groups? The answer we believe lays in an accelerating and profound shift in our sections’ manpower and focus from the public system over to the private (cosmetic surgery) sector. D) Private (Cosmetic) Plastic Surgery – Myths and Realities The private or cosmetic practice in plastic surgery has existed since our specialty originated. Many views about private surgery reflect the situation either in the media (movie/television portrayals of cosmetic surgery) or is based on historical behavior (30 years ago private surgery was the domain of those who had â€Å"put their time in† for 25-30 years of active public practice and could now enjoy a more elective pace with less after hours and weekend responsibility.) The private system allowed for more elective daytime work with greater financial rewards and a less hectic pace. The move to a private practice by this group of older surgeons has never impacted the total number of full time surgeons in this province in the past. Something is different in the last 6 years and we are concerned by the changing pattern. It is our position that chronically low plastic surgery remuneration compared to our colleagues is driving our membership into the private system. Unfortunately the perception that we Research Paper Outline can make up for low MSP payments by simply doing private work has allowed MSP fee suppression to continue and driven more people out of the public system faster than ever. vii The BCMA has effectively handicapped the Section of Plastic Surgery over the past 7 years by including a multiplier in their MANDI (Modified Adjusted Net Daily Income) formula that assumes all plastic surgeons receive 30% of their net income from private surgery. This formula is central to any BCMA attempts at correcting intersectional disparity via the â€Å"microallocation† process. Our section feels this assumption is based on inaccurate, incomplete and out of date information and has spent significant time trying to correct the situation. We would be happy to provide more detail on how this has crippled the attempts at fee and income parity for full time MSP plastic surgeons in BC if requested. The psychological and physical toll of being one of the busiest surgical services while remaining at the bottom of the surgical specialist pay scale has come home to roost. A survey of membership done last month online (65 out of 76 responded) shows that: Most plastic surgeons in BC are engaged full time in the public MSP system 51% feel that in the next few years the proportion of their time private work to public will increase The most common cause for this transition is cited as poor MSP remuneration 34.5% feel burned out often or most of the time 33% intend to retire in the next 10 years Only 40% would advise new UBC plastic surgery grads to stay in BC

The Use Of Torture In Guantanamo Bay Philosophy Essay

The Use Of Torture In Guantanamo Bay Philosophy Essay Since the opening and the use of the Guantanamo Bay as a military prison that was allowing the use of torture to get information from prisoners there has been a rise in public debate over whether there the use of torture on prisoners is right (Greenberg, 3). This paper looks into these public debates through the eyes of Plato, Aristotle and Karl Marx some of the well renowned thinkers that have come to pass. To some the use of torture in Guantanamo bay is morally and incorrect while to some it is an end to a means, which is necessary so as to ensure that America is safe from terrorism and danger. From Plato, Aristotle and Marx the former view is wrong and uncalled for. The former view can be likened to the theory of ethical relativism which both Plato and Aristotle were both against. It can also be likened to the ulitarism principle, which Marx was against. For the ethical relativism theory, it claimed that moral judgment and acts vary from one society or culture to another. It also proposes that moral judgment varies depending on the situation that an individual or group of individuals are placed in (Peters, 138). The theory proposes that in one culture an action can be viewed to be morally correct while in another the action can be viewed as inappropriate. If applied in the current situation the theory upholds the use of torture if the American society does not view it as wrong then it is right for the torture in Guantanamo bay to continue. The theory proposes that no one set of moral values in any society is better than the other. However, Plato and his student Aristotle were not for this view (Huard, 20). Plato and Aristotle were for the ethical objectivism theory, which states that. In Platos dialog, titled The Republic the conflict between the two theories becomes apparent. In the dialog Socrates is seen trying to engage Thrasymac hus about his thoughts on what justice is. Thrasymachus a large proponent for the relativism theory argues that justice is in the interest of the strong and there is nothing more to it. He further explains how he has travelled to so many countries around the world and all the laws have been tailored so as to suit the strong while oppressing the weak (Plato) In Platos and Aristotles view however this is not correct. In the present situation, Plato and Aristotle would be view the use of torture in Guantanamo bay as ethically wrong and lacking in moral judgment. In Platos argument, the use of torture and the detention of criminals is not justice. The strong that Thrasymachus is referring to can be viewed to be the United States of America and the weak are those who have been detained in the camp. Plato and Aristotle did not agree with the view that justice and law were tailored to the benefit of those in power while disregarding the human nature of those being oppressed. Plato in the dialog believes that justice is universal, that it was a constant, and that it applied to everyone. According to Plato and Aristotle, all men were created equal. This is stated in the declaration of independence and is gifted with a number of unchallengeable rights, which are the right to life, the right to liberty, and the Pursuit of Happiness. This is contra ry to what is going on in Guantanamo bay. The prisoners right to liberty and their pursuit of happiness have been curtailed by their detention as well as the use of torture on them (Malcolm, 89). The view of Karl Marx is also against the use of torture and the detention of prisoners without trial. Marx is known for his teachings in his work that human were different from animals and that they could not behave in the way animals do. In his argument, he argues that the main difference between man and animals is the human conscience, religion and a host of other factors that are present in everyday life. In his argument, he says that humans distinguish themselves from animals the moment they start producing for their own survival and organizing themselves in social groups (Wood, 30). Therefore, his argument can be interpreted to mean that he does not expect human beings to behave and act like animals. The torturing and detention of military prisoners in Guantanamo Bay can be interpreted into animalistic behavior which according to Karl Marx is not human. Karl Marx further argues that human beings have the will and conscience to do what is right unlike animals, which only act on their basic instinct of survival. The torturing of inmates in the Guantanamo bay prison can be viewed as Americas basic instinct to try and survive just like the animals in the jungle (Rejali, 98). This is because every human being has his or her basic human rights, which are not being upheld in the prison. The life of the prisoners in the prison can be compared to that of animals, which Karl Marx is against. Marx is also known for his fight against the unitarianism theory, which is a theory that looks into the moral merit of a deed and determines the merit of the deed depending solely on the usefulness of the deed in maximizing what an individual is to gain out of that deed. The theory proposes that the moral worth of any action that a human being takes can be judged by the outcome of the deed. This is in line with the end justifies the means (Allen Wood pp 33). Karl Marx was largely against this mode of thinking arguing that it was against his theory that human nature was different from that of animals and that free will was the main control when it came to the measurement of the moral merit of an action. If the unitarianism theory is placed in the present Guantanamo bay situation, the theory proposes that if the product of the use of torture on the detainees produces a good outcome that was beneficial to the American people then the actions are justified. Karl Marx was however against this theory and he argues that human nature is dynamic and he argues that the theory is just a measure for present situations. For example if torture is used effectively to the benefit of the United States government it does not mean that it is opposing human progress. His argument is that not all the merit of any action can be placed on the outcome since actions like torture, which may lead to a positive outcome, are not human and they go against the basic human nature (Smith, 4).

Importance of Money in Midnight in the Garden of Good and Evil Essay

Importance of Money in Midnight in the Garden of Good and Evil     Ã‚   Inherited money is held in much higher esteem than earned money in Savannah, Georgia. This is a theme seen throughout Midnight in the Garden of Good and Evil, John Berendt's non-fictional account of life in Savannah. Characters such as Jim Williams, who worked for their money and brought themselves up the social ladder, are seen as being beneath those who inherited their money, such as Lee Adler. The old wealth tend to look down on anyone who wasn't born with their money. Their views of just about everything, including laws and punishments, differ depending on whether the person in question is of wealth due to blood or sweat. While Savannah is a town full of rich people, there isn't a whole lot of earned wealth. Most of Savannah's wealthy people have been rich for generations. Among the few exceptions is Jim Williams. He was born in Gordon, Georgia, a small town near Macon. "My father was a barber, and my mother worked as a secretary for the [town's chalk] mine. My money - what there is of it - is about eleven years old," says Williams (Berendt 4). Jim Williams is an oddity in Savannah. This "socially prominent antiques dealer" (Bellafante 79) is arrogant and pompous, but unlike those who are this way because they believe they were born with the right to be so, he is this way because he knows he has earned the right. It is because of this, though, that he is not truly accepted by his neighbors. For instance, there is the Oglethorpe Club, one of the highest class social clubs, even by Savannah standards. It would make sense for one of the richest aristocrats to be a premier member of the club. This is not the case, however. According to Berendt, bachelo... ... greatly upset those who hadn't had their turn. Appropriately enough, it seemed to Williams at least, it was Adler who prodded the district attorney to charge Williams with murder rather than a lesser crime. John Berendt's Midnight in the Garden of Good and Evil is a non-fictional account of the aristocratic lifestyle of Savannah, Georgia. The book examines many aspects of life in Savannah, as well as the mind sets of its people. One of these mind sets is the conflict between "old money" and "new money." People who have always had money seem to think that they are of a higher class than those who have had to work for it. Lee Adler and Jim Williams are two of the combatants in this ongoing war. Adler fights for the side of inherited money, Williams for earned. The problem for Williams is that the inherited side seems to control all the cards, even those of the law. Importance of Money in Midnight in the Garden of Good and Evil Essay Importance of Money in Midnight in the Garden of Good and Evil     Ã‚   Inherited money is held in much higher esteem than earned money in Savannah, Georgia. This is a theme seen throughout Midnight in the Garden of Good and Evil, John Berendt's non-fictional account of life in Savannah. Characters such as Jim Williams, who worked for their money and brought themselves up the social ladder, are seen as being beneath those who inherited their money, such as Lee Adler. The old wealth tend to look down on anyone who wasn't born with their money. Their views of just about everything, including laws and punishments, differ depending on whether the person in question is of wealth due to blood or sweat. While Savannah is a town full of rich people, there isn't a whole lot of earned wealth. Most of Savannah's wealthy people have been rich for generations. Among the few exceptions is Jim Williams. He was born in Gordon, Georgia, a small town near Macon. "My father was a barber, and my mother worked as a secretary for the [town's chalk] mine. My money - what there is of it - is about eleven years old," says Williams (Berendt 4). Jim Williams is an oddity in Savannah. This "socially prominent antiques dealer" (Bellafante 79) is arrogant and pompous, but unlike those who are this way because they believe they were born with the right to be so, he is this way because he knows he has earned the right. It is because of this, though, that he is not truly accepted by his neighbors. For instance, there is the Oglethorpe Club, one of the highest class social clubs, even by Savannah standards. It would make sense for one of the richest aristocrats to be a premier member of the club. This is not the case, however. According to Berendt, bachelo... ... greatly upset those who hadn't had their turn. Appropriately enough, it seemed to Williams at least, it was Adler who prodded the district attorney to charge Williams with murder rather than a lesser crime. John Berendt's Midnight in the Garden of Good and Evil is a non-fictional account of the aristocratic lifestyle of Savannah, Georgia. The book examines many aspects of life in Savannah, as well as the mind sets of its people. One of these mind sets is the conflict between "old money" and "new money." People who have always had money seem to think that they are of a higher class than those who have had to work for it. Lee Adler and Jim Williams are two of the combatants in this ongoing war. Adler fights for the side of inherited money, Williams for earned. The problem for Williams is that the inherited side seems to control all the cards, even those of the law.

Good and Evil in Human Nature in Lord of the Flies and The Strange Case of Dr. Jekyll and Mr. Hyde :: William Golding Robert Louis Stevenson Essays

Good and Evil in Human Nature in Lord of the Flies and The Strange Case of Dr. Jekyll and Mr. Hyde The novels The strange Case of Dr. Jekyll and Mr. Hyde written by Robert Louis Stevenson and Lord of the Flies by William Golding both portray a very similar message. In both novels there are characters, which represent both good and evil showing the contrasts, which occur throughout the whole storyline. Both novels can be described as an allegory as they both show different levels and meanings e.g. in Dr. Jekyll and Mr. Hyde one represents good the other evil even though they are the same person. This gives us the indication that Stevenson's message is that evil can be found inside everyone. Also Golding uses characters to bring this message across as well. Lord of the Flies is situated on an island and when the boy's plane crashes they are provided with the ideal surrounding with great resources to survive until they're rescued. The island almost acts as a parent even though they are without parental supervision. The island can be compared to the Garden of Eden as it's described as a "natural beauty". But straight away we are warned there is a "dark side" to the island. Almost suggesting something will go wrong or this is where something horrendous will take place. The children's main aim when they are all together is to pick a leader. This is where the conflict begins mainly because Ralph gets picked and Jack becomes Jealous. Ralph shows maturity and intelligence where Jack shows power and strength. Golding almost suggests that if Jack and Ralph were combined they would be the ultimate leader. Dr. Jekyll and Mr. Hyde shows how scientific experiments can go wrong and Stevenson tells that even though we try to avoid evil it will never go away. The novel all starts with the concern of Mr. Utterson, Henry Jekyll's lawyer. He is worried and confused that Jekyll has left all his possessions in his will to a Mr. Hyde who he has never met. "All his possessions were to pass into the hands of his friend and benefactor Edward Hyde" Utterson confronts Jekyll's old friend Dr. Lanyon but he hasn't heard of a Mr. Hyde. "No. Never heard of him. Since my time" Its ironic that the name Hyde can be heard as hide so we are told that even before we begin to read that Mr. Hyde must be strange or almost none existent. Utterson tracks down Hyde and is horrified by the way he looks and doesn't understand how Jekyll could be friends with such

Education Reform Essay -- Education

Ideas swarm around us everyday. They run through our heads and at times they alter our thoughts, believes, and perception. The question is, what ideas, events, or words affect us so that we do the things we do and say the things we say. If we understand the causes and know the effects, we have yet to fully understand the â€Å"chain.† In essence, the real question is not â€Å"what† ideas, events, or words affected the person but rather â€Å"why† it affected them. To understand the why, we must first understand the initial cause and effect. George Santayana’s philosophies found in his essays, â€Å"Intellectual Ambition† and â€Å"Intuitive Morality,† were enthused by the rise of education and change in literature during the time. The cause and effect can be as simple as the rise of education and such forth brought Santayana to write these essays; however, with the lack of detail, the lack of evidence, and no answer to why these things affected his writing, it is impossible to complete the chain of cause and effect. Basically, the causes, effects, details, and evidence must first be analyzed then organized in order to understand the question of why. During the late 1880s and early 1890s, reforms in education allowed for a more open view of education and the world sparking creativity and independence in schools. (America Past and Present, paraphrase) The world, especially the United States, was beginning to understand that through creativity and education beyond the core subjects the spectrum of knowledge known would spread beyond regions imaginable. The curiosity spread through out the U.S and eventually influenced many great people, one being George Santayana. In his essay, â€Å"Intellectual Ambition,† Santayana signifies the strength of creativity and... ...Works Cited Santayana, George. â€Å"Intellectual Ambition.† The Oxford Book of Essays. Oxford University Press. ED. John Gross. 1991. 341-342 Santayana, George. â€Å"Intuitive Morality.† The Oxford Book of Essays. Oxford University Press. ED. John Gross. 1991. 342-345 Saatkamp, Herman, "George Santayana." The Stanford Encyclopedia of Philosophy (Fall 2010 Edition), Edward N. Zalta (ed.) . â€Å"Chapter 19: Towards an Urban Society, 1877-1900.† America: Past and Present. Ed. Michael Boezi. 8th edition. New York: Pearson Longman, 2007. 538-570 â€Å"Chapter 20: Political Realignment in 1890s.† America: Past and Present. Ed. Michael Boezi. 8th edition. New York: Pearson Longman, 2007. 572-598 â€Å"George Santayana.† Britannica. 2005. 17 Jan. 2006 .

Patient Satisfaction

Patient satisfaction is critically important to the health care industry today due to the competitive nature of the field. Patients have many choices when it comes to seeking medical attention, and hospitals are dependent on return business to stay operational. Hospitals have traditionally utilized the semi-private room model in order to increase profitability. A semi-private room is a room shared by two patients. Each patient is given their own bed, but they usually share a single bathroom. Unfortunately the financial practice of using semi-private rooms comes at the expense of patient satisfaction. Research has shown that private rooms increase patient satisfaction, because of the decreased likelihood of nosocomial infection, a quieter environment, and the inherent privacy afforded when conducting patient care. Nosocomial Infection Perhaps the biggest challenge facing healthcare today is the epidemic of hospital acquired (nosocomial) infection. Patients come to the hospital for varying degrees of injury, or illness with the expectation of receiving medical treatment. What they are not expecting is exposure to potentially life threatening infections during their stay. According to a joint study by Jimma University and Addis Ababa University the most common causative agent found in nosocomial infection is Staphylococcus aureus. This harmful pathogen can be transmitted via direct or indirect contact. This means the pathogen can be transmitted by patient to patient contact, staff to patient contact, or the sharing of a common surface like a toilet seat (Bereket et al. , 2012). Patients in private rooms are far less likely to come into contact with each other, shared surfaces, or shared medical equipment all of which can harbor infectious microorganisms (Skocynska et al. , 2012). Standardizing the practice of private rooms can greatly reduce nosocomial infection rates within patient populations. Patient's who contract nosocomial infection are bound to have lower satisfaction rates. By reducing the nosocomial infection rate hospitals can ensure increased patient satisfaction. To make matters worse strains of methicillin-resistant S. aureus (MRSA) are becoming commonplace. MRSA is easily transmittable and resistant to most commonly used antimicrobial agents (Bereket et al. , 2012). Nosocomial infections such as MRSA result in increased length of stay, higher morbidity rates, and increased cost of hospitalization. Recent studies have shown that each exposure to a new roommate in the hospital setting results in a 10% increase in the risk of acquiring MRSA (Stall, 2012). Private rooms eliminate the possibility of exposure to MRSA infection related to roommates in the hospital setting, which vastly reduces the rate of hospital acquired MRSA infections amongst all patient populations. Reducing the spread of MRSA can result in decreased length of stay, lower morbidity rates, and decreased cost of hospitalization. A hospital concerned about patient satisfaction can see the value that private rooms have to offer when it comes to reducing MRSA exposure. Proper hygiene is also of major concern where nosocomial infection is concerned. Unfortunately staff members are usually to blame for spreading infectious microorganisms from one patient to the next. Studies have shown healthcare professionals are more likely to perform hand hygiene between patient rooms rather than between beds in the same room (Bereket et al. , 2012). This is not necessarily due to a failing on the part of healthcare professionals, but a failing of healthcare systems utilizing semi private rooms. Take this scenario for instance: a nurse is working with a patient in a semiprivate room when suddenly the bed alarm goes off on the neighboring bed. The roommate is an elderly female with Alzheimer's-dementia who recently fell at home and suffered a fractured hip. The nurse has already been in physical contact with one patient and now has to take action in order to prevent the roommate from falling. The nurse must act quickly to prevent a fall-related injury and does not have time to perform hand hygiene before assisting the roommate back to bed. This nurse would not have been put in such a position had her patients been placed in private rooms to begin with. Standardizing the use of private rooms prevents situations such as the above from occurring, promotes proper hand hygiene amongst healthcare professionals, and protects patients from unnecessary exposure to nosocomial infection. Peace and Quiet Nosocomial infection is not the only issue having a devastating effect on patient satisfaction. In fact the most common complaints in hospitals today are noise related (Eggertson, 2012). With patient satisfaction being of paramount importance hospital systems should be paying close attention to what bothers their patients. Loud roommates, visitors, medical alarms, and television sets can worsen an already noisy environment for a patient trying to get some much needed rest. Some patients need more frequent monitoring than others. A post-operative patient may need to have their vital signs checked hourly, a diabetic may need to have their blood sugars checked regularly, and a patient on a high risk infusion may need constant monitoring. This can be extremely disrupting for the patient in the neighboring bed. Some patient's may also have numerous visitors, watch TV late at night, or be just generally disruptive to their neighbor. Private rooms may not address all noise complaints in the hospital, but will at the very least resolve those related to roommates. Considering this issue is the number one patient complaint in hospitals today it is guaranteed to increase patient satisfaction. In addition to being the number one patient complaint excessive noise has been proven to cause sleep disturbances in hospitalized patients. Sleep disturbances result in increased lengths of stay, increased morbidity, and higher costs of care (Buxton et al. , 2012). Patients recovering from surgery or acute illness need undisturbed rest periods for proper healing. An unnecessarily extended, complicated, and expensive hospital stay caused by sleep deprivation is extremely detrimental to patient satisfaction. Private rooms increase the quality of sleep, reduce lengths of stay, decrease morbidity, and result in a lower cost of care. These factors result in increased patient satisfaction. Noise-related issues in hospitals not only affect the adult population, but can have deleterious effects on the infant population as well. The neonatal intensive care unit (NICU) often places infants in nurseries where multiple babies are cared for in the same room. NICUs consist of high risk infants with varying degrees of illness. Some of the infants being cared for require constant monitoring and intervention. This can result in a very ill infant receiving care that involves noisy alarms, life saving machinery, and ongoing care-related activity. The result is sleep disturbances, increased tress levels, and compromised healing processes for all infants in the room. Placing infants in private rooms eliminates the noise concerns created by the delivery of care for other infants and facilitates family interaction with the ill infant (Feldman, 2009). This results in better outcomes for the infants and happier parents. Considering the fact that infants are not old enough to make decisio ns regarding where to seek medical treatment, it is necessary for hospitals to recognize that parental perception of infant care is of paramount importance to patient satisfaction. Respecting Privacy Another large concern affecting patient satisfaction is related to patient privacy. In 1996 the U. S. Department of Health & Human Services (HHS) instituted the Health Insurance Portability and Accountability Act (HIPAA) in order to protect patient privacy (HHS, 2013). HIPAA violations can have a devastating effect on a hospital's financial health, with each violation resulting in up to $1. 5 million in penalties annually (AMA, 2012). In a financially unstable economy with reimbursement rates at an all time low these penalties can add to existing budget deficits. Budget deficits in a healthcare system result in understaffing, which leads to disgruntled employees and higher patient-to-staff ratios. Understaffing leads to the degradation of patient care. A prime example of this is call bell response time. Patients do not appreciate having to wait twenty minutes for a staff member to respond to a call button. When there is a high patient to staff ratio the time it takes for staff to respond to each patient call lengthens. Unfortunately when hospital administrators make budget cuts, cutting staffing is usually where they begin. Private rooms can help prevent HIPAA violations from occurring during the delivery of care, which can save a hospital millions of dollars in penalties, and allow greater financial resources for staffing needs. A financially healthy hospital can afford to keep a reasonable patient-to-staff ratio, which allows for staff members to deliver quality care in a timely fashion, and results in greater patient satisfaction. The financial repercussions of HIPAA violations are not the only concern when it comes to patient privacy. Patient perception of measures taken to protect privacy during hospitalization has a great impact on patient satisfaction. Performing patient care while maintaining a patient's right to privacy is nearly impossible in a semi-private room. A study conducted by Juliet Whitehead and Dr. Herman Wheeler shows that patients define and conceptualize privacy by the following criteria: â€Å"Privacy of information, e. g. having one's conversation being not over heard. Privacy of person and body, e. g. not being viewed during one's private moments. Having one's own personal space. † (Whitehead & Wheeler, 2008). The very concept of sharing a room with another person makes it extremely difficult to conceptualize having personal space. The delivery of care almost always involves private bodily functions and the sharing of private information. Privacy cannot be reasonably protected in the delivery of care when two patients share a room with nothing but a curtain separating them. Private rooms increase a patient's perception of the privacy they experience during their stay, which is of great importance in increasing patient satisfaction levels. The most common form of HIPAA violations occur when healthcare is being delivered to a patient in the presence of others without obtaining the patient's informed consent (Ziel, 2004). In a semi-private room a nurse has to ask her patient if it is OK to discuss details of the patient's care in front of anyone who happens to be present at the moment. If the patient does not agree the nurse is required to provide a private setting in which to discuss, or deliver care. This means that if a patient is in a semi-private room the nurse is required to move her patient to a private area, or ask the roommate to leave while care is performed. In reality it does not happen this way in the hospital setting. Care is delivered regardless of whether or not there is a roommate present. Nurses do ask visitors to leave the room while delivering care if a patient requests, but do not ask other patients to do so. This means that privacy violations occur multiple times a day to patients in semi-private rooms. The use of private rooms makes it much easier to deliver care while protecting patient privacy and thereby increases patient satisfaction. Conclusion With the ever growing research indicating that private rooms increase patient satisfaction it is truly a wonder why some hospital systems continue to argue against the switch to private patient rooms. Whether by decreasing nosocomial infection rates, providing quieter environments, or increasing patient privacy the use of private rooms clearly has a positive impact on patient satisfaction. In an extremely competitive economy where patients have a choice where they will seek medical attention it seems only logical that patient satisfaction should be a top priority when considering the choice between private or semi-private rooms. Hospitals that chose to listen to their patient population will soon realize that private rooms result in greater patient satisfaction and return business. References American Medical Association (2013). HIPAA Violations and Enforcement. Retrieved from https://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/hipaa-violations-enforcement.page Bereket, W., Hemalatha, K., Getenet, B., Wondwossen, T., Solomon, A., Zeynudin, A., & Kannan, S. (2012). Update on bacterial nosocomial infections.  European Review for Medical and Pharmacological Sciences,  16(8), 1039-1044. Buxton, O., Ellenbogen, J., Wang, W., Carballeira, A., O'Connor, S., Cooper, D., & †¦ Solet, J. (2012). Sleep disruption due to hospital noises: a prospective evaluation.  Annals of Internal Medicine,  157(3), 170-179. doi:10.7326/0003-4819-157-3-201208070-00472 Eggertson, L. (2012). Hospital noise.  The Canadian Nurse,  108(4), 28-31. Feldman, L. (2009). Patient safety. Private rooms becoming the standard in NICUs. Hospitals & Health Networks/AHA, 83(11), 10. Lorenz , S., & Dreher, H. (2011). Hospital room design and health outcomes of the aging adult.  Herd,  4(2), 23-35. SkoczyÅ„ska, A., Sadowy, E., Krawiecka, D., Czajkowska-Malinowska, M., Ciesielska, A., Przybylski, G., & †¦ Hryniewicz, W. (2012). Nosocomial outbreak of Streptococcus pneumoniae Spain9VST15614 clone in a pulmonary diseases ward.  Polskie Archiwum Medycyny WewnÄ™trznej,  122(7-8), 361-366. Stall, N. (2012). Private rooms: a choice between infection and profit. CMAJ: Canadian Medical Association Journal = Journal De L'association

Discrimination and Sexual Harassment

virtu completely(prenominal)y Americans can trace their predecessors back to any(prenominal) country crosswise the oceans or the Mexican-American or Canadian-American b rambles. Each ethnic group has enriched American culture with its own particular faces of music, food, customs, and dress. It usu wholey rams two or more generations for the members of a reinvigorated immigrant group to be nonplus sufficiently absorbed into the life of a corporation that they lose their separate identity. Some ethnic groups mainly those of dark skin colorize never achieve total acceptance.People come to astir(predicate) improving group transaction in their brass section moldiness(prenominal) represent against such clichs as Im non prejudiced and I treat completely(a) race the same. Even the most propagatehanded several(prenominal)s do non treat any spate the same. muchover, they should non. both heap atomic issue forth 18 prejudiced for or against former(a) people . However, it is behaviors, non attitudes, which comprise the major group capers confronting theater directors and supervisors. on that point atomic number 18 many laws against racist behaviors, yet there atomic number 18 none against prejudicious attitudes.The ethnic prejudices found in neighborhoods, schools, and bloodlines come from two main sources (1) the apprises and whimseys item-by-items key out from others, and (2) the tensions and frustrations all people experience piece competing with other people, especially those who ar culturally divers(prenominal). Race and racism, outgrowths of prejudice, disrupt governing behaviors (Shepherd & Penna 34). heathenish diversity changes the organic law by providing new human resources and coachial contests to employers.As the United States experiences shortages of apt workers, most memorial t sufficientts should to find ways to optimally utilize multicultural workers. This often entails dealing with employees w ho pick up different attitudes toward clip, status and references, transactionhips, responsibility, decision-making, and engine room (Goldstein & Leopold 45). In addition, as the nations workforce is reshaped with admiration to age, sex, racial composition, and national origin, the challenge to managers and supervisors is enlarged managers moldiness take crocked lead in eliminating ine musical none and familiar curse in the piece of work. Abbasi & Hollman 96).If physical composition devises an creative activity outline to cope with favoritism and intimate badgering the settlement lead be the successes an presidential term will experience. First, managers should play de hall in the perplexity of diversity initiatives in order to deliver permanent change in organisational culture, systems, and structures should work in an interconnected partnership within their scheme to accomplish diversity success aboundingy second, cultural and sex diversity includes every employee, so, managers and supervisors essential be aw atomic number 18 of their values, motivations, communication styles, attitudes, and postulate.Arguments that support the thesis 1. Helping across cultures at work level can be accomplished hardly with the countenanceance of well-trained manager Most favoritism and familiar badgering paradoxs ar grow in the arranging culture. Certainly, group therapy is an alternative. another(prenominal) alternative is affirmative action designed to change jobs. One of the reasons managers and supervisors atomic number 18 continually frustrated is because the t stamp outer puzzles they atomic number 18 called upon to form atomic number 18 themselves the products of a larger social environment.Frequently, for example, an alienated workers problem resolution depends not on his or her adjustment to an animated situation scarcely instead on being moved to another job or another society. This kind of environmental change is mod eled after environs therapy. It is clear that many minorities and women do not get the sustain they need because company resources be not attuned to their needs. The more trenchant employers behave in the following vogue 1. They regard each employee as a vital part of the composition.2. They view all personnel positively, because whatever diminishes anyones self (e. . , humiliation, discrimination, degradation, failure) has no place in a culturally sensitive organization. 3. They allow and provide for individual and cultural differences. 4. They learn how employees see things. Since sensitivity to their own noteings is a prerequisite to useful attractership, it is beneficial for administrators to have maximum self-insight. For about administrators, this is an integral part of their personality for others it mustiness be learned. A growing number of administrators are participating in about type of sensitivity training.If it is true, that helping across cultures can be accomplished unaccompanied with the assistance of a healthier person. A worker does not need direction from an administrator who is a racist. Nor does a fe anthropoid person person employee need a prejudiced supervisor. The more effective administrator is a raise person who functions with compassionate efficiency, who is able-bodied to assist his or her subordinates to form their problems without resorting to pity, panic, or resignation. This type of administrator maintains professional balance and keeps his or her perspective with self-insight and humor.Once diversity- connect problems are identified, managers should move with not bad(p) care when implementing change. Some actions, although well intentioned, will only exacerbate the problems. Anything that disrupts the existing hunt of work activities can cause superfluous complaints and stress. 2. Diversity-related leadership is an grand organizational grammatical constituent determine the extent of discrimination Witho ut the full commitment of upper-level leaders in an organization, discrimination and intimate badgering initiatives are probably to fail and thus discriminatory practices are incredible to be s meridian (Cox& Blake 8).However, it is also necessary to look at a lower place the upper-most levels to contemplate the ways in which the behaviors and decisions of mid-level worry and direct supervisors whitethorn also preserve discrimination and inner harassment. Upper-level forethought at the highest levels of leadership in organizations, the chief operating officer, the top management team (TMT), and the corporate placard are instrumental in determining the direction that the organization will take with regard to discrimination and intimate harassment.Leaders must first recognize the potential for discrimination in traditional organizational practices and structures and must desire in the need to value all employees and remove obstacles to their success (Stoner & Russell-Chapi n 13). The chief operating officer and top management team necessitate important decisions regarding organizational strategies and resources, and they communicate the organizations priorities to all members and stakeh elderly groups (Chevrier 45).The extent to which leaders choose to try inclusiveness in the organizations strategy and the extent to which resources (i. . , personnel, money, time) are devoted to eliminating all forms of discrimination and inner harassment are indicators of leaders priorities and of which types of employees are make up (Morrison & von Glinow 67). Top-level leaders can also caution discrimination and inner harassment by implementing systems of accountability that make rewards contingent upon brush diversity goals. After the corporate panel and TMT have decided to pursue an organizational change strategy byout the organization, the role of the CEO is particularly important.Cox and Blake (1991) argued that for champions for diversity are unden iable to enact changeand the CEO is in a very full(a) position to passionately pursue change, to role model the behaviors required for change, and to help the organization to move forward. Such a leader can help to establish an inclusive organizational culture through persistent communication of and visible support for all programs and policies aimed at reducing discrimination and sexual harassment (Morrison & von Glinow 89). In addition, when successes occur, he or she would provide rewards and interpretations broodent with the desired values.In this manner, a CEO who demonstrates commitment to eliminating all forms of discrimination and sexual harassment throughout the organization may play a crucial role in transforming an organization from monolithic (unicultural) to multicultural. The quality of leader-subordinate relationships is also an important term for discrimination and sexual harassment in organizations. High-quality leader member exchanges (LMX) may be less likely to develop amongst leader subordinate dyads composed of individuals who are demographically different (Hiller & Day 34).Yet, because LMX relationship quality is thought to be pivotal for the admission fee that subordinates receive to resources, in organisation, important networks, and opportunities, high-quality LMX relationships with diverse subordinates are one key to combating discrimination sexual harassment in organizations. Ultimately, those managers who establish high quality LMX relationships with all of their employees without discriminating against minority subordinates will be in a crack position to utilize all of their human resources (Douglas et al. 8). Indeed, recent evidence present that departments in which racial minorities reported high-quality LMX relationships with their managers had higher(prenominal) profits than departments where minorities reported low-quality LMX relationships (Nishii, Mayer, Goldstein, & Dotan 19). 3. Without integration of equivalen ce goals within the broader crinkle diversity-oriented strategy the organization will not develop open communication, mutual trust, and confidence in managementWhen strategies for pass on diverse employees and creating a culture of inclusiveness are embedded within an organizations strategic headache architectural plan, consequent levels of discrimination and sexual harassment remainder tend to be lower. real including EEO as part of a companys business strategy is important because statements of non-discrimination are a very tangible and salient sign that discrimination is not tolerated within an organization (Morrison & von Glinow 167).Further, publicly stating the importance of diversity as a basis of competitive avail and human resource quality fosters the belief that diversity represents an opportunity for the organization preferably than a problem. There is also a theoretical basis for expecting that organizations that pursue an innovation strategy will be move to capi talize on the diversity of behavioral scripts that result from a diverse workforce.This is found on the evidence that diverse groups are more likely to produce a diverse set of ideas compared to homogeneous groups (Milliken & Martins 78), and the wider set of ideas is expected to translate into better decisions. An organization that perceives the differential competencies and experiential bases of diverse employees as a source of competitive usefulness is less likely to engage in practices that discriminate against diverse groups. Arguments on the other side 1. People form different backgrounds and cultures tend to form unhealthy teamwork with diversity-related problemsWorkplace harassment which entails the use of abusive language or isolation of specific workers may result because of their diversity (disabilities, performance record, sex, or place of birth) which will hinder the efficient formation of teamwork (Broadnax 13). People are more nonresistant to oeuvre harassment an d discrimination, which is bad for the organization. However, people form different backgrounds and with varied skills when effectually managed tend to form a brawny teamwork. Teamwork is useful for an organization in that people are able to share their ideas or problems, thereby, providing workable solutions to issues.The use of cross-functional teams and employee participation are key to success of the organization. This is because they provide a more firm platform on which to exchange knowledge and instruction. Therefore, managers who take substantive leadership in this area are essential. Workplace harassment practices such as sexual harassment are so inhuman that it results in the breakdown of individual and team relationship in an organization and in most cases it results because of ones race, disability, or gender. curse is not only order to young employees moreover it can be directed to a senior member of the group.The consequences of workplace harassment and surveill ance are commonly severe in that it results in mental, physical, and horny illnesses. Therefore, the managers in this case have a lot to lose if they do not act quickly. 2. People solve nothing, time solves problems Most managers are reluctant to study that there diversity-related problems that should be angiotensin-converting enzyme-minded. While managers must be supportive and allow a reasonable period of time for problem abatement, it is important to remember that managers do not help employees or the organization by neglecting problems.Nor do problems go away or unthaw themselves if given ample time. If a business is managed poorly, it loses profits and eventually fails. If cultural conflicts and sexual harassment are handled poorly, worthful employees are lost. Avoiding financial and human resources losings tests the leadership mettle of managers. Central to conflict resolution is mastering the processes of problem solving, the dynamics of which are terzettofold (Nishii, Mayer, Goldstein, & Dotan 78-90) 1. The facts that constitute the problem must be understood. Facts usually consist of both objective reality and natural reactions. 2.The facts must be thought through. They must be probed into, reorganized, and deformed over in order for distressed employees to grasp as lots of the total configuration as possible. 3. A decision must be made that will result in resolving or alleviating the problem. This usually involves a change in behavior and, if possible, attitude. Succinctly, the three operations of problem solving are fact-finding, analysis of facts, and implementation of conclusions. For the maximum effectiveness, the people involved in the discrimination and sexual harassment conflict must be fully involved in the efforts to solve their own problems.It is possible for a manager to define the problem and prescribe solutions, yet when this go acrosss the self-responsibility of the employees involved in the conflict is weakened. It is const antly better if the employees who have problems are able to assist in bringing about the resolution. A problem cannot be solved if the necessary study is missing. A manager may want to understand his or her subordinates conflicts but be unable to do so because slightly of the data are missing or distorted. In some situations, administrators are not privy to all the information. In other instances, the information may have been misinterpreted.Like any puzzle, missing pieces of information in a human relations problem will render it insolvable. data alone is seldom enough. Too much information can freeze contradict attitudes and reinforce dysfunctional behavior. Conditioned by organization and peer group norms, remote information may cause a manager to say to a complainant, I understand what you have said but I dont believe it. For example, a sexist supervisor may disregard musical accompaniment of a females abilities to do male-oriented jobs. An individual with delusions of ma le superiority is not likely to believe reports documenting female competence in male jobs.Thus, in order to be helpful, information must be believed by the manager. All of this underscores the crucial importance of managers taking strong leadership in order to go across harassment and discrimination. Sensitivity is the capacity to call and empathize with the values, aspirations, and olfactory sensationings of subordinates. Today, more than ever, organization needs culturally sensitive administrators. Without being able to see employees as they see themselves, to photocopy fears of cultural differences, and to communicate with their subordinates, managers will turn their organizations into socially and psychologically destructive battlefields.If they are unable to put themselves in the minds of their subordinates, there will be little help for the aggrieved persons. Frequently, managers are problems themselves or causes of problems. As noteworthy earlier, the ability of manager s to achieve and maintain a condition of objectivity when dealing with their subordinates problems is important in the conflict resolution process. If a manager is wrapped up in his or her own inner initiation, he or she will not be able to perceive clearly the feelings of others. The challenge to administrators is awesome They must empathize with subordinates but not to the point of losing their objectivity.In many instances, aggrieved workers do not know how they really feel about their situation until they have communicated these feelings to person else. Distressed workers may only be aware of internal discomforts. Providing opportunities for them to tell how they feel is usually the first step in isolating electronegative feelings and related behaviors. They may have previously communicated internal discomforts by arguing with, laughing at, or avoiding soupcon with other workers. Talking about negative feelings can provide a better view of them and a better recover for manag ing them.While allowing an employee to tell is a semiprecious technique in resolving problems, it is only a first step. Telling should be related to some end and not further an end in itself. Solutions must be sought. Perhaps the major distinction lies mingled with talking about the discrimination and sexual harassment conflict and talking through the discrimination and sexual harassment conflict. In the first instance, usually nothing more than random talk, free association of ideas occurs. In the second instance, more structured thought occurs a problem is acknowledged, its implications and related behaviors examined, and solutions pondered.Talking through a problem excites all the dust processes, often causing increased flashbulb and sweating. The whole person is caught up in it. It is imperative that distressed workers focus on problems that can be solved. This is by furthest the most efficient use of ones energies. For example, an older worker who focuses on his age, a adult female on her gender, and a Hispanic on his ethnicity are all wasting valuable time and energy, as they cannot alter those things. However, if they pore on ageism, sexism, and, racism, then something constructive is possible. Managers must also focus on problems that have the potential of being solved.Some of the questions to be answered by managers and supervisors during this process are What is the problem? (Who did what, when, where, what happened? ) Who senses (feels) the problem? (Only the aggrieved, co-workers, supervisors? ) How are you personally affected? (Emotionally, socially, economically, professionally? ) What was the immediate cause for what happened? What organization rules and regulations bring up to the problem? Who can act to resolve this problem? What do you want to happen? What are your options? What will you do? ConclusionDiscrimination and sexual harassment management in the organization is a reflection of how the changing world and market pl ace will be in the future. Diversity will kindle respect for individual differences within the organization and hence make it able to clear a competitive advantage in the organization. Discrimination and sexual harassment management in the organization is able to avail associates through the creation of safe and honorable environment for all. Future research is needed to examine the consequences that the alignment among organizational processes and structures has for levels of organizational discrimination.This is critical because an intervention into a single process or structure is unlikely to effectively reduce discrimination and sexual harassment. For example, if top management leaders squeeze a strategic business plan that explicitly involves reducing discrimination and sexual harassment, but fail to also pattern a culture of inclusion, their efforts are likely to be ineffective. It would be useful to examine how individuals perceive the alignment of organizational proces ses. More generally, research needs to take a systems approach to discrimination and sexual harassment. fictionalize your thesis somewhere near the end of your paper.