The Institute of Medicine Report Essay Example for Free

The Institute of Medicine Report Essay The impact of the Institute of Medicine report on nursing education suggests the nursing profession should have a more advanced education system providing limitless opportunities for growth. The future of nursing providing care to the entire realm of health care, especially primary care and community settings, will be determined by the evolution of a new educational system. The IOM report states that sixty percent of hospital employed nurses will be impacted by the Affordable Care Act because of the transition of patients to primary and community health care. (National Research Council, 2011) Tension in the current educational system has been steadily increasing due to the newly required nursing skills in many specialty areas. That being said, the new educational structure will have to be expanded immensely. The IOM report suggests increasing the number of baccalaureate nurses from fifty to eighty percent by the year 2020. (National Research Council, 2011, p. 12) The report also suggests doubling the current number of nurses with a doctorate degree. Reaching these goals along with overcoming many other educational obstacles will require many changes and modifications to the current system. Increasing the use of technology to educate nurses through on-line programs is one necessary effective strategy. This will create continuous opportunities for nurses from all ethnic groups with associate degrees to obtain their baccalaureate and master’s degrees. Leaders of organizations, hospitals, accreditors, philanthropist, employers, etc. should work cohesively to secure funding for these educational programs. Generating more diversity in nursing will help meet the demands of the projected increase of ethnic groups receiving health care due to the ACA. Intra-professional diversity has been suggested by the IOM report too. (National Research Council, 2011) It is recommended that nurses, physicians and other health care disciplines should be educated together as students and their professions. The IOM report suggests utilizing a nurse empowering trend by hospitals around the country. This trend consists of health care organizations encouraging their nurses with associate degrees to enter into baccalaureate nursing programs within a few years of graduation or hire. (National Research Council, 2011) Impact of the IOM Report on Primary Care Nursing Practice The impact of the IOM report on primary care nursing practice suggests a direct link to the conversion of the education system. With specialty care expecting to diminish, primary care is foreseen to generate large numbers of health care consumers in the near future. People across the country will have increased access to primary care. Therefore, it is speculated that primary care nursing practice will require more opportunities and faster transitions for the advancement of nurses to obtain BSN, master’s and doctorate degrees. Advanced practice registered nurses should have a huge role in the success of primary care. Since there are few APRNs practicing in primary care settings then there will be plenty of opportunity for this group to grow. If these ideas do not evolve as projected then nursing shortages for primary care providers could impede nursing care. The IOM report states that continuous updates to nursing practice and education should be created by collecting and analyzing data from each role and scope of practice. (National Research Council, 2011) The collected data will also be used for future predictions of health care professional requirements in each setting. My Practice Changes in Regard to the IOM’s Report My practice changes in regard to the IOM report in many ways. It is not rare that my unit admits children who are over or under dosed on their medication or are prescribed medicines that are ineffective or not recommended for their diagnosis. I could change my practice to meet the goals of the IOM report by providing families and patients information about their mental health diagnosis, signs and symptoms of an exacerbation of their disorder, contact information to our facility and collect their contact information for a discharge phone call. More so, I can provide them with contact information for trained and skilled mental health professionals in their area and have appointments scheduled within a week or two of discharge. I would ask if the information discussed in the discharge meeting is realistic for them and meets their expectations. Another way I can change my practice to meet the goals of the IOM report is by continuing to chair and co-chair evidence based practice projects pertaining to technology. Technology is mentioned in several case studies in the IOM report and I agree that we should continue to find methods to use it being fiscally responsible. Recommendations for the Nurse Leader Recommendations for the nurse leader according to the IOM report are for nurses and physicians to start working as complete equals while providing healthcare. Nursing must contribute more to leadership roles and continue their education in these roles to help provide increased quality care to patients. Nurses must become more fluent in policy reform by becoming more involved as members of committees, councils and legislation. There should be a greater emphasis and expanded education on nursing leadership in educational programs and employer based competencies. Employers should begin or continue incentives for professional development as the IOM report suggests more nurse leaders are required for reform. (National Research Council, 2011) References National Research Council. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press, 2011. Retrieved from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx

A Feminist Alternative to Fetterleys Criticism of A Farewell to Arms :: Farewell Arms Essays

A Feminist Alternative to Fetterley's Criticism of A Farewell to Arms      Ã‚  Ã‚   After finishing A Farewell to Arms, I found it difficult to reconcile Judith Fetterley's feminist attack of the novel with my own personal opinions. I agree that Hemingway does kick women to the curb in his portrayal of Catherine, but my reasons for pinning this crime on Hemingway are different from hers'. Although she means well, Fetterley makes the ridiculous claim that by portraying Catherine as an angelic, selflessly loving "woman to end all women," Hemingway disguises misogynistic attitudes and a deep-seeded hatred towards the XX chromosome. This claim is not supported by the text. If we look at Hemingway through the lens of his own words, we find that his misogyny does not spring from a "too good to be true" portrait of Catherine, but rather in his tendency to cast her down into the dirt-Catherine is a dependent, baby-manufacturing trap that stifles Lieutenant Henry: "Poor, poor dear Cat. And this was the price you paid for sleeping together. This was the end of th e trap" (320). It is his penchant for sex and his need for womanly comfort that keeps Henry coming back to Catherine, not some notion of "love" or true connection. This is Hemingway's misogyny, however unintentional, unmasked.    But to get a true sense of this "anti-Fetterley" feminist view of the novel, it is important too look at the specifics of Hemingway's construction of Catherine-facts that stand in direct opposition to Fetterley's stated attacks.    First of all, Catherine is not Fetterley's unique and unattainable goddess-she is an object in Henry's universe, a feast of sensations but nothing more. She is akin to good food and good drink: "'I was made to eat. My God, yes. Eat and drink and sleep with Catherine'" (233). Indeed, Henry's thoughts about Catherine, both when he is at the front or by her side, mingle with longings for good wine and reflections on sumptuous meals. In Henry's world, a good Capri would be nice, a nice hunk of cheese would be grand, and sleeping with Catherine would be sublime. These things all equate to the satisfaction of basic human needs. Every now and then, Henry feels a grumbling in his loins-a periodic hunger for the "cheese" between Catherine's legs. Hemingway dissolves Catherine into the least common denominator-the object, devoid of meaning or real importance (when Henry isn't hungry).

Prospects for the Future of Liberal Democracy in Libya

Following the death of the infamous former Libyan leader Colonel Muammar Qaddafi former Libyan leader, a lot of debates and concerns have been raised worldwide about the future of the nation. A range of issues from social, economic, religious and political are being raised and the big question seems to be, what next? After years of authoritarian rule and with the ‘enemy’ finally out of the picture, the Libyan government faces different prospects for its development and in this essay I will be looking at different possibilities for the nation in relation to the promotion of liberal democracy.Currently under a transitional government, Libya stands the chance to embrace change and adopt what may be considered by some as positive western ideals. According to a Freedom house report â€Å"another country that endured decades of brutal misrule, Libya, now has the potential for significant gains thanks to the overthrow of al-Qadhafi. † (Puddington, 2012) Democracy has at no other time in history been knocking at the doors of many political regimes and with voices calling not only from foreigners but also from indigenous citizens it would be very hard to ignore the relevance that democracy plays in our modern day society.Over the past year especially, the world has witnessed many political resistance campaigns; what is now popularly referred to as the Arab Spring has flooded the news very often and one common outcry from these people is the need for change. One might wonder what fuelled this uprising from the people to demand new leadership, in my educate d opinion, decades of authoritarian rule, human rights abuses, oppression on opposition and the inability of people to speak freely amongst others have all led to this desire for change. Before delving into the prospects for democracy in Libya, I feel it will be essential to underline what democracy entails.Robert Dahl in his book ‘On democracy’ lists various desirable features of a dem ocratic society as follows: †¢Control of military and police by elected officials. †¢Democratic beliefs and political culture †¢No strong foreign control hostile to democracy †¢A modern market economy and society †¢Weak subcultural pluralism (Dahl, 2005) Based on this it is fair to say that liberal democracy demands the inclusion of people, it believes in equality and fairness and encourages the notion of two (or many) heads being better than one.However it is also true that democracy is not the only route for stability, in reality â€Å"the highest risk of political crisis lies in the middle ground between authoritarianism and democracy† (Goldstone, 2005) I believe a democratic and representative government can be attainable in Libya despite being broken into various sects for close to fifty years. Both pro and anti Qaddafi forces can push Libya forward but as to whether this will mature fully into a liberal democracy is tricky. The prospects for Lib ya would look bleak especially when considered from the perspective of historical precedents.In the Libyan case, several factors cement this view. To begin with, Libya is a society filled with many different tribes. From what might be considered extreme Islamists, to the more moderate ones, to the presence of Christians and then other religious and secular divisions the presence of diversity in terms of culture or beliefs could either hinder or promote liberal democracy. In other parts of the continent, particularly sub-Saharan Africa, this situation has been witnessed before but â€Å"among the most important lessons to emerge is the importance of avoiding factionalism. (Goldstone, 2005) Take Rwanda for example, where Hutu’s and Tutsi rebels have shed blood over conflicting tribalistic views. In places where there is a vast difference in opinions, quite often people tend to disagree rather than agree and in order for democracy to prevail it is mandatory that people learn to compromise and agree for the better of the people. In the eastern part of the nation, we can find the current ruling rebels and in the West where Sirte is located there is a stronger presence of pro Qaddafi forces or loyalists. In order for democracy to take place it will take a combined effort from the North to South and East to West.A scholar who has engaged in different studies of transitional governments, Professor Michael Greig made several observations on the Libyan scenario, he bases his conclusions from his studies on transitions over the last 170 years of history and notes that the more diverse a society is, the less stable new regimes tend to be. (Coleman, 2011)With the murder of the former leader, the fear for this transition to be peaceful of fairly smooth is that loyalists might try to hold reprisal attacks, there could be various terror attacks even on innocent victims and militants, leaders, or officials under the former regime might strongly esist cooperating with t he new government and this will undermine attempts to achieve a sound and stable democratic environment. Should this occur, it could lead to an indefinite civil war and the country which already seems to be broken down into various fragments could end up losing more lives, it could also deter foreign investment and trade and regardless of the large oil reserve the country has, it could still have serious economic implications such as higher inflation rates.On the political front also, as to how confident citizens are in the government and how effect institutions being put in place will benefit the nation, only time will tell. Indeed Libyans have been shown a glimmer of hope since the death of their former leader however can they be guaranteed that another Qaddafi will not surface? â€Å"And while Libya has benefited greatly from the demise of the Qadhafi dictatorship, the country confronts an array of daunting political and security challenges, and has yet to hold its first electio ns†. Puddington, 2012)The Libyan people understandably seem to have trust issues in their new government and with this lack of trust, the people might not be too welcoming to the new rules or laws that might be put in place. Should they not have faith in the new government for too long they could be a coup d’Etat or some other form of uprising. Unrest could take place and this could just mean that democracy will fail yet again. Furthermore, there are serious doubts about how women, former members of the Qaddafi government and minorities will fare in the new order.The role of women is essential in achieving a liberal democracy. Women can be instrumental in broadening the parameters of democratic participation. They can challenge and sensitize others about the preconceived notions of what Islam can entail in a liberal democracy. For example, in Turkey, women activists achieved this to within the Islamist Refah (Welfare) Party. Libya has no democratic role models in the Ar ab world from whom to seek mentorship.One main factor that the people of Libya have going in their favour is the fact that when they finally decided to come out and rebel against their long term leader they were not influenced by the western nations or the international community as a whole. The effort was undoubtedly from within the very borders of the country and throughout the country there were many cries which eventually fell unto the ears of the international community. The freedom house report confirms this by stating â€Å"America’s firmness in assisting NATO’s Libyan campaign was an important step.After initial hesitation, the administration has also cautiously supported the process of building democratic systems in Tunisia, Egypt, and Libya. † (Puddington 2012) The Libyans did indeed capture and kill Muammar Qaddafi with the help of NATO forces however they initially started the movement and asked for help to take power away from Qaddafi. The significa nce of this is that there are dependency theorists for example who believe that the western world continues to infiltrate third world nations and prevents them from standing on their own but in this particular case that can be debunked.The issue of neocolonialism at least at the time that the uprising in Libya took place was arguably not present or wasn’t the main driving force and this means that the people of Libya do indeed have a voice of their own and will not be coerced into making policies or vital decisions presented to them by countries like the United Kingdom and United States of America. Liberal democracy therefore can eventually be introduced and maintained in a society like this where the people have a voice and do what they believe and agree together is best rather than allowing external forces to impose laws on them.Another positive factor about Libya which should well favour the nation is that due to its large oil reserves and the fact that they are a major ex porter of oil to different parts of the world, they have a more attractive economy as compared to others in the Arab spring. It is common for nations to establish and develop their political and democratic institutions before any significant change is seen in the economy, however the presence of an already good and healthy economy makes it fairly easier for the presence of democracy.The important thing here would be to have competent people in government to take key and important decisions and also to manage the resources of the nation well. When this is done and the citizens see an even better improvement in the economy it will build their confidence in the government and promote more civilian participation (a very important feature for liberal democracy). With higher literacy rates than other African nations (Puddington, 2012) and with the introduction of new laws for the land Libya in the future can definitely be a success story.To reiterate what has been mentioned above in this essay there is a fair possibility of the existence of a liberal democracy in Libya. It is important to note that â€Å"remarkably, after several years of assembling and sifting data , the panel found that economic , ethnic , and regional effect shave only a modest impact on a country’s risk of political instability. Rather, stability is overwhelmingly determined by a country’s patterns of political competition and political authority. (Goldstone, 2005). Although Libya is a country that is divided along tribal lines, it also has a good educated population and a decent economic growth. Research has shown that economic, regional and ethnic effects only have a modest effect on a country’s risk of political instability and â€Å"clearly, what â€Å"works† in establishing a stable democracy is moving toward a political system with completely open and fully competitive parties that maintains strong checks on executive authority. (Goldstone, 2005) Stability is hugely determined by the prevailing patterns of political authority and competition. The key to maintaining stability lies in the following 1. making democratic institutions that promote open and fair competition 2. Avoiding political polarization and factionalism 3. Imposing substantial measures against abuse of executive power Furthermore, wealth and few or no communal tensions help, but a country does not need wealth or a homogenous population to achieve stability.The fact of Libya having a well educated population also aids in its capability for liberal democracy. Educated people tend to hold liberal views and be more tolerant of divergent views. In the case of Libya, there exist factors that are in its favour in terms of achieving a liberal democracy. In addition, its oil reserves and a wealthy treasury are assets that can be used to build democratic institutions and improve capacity building in its current institutions. The enactment of laws that curb excesses by the executive will be huge boost in this direction.Thus, the prospects of democracy in Libya are not so bleak when considering its wealthy treasury and its small and talented population which have proven that they possess a voice to speak out for the promotion of a good agenda in Libya. Unlike poorer countries who may have to seek external funding to support their democratic initiatives, it need not do so. It has the necessary capital to start a wide range of socio-economic programs aimed towards a liberal democracy.For now, the rebel leaders seem to be receiving acceptable levels of support from the populace and this among other factors serve as crucial pointers that the prospects of a liberal democratic Libya are real. To conclude, we deduce from the above highlighted points that democratic development in Libya is faced with numerous challenges, political and economic, internal and external of long year’s authoritarian regimes, coupled with bad governance, fear of mismanagement of accum ulated capital and mass participation, non-conducive investor atmosphere and a shield from the West.At a minimum, the core elements of developing political democracy are: A strong, pluralistic civil society independent of state control and able to hold government accountable; Regular and effective mechanisms to choose and to change representatives, governments, and policies by non-violent means; wide dispersion of economic resources and state commitment to broadly distributed human development; The rule of law incorporating the principles of the supremacy of the law, equality before the law, and the impartial and fair administration of the law; Strong institutions and an international environment which supports, or at least not harmful to, the above element. This is what Africa and other emerging liberal democracies need in achieving political and economic development of this ‘new world order’ regime.

Welfare State - Definition in the Study of Sociology

Definition: A welfare state is a social system in which the government assumes responsibility for the well-being of citizens by making sure that people have access to basic resources such as housing, health care, education, and employment.