Private enterprise system Research Paper Example | Topics and Well Written Essays - 1500 words

In Goyas Greatest Scenes We Seem to See free essay sample

In this paper I will investigate the social analysis that is passed on by Lawrence Ferlinghetti in his sonnet â€Å"In Goya’s Greatest Scenes We Seem to See. † Ferlinghetti reprimands the modern insurgency in America; he contrasts its results and war. Ferlinghetti implies different works of art by Goya that portray war, and connections their understanding to the industrialization in America. The sonnet contains different beautiful components, for example, similar sounding word usage, metaphor and Ekpharsis all strengthen his talk. Being a painter just as an artist adds to Ferlinghetti’s splendid blending of workmanship and verse, the poem’s appearance has a solid enhanced visualization, one that move the idea of war and tumult through its structure. I will show Ferlinghetti’s utilization of similar sounding word usage, metaphor and Ekpharsis, as a way to condemn the industrialization in America. The socio chronicled setting of this sonnet is the financial development that the American culture has encountered during the 1950’s, otherwise called â€Å"the brilliant period of free enterprise. Lawrence Ferlinghetti was a piece of the â€Å"Beat Generation,† a gathering of writers that in addition to other things were known for their analysis of private enterprise and dismissal of realism. The sonnet was distributed in Ferlinghetti’s book titled â€Å"A Coney Island of the Mind† in 1958. It is written in an open structure and needs clear rhymes and structure; it follows the musicality of regular discourse. I will allude to the sonnet by lines, and as having two segments: the first talks about craftsmanship, and the second examines American culture and expressways. The speaker recipient connection in the sonnet is starting with one researcher then onto the next. Ferlinghetti’s language just as his reference to craftsmanship demonstrates that the sonnet targets instructed individuals, conceivably his kindred writers. In this sonnet Ferlinghetti wires two periods, the peninsular war as it was portrayed by Goya, and the industrialization in the 1950’s. In the principal area and lines, Ferlinghetti depicts the torment and enduring that is incurred on mankind utilizing Ekpharsis, he alludes to workmanship and significantly depicts its importance, which later he connects to industrialization. â€Å"In Goya’s most prominent scenes we appear to see/the individuals of the world† (lines1-2) The similar sounding word usage in the principal sentence attracts consideration explicitly to Goya’s artistic creations, joined with the plural ‘we,’ can be viewed as alluding to individual researchers, similar to him, they can decipher Goya’s works of art. These lines contain a hyperbolic misrepresentation; Ferlinghetti sums up the individuals of the world, as all being depicted in a specific artwork. All the individuals on the planet would never be delineated in a solitary work of art. The utilization of exaggeration causes to notice Ferlinghetti’s understanding of that specific second, as though individuals from the 1950’s are portrayed in it. He keeps on depicting â€Å"[the exact] second when/they initially accomplished the title of/†suffering humanity† (lines3-5). Ferlinghetti alludes to a specific second that portrays aggregate torment; anyway the particular snapshot of arriving at the title of â€Å"suffering humanity† (line 5) can't be resolved. Ferlinghetti embodies the painted â€Å"suffering humanity† (line 5) they â€Å"writhe upon the page,† (line 9) as though curving in torment in the artwork. Every one of these occasions of exaggeration depict revulsions of war as though they become alive today, at the peak of the industrialization. Ferlinghetti utilizes hyperbolic depictions to perform and stand out to the conditions in the artistic creations; he interfaces the results of past war, to the present-day industrialization. Ferlinghetti reference to specific works of art is so as to interface the delineated war to industrialization. It is obvious through the â€Å"suffering humanity,† (line 5) and explicit components, for example, â€Å"groaning with children and knifes/under concrete skies†. These pictures suggest a progression of painting by Goya called â€Å"The Disasters of war,† that portray reasonable pictures of war. These pictures speak to Ferlinghetti’s view of industrialization. Lines 10 and 11 that delineate a scene of fight, additionally show a solid complexity among children and blades. Infants represent birth, giving life and continuation, while blades represent passing, murder, and the taking of lives. The depiction of Goya’s works of art gives a solid complexity among nature and industrialization. There are no regular components in Goya’s artistic creations, the skies have all the earmarks of being concrete like, trees are â€Å"blasted,† (line12) hit, stricken, not by a characteristic power however by war. The â€Å"cement skies† (line11) have a two sided connotation; other than proposing a picture of a dull war they give an association with the idea of industrialization. â€Å"Bent sculptures bats wings and mouths/tricky gibbets/corpses and meat eating cocks† (lines 13-15) these lines contain solid similar sounding word usages; the accentuation in their articulation makes show that causes to notice the message ofâ death that is passed on in these lines. The â€Å"abstract scene of impacted trees,† (line12) additionally suggests industrialization; Ferlinghetti stands out normal components from men made material. The hypothetical scene of bowed trees brings out the feeling of war between regular versus unnatural components, through the decimation of regular components, results of war are connected with industrialization. Ferlighetti’s depiction of pictures from Goya’s â€Å"The Disasters of war,† intercede between his insight into craftsmanship and verse, changing incredible and striking scenes of war, to those of industrialization. The specific pictures that Ferlinghetti depicts are named in an extremely specific and exact word decision. Ferlinghetti’s language in the sonnet has a solid political undertone. Being a piece of the â€Å"Beat Generation,† has impacted his composition and word decision in this sonnet. The principle motivation of the â€Å"Beat† culture involved excusing realized shows recorded as a hard copy, being current and progressive, trying different things with medications and sexuality, dismissing and scrutinizing realism, and express delineations of human condition. The vast majority of these components are shown in the sonnet. Terms like â€Å"blasted trees† (line 12) and â€Å"bent statues,† and â€Å"beaks,† (line 13) might be deciphered as medication related. As far as slang being ‘blasted’ implies ‘high,’ ‘bent’ implies inebriated with medications and ’beaks’ is a term for cocaine. Potentially, these terms were explicitly chosen, so as to stay aware of the plan of being present day, progressive, and express about the genuine state of humankind. The structure just as the word decision are Ferlinghetti’s defiance to the recognizable shows in verse, the absence of evenness and the twofold implications in his expressions all satisfy a notoriety of a â€Å"beat† writer. Ferlinghetti’s combination of past wars through Goya’s works, with present occasions as the industrialization, demonstrates him to be capricious, inventive, express and incredulous of current happenings, he effectively keeps up his status as a â€Å"beat† artist. Goya’s â€Å"imagination of disaster† (line18) ends up being â€Å"bloody real,† (line19) as Ferlinghetti’s moves the peruser to the current where it all â€Å"still exist[s]† (line20), and the danger of industrialization on the American culture is equivalent to the danger of war, yet with an alternate scene. In the second piece of the sonnet Ferlinghetti presents a move of periods; he centers around occasions in the 1950’s. As indicated by Ferlinghetti, there was an adjustment in the scene that comprised of announcements that promoted and energized private enterprise, development of expressways, vehicles and motors, these came about because of industrialization. â€Å"It is as though they truly still existed/and they do/Only the scene is changed,† (lines 20-22) the capitalization of ‘only’ strengthens Ferlighetti’s guarantee that industrialization is war like. The most and just huge change is that of the foundation, the presence of boards and vehicles. â€Å"They are still gone along the streets/tormented by legionnaires/bogus windmills and maniacal roosters,† (lines 23-25) Ferlinghetti’s word decision is unique; he keeps on melding the idea of war with industry in the line â€Å"plagued by legionnaires† (line 24). legionnaires suggests an army in the military and along these lines to war, returning us to the thought of decimation, then again the utilization of the term to depict an ailment is incredible. Legionnaire’s sickness is known to be moved by microbes that flourish in pipes, water tanks and cooling frameworks, which have all been made with the assistance of industrialization. By utilizing this term which partners two distinct implications, Ferlinghetti ably embeds the possibility that humanity’s biggest adversary is the plague of industrialization. Ferlinghetti demands depicting the adjustment in the scene as an ailment, as a war where humankind previously lost. Ferlinghetti keeps on battling against â€Å"bland billboards† (line 30) that are â€Å"ranged along the roads,† (line 23) and pulverize the common scene. The scene is tormented by â€Å"false windmills and hysterical roosters† (line 25) which speak to private enterprise at its best. Ferlinghetti’ decision of word is political, the windmills insinuate ‘Don Quixote’ and the bogus mammoths he battles, and also Ferlinghetti battles the monster boards, the goliath organizations which remain behind them. The â€Å"demented roosters† (line 25) that plague Fe

Suboxone Withdrawal Symptoms, Timeline, and Treatment

Suboxone Withdrawal Symptoms, Timeline, and Treatment Addiction Coping and Recovery Print How Long Does Withdrawal From Suboxone Last? By Corinne O’Keefe Osborn linkedin Corinne Osborn is an award-winning health and wellness journalist with a background in substance abuse, sexual health, and psychology. Learn about our editorial policy Corinne O’Keefe Osborn Medically reviewed by Medically reviewed by Steven Gans, MD on February 26, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on February 26, 2019 More in Addiction Coping and Recovery Methods and Support Overcoming Addiction Personal Stories Alcohol Use Addictive Behaviors Drug Use Nicotine Use In This Article Table of Contents Expand Overview Signs and Symptoms Coping and Relief Warnings Long-Term Treatment Resources View All Back To Top Suboxone is a prescription medication used to treat opioid addiction. When used as directed, it relieves the symptoms of opioid withdrawal without getting you high. Suboxone also reduces opioid cravings, which goes a long way toward preventing relapse. Many recovering addicts take it for months, even years, after they stop getting high.??   While it doesn’t get you high, Suboxone is still an opioid, which means that you  will experience withdrawal symptoms if you try to quit cold-turkey.   Overview The way Suboxone works is a little complicated, so let’s break it down. Think of the opioid receptors in your brain like a light switch. First, you touch the light switch, then you flick it on. Heroin, morphine, and prescription opioids are what’s known as full opioid  agonists. They bind to the opioid receptors in your brain and turn your lights on. Suboxone is a combination of two drugs: buprenorphine and naloxone.   Buprenorphine is what’s known as a  partial  opioid agonist. Think of this as your opioid dimmer switch. It binds to your opioid receptors and dials up the brightness, without turning the lights on completely.?? Naloxone is an opioid  antagonist, which means that it binds to the opioid receptors but doesn’t turn them on. Naloxone acts like a hand over your “light switch,” preventing other opioids from flicking the switch on and getting you high.       If your “light switch” is already turned on, naloxone will shut it off. Naloxone was added to Suboxone to prevent diversion and misuse. This means that if someone injects Suboxone when they have opioids in their system, it can cause them to enter withdrawal immediately. When used as directed sublingually, the naloxone is not absorbed. You should not begin taking Suboxone until all other opioids are out of your system. Suboxone is most effective when taken after you begin experiencing withdrawal symptoms (lights out). The buprenorphine in Suboxone will dial up the lights enough to stop your withdrawal, but not enough to get you high.?? Abruptly quitting Suboxone can cause the same symptoms as traditional opioid withdrawal, but they are typically less severe. You may experience sweating, anxiety, agitation, muscle aches, and an upset stomach. Rather than quitting cold turkey, clinicians typically advise slowly tapering down your dose. By slowly dimming the lights, your withdrawal experience should be relatively smooth. The most common complication of opioid withdrawal is relapse. Relapse is more common when withdrawal symptoms and cravings are severe. A combination of tapering, medication management, and counseling can help improve your odds.??     Signs and Symptoms If you are using Suboxone as directed for the treatment of opioid addiction or to treat pain, you can expect to experience withdrawal symptoms if you miss a dose or try to quit cold-turkey.??       Opioid dependence occurs with any long-term opioid use, regardless of whether you are following a doctor’s orders. Once you become physically dependent on a drug, you experience withdrawal symptoms when it leaves your system.     Suboxone causes most of the physical symptoms typical of opioid withdrawal. These include:?? Muscles aches and painsSweatingChillsStomach cramps or diarrhea  Nausea or vomiting  Tremors or twitchingAnxiety  Restlessness  Runny noseTeary eyesGooseflesh   If you take Suboxone to treat an opioid addiction, then your withdrawal symptoms should be less severe than what you have experienced in the past. To get a better idea of how mild to moderate opioid withdrawal symptoms compared to more intense symptoms, you can check out the  Clinical Opiate Withdrawal Scale (COWS). Health professionals use this scale to determine the severity of opioid withdrawal syndrome.??     The timeline of Suboxone withdrawal will also be a bit different than your past experiences. Buprenorphine is a long-acting opioid, which means withdrawal symptoms can take several days to appear.   Suboxone withdrawal typically begins within 2 to 4 days, peaks around days 3 to 5, and resolves within 7 days. Sometimes, however, psychological symptoms can linger for several weeks. This may include depression and an inability to experience pleasure.     The psychological challenges associated with withdrawal are not always caused by withdrawal itself. Withdrawal can trigger the return of mental health problems that were muted by drug use, such as anxiety and depression.?? After withdrawal, people are also forced to take a good look at the damage that their drug addiction has wrought. It is not unusual to struggle with issues of guilt and regret. Figuring out how to get your life back on track can feel overwhelming and emotionally exhausting. That’s why it’s so important to reach out for help. Coping and Relief The most effective way to treat Suboxone withdrawal is to avoid it in the first place. You can avoid the symptoms of withdrawal by working with your doctor to taper down your dose. Tapering means gradually reducing your dose overtime. If you have been acquiring your Suboxone illicitly, you will want to find a doctor to help your taper.     Suboxone tapering schedules typically take place over the course of 7 to 28 days. Some studies have shown that overall success (measured by a period of prolonged abstinence) tends to be better with a shorter, 7-day taper.??  Other studies have found that withdrawal symptoms are managed best by a slow, flexible tapering schedule. With a flexible taper schedule, your doctor can slow the dose reduction if you experience any uncomfortable symptoms.??     If you are still struggling with withdrawal despite the Suboxone taper, your doctor may recommend one or more support medications. This could include the following: Lucemyra (lofexidine hydrochloride) Lucemyra is a brand-new medication approved by the FDA in May of 2018.?? It is the first non-opioid medication approved to treat the symptoms of withdrawal. Lucemyra works by reducing the release of norepinephrine, a neurotransmitter believed to play a role in withdrawal symptoms. Because it does not contain an opioid agonist, Lucemyra treatment can begin immediately after your last dose of Suboxone. It is currently approved to treat healthy adults for a maximum of 14 days following opioid cessation.   If you are struggling with Suboxone withdrawal, consider the following tips:?? Drink more fluids than usual during withdrawal to prevent dehydration.  Eat a well-balanced diet to keep your vitamin and electrolyte levels up.Work closely with a doctor, counselor, or physical therapist to develop new ways of coping with pain during and after withdrawal.Practice relaxation techniques (meditation, listening to music) to help you deal with anxiety and agitation.Try mild to moderate exercise to help you deal with restlessness.Find something else to focus on during withdrawal, such as a television show, book, or hobby.  Get support and encouragement from a local community group or Narcotics Anonymous (NA) meeting.   Warnings Opioid withdrawal is often unpleasant, but it is very rarely dangerous. When it comes to Suboxone, complications are even more unlikely.?? Still, it is important to work closely with a medical professional during your Suboxone taper. The biggest threat to people withdrawing from Suboxone is the risk of relapse.   Relapse is common among people with opioid use disorders and is generally considered a normal part of the recovery process. But people who have been taking Suboxone are typically further along on the path to recovery. A relapse at this point can be both dangerous (because your tolerance will have plummeted) and discouraging.   If you have been acquiring your Suboxone illicitly or do not have a close relationship with your doctor, it can be tempting to try tapering down on your own. This is inadvisable for several reasons. Tapering on your own increases the likelihood of failure. Unsuccessful attempts to quit are discouraging and psychologically distressing. If you are quitting Suboxone because you’re pregnant or breastfeeding, then you definitely want to talk to a doctor. Suboxone is not recommended for pregnant women, so it’s great that you’re considering stopping.?? Depending on your situation, your doctor may recommend an accelerated taper or a switch to buprenorphine or methadone, which have been proven safe to use during pregnancy.     Long-Term Treatment Opioid use disorders are notoriously difficult to beat. It is not uncommon for someone to make it through detox successfully only to relapse a few weeks later. But if you have been using Suboxone to treat your addiction, you are already ahead of the game. Suboxone allows you the time to develop a long-term treatment strategy without being distracted by the discomfort of withdrawal.   After Suboxone, a long-term treatment plan should focus on preventing future relapse. Talk therapy plays a very important role in relapse prevention. Once you come off Suboxone, you will have beaten your physical dependence on opioids, but not the psychological aspects of addiction.   Talk therapy can help you figure out why you began abusing drugs in the first place. You can learn to identify specific situations and feelings that have led you to use in the past. Identifying these triggers helps you recognize and eliminate the negative thought patterns that cause you to make poor decisions.   Research shows that combining talk therapy with medication management is more effective at treating opioid addiction than medication alone. There are many ways to explore talk therapy. You might consider working one-on-one with a psychologist or mental health counselor in private practice. You can meet with a mental health or addiction counselor at a local community clinic. Or you can explore group therapy programs, which are offered at many hospitals, clinics, and addiction treatment facilities.   Resources To find a psychiatrist or psychologist who specializes in opioid use disorders, you can use this searchable directory from the  Substance Abuse and Mental Health Services Administration (SAMHSA). You can also call SAMHSA’s national helpline at 1-800-662-HELP (4357).     To find more information about Narcotics Anonymous (NA) meetings in your area, check out their  website. You can find a meeting near you with their  searchable directory.   If you are the loved one of someone with an opioid use disorder, you may want to consider attending a support group for people like you.  Nar-Anon is a 12-step program for family and friends of people with substance abuse problems. At these meetings, you can talk with people who have experienced the same fears and frustrations as you.   A Word From Verywell   If you are on Suboxone and making plans to quit, chances are you are already on the path to recovery. Don’t mess things up for yourself by trying to quit cold turkeyâ€"work with a doctor. Remember that a relapse at this stage can be very dangerous, so don’t become over-confident in your ability to abstain. Finding some sort of support, whether through meetings or therapy sessions, can help you stay sober in the long-term. Is Suboxone Better at Treating Opiate Addiction Than Methadone?

The Surname Baker Its Genealogical Meaning and Origin

From the Middle English bakere and Old English bà ¦cere, a derivation of bacan, meaning to dry by heat, Baker is an occupational surname that originated in medieval times. The name did not, however, necessarily involve a tradesman who baked bread. Baker was also used for others involved with baking in some capacity, including owners of communal ovens in humbler communities. Fast Facts for the Surname Baker Baker may be an Americanized version of similar sounding surnames from other countries, including the German Bà ¤cker and Becker; Dutch Bakker and Bakmann; and the French Boulanger.Baker is the 38th most popular surname in the United States, the 37th most common surname in England, and the 35th most common surname in Australia.Surname Origin:  EnglishAlternate Surname Spellings:  Bakere Where do People with the Baker Surname Live? According to WorldNames PublicProfiler, the Baker surname is most popular—based on a percentage of the population—in Australia. It is next most popular in the United Kingdom, especially in southern England, followed by the United States, and New Zealand. The Baker surname is also especially popular in Newfoundland and Labrador, Canada. Forebears ranks Baker as the 740th most common surname in the world, and marking it as most common, based on frequency, in Australia, Jamaica, the United States, Wales, and England. Famous People with the Surname Baker Ella Baker—American civil rights activistJosephine Baker—jazz singer and Harlem Renaissance figureGilbert Baker—creator of the gay pride flagAnita Baker—Grammy-winning RB singerMary Baker Eddy—American author, teacher and religious leader; founder of Christian ScienceHenry Baker—assistant U.S. patent examiner dedicated to uncovering the contributions of African American inventorsChet Baker—American jazz trumpeter and singer Genealogy Resources for the Surname Baker Contrary to what you may have heard, theres no such thing as a coat of arms for the Baker surname.  Coats of arms are granted to individuals, not families. Coats of arms may rightfully be used only by the uninterrupted male-line descendants of the person to whom the coat of arms was originally granted.  While you wont be able to look up a coat of arms, there are many other resources to help further your study of all things Baker. Here are just a few: 100 Most Common U.S. Surnames Their Meanings—Smith, Johnson, Williams, Jones, Brown. If youre one of the millions of Americans sporting one of these top 100 common last names from the 2000 census, this is a great resource for finding out more about your family history.Baker Family History and Genealogy—Pictures, documents, and stories for the descendants of Reason Baker of Rowan County, North Carolina. There are also genealogies for a number of other early Baker lines.Baker DNA Study—Over 300 male Baker descendants from around the world have already submitted their DNA to this project in order to determine who connects to whom. Individuals with the Baker surname and variations passed down through their direct male line are welcome to join the project.Baker Family Genealogy Forum—Search this popular genealogy forum for the Baker surname to find others who might be researching your ancestors, or post your own Baker query.FamilySearch - BAKER Genealogyâ€⠀Access over 8 million free historical records and lineage-linked family trees posted for the Baker surname and its variations on this free genealogy website hosted by the Church of Jesus Christ of Latter-day Saints.  BAKER Surname Family Mailing Lists—RootsWeb hosts several free mailing lists for researchers of the Baker surname. You can either join the list or browse or search the list archives to research in postings going back more than a decade.DistantCousin.com - BAKER Genealogy Family History—Explore databases and genealogy links for the last name Baker.The Baker Genealogy and Family Tree Page—Browse genealogy records and links to genealogical and historical records for individuals with the Baker surname from the website of Genealogy Today. Sources Cottle, Basil. Penguin Dictionary of Surnames. Baltimore: Penguin Books, 1967. Menk, Lars. A Dictionary of German Jewish Surnames. Bergenfield, NJ: Avotaynu, 2005. Beider, Alexander. A Dictionary of Jewish Surnames from Galicia.  Bergenfield, NJ:  Avotaynu, 2004. Hanks, Patrick and Flavia Hodges. A Dictionary of Surnames. New York: Oxford University Press, 1989. Hanks, Patrick. Dictionary of American Family Names. New York: Oxford University Press, 2003. Hoffman, William F. Polish Surnames: Origins and Meanings.  Chicago:  Polish Genealogical Society, 1993. Rymut, Kazimierz. Nazwiska Polakow.  Wroclaw: Zaklad Narodowy im. Ossolinskich - Wydawnictwo, 1991. Smith, Elsdon C. American Surnames. Baltimore: Genealogical Publishing Company, 1997.

The Alienation Of Gregor Sams The Bug Man - 1451 Words

Michael Gray 5/16/17 Intro to Literature: Fiction The Alienation of Gregor Samsa: the Bug Man Life can at times be an illusion that drops people into the deepest realms of the world. It can be an illusion so vivid and confusing that a person is seen by his or herself as nothing but an insect. This is the sad but real case for Gregor Samsa in the book, The Metamorphosis, written by Franz Kafka. Kafka delivers a story of a character, Gregor, who lives a tedious life. He is told as a man who cares for his family greatly, yet a man who lives in isolation. He works as a salesman for a boss he cannot stand, at a job he despises, yet he continues to work in order to support his mother, father, and sister. He has difficulties maintaining†¦show more content†¦The first step of Gregor’s alienation stemmed prior to his transformation into an insect. His work environment is an extremely dehumanization experience for him. His boss treats him awfully, and when Gregor missed the initial train he usually took to work, his mother and father were worried as to what do to. If he misses work they knew that he would be in extreme trouble with his boss. Kafka explains this situation as, â€Å"And even if he managed to catch the train, he couldn’t escape a dressing-down from the boss, for the attendant from work had been waiting at the five-o’clock train, and had long ago informed the boss that Gregor had missed it. He was the boss’s creature, stupid and spineless† (31, Kafka). Kafka describes Gregor as nothing but an insect floating around work, waiting to be stomped on by his boss. Gregor’s loathe for his work helps develop his isolation from the rest of the world, alienating him from his own body, into that of an insect. It becomes evident that Gregor hates his job, and especially his boss, when he first wakes up in the morning. Gregor thinks to himself, â€Å"If it wasn’t that I’ve held back on account of my parents, I’d have given in my notice long ago. Ià ¢â‚¬â„¢d have gone to the boss and told him what I thought outright, with feeling. It would make him fall off his desk† (30, Kafka). Gregor is sick and tired of working for his boss at the job

Applicability of Lean Management in Nursing Free Essays

Nurses also bring added advantages to the role of Lean leader-an uncompromising commitment to patient care and the natural ability to view hospital yester through the lens of the patient. The second literature â€Å"Lean Management in Med/Surge† By Barbara Mercer talks about the pros and cons of lean Management as Tracy Galilee, MBA, URN, has developed a professional and personal investment in the success of the organization- one aftercare’s lean facilitators. Lean management principles are derived from the manufacturing industry, specifically from Toyota Motor Corporation, which espouses continuous improvement and respect for people. We will write a custom essay sample on Applicability of Lean Management in Nursing or any similar topic only for you Order Now Sounds like a great idea to incorporate into healthcare, wouldn’t you think? The Institute for Healthcare Improvement (III) agreed. The ‘His 2005 White Paper Going Lean in Healthcare was based on expert presentations from the ‘HI Calls to Action Series. Among the experts was John Toasting, MD, president and CEO at Teacher, who was integral to bringing lean management to the organization. The white paper’s executive summary briefly explained the purpose and goals of lean management as they would relate to healthcare: â€Å"The Institute for Healthcare Improvement believes that lean principles can be – indeed, already are being – successfully applied to the delivery of health care. Lean thinking begins with driving out waste so that all work adds value and reverse the customer’s needs. For those unfamiliar with lean management practices, Galilee did not take over as a dietary counselor; instead, she assisted nursing staff to cut the fat from daily processes that stand in the way of the most efficient practices and the best possible outcomes for patients. Now the business unit manager of the med/surge unit, Galilee continues to assist staff in employing lean principles in a developing community of empowered problem-solvers. (2) The last literature to be reviewed is an article that spoke against the implementation of Lean Management Don’t ‘Lean’ on Me, Hospital Workers Say’ by Alexandra Bradbury [August 1 5, 2013. Part of the lean ethos is getting workers to participate in their own exploitation. Some hospitals offer nurses a boost of pay and status for championing a lean project. â€Å"Hospitals are very often successful at co-opting natural leaders,† Mencken said. What can the union do? First is to educate members to see through management’s hype-?what labor educator Charley Richardson called the â€Å"tricks and traps† designed to lull you into believing you and management have the same concerns at heart. These include Joint brainstorming, win-win rhetoric, and trust exercises. One strategy is to try to get your people onto the lean team-?but they probably won’t be picked, and it’s a â€Å"slippery slope,† Sheridan-Gonzalez said. Union members on Joint committees should treat every meeting as if it were a bargaining session, with two opposing sides. They can say, â€Å"We don’t accept your framing. We see this as a potential for harm,† Mencken recommends. And the usual union tactics can be used against lean, too: petitions, forms that document unsafe staffing, button/ sticker days, and marches on the boss to resist speed-up. 3) Study Population Nurses have served as leaders of 2 very successful Lean initiatives at the Robert Wood Johnson University Hospital (RUSH). Founded in 1884, RUSH is a Magnet hospital that is the principal teaching hospital of the University of Medicine and Dentistry of New Jersey’s Robert Wood Johnson Medical School. Ea ch year Rush’s 1300 physicians and 1500 nurses care for more than 200 000 patients. The first case study-â€Å"OR Lean†-details the Lean transformation of Rush’s operating room (OR). The second case study describes the remodeling of Rush’s emergency department (DEED) with Lean principles and practices. Monsoons et al,2012) While nurses in Interiors Medical Center, New York and California Pacific Medical Center have iced out the disadvantages of Lean Management in their respective hospitals. Sources of Data A primary source data was utilized in this study. Lean management as cited in journals, articles and blobs and are mostly Internet based were used and acknowledged. Some of these Journals and articles are: â€Å"From Toyota to the Bedside: Nurses Can Lead the Lean Way in Health Care Reform† by Joyce E. Johnson, Amy L. Smith and Kari A. Master (Nursing Administration Quarterly,September 2012 ,Volume 36 Number 3 ,Pages 234 – 242), â€Å"Lean Management in Med/Surge† By Barbara Mercer, and â€Å"Lean Management Don’t ‘Lean’ on Me, Hospital Workers Say’ by Alexandra Bradbury ‘August 1 5, 2013 among others. Data Analysis As stated in the research’s sources 2 data clearly evolved and both stating favor and opposition towards lean management. The 2 cases in RUSH that favor lean management has the following results from their studies: case study 1 : OR LEAN The need for improved efficiency in OR scheduling has been although the number of Lean interventions in the OR reported in the literature is relatively small when compared with interventions in other hospital departments. Most recently in 2011, Violence reported a 20% increase in OR productivity and capacity n a Canadian hospital that adopted Lean methods. The electronic paperwork to discharge a patient is â€Å"eight pages of clicks,† said Betsy Prescott, a leader in the Massachusetts Nurses Association. Muff get spoken to if you miss one thing. ‘†some of these floors can have 15-19 discharges a day,† she said. Mire’s not taking care of the patient, you’re documenting. † (Bradbury,2013 ) Standardization is a watchword of lean management. Nurses at SST. Charles Medical Center in central Oregon were Justly proud of their Rapid Response Team-?it had saved lives. But that didn’t stop the administration from announcing plans to end the team. The rationale? Other hospitals don’t have one. Most hospitals now use computers to set staffing. You enter the number of patients on the unit today, and the software spits out how many nurses and nursing assistants are needed. Employers claim they factor in the severity of patients’ conditions-?but Mortally none of them do,† Burros said. (Bradbury,2013 ) Strengths and Weaknesses of the Study The strengths of this study can be summarized as the following: lean management was applied to a well known and prestigious hospital Robert Wood Johnson University Hospital (RUSH). Founded in 1884, RUSH is a Magnet hospital that is the principal teaching hospital of the University of Medicine and Dentistry of New Jersey’s Robert Wood Johnson Medical School and with well documented evidences that lean management worked for them. Other credible articles as to the applicability of lean management were also cited and gave a good argument to the promise that lean management can work for the healthcare sector. So in terms of credibility, accurate accumulation and evidence based arguments both for and against lean management were well presented. On the other hand, it is very clear that the main weakness of the study is its very limited scope and hence the uncertain conclusion as to whether lean management is applicable or not in nursing management. Conclusion It is very clear that the study has a very limited scope but we will summarize below both arguments for and against lean management in regards to its applicability in Nursing management. As shown in the results of the 2 case studies in order for lean management to succeed it must be: Leadership is critical for success The literature emphasized the central role of committed leadership in the success of Lean work. According to Doss and Orr, leadership is â€Å"an integral part of the Lean Operating System, not an afterthought. † The support of leaders, they suggest, can â€Å"make the difference between superficial attempts at implementing Lean-where the tools and techniques are evident, but the behaviors haven’t changed-and full transformational deployments where the entire organization embraces Lean from the bottom up and the top down. Monsoons et al,2012) Lean work is systems work In their 2010 review, Macho and Litter emphasized that Lean work is a whole yester strategy that cannot be done piecemeal and that no single â€Å"silver bullet† solution, such as a new computer system or automated equipment, can achieve the same results. Systems thinking, the discipline of seeing wholes and inter- relationships, is certainly not new. As Sense suggested more than 20 years ago, the systems perspective is badly needed in a world overwhelmed by rapid technological change, changing demographics, shifting borders, and increasing complexity. 5)(6) Monsoons et al,2012) Communication is critical to success From the outset of our Lean work, we knew that communication was the key to the horn-term and long-term success of our work. As we had done with past quality improvement efforts, we regularly reminded the staff to keep the vision of the future state in mind because, as the anticipatory principle suggests, the image of the future is what guides the current behavior within an organization. Monsoon et al,2012) As for the argument of those who are against lean management, the following reasons are cited: Lean management according to critics does not consider human factor for it stresses â€Å"no downtime, Just in time staffing, emphasis on the use of technology to monitor staffs performance, among others. Standardization is an emphasis of lean management that also rin gs alarm bells among employees who do not yet have a holistic appreciation for lean. In lean, first you standardize, then you improve. Improving a non-standard process is like remodeling a house built on quicksand. It won’t do you much good in the long run. â€Å"(Bait, 2010 ) If we continue to standardize work in hospitals without accounting for the variety nurses and hospitals get from patients we will make things worse for patients, nurses, doctors and the bottom-line. The system needs to be redesigned around the work by management, ruses, doctors and others working together to improve the system. This all begins by management changing their thinking around the design and management of work. Once management understands by seeing the damage of their thinking in a normative way can real changes impact the work. Bait,2010 ) Now, to answer our query whether lean management is applicable or not in Nursing management, we say it is still remain to be seen. Learning from both sides of the argument of for or against lean, it is safe to conclude that lean management is applicable but not to all types of health care institution and setting. As much as success of lean management s well documente d in the ROUGH, we have to remember this is a Magnet accredited hospital and employees are expected to get used to high standard work and compliance to a strong administrative leadership and management. Lean management is also about culture change and resistance will be expected so those who oppose have some valid points in which management has to seriously consider. After all for any system or management to work, people’s satisfaction and cooperation should be addressed foremost and not to be ignored or taken for granted. Otherwise, what is the use of introducing a promising system such as lean management when in he process it will lead to dissatisfied and tired staff? How to cite Applicability of Lean Management in Nursing, Papers

Why does Mrs Maloney get away and Roylott doesnt Essay Example

Why does Mrs Maloney get away and Roylott doesnt Essay Although both Lambs to the Slaughter and the Speckled Band are of the same genre (murder mystery) they have many differences making them different from each other. These differences suggest why Mrs Maloney gets away and Roylott doesnt get away with it. The protagonist in each story is viewed in a different way. We watch Maloney to see if she gets found out, Sherlock Holmes to catch his man because Sherlock Holmes always gets his man. From this simple quote his man you can see it brings up a number of issues concerning the historical differences in the story. His man already suggests the murderer is a man because of the sexist views on woman on this time. Roald Dahl capitalises on this idea and makes a change. This shows how the audience expectation over time changes and what changing prolonging ideas do to the surprising aspects of the story. There are countless differences in the stories although theyre of the same genre: murderers are of different sex, Roylott is selfish selfless; Mrs Maloney is selfless, protagonist murderer; protagonist detective. These are just a few of the differences. These sources show that the two stories could be of there own specialised genre because of the vast number of differences. They could be in their own category within the murder mystery genre. This suggests why Roylott is caught and Mrs Maloney isnt, because their two different genres, within the vast murder mystery genre. The murderers caught in one genre and in the other genre the murderer doesnt. In Roylotts book genre he gets caught because that is the way it is in that particular genre. We will write a custom essay sample on Why does Mrs Maloney get away and Roylott doesnt specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Why does Mrs Maloney get away and Roylott doesnt specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Why does Mrs Maloney get away and Roylott doesnt specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Although there are many differences there are also many similarities, which makes the two stories, fall under the same genre: both involve murders, both are stories, both employ unexpected murder weapons. The time difference in the two stories means that the people have a different expectation of what expect in a story. The time difference in the Speckled Band is clearly shown by the language, yet you had a good drive in a dogcart. We wouldnt use dogcart in todays language; if people wrote differently their expectation is bound to of changed. The audience at the time of the Speckled Band Would expect the murderer to be a man. Change in audience suggests why Roylott gets caught and Mrs Maloney doesnt. Out of the two murderers Roylott seems the more likely to get away with the murder because he is very scheming. He plans the whole murder, which seems flawless and hes a doctor so hes intelligent enough to get away with planning a successful murder. Mrs Maloney on the other hand because she doesnt work and stays at home waiting for her husband would be less intelligent, Mary Maloney was waiting for her husband to come home from work. This would be normal for a mid 20th housewife to stay at home and wait for husband. A woman wouldnt be expected to work let alone kill someone. A woman wouldnt be able to conceal such a crime without planning it according to audience preconceptions: At that point Mary Maloney simply walked up behind him and without any pause she swung the big frozen leg on the back of his head. She also loved the man so much she would do anything for him, she loved to luxuriate in the presence of this man. Any reader, Dahls 20th century one audience or Doyle that emotional state to be caught where as Roylott who took a medical degree and went to Calcutta, where by his own professional skill, he established a large practice wouldnt. Just for being a woman and not a man a Doyles 19th century audience and Dahls 20th century audience would expect Mrs. Maloney to be caught. Also Roylott to a 19th century reader would be thought to be tougher than a woman who are portrayed weaker in the Speckled Band as well as in Lamb to the Slaughter. Ii was Mrs Stoner who went to see Holmes because she was scared, its not the cold that makes me shiver. Roald Dahls subverts what people expect and makes Mrs Maloney the murderer to surprise the audience. It is even more surprising for Doyles 19th century audience and Dahls 20th century audience that Mrs Maloney gets away with it. Mrs Maloney gets away with it because Dahl as an author wants to surprise the audience by making something unexpected happen. The story is a murder mystery and it is a shock to the audience that a woman could kill. Dahl shocks his Lamb to the Slaughter reader because it is not Mary Maloney (not because she is a woman) but her husband who seems the more likely killer. When her husband comes in, his mind seems to be occupied by something else. He seems to answer her questions rudely, darling shall I get your slippers (Mrs Maloney speaking) no he answers (Mr Maloney). He answers the next questions no, I dont want it, forget it. Clearly he doesnt really want to speak to her. Mr Maloney is also drinking heavily: When he (Mr Maloney) came back, she noticed that the new drink was dark amber with the quantity of whisky in it. Mr Maloney was clearly occupied by something else and dinking heavily. Any reader, whether it was 100 years ago or present day would expect Mr Maloney to be the murderer. Dahl then makes Mrs Maloney the murderer to surprise the audience. This suggests why Mary Maloney kills in the first place, to make it a better story. Mary Maloney seems the unlikely murder to surprise the audience. Mrs Maloney seems to be the more unlikely murderer to surprise the audience. Mrs Maloney seems exceptionally happy and very much enjoyed the company of her husband, she loved to luxuriate in the presence of this man She seems eager to do anything for her husband, Ill get it she cried (Mrs Maloney) jumping up. It isnt at all obvious right up to the point that she kills her husband that Mary Maloney is the murderer. Any audience, Dahl or Doyles would not put Mrs Maloney, such a loving wife, on their list of suspects. This (the element of surprise) idea, which I have expressed earlier, is what Dahl capitalises on. This is even more so for Dahls mid 20th century audience who even more surprised the woman is a murderer. In the Speckled band it isnt a shock to see that Roylott is the murderer. Dr Roylott is a violent aggressive character. In the start of the story Mrs Stoner describes how he beat his native butler to death and, on his return to England, his own two stepdaughters and everybody in the local area fear him: .. For he (Roylott) is a man of immense strength, and absolutely uncontrollable in his anger. Any reader, whether it is Doyles original 19th century audience or a modern on, would place Roylott at the top of their fist of suspects. Doyle chooses such a two dimensional-character in Roylott. Roylott is easy to dislike because of his selfish, uncaring and mean behaviour, I am a dangerous man to fall foul of he shouts at Holmes furiously. From his first appearance you can tell hes a horrible man thats easy to dislike. Holmes the meddler, Roylott screams. It would be against the conventions of Holmes for the horrible, bad, murderer to get away with it. Any reader of the Speckled Band irrespective of time would want Dr Roylott to get caught. If Mrs Maloney a nice woman were the murderer in the Speckled Band she would probably get away with it again. The fact that Roylott is horrible suggests why he is caught and Mrs Maloney isnt. We also feel pity for Mrs Maloney and if we felt pity for Roylott, Holmes wouldnt be able to catch him because it would be against conventions of the good detective catching the bad killer. This suggests why Roylott is caught. We feel pity for Mrs Maloney because she only hides her crime to protect her baby, what were the laws on unborn children? Did they kill them both mother and child. These factors build on the growing pity the audience is feeling for Mrs Maloney. Her husband who she loved so much, for her (Mrs Maloney) this was a blissful time of day enjoying his (her husbands) company after the long hours alone in the house, told her he was having a affair: This is going to be a bit of a shock to you, Im afraid he said (Mr Maloney) nd he told her She sat very still through it all, watching him with a kind of dazed horror. She kills her husband because she is mentally unstable and the growing emotion is taken out as she kills her husband. No wonder the audience feels pity for audience would, whether its Dahls 20th century one, or Doyles original 19th century one. These factors suggest Roylott was caught, because hes the bad guy and the bad guy always loses. Mrs Maloney wasnt caught because she was on the good side. This evidence shows why Mrs Maloney gets away, Roylott does not. It is also questionable whether Mrs Maloney does get away with it in these circumstances. Her husband who she greatly relied on not just for expenses, of course Ill give you money but for love, is dead. She is also left with a baby to bring up without a dad and without the money he would supply. Does Mrs Maloney get away with it? Clearly to any reader, she doesnt. So does it mean both Roylott and Mrs Maloney were caught but just in different ways. The earlier quotes link in with the motive, Roylotts is selfish; Mrs Maloneys is selfless. Mary Maloney killed her husband because he was having an affair or something along the lines. Dahl leaves the reader to play at detective; he leaves some unsolved clues, which Doyle does not allow the freedom of because Sherlock Holmes cannot miss a thing: And he told her; it didnt take long, four or five minutes at the most, and sh sat very sill through it all, with a kind of dazed horror. She is so in love with he husband she ignores him: It occurred to her he hadnt even spoken After this she realises her world is falling apart and she cracks, hence the killing. The motive, which is so cleverly hidden by Roald Dahl, is not so apparent but we have a fair idea what it is by her reaction. Any reader would be just as emotionally jacked up to killing someone; anyone would, considering her state of affairs. On the other Roylotts selfish killing for money more than underlines his greedy personality. His motive is clear and we can see why he may want to kill his stepdaughters when Mrs Stoner tells his story. We find out that in the event of marriage Roylott: would have to pay a certain annual sum in the event of our (Mrs Stoner and her sisters) marriage. Mrs Stoners twin sisters suspiciously die the night before her wedding. This shows Roylotts clear motive to kill his two stepdaughters before the night of their wedding. Mrs Stoners twin sister was killed the night before her wedding and a few weeks before this heard a strange whistle. Now Mrs Stoner before her wedding hears the same whistle: Imagine, then, my thrill of terror last night when I heard in the silence of the night the low whistle. What a coincidence! The evidence shows to any reader Roylott has a clear motive (for money) to kill his two stepdaughters and that he has already killed one. The evidence shows Roylott: is selfish; Mrs Maloneys is selfless as stated previously or Roylott is killing for money (which he does not need) and Mrs Maloney for emotional pain of having to bring up a baby on her own. Roylotts clear motive, which is apparent to a reader of either Lamb to the Slaughter or the Speckled Band, shows that he is the murderer, its just a matter of obtaining evidence. Roylotts selfish plot is uncovered because he is selfish and Sherlock Holmes as one of the conventions of his character always gets his selfish murderer. Roylott when under pressure from Holmes in the Speckled Band loses his temper and subsequently goes to Holmess house. He shouts at Holmes ever more underlining that hes the killer. If he didnt kill his stepdaughters he wouldnt worry because Holmes would not find any evidence. By going to the house and losing his temper he is almost begging to be caught: Holmes then Scotland Yard jack in the office! Roylott is so obviously the murderer any reader would be putting their life on it. The story would all most be stupid if he didnt get caught. Roylotts horrible, nasty portrayal is underlined when he storms in Holmess house: The ejaculation had been drawn from my companion (Holmes) our door had been suddenly dashed open. This underlines the audiences hate of him. His two dimensional bad man image makes the audience hate him, which makes Doyles portrayal successful. Doyle wants us to hate him so the reader reads on to see if he does get caught, which in the end is true this audience are satisfied someone they hate is caught. In Lamb to the Slaughter Mary Maloney conceals her crime in a number of ways. Firstly, lucidly enough for her she suddenly hits out at her husband with a leg of lamb and not an obvious murder weapon like a knife: Mary Maloney walked up and Swung the big frozen leg of lamb, down as hard as she could on the back of his head. This isnt an expected murder weapon and works to her side later on when the detectives eat it. After her sudden act of emotion she pulls herself together and practises speaking to the green grocer, which could act as an alibi. She tried a smile. It came out rather peculiar Hullo Sam, she (Mrs Maloney) said. She then actually goes to the green grocer and acts very calm: Patrick decided he doesnt want to eat out tonight. This shows that by managing to keep calm when under pressure, unlike Roylott, Mrs Maloney successfully hides her crime. This suggests to a modern or 19th century audience by acting natural and not losing your temper like Mrs Malone you would not get caught. After getting her alibi Mrs Maloney goes back to the lamb in the oven, which, she put in earlier acting natural. She phones the police not before seeing her husband dead on the floor, which gets her in a state, realising what she had done. This makes it easy to act natural like she says Quick! Come Patricks dead! The police arrive and go about the business of checking for clues. She then offers them a drink playing the typically portrayed housewife image. The policeman answers, I m not strictly allowed but Ill have just the one to keep me going. Mrs Maloney hears the detective that went to see the greengrocer talking about how she acted when she bought the stuff for dinner there. The detective says she was, very cheerful impossible that she (killed her husband). This shows she has got a successful alibi in he greengrocer. Mrs Maloney then goes back to manipulating the policemen by begging them to eat the lamb, please she begged eat it. Through these actions of manipulating the policemen she gets away with it. The main aspect of Mrs Maloneys story is based on the representation of woman to be feeble. Roald Dahl subverts traditional conventions by making a woman (Mrs Maloney) the murderer. A reader in the 19th century would be shocked at the idea of a woman murdering because of the sexist views on woman at this time. This is the principle reason why Mrs Maloney gets away. She plays on the convention that women are feeble breaking the convention of the male murderer. The detectives before anything subconsciously think its a man: Its the same old story. Get the murder weapon, and youve got your man. The detectives already think its a man and when she manipulates them into thinking She would never do it they have got know chance of getting her, why dont you have one yourself (Mrs Maloney as detective for a drink) you must be awfully tired. She is clearly trying to manipulate them to any reader. Unlike Roylott who is typical murderer, a man, who killed a butler, who makes Folks fly at his approach, Mrs Maloney is your much complex character who clearly to any reader or in this case the policemen not a obvious murderer. Roylott gets caught because he is your average easy to catch murderer because of what he is. If he were a nice woman who never banned anything he would not get caught. Likewise if Mrs Maloney drunk heavily wore shabby clothes she would probably get caught. It doesnt matter whos got the best plan its who is portrayed without the characteristics of your normal stereotypical murder. Mrs Maloney knows she (Mrs Maloney) knew nearly all of the men (policemen) at the precinct which adds to her favour. The policemen dont need much manipulating because they know she is a loving housewife, they (the policemen) were always nice to her. If she was horrible they wouldnt be nice but they are always nice to her, always almost suggest they make a special effort to be nice to her. Any reader irrespective of time, from the evidence shown could say all the factors of who she is as a person and what she is (a woman) successfully lead to her survival. Mrs Maloney manipulates them into eating the lamb, you must be terribly hungry and (Mrs Maloney) know Patrick would never forgive me. The police eat the lamb totally feeling sorry for Mrs Maloney. In the other room Mary Maloney to giggle shows her acknowledging the fact she manipulated them and to us she succeeded in breaking conventions. Mrs Maloney clearly manipulated so much she had the policemen breaking rules. She asks Jack Noonan a detective if he wants a whisky to which he replies Im not strictly allowed, but through Mary Maloneys manipulation he does anyway but (the detective) might just take one drop to keep me going. She then manipulates the others to having a drink, one by one the others came in and were persuaded to take a little nip of whisky. She has clearly to any audience over powering them, the whole group falling straight into her trap. The group stood round rather awkwardly trying to say consoling things, it wouldnt be awkward if they didnt care or feel sorry for her they wouldnt try to sat the right things to her but she has manipulated them so much they are going out there way to be nice. Clearly to any reader whether it a 19th century Doyle reader or a modern one you can clearly see she has manipulated them. Her behaviour before her husbands death and after is totally contrasting. From the lovely housewife she turns into a crafty killer. This shows shes more than just a housewife, like all women are but she is portrayed leading us to think differently. Unlike Mary Maloney Roylott fails to manipulate the detectives but even worse approaches them with threats. Roylotts more complex way of disguising the crime, which he thinks will hide it, is secondary to how the characters are portrayed. If you know someone did the crime its just a matter of finding evidence but if you are led to believe its definitely not them you dont even try to catch him or her, this is Roylotts fault. Roylott trys to conceal his crime by training a snake to go up a ventilator, the rope was there as a bridge for something to pass through. Roylott was put in the story to be caught by the ever-successful Holmes; if Roylott werent caught the story would be unsuccessful. The story is a jigsaw puzzle, which to us seems impossible but all the while Doyle knows Holmes will uncover it making him look intelligent and clever. Irrespective of time Holmes will always get his man. Any reader realises this as soon as Holmess name is mentioned. If Sherlock Holmes were investigating Mrs Maloney It is questionable whether she would get away with it. Note man underlines that men are the prime suspects and this is true to any audience irrespective of time. So why does Roylott get caught and Mrs Maloney doesnt? There are many aspects to say why and why not. Mrs Maloney is the protagonist in one leading her to come out on top. This is one important factor into who gets caught. They should be separated into different genres because they are so different (many differences) but it is due mainly to the authors to outcome of the story.