Caring for Children: Roles, Regulations and Practices

Caring for Children: Roles, Regulations and Practices Describing the role of the practitioner in caring for children The role and responsibilities of an early years practitioner follow a number of codes of practice which clearly state how practitioners and other staff must conduct themselves. Chief amongst the codes presently in operation are those that govern special needs, safeguarding children, childrens learning, behaviour, working with parents, and data protection (Nutbrown and Clough, 2014). As Spodek and Saracho (2014) note, the early years practitioner has a clear set of designated responsibilities including: working to the principles of the sector and its codes of confidentiality; meeting the learning needs of each individual child by ensuring that issues of differentiation are met; providing and sustaining an environment that is warm, welcoming and stimulating; working with parents and partners; and working as part of a team that provides a quality service for both children and parents. In addition, the practitioner may also, especially in cases of suspected abuse, have to work with an array of outside agencies and conform to issues of child safety (Daniel, Gilligan and Wassell, 2011). In fulfilling their statutory duties, it follows that the practitioner must put the needs of children first because, as Bradshaw (2011) comments, this helps to keep children out of harm, and by keeping them safe, a productive environment can be created in which they can maximise their potential. It is imperative that practitioners respect others’ choices because failure to do so can cause friction between staff members and can negatively reflect on the setting and upset the children (Sylva et al., 2010). Further, there is a pressing need, as Willow (2014) suggests, to ensure that one always respects issues pertaining to confidentiality. This is because it can help a child stay out of trouble, keep them safe, and help them to develop into responsible adults. Seemingly of secondary importance, because it is removed from direct interaction with the child, but actually of just as much importance, is planning, recording and reviewing the child’s progress (Bradbury, 2014). This is important for two major reasons. First, the formal keeping of records allows the progress of children to be monitored and evaluated against national criteria (Bradbury, 2014). Secondly, it can help practitioners to be reflective upon their own strengths and weaknesses (Paige-Smith and Craft, 2011). This is not, however, merely an issue of internalisation, for such a process also helps when one is undertaking activities because one can evaluate how well the event went well, and from that, make improvements to ensure that in future events are even better planned. Indeed, such reflection is, as Paige- Smith and Craft (2011) contend, an essential function of effective practice. It is also important, as Sims-Schouten and Stittrich-Lyons (2014) recommend, to demonstrate responsibility in the way that one conducts oneself at work, as it helps the children to learn right from wrong. This is an important consideration because it is partly the responsibility of the professional (in co-operation with the parents) to teach the children and in this way one acts as a role model. The creation of a meaningful partnership with parents is also of pivotal importance as the latter can learn from the former as to what the child likes and dislikes – it also allows the parents to take a proactive interest and role in the raising of their children and may help them to ensure that the child’s development is in line with national curricular expectations (Read, 2014). Continuing professional development (CPD) is, as Sims-Schouten and Stittrich-Lyons (2014) explain, critical as it enables the practitioner to enhance their existent skill set and further learn from best practice. It also shows others that the practitioner is interested in helping the children to be the best they can be and that they are dedicated to their role – which may also be useful when seeking promotion or a change of professional employer. Observing children as a form of CPD also helps one to recognise the distinctive stages of a child’s development and this can help with the prioritising of a childs needs, particularly with regard to where they may need additional support (Carroll and McCullough, 2014). Lastly, within this section it can be commented that working as part of a wider team helps to create a positive environment for everyone to work within; by making people feel valued, this may increase self-confidence and productivity (Pugh and Duffy, 2013). Comparing the differing roles of statutory, private, voluntary and independent settings Many parents successfully adapt to changes in their lives and in so doing have the benefit of support from their family and friends to provide assistance if it is required. A significant number of families, however, face issues that affect family life in such a manner that they require professional assistance, or may be hampered by a lack of ‘family and friend’ support or a lack of internal ability to deal with change. Such factors, as Daniel, Gilligan and Wassell (2011) observe, include: financial difficulties, unemployment, divorce and separation, caring for others, bereavement, and social isolation. If one looks at each of these in turn it is possible to comment further on the individual problems that each factor may entail. Thus, with regard to financial difficulties it can be noted that problems faced are likely to be exacerbated where there is a low income family that cannot afford food or clothes or proper rent (Burchinal et al., 2010). Indeed, the rise in food banks within the UK gives a graphic illustration of this problem, as Sylva et al. (2010) note. Poor housing may also lead to feels of depression and declining health as a result of factors such as damp. With reference to unemployment, the loss of a job, and the resultant lack of income can, in addition to depression, lead to stress within relationships and may also result in other family members, such as young mothers, having to go out to work (Shonkoff and Bales, 2011). Unemployment may also lead to a loss of child care as parents cannot afford support whilst a mother is forced to work, possibly culminating in a separation of child from mother at a crucial stage of infant development (Read, 2014). Divorce and separation can also cause several problems which need addressing and assistance from trained professionals. The three major problems are loss of income, smaller housing and cramped conditions, and a sense of guilt on the part of the child for a parent leaving (Bradshaw, 2011). Such issues can create tension and stress that can impact upon development and behavioural issues. In a similar manner, caring for other family members or caring for someone with a long-term illness (such as elderly relatives) can result in additional costs and a perceived ‘rationing’ of care towards children which can cause emotional disturbance (Pugh and Duffy, 2014). Bereavement brings with it, as Read (2014) explains, emotional strain, and issues pertaining to dealing with grief – which may also affect the internal dynamics of a family’s daily life and routines. Finally, social isolation, with its associated lack of communication, may cause health concerns to worsen which need additional support. In such scenarios, it becomes clear, from the comments made above, that children and families may need additional support at certain times in their lives (Burks and Kobus, 2012). There are many organisations and self-help groups that can provide this support. These include, the National Childbirth Trust, the National Association of Toy and Leisure Libraries, the Child Poverty Action group, Home Start, Parentline Plus, Gingerbread, various elements of local authorities’ services, and the National Health Service. In addition, as Shonkoff (2010) has commented, there are many different settings where children can be cared for, including, but not limited to, respite care, holiday play schemes, parent and toddler groups, schools, workplace nurseries, child-minders, pre-schools, after school clubs, residential care, day nurseries and crà ¨ches. The suitability of the option chosen is likely to be influenced both by the specific issue that the family faces and their financial circumstances. There are three different sectors that provide care and education for children. They are: the statutory (or state) sector, voluntary sector, and private sector. The statutory sector is a sector that has to be there by law, such as local state-funded schools and hospitals. The age range that primary schools cover is from five years to eleven years old and they follow a set curriculum (Nutbrown and Clough, 2014). The aim of a state sector school or similar facility is to provide opportunities for the education of every child and to support their learning (Pugh and Duffy, 2014). In so doing, they provide a safe and secure environment for children, which keeps them free from harm. Such schools also provide social opportunities for a child, which include learning to make friends, learning to socialise with people, learning the difference between adults and children, and learning to respect others. It may also provide opportunities for the families of children. This may be achieved by, for instance, new parents’ evenings and sports afternoons, as well as the Parent and Teacher Association. In contrast to the state sector, the voluntary sector is a sector in which people volunteer to organise and run specific facilities. A mother and toddler group (that is not aided by the state) or the Brownies and Girl Guides are examples of such organisations (Pugh and Duffy, 2013). Mother and toddler groups are usually aimed at children who are aged between two and four. Often these kinds of organisations are to be found placed in a church or community hall. Such buildings have not been designed specifically for children and thus may contain hidden dangers (Bradshaw, 2011). Nevertheless, the staff are usually parents themselves and the person in charge of the organisation must have at least a Level Three childcare qualification (or an equivalent). It would also be expected that people who are in positions of trust in such organisations will have been police checked so as to ensure that the children and parents are safe. The organisation, in this case a mother and toddler group, may ask for a small donation each week, and this may range from 50p in some deprived areas of northern Scotland, to approximately  £5.00 a week in Surrey (Burchinal et al., 2010). This money is used to cover the basic cost of booking the hall and associated costs such as lighting and water bills. The area in which the organisation is situated may not have an outdoor area for the children to play in and this can be seen as a disadvantage as keeping fit is an important consideration in the development of children (Marmot and Bell, 2012). It is also to be expected that toddler groups should follow the Early Years Foundation Stage curriculum so as to ensure that children may be taught appropriately and their progress monitored from the earliest possible age (Shankoff, 2010). It is also likely that such groups will be Ofsted-inspected, which is important as it gives the parents confidence as to the quality of education and opportunity being afforded to their offspring in voluntary toddler play groups (Willow, 2014). Whilst the main aim of a mother and toddler group is to provide short-term care to young children, it should also be remembered that such groups also need to prepare the toddler for primary school by equipping him or her with the basic skills that he or she will need to excel in school. In addition such groups also provide social opportunities for the parent or carer (as well as the child) to meet new people and this can help to integrate marginalised groups within society (Barnett, 2011). The private sector is one in which people pay extra to get the best available opportunities for their childs education or health, as well as their own. When a parent uses a private day nursery he or she is charged for using it, with specific charges depending upon the service delivered and the area of the country in which the client resides. Though this may not be true in all such facilities, it is suggested by Burchinal et al. (2010) that the private sector usually provides hot meals for all children who use their services, as well as indoor and outdoor play areas for children to play in. The staff in such centres are likely to be highly motivated and to receive better remuneration packages that their state sector counterparts (Sims-Schouten and Stittrich-Lyons, 2014). Though it may be the case that private day nurseries are not housed in purpose-built buildings, many are – and the private sector tends to pride itself on the quality of the resources that it provides (Walker et al., 2011). As with the state sector, Ofsted may inspect the facilities provided. It is notable that in the last few years a greater proportion of such facilities within the private sector have been rated as more consistently excellent than those in the state sector. The main regulations that govern the care of children in different types of settings The following is a list of the primary legislation that relates to working with children in a childrens centre: Health and Safety at Work Act 1974 Race Relations Act 1976 Human Rights Act 1998 Data Protection Act 1998 Disability and Discrimination Act 2004 Within their day to day working, children’s centres must, at all times, comply with the Data Protection Act, 1998. This can affect daily working practices as it places a duty of care on practitioners to ensure that records are kept in a safe and secure environment and not shared with third parties (Willow, 2014). In addition, through the provisions of the Disability and Discrimination Act 2004, it is assured that there will be, within such centres, no discrimination against any person with respect to their opportunity for employment, the conditions of their employment or the delivery of services as a consequence of their sex, marital status, race, or disability. Cumulatively, therefore, the laws noted above require children’s centres to make sure that they perform their responsibilities in a timely and professional manner and, through so doing eliminate unlawful racial discrimination. The centre should be responsible for and take all such precautions that are necessary to protect the health and safety of all persons employed by it and should comply with the requirements of the Health and Safety at Work Act 1974 and any other Acts or Regulations relating to the health and safety of employed persons (Human Rights Act 1998). It gives further effect in the UK to rights contained in the European Convention of Human Rights. The Care Standards Act 2000 and the Regulations and National Minimum Standards set out the responsibilities of agencies and carers in promoting the health of children who are looked after (Davis et al., 2012). The Education Act 2002 regulates that local authorities and schools are required to protect, safeguard, and promote the welfare of children. This includes health and safety, child protection and the overall well-being of children. The Every Child Matters guidance and the Children Act 2004 introduced a new duty (Section 10) to co-operate at a strategic level on local authorities, Primary Care Trusts and other relevant childrens services partners. The focus of these Acts and the ECM guidance is to protect children and promote the welfare and well-being of children. This encompasses elements such as: being healthy – enjoying good physical and mental health and living a healthy lifestyle; staying safe – being protected from harm and neglect; enjoying and achieving – getting the most out of learning and life, and developing skills for adulthood; making a positive contribution – being involved in community and society and not engaging in anti-social or offending behaviour; and economic well-being – not being prevented by economic disadvantage from achieving their potential. Other legislation that helps the health and well-being of children includes the Children Act 1989, which provides care and protection of all children and young people in need, including those living away from home. Local authorities have a specific duty under Section 22 of the Act to safeguard and promote the wellbeing of each child they look after. The Children and Young Persons Act 2008 amends the Children Act 1989 and supports the care system, putting in place the structures necessary to enable children and young people to receive high quality care and support. Daily care of children There are many different daily routines for children that can help them develop, such as hygiene, including toileting, washing hands, bed time and teeth cleaning; meal time routines, involving sitting at the table, using knives, forks and spoons; and sleep routines, to ensure that children acquire healthy sleeping habits that will stand them in good stead not only through childhood but in adulthood (Barnett, 2011). Daily routines vary depending where the child is being cared for. Promoting and supporting a child’s independence and self-care is important and a child’s self-image and self-esteem are vital to their overall well-being (Marmot and Bell, 2012). For the purposes of this essay, a focus is given on two particular learning activities: tying shoelaces, and dressing appropriately for the weather. Activity One: Shoelaces The activity involves teaching children to tie their laces by making a personalised shoe that the children decorate themselves, with laces for them to practice at home and at day-care. In this, there are two primary roles: the adult role, helping children learn to tie their laces, and the child’s role, which not only covers learning to tie shoelaces, but practising doing so at home. This promotes independence because the children feel a sense of accomplishment in achieving a daily activity that previously adults fulfilled for them. They are able to tie and re-tie their shoes at their convenience and it reduces the need for adult intervention in dressing. The activity promotes intellectual, physical and emotional well-being (Bruce, Meggitt and Grenier, 2010). The decoration of the ‘practice shoe’ is fun and develops their artistic abilities. Targeted at the four- to five-year old, it is within their technical capability (Bruce, Meggitt and Grenier, 2010). Activity Two: Dressing appropriately for the weather This activity involves dressing up a doll in appropriate clothes for going outside to play, which will keep them warm and dry, or cool, depending on the weather. The adult fulfils a teaching role by helping the children learn how to dress first a doll, and then themselves, appropriately. The objective for the child is to understand how clothes are related to temperature, comfort, and the planned activity (such as playing outside, going to the beach, or walking to school in the rain) (Carroll and McCulloch, 2014). This learning opportunity promotes independence by helping them to dress themselves for appropriate situations and weather. Ultimately, they will develop the ability to choose the clothes that they want to wear within a range of acceptable options. The children learn to stay healthy by avoiding becoming drenched, cold, or sunburnt, and their reliance on adults is decreased (Moyles, Georgeson and Payler, 2011). This builds on their intellectual, physical, emotional, and health-related skills (Bruce, Meggitt and Grenier, 2010). The use of the doll can help the activity be fun. The activity can be extended by considering holiday clothing, seasonal variations, and so on. Key issues which enable multi-professional teams to work together A multi-professional team approach allows professionals to share knowledge about a familys needs so that the parents do not have to answer the same questions over and over again (David, 2013). The professionals are aware of each other’s roles in supporting the family so that conflicting advice can be minimised. It is essential that each agency communicates well and understands not only their role and responsibilities but those of the other agencies as well. Parents/guardians are the most important people in a childs life, and carers recognise the importance of this. They have a responsible role that involves sharing care of the child with parents/guardians; listen to parents/guardians, as they are the ‘expert on their child (Sylva et al., 2010). Respect must always be shown for family traditions and childcare practices and when, for instance, there has been a bereavement, it may be important to engage the assistance of an educational psychologist to assess behavioural needs and bring about positive behaviour. Indeed, by adopting a multi-professional approach to working with children and parents the chances of the child being allowed to slip through the net of negligence or abuse is minimised. An understanding of diversity and inclusive practices Recognising diversity is about recognising that children can come from lots of different backgrounds and family structures (Burchinal et al., 2010). Diversity means responding in a positive manner to differences, and valuing all people. The following, though not an exclusive list, can be seen as a solid foundation of ‘checks’ upon which professionals should base their approaches to both children and parents. All children are citizens and have rights and entitlements. Children should be treated fairly regardless of race, religion or abilities. This applies no matter: What they think or say What type of family they come from What language(s) they speak What their parents do Whether they are girls or boys Whether they have a disability or whether they are rich or poor All children have an equal right to be listened to and valued in the setting. It follows that practitioners should aim to improve the physical environment when such improvements are needed. This might include the increased use of physical aids to access education such as ICT equipment and portable aids for children with motor co-ordination and poor hand/eye skills. New buildings should also be physically accessible to disabled pupils by making sure that they have access to existing buildings through the use of ramps and wider doors. Such improvements must be ongoing within organisations to ensure that no section of society is marginalised (Marmot and Bell, 2012). Improving the delivery of information to disabled children at nurseries or schools is a very important objective. The information given (and the manner in which it is given) should take account of pupils disabilities and parents preferred formats. It follows that all children should be treated fairly regardless of race, religion or abilities. This applies no matter what they think or say, what type of family they come from, what language(s) they speak, what their parents do, whether they are girls or boys or whether they have a disability or whether they are rich or poor. Bradshaw (2011) stresses the importance of treating all people equally and with respect. All children have an equal right to be listened to and valued in the setting and all children have a need to develop. These are natural parts of their life and they must be supported at all times within a given setting. This is especially true if there is a scenario in which childrens development may be at risk. For example, children who are disabled and those with special educational needs, those from socially excluded families, the homeless or those who live with a parent who is disabled or has a mental illness, children from traveller communities, refugees or asylum seekers and those from diverse linguistic backgrounds may all faces especial challenges in their individual development. These must be assessed and catered for in an holistic manner to ensure that every child reaches their own maximum potential. This is because, as Wall (2010) notes, all children are entitled to enjoy a full life in which conditions are established by which they may take part in society and develop as individuals, Practitioners must therefore ensure that their own knowledge about different cultural groups is up-to-date and that they consider their own attitudes to people who are different from themselves. Children in the UK are raised in a society with many sources of cultural diversity (Carroll and McCulloch, 2014). Good early years practice needs to support this from the earliest months of babyhood. Practitioners need to work to create a positive learning environment. Play materials, books and other resources can be offered in a helpful way by reflecting on how young children learn about culture and cultural identity. Such diversity and inclusion is also linked to legislation such the Children Act 1989, Special Educational Needs and Disability Act 2001, Rights of Children 1989 and the Race Relations Act 1976. Children like experiencing food, music or dance forms that reflect their own family and neighbourhood experiences, as Gray (2014) elaborates. Early childhood is a good time to offer opportunities that enable children to stretch themselves beyond that with which they are already familiar. Children can learn to appreciate cultural diversity in styles of art, craft, music and dance and all opportunities need to be well grounded in positive pride for styles common to every childs own background. Meeting childrens diverse learning needs means identifying needs, developing individual goals and objectives, selecting or designing appropriate supports and services, and then choosing the best learning setting in which those goals can be realised, and ideally, exceeded. It logically follows, therefore, that the role and responsibilities of an early years practitioner should be cater to the individual childs needs, and to teach them what they need to know and to find out the right way to teach them. Thus, the practitioner must be well-versed in a range of different teaching pedagogies and apply the most appropriate one to the given child at all times (Spodek and Sarancho, 2014). Indeed, it is particularly important, in this regard, to understand different planning stages when planning activities for children and to understand a childs age and stage of development when planning tasks for them (Sylva et al., 2010). It is imperative, that the activities planned are stage-appropriate for them to increase knowledge. Setting appropriate tasks and initiatives helps practitioners meet the individual needs of children (Bruce, Meggitt and Grenier, 2010). A discussion of two strategies for improving learning and performance There are many ways in which a person can improve their own learning and performance. Two are discussed in this section. The first is being under observation. A member of staff could observe you and give you feedback on where you are doing well, and where you need to improve. This could be a colleague, or it could be a formal inspection. The person observing can give you tailored feedback and ideally there should be plenty of time to discuss their observation. This should lead to personal reflection and the setting of career development goals – whereby you can spend time working on improving those areas (observed) where you displayed weakness. The importance of this form of observation and subsequent career development is noted by David (2013). The second commonly used approach is to reflect on one’s own practice and to use this reflection to inform further improvement (Paige-Smith and Craft, 2011). This may involve a reflective practice model, such as Kolb’s theory of experiential learning (Kolb, 1984). I have frequently used his reflective cycle – and by noting what has gone well and what areas need further improvement, I have been able to learn how to handle situations more smoothly and to apply knowledge effectively. Through combining both approaches I have gone through official ‘professional development’ sessions and have held protracted discussions with my line manager and other practitioners. Through so doing we have all shared best practice and perceived improvements in our daily working lives with each other and the way in which we plan activities for the children (David, 2013). A brief overview of how regulations can influence care provision Legislation plays a significant role in working practices within an early years setting but the primary aim is to safeguard and protect children and their families. Legislation, policies and procedures involve those relating to medicines, staffing and employment laws, child protection policies, health and safety, equal opportunities, behaviour management, special educational needs and working with parents (Shonkoff and Bales, 2011). Children and young people should feel happy, safe, respected and included in the school or early years setting environment and all staff should be proactive in promoting positive behaviour in the classroom, playground and the wider community (Willow, 2014). Policies and practice help to make sure the safety and wellbeing of children is in place and it is this legislation, developed through many years and experiences, and even mistakes, that underpin the working practices that are used today (Shonkoff, 2010). The owner of the workplace as a practitioner is t

End-of-life Essay

End-of-life care is a form of medical treatment which is usually provided for terminal illnesses, when the condition is no longer curable and every effort should be made at improving the quality of life rather than increasing the duration of life. Cancer is one condition which is incurable during the advanced stages. End-of-life usually does not involve provision of anticancer treatment but concern for lowering the physical symptoms (especially pain so that the patient is comfortable), addressing the psychosocial issues and the spiritual concerns, so as to improve the quality of life. Often an ethical dilemma exists at the situations under which end-of-life care should be started. The need to provide end-of-life care arises out the physician’s obligation to ensure that the patient can live and die with dignity, compassion, comfort and respect. Two of the cases which demonstrate the physician’s obligations to the patients were the Ann Quinlan case (1976) and the Cruzan V. Harmon case (1988) (Meisel, 2005 & Rekel, 2007). In the Quinlan case, Ms. Quinlan suffered irreversible damage to the brain cortex and was left in a permanent vegetative state. She required ventilator support, artificial nutrition and artificial hydration to maintain her medical and nursing care. She could be kept alive for any duration, but this was morally not required and not in the patient’s best interest. The physician’s refused to remove ventilator support and hence the family had to go to the New Jersey Court. The court in the landmark decision permitted to remove ventilator support as it was not in the patient’s best interest. The court had said that although the patient was in a permanent vegetative state and did not have to ability to make a decision about withdrawing ventilator support, it did not mean that she could not exercise her choice and give her decision. The decision-making could be made by a surrogate who would be doing so in the best interest of the patient. In the Roe vs. Wade case, the court gave the decision that the patient could control their medical treatment and had the right to make decisions. In the Cruzon case, after the ventilator was removed, the patient survived for about 10 years. The Missouri court in this case did not follow the advice of the parent’s on removing life-saving support. The court said that all measures should be done in best interest of the patient, and if there were not clear evidence of the patient’s wishes, then the legal guardian should be acting in the patient’s best interest. The court said that even if there was a need to prolong life through ventilator support, if there was no evidence that the patient’s best interest would be fulfilled. In the case Westchester County Medical Ctr (1988), the New York court said that there had to exist clear and convincing evidence whenever important decisions had to be taken by the surrogate (Meisel, 2005 & Rekel, 2007). Some of the common ethical issues regarding medical treatment have been ‘beneficence’ and ‘non-maleficence’. The physician should do treatment that benefits the patient and does not cause more harm. They should help reduce the suffering and help the patient to return to health. However, in the end-of-life issues, the patient would be dying due to the terminal cancer condition, and using life-sustaining treatment would not have any potential benefits, as it would prolong life, but not improve the quality. In this case medical treatment is doing lot harm than benefits, and hence using it would be inappropriate. However, a clear judgment has to be made in the clinical-decision making and one of the most important issues is whether the patient has made the intention of withdrawing all the life-saving treatment and instead goes into palliative care (in which symptomatic treatment would be provided so as to improve the quality of life during the last few days). Having the patient make this decision is based on another ethical principle known as ‘autonomy’. The patient has the right to choose or disregard whichever treatment he/she wants as the have the right to control any act that is done with their body (Walker, 1999 & Meisel, 2005). Implications of risk management – †¢ Mainly with the use of opioids to manage pain (especially from its prolonged use) †¢ Clinical practice guidelines and protocols should be followed to ensure the greatest amount of benefits for the patient in the form of improved quality of life and lowered discomfort levels (Hoffman, 1998). The right to autonomy of the patient should not be disregarded under any circumstance. The patient has the right to choose palliative treatment or reject it based on their own choices. The patient may also want to undergo curative treatment for cancer even though the survival rate may be low. The patient should be informed of the benefits, risks, options, outcome and costs of all forms of treatment available. The physician should answer all the queries the patient has of all the available forms of treatment. No treatment should be done against the will and intention of the patient. If the patient is not able to make a reasonable decision as they may not be legally competent, then the surrogate (including the family member or a legal guardian) of the patient should make a decision on the patient’s behave, keeping in mind the clear interests of the patient (Walker, 1999, Meisel, 2005 & Rekel, 2007). There may be a lot of competing loyalties between the patient and the organization:- †¢ The organization may try to keep the interest of the patient in mind and may do all that it can to reduce sufferings, improve the quality of life and ensure a peaceful end †¢ The organization may demonstrate a greater opinion towards anticancer treatment as it would involve higher costs (even though it is not beneficial to the patient anywhere) †¢ Even though the patient can benefit to a reasonable extent from anticancer treatment, the organization may force end-of-life care on the patient, as the family members have provided consent. In this case the family members would be having conflicting interests with the patient and may want a faster end to the patient. To prevent any conflicting interest of other parties, it is important that any decision made regarding use of anticancer treatment of initiation of end-of-life care should be clearly justified and documented through evidence-based findings. An ethical approach should be initiated to ensure that all issues are sorted out keeping the patient’s interest in mind:- †¢ The physician should ensure maintaining autonomy of the patient at all stages †¢ If the patient is not competent enough to make a decision by himself, decision-making should be done by the surrogate keeping in mind the patient’s interest and choices †¢ It is the obligation of the physician to ensure that the patient lives †¢ The patient’s competence needs to be determined so that a reasonable decision can be ensured †¢ The patient has to be informed of all the alternative choices available at all the stages †¢ In case of diagnosis of a terminal illness, confirmation should be taken from two physician’s (second opinion) †¢ In case of terminal illness, and the patient choice palliative care, efforts should be made at all stages to improve the quality of life (through symptomatic treatment of physical problems, addressing the psychosocial and spiritual issues), rather than on prolonging life The other issues which need to be addressed include:- 1. Active Euthanasia – This is legal in only a few states of the world including Netherlands and Belgium. The patient should make a reasonable decision, and should be a native from that state in which euthanasia is legalized. The physician himself would take the active step of ending the patient’s life. The patient should be diagnosed with a terminal illness 2. Physician-Assisted Suicide – This has been legalized in the US state of Oregon, PAS has been legalized. The patient would perform the active step of ending life and the physician would merely assist the patient. The patient should be diagnosed with a terminal illness (in which death would be certain within 6 months). The patient should be legally competent to make a reasonable decision (Rekel, 2007). References: Hoffmann, D. E. (1998). â€Å"Pain Management and Palliative Care in the Era of Managed Care: Issues for Health Insurers†, Journal of Law, Medicine & Ethics, 26(4), 267-289. http://www. aslme. org/research/mayday/26. 4/26. 4c. php Meisel, A. (2005). Ethics, End-of-Life Care, and the Law: Overview, Retrieved on August 16, 2008, from Hospice Foundation Website: http://www. hospicefoundation. org/teleconference/books/lwg2005/meisel_jennings. pdf National Cancer Institute (2002). End-of-Life Care: Questions and Answers, Retrieved on August 16, 2008, from NCI Website: http://www. cancer. gov/cancertopics/factsheet/Support/end-of-life-care Rekel, R. (2007). Rakel: Textbook of Family Medicine, 7th ed, Philadelphia: Saunders Elsevier. Walker, R. M. (1999). Ethical Issues in End-of-Life Care, Cancer Control, 6(2):162-167. http://www. medscape. com/viewarticle/417700_1

The Effects Of Power Play On Sexual Harassment - 1093 Words

1. Q: Explain the role that the perception of power plays in determining a sexual harassment claim. In your role as an HR manager, what actions would you take to reduce or eliminate sexual harassment in the workplace? What, if any, punishments would you use in your plan? Although sexual harassment cases happen more often than we would like, power play is one of the most common reasons these type of behavior surfaces within the work area; more often than expected. So, what is power play exactly? It’s a method people use to benefits themselves in a way others cannot, due to the position to which there in; while putting people in an unwanted compromise. One example, is a man that is the General Manager of a well-known establishment may†¦show more content†¦47). Additionally, â€Å"in a recent survey conducted by the University of Minnesota, more than 130 percent of women in a higherer bracket within a company will face some form of sexual harassment; than those in a less stressful job title† (DeNisi Griffin, p. 47). While there are many steps one can take in handling a claim such as sexual harassment, some steps are far more necessary than others; in order to see lasting results. That’s, why I’d take the following steps: to eliminate any form of sexual harassment from taking part in my company I’d begin by having a manager that is familiar with the codes of conduct and punishments one can/will face in a case such as this handle the claim. â€Å"First, the Human Resource Manager should make it clear that conduct such as this is not acceptable behavior; and will not be tolerated by any means† (Heathfield, par. 1). Then move forward by coming up with a plan of action, talk with the victim and gather the information needed to proceed with the allegations by informing them that there’s no worry of retaliation for reporting this claim; ever. â€Å"Then follow-up by having they explain what, where, when, and how this took place, ect.; as well as the time, place, and date of the incident; so a claim can be submitted to the proper authorities† (Heathfield, par. 6). Once

Essay on Human Resources Management - 1168 Words

NAME _________________________ DATE________________ This exam has two (2) parts – multiple choice and short answer essay. Circle the correct answers (2 points each). 1) The methods used to give new or present employees the skills they need to perform their jobs are called ________. A) orientation B) training C) development D) appraisal 2) The first step in a training program is to ________. A) assess the programs successes or failures B) design the program content C) conduct a needs analysis D) train the targeted group of employees 3) What is the second step in the training process? A) assess the programs successes or failures B) present the program to a small test audience C)†¦show more content†¦A) Fair Labor Standards Act B) Civil Rights Act C) Employer Retirement Income Security Act D) Davis-Bacon Act 21) Jill works as a cashier at a grocery store. She earns $8 an hour (or $320 for a 40-hour week). Last week, she worked 44 hours. What did she earn last week? 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