Clarify as best as you can, the difference between modernity, modernism and postmodernism, according to Mary Klages’s definitions and the other items posted in the course. Write at least 600 words. Quote BRIEFLY from her essay throughout your posting. Most of the writing should be your own words. The ratio of your own writing to quotes should be about 4 to 1. Paragraph your ideas. Organization is important. Try to bring some insight to the discussion. You will be graded on organization, your use of quotes from the item posted in the course, and the insight you bring to the ideas. You MUST use quotation marks and cite your the works you use with a Works Cited page. If you do not include quotes from the course items, quotation marks, a Works Cited page, and if your response is shorter than 600 words, you will be automatically graded down for not fulfilling the basic requirements.
900 – 1200 word. You will discuss the ways in which Death of a Salesman is a modern play, according to Klages’s essay, and the ways in which David Mamet’s Glengarry Glen Ross is a postmodern answer to Arthur Miller’s play. Read the entire explanation below before starting your paper. At the end of the explanation are some parameters for the paper.
In your final paper, you are to use Miller’s essay (as opposed to his play) and Klages’s essay to discuss how one play is modern and the other postmodern.
Create an introduction that ends in a thesis (the main idea of your paper).
Create at least two body paragraphs (though there can be more). Each body paragraph should start with at topic sentence that captures the main ideas of the paragraph. The topic sentences SHOULD NOT be a statement about what happens in the play. It should state the ideas the student wishes to discuss in the paragraph. Following the topic sentence students will develop those ideas with explanation that is supported by both the essays and the play.
Use MLA citations in the paper and create a Works Cited page. Use the Owl Purdue website at http://owl.english.purdue.edu to answer your questions on MLA. Turn the final paper in by the due date.
Your paper will be graded on the following:
Understanding of the concepts (are the concepts of modernism, postmodernism, and tragedy clear?)
Structure (is there an introduction? a thesis? topic sentences?)
Development (are the ideas developed with enough explanation and textual support in the form of brief quotes? Are the paragraphs clear and do they hold together?)
Understanding of the plays (is there enough information about the plays to show real depth of understanding?)
Use of MLA (is it correct? Is there a Works Cited page that is also in correct format?)
Grammar and spelling
SAMPLE ANSWER
Both plays are about salesmen and the effects of unbridled capitalism on the human psyche. Miller’s take on this theme is decidedly modern. Miller’s modernist views are clear in the plot and characters of the play, but they are also underlined in Miller’s essay about tragedy, where he defends the notion of a modern tragic hero. Tragedy is a classical concept, but Miller reworks that idea and turns it into a modern concept (not a postmodern one). One of the most important ways in which Miller’s play is modern has to do with the idea that modern writers “try to uphold the idea that works of art can provide the unity, coherence, and meaning which has been lost in most of modern life; art will do what other human institutions fail to do” (Klages).
Clearly, in Miller’s view, the institutions of capitalism have failed to provide Willy with a meaningful life. Willy cannot buy his way into meaning, though he tries; nor can he work his way into meaning, though he tries. Not only is this failure a problem for Willy, but it is a problem for many Americans in Miller’s world. Willy represents an American Everyman. The character personifies the typical working stiff in Miller’s imagination. Willy Loman is truly a low man within the capitalist hierarchy. As such, his life has little meaning within the capitalist system. But in writing his play, Miller attempts to give Willy’s life meaning. He attempts to provide “what other human institutions fail to do” (Klages). Updating the classical form of tragedy, Miller attempts to do for Willy, and all men like him, what money and capitalism can’t – provide meaning for his existence to the rest of the world. And thus, Willy’s story becomes a dire warning to everyone in the audience, telling them to ignore the lure of money and try to do something of value with their lives. “He never knew who he was,” says Biff of his father (Miller 2391). And that is Willy’s greatest tragedy. In his attempt to achieve the capitalist dream of riches, he loses his soul.
Mamet’s play gives us an altogether different take on capitalism – different, not better. His play is decidedly postmodern. And he knows he is writing in the very long shadow of Arthur Miller, who was one of America’s greatest living playwrights at the time Mamet wrote his play (Miller has since died). Where Miller saw tragedy and sadness, Mamet sees the farcical horrors of a system that would grind up men for a Cadillac. And while Miller tries to create meaning from Willy’s tragic life, Mamet’s play makes no claims to creating meaning out of the pathetic lives of his characters. His characters live very provisional lives; in fact, the entire plot hinges of the provision of each man getting his name on the board. But Mamet’s play “doesn’t lament the idea of [the] . . . provisionality, or incoherence” of his characters’ lives; instead Mamet’s play says something along the lines of “let’s not pretend that art can make meaning . . . let’s just play with nonsense” (Klages).
His playfulness is clear in the dark comedy of the play. Unlike Miller’s play, Mamet’s is very funny (one good reason to see the film is that it’s easier to get the comedy). That doesn’t stop it from presenting a very, very dark vision of humanity, but Mamet makes no claims to providing an answer to that darkness. He just examines it and holds it up to the theatrical lights for his audience to examine as well. Another way he uses playfulness is in the dialogue. He takes the way he’s heard men speaking to each other and exaggerates it. The characters are left with little besides profanity to express the rage, disappointment, fear, and horror they feel at the condition of their own lonely lives. Thus, this play is NOT modern because as sad as these characters might be, they do not give us one of the fundamental pieces of tragedy that a modern play does: in a modernist play’s attempt to provide meaning it must provide catharsis for the audience. Catharsis, that rush of feeling that comes at the end of all tragedies (whether they are classical or modern), is what makes the audience feel like they want to make better choices than Willy did after seeing the play. Both Aristotle and Miller discuss the importance of catharsis in tragedy. Mamet’s play provides no catharsis and is not tragic or modern. It is postmodern, especially in the way it offers us no answers and no meaning beyond the experience of enjoying or being repulsed by the world he creates for us in his play.
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Select one of the following ethical issues in healthcare:
Foregoing curative medical treatment due to religious beliefs
Use the CSU Global Library and select Internet sources to conduct research on your chosen topic. Based on your research, provide the history of the issue from a legal, ethical, and moral perspective. In your paper address the following questions:
Do the consequences of actions always direct what is morally required?
What should happen when two principles come into conflict? For example, should patient autonomy be considered more important than beneficence? Defend your position.
Are moral and ethically rules always binding, or are they only guidelines to be assessed in each case? Defend your position.
Your paper should be 10-12 pages in length, well-written, and formatted per CSU-Global specifications for APA Style. Support your analysis by referencing and citing at least six (6) credible, peer-reviewed sources other than the course textbook (Ethics in Health Administration: A Practical Approach for Decision Makers, 2nd ed, by Eileen E. Morrison).
SAMPLE ANSWER
Foregoing Curative Medical Treatment Due to Religious Beliefs
Introduction
Healthcare professionals frequently find themselves in dilemmas as they undertake their chores at the workplace, with some directly confronting the ethical issues while others turning away. Usually, the moral courage that one possesses is what matters most as it, more often than not, helps the practitioners in addressing the various ethical issues that may present themselves; which could even involve doing something otherwise considered wrong. Inasmuch as there usually are predetermined courses of action considered ethically moral or otherwise, the consequences of the course of the action taken is what really matters (Stewart, Adams, Stewart, & Nelson, 2013). Because of this, an action that is otherwise not acceptable may have to be carried out in order to get to achieve a desirable consequence; for instance, according to most religious doctrines, abortion is not acceptable, even the conscience of the individual that may be involved may not allow it. However, if done for the sake of good will remains morally binding, for instance, the case of complications in pregnancy.
In order for us to get to understand the implications of the ethical issues pertinent with the health care practice, there is the need to understand the definition of nursing by the International Council of Nurses (ICN). Under it, the profession is defined as: “Nursing encompasses autonomous and collaborative care and communities of all ages, groups, families and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention f illness and the care of ill, disabled, and the dying people. Advocacy, promotion of safe environment, research, participation in shaping the health policy and in patient and health systems management, and education are also key nursing roles.” (ICN, 2011). As outlined by Morrison (2011), the definition incorporates the three fundamental components of bioethics. It is, thus, conceivable to say that the health practitioners have the obligation of developing a well-founded ground of ethical understanding with regards to the protection of the people; which is their sole duty.
Moral Courage
The ability of one to make the right decisions in such situations that involve moral and ethical issues is what is called moral courage. According to Day (2007), moral courage is “a trait displayed by individuals, who, despite adversity and personal risks, decide to act upon their ethical values to help others during difficult ethical dilemmas. As Hall (2014) asserts, such individuals tend to strive to see to it that the only do what is right, even in cases whereby most are expected to choose least ethical behavior, which could even be not taking any action.
Conflict of Principles
Religious, spiritual and cultural beliefs and practices remain very crucial in the lives of most patients, yet most health practitioners usually find themselves at the dilemma of whether to, how and when to address such issues when dealing with patients. In the past, the physicians were basically trained on the various ways of diagnosing and treating the various diseases, but with very little or no training on the spiritual approach to the ordeal. Besides, the professional ethics allows the professionals no chance of impinging their personal beliefs on their patients who are usually very vulnerable (Brierley, Linthicum, & Petros, 2013). The matter is even complicated further by the characteristic nature of most nations of religious pluralism, having a wide range of systems of beliefs: agnosticism, atheism to the very many religious assortments. Because of this, it tends to be very difficult getting to fully understand the religious beliefs of all the patients from all walks of life.
The very first temptation that would prove worthwhile in this case is for the professionals to fully avoid the doctor patient interactions with respect to their spiritual or religious beliefs. This simplest solution may never be the best as several studies have shown that the spiritual and cultural beliefs f various patients have been proved to be very important factors for the patients to be in a position of coping with relatively serious illnesses (McCormick et al, 2012). McCormick et al (2012), assert that the engagement of the spiritual beliefs of the patients in their healing process may be devised by the health practitioners through comparison of their own beliefs against those of the patients.
Case Scenario: Foregoing Curative Drugs due to Religious Beliefs
In some communities, there is too much belief in the traditional practices that accepting the modern medicines becomes very difficult. Such communities have a belief system in which they believe and may recognize the move towards accepting the western medicine as evil. In such a case, the patient may never be taken to the hospital, or worse still, after getting to the hospital refuse to take the prescribed medicine on the belief that it is against the doctrines of their religion. The most common cases, include, but not limited to; blood transfusion, abortion, taking of family planning pills and even the normal tablets.
Conflict in Principles
In case of the principles coming into conflict, there usually is the need to be very flexible as there are so many ways in which the situations may present themselves. For effective resolution of such conflicts, the ethical and professional principles, rather than the personal preconceived ideas, should always form the pillar for the effective decision making when it comes to ethics (ANA, 2011). The ethical behavior of nurses is usually guided by a set of principles contained in the American Nurses Association (ANA) Code of Ethics of Nurses (2001). It is expected of all the nurses that they uphold all the principles in the course of their practice of professional nursing, while, at the same time, the Cord of Ethics for Nurses encourages them to ensure consistency with their personal values. There is also emphasis on the need to hold open discussion with regards to conflicting ethical principles in such a manner that all the principles are placed at the same level and treated equally.
Autonomy versus Beneficence
Autonomy
Autonomy refers to the personal self-rule that is both free from controlling such interferences that may result from others and the personal imitations that my put meaningful choices at jeopardy. In the health care, autonomy forms one of the key guidelines for the clinical ethics. A point that must be noted is that when speaking of autonomy, it does not merely imply leaving the patients the freedom of making their own choices. Rather, the health practitioners are under an obligation to see to it that they create the conditions that provide room for the independent choices, thought under some guidance. The respects for autonomy scenarios include giving room for autonomous choices as well as respecting the right to self-determination of an individual.
It must be noted that the doctors are usually visited by the people because they may not be equipped with the necessary information or background necessary for the making of informed choices. Hence, it is the physicians that educate the patients in order for them to adequately understand the situations, including; addressing the fears and emotions that may interfere with the decision making ability of the patients. Confidentiality is another form of autonomy very crucial in administering the treatment to the patients.
Beneficence
Usually, this is an action done purely for the benefit of others through either removing harm or simply by improving their situations. Apart from being refrained from causing harm, the health practitioners are expected to see to it that they help the patients. Due to the nature of the relationship inherent between the patients and the physicians, the doctors have the obligation removing or preventing harm and balancing and weighing the possible risks against the possible benefits of any action.
Balancing of autonomy and beneficence
Amongst the most difficult and common ethical issues to tackle comes in when the patient’s autonomous decision comes into conflict with the beneficent duty of the physician, which is mainly looking after the best interest of the patient. For instance, a patient who has very strict religious background may refuse to take medicine, simply because they believe in spiritual healing. This may be so challenging, especially when the physician has successfully diagnosed the ailment and knows its cause well, hence, its prescription (ANA, 2011). At such a point, the physician may be under the challenge of whether to maintain the autonomy of the patient or take a beneficence action, which will violate the autonomous requirement of the patient. More often than not, the two are equally important, however, beneficence comes first as it is a matter of life and death.
Basically, the modern biomedical ethics are grounded on four principles, which balance categorical Imperative of Emmanuel Kant: you must always do the right thing no matter what it takes, and Utilitarianism of John Stuart Mill and Jeremy: make the best decision for everyone all around. When in combination, the principles are usually called Principalism.
Respect for autonomy: giving priority to the informed choices of the patient. This theory asserts that the practitioners need to see to it that the wishes of the patients are taken into consideration. As such, the wish by a patient to have a kind of special attention with regards to choice of the health care services administered should solely depend on the patient’s wish.
Non-malfeasance: do no harm
Beneficence: do what is best for the patient, regardless of their consent. This principle asserts that the consent of the patient may be overlooked in order to see to it that the course of action is for their own good. With this, the health care practitioners are expected to ensure the good of the patients even if it means doing what they don’t wish for. The ultimate consideration of the morality will lie in the consequences, and at times, even if a patient requested for the end not to have blood transfusion due to religious beliefs, they may eventually end up thanking the physician, rather than suing them (Morrison, 2011).
Justice: always balancing the social and individual costs, risks and benefits. The physician has the obligation of seeing to it that they properly advise the patients with respect to the possible risks involved to ensure they are well informed before getting to a medical ordeal.
Morals and Ethics
Most of the moral dilemmas that tend to arise in medicine are usually analyzed using the four aforementioned principles but with some consideration given to the resultant consequences, though the frameworks may have limitations. The judgment of the best consequences is not always clear, and din case the principles conflict, the ease of deciding on the best dominant is always very hard. Virtue ethics usually focuses on the nature of the moral agent rather than how right the course of action taken is. Usually, as a practitioner, the ethical principles, which guide what action to be taken do not usually take into account the moral agent’s nature (Cordella, 2012). To look into how binding the morals usually are, the “standard” Jehovah’s Witness case may be used.
A very competent adult believer loses too much blood due to bleeding in a vessel in an acute duodenal ulcer, and the only best chances of saving his life is by having a blood transfusion together with some operation done on him. In exercising his autonomous decision, the patient requests for surgery and treatment with the best non-blood products available, and refuses blood transfusion. He even accepts the risks that are pertinent with surgery without blood transfusion.
It is very important for the health practitioners to get to distinguish between morality and legally binding courses of actions as an action may be legal but not moral and vice versa. For instance, the resuscitation of a dying patient may be considered legal, but not moral. On the other hand, when a patient falls too sick at home, it may be moral to over speed to the hospital but illegal. Also, the physicians have the obligation of distinguishing between religion and morality. From instance, some of the religions believe in circumcising women while others recognize it as a sin.
Moral Frameworks
However, the moral theories tend to provide different frameworks upon which the nurses may be able to get clarification as well as view the patients’ disturbing situations. Widely used and applicable are three frameworks that may guide the physicians. The three basic broad categories of the moral frameworks are: virtue theory, deontological and utilitarianism theory.
Virtue theory
This theory exclusively probes the human morality. It gives very little attention to the regulations that people need to adhere to; rather, it puts more emphasis on what is deemed necessary in development of human characteristics considered as good, just like living a generous and kind life.
Deontological ethics
These are usually associated with the ethical and moral standards in the execution of the professional duties by the health professionals.
Utilitarianism theory
This is the belief that any form of action is considered as being right as long as it leads to the greatest good for larger number of people. As such, there usually is a calculation on the outcome of any particular action. As such, if a health practitioner considers an action as having high propensity of bringing good and happiness to larger number of people; it definitely is the right thing to do (Morrison, 2011). In other words, the utilitarianism tends to base its reasoning on the usefulness of the action that may make it be considered as moral or immoral; for the course of action to be considered as moral, the good outcomes have t outweigh the bad ones.
Moral principles
They are the broad and general statements of philosophical concepts that provide the foundations upon which the moral rules are founded.
The health practices usually come with too many challenges which leave the practitioners at a dilemma in more often situations than not. For instance; the debate n abortion, organ transplant, end-of-life issues, management of personal health information and the allocation of the scarce health resources. Looking into each of the aforementioned issues, it usually leaves the platform very open for the practitioner to decide what they deem right course of action to take. As put across by Elliot (2011), “Culture provides the rules or framework that guides us as we negotiate our way through our daily activities of life.” Through the assessment of the heritage of any particular patient helps the nurses to understand well how such a person relates to their surroundings, how they view health and wellness, their various ways of gaining and applying knowledge as well as any other area that may be of interest in health care provision.
Most of the nations of the world, for instance, in America, the populations are characterized by people of vast diversification in the religious, ethnic, sexual orientation and nationality. As such, the patients that visit the health centers present with themselves varied symptoms requiring medical attention, some based on illness while others grounded on the cultural and religious backgrounds of the patients.
As the patients are guided through any healthcare facilities of the dialysis unit, it is very recommended that the practitioners not only concentrate on the clinical needs, but also see to it that they identify the patient’s demographics and religious orientations amongst others. The problem very common is the avoidance of the common mistakes that greatly impact safety and quality and instead, pay too much attention on the nature of the illness and how the patient may be treated. In doing this, they are not really identifying with the patient in order to attend to them as an individual. A point that must be noted is that all patients have diversified characteristics and needs, both the clinical and non-clinical, which affects the manner in which they participate, receive and view their treatment (Morrison, 2011).
Unlike in the past when health provision was mainly limited to a particular community, mostly, where one came from, there have increasingly arisen changes due to the cultural and religious diversity. There is need for the healthcare providers to see to it that they are well conversed with all the possible cultural and religious traditions inherent in the societies within which they work. It is based on this challenge that the terminology ‘cultural competence’ came to be, whereby all the practitioners are expected to be able to work in the various cultural and geographical regions without much trouble (Cordella, 2012). This may only be so through getting to first and foremost understand the various cultures to help learn their beliefs.
A fact that all health care practitioners must come to terms with is the diversity in the religious beliefs inherent in the various cultures and people from different walks of life. The beliefs of the various patients tend to be aligned to their religious backgrounds, which may never be easy to change. Due to this, it is in order that all the professionals fully understand the possible challenges that they may expect, however, they should never let the various beliefs by such patients waver their conscious mind of making the right decisions to do good. Once a person believes in the consequence o the course f action they are about to take, they should do so without any fear.
Conclusion
In conclusion, we as health practitioners are faced everyday with caring for patients of different faiths, cultures and religions. It is important to always keep an open mind and allow yourself to try to understand the faith that our patients believe. Understanding other cultures and beliefs are critical in the healing process. In healthcare today as physicians, we need to keep an open and unbiased mind, treating everyone as equal. Through the development of proper cultural competence, we may help our patients by accepting their beliefs without abandoning our own personal customs. As health practitioners, we may not be able to change the beliefs of the various patients from the different walks of life as the populations continually get diversified, rather, there is need to remain open minded in order to accommodate the diverse beliefs. In addition, as long as we believe that the course of action that we are taking will lead to more good than bad, then the autonomous stake of the patients should always be put at stake. After all, they will eventually appreciate the results.
Brierley, J., Linthicum, J., &Petros, A. (2013). Should religious beliefs be allowed to stonewall a secular approach to withdrawing and withholding treatment in children?. Journal of Medical Ethics, (9). 573. doi:10.1136/medethics-2011-100104.
Conflicts between religious or spiritual beliefs and pediatric care: informed refusal, exemptions, and public funding.(2013). Pediatrics, (5), 962.
Cordella, M. (2012).Negotiating Religious Beliefs in a Medical Setting. Journal Of Religion & Health, 51(3), 837-853.
Elliot G. (2011). Cracking the cultural competency code. Canadian Nursing Home, 22(1), 27-30.
Hall, H. (2014). Faith healing: religious freedom vs. child protection: the medical ethics principle of autonomy justifies letting competent adults reject lifesaving medical care for themselves because of their religious beliefs, but it does not extend to rejecting medical care for children. Skeptical Inquirer, (4). 42.
International council of nurses, (ICN). (2011). Nursing and health professions. 2011.
Krohn E. (2013). Recovering health through Cultural Traditions. Forth World Journal, 12.
Lamparello, A. (2001). Taking God Out of the Hospital: Requiring Parents to Seek Medical Care For Their Children Regardless of Religious Belief. Texas Forum On Civil Liberties & Civil Rights, 647.
Morrison, E. E. (2011). Ethics in health administration : a practical approach for decision makers / Eileen E. Morrison. Sudbury, Mass. : Jones and Bartlett Publishers, c2011.
Stewart, W., Adams, M., Stewart, J., & Nelson, L. (2013).Review of Clinical Medicine and Religious Practice. Journal Of Religion & Health, 52(1), 91-106.
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Closing the gap on health inequities has been an important part of the work of the EU since 1992, when specific competencies for public health were included in the Maastricht Treaty. However, large differences in health still exist between and within all countries in the EU, and some of these inequalities are widening. The consortium report has identified many inequalities among its member states (EU, 2003).
The report examines some of the factors causing health inequalities. The analysis supports the findings of the WHO CSDH (1) that social inequalities in health arise because of inequalities in the conditions of daily life and the fundamental drivers that give rise to them. There are significant differences in mortality between Member States, with higher mortality for males than females in each Member State. In Bulgaria and Romania, the age-standardized death rate for males in 2010 exceeded 1 200 per 100 000, while it was below 800 in 17 Member States, with the lowest values being 561 for Greece and 619 for Sweden. A similar pattern was seen for females, but at a lower level of mortality. In six Member States the female rate exceeded 600 per 100 000 and in 16 Member States it was below 500 per 100 000. In this case, the highest values were seen in Bulgaria and Romania. Inequalities in life expectancy between Member States were smaller for females than for males. Female life expectancy was lowest in Bulgaria — 5.5 years below that for the EU – and 7.9 years or 10 % higher than in Bulgaria, 2.4 years above the EU average (EU, 2010).
EU (2012) has indentified many actions for strengthening the existing actions to reduce health inequalities. They include:
Distributing health equitably as part of the overall social and economic development;
Improving the data and knowledge base and mechanisms for measuring, monitoring evaluation and reporting;
Improving the exchange of information and coordination of policies between levels of government and across departments, and creating partnerships that are more effective with stakeholders:
Meeting the needs of vulnerable groups; and
Evaluating the effectiveness of EU policies in tackling health inequalities, directly or indirectly.
There are also health differences in USA, just like in EU. In EU, with its publicly funded health care systems, the healthy sustainability gap still exists. In the USA, where only about half of healthcare spending is publicly financed and half privately funded, the excess growth in health care spending still presents the greatest threat to service provision. If the actions, which have been identified by the EU will be implemented in my society, the health inequity gap will be reduced. Distributing health equitably as part of the overall social and economic development and meeting the needs of vulnerable groups in the community will largely reduce this gap.
Most policies with explicit aims to reduce health inequalities should focus on vulnerable groups such as immigrants, ethnic minorities, early school leavers, people from lower socio-economic groups or unemployed or homeless people. Equally, universal policies do not have a proportionate leveling-up component. The policy implications of the social gradient in health, and effective methods of addressing these gradients appear to be poorly understood and acted upon. Greater emphasis should be placed on introducing, monitoring, and evaluating policies that have this component.
References
EU, 2012. ‘Report on reducing health inequalities in the EU’, Committee on the Environment,
EU, 2010. European Economic and Social Committee opinion ‘Solidarity in health: reducing health inequalities in the EU’, 3.5.2010 [date accessed: 8.10.2014]. Available from: http://www.eesc.europa.eu/?i=portal.en.soc-opinions.14245
WHO, 2008. Closing the gap in a generation — Health equity through action on the social determinants of health. Final report of the World Health Organization Commission on Social Determinants of Health, 2008. [date accessed: 8.10.2014]. Available from: http://www.who.int/social_determinants/en
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1. To define organizational development tools as they relate to the process of altering, accelerating, and sustaining changes in corporate culture.
2. To illustrate through multiple examples the importance of active and enthusiastic involvement of leadership through out the cultural shift.
Placement in the Course:
This case has multiple teaching objectives: (1) to convey the lengthy processes involved in shifting a corporate culture, especially a company segmented into large and independent business units like MECK Insurance, (2) to impress upon the reader the key factors of success involved in organizational change: leader participation, defining a common and clear purpose for your organization, setting clearly defined goals based on your defined and shared vision, (3) to highlight the importance of genuinely involving employees from every level of the organization in the transformation.
Provide a 2 pages analysis on the case and be sure to address all questions fully.
SAMPLE ANSWER
The Transformation of MECK Insurance
Organizational transformation involves changing an organization into a very proactive institution. This reduces costs and does away with duplication and non-value adding processes, hence, improving product and service delivery (Anderson & Ackerman-Anderson, 2010). In this regard, organization development tools enable an entity to adopt better to the fast changing external environment of new markets, regulations, and technologies. This could be done through altering, accelerating, and sustaining changes in corporate culture (Tate, 2009).
Changing the culture of a corporate is a slow and tricky process since it entails convincing the employees about the reason behind alteration of the current culture. The employees have to be cognizant with the way the changes are being proposed. The resources have to be moved from one activity to the other for the sake of change. In addition, the employees have to be motivated in order to make them buy into the reforms. The management, afterwards, needs to deal with the organizational politics by getting the people on board especially those with greatest influence (Klewes, & Langen, 2008).
Corporate culture change can be accelerated through carrying out culture survey. This survey’s main goal is to reveal cultural strengths, dangers, and any opportunities. This enables the leadership to know how to align the strategy, leadership and culture. The road map ought to be very clear to ensure that resources are allocated promptly to leadership and the goals of the culture. In addition, there should be support from the leaders to ensure cohesion, conviction and capability from all the employees (Dawson, 2010).
Ensuring that the change stands the test of time is very important in any organization. This is simply because, this approach improves the organization’s brand image, the company gains upper hand in competiveness, the employees get more satisfied, the risks are easily managed, and there is enhanced stakeholder relations (Anderson & Ackerman-Anderson, 2010). Apparently, these benefits can only be realized through sustainable management of change. The changes ought to be defined especially on how different they are from any other change, there should be a strategic plan on how to implement those changes, and the top management has to implement the changes through rewards and incentives. In addition, the corporate has to get seasonal employees and develop a system where employees get to embrace the culture. Moreover, the performance of those reforms has to be monitored always (Howard-Grenville, 2007).
To achieve all thsse reforms, the leadership has to be actively involved in cultural shift. However, the leader can only manage and bring change in an organization if he/she is competent. Leadership that can be relied upon is very relevant for the success of an institution. (Klewes, & Langen, 2008). The leaders always look for change through people towards the set down objectives. Kono & Clegg (1998) insisted that leadership was a procedure that not only influenced employees, but leaders as well, to accomplish the goals of the organization through change. Leadership revolves around the leaders and the employees, influence, organizational objectives, change, and people. Leadership involves giving people directions. In order to be a good leader, one must be a good servant (Anderson & Ackerman-Anderson, 2010). Active involvement of the leaders will ensure that increased technological advancement is incorporated in the organization. Also high expectation from clients and rapid change in the markets will be managed and controlled (Tate, 2009). The leaders, therefore, are able to examine their performance so that they can adopt and implement changes in an institution. Moreover, active involvement of the leadership ensures that the leadership always remains keen in the process of evolution of an organization in order to realize its desirable shape, hence, address the issues of organizational change appropriately.
References
Anderson, D., & Ackerman-Anderson, L. S. (2010). Beyond change management: How to achieve breakthrough results through conscious change leadership. San Francisso: Pfeiffer.
Dawson, C. S. (2010). Leading culture change: What every CEO needs to know. Stanford, Calif: Stanford Business Books.
Howard-Grenville, J. A. (2007). Corporate culture and environmental practice: Making change at a high-technology manufacturer. Cheltenham, UK: Edward Elgar.
summarize your strategy for disseminating the results of the project to key stakeholders and to the greater nursing community.
SAMPLE ANSWER
Dissemination Strategies
Dissemination is a process where deliverables and outcomes of projects are made available to stakeholders and to the clinical practice audience. Its main intention is to make knowledge and its associated evidence-based interventions widely spread (Gellis, Solomon, Lukens & Huz, 2014). Dissemination evidence has several goals; first, to increase the evidence reach. Second, it increases people’s motivation of using and applying evidence. Lastly, it increases people’s ability of using and applying evidence.
The aim of the dissemination strategies is to spread knowledge and the evidence-based interventions across or within the geographical locations, the settings of practice, or other networks of end users such as health care providers and patients. The results of the project outcome are disseminated to key stakeholders. The main purpose for this is to inform the development of project, to allow feedback receipt and to ensure that the practice and the outcome are maintained after project implementation (Cleary & Hunt, 2013).
Passive dissemination strategies are not as effective as the active strategies. Interventions that solely rely on transfer of passive information are comparatively ineffective. Despite the effects of the active knowledge translation strategies being modest, they are usually very effective. The interventions that are multifaceted (i.e. one that incorporates two or more distinct strategies) are more likely to work than the interventions that are single (Cleary & Hunt, 2013).
Dissemination need to be considered early in the stage of project planning. It requires a period of time for dissemination at the end of the project work. The audit committees are required to strengthen the research findings implementation and the evaluation of winning implementation put into practice making use of the necessary outcome measures.
References
Cleary, M., Happell, B., Walter, G., & Hunt, G. (2013). Obtaining higher research degree qualifications: Key strategies to consider. Contemporary Nurse: A Journal For The Australian Nursing Profession, 44(2), 196-203.
Gellis, Z. D., Solomon, P., Cullen, S., Lukens, J., Gleba, J., Zalucki, D., & Huz, S. (2014). Dissemination of Evidence-Based Depression Care for Community-Dwelling Older Adults. Best Practice In Mental Health, 10(1), 1-15.
Riesch, S. K., Ngui, E. M., Ehlert, C., Miller, M., Cronk, C. A., Leuthner, S., & … Durkin, M. S. (2013). Community Outreach and Engagement Strategies from the Wisconsin Study Center of the National Children’s Study. Public Health Nursing, 30(3), 254-265.
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discuss methods to evaluate the effectiveness of your proposed solution and variables to be assessed when evaluating project outcomes.
Example: If you are proposing a new staffing matrix that is intended to reduce nurse turnover, improve nursing staff satisfaction, and positively impact overall delivery of care, you may decide the following methods and variables are necessary to evaluate the effectiveness of your proposed solution:
Methods:
Survey of staff attitudes and contributors to job satisfaction and dissatisfaction before and after initiating change.
Obtain turnover rates before and after initiating change.
Compare patient discharge surveys before change and after initiation of change.
Variables:
Staff attitudes and perceptions.
Patient attitudes and perceptions.
Rate of nursing staff turnover.
Develop the tools necessary to educate project participants and to evaluate project outcomes (surveys, questionnaires, teaching materials, PowerPoint slides, etc.).
SAMPLE ANSWER
Developing an Evaluation Plan
Project outcomes need to be evaluated to see how effective the applied solutions were or whether they carry any potential. The solutions and variables applied are evaluated resulting to some findings. The greatest contributors to job dissatisfaction with the staff are found to be in relation to the organizational climate, nurse turnover, their health benefits and working conditions. Nurses express satisfaction with the provision of essential drugs. The staff have a negative attitude towards working as they are not put into consideration as individuals whose needs are also to be attended to for the better of the patients and themselves (Needleman, 2006). All these will be analyzed before the initiation of change. The survey will be done and solutions derived. A strong line management and support from it will be found to have improved the staff’s attitude and led to a reduction in job satisfaction (Lankshear, 2005). Support from the management and good communication improve the working state. Essential working instruments like gloves will also be administered to change the working condition.
The rate of nurse turnover is a great concern for healthcare organizations and is likely to become worse. It costs a lot in terms of hiring, orientation and training, compromised quality of care and the lack of organizational knowledge. It can be especially problematic: directly or indirectly. It may be considered direct when the costs are clearly attributable to a specific activity or are more obvious like advertising costs. Those that cannot be attached to a particular activity and may be inappreciable like loss of organizational knowledge are indirect (Finkler et al., 2007). After coming up with solutions like increasing compensation and benefits for nurses, supporting flexible scheduling and job sharing, recognizing and rewarding superior performance, the rate of nurse turnover will reduce remarkably and improve the concerned areas.
A great comparison between patient discharge surveys before change and after initiation of change is a great step to be used in this evaluation. Initially, patients express with great satisfaction their thoughts on clinical service and the public health services but may be less satisfied with the provision of essential drugs and health insurance schemes. Those greatly affected are the elderly, retired, and those with low income. After coming up with ways to solve the issue with the help of the government, a program will be enacted with the sole responsibility of providing supplement support to the disadvantaged by paying health premiums and covering all extra costs. Primary care facilities will also not be allowed to earn any profits on essential drugs thus reducing the prices of essential drugs.
The attitudes and perception of staff in their work place are full of tension as they are not provided with everything they need for job satisfaction in the various departments. They perceive the administration or management to be one that does not care about their wellbeing as individuals and as employees. Recognition is not administered to them for their work done. A positive attitude towards the provision of drugs was registered but with issues like working conditions and organizational climate, a negative attitude was registered. The patients’ perception about the staff, management and activities to be carried out will be of great standard. To them, everything to do with healthcare ought to be of great value and lots of care considered for healthy lives and good working force. The rate of nurse turnover is viewed as an aspect to be considered for the success of flow of activities. The administering of proper measures to resolve the issue save time and efforts that would be highly costly at a later time (Aiken 2007).
To successfully educate project participants and evaluate project outcomes, questionnaires will used. The questionnaires will structured in a way that provides the name of the employer, allowing us to aggregate responses by hospital for the analysis of nurses’ reports and patient satisfaction. They shall also include questions about the work environment, job satisfaction, and experience of nurse turnover.
Finkler, S.A., Kovner, C.T., & Jones, C.B. (2007). Financial management for nurse managers and executives.
Lankshear, A.J., Sheldon, T.A., & Maynard, A. (2005). Nurse staffing and healthcare outcomes: A systematic review of the international research evidence.
Needleman, J., Buerhaus, P.I., Stewart, M., Zelevinsky, K., & Mattke, S. (2006). Nurse staffing in hospitals: Is there a business case for quality? Health Affairs, 25(1), 204-211.
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This paper is critical and it is a continuation of the policy change proposal paper that you have been written for me . Take a look at the details below and most importantly base on the two examples provided complete the paper. It is critical that it must be written in expository style , that’s part of the requirement of this paper and the writer must follow that . You will use chose one of the examples below and write the paper base on my propose amendment that is also included hear below. I will strongly advice that the writer read my previous paper with references below to fully understand the other parts of the paper. I will also send the instructions as a word document in the file section just if the table doesn’t come out when I copy and paste as it will be very important to also include the table in the completed paper since it is the scorecard.
I will send the details of the assignment as an attached file under the file upload instead of copying and pasting hear.
SAMPLE ANSWER
Scoring the Financial Criteria Against the Policy Change Options
Policy change option
These policy change options include, major changes, incremental changes and do-nothing change. Incremental changes are best when the issue is complex and takes place in stages (Mason, Lavitt & Chaffee, 2013). Do nothing change is where things are left to run as usual while major changes happens ones as here is no re-evaluation stages.
Measurable goals
Public education in regard to use of the contraceptives as well their side effects and other benefits
Worker engagement to determine whether or not they understanding the implication of the amendments
Engagement of organizations opposed to the bill to enable them support the bill
Financial Criteria
Instituting policy change requires financial support. Substantive funding stream is the funds available to support policy amendment. For the federal government to amend section 5316 of PL 111-148, it will be obliged to fund the amending section through taxes, Medicaid and Medicare. Taxes will directly affect the middle class while other category of population will be indirectly affected through higher insurance premiums, increased cost of goods and low wages. Taxpayers and government agencies will continue to support the funding for section 5316 of PL 11-148 n to meet both current and future demands. Political feasibility is a situation where a bill is sustainable after legislation to warrant its enactment. The bill must therefore have enough votes to pass a legislative body to be implemented within a certain period for it to be considered politically feasible (Sullivan, 2014).
Pros and Cons for Policy Change Options
Pros for Doing Nothing
If nothing is done, the plan cannot precede immediately, hence time to ponder about its viability again
If nothing is done, funding of the previous programs will go on as earlier planned
Cons for Doing Nothing
If nothing is done, there will be no funding, hence, status quo remains
If nothing is done, workers will shoulder the burden of paying for their birth control cover.
If nothing is done, birth control would not be provided to workers as part of their employment insurance cover.
Pros for Incremental Change
An incremental change will allow continuous evolution of the policy during the phases
An incremental change will increase the number of workers under insurance cover
An incremental change will maintain productivity hence impact positively on employment opportunities
Cons for Incremental Change
An incremental change means high expenses through evaluations and institutions of other changes.
This will require more time compared to major changes
With this kind of changes, policy makers have adequate time to repeal
Pros for Major Change
Major changes will makes it easier for the workers to take cover
Major changes will help the workers and the employee to agree on the modalities quickly
Major changes will ensure regulation of birth among workers
Cons for Major Change
Major changes may not be well thought ought to take longer to create.
Major changes may require long period to develop
Major change will result in increased employee deductions.
Policy Option Analysis Scorecard
Do Nothing Option
Incremental Change
Major Change
Criteria
Substantive Funding Stream
+
+
–
Likelihood of Ongoing Funding
+
+
–
Ability to Meet Current/Future Demands
–
+
+
Political Feasibility
+
+
–
3+/1-
4+
1+/3-
Score for Each Alternative
2
4
-2
(Mason, Leavit, & Chaffee, 2012)
Summary
As based on the scorecard analysis provided above and pros and cons analysis, the incremental change policy option will be used to implement the proposed amendment because the option totaled a plus four. Implementing the policy through incremental change policy will ensure that all the stakeholders understand the process and appreciate the same. They will therefore render their support to the process.
As mentioned below , this is a continuation of 111490 SECTION B, basically in section B the writer wrote the introduction of the paper, and now the writer will have to write the entire paper. The paper will have 4 pages minimum excluding the introduction which is already written in 11490 SECTION B. follow the instructions below and also note that this is a fact-based assignment that will not include your opinion.
• This will require research and support for what is written.
• The assignment should be paraphrased without quotations from scholarly and fact-based publications.
Case Study Ethical Legal Dilemma Advanced Practice Nursing
Description.
This paper is a continuation of 111490 SECTION B, in that section, the introduction was written and for this paper the writer will take the introduction and continue by responding to the questions below base on the instructions giving hear below. Basically SECTION B of 111490 is the introduction of this paper, as you will realized if you read through it, so the writer will continue written the entire paper from where the introduction ended.
Also it is very important to note that this is a fact-based assignment that will not include your opinion.
• This will require research and support for what is written.
• The assignment should be paraphrased without quotations from scholarly and fact-based publications.
The paper should have a minimum of 7 citations and some of these should be case law or applicable statutes. The APA Manual and the textbook have instructions on legal formatting.
Directions:
1. Create an ethical legal decision-making dilemma involving an advanced practice nurse in the field of education, informatics, administration, or a nurse practitioner.
2. Include one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts in the law.
3. Construct a decision that would prevent violation of the ethical principle and prevent the law from being violated.
4. Describe the legal principles and laws that apply to the ethical dilemma.
5. Support the legal issues with prior legal cases or state or federal statutes.
6. Analyze the differences between ethical and legal reasoning and apply an ethical-legal reasoning model in the case study to create a basis for a solution to the ethical-legal dilemma.
7. List three recommendations that will resolve advanced practice nurses moral distress in the dilemma you have presented.
8. Based on the issue you presented, the rules of law apply the laws to you case and come up with a conclusion.
Note:
• This is a fact-based assignment that will not include your opinion.
• This will require research and support for what is written.
• The assignment should be paraphrased without quotations from scholarly and fact-based publications.
SAMPLE ANSWER
Ethical Legal Dilemma Advanced Practice Nursing
In a case on the night of April 15, 1975, a patient by the name Quinlan ceased breathing for two intervals of 15 minutes. The parents decided to transport the patient to hospital where it was determined that her pupils were not moving and she failed to respond to deep pain (Karen Ann Quinlan Memorial Foundation, 2010). The patient was placed on a ventilator at the hospital and received a tracheotomy. The parents watched the condition of their daughter and observed that as days went by their daughters’ condition was deteriorating continuously. After much discussion and counseling, the family decided that it was at their best interest to remove the ventilator. The nurse attending the patient went to remove the ventilator but as she was about to start removing it the patient asked her to stop removing it. The nurse was in a dilemma not knowing what to do and who to listen to. This forced the hospital top disagree with the parents decision and later filed a case in court.
The principle of autonomy could be violated in this case if the nurse had done as by the parents’ wishes. Autonomy is essentially independence, the ability of an individual to choose his or her own actions (Fowler & American Nurses Association, 2008). According to this principle patients have a right both morally and legally to decide what type of treatment should be offered to them. The patient’s decision should be upheld and respected by all those involved in attending to the patient (Milton, 2003). Violating an ethical principle is a civil wrong.
The self-determination act could be violated if the nurse acted according to the demands of the family. The law provides that the parents are part of the patients family and that they have a right to call off the treatment or a do not resuscitate order for their patient (Bandman & Bandman, 2002). The 1990 act of self-determination provides that all the paternal relatives of the patient have a right to determine the treatment of their patient. The law further says that in case of life determination and maintenance the patient has a last decision on the same if at they can speak. Violation of this act is a criminal act punishable before a court of law.
When presented with the same case as above the nurse could choose to do what any reasonable and profession al person in the nursing field could do when faced with such a situation. The beneficence principle is based on the provision of bringing good to the patient (Purtilo, 2005). Every day of work is a day of nursing reflection; every day that a nurse is working is making decisions that are very crucial to the life of the patient (Furlong, 2007). In consideration to the beneficence principle, I could not remove the ventilator and instead ask the hospital administration to take the case to a court of law.
Another similar case to this was the case of Terri as described by Bratcher, Farrel, Stevens, & Wanderground (2007). The case was about the right to remove a feeding tube from the patient who had been using the tube for feeding for so long. Terri suffered a cardiac arrest in 1990. Her husband took her to hospital to seek for medical attention with the hope that Terri could recover. As time went by, the husband lost hope that the patient could not recover band therefore sought the ethical committee to take off the tubes. Terri’s parents refused that the tube should not be taken away from their only daughter. This brought a very serious battle between the two families. When they presented the case before a court of law, the court ruled in favor of Terri’s husband. However, the parents using their political power influence they did not heed to the court order and instead asked to pay the costs of the hospital as long as their daughter is arrive. First in this case, the court arrived at the decision after proving beyond reasonable doubt that the patient could not survive any longer on the tube after they were presented the facts about the situation of the patient by the nurse in charge of Terri.
Legal reasoning is the kind of thinking that comes from law, which consists mainly in legislation and the courts decisions (Rantmeester, 2013). The law is produced in relationships among the federal and state government and the governed. Law is very flexible and is subject to challenge depending on individual’s way of reasoning. Legal reasons suggest what is to be done from a legal point of view and suggest legal consequences for not doing what there are legal reasons to do (Lir & BJumtschkc, 2001). Ethical reasoning on the other hand emphasizes on the obligations, relationships, virtues, duties, responsibilities and personal character. Ethical reasoning focuses on practices of deliberation, argumentation and justification in which individuals try to make their moral lives in their line of professional communities. Ethical reasoning suggests what should be done and why it is right to do so. Whereas legal reasoning is a process of a legal expert giving advice to non experts, ethical reasoning is a process of reasoning among several different parties who are acting in the best interest of their loved one or patient, or who cares deeply about the rights of others (Rantmeester, 2013).
Savage & Milton (1989) came up with a decision making model for nurses. This framework is arranged into 9 steps that a nurse can follow in making a decision on the action to take when in a dilemma. The first steps require the nurse to use their professional and reflection practice in order to identify the health problem that the patient is suffering from. Once the health professional has discovered the health problem of the patient then they should identify the ethical problem or the ethical principle that is in the dilemma. Step there the practitioner should identify all the stakeholders who are involved in the decision. The fourth step the practitioner should identify their role as stated by the duties and responsibilities guidelines. The fifth step is to identify as many alternative solutions as they are available. These decisions should be based on reflective practice and application of past experience and also the use of evidence based practices (Sims, 1994). The sixth step is to consider the long-term and short-term consequences of each alternative solution that the practitioner has identified. The seventh step requires the practitioner to make a decision based on the best considered option. The eight steps is consideration on how the decision fits in with the general philosophy of practice care. The last step requires the practitioner follow the situation until they can see the actual results of the decision and use this information to help in making future decisions.
In the case presented in this paper, I could recommend the following when the advanced nursing practitioners are faced with a similar case. Never bring personal sympathy and feelings when dealing with such a case. When one brings their personal emotions and feelings in such a case, they may not act according to the will of the patients paternal relatives of family. This will b e very contrary to the patients will and families will. Secondly, the practitioner should listen to the two parties before they act, before removing any measures to resuscitate the patient’s life sustaining services first find out whether the patient is able to speak and think on their behalf. Thirdly, never act against the patients will. If at all the case is in such a way that the parents or relatives of the patient have refused the decision of the patient then take the matter to court for determination on the issue.
The ethical legal dilemma of the advanced nursing practice is basically solved through the application of the code of ethics principle and the law. Respect to the ethics of practice and the law will help one deal with the ethical legal dilemma effectively. Therefore, there is a dire need for masterly of the law in relation to nursing practice and the masterly and implementation of the code of ethics.
References
Bandman, E. & Bandman, B. (2002). Nursing Ethics Through the Life Span. (4th ed.). Upper Saddle River, NJ: Prentice Hall
Bratcher, R., Farrel, J., Stevens, K., & Wanderground, K. (2007). Ethical and Legal issues. Jones &Barllet Learning, chapter 25; 387-400.
Fowler, M. D. M., & American Nurses Association. (2008). Guide to the code of ethics for nurses: Interpretation and application. Silver Spring, MD: American Nurses Association
Furlong, E. (2007). Right or wrong: legal and ethical issues and decision-making. Jones and Bartlett Publishers, chapter 3: 29-45
Karen Ann Quinlan Memorial Foundation, (2010). Karen Ann Quinlan: she changed the way people looked at life and death. Retrieved September, 27, 2014. From www.karenannquinlanhospice.org/history.htm
Lir&J. Jumtschkc,(2001). Ethical Dilemmas and the Nurse Practitioner in the NICU. Neonatal Network, 20 (1): 33-38
McLean, D. J., & Yoder, D. G. (2005). Issues in recreation and leisure: Ethical decision making. Champaign,Ill:HumanKinetics
Milton, C. (2003). The American Nurse Association Code of Ethics: a reflection on the Ethics of Respect and Human Dignity With Nurse as Expert. Nurse Science Quarterly, 16(4), 301-304
Purtilo, R.(2005). Ethical dimensions in the health professional (4th ed.). Philadelphia: Elsevier Saunders.
Rantmeester, C. (2013 ). What’s legal? What’s moral? What’s the difference? A guide for teaching residents. American journal of bioethics, volume 6(4). Creighton University Medical Center.
Savage TA, and Milton CB. 1989. Ethical decision-making models for nurses. Chart 86(4): 2-5.
Sims, R. R. (1994). Ethics and organizational decision making: A call for renewal. Westport, Conn., u.a: Quorum Books.
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Evaluating Systems Thinking
Think of the last time you visited a zoo. You visit the zoo to enjoy the wealth of variety of animals in their natural habitat. Next time you visit a zoo, notice that similar types of animals are presented together whereas ones that may be natural enemies are separated. In order for the entire zoo experience to work systematically and to be sustainable, the zoo leaders need to ensure all animals are available for the visitors to view, enjoy, and learn. The zoo leaders need to come together to share expertise of their individual areas to develop a holistic view of their system that takes into account all the relationships among the animals at the zoo. All parts of the zoo working together collaboratively, with effective communication and change management, allows for a total zoo experience that meets the organizational mission and vision. The zoo has successfully implemented systems thinking. Systems thinking can potentially create an organization in which all internal and external stakeholders, regardless of job or position, work together collaboratively. These stakeholders collectively use decision making and strategic planning to meet the needs of the customers while maintaining the objectives of the organizational mission and vision.
To prepare, consider the organization that you chose for your SSP as a system.
By Day 5 of Week 4, read two of your colleagues’ posts and respond to at least two of them individually in one of the following ways:
•Critique your colleagues’ evaluations and provide additional insight on how systems thinking might enhance their organizations.
•Critique your colleagues’ evaluations and provide additional insight on the potential drawbacks of applying systems thinking to their organizations.
•Answer one of the questions posed by your colleagues in their posts.
and also once again please remember to answer each colleague individually with two references for each !
Colleaque ( Quintin Cain )#1
Evaluating Systems Thinking
Eden and Ackermann (2013) described strategic thinking as an approach to improve decision making in a company and to provide the company with constructive great values. System thinking is an approach for developing models to promote understanding of events, patterns of behavior resulting in the events, and the underlying structure responsible for the pattern of the behavior. System thinking is one of the key elements of strategic thinking. System thinking involves the action, view, creativity, and action learning. System thinking is a holistic approach to analysis that focuses on the way the system’s constituent parts interrelate and how systems work over time and within the context of larger systems.
Koskinen,(2013) explained that system thinking focused on how the thing being studied interacts with the other constituents of the system. Instead of isolating smaller and smaller parts of the system being studied, system thinks works by expanding its view to take into account larger and larger numbers of interactions as an issue being studied (Nguyen & Bosch, 2013). The main element of system thinking is to change the viewpoint. Caldwell (2012) described systemic thinking as the conceptual cornerstone of systems theory. Senge argued that one of the key problems with system thinking is that a simplistic framework was applied to complex systems. Organizations tend to focus on parts rather the whole and fail to see the organization as a dynamic process. Organizations faced with problems usually tend to look for short-term improvements, which can result in long-term cost for the organization. Attention to feedback is an essential component of system thinking. System thinking uses computer simulation and diagrams to illustrate and predict behavior.
According to Kerzner (2013) system, thinking enables continued improvement for the organization. System thinking improves businesses, schools, hospitals, families, and workers. Organizations can utilize system thinking effectively to examine complexities, test employee’s mental models, and recognize advantage points. System thinking allows the organization the opportunity to see how everything interacts and helps identify the best way of delivering the product to the consumer. System thinking offers the organization advantages to address complex problems; however, since it represents a paradigm shift in how problems are broken down, putting the process into effect is not without challenges.
The Vice President of international design and construction for Nike stated the first step in system thinking is to “bring systems thinking to the table.” Nike looks at the opportunity holistically: Instead of focusing on one thing, Nike looks at maintenance, equipment replacement and cost. Nike system thinking approach applies to other technologies and applications as well. Nike continues to enhance the main goal of the organization, which is low cost for the customers (Fishman, 2011).
Why are organizations not adopting the use of system thinking in their organizations?
What works against the adoption of systems thinking?
References
Caldwell, R. (2012). Systems thinking, organizational change and agency: Practice theory
critique of Senge’s learning organization. Journal of Change Management, 12(2), 145-
164. Retrieved from doi: 10.1080/14697017.2011.647923
Eden, C., & Ackermann, F. (2013). Making strategy: The journey of strategic
management. Thousand Oaks, CA: Sage.
Fishman, C. (2011). Has Wal-Mart found its soul? A new introduction to the national bestseller
the wal-mart effect. A Penguin eSpecial. Westminster, LDN: Penguin.
Kerzner, H. (2013). Project management: a systems approach to planning, scheduling, and
controlling. Hoboken, NJ: John Wiley & Sons.
Koskinen, K. (2013). Systemic view and systems thinking. In knowledge production in
organizations (pp. 13-30). New York City, NY: Springer International Publishing.
Nguyen, N. & Bosch, O. (2013). A systems thinking approach to identify leverage points for
sustainability: a case study in the cat ba biosphere reserve, Vietnam. Systems Research
and Behavioral Science, 30(2), 104-115. Retrieved from doi: 10.1002/sres.2145
Colleague (Tracey Foster) #2
Evaluating Systems Thinking
Systems Thinking Described
Systems thinking views an organization as a system of systems, with each subsystem affecting and affected by one another. Stacey (2011) describes system thinking as considering a firm as one of potentially many within the industry, where the actions of one firm affect the others. Stacey (2011) explains that larger firms are composed of business units (subsystems), and each business unit consists of operational and functional units, with each one affecting others. Senge (as cited in Stacey, 2011) describes the impact of actions of players within the system by using the example of supply and demand for retailers and distributors. In the illustration, the amplified effect of fluctuations in supply due to imperfect information caused large shortages and overages within the system.
Systems Thinking Applied – Impact, Benefits, and Drawbacks of Systems Thinking
The relevance of Senge’s illustration and systems thinking in general is for organizational leaders to understand the relationships of systems within their organization. Managers must also recognize how their organization influences and is influenced by other external factors of the overall system in which firms operate (Stacey, 2011). Senge (in Stacey, 2011) argues that a firm is best managed when leaders view and understand their organization as part of the whole system and not just an individual part. System thinking, then, closely relates to Value Chain and SWOT analyses, both of which consider factors and elements of the entire system in which a firm operates. In addition to identifying internal strengths and weakness and external threats and opportunities, leaders can understand pressure points within the system (Stacey, 2011). Managers can then leverage these pressure points by addressing them in their firm’s strategy. A potential drawback to systems thinking is that relationships and pressure points can be difficult to identify or fully understand (Stacey, 2011). Even when managers can understand system’s pressure points or relationships, they may not be able to influence them effectively (Senge in Stacey, 2011).
Systems Thinking Applied to Waste Management, Inc.
In the case of Waste Management, systems thinking can help identify and understand the firm’s stakeholders and the relationships to each other. For example, Waste Management is composed of distinct but related business units that include solid waste management and waste-to-energy operations (Waste Management, 2014). Waste management is further divided into waste collection, transport, disposal, landfill, and recycling operations (Waste Management, 2014). These subsystems are interrelated in that customers supply the waste materials that are then collected and either deposited in landfills or recycled. Waste Management then sells recycled materials commercial customers, who then use these recycled materials in their manufacturing operations (which will eventually be disposed of and collected again). In the case of landfills, solid waste is converted to energy through clean-burning incinerators (which generate steam power) (Pavlas, Tous, Klimek, & Bébar, 2011; Winters, 2007) or by capturing and selling gases that are created by decomposition (Crawford, 2013). Each part of this system relies on other elements of the system. For instance, if the volume of solid waste decreases, less waste must be collected, resulting in less waste available for recycling or waste-to-energy purposes. To succeed, leaders at Waste Management leaders must understand these relationships as they develop their strategy.
Conclusion and Implications for Further Study
Systems thinking can serve as a powerful tool to help organizations develop and implement strategy. Leaders can more effectively manage their organization when they understand the relationships of subsystems within their organization, and then how their organization relates to others within the larger system. System thinking can expand to consider how the industry is part on the overall economy. Industries do not operate in a vacuum, but rather are part of larger economic, ecological, and political systems (Senge, Smith, Kruschwitz, Laur, & Schley, 2008). Would Waste Management’s leaders benefit from expanding their systems thinking to this level? If so, how could they implement this understanding into their business? What are the benefits and drawbacks to this expanded view?
Pavlas, M., Tous, M., Klimek, P., & Bébar, L. (2011). Waste incineration with production of clean and reliable energy. Clean Technologies and Environmental Policy, 13(4), 595-605. doi:10.1007/s10098-011-0353-5
Senge, P., Smith, B., Kruschwitz, N., Laur, J., & Schley, S. (2008). The necessary revolution: Working together to create a sustainable world. New York, NY: Broadway Books.
Stacey, R. D. (2011). Strategic management and organisational dynamics: The challenge of complexity (6th ed.). Essex, England: Pearson Education Limited.
Waste Management, Inc. (2014). United States Securities and Exchange Commission Form 10-K. Retrieved from http://investors.wm.com/
Winters, J. (2007). Refining Trash. Mechanical Engineering, 129(3), 12. Retrieved from http://www.memagazine.org/
File DDBA_8161_WK4_DP_FosterT.doc (39 KB)
SAMPLE ANSWER
Systems Thinking
Systems thinking ideally entails the use of decision making and strategic planning by the stakeholders in an organization to heed to the customer demands while at the same time maintaining the organizational objectives as outlined in its mission and vision. All parts of the organization, which in this case is the zoo, have to work cooperatively, with the involvement of effective communication so as to allow total organizational experience to enable it meet the demands of its customers. Systems thinking has the potentiality of creating an organization in which both the internal and the external stakeholders, not considering their position or their job, work collaboratively thereby resulting into a successful organization.
In Quintin Cain’s posting, he states that “System thinking is an approach for developing models to promote understanding of events, patterns of behavior resulting in the events, and the underlying structure responsible for the pattern of the behavior.” This, according to me, is an understatement of what systems thinking actually is. Systems thinking is more than just developing models for the above stated purpose. It has to entail strategic planning that involves stakeholders from the various parts of the organization. All the stakeholders should be involved irrespective of their position within the organization as was observed in the case of the zoo.
Tracey Foster’s posting is in fact less comprehensive in describing the meaning of systems thinking as it fails to highlight the role of other stakeholders apart from the mangers. He only tells us that “…systems thinking in general is for organizational leaders to understand the relationships of systems within their organization.” All the people involved in the running of the organization, regardless of their position or the kind of job they do, have to get involved in systems thinking as his is what will help the organization to achieve its set objectives.
Quintin Cain’s Question
Why are organizations not adopting the use of systems thinking in their organizations?
As has always been with any other self-improvement activity, adopting the systems thinking is not an easy task for most organizations (Denise & Will, 2010). It is a great challenge for human beings to embrace new behaviors and do away with the ones that have been engrained in them over time and instilled into them by their respective organizations (Gazzaniga, 2010). Such organizations that are resistant to change, and have found it difficult to adopt systems thinking, should borrow from other organizations that have successfully made use of systems thinking to achieve their maximum potential.
Tracey Foster’s Question
Would Waste Management’s leaders benefit from expanding their systems thinking to this level? If so, how could they implement this understanding into their business?
Waste Management, Inc. is a typical organization that would greatly benefit from systems thinking as it is subdivided into various systems and thus it is a systems of systems. Systems thinking will help the leaders to effectively manage this organization as they will seek the opinions of various stakeholders within the subdivisions (Giovanni, Daniela & Francesco, 2012). This implies that they will actually benefit from the expansion of their systems thinking. The managers could implement this understanding into the business by collecting the various opinions of the stakeholders from each of the sectors of the organization and reviewing them so as to come up with the best ways to implement to achieve the goals and objectives of the organization (Mark, Alan, John & Stan, 2011).
References
Denise, M. C. & Will, A. (2010). Who do you think you are? An examination of how systems thinking can help social marketing support new identities and more sustainable living patterns. Australasian Marketing Journal (AMJ), 18(3), 195-197.
Gazzaniga, M. (2010). Psychological Science. New York: W.W. Norton & Company.
Giovanni, S., Daniela, C. & Francesco, S. (2012). Applying a systems thinking framework to assess knowledge assets dynamics for business performance improvement. Expert Systems with Applications, 39(9), 8044-8050.
Mark, D., Alan, H., John, F. & Stan, M. (2011). Systems thinking, market failure, and the development of innovation policy: The case of Australia. Research Policy, 40(9), 1145-1156.
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This is a essay question to be written for entry into a nursing school…
SAMPLE ANSWER
Patient Care Influence on Career and Decision to Continue Education
In life, it is important to set goals and have ambitions. These goals and visions act as a catalyst and a sense of direction towards attainment of one’s ambitions. I have an ambition of becoming the best healthcare provider in the years to come, attested to by my desire and determination to attain higher levels of education in this field. My background and patient care have motivated me to continue with my education.
I am highly esteemed that in the near future, I will be joining your college to pursue higher education in nursing. It has been long since I made the decision of pursuing a career in nursing. I always wanted to help people overcome their health problems and restore them to their normal life. This dream was born in me when I was in my adolescent. I experienced a sad episode when my grandparent lost his life because of negligence by the health practitioners. My grandparent was one of my best and closest friends. This incidence hurt me and I developed an interest in the field hoping that I will one day come to help many people that go through what I went. I always wanted to be the person that will help provide the best patient care to patients regardless of their age, status in society, race or even religion. I did not know what it would take me to become the person I wanted to be at this early stage, however as I continued with my studies, I sort advice from the teachers who advised me on the areas that I was required to concentrate to make my dream a reality.
The education I gained enabled me to serve in various health facilities and I appreciate the opportunities as I have managed to acquire enough experience. Working with different calibers of patients is not a simple task. Patients have different needs and as a care provider, I have done my best to ensure that they receive the best quality care to my best of my knowledge. Some of the patients are cooperative while others are demanding and do not understand. However, I am thankful that I managed to do my best to ensure that they recover well. These opportunities have enabled to learn a lot. I have managed to understand the psychology of the patients and the best way to respond to them. Patient requires motivation, caring, and love. This makes them feel a sense of belong and they as well feel encouraged. Furthermore, patients require constant interactions and assessment. This ensures that, their health is closely monitored and in case of an emergency, they receive immediate care to manage their ailments. I have also gained more skills on socialization and importance of respect when working with other people.
Regardless of these, I always felt that I could do better to enhance patience care. I was, therefore, motivated to pursue further education to acquire more skills and knowledge in the area to improve my services. Education is one of the platforms that would help me understand the patient care in detail, hence, impact on my service delivery. I want to be the best decision maker and problem solver in healthcare to improve the lives of the patients. I also want to acquire more skills to improve on nursing research. Nursing has grown of age and it requires application of evidence-based research to render superb services (Fawcett & McCulloch, 2014). Therefore, to me, I want to build on my experience to improve my skills and knowledge to render high quality care. I want to be able to deal with challenges in patient care in a professional way to enhance quality care.
I will appreciate if this opportunity to further my studies in your college is accepted. As indicated earlier, I am a dedicated and a determined individual who has high ambitions. The institution is the best for me in imparting in me requisite skills to enable me achieve my goals.
