Leadership and Change in Nursing

Leadership and Change in Nursing Leadership and Change Kym Bell I have chosen to use Jersey College in Trenton, New Jersey for my leadership change project. Jersey College is an educational nursing program that provides the combination of Licensed Practical nursing (LPN); Bachelor of Science in Nursing (BSN) and bridge programs for Registered Nurses (RN). The college is located in an urban setting with the student body predominantly from lower income families. The college provides, â€Å"education for adults through an open curriculum that accommodates diverse lifestyles† (Jersey College, 2014). The school prides itself on being the conduit to provide diverse opportunities for Certified Nursing Assistants (CNA), LPN’s, RN’s. The program provides the opportunity for LPN’s and RN’s to acquire a BSN. Jersey College was founded in 2003 and was originally called The Center for Allied Health Nursing Education. In 2004, the LPN program was approved by the New Jersey Board of Nursing. Since opening in 2004, the school has grown to incorporate two New Jersey campuses and two Florida campuses. The school is affiliated with many institutions who provide a variety of other educational opportunities for students (Jersey College, 2014, p. 1). In the past few years, there has been a decrease in the availability of nursing faculties and training sites for nursing students. This has increased the need for nursing instructors to look at alternative clinical sites. A variety of clinical sites are needed to provide students diverse learning and training opportunities. These practice opportunities are needed to prepare students to become independent professional heath care workers. One solution to this problem is to establish a virtual skills laboratory software program. The stakeholders for this project will be the college, instructors, students, parents, and the future communities that these students will be working in. Organizational Structure There is an organizational structure that depicts the framework for running Jersey College (Appendix A). There is a board of directors that hold the governing power. The Chief Executive Officer (CEO) is included in this group. The budget and financial management of the college is overseen by the CEO. The board hires the president of the college. Presently the president of Jersey College is Steven Litvak. He responsible for organizing, constructing, executing, and assessing the financial aspect of the college. The president is responsible for maintaining and establishing the mission, purpose, and policies of the college. The nursing education department is led by the Dean of Students. The education department is split into the Practical Nursing Program and the Professional Nursing Program. The two combined programs have a budget for educational needs. If a large purchase needs to be approved the department must submit a written request to the Dean of Nursing. The request is then submi tted to the president who then submits the request to the Board of Directors. The school is accredited by the Council on Occupational Education (COE), New Jersey Higher (NJ) Education, and the New Jersey State Board of Nursing (Jersey College, 2014). The department of Health and Human Services (HHS) has supported grants that will sponsor a wide variety of research grants to improve the quality, safety, effectiveness, and efficiency of health care in the use of technology. My plan is to apply for a grant called Faculty development: Integrated technology into nursing education and practice (ITNEP). The US Department of Health and Human Services (HHS) (2014) offers a grant that provides support to nursing collaboratives for faculty development in the use of information and other technologies in order to expand the capacity of collegiate schools of nursing to educate students for 21st century health care practice. Nursing collaboratives will use health care information systems to enhance nursing education and practice, optimize patient safety, and drive improvements in health care quality (HHS, 2014, para. 1). Assessment of Readiness Jersey College has a very small simulation lab that has very poor ventilation and very few nursing supplies. There are currently two students in my group that have latex allergies and cannot physically work in the skills lab without having allergic reactions. The students often complain that, even though there are many mannequins, there are no simulators that attach to the mannequins. Many of the other machines and supplies are in disrepair. The mannequins’ teaching capabilities are outdated. Many of them have missing limbs or do not have anatomically correct parts. For example, one of the mannequin’s tracheostomy hole is drilled incorrectly so that the student can only put in the tracheostomy tube upside down. The students do not feel that they are truly getting exposure to best practice in the present skills lab. The cost of replacing the lab has been discussed at many meetings and the concept of implementing a virtual lab has been in committee for the past year. The committee has researched many options and has come up with pros and cons of switching to a virtual lab. With the assistance of community and government funding options, the future of a virtual skills lab appears to be on the horizon. According to the Joint Commission (2014), one of the major causes of a sentinel event in the United States is the lack of communication. This means miscommunication is usually demonstrated in the form of â€Å"wrong patient, wrong site, and wrong procedure†. A sentinel event is a recurring medical issue within a facility that causes patient harm. The Joint Commission has recognized that many of these errors can be avoided by taking a â€Å"time out†. The â€Å"time out† procedure requires a consensus of all healthcare individuals that are involved with the patient. Everyone must stop what they are doing to verify that they have the correct patient; the correct site being assessed; and the correct paperwork/lab results must be verified. Nursing students need to recognize how important it is to verbally and nonverbally communicate with each other to avoid potential medical mistakes. The use of a virtual nursing skills lab can mimic medical situations in a safe and consistent environment. This type of laboratory will provide multiple opportunities for students to interact and communicate with a variety of cyber patients. Nursing students can utilize a virtual environment to learn clinical skills and to practice communication techniques. These skills will be useful when students are interacting with patients, families and other healthcare team members. Currently, the students do not have ample opportunities to access a computer during their class time. Many of the students, over ninety percent, have computers of their own. The nursing program is not currently set up to allow access to class information or other learning materials online. The Dean of Nursing is a very forward thinking person and has petitioned the president to acquire a working virtual laboratory. The Dean and instructors would like to update the school’s equipment and keep the facilities modern and technologically savvy. The new program will keep current students up to date and a new virtual laboratory would be a great way to entice new students into the program. Analysis of Data There are many different types of leadership theories, I chose to use Lippett’s Theory of change. This type of theory decrees that a leader is needed to promote the need for change. Lippitt, Watson, Westley (1958) utilized the basics of Lewin’s Theory of Change which included the concept of freeze, unfreezing and refreezing. Lippitt expanded on Lewin’s theory by adding four more steps. Lippitt et al. (1958) discovered that: Maintaining a favorable balance of forces is a continuous job for the change agent and client system, beginning with the initial decision to undertake a change project or helping relationship and continuing until the project has been completed (p. 73). Lippitt’s Theory of change has seven phases. Phase 1: Recognize there is a problem The problem is that the current hands-on skills laboratory is out of date and in need of a massive facelift. The cost of this renovation would be staggering to the institution. Phase 2: Assess the motivation and capacity for change The students, as well as faculty, have voiced their opinions that either a new skills hands on laboratory or virtual laboratory needs to be added to enhance the teaching/learning capability of the school. Phase 3: Assess the resources and motivation of the change There is a grant and government funding for the school to replace the current lab with a virtual one. Many of the faculty have gone back to school and have been exposed to new technological advances. Virtual software can provide nursing students with a multitude of learning opportunities that cannot always be accessed in the â€Å"real† world. The faculty is eager to learn how to work within an online environment. They have stated that they are willing to be instructed in how to run this type of lab. Upper management is willing to put in the time and energy that is necessary to make this change. Phase 4-Design the progressive stages of change The stages that will take place will be: Have a representative, from the selected virtual laboratory software company to come and speak to those staff members that have volunteered to be â€Å"Super Users†. Implement a training sessions for â€Å"Super Users†. These are fellow colleagues that that are given extensive training to assist others in transitioning to a new product or service. Meet with the nurse managers to provide training using the new laboratory software. Answer all questions and concerns that may affect each individual instructor’s educational needs for each specific laboratory classroom. Provide training sessions for educators to provide each instructor guidelines for the new software. Go â€Å"live† with the virtual laboratory software with students. Phase 5: Ensure the role and responsibility of the change agent is clearly understood Clearly identify as many of the problems as possible to fix prior to going â€Å"live† with the program. Ensure that everyone that works with this change will have technical backup and support. Confirm that there will be a representative from the company to answer any and all questions. Phase 6: Maintain the change through communication, feedback, and group coordination There will be evaluation forms for managers and students to provide feedback. Users will be surveyed to evaluate any changes that may be needed to support their teaching/learning needs. The evaluation will be an ongoing process. As problems arise, there will be a representative available on site or by telephone to assist any users. Phase 7: Gradually remove the change agent At the initial phase of the project, there will be a representative on site to help anyone who is having trouble accessing or understanding how to navigate the new laboratory software. After the first six or eight weeks, the physical presence of the software company will no longer be on site but, there will always be twenty-four hour telephone support (Lippitt, Watson, Westley, 1958). Plan for Change After careful research, by a chosen committee, a specific software program will be bought by the college. The college is currently looking into the software called â€Å"The Digital Clinical Experienceâ„ ¢Ã¢â‚¬  made by Shadow Health. Farmer (2014) states that there are over four hundred colleges and universities that are currently using this type of software in their nursing programs. The article goes on to state that the Shadow Health’s program â€Å"is broken down into ten modules, each of which correlate with a body system students study in class† (Farmer, 2014, para. 10). The acquisition committee has a chairwomen that will contact the software developer and set up a demonstration of the product. The committee members will have the opportunity to talk to one of the four hundred present user sites and observe the software in action. Once the decision has been made to purchase this program, the training will begin. Phase I will be the technical part of installing and updating any computer equipment that the school has. Phase II will be educating and training the instructors and â€Å"Super Users†. Phase III will be educating the students and remaining faculty. Phase IV Take the program â€Å"live† and start assigning lessons within the software website. There will be follow up meetings and suggestion boxes to evaluate the staff and students feedback in using this new system. The staff and students need to feel like their suggestions and feedback will make a difference in promoting advanced learning. The amount of money it will take to update, install, and train faculty and students will be added into the cost of tuition. The research committee has evaluated the cost and have estimated that the increase in semester cost will be two-hundred and fifty dollars per student. There will be opportunities for students to reduce this cost by applying for grants and/or financial aid. Evaluation As with any change, it will take time and dedication for staff and students to get used to the new software and work within an online environment. There will be an initial survey for students and faculty prior to starting the online learning lab project. After the software has been up and running for six months, a follow up survey will be given to evaluate the student’s and staff’s perception of the learning quality provided by the software. The students should be aware that there will always be technical support available to them and that instructors will be reasonable regarding grades and assignment within this initial new setting. The students should be contacted, by the instructor, via email numerous times throughout the semester and asked if they are experiencing any issues or concerns with the new software (O’Neil, Fisher, Rietschel, 2014, p. 134). The continuous evaluation process will allow the college to work with the software developers to custom fit the needs of the college. References Farmer, R. (October, 2014) Virtual patient teaches nursing students lessons in real-life care. Nurse.com. Retrieved from http://news.nurse.com/apps/pbcs.dll/article?AID=2014141009007#.VFvjrvnF8mvAssets/ 092014_SpaceCoastBusinessMagazine_FlCTWWinners.pdf Jersey College. (2014). About us: Accreditation and licensing. Retrieved from http://www.jerseycollege.edu/about/accreditation-licensing/ Joint Commission. (2014) Sentinel event data: root causes by event type 1995–2Q2014. Retrieved from http://www.jointcommission.org/assets/1/18/General_Information_1995-2Q_2014.pdf Lippitt, R., Watson, J. Westley, B. (1958). The dynamics of planned change. New York: Harcourt Brace. O’Neil, C., Fisher, C., Rietschel, M. (2014). Developing online learning environments in nursing education (3rd Ed.). New York: Springer. Shadow Health. (2014). Health assessment software. Retrieved from http://www.shadowhealth.com/health-assessment.html The Center for Allied Health Nursing Education. (January, 2012). Faculty guidelines for practicum experiences. United States Department of Health and Human Resources (HHS). (2014). Faculty development: Integrated technology into nursing education and practice (INTEP). Retrieved from http://bhpr.hrsa.gov/nursing/grants/itnep.html Appendix A ORGANIZATIONAL STRUCTURE OF JERSEY COLLEGE Admission Advisors `Education Coordinator Financial Aid Planner Career Services AdvisorProgram Administrator Media Services and LibrarianNursing Faculty Administrative AssistantProgram Administrator Registrar Nursing Faculty Academic Affairs Coordinator The Center for Allied Health Nursing Education. (January, 2012, p. 14)

Sir William Wallace :: essays research papers

The Help of Sir William Wallace Sir William Wallace is one of Scotland’s greatest generals and was a great help towards the freedom of Scotland because he brought patriotism to the minds of his fellow Scotsmen in order fight for the freedom for which was nearly taken away by the their English neighbors. He would ride through Scotland gathering clans both from the high and lowlands. Over the years after his death, Scots have proclaimed Sir William Wallace as their countries hero and the man who made freedom run through the blood of so many who were by his side.   Ã‚  Ã‚  Ã‚  Ã‚  Hundreds of years before the time of Sir William Wallace, Roman troops tried to conquer parts of Scotland but failed. The savagery of the Scots put the fear in the Romans and caused them to build Hadrian’s Wall. The wall separated Scotland and England (which was part of the Roman Empire). When the great empire fell to destruction by many Germanic tribes, Scots began to live a more peaceful life. During the Norman conquest of 1066, a group of people called the Normans invaded England, killed many Anglo-Saxon and Celtic tribes, and took over the country. England was now under Norman rule and would stay that way. (Compton’s Home Encyclopedia CD Rom)   Ã‚  Ã‚  Ã‚  Ã‚  In 1296, English troops invaded the lowlands of Scotland burning villages, killing innocent Scots, and trying to over rule the vast countrysides of the lowlands and the highlands. The new ruler of England, King Edward I the Long Shanks, started all this. He believed that he should have control of the whole island itself. His idea about conquering Scotland was that if he can’t beat them out, then he could breed them out. He brought the old English custom called Prima Noctes; if a woman is married in the country of Scotland, an English lord has every right to take her away from her husband for a few days and have his ways with her. Clans of lowlanders came together to form an army. It took awhile for the highlanders to know about this. Conflicts brook out between the Scottish rebels and English troops. Bows and arrows and other combat weapons were taken from the Scots except for their swords and axes. (Compton’s Home Encyclopedia CD Rom)   Ã‚  Ã‚  Ã‚  Ã‚  The answer to Scotland’s problems came with the birth of William Wallace. His exact date of birth is unknown but he was born in the 1270’s.

Justice in Silas Marner

Justice in Silas Marner ‘At the end of Silas Marner, there is a feeling that justice has been done: that the bad have been punished and the good rewarded. ’ To what extent is this statement true? For centuries, the definition of justice has been disputed over by wise men of all countries. Through the works of Plato, the views of Socrates are recorded for all to read and reflect upon. He believed that justice was good, and the good could only be attained through self-knowledge.In the Republic, Socrates defines justice as ‘working at that which he is naturally best suited,’ and ‘to do one’s own business and not to be a busybody’. George Eliot induces her personal opinions in and further elucidates her nineteenth century readers on the very real and prevalent issue of justice by intertwining several cases between characters in her novel Silas Marner, cleverly using terms that can be interpreted in various ways and presenting as clearly progr essing throughout.Justice is shown to have prevailed at the end of Silas Marner by contrasting it with injustice in the beginning, as the reader becomes familiarized with Silas’s situation and standing with justice. After leaving the vestry, Silas murmurs, ‘. . . there is no just God that governs the earth righteously, but a God of lies, that bears witness against the innocent. ’ This critical attitude towards his environment and world devoid of God not only sets the stage for the story but also provides contrast and room for development with the theme of justice so that the rectification in the end of the novel is represented as profound and significant.Silas has been hurt severely by the shortcomings of his friend, his fiancee and the religious systems and practices in which he had been indoctrinated with for many years like the drawing of lots and prayer independent of any actions (like defending himself verbally and not just leaving it to God to clear him). T his injustice upon Silas Marner is exacerbated by the figurative justice done to one who was undeserving – a manipulative Dunstan Cass.Although not to be taken literally, by Dunstan Cass’s utterance ‘you do me justice, I see’, in response to Godfrey’s accurate description of him, it serves as a taunting echo to highlight the unfairness in the beginning of the novel. This was soon to be stopped by the protagonist himself – Silas Marner. George Eliot portrays Silas Marner as seeking to restore fairness after experiencing another injustice as if it was the last straw when he says, ‘I’ve been robbed!I want the constable—and the Justice—and Squire Cass—and Mr. Crackenthorp. ’ Although ‘Justice’ is in reference to Justice Malam, it is clear that Eliot wanted her readers to construe it as also justice in the non-titular sense; the proper name ‘Malam’ was only introduced later in the chapter. In this sense of the word, Silas ‘want[ed] . . . the Justice’ as if it was a definite and universal object with the use of the definite article and the capitalization of ‘justice’.This shows the progression from injustice to justice. While external justice was developing, Silas needed to take an introspective approach and check if he was disadvantaging himself by brooding over offenses against him; like prayer, justice didn’t come solely from external forces but needed action on the part of the aspirer. The reader is made to reflect upon this when the narrator remarks that ‘such things had been known as a man’s doing himself a mischief, and then setting the justice to look for the doer. Thence on, Silas interacted with Dolly Winthrop more often and with a faint sense of gregariousness. Silas fully remedied this self-impediment and self-injustice when Eppie came. The readers’ attention is once again diverted to the develop ment of external justice in a similar manner as to that with Dunstan Cass, but with a different outcome. The other undeserving Cass brother, Godfrey hopes for justification but, justly, doesn’t receive it. He fled to his usual refuge, that of hoping for some unforeseen turn of fortune, some favorable chance which would save him from unpleasant consequences—perhaps even justify his insincerity by manifesting its prudence. ’ After prevaricating proper responses to his father’s interrogation, he sought to justify his insincerity. As we know, Godfrey is later found out when Dunstan’s body is recovered from the Stone-pits, nullifying his efforts and hopes in successfully avoiding the truth.The Socratic dialogues, again, have some insight to this matter. In Gorgias, Socrates suggests that on the scale of evil – which goes hand in hand with the scale of misery, second is the man who does wrong, but first is the man who does wrong and gets away with it. Godfrey is this ‘first’ who is more miserable, which shows that he has been justly served; for several years, he had to endure being this ‘first’ man, hiding his guilt before having the courage to be the ‘second’, less miserable man.Godfrey again pushes for his perceived justice (personal interest) when he tries to coax Silas into giving him Eppie ‘You may look at it in that way, Marner, but I never can; and I hope you’ll let me act according to my own feeling of what’s just. ’ Again, justice prevails and Godfrey is unsuccessful. Justification and religion are somewhat reconciled when the narrator reflects upon Nancy’s character and Sunday thoughts by recognizing that ‘the spirit of rectitude’ came with the ‘sacred documents of the past’.This opens the way for the justice to come upon her, first with ‘Godfrey . . . [doing] Nancy no injustice as to the motives of her obstinac y’ and the deserved revelation that Godfrey was Eppie’s biological father. A series of events drives justice to triumph by the end of Silas Marner. Effectively, George Eliot starts the narrative from the complete opposite – injustice – so that there is room for justice to develop. She recognizes the complexity of achieving justice when she writes about Molly’s struggle. Just and self-reproving thoughts do not come to us too thickly, even in the purest air, and with the best lessons of heaven and earth’. This adds to the gravity of the accomplishment of justice in the end of the novel. Furthermore, George Eliot does not restrain this achievement and discourages us, as readers, in doing so. She provides this wise insight: ‘When we are treated well, we naturally begin to think that we are not altogether unmeritorious, and that it is only just we should treat ourselves well, and not mar our own fortune. ’ By Chino Jose San Diego Gar cia

Definitions, Examples, and Discussions of English Grammar

The grammar of a language includes basic axioms such as the existence of tenses of verbs, articles and adjectives and their proper order, how questions are phrased, and much more. Language cannot function without grammar. It would simply make no sense. People require grammar to communicate effectively. Speakers and listeners, authors and their audiences must function in like systems in order to understand one another. In other words, a language without grammar is like a pile of bricks without mortar to hold them together or the masons to build with them. While the basic components are present, they are, for all intents and purposes, useless. Fast Facts: Grammar Word Origin and Definition The word grammar  comes from the Greek, meaning craft of letters. Its an apt description. In any language, grammar is:The systematic study and description of a language (as compared with usage).A set of rules and examples dealing with the syntax and word structures (morphology) of a language.   We Learn Grammar From Birth British linguist, academic and author David Crystal tells us that  grammar  is the study of all the contrasts of meaning that it is possible to make within sentences. The rules of grammar tell us how. By one count, there are some 3,500 such rules in English. Intimidating, to be sure, but native speakers dont have to worry about studying each and every rule. Even if you dont know all the lexicographical terms and pedantic minutiae involved in the study of grammar, take it from noted novelist and essayist Joan Didion: What I know about  grammar  is its infinite power. To shift the structure of a sentence alters the meaning of that sentence. Grammar is actually something all of us begin to learn in our first days and weeks of life, through interaction with others.  From the moment were born, language—and the grammar that makes up that language—is all around us. We start learning it as soon as we hear it spoken around us, even if we dont fully comprehend its meaning yet. Although a baby wouldnt have a clue about the terminology, they do begin to pick up and assimilate how sentences are put together (syntax), as well as figure out the pieces that go into making up those sentences work (morphology). A preschoolers tacit knowledge of  grammar  is more sophisticated than the thickest style manual, explains cognitive psychologist, linguist, and popular science author Steven Pinker. [Grammar should not] be confused with the guidelines for how one ought to speak. Real-World Uses of Grammar Of course, anyone who wants to be an effective speaker or writer must have at least a basic grasp of grammar. The further  beyond the basics you go, the more effectively and clearly youll be able to communicate in almost any situation. There are several applications of grammatical study:(1) A recognition of grammatical structures is often essential for punctuation(2) A study of ones native grammar is helpful when one studies the grammar of a foreign language(3) A knowledge of grammar is a help in the interpretation of literary as well as nonliterary texts, since the interpretation of a passage sometimes depends crucially on grammatical analysis(4) A study of the grammatical resources of English is useful in composition: in particular, it can help you to evaluate the choices available to you when you come to revise an earlier written draft.—From An Introduction to English Grammar by Sidney Greenbaum and Gerald Nelson In a professional setting, having advanced knowledge of grammar can help you interact efficiently and easily with your colleagues, subordinates, and superiors. Whether youre giving directions, getting feedback from your boss, discussing the goals of a particular project, or creating marketing materials—the ability to communicate effectively is extremely important. Types of Grammar Teachers follow a course of  pedagogical grammar  when instructing English language learners. While students mainly have to deal with the nuts-and-bolts of prescriptive,  traditional  grammar (such as making sure verbs and subjects agree and where to put commas in a sentence), linguists focus on the infinitely more complex aspects of language. They study how people acquire language and debate whether every child is born with a concept of universal grammar, and examine everything from how different languages compare to each other (comparative grammar) to the variety of permutations within a single language (descriptive  grammar) to the way in which words and usage interrelate to create meaning (lexicogrammar). More Grammar to Explore Case grammarCognitive grammarConstruction grammarGenerative grammarLexical-functional grammar (LFG)Mental grammarTheoretical grammarTransformational grammar Sources Crystal, David. The Fight for English. Oxford University Press. 2006Pinker, Steven. Words and Rules. Harper. 1999Greenbaum, Sidney; Nelson, Gerald. An Introduction to English Grammar. Second Edition. Pearson. 2002