Psychotherapy in Depression Intervention

Depression Intervention

Depression Intervention

Psychotherapy is a term for treating mental health problems which entails consulting with a psychiatrist, psychologist, or other mental health providers. During psychotherapy, an individual learns about their conditions, moods, feelings, thoughts, and behaviors. It does help one in learning how to take control of their life and respond to challenging situations with essential healthy coping skills (Minuchin, & Fishman, 2004).

There are various specific types of psychotherapy, with each psychotherapy approach being unique on its own. The type of psychotherapy that is right for an individual varies within the diverse individual needs and demands. Therefore, each person is entitled a choice of psychotherapy that suits his/her personal conditions. Psychotherapy is a distinct profession in its own right, with many different types of professionals and practitioners engaging in it regularly with a range of qualifications. Such qualifications include psychiatry, clinical psychology, counseling psychology, clinical or psychiatric social work, mental health counseling, marriage and family therapy.

Rehabilitation counseling, school counseling, play therapy, music therapy, art therapy,drama therapy,  dance/movement therapy, and occupational therapy are among other professional qualifications. Besides, this group of professional specializes in psychiatric nursing, psychoanalysis, and other psychotherapies. Individuals wishing to practice this lucrative profession may opt for clinical psychologists, psychiatrists, counseling psychologists, marriage and family therapists, counselors, social workers, mental health counselors, occupational therapists and psychiatric nurses (Compas, & Gotlib, 2002; Minuchin, & Fishman, 2004). Psychotherapy may be legally regulated, voluntarily regulated, or unregulated based on the jurisdiction. Requirements of the mentioned professions vary, but they often require graduate school and supervised clinical experience.

Clinical psychologists are largely responsible for the intervention and reduction of depressions among patients. These clinical specialists are charged with the responsibility of assessing and treating mental illness, abnormal behavior, and psychiatric problems. Psychotherapy incorporates science of psychology with the treatment of complex human problems. Clinical psychologists, in most instances, work in medical settings, private practice, or academic positions at universities and colleges. Some of the specialists in the private practice work directly with clients, those suffering from severe psychiatric disorders.

Some of the clinical psychologists prefer working in private therapeutic settings offering short-term and long-term outpatient services to clients who need help coping with psychological distress. Others will work in other settings specializing in research, teaching university-level courses and offering consultation services (Henrik, 2010). One needs to graduate with a degree in psychology followed by professional examination and evaluation to qualify as a psychiatrist. Besides, psychiatrists must have medical and clinical training. A masters or doctoral degree, and a license, are required for senior psychologists. A doctoral degree usually is required for independent practice as a psychologist.

Cognitive Behavioral Therapy use in Depression Intervention

The cognitive behavioral therapy model entails a vast number of techniques focusing on the construction and re-construction of people’s emotions, behaviors, cognitions (Minuchin, & Fishman, 2004). The therapist, through CBT, helps clients assess, realize, and deal with problematic, dysfunctional ways of behaving, thinking, and emoting. CBT model’s characteristics are time limited, among the most rapid in terms of results. It normally offers a sound therapeutic relationship between the therapist and client, based on the scientifically supported assumption that most emotional and behavioral reactions are learned, it is structured and directive in the sense that therapists have a specific agenda for each session (Compas, & Gotlib, 2002).

Study samples have shown that CBT is an effective method in getting rid of depression. Therefore, it is worth recommending CBT to people suffering from depression and for sure, this form of therapy would be very effective for such group of people. In most instances, depression entails one’s feelings and emotions having been hurt (Henrik, 2010). Through consulting with counselors and psychotherapists, studies have shown that the counseling session is very effective in reducing depression and hence, relieving the patients of the despair.


Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-09 Edition, Psychologists, on the Internet at HYPERLINK “”

Compas, Bruce & Gotlib, Ian. (2002). Introduction to Clinical Psychology. New York, NY: McGraw-Hill Higher Education.

Henrik, R. (2010). The Psychotherapy Handbook. The A-Z handbook to more than 250 psychotherapies as used today. New American Library.

Minuchin, S.& Fishman, H. C. (2004). Family Therapy Techniques. Harvard University Press.

Nursing as Moral Agents

Nursing as Moral Argents

Nursing as Moral Agents

A moral agent does things with reference to knowing what is wrong or right and can personally be held responsible for his or her actions. In the nursing profession, nurses are seen as people who care for patients in almost every aspect of life. Their main duties being to provide the best possible care a patient can receive. In their code of professional conduct and business values, they should be responsible for every action and decision they make in their line of duty (Allen, 2011). Nursing can be practiced by anybody, for example, a family member may decide to take care of another sick family member. The only difference here is that a professional nurse works with certain set codes of nursing conducts and business ethics.

It, therefore, means that, nurses must hold moral competency in their duties for the delivery of good healthcare to the patients. Competency is the ability of a person to deliver good outcomes in their duties at all times. Competency in nursing includes the possession of basic nursing skills and the technical knowledge of handling different medical equipment and the ability to read and interpret medical reports that will lead to the delivery of the desired services by the patients. Morally, competent nurses will always advocate in the best interest of their patients. Many nursing councils have adopted advocacy as an essential part of the nursing career with the main focus being on the safety of patients

Reports of past occurrence show that patients get involved in fatal incidents such as injection of wrong drugs, suffocation due to lack of enough oxygen and also prescription of wrong medication. In a bid to help nurses act more responsibly, the American Nurses Association (ANA) have developed new work standards for nurses.

Nurses on their parts, have to demonstrate high levels of competence in caring for patients. They must possess the necessary basic skills required to carry out their duties. Nurses also should have and uphold the values that their profession demands. The values range from personal, social, and professional. These are the major indicators of ethical competence in the nursing profession. Nurses do a great deal of work in terms of caring for the patients. It doesn’t only involve classwork as there is so much of practical work involved. Nursing is a field that demands much more than just classwork. They must have desire to help a suffering person. According to Allen (2011), compassion is another key component in the moral competence of a nurse. It is not just only responding to the suffering of others, but is more of an obligation in the nursing practice. Kindness and loving are other core values in the moral competency. Nurses must always feel love for the patients they care for and be kind to them at all times. As a result, strong trust will develop between the nurses and their patients, thereby aiding in the recovery process of the patients. Consequently, these two values should be included as values of moral competence that nurses must exhibit and uphold in the nursing practice.

Responsibility is a value that expresses the level of accountability by the nurses. It implies that nurses do what is right and make decisions from an informed position, for example, call for an emergency when it is necessary. Therefore, nurses need to recognize mistakes and quickly correct them so as not to compromise their moral obligations. Discipline is another key value for nurses who want to be morally competent (Basavanthappa, 2008). Being disciplined in nursing is the ability of nurses to carry themselves with dignity in discharging their duties and be able lead an organized life. With high levels of discipline maintained among nurses, they can perform much better in a social environment where they get to interact with many people of different kinds. It goes a long way in cultivating the liaison between nurses and their patients. This value, however, should come from the inside of a person and not necessarily leant or practiced. Studies have shown that nurses who uphold high standards of discipline in their jobs have goods records of successful recoveries of most patients. Honesty is another value that focuses more on the nurses to uphold the truth and avoiding deceit as well as being truthful to others. Consequently, nurses will be able to make good judgments on their actions. It also involves clearing up any misunderstandings that may arise and thereby creating a healthy working environment for both the nurses and their patients. Lastly, respect for human values is very crucial for nursing practice. Without the respect for human values, patients may feel lost and as not being part of others. Nurses meet different patients with different needs, but all these patients must be treated equally to help them feel appreciated and respected for who they are (Basavanthappa, 2008). As a result, this will aid in improving their general health and at the same time reducing the sense of feeling lonely among them.

In conclusion, nursing profession calls for more than just passing exams in the classwork. It should reflect the passion one has for helping others. Nursing practice is a field that is guided by the set work ethics, and also the ethical standards that a person aspiring to be a nurse must uphold.


Allen, J. E. (2011). Nursing Home Administration. New York: Springer Pub.

Basavanthappa, . (2008). Community Health Nursing. S.l.: Jaypee Bros. Medical P.

Nursing Staff Shortages in the Health Care System

Nursing Staff Shortages in the Health Care System

Nursing Staff Shortages in the Health Care System


The shortage of nurses is a global health issue that negatively affects healthcare delivery, and the problem is expected to worsen with the increasing demand for healthcare providers caused by the aging population. To goal of this paper is threefold. Firstly, the paper seeks to uncover the causes of nurse shortages. Secondly, the paper aims to uncover the adverse effects of nurse shortages. Lastly, the paper aims to uncover practical solutions for minimizing nurse shortages in healthcare facilities. The most common causes of nurse shortages include low income, poor funding for nursing education, low expenditures on healthcare, nurse burnout, low levels of income, reduced supply of nurses, poor recruitment plans, ineffective planning, improper use of the available nursing resources, and lack of cultural competence and cultural diversity. Effects of nurse shortages include sleep deprivation, which negatively affects nurses central nervous and cardiovascular systems. Nurse shortages also cause in-hospital deaths, HAIs, medication errors, increased medical costs, reduced job satisfaction, burnout, and moral distress. Possible solutions to minimize nurse shortages include improving nurses’ job satisfaction, increasing healthcare expenditure, increasing funds for nursing education to make it affordable for students to pursue a career in this field, and establishing laws that promote retention of nurses. Minimizing nurse shortages will help improve the patient outcome and quality of life.

Nursing Staff Shortages in the Health Care System


Nursing is an integral part of the healthcare system and accounts for about 56% of any hospital’s staff (Shamsi & Peyravi, 2020). Nurses are renowned for being proponents of healthcare promotion, training patients and the society about how to avoid diseases and injuries, taking part in rehabilitation, and offering assistance and care. Despite the important roles played by nurses, healthcare facilities today face an increasing challenge of nurse shortage. Supporting this statement, Shamsi and Peyravi (2020) claim that nursing staff shortage is a significant and multifaceted problem and has reached a warning threshold. It is also expected that the issue of nurse shortage will continue to worsen due to increasing demand for healthcare providers caused by the aging population (Stokes & Iskander, 2021). It is approximated that by 2029, there will likely be 73% more Americans over the age of 65, which will increase the demand for healthcare practitioners to provide medical services. This paper provides a comprehensive understanding of the issue of nursing staff shortages in health care system. Specifically, it also illustrates the causes of nurse shortages, the effects of nurse shortages, and the possible solutions to this problem. The purpose of pursuing this topic is to reduce the negative effects of nursing shortages in the health care system. This goal is realistic when the government works together with the health facilities to achieve it.

To help with research and understand the causes, effects, and possible solutions of the issue of nurse shortages, various research questions from different perspectives of inquiry have been used. The different perspectives of inquiry include scientific, analytical, ethical, and cultural perspectives of inquiry. For each perspective of inquiry, one Level 1 and one Level 2 questions were selected. For the scientific perspective of inquiry, the chosen level 1 research question is “Which body systems are affected?” while the formulated level 2 research question is “What are the effects of nursing staff shortages on the patient outcome?” On the other hand, the level 1 research question from the analytical perspective is “What are the economic issues involved?” while the level 2 research question under this type of inquiry is “what are the causes of nursing staff shortages, and how can this problem be solved?”. Furthermore, the chosen Level 1 question from the ethical perspective of inquiry is “What laws pertain to the issue?” while the formulated level 2 question from this perspective is “What are the ethical implications of nursing staff shortages?”. The chosen level 1 question from the cultural perspective of inquiry is “Which cultural values influence the issue?” and the corresponding level 2 question is “How does cultural diversity affect nurse shortage?” The answers to these questions have been combined to develop the paper.

Causes of Nurse Shortages

In order to define practical solutions to a problem, it is important to first understand the cause of the problem. Therefore, it is important to explore the factors which contribute to the nursing staff shortage. Nursing shortages are caused by a number of reasons. One of them is the fact that the nurses are growing old and need to retire (Mac et al., 2019). They however lack people to replace them and some of them are forced to continue working even during old age. This mostly brings about inefficient work. Another cause of nurse shortage is nurse burnout. This is mainly caused by the availability of few nurses who are forced to work overtime (Manyisa & Aswegen, 2017). Other causes of nurse burnout include low shifts, high workloads, and low staffing (Dall’Ora et al., 2020). When nurses experience burnout, fewer nurses are left to attend to patients; thus, a healthcare facility may experience a nursing staff shortage. Additionally, since most of the nurses are females, they are forced to leave the profession to go and bear children and take care of their families. In some American states, the number of nurses is high compared to others. This results to shortages in states that have few nurses. This is also due to the fact that nurses will prefer to work in regions that are good for settling with their families (Haddad et al., 2022). Some nurses complain of emotional and physical abuse caused by the stressful hospital environment.

Another cause of nurse shortages is lower income levels. Drennan and Ross (2019) reveal that low-income countries experience nurse shortages since nurses move to low-income countries to seek employment. On the same note, Fawaz et al. (2018) reveal that relatively low pay contributes significantly to the nurses’ deficit. Based on the classic economic theory, income level is a major factor in pushing or attracting people from one job to another as well as from one market to the other (Drennan & Ross, 2019). Also, the lack of funding to support nursing education contributes to the nurse shortage. Supporting this point, Drennan and Ross (2019) argue that the nursing staff shortage is high due to the poor funding for nursing education. Lastly, underfunding of the healthcare system contributes to nurse shortages. Marć et al. (2019) claim that low healthcare expenditures translate into nurses’ low salaries. Consequently, this results in nurses quitting their job and hence the problem of nurse shortage. In relation to the economic effects of nursing staff shortages, Haddad et al. (2022) reveal that nurse shortages lead to medical errors. These medical errors may lead to patients’ prolonged stay in the hospital, which increases the cost incurred in the hospital.

Furthermore, lack of cultural competence also causes nurse shortages. Notably, cultural competence is recognized as one of the cultural values that influence the issue of nurse shortages. Cultural competence is the set of values, practices, behaviors, and attitudes within an organization system or even individuals, which allows them to work effectively across different cultures. Cultural competence influences nurse shortages because when nurses are not culturally competent, they tend to get stressed, which results in nursing burnout. Another cultural value that influences nurse shortages is cultural diversity. Cultural diversity is the existence of many cultures in the same society. Nurses must be well prepared to serve culturally diverse patients. Unless nurses are culturally competent, they cannot be in a position to provide quality care to patients. When nurses cannot provide quality care, they get stressed and end up quitting their jobs. The last cultural value that influences nurse shortage is cultural awareness. Nurses’ cultural awareness is their comprehension of differences between themselves and patients from other cultural backgrounds. Similar to cultural competence, a lack of cultural awareness may result in nurse shortages.

Lastly, cultural diversity causes nurse shortage. Research reveals that nurses without a firm understanding of cultural differences may experience frustrations and stress when dealing with culturally diverse patients (Balante et al., 2021). Consequently, this may result in nurse burnout. Burnout is one of the leading causes of nurse shortages. Thus, it can be concluded that nurses’ lack of cultural competence indirectly results in nurse shortages. On the contrary, cultural competence allows nurses to provide inclusive healthcare service, improves nurses’ job satisfaction, and facilitates patient satisfaction. When nurses are satisfied with their job, they tend to retain their profession. Consequently, this minimizes nurse shortages.

Impacts of Nurse Shortages

Nurse shortages cause a huge negative impact on the health care systems today. One of these impacts include, increase in patient deaths. This is because patients will be sent home to be taken care of by care givers rather than nursing professionals. Another impact is the increase of medication errors (Haddad et al., 2022). Studies have shown that 46.8% of nurses have committed errors in the last one year. These errors include giving medication to wrong patient, omission of medication, mistaken medication and giving a patient medication twice instead of once. Lastly, nursing shortages increase overcrowding in emergency rooms. This is because the nurse-to-patient ratio is uneven. By solving the nurse shortage problems, these negative impacts will be reduced.

Furthermore, the shortage of nurses indirectly affects the nurses’ body system, where it causes sleep deprivation. Nurse shortages force nurses to work overtime. The long working hours put nurses at an increased risk of short sleep duration, sleep disturbances, and fatigue. Sleep deprivation and fatigue affect the nurse’s central nervous system making their brain not to function correctly. Also, research reveals that lack of sleep among nurses may lead to psychological issues such as memory loss, serious thought retardation, stress, anxiety, and depressive symptoms (Deng et al., 2020). Sleep deprivation due to long working hours also affects nurses’ cardiovascular system. This is because sleep affects processes that affect blood pressure and body sugar levels. Research reveals that sleep deprivation causes severe cardiovascular diseases such as heart attack and stroke (Ahmad & Didia, (2020). On the same note, Liew and Aung (2021) reveal that sleep deprivation causes high blood pressure, a leading risk factor for stroke. It also makes it easier for blockages to occur in arteries causing strokes.

Also, nurse shortage is shown to affect patient outcome. Ghafoor et al. (2021) reveal that the shortage of nurses adversely affects patient care leading to health decline in the nation at large. On the same note, Haegdorens et al. (2019) reveal that lack of sufficient nurse staffing in healthcare facilities is associated with negative events such as hospital-acquired infections (HAIs), patient falls, in-hospital mortality, and medication errors. Also, nurse shortages result in rationing time to care, increasing the risk of missed care. This translates to poor patient care delivery. According to Janatolmakan and Khatony (2022), missed nursing care results in patient dissatisfaction, psychological and physical complications, and even death. Missed care may also result in delayed treatment and medication.

Nurse shortage leads to the medical errors in the process of service delivery and the data entries. The medical errors are caused by the overworking conditions of the working nurses that may make them exhausted to deliver the approved quality services (Haddad et al., 2022). Hospitals with high patient to nurse ratio are characterized by the nurse experiencing of the burnout, dissatisfaction. As such the dissatisfaction creates a mechanism where the nurse may unknowingly error in medical service delivery. The error in service delivery henceforth causes the higher mortality of the patients and failure to rescue the ailing patients

Furthermore, persistent nurse shortages across the world challenge the values and beliefs of this profession and result in various ethical implications. One of these ethical implications is poor patient care. One of the ethical obligations that nurses must fulfill during their line of duty is ensuring that patients are protected from harm (Haahr et al., 2020). However, nurse shortages make it challenging for the nurses to fulfill this obligation as the hospitals assign them to cater for many patients. Since chronically ill patients require holistic care, inadequate staffing denies nurses an opportunity to provide such care to these patients, resulting in poor patient care. Another ethical implication of nursing staff shortages is nurses’ reduced job satisfaction. Usually, ethics assist nurses in making the right decisions guided by their morals. However, nurse shortages leave nurses dissatisfied with their jobs because they do not have sufficient time to communicate with their patients and provide holistic care. Moral distress is another ethical implication of nursing staff shortages. Nurses who serve in healthcare facilities with shortage of nursing staff experience moral distress since they feel that they are compromising their ethical obligation of ensuring patients are protected from harm by providing inadequate patient care (Bayat et al., 2019). Also, nurses who work in health care facilities facing the issue of nurse shortage may suffer moral distress because they feel that they would have rendered better patient care if they were not assigned many patients. Lastly, burnout is another ethical implication of nurse shortages. According to Mullen et al. (2017), increased ethical conflict at work may result in emotional stress and mental burnout. Consequently, this may result to nurses quitting their profession, leading to nurse shortage.

Possible Solutions to Nurse Shortages

The best-known solution is increase in nurse salaries and incentives. This will make more people consider the nursing field. It will also make them feel motivated especially for the nurses who work in the unfriendly areas (Haddad et al., 2022). The male gender is also highly encouraged to join the nursing field so as to enable women to have maternity leaves and go take care of their families when need be. Male patients feel more understood when they are taken care of by male nurses. Health care institutions should also provide training and counseling to their staff. These will enable nurses to speak about the issues they face at work, prompting the management to find the solutions to the issues hence decrease in nurse turnover (Manyisa & Aswegen, 2017). In the event of pandemics or flu, the management of health institutions should hire temporary nurses to help the permanent ones. This will reduce chances of nurses getting burnout. Another solution is having policies that make health centers carry out effective nurse staffing which will increase job satisfaction and nurse retention rates therefore reducing nurse turnover (Holmberg et al., 2018). Nursing programs can also help reduce nurse shortages by increasing wages for nursing educators and therefore motivating them. The nurse students can also receive scholarships which will encourage them to start and finish the nursing courses without financial problems (Marc et al., 2019). Having nursing online classes will motivate more people to take up the nursing career since they do not have to travel to access institutions of higher learning.

Additionally, concerning how nurse shortages can be minimized, research reveals that policy attention is needed in all elements of human healthcare resources and to avoid policy-making that relies overly on oversimplified linear thinking (Drennan & Ross, 2019). For instance, policymakers should not only focus on increasing the number of individuals who enter nursing training but should also make policies that seek to increase the numbers entering the workplace and increase burses retention. Also, improving nurses’ job satisfaction can help reduce nursing staff shortages. This can be achieved through improving role transitions and orientations. According to Lockhart (2020), transition programs for new graduates improve job satisfaction and increase nurse retention. Other ways of improving nurses’ job satisfaction identified by Lockhart (2020) include nursing mentorship programs and improving the workplace environment. Increasing the salaries of nurses may also improve their job satisfaction.

Also, nurse shortages can be minimized by implementing rules and regulations. Since different countries have different laws that pertain to this healthcare issue, the focus of this paper will be on the US laws that pertain to the issue of nursing staff shortages. One of these laws is the Nurse Reinvestment Act, P.L. 107-205. The 107th Congress passed the Nurse Reinvestment Act on July 22, 2002. Congress had been significantly engaged since the 1960s with the goal of providing the US with sufficient nurse manpower. The Act was later signed into law by President George W. Bush on August 1, 2002. The Nurse Reinvestment Act pertains to the issue of nursing staff shortages because Title I and Title II pertain to nurses’ recruitment and retention, respectively. Title 1 of the Act provides two ways of boosting nurses’ recruitment. The first initiative is the development and broadcasting of grant-based funding of local and state public service announcements to promote and advertise the nursing profession. During broadcasting, the rewards ad advantages of the nursing profession should be highlighted, and people are persuaded to enter into this profession. The second initiative entails the revision of provisions of the National Nurse Service Corps (NNSC) related to items such as scholarships, loan repayment, funding, and reporting and eligibility requirements. Boosting nurses’ recruitment helps in addressing the main health care issue selected, which is nurse shortages. Title II of the Nurse Reinvestment Act presents policies intended to improve the retention of nurses. The provisions of Title II relate to areas such as creating career ladders and retaining high-quality nurses through retention grants and nurse education, developing and funding comprehensive geriatric education, and creating and running a nurse faculty loan program to improve the number of qualified nursing faculty. Title II of the Act helps address the issue of nurse shortages by ensuring nurses do not quit their profession. Another law that pertains to the issue of nursing staff shortage in the US is the Nurse Training and Retention Act of 2007, S.2064. The 110th Congress passed this Act on September 18, 2007. This Act aims to ensure comprehensive programs are funded to facilitate a sufficient supply of nurses. Increasing the supply of nurses helps deal with the selected healthcare issue, nursing staff shortage.

Investing in the long term-training of the nurses to enhance the professional development has enabled the healthcare organization to mitigate the detriment of the nurse staff shortages. Medical institutions should create a lifelong learning for nurses through the promotion to innovative and management positions (Challinor et al., 2020). The conditions for the promotions get based on knowledge provision and skills through distance learning, on-site classes, and the self-tutorials by the employers. Notably, avoiding the expensive and immediate training can get achieved by the organizations through the adoption of the fun training for the senior nurses.

Another approach of reducing the nurse shortage by the healthcare organization is the conversion of the current nurses into compensate for the referrals and the recruiters. The conversion will enable the nurses to communicate in one language hence creating a framework of delivering the quality services through limiting the time w3astyage in service delivery. The act of cp0nvertiong the nurses to compensate for the referral and he recruiters get achieved through monetary compensation to encourage the nurses in their duty delivery hence creating a position of recruiting other nurses to the organizations.

Moreover, offering the altered schedules for the accommodation of the professional and the personal needs of nurses remains an initiative of addressing the nurse shortage in the healthcare organization. However, maintaining and achieving professional and personal life balance sometimes becomes difficult for the nurses. As such, the immediate improvement strategies that should be achieved by the nurse leaders get based on offering the altered schedules for the nurses to accommodate the professional and personal needs like offering the special mum shifts for the busy mothers who may have opted to take a leave (Buchan & Aiken, 2008). Also, the ability of the organization to create a part time shift in service delivery accommodate the personal and the professional needs of the nurses hence are creating a framework of choosing the options that fits the personal obligations. Choosing the fit shift makes nurses happy with the service delivery hereby enhance the work balance and promoting the satisfaction and wellness within the organization.

Furthermore, the use of the onboard programs to make new recruited nurses feel welcomed in the service delivery creates the group cohesion hence effective and efficient service delivery which bridges the gap of the nurse shortage and encourages their retention. Also, good onboarding program eases new recruits into the job market hence reduce overwhelming at the first few days at the new job (Challinor et al., 2020). As such, the organization and the management should avoid assigning nurses to the new patients immediately after recruitment. The onboarding program continues to involve the use of new mechanisms that enable the new nurses to know the current nurses for the sense of community encouragements. As a result, the nurses tat feel part of the nursing community are likely to retain their jobs and bring along the qualified friends. Nurse residency program continues to characterize the onboarding program through provision of accommodation that make the nurse feel easier to transit from being the student nurse to handling the nurse responsibilities. The initiative creates a mentorship program through combination of the new nurses with the experienced nurses to create a comprehensive knowledge of caring for the patients.


Overall, the nursing unit forms an integral part of the healthcare system. As such, the increasing challenge of nursing staff shortages poses an increased risk to the health outcome of patients. The main causes of nurse shortages include low income, poor funding for nursing education, and low expenditures on healthcare. Other causes of nurse shortages include nurse burnout, low levels of income, reduced supply of nurses, poor recruitment plans, ineffective planning, and improper use of the available nursing resources. Lack of cultural competence and cultural diversity also cause nurse shortages. It has been established that nurses’ body systems, including the central nervous and cardiovascular systems, are indirectly affected by this healthcare issue. Usually, nurse shortages cause sleep deprivation, thus negatively affecting the aforementioned systems. Also, nurse shortage has shown to impact patient outcome, where the issue results in missed care, in-hospital deaths, HAIs, and medication errors. Furthermore, shortage of nurses is associated with increased medical costs, which are associated with prolonged stays in hospitals. Other effects of nurse shortages include reduced job satisfaction, burnout, and moral distress. Nursing shortages can be improved by improving nurses’ job satisfaction. This can be achieved by launching nursing mentorship programs and improving the workplace environment. Also, increasing healthcare expenditure may increase nurse satisfaction since they will receive higher pay. Increasing nurses’ salary will also make more people to consider pursuing a career in this field. Another solution to reduce nurse shortage is increasing funds for nursing education to make it affordable for students to pursue a career in this field. Also, laws such as Nurse Reinvestment Act, P.L. 107-205, and the Nurse Training and Retention Act of 2007, S.2064 help minimize the problem of nurse shortages. Notably, the Nurse Reinvestment Act pertains to the issue of nursing staff shortages because Title I and Title II pertain to nurses’ recruitment and retention, respectively. On the other hand, the Nurse Training and Retention Act of 2007 aims to ensure comprehensive programs are funded to facilitate a sufficient supply of nurses.


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Nursing theories

Nursing theories

There are various nursing theories that are used by nurses as a guide to their day to day practice in nursing. This paper will look give views on theory-driven and evidence based of two nursing theories.

One of these theories is the self-care theory by Dorothea Orem. The major concept in this theory is an art through which the nursing practitioner gives assistance that is specialized to individuals with disabilities that makes more than ordinary assistance necessary for meeting the needs for self-care. Self-care requirements are actions that are directed towards providing self-care presented in three categories; universal self-care requisites, development self-care requisites and health deviation self-care requisites.

Assumptions of Self-Care Theory

There are various assumptions that were made in this theory such as people have to be self-reliant and responsible when it comes to their own care as well as others within the family needing care. It also assumes that people are distinct individuals and nursing is a form of action that involves an interaction between two or more people. Another assumption is that meeting universal and development self-care requirements is a crucial component when it comes to the primary care prevention and illnesses. There is also an assumption that an individual’s knowledge of potential health problems is an important thing when it comes to the promotion of self-care behaviors (Gonzalo, 2011).

Applications of Self-care theory

This theory is applicable for nursing by those beginning the practice as well as the advanced people. In this theory nursing is needed when a person can not maintain continuously the amount and quality of self-care that is required to sustain life and health recover from an injury or disease or cope with the effects from illnesses or injuries.

Another nursing theory is the need theory by Virginia Henderson. The background of the theory was the emphasis on the importance of increasing the independence of a patient in order for progress after hospitalization not to be delayed. It aims at assisting individuals in gaining independence in relation to performance of activities that contribute to their health or recovery. According to this theory the role of nurses is substitute, supplementary, complementary with the main aim of helping the individual become as independent as possible.

Assumptions of Need Theory

There are several assumptions in this theory one is that nurses are supposed to care for patients until they are able to care for themselves once again. Another assumption is that nurses are willing to serve and that they will devote themselves to patients day and night (Currentnursing, 2012).A lot of focus on Orem’s work is self-care. Even if there is a wide scope as seen when it comes to encompassing theory of the nursing systems, Orem’s goal of letting readers look at nursing care as a way of providing assistance to people was apparent when it came to all the concepts that were presented. From the definition, health that is sought as rigid can now be refined through making it suitable to general view of health as a state that is ever changing and dynamic. The role of nurses when it comes to the mantainace of health of patients was set by Orem with a lot of coherence according to the life-sustaining needs of every person. This theory appears simple but yet it is quite complex, the use of self-care agency, self-care deficit, universal self-care can be quite confusing. The theory does not recognize the emotional needs of an individual (Gonzalo, 2011).

The needs theory is based on four major concepts the individual, who has basic needs which are component of health. The second concept is environment is the setting which an individual learns of unique pattern of living. The third concept is health whereby nurses are required to stress on promoting health and prevention and cure of illnesses. The final concept is nursing that assists and supports individuals in life activities as well as their attainment of independence. The theory puts emphasis on basic human needs as a central focus of the nursing practice which has led to the development of theory when it comes to needs of an individual and how nursing can be used to meet these needs (Currentnursing, 2012).


Gonzalo, A. (2011). Theoretical Foundations of Nursing. Retrieved October 7, 2014 from (2012). Virginia Henderson’s Need Theory. Retrieved October 7, 2014 from

Dementia Pathophysiology and Etiology

Dementia, Pathophysiology and Etiology

Dementia: Pathophysiology and Etiology

Dementia is a brain disorder that affects an individual’s thinking and reasoning capacity. Dementia involves a combination of many neurodegenerative diseases and conditions that affect daily activities as opposed to a single disease. It mainly affects neurons and cells in the cerebral cortex causing deterioration of function in the cortex (Alzheimer’s Association Web). Dementia mainly affects older people aged 65 years and above because old age is a contributing factor. Neurodegenerative disorders are the main causes of dementia, with Alzheimer’s disease contributing 60-70% of the cases (Davis Web). Other diseases associated with dementia include dementia with Lewy bodies and frontotemporal dementia. The diseases often cause brain damage leading to premature brain degeneration and cell death. Thus, an individual’s mental activity is affected, causing memory loss and thinking incapability. The collection of isolated proteins in the brain is the main cause of brain damage that leads to dementia. Dementia is often not a hereditary disease, but a few cases of frontotemporal dementia and Alzheimer’s disease can be hereditary. Shortage or interruption of blood supply to the brain often causes vascular dementia. Other causes of dementia include vitamin B and thyroid hormone deficiency, head injury, brain tumors, prolonged alcohol abuse, and depression (Bourgeois and Ellen 17).

Signs and Symptoms of Dementia

Dementia often manifests itself in various symptoms, both mental and physical. Memory loss and inability to reason are the main symptoms of dementia, where an individual fails to keep track of vital things such as wallet and keys, forgets to pay bills, prepare meals, or appointments. The individual also experiences difficulty communicating, organizing, planning, handling complex tasks, coordinating and other motor functions. In addition, the individual also suffers detrimental mood swings, hallucinations, paranoia, irritability and other personality changes. Visual perception and disorientation such as getting lost easily are also symptoms associated with dementia. Most dementia signs and symptoms are progressive and worsen with time; thus, early diagnosis is recommended for treatment, management and future planning (McNamara 35).

Treatment of Dementia

Most cases of dementia such as Alzheimer’s diseases have no cure, and treatment options often aim at reducing symptom development. Both drug and nondrug options are available for the management of dementia. Drug based options include medications that help in boosting the levels of chemicals associated with memory and judgement in the brain. The drugs include galantamine, rivastigmine and donepezil. Memantine is another drug that helps in the regulation of glutamate, a brain chemical that controls essential brain activities such as memory and learning. Nondrug options include therapies and lifestyle adjustment (Bourgeois and Ellen 133). Occupational therapies are often recommended to help an individual cope with the condition and adapt to daily activities and movement while living with dementia. Modifying the environment helps an individual function and focus by reducing noise and clutter. Handling the individuals with care, such as avoiding scolding, correcting, or quizzing them helps improve the condition. Making tasks easier to reduce confusion for people with dementia is also essential in managing the condition.

Prevention of Dementia

Dementia can be prevented by adopting various behavior and lifestyle changes. Both physical and mental activity helps in delaying the onset of the condition and reducing its symptoms. Engaging in various activities such as board games, memory training, sports, and social interactions help in keeping an individual active. Lifestyle changes such as adopting habits that aim at lowering the blood pressure and quitting smoking help in reducing the risk of dementia. Maintaining a healthy diet rich in omega 3 fatty acids, vegetables and fruits helps in boosting an individual’s health and reducing the risks of dementia. Research has also revealed that reading and pursuing education helps the brain to build a strong network of nerve cells that help in compensating the brain damage caused by neurodegenerative diseases (MediLexicon International Limited Web). Thus, education helps in reducing mental decline that often leads to dementia.

Works Cited

Alzheimer’s Association. What Is Dementia? 2014. Web. 26 May 2014.

Bourgeois, Michelle and Ellen Hickey. Dementia: From Diagnosis to Management – A Functional Approach. Boca Raton: Taylor & Francis, 2011. Print.

Davis, Charles. Dementia. Medicine Net, 1996. Web. 26 May 2014.

McNamara, Patrick. Dementia. Santa Barbara: ABC-CLIO, 2011. Print.

MediLexicon International Limited. What is dementia? The signs, symptoms and causes of dementia, 13 Mar. 2009. Web. 26 May 2014.

Democracy in America Book Review

Democracy in America Review

Democracy in America Book Review


Democracy in America is a book that consists of two volumes. The author of the book, Alexis de Tocqueville, completed the first volume in 1835 and the second one in 1840. In 1831, Tocqueville was working as a lawyer in his country (France) when the county’s government sponsored him for a nine-month visit to America to study various aspects related to American democracy. Tocqueville was sent together with Gustave de Beaumont, who was working as a magistrate. The two gathered information through interviews from more than 200 Americans on various topics related to social practices, law and politics (Tocqueville, 2007). Although the primary aim of the book is to examine the purpose and extent of democracy in America, it has extensive information pertaining communication studies. Among other concepts, the book explains the source of American culture and language. The impact of democracy and institutions such as Jury and religion freedom of speech in America is also explicit in the book. The second volume provides an extensive explanation of how democracy influenced Americans to focus on practical science rather than theory. The ultimate impact was deficiency in quality of their products, including drama, literature and poetry works (Tocqueville, 2007). The book is unique in the sense that some of these concepts are hardly explored in communication studies. The extensive exploration of such concepts makes the book qualify for the purpose of study in our communication class. This paper provides a reflective analysis of various concepts that relate to communication studies in the book.


In the first volume of the book, Tocqueville begins with exploration of social and cultural aspects of people who lived in different parts of America in early 19th century. Tocqueville notes that the Red Indians who inhabited different parts of North America prior to the entry of people from other regions were socially disorganized and relied more on hunting than agriculture. As people from different parts of the world moved to America, they interacted and started using the same language, which ultimately ended up in building American English (Tocqueville, 2007). The natives also learned the new language and started sharing it with the immigrants. English language was more influential since North America was once a British colony. The Britons, who migrated to America, exerted their influence to the natives and slaves in different aspects of life, including language. They applied criminal and political laws which were borrowed from Britain in North America. However, there was slight modification in laws that were meant to meet the conditions that existed in America (Tocqueville, 2007). Also, people from different social and cultural backgrounds practiced some social and cultural aspects of their forefathers, especially the natives. They also shared different cultural aspects. As a result, American people had a unique culture and language. When reading the first three chapters of the book, I found out that it provided a brief explanation of how the current unique America culture developed. The book enhanced my knowledge about how people from different cultural and racial backgrounds in America ended up having one common culture and language . Exploring how a society built up its culture and language is one of the key concepts explored in communication studies.

In chapter sixteen of the fist part of the second volume, Tocqueville gives an elaboration about how the unique language of Americans was built. According to Tocqueville, the myriad of changes in cultural aspects of American people was highly facilitated by the presence of democracy that was practiced by rulers, rather than aristocracy that was present in countries such as Britain and France (Tocqueville, 2007). Tocqueville notes that the English language that was being spoken by educated people in Britain had significant variations from the English language that was spoken by educated people in America. According to Tocqueville, language usually remains static in a country where autocracy is embraced. Changes hardly occur to the existing words and new words are hardly invented in an autocratic system. This, according to Tocqueville, explains the fact that no significant changes took place in the English language that was being spoken by educated persons in Britain (Tocqueville, 2007). On the other hand, Tocqueville noted that persons in democratic systems like making changes even without good reasons. This is evident in their politics, as well as in their language. Even when they do not have to change words, they try to transform them. In most cases, the new words that are invented by people in a democratic system tend to represent new ideas. They borrow ideas from the daily activities they engage in. According to Tocqueville, this explains the reason many words added by Americans to their English language were acquired from the language of trade, mechanical arts and jargon of parties (Tocqueville, 2007). I found this chapter being quite relevant for communication studies since it provides an explanation of the impact of democracy and aristocracy on language. I had never encountered the concept before or thought about the connection. I learned that democracy and aristocracy have different impacts on language.

In the second chapter of the firsts part of the first volume, to Tocqueville explores the issue of equality and freedom in American society. Tocqueville noted that people of American had a passion for equality and freedom. Tocqueville also explores the same issue in chapter two of the second part of the second volume. Although Tocqueville is concerned with the possible negative impact of too much passion for equality, he notes that equality and freedom coexisted in American society (Tocqueville, 2007). According to Tocqueville, the two were able to coexist because of existence of a local government that supported ways of exercising freedom by citizens. Tocqueville elaborates the issue through explaining key local liberties that were offered to citizens in laws in chapter five of the first part of the first volume. Also, Tocqueville explains that the existence of an independent jury that supported and propagated the local liberties played a major role in enhancing freedom in America. The impact of the jury is explained in length in chapter sixteen of the first part of the first volume. In addition to the existence of jury and laws supporting freedom, Tocqueville noted that religion played a major role in enhancing freedom in America. According to Tocqueville, religion played the role of teaching Americans how to utilize their freedom well. As a result, the government hardly intervenes through interference of freedom. Tocqueville gives a lengthy explanation of the connection between religion and freedom in chapter nine of the first part of the first volume. One of the key impacts of the ultimate freedom noted by Tocqueville is freedom of speech. Tocqueville notes that journalists were hardly restricted in writing content on newspapers. Also, people had freedom of speech which was recognized in laws. Thus, after reading the book, I learned that freedom of speech existed in America for a long time ago. I discerned the source of the current rights of freedom of speech that that are enjoyed by American people (Tocqueville, 2007). I felt that this might have been one of the factors that led to growth of journalism in America. Freedom of speech and how people utilize it is an important concept for communication studies and thus, I found the issue as being important for exploration in our communication class.

In chapter ten of the first part of the second volume, Tocqueville noted that Americans were more concerned with practical science than theory. According to Tocqueville, this is due to the fact that democracy is not conducive to abstract knowledge that is applied in theoretical science, which requires mediation and thought. Although this leads to an increase in material prosperity and innovation, people may end up forgetting principles and hence, dwindle away civilization (Tocqueville, 2007). In the next chapter, Tocqueville notes that this is one of the reasons why Americans focused on quantity and not quality when producing their artistic works. They were less concerned with reality and more concerned with appearance. This could also explain the reason why the Americans did not attach importance to the meanings of monuments, despite being plenty. Rather than taking an intellectual endeavor in literature, Tocqueville notes that people in a democratic society perceive it as a trade and take an industrial spirit. Tocqueville elaborates this issue in chapter fifteen of the second volume in which he explores the differences between American literature and Latin and Greece literature. According to Tocqueville, Latin and Greece literature of aristocratic ages indicated that they did nothing at random or with haste; rather they concentrated on every line that they wrote and tried to achieve perfection. In short, their literary works portrayed exceptional skills (Tocqueville, 2007). On the other hand, the literature works written during democratic ages, such as during the period when Tocqueville visited America, were naturally deficient and did not portray keenness. In addition, Tocqueville noted that the literature works produced during aristocratic ages have remained relevant throughout, unlike most of the literature works of democratic ages, which quickly became irrelevant. According to Tocqueville, the same applies to other aspects of literature such as poetry and drama. For these reasons, Tocqueville argued that the significant disparity between literature works of aristocratic ages and democratic ages implied that literature of democratic ages should not be read (Tocqueville, 2007). When reading chapters nine to eighteen of the first chapter of the second volume, I realized that Tocqueville exposed the negative impacts of democracy on various communication aspects of people, including artistic works, literature, poetry and drama. I did not know about the connection before. I learned that much of the existing literature is borrowed from countries in which aristocracy has existed for a long time and hardly from countries in which there has been democracy. This is an issue that relates to communication studies and would like to explore and understand it further.

Overall, I found Democracy in America as being a useful book for communication studies. Tocqueville gives a background that enables the reader to understand the source of the current unique culture and language of Americans, despite the fact that their forefathers have different cultures and languages. Further, the Tocqueville explains the impact of democracy and institutions such as religion and jury in enhancing freedom in America, which has had a positive impact on freedom of speech among Americans. As well, the book gives an elaborate explanation of the reason why American literature, poetry, drama and other communication aspects created during democratic age might be deficient in comparison to those that were create in aristocratic ages in other countries. The existence of such concepts, which are extensively explored, explains why the book can be recommended for reading in class.


Tocqueville, A. (2007). Democracy in America. Ed. Isaac Kramnick. Trans. Henry Reeve.

New York: Norton.

Nursing Staffing challenges in Maryland

Nursing Staffing challenges in Maryland

Nurse Staffing challenges in Maryland.

The medical profession has been witnessing rapid growth mostly in the demand for the primary care services. Although this growth was somehow expected, it has not been accompanied by an increase in the number of doctors. This has led to the health care industry in Maryland calling upon the nurses into action.

Unfortunately, the nursing field is also facing its own shortages in staff numbers and who operate under very demanding schedules. Previous studies like the one by the University of Maryland Nursing School (Nursing research 2011 quoted in Rajaraman 2013)Bottom of Form.One of the issues that were associated with low numbers of staff was the long hour shifts. These long hours at work and reduced off job hours contributed to poor patient handling and even deaths from avoidable errors.

The cadres that have been targeted mostly to replace the physicians are the nurse practitioners who have the skills to perform the tasks of a physician. This is only a stop gap measure since as indicated above; this has a domino effect on the lower job cadres.

Currently, Maryland’s population of nurses stands at 49,600, registered nurses who are active. Of these, 3,500 are nurse practitioners which mean they hold master’s degrees and a board of nursing license. The Government of Governor Martin O’Malley has committed to increase the population of nurses by 25% by 2020 partly via improving educational access as well as address the burden the medical staff faces (Gantz 2012).

In the words of Phyllis Snyder the vice president of the council for adult learning, it is not business as usual and we have to develop a variety of new pathways. One of these ways has been the concerted effort by health advocacy groups and nursing training institutions towards increase their drives towards having more students in the college level to choose nursing as a career. The groups are also encouraging nurses who are already in practice to pursue higher qualifications (Hoffman & Kaplan, 1998).

Schools have also embarked on missions to make nursing studies more accessible and affordable through inter schools partnerships, credit earned against prior experience and offering support towards tuition. The state on its part is designing ways in which it enhances access to nursing training as well as attracts more nurses into the state’s workforce.

An earlier report from the CGME (Council for Graduate Medical education) had established that only fewer than 20% of med school grandaunts pursue primary care as careers instead going for specialties with higher pay (Goldfarb, Goldfarb & Long 2008).Under the prevailing circumstances, nurses have been more than willing to take up the challenge of filling the gap but are forced to grapple with regulation and bureaucracy issues. For example, an assistant dean at the school of nursing University of Maryland Jane Kapustin bemoans the fact that she can legally diagnose diabetes at the university of Maryland Medical Center diabetes clinic, issue a prescription for insulin and commission tests but if she were to recommend special shoes, a physician would have to sign against the order.

It is encouraging to note that nurses in collaboration with advocacy organizations are exerting pressure to have the barriers reduced and it is hoped that these efforts combined with the pressure from increased need for additional primary care providers will eventually break the barriers.

References.Gantz S (2012). Maryland Nurses Come to fore as care landscape shifts, Baltimore Business Journal. Retrieved from of Form

Goldfarb, M., Goldfarb, R., & Long, M. (January 01, 2008). Making Sense of Competing Nursing Shortage Concepts. Policy, Politics, and Nursing Practice, 9, 3, 192-202.Top of Form

Hoffman, S., & Kaplan, M. (January 01, 1998). Problems encountered in the implementation of dementia care programs. American Journal of Alzheimer’s Disease and Other Dementias, 13, 4, 197-202.

Rajaraman M (2013) Study suggests link between lengthy Nurse shifts and patient deaths. Southern Maryland online. Accessed from of Form

Nursing And Millennium Goals

Nursing And Millennium Goals

Nursing And Millennium Goals


This paper looks at UN millennium development goals, focus being on the fifth millennium development goal which is improvement of maternal health. This goal is divided into two parts. The first part deals with reduction of maternal mortality and the second the second part deals with universal access to reproductive health. The paper also elaborates on the importance of improvement of maternal health to the nation. It further highlights on the importance of this goal to the community. Nurses have a great role in working towards achieving the millennium development goals. These roles are also elaborated in the paper.

Millennium development goal 5A: Reduction of maternal mortality

Almost half a million lives of women and children are lost during pregnancy and child birth. A large percentage of these deaths can be avoided or are preventable. The reduction of maternal mortality is not only an issue because of its effect on development of a nation but also since it posses a challenge in human rights. Low mortality rates means that the nation is better placed in terms of health. It also means that there are measures that have been put in place to ensure a decrease in this maternal mortality rates. If there is a risk of transfer of HIV from an infected mother then caution is taken to prevent this transfer and decrease deaths due to HIV among infants. This decrease in child mortality rate will have a positive effect on the health of the nation since there will be no deaths due to HIV and further more new cases of HIV are not registered. (Hunt, p., & Bueno, 2000.). Reduction of maternal mortality is also important since it promotes the right to life. This means that the nation will be a healthy one with no individual mother or child denied the right to life.

Millennium development goal 5B: Universal access to reproductive health

The access to universal health is important in terms of the health of a nation. Pregnant women are entitled to effective and sufficient health in the preconception period, the prenatal stage and also the postnatal stage. Access to this reproductive health ensures that there are no complications in child birth and also after child birth. Both the mother and the child are expected to be perfectly healthy after delivery. This therefore means that the health of the nation will be improved since there will be reduced cases of pregnancy related deaths.

Application of millennium development goal 5 to the community

This millennium development goal is very important to the community in various aspects. The World Health Organization has the expectation that in each community this goal can be fully realized. The goal is applicable in the community since there is the general need to reduce the mortality rate of children and mothers in cases that relate to pregnancy and child birth. Therefore, proper care should be given to the expectant mothers in terms of check up and advice during the time they are pregnant. There should be adequate health providing facilities within the community that offer prenatal and post natal clinics for pregnant women which arrest any emergency case and hence prevent mortality. The existence of quality education on issues pertaining to reproductive health is also a way in which the community can work towards attaining the goal. Members of the community should be educated on family planning, and ways to prevent mother to child HIV transmission. They can also access information on how they can take care of themselves and the child after birth. Therefore there is building of health institutions and employment of qualified workers in these institutions who will help in realization of this goal. Through this the goal becomes a reality that can be achieved within the community.

Monitoring and Measuring the Progress towards the Millennium Development Goal 5

For there to be realization of the millennium development goal five, the process of putting it into force has to be carefully monitored and measurement of the progress constantly done. There are various international bodies that help in monitoring the process such as the WHO and the Centre for Disease Control.

Health workers within a community can be of great aid in monitoring the implementation (Tanzania, A. 2012). There can be regular checking of the population which should be done carefully and the records used to compare with previous ones and check if there is a decline in pregnancy related deaths within a community. The equipment within health facilities should be checked constantly and any outdated ones should be replaced with new effective equipment. The employees in these health facilities should also be very qualified and fresh talent should be constantly incorporated into these institutions.

Nursing Role in Attaining the Millennium Development Goals

Nurses play crucial roles towards the achievement of millennium development goals. There are various ways through which they aid in achievement of these goals this may be for instance; achieving goal three which is promoting gender equity and empowering women. They can develop understanding of the instruments and the various declarations of human rights. They can educate the public using examples such as violation of human rights, which can take forms such as discrimination based on gender, crude practices such as female genital mutilation and other violence. They can do this through demonstration of their harmful consequences on the health. They can also encourage women to acquire skills that will make them elevate their economic and social status (Christi, 2011). They should also lobby for equity in access and to affordable and effective health.

Nurses also have a role in achieving the fourth goal which is to reduce child mortality. They do this through putting emphasis on the child immunization and highlighting the risks that are associated with lack of immunization which can be causes of deaths. They also encourage parents to attend antenatal and postnatal care. They can also make formal teachings to parents on health and illness where they are the main information providers. They can also provide health services or be supervisors in the process of health service provision (Christi, 2011). They can also organize for door to door immunization services which will reduce child mortality rates.

In conclusion,  the paper shows that there are serious measures that are undertaken in achievement of the various millennium development goals and the key stake holders in the achievement of these goals. The importance of realizing these goals are also highlighted and the effect they have on the community.


Hunt, p., & Bueno, j. (2000.). REDUCING MATERNAL MORTALITY. The contribution of the right to the highest attainable standard of health. Retrieved September 27, 2012, from

Christi, L. (2011). Roles of Nurses in Achieving Millennium Development Goals | Healthmad. Healthmad. Retrieved September 27, 2012, from

Tanzania, A. (2012). Community Health Workers – an important resource towards achieving the MDGs. Community Health Workers – an important resource towards achieving the MDGs. Retrieved September 27, 2012, from & the Millennium Development Goals (MDGs) – Goals # 4, 5, 6: Improve Public Health – United Nations

Environment Programme (UNEP) –. (2008.). United Nations Environment Programme (UNEP) – Home page . Retrieved September 27, 2012, from Millennium Development Goal 5: Reproductive Health, Poverty Reduction and Health Sector Reform | World Bank Institute (WBI). (2012). World Bank Institute (WBI). Retrieved September 27, 2012, from

Crawford, B. (2008). Global Health 1. Retrieved September 27, 2012, from

Coca-Cola Case Study

Noca-Cola Case Study

Coca-Cola Case Study

The company is known for its flagship product, Coca-Cola, and other brands, such as Diet Coke, Fanta, and Sprite. Coca-Cola also manufactures and sells bottled water, coffee, and tea. In terms of environmental sustainability, Coca-Cola has a mixed record. The company has been criticized for using water in its manufacturing process and relying on plastic bottles. Coca-Cola has also been criticized for its marketing practices, which some say target children and contribute to obesity.

On the other hand, Coca-Cola has taken some steps to address its environmental impact. The company has set a goal to recycle all its bottles and cans by 2030. Coca-Cola has also invested in renewable energy, such as solar and wind power. Regarding social responsibility, Coca-Cola has been criticized for its labor practices. The company has been accused of using child labor and paying its workers low wages. Coca-Cola has also been criticized for its marketing practices, which some say target children and contribute to obesity. Coca-Cola has taken some steps to address its social impact. The company has set a goal to provide safe water and sanitation to all its employees by 2020. Coca-Cola has also established a foundation to support education and economic development in its communities.

An international psychologist can provide several benefits to the Coca-Cola Company. They can help the company to understand the psychological factors that influence consumer behavior in different cultures. It can help Coca-Cola tailor its marketing and product offerings to better meet the needs and desires of consumers in different countries. Additionally, an international psychologist can help the company develop and implement employee training and development programs sensitive to employees’ cultural differences in different countries. It can help to improve employee productivity and satisfaction and to reduce turnover. An international psychologist can also help Coca-Cola create a work environment that supports employees from different cultures. They can guide how to create policies and procedures that are fair and equitable for all employees, regardless of their cultural background. Additionally, an international psychologist can help to resolve conflicts that may arise between employees from different cultures. It can help to create a more harmonious and productive workplace.

Coca-Cola Strategic Plans

Networked Organization

Networked organizations connect to other organizations and individuals through social media and digital platforms. Being a networked organization has several advantages, including connecting with potential customers and partners, sharing information and ideas, and receiving feedback in real-time. Networked organizations are often more agile and responsive to change, as they can quickly adapt to new market conditions and trends. Being part of a network can provide employees with a sense of community and belonging, increasing morale and engagement. Being a networked organization has helped Coca-Cola company in several ways. First, it has allowed the company to connect with a larger pool of potential customers and partners. It has helped the company expand its customer base and find new business opportunities. Being a networked organization has helped Coca-Cola improve its communication and coordination with its partners. It has assisted the company in operating more efficiently and avoiding misunderstandings. Finally, being a networked organization has helped Coca-Cola company share best practices and learn from other companies’ experiences. It has helped the company improve its operations and become more competitive.

Brand Building

A world-class marketing strategy is key to building a strong brand. By aligning your marketing efforts with your business goals, you can create a powerful brand that will resonate with your target audience. Coca-Cola’s brand identity is all about refreshment. Their products are designed to give consumers a refreshing break from everyday life. Their marketing collateral and digital presence reflect this, focusing on bright colors and fun imagery. Coca-Cola’s marketing message is all about refreshment and fun. Their products are designed to give consumers a refreshing break from everyday life. Their marketing collateral and digital presence reflect this, focusing on bright colors and fun imagery. Coca-Cola’s marketing collateral is all about refreshment and fun. Their products are designed to give consumers a refreshing break from everyday life. Their marketing collateral reflects this, focusing on bright colors and fun imagery. Coca-Cola’s digital marketing strategy is all about refreshment and fun. Their products are designed to give consumers a refreshing break from everyday life. Their digital presence reflects this, focusing on bright colors and fun imagery. Coca-Cola has a strong social media presence with over 2.5 million followers on Facebook, Twitter, and Instagram. The company uses social media to share news, product updates, and special offers with its fans and followers.

Coca-Cola also uses social media to connect with customers and answer their questions. Coca-Cola has a strong public relations and influencer marketing strategy. The company often partners with celebrities, athletes, and other influential people to promote its products. Coca-Cola also uses PR to share news and updates about the company with the media. Coca-Cola tracks, measures, and analyzes its marketing results regularly. The company uses data to improve its marketing strategies and ensure effective campaigns. Coca-Cola’s marketing efforts are designed to give consumers a refreshing break from everyday life. The company’s marketing message, collateral, and digital presence reflect this, aiming at bright colors and fun imagery. Coca-Cola is a successful company that uses various marketing strategies to promote its products. These strategies include advertising, social media marketing, events and sponsorships, and public relations. Coca-Cola also uses data to track, measure, and analyze its marketing results to ensure that its campaigns are effective.


Innovation is important for any company, but it is especially important for the Coca-Cola company for a few reasons. For one, Coca-Cola has been around for over 125 years and is one of the most recognized brands in the world. Coca-Cola must continue to innovate and evolve to maintain its position as a top global brand. Additionally, the soda industry is facing challenges, such as declining sales and health concerns. To overcome these challenges, Coca-Cola must innovate to stay relevant and top-of-mind for consumers. Coca-Cola also needs to innovate to stay ahead of its competitors. Pepsi, for example, has been investing heavily in innovation in recent years.

To keep up with Pepsi and other competitors, Coca-Cola must also innovate. Innovation has helped the Coca-Cola Company in a few ways. One way is that innovation has helped Coca-Cola develop new products. For example, Coca-Cola innovation created Diet Coke, which is now one of the most popular diet sodas on the market. Created diet coke was in response to the growing health consciousness of Americans. Another way innovation has helped Coca-Cola is by helping the company develop new ways to market its products. For example, Coca-Cola has used innovation to create marketing campaigns that are very popular with consumers. Innovation has also helped Coca-Cola to reduce its costs. For example, the company has developed new ways to recycle its bottles and cans. It has helped Coca-Cola to save money on packaging costs. Innovation has also helped Coca-Cola develop new production methods that are more efficient and use less energy. It has helped the company to save money on production costs.

Revenue Growth Management

Revenue growth management is critical for the Coca-Cola company because it drives top-line growth. It, in turn, enables the company to invest in other areas of the business, such as marketing and product development, which further drives growth. Additionally, revenue growth allows Coca-Cola to maintain its position as a market leader and continue to generate strong profits. Coca-Cola has a long history of success in revenue growth management, which has allowed it to become one of the most valuable brands in the world. The company has a disciplined approach to driving growth, starting with setting clear goals and objectives. Coca-Cola then develops comprehensive plans to achieve these goals, which are implemented across the organization. Revenue growth management is a key part of Coca-Cola’s success story and has helped to make it the global powerhouse it is today.

In conclusion, the Coca-Cola company has a lot of work to improve its ethical standards. However, their strategic plan is a step in the right direction and shows that they are committed to making changes. The ethical concerns for the Coca-Cola company are many and varied. From their use of child labor in their supply chain to their involvement in political lobbying and campaign finance to their impact on the environment, there are some areas where the company could improve its ethical standards. However, it is encouraging to see that the company has developed a strategic plan to address these concerns. It is hoped that this plan will lead to meaningful change within the company and help to improve its ethical reputation.

New Zealand King Salmon

New Zealand King Salmon

New Zealand King Salmon

Executive Summary

New Zealand King Salmon rules in Sydney market with the best species ranks that one has never experienced. King Salmon have the ability of showing exceptionally strong results amongst the consumers which has caught attention of Aussie palates. However, the company has the dilemma of developing four new fish farms in the Marlborough sounds ever since they were faced with environmental and social factors from the community, despite the expansion being profitable. The major problem was that, the decisions that were previously made by the Environmental Protection Authority to grant the four sites for salmon farming had prohibited zone of the Marlborough Sounds, hence posed some interesting questions for the Marlborough District Council and for the wider community. It is a recommendation for the New Zealand King Salmon to involve in the expansion of fish farming that will then improve the living standard of people through job opportunities.


For many years New Zealand King Salmon has been dedicated to producing a top quality product which was achieved through good managing practices such as choosing a pristine and unpolluted rearing environment. The New Zealand King Salmon’s innovative farming, processing as well as distribution operations are integrated in single systems which allowed easier monitoring and controlling at all stages. The New Zealand King Salmon faces a dilemma in the salmon rearing in spite of it being the largest producer in the New Zealand. One of the dilemmas that face the company is the growth retardation of King salmon walbaum (Martin & Gillard, 2003). This is a major challenge facing the marine fish farming. Despite the sound understanding of the ecological rearing conditions for the king salmon in the seawater, the theory that leads to the growth retardation remains a dilemma. Collaborations have been made with leading New Zealand aquaculture companies to study the physiological state and the causal factors for the retarded growth. The retarded growth of the king salmon poses a major challenge to the company in meeting the great seafood demand in both New Zealand and the foreign markets. The delayed maturity means that the supply is less as compared to the demand leading to disequilibrium in the market. Thus, the company is carrying out a research on the conditions while trying to implement the control mechanisms for the prevailing dilemma (Sankaran, 2004).

Relevant aspects of the business environment

In regards to various dilemmas affecting the New Zealand King Salmon the advancement of technology has formed an inherent part in the business environment of the New Zealand King Salmon company. And as a result, this has forced the company to adopt the most recent and developed techniques in the breeding, rearing, harvesting and processing of the salmon fish. In this, the companies tend to enjoy the benefit of effectiveness and efficiency while helping it to minimize the operational costs. The fish eating culture that exhibit the people of New Zealand as well favors the operations of the New Zealand King Salmon. Through this, the demand for their products is high and the company realizes a high revenue margin (Sankaran, 2004). To allow the company to continue gaining its competitive advantage from other competitors, the company should scan its environment by using the PESTLE analysis tools. The company has a rich consideration for its environments in terms of sustainability and preservation. Further, the company faces some political interference thereby hindering a smooth operation. In the recent past, the Environmental Management Authority had filed a Supreme Court challenge against the company to stop its bids for expansion. However, they were withdrawn successfully (Martin & Gillard, 2003).

The relevant aspects of the business environment of New Zealand King Salmon Company are that, the company markets four retail brands of sea food products. These include, Regal Salmon, Southern Ocean and Sea smoke. Regal salmon is available in a range of wide varieties of cuts and styles such as fresh and frozen fish (Regal Salmon, 2012). The southern ocean brand is natural, affordable and a convenient pack of smoked salmon. These are produced from South Island waters in the New Zealand. While the sea smoke is a traditionally smoked product, locally sourced and cured in a selective hardwood smoke, sea salt and some natural marinades to enhance its flavor. These are the products that keep New Zealand King Salmon Company in business. In carrying out the seafood business, the company is restricted to some environmental and legal factors that are meant to be complied with. For instance, the company is required to comply with environmental considerations for it to be allowed to expand its fishing farms (Sankaran & Research, 2007).

Stakeholder Interests

The New Zealand King Salmon is a top business performer in the Sydney market. The two major and key owners run the New Zealand King Salmon. These include Evergreen Holding Limited and Direct Capital. The Evergreen Holding Limited has a stake of 51% while the Direct Capital with a stake of 42%. The management and the directors with 7% stake hold the remaining stake. The annual turnover of the company is on average NZ$115 million with a total asset value of more than NZ$75 million (New Zealand King Salmon, 2013). This is realized from the company’s annual harvests of 8500 metric turns that account for 70% of all salmon production in New Zealand and 55% of the world production (Martin & Gillard, 2003).

The research also showed that, during the month of March, the fish sales tripled with an expected future-increased sale. In July 2013, the largest owner, evergreen holdings had 12,856,250 shares followed by Direct Capital Partners with a total of 3,192,513 shares. The main stakeholders interests in New Zealand King Salmon is to maximize profit given that the research showed that they own the business and at the same time are majorly concerned about the success as well as, the growth of the company. A good example is the Evergreen Holding Limited who tried their best in contributing to the growth and success of New Zealand King Salmon Company (Martin & Gillard, 2003). Other key stakeholders includes Pohutukawa Lambda Investments Ltd with 2,721, 682 shares (10.77%), and Direct Management Investments Ltd with 1,989,613 shares (7.87%) whose main interests is to see if New Zealand King Salmon improve what it offers as well as, coming up with entirely new solutions to the customer needs based on the demand of the customers (Larsen, 2011).

Business Decisions

Regarding the dilemma that faces the New Zealand King Salmon Ltd, the company is tasked with the responsibility of making decisions ethically to handle the issue professionally. As discussed earlier, the dilemma that faces the company is the dilemma of dilemma of developing four new fish farms in the Marlborough sounds. To handle the issue in the professionally way possible, the company has joined hands with the major aquaculture companies in the New Zealand to carry out an intensive research regarding the dilemma. Conversely, the New Zealand King Salmon Limited is involved with corporate social responsibilities. The rearing and sea farming is said to contribute to environmental issues, however, the company has resolved to maintain a sustainable environment in a bid to expand its operations.

The company also plays a role in the improvement of the welfare of the community living around them. This is facilitated through donation to fund education for the needy children within the population (Scoop, 2013).The company also establishes social facilities such as schools, medical facilities and takes part in the environmental conservation programs. Through this, the New Zealand King Salmon Limited remains a responsible social entity in the administration of social welfare of the society and as it makes it decision in an ethical manner.

Applying the Solomon’s three C’s of business ethics in business has made good sense to the New Zealand King Salmon. In regards to Kantian theory, it is believed that some actions within the company should be prohibited. For example, New Zealand King Salmon Company has involved in ethical rather than unethical issues hence ensures that class of actions in accordance with their duty is distinguished from the class of actions performed from duty. The company’s major aim is to maximize the happiness and reducing suffering of the customers (Sankaran & Research, 2007). The company is involved with the CSR ensuring its customers with a good environmental status to facilitate a serene environment for the communities living in the New Zealand Cook Island. The waters as well are maintained to the freshest waters, to ensure that it is quite conducive for salmon and for the community. The main objective of the New Zealand King Salmon Company is to improve the welfare of the employees by providing working environment for the employees, proper scale wages and promotional strategies. They ensure to work with the employees while improving their skills and productivity (Larsen, 2011).


In conclusion, New Zealand King Salmon is a leading producer of salmon fish in both New Zealand and the world with a production of 8500 metric ton. These comprise 70% of the salmon production in the New Zealand and the portion of 55% of the world’s salmon production. However, the company is faced with a challenge that retards the growth rate of the salmon fish leading to underestimated supply. However, the company has joined hands with major fish industries in the New Zealand to reveal the causes of the retarded growth. The company is owned and run by two major shareholders; Evergreen Holdings and Direct Capital Limited. Their shares composition is 93% with the remaining 7% owned by the management and the board of directors.

The company has been influenced by some macro-environment factors such as political, environmental and socio-cultural factors. The company has adopted proper technological techniques that enable it to run both efficiently and effectively. The company is socially responsible to the main people around its operations. These are employees, society, shareholders and relevant stakeholders. The company has a high sales turnover that leads in the Sydney Market. Lastly, the company is also socially responsible to its stakeholder who provides the funds for the running of the business. The company pays good returns on investments to the shareholders (Sankaran & Research, 2007). These serve as a good return. Generally, the New Zealand King Salmon Limited is a responsible corporate body which appreciates the efforts to environment, employees, customers and its stakeholder.


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