The Indian Historical Period Essay Example | Topics and Well Written Essays - 1000 words

The Indian Historical Period - Essay Example Varghese, (2008) argues that the Arabic language became a medium of literary communication throughout the areas which the Arabs conquered and in a relatively short time, Arabic displaced other tongues as the everyday speech of the population over most of North Africa and the Near East. Thought and learning flourished; trade and industry prospered; a brilliant and graceful civilization arose beside which Western Europe seemed barbarous and even Byzantium paled. According to McNeill (1986), the immediate stimulus to the Arab expansion was the appearance of a new religion; Mohammed was a native of the city of Mecca and as a young man, he made his living as a camel driver and petty trader and on his travels he picked up a smattering of Jewish and Christian religious ideas. He acknowledged the prophets of the Old Testament and Jesus of Nazareth as worthy predecessors of his own prophetic mission and as such prophets that he recognized had received divine plans for men but with time misunderstanding and corruption crept in. As one of the renowned leaders, Mohammed simply claimed to correct and restore the revelation of God and just after his death; his teachings were set forth, cast in poetic form, written down and became the Koran – a sacred book of the Moslem re ligion. ... After his death, the expansion continued at a rapid rate and a series of prophetic successors united the Arab tribesmen for great raids into Syria and Mesopotamia. It was within an amazingly short time that they stripped the Byzantine empire of its eastern provinces and completely conquered the Persian empire; during the following generations, (Sowell, 2004). In the east, the Arab expansion continued at a similarly rapid rate extending into India and the oases of central Asia.

The Starbucks Experience Essay Example | Topics and Well Written Essays - 1000 words

The Starbucks Experience - Essay Example It provides a background of Starbucks’ growth from humble origins to a household name globally as a result of their amazingly successful management philosophy. The book states five guiding principles for turning ordinary into extraordinary whether one is a small business owner or a multi-million dollar company. Based on facts in the book, during the company’s peak, Starbucks’ success equated to five new stores every day – 365 days each year worldwide (Michelli 7). In spite Starbuck’s amazing growth, the company keeps on maintaining their reputation for quality and a special customer experience. This is an indication of how well the company understands globalization and international business. With coffee shops in over 35 countries, Starbucks has proven that its principles transcend cultural barriers. There are many tips from the book that will benefit Human Resource professionals as well as supervisors and managers of companies and organizations. The book sites, for example, the problem of employees’ lifeless customer service. The book does not offer the usual one-sided approach to good customer service, but rather gives the inside secrets based on a model of success. From each of the five principles, Michelli provides practical methods for the reader to absorb and apply as appropriate in his or her specific work situation. For example, little acts as simple as reminding employees to be â€Å"litter picker-uppers† (34) would be an innovative idea for some businesses. Companies never know what catches the eye of their clients or customers, so they must pay attention to little details inside the store. These small things may leave customers walking away with poor lasting impressions. Michelli further points out, â€Å"Consistency, ritual, routine, community and service recovery are key. If you and your business succeed at delighting every person you work with, you will be a beloved company.† (108) Additionally, the book explains problems

Care Giver Perceptions of End of Life Care for COPD Patient

Care Giver Perceptions of End of Life Care for COPD Patient RESEARCH PROPOSAL Title: Exploring the primary family care givers perceptions of care giving for end of life care of COPD ICU patient. Introduction: The world perspective is shifting towards non-communicable diseases, with chronic conditions such as heart disease, stroke and chronic obstructive pulmonary disease (COPD) as chief causes of death globally. COPD is a chronic progressive disease of air flow obstruction which includes emphysema and chronic bronchitis. COPD is predicted as 3rd leading cause of death in 2030 according to 2008 WHO statistics. In terms of social burden of disease quantified by disability-adjusted life-years (DALYs) lost, COPD ranked as the 12th leading cause of DALYs lost worldwide in 1990, but will be the 7th leading cause of DALY lost worldwide in 2030.COPD is more common among world age people due to decreased lung function capacity. The world population above 60 years was1.7% in 2013 and will continue to grow as a reaching 21.1 per cent by 2050 (world ageing population 2013). COPD is one of the major 8th leading causes of death in Singapore. According to MOH 2013 census COPD causes 1.6% of deaths per 18938 populations.COPD is a treatable disease but not a curable one. So ultimately it increases the economic burden of the country by its chronicity, rate of hospital readmission and affects the quality of life activities of daily living of the patient and family members. The total expenditure for COPD was $9.9 million per year. $ 7.2 million accounts for inpatient care cost (W.-S. Kelvinteo et.al, 2011). For last 10 years no studies found in Singapore on family care givers perspectives on end of life care in ICU. Primary family care givers most of the time the spouse are the carer for the COPD patient The Singapore old age percentage is in increasing trend 7.3% in 2000 9.3 in 2011 expected to rise up to 18.7% 2013. When a family member is dying, conversations about the end of life can be uncomfortable and difficult. Still, discussing end-of-life care is important. Patients with end-stage of diseases may suffer from distressful symptoms.The Advanced COPD patient suffer from severe distressful symptoms such a dyspnea anxiety and depression. Palliative care of malignant disorder gained more attention when compare to non-malignant diseases (Blackler et al., 2004; Lynn, 2000; Simonds, 2004).The palliative care needs of patients with end-stage respiratory diseases are increasingly being recognized (Curtis, 2008; Lanken et al., 2008) . The COPD patient experience significant impairment of quality of life and physical and psychological needs when compare to individual with lung cancer (Core et al., 2000; Edmonds et al., 2001; Skilbeck et al., 1998; Tranmer et al, 2003). Why family members? When there is progression of diseases it imposes negative impacts on psychological health of Care givers (Daniela Figueiredo, 2014). Careers are more likely to suffer from anxiety and depressive symptoms providing continuous care during the advance stage of the disease and end of life care (Abebaw Mengistus Yohannes 2007). Preparation for death should include a realistic appraisal of the prospects for dying peacefully at home. (Hansen –Flaschen J .2004) Most of the patients are willing to be housebound at the end stage of life so its responsibility of family cares to provide continuous care and support them White P (2011) stated 45% were housebound, 75% had a career in end stage of COPD . despite no studies have been conducted qualitatively on family care givers perception on End of life care on COPD in Asian countries . Review of literature: â€Å"Palliative care in COPD† search in PUBMED extracted only 285 titles from 1991 to 2011. ( Anirban Hom Choudhuri 2012) .The absence of palliative care services highlights the need for research into appropriate models of care to address uncontrolled symptoms, information provision and end of life planning. (Jones et al 2014). Synthesis of findings: The literature review showed that the family care givers suffer from intense conflict, emotions such as helplessness, guilt, anger, anxiety and frustration. These suffering are due to deterioration of the health of the loved one and cumulative losses over time that the patient illeness affect the care givers the most. The key findings of each study were identified and supplemented based on a review of the full article. Then, categories were derived by grouping the key findings thematically. Lack of support: Most of the family care givers reported they were unaware of the facilities for COPD patient. There was no social or psychological support. If the support is received also this is inadequate or sporadic. They learnt most of the things by their experience regarding prognosis, treatment signs and symptoms, illness. They faced the financial constraint in addition too. They are expecting support from the health care professionals. â€Å"Well, the care from Father’s doctors was extremely basic and, I felt, on the most part extremely uncaring†¦ The doctors really had an attitude of ‘You were a smoker, you’re dying of lung disease, and what do you want us to do about it?’ The way they spoke to him, and the fact that they really weren’t concerned, and they didn’t doo very much for him; anything they did for him, I was disappointed in† – participant from Hasson et al. (2009) Burden of care givers: Burden of care givers are noted in all the studies. Most of the care giver said they are exhausted and need to perform multi task. They need to spend most of time in caring the patient. The involvement in social life is reduced, change of relationship with patient. Mostly they are anxious and frustrated. Sometimes care givers are helpless when they patient are suffering from breathing difficulties. â€Å"It is very frustrating, and you know I don’t know if the government realizes how hard it is for carers..It’s a full-time job. It’s work isn’t it? It’s not something you do because you like it. I mean I care for my Dad, I love him and I want to look after him, but I also need my own time.†- participant from Philip et al. (2014) End of life care and support of Bereavement Mostly family career are involved end of life decision making which lead to a peaceful death and die with dignity for the patient. â€Å"I think the situation was the way is should have been. I think if there had been any external help, it would have been a bit of an intrusion. [Father] did not want to leave the house and that was fine but also whenever he was like that and he was not feeling the best, it was just best to leave him alone† – participant from Hasson et al. (2009) Some said the hospital policy did not allowed us to care for the patient in home during end stage of life. No adequate bereavement support for the family careers after the death. Some had counselling in later part of life. Rewards, meaning, and coping: However, some caregivers described their experiences as positive. Identified positive features include sense of pride, esteem, and mastery as a caregiver a sense of normalcy; being able to demonstrate love and fulfill satisfaction and sense of accomplishment ability to be with and help the patient life-enriching experiences closer relationships a sense that it is important. Some care givers felt that their loved one died with dignity and respect. They were able to provide good care and that provided them a sense of accomplishment. Conclusion: The COPD has a great impact on Family care givers. All the studies stated that there is a lack of support and facilities, unmet needs. There was a lack of knowledge about the available facilities and lack of emotional support .There is a need for supportive and education regarding the palliative and end of life care. Mostly of the careers reported they are helpless when patient suffering from breathlessness and guilt of not doing enough. Caregiver’s involvement in providing care and feeling able to provide quality care, will enhance the coping among the care givers. These four studies were conducted in European countries and thus there is a lack of ethnic diversity which may have an additional impact on caregiving culturally. Many recommendations were made for further research relating to the care givers perspectives. The studies did not discuss if there were any difference in the care provided by spouse/children or by ethnicity. Thus, further research can be done to study the cultural influences on care giving of COPD patients. Research Objectives What are the experiences of Family care givers on end of life care of patient with COPD in ICU? What are the needs of family care givers on end of life care of patient with COPD? What are the barriers of caring family care givers Details of Research Proposal: Aims To explore the needs of Primary family care givers or bereaved careers on end of life care of ICU COPD patient To explore the perspectives of Primary family care givers or bereaved careers on end of life care of ICU COPD Patient. Operational definition: End of life care: The care provided to alleviate the symptoms of patient during the end stage of COPD. Family care givers: Care provided by the Family members other than the health care professionals. Bereaved careers: Bereaved careers are one who suffered from the death family members due to COPD. Research Methodology: Study design: A Phenomenological Descriptive approach will be adopted to explore the perspectives of Family care givers on End of life care. Interviews will be conducted. Sampling: The study will use purposive sampling method to select the participant for the interview. Samples: Primary Family care givers COPD patient who have died in ICU Inclusion criteria: Participant Speak English Participant over 18 years of age Bereaved careers of COPD patient within a year. Exclusion criteria: Bereaved careers of other diseases. Family care givers of other diseases Bereaved and Family care givers of More than one year of COPD patient Sample size planning: Approximately 10-15 primary bereaved careers of COPD patient until the data saturation is obtained Ethical Consideration: The DSRB approval will be obtained before data collection. The purpose of the study will be explained to the participant before informed consents are obtained. The participant will be ensured that the information collected will be kept confidential and it will be used only for research purpose. Data collection: The researcher will get access to the COPD Program coordinator and get permission to conduct a study. After Permission is granted, the COPD patient died in ICU will be identified through the register. The eligible participant will be selected who meet the inclusion criteria. Then the family members will be contacted through telephone by the researcher and if the participant is willing to participate in the research.. The research process will be first explained to the selected participants in an appropriate manner without hurting their sentiments and understanding their difficult situation’s as well. Face to face semi structured interviews will be conducted with the Family care givers. In that interview, a set of general and open ended questions would be asked. And the entire conversation will be audiotaped. Each conversation is assumed to last for 40 to 60 minutes. When the participant become too emotional, the interview will be stopped and reassured by the researcher. Again the interview will be conducted when normality is retained. After the interview, basic demographic data will be collected and the same will be kept confidential. A pilot study will be conducted based on the interview guidelines prepared with 2-3 participants to assess the feasibility of this study. Interview guidelines: Introduction 🙠 2 minutes) Good morning .Thank you for participating in our Research. I Arunadevi graduate student from Alice Lee Center of nursing Studies, National University of Singapore. As a Part of my program I am conducting this Interview. The interviews will be carried out for 45 minutes to an hour. The Questions will be open ended questions. The answers will be audiotaped. Objectives :(1 Minute) To identify the perspectives of primary Family care givers on End of Life care Interview Questions: 45 minutes to One hour) How did you become a Primary care giver? What you understand your role as a care giver? What do you understand about end of life care? How do you experience providing care to family members at the end stage? What helped with the care? What do you felt as lacking while providing the care? What could be improved? Ending session: (5 minutes) Would you like to say anything further? Thanks for sharing your thoughts and views. It would surely help others and provide support when others are facing the same problem. Data analysis: The analysis of the data is based on Colaizzi (1978) which includes various steps such as read and acquire the meaning, organize it into meaningful themes, integrate results, send it to the participant as final validating steps. The recorded interviews will be listened repetitively and transcribed to verbatim by the researcher. The initial impression and reflection will be noted in a separate note book. The themes will be emerged from the transcript. The clustering of the themes with similar context will be made .The thematic analysis will be used to analyses the data. Whenever possible the transcript will be send to the participant to know the meaning or to validate the information. Gaps will be identified as well based on the expectations of the family care givers. Then certain recommendations/suggestions will be generated for the group based on the findings, in addition to the current facilities available. Rigour /Validity: The four essential criteria highlighted by Lincoln and Guba (1985) are as follows: Credibility, Transferability, Dependability and Conà ¯Ã‚ ¬Ã‚ rmability. Credibility refers to the confidence in the truth and interpretation of Data. After transcribing the transcription will be send to the participant when possible to validate the information. To ensure the findings are not modified by the researcher. Reflective Questioning will also be used to ensure the credibility. Transferability of the results generated in the study will be achieved through ‘thick description’, (Lincoln Guba 1985). The study findings will be useful to all the health care professionals family care givers of COPD patient on End of life care. Conformability and dependability rest on the consistency, objectivity and accuracy of the data findings chiefly depends on the data consistency and accuracy and (Richard Morse 2007). Audio recording and supervisor member check in will be done for conformability and dependability.

Essay on Colonialism: Comparisons Between Things Fall Apart and Histori

Nigerian Women and Colonialism: Comparisons Between Things Fall Apart and Historical Accounts. Chinua Achebe is arguably the best known African writer of the twentieth century. And more than any other writer, he has shaped the world's idea of what African literature is. As Rose Mezu states, "Things Fall Apart is significant because it began the vogue of African novels of cultural contact and conflict" (Mezu 1). This is a highly influential position for a single writer. So what was Achebe's purpose in writing his novels? What does he hope to accomplish? According to Cora Agatucci's summary of Achebe's essay, "The Novelist as Teacher," she writes, " Achebe describes a dual mission to educate both African and European readers, to reinstate a sense of pride in African cultures and 'to help my society regain belief in itself and put away the complexes of years of denigration and self-abasement'" (Agatucci). So Achebe's purpose for writing is to overcome the stereotypes of Western readers that Africans are primitive savages with no sense of culture or history, and to combat the internalization of these stereotypes by his fellow countrymen. So where does Achebe's purpose for writing his novels leave women and are the gender roles as described in Things Fall Apart culturally accurate? Before this question can be accurately be answered; gender roles both in history and in Achebe's novel must be addressed. Specifically, what roles did men and women play in society in all three stages of Nigeria's more recent history? In the last 200 years of Nigeria's history, there have been basically three distinct phases in government: pre-colonial rule overall by Muslims (there were some tribes unaffected by this rule), colonial r... ...~womanist/1995/mezu.html "Nigeria." Encarta Encyclopedia. 3 July 2001. http://encarta.msn.com/find/concise.asp? mod=1&ti=761557915&page=2 "Nigeria." U.S. Department of State, Human rights Reports for 1999. 30 June 2001. http://www.state.gov/www/global/human_rights/1999_hrp_report/nigeria.html Ogunsuyi, Austin. "Women in Africa." African Cultures Page. 30 June 2001. http://africancultures.about.com/culture/african cultures/library/weekly/ aa011401a.htm Rojas, Maria. "Women in Colonial Nigeria." African Postcolonial Literature in English in the Postcolonial Web Page. 30 June 2001. http://landow.stg.brown.edu/ post/nigeria/colonwom.html ----- "Women in Pre-Colonial Nigeria." African Postcolonial Literature in English in the Postcolonial Web Page. 30 June 2001. http://landow.stg.brown.edu/ post/nigeria/precolwon.html

Models of Organization Diagnosis

Introduction The primary purpose of this essay is to understand various models of organization diagnosis and their differences also well as their similarities, and also evaluate their strength and weakness. In order to understand these OD models we will need to know what is organizational diagnosis. What is Organizational Diagnosis? This is a strategy implemented by organizations to increase its effectiveness. This involves assessing an organization’s existing levels of performance, to design a suitable change that will achieve the expected performance. In organizational diagnosis, diagnostic activities should centre its focus on 2 main areas: – Subsystem areas (management, group, individual unit) – Organization processes (decision-making process, communication model, relationships between groups and the setting of goals. Organizational diagnostician carries out this process of diagnosis considering the whole organization as a total system. They use data form internal and external sources for this purpose. The organizational diagnosticians direct their focus on the activities they think are the vital for the existence of the organization. When performing the diagnosis whole organization is put into focus when drastic changes are needed (French & Bell, 1995). Lastly in the organizational diagnosis process, all the data collected are communicated back to the organization’s management in order to begin the organizational change phase (Harrison 1987). Uses of Organizational Diagnosis Models Organizational diagnosis models help to clearly understand inefficiencies and diversions from organizational goals and targets. Organizational diagnosis models also provide a systematic way together, categorize and understand data. Models identify crucial organizational variables which are theorized to exist according to previous research. Models also reflect the nature of relationship between important variable. Without such models it would be hard to collect and interpret data. Here I will analyse three such organizational diagnosis model, – Weisbord’s Six Box Model – Sharp-image Diagnosis model – The Congruence Model Weisbord’s Six Box Model This model of organizational diagnosis consist six elements which are purpose, structure, relationship, rewards, leadership and helpful mechanism. The model focuses on the areas of dissatisfaction as a starting point. The areas of dissatisfactions considered are from the customer point (external), internal point of view (management and employees). The main advantages of this organizational diagnosis model have been its easy to understand and adopt. The model draws from a number of management theory schools -organisation design, behavioural, psychology and organisational learning. Due to its very simplistic approach it has a lack of theoretically basis to determine the actual gaps, degree of change and inefficiencies in an organization. Weisbord’s model also fails to provide the actions needed to close gaps, degree of change and inefficiencies of organization structure. Harrison and Shirom (1999) says that Weisbord’s model, on identification of gaps, â€Å"for each of these elements, consultants has to diagnosis the gaps and degree of changes. – Gap between what exists now and ought to be – Gaps between what are actually done and what the mangers say is done. The Congruence Model The Congruence model considers data from internal and external of the organization, strategies employed, product and services (output) and how the people of the organization are organised to convert the inputs into outputs. In order to understand the organization system and also how these factors influence in achieving intended results. The Congruence model’s most important element is the concept of fit. Organization success depends on the alignment of each factor (people, work, structure and culture) to one another. The tighter they fit the greater congruence and higher performance is achieved. Sharp-image Diagnosis model This model is a combination of open system and political frame, which aims at a border view of the organization initially but later focus on core problems and challenges (Harrison and Shirom 1999). Sharp-image diagnosis model uses 3 steps to evaluate: 1. Gather data to identify problems 2. Uses theoretical models targeted to specific problems 3. Development of a diagnostic model to identify the root causes of problems Weakness of this model has been The lack of predetermined tools to carry out the organizational diagnosis – Need for highly experienced practitioners to develop customised diagnosis models The strengths of this model has been – The customised diagnosis models targeted at specific problems – Deals with high levels of feedback to managers to understand the diagnostic results. Main Similarities All three, the six box model, sharp-image diagnosis and the congruence model are based on action research models. Action research involves data collection, feedback of data to management and planing for change based of data. These models focus on inefficiencies to bring about change in those areas, will bring benefits the organization. Apply Weisbord’s Six Box Model to â€Å"Lentil as Anything† Marvin Weisbord identified a process with six steps to assist business to diagnosis its business operations. These steps identified by him are purpose, leadership, reward, structure, relationships and helpful mechanisms. These steps were introduced to assist organizations to improve their internal processes. â€Å"Lentil as Anything† and ordinary business with an extraordinary mission, which as has been giving a new meaning to pricing of meals. The concept that Lentils as Anything functions under is â€Å"No Pricing†, here customers can decide what they think their meals valve or how much they can afford to pay. â€Å"Lentil as Anything† first started with two employees and in one location but now after 8 years it has over 100 staff and operates in 4 locations in Melbourne. Its purpose being to serve its customers with food wether they can afford or not as become a reality. The next step in the model is structure. Structure is where an organization splits workloads between staff members, as every member cannot do all types of work. Everyone in the organization has to know and understand what there are required to do and what they are suppose to do. If staff does not know what is expected form them, there would chose and no work would be done efficiently. â€Å"Lentil as Anything† has mainly 3 departments, which administration dept, front of house and back of house. All of them have specific jobs at Lentils. Admin dept coordinates the purchases, supervision and other admin duties. While the back of house is responsible for preparing quality meals and the front of house is responsible for delivering quality customer service and maintaining the restaurant floor. Another step in this model is rewards. Rewards systems include bonuses, vacation time, awards, promotions and recognition. According to Michael le Boeuf, â€Å"you get more of the Behaviour you reward’. If business wants to achieve success and have satisfied employees there should be a reward system in place. In â€Å"Lentils and Anything† the reward system as been in the way of promotions to employees. Which as kept most of the staff happy and content with the recognition give to their hard work? The next step in the model is leadership. According to Weisbord, Leadership’s tasks are to set goals, scan the environments for opportunities and keep performance to defined objectives. Lentil as Anything has a laid back leadership style. This fits this environment as there are no rule and special guide line that staff as to follow at Lentils. Shanaka Fernando has being able to get his staff to carry out his vision successfully. The former Secretary of State, Colin Powell once said, â€Å"†¦the essence of leadership is the willingness to make the tough, unambiguous choices that will have an impact of the fate of the organization. Another step of the model is relationships. This one of the important factor in an organization, this allows management to solve conflicts between top management and staff. At Lentil, even though the relationship between the managers and other staff is good there are some thinks that need to improve. That is from the side of the founder Shanaka, who does not like to take others opinion and advice when making decisions. This has lead to managers leaving the organization. The last element of this model is helpful mechanisms. Helpful mechanisms refer to the policies, programs, meetings, systems, and committees. Those facilitate concerted efforts to meet goals. They include budget systems and planning and control mechanisms. At Lentil as Anything management meeting are rare and there has not been any staff meeting held to discuss any sought of issues. And also there are no mechanisms for employee feedback but there is strong informal grapevine is used to communicate issues. Lentils do not provide any training for its employees, it basically fits in the staff where work need to be done. Conclusion While six box model uses a simple and straightforward method and predefined models look at the organizational strategy, structure, rewards, leadership, relationships and helpful mechanisms. The sharp-image diagnosis model uses customised model to depending on the problem. While the congruence model considers data from internal and external of the organization, strategies employed product and services (output) and how the people of the organization are organised to convert the inputs into outputs. Despite their differences these models derive from action research. When applying the organizational diagnosis model to Lentil as Anything, the best and easy model was Weisbord’s Six Box theory. This model allowed to see the inefficiencies that were at every level of the organization. Now it’s up to the Lentil as Anything management to implement the necessary changes where the inefficiencies were highlighted. References: Kotelnikov,V. (2001), â€Å"Effective Reward Systems. † E-coach. 19 December 2010 Powell, C. (2001) â€Å"18 Lessons for Leaders. † 1000 advices. 19 December 2010 Weisbord, M. (2005-2008) â€Å"Six Boxes. Proven Models. 19 December 2010. Harrison, M. I. (1987). Diagnosing organizations: Methods, models, and processes. Newbury Park, CA: Sage Nadler, D. A. & Tushman, M. L. (1980). A model for diagnosing organizational behavior. Organizational Dynamics, French, W. , & Bell, C. (1999). Organization development: Behavioural science interventions for organization improvement. Upper Saddle River, NJ: Prentice-Ha ll. Harrison, M. I. & Shirom, A. (1998) Organizational Diagnosis and Assessment: Bridging Theory and Practice, Thousand Oaks, CA: Sage Publications.

Nursing Management Essay

Nursing Management, named 2003 Publication of the Year by the American Society of Healthcare Publication Editors, places special emphasis on the new skills needed to succeed in today’s turbulent health care arena, and prides itself on being a strong, independent platform for the expression of a broad range of opinions and views. It is devoted to nursing management concerns including recruitment, retention, reimbursement news, legal issues, and the pressing health care industry. Nursing management is performing leadership functions of governance and decision-making within organizations employing nurses. It includes processes common to all management like planning, organizing, staffing, directing and controlling. Importance of nursing management and function of the nurse manger: Nursing Management a useful source for current advice on how to manage health care delivery across the continuum of care. Novice nurses’ orientation to clinical nursing practice occurs in the critical period between graduation and acquiring the professional nurse role. Accommodating this transition process presents a challenge to expert clinicians in communicating essential behaviors intrinsic to the nursing discipline. In general, the beginning nurse lacks confidence in performing many new skills, and initial responses to problematic situations can escalate into dilemmas without intervention from an experienced clinician of we can say by nurse manager. Therefore, to gain recognition as a discipline that nurtures, supports, and provides guidance for new members, strategies must be developed to improve the transition of the novice nurse to professional nursing practice. Nurse Managers are key to retention, but limited by the scope and multiple skills needed for the role. The role and expectations for nurse managers in ambulatory settings are rapidly changing. Several recent trends should be of concern to nurse executives. Increasingly complex health care services are being provided in this profession. The Nurse Manager plays an essential role in healthcare. She sets the tone of any Healthcare System. The Manager is the backbone of the organization. The quality of patient care, as well as staff recruitment and retention success, rests with this key role. Over time it will be the strength of the nurse manager group that determines the success or failure of nursing leadership, the COO, and even the CEO. As critical as it is to develop those concrete and pragmatic skills noted above, there is also a delicate subtle art to being a Nurse Manager, to balancing the tensions between quality and cost, to dealing with multiple stakeholders, presenting conflicting agendas, to dealing with stress and pressure every day, to implementing processes needed to ensure that individualized compassionate care is provided consistently in the most efficient and effective manner possible ,these qualities in the manager comes from experience. He has the pivotal role in creating an environment that provides quality care for patient and opportunities for growth and development and staff. Constructive and positive attitude towards employ relation makes good manager sense . manager attitude is critical to the ability to staff to meet both there own profession goals of the organisation. the nurse manager has two main roles manage of patient care and provide the necessary source for that situation. The manager action must be superior in grievance handling, employ discipline. On the other hand nurses ensuring that patients receive the best care possible by highly competent and caring. A vital component of nursing consists of communicating effectively with patients and their family. One would assume that this principle would also apply between colleagues. Nurses are professionals and therefore should communicate accordingly with fellow peers as one’s attitude of another can jeopardize or influence others in regards to an effective working relationship and environment in a health care environment characterized by a shortage of nurses, retention is important to achieving good outcomes. The nursing is to provide quality patient care. This mandate becomes harder all the time, especially given the financial and staffing issues that healthcare organizations are facing. Nevertheless, the Nurse Managers is the person responsible for maintaining quality on the unit. She must define what quality means on her unit, set standards for quality, develop consistent processes, eliminate errors, measure results, and constantly improve performance. Benner (1984) discussed the need for clinical experts in patient care areas to provide clinical teaching for new nurses who are in the beginner or advanced beginner levels in their nursing practice. Because novice nurses do not typically understand the contextual meaning of newly learned theoretical concepts, they require guidance in the clinical setting that is generally provided by a more experienced nurse. As a nurse manager, you are expected to handle all the problems on your unit – whether internal or interdepartmental, concerning competencies or complaints, or concerning patients or families. But you’ve come up through the ranks, you’ve seen it all, and you can handle everything thrown at you. Nurse Managers were interviewed and all ward-based G grade charge nurses within the trust were sent a questionnaire to ascertain: the level of satisfaction with the way the changes had been introduced; whether they were in favor of the changes; and if they had sufficient time, knowledge, resources, preparation and support to enable them to undertake their new role. A random sample of charge nurses was also interviewed. It was found that the majority of charge nurses were in favor of the development of their role, believing it to be both inevitable and necessary. However, many felt that the change process had been managed ineffectively. There had been insufficient consultation during the change process, preparation and support were perceived as inadequate, the roles of the various protagonists were often unclear, and the lack of supernumerary status led to role conflict and confusion. As a consequence the new ward managers were often unable to fulfill the true potential of this demanding but exciting role. The nurse manager who clarifies the vision of collaboration, practices as a role model for collaboration, and inspires others to achieve this difficult goal. In addition, the nurse manager manipulates the environmental resources and facilitates self-confidence of staff. The management paradigm that unites the work environment with individual ability is most likely to facilitate collaborative practice. Difference between the expert nurse and the novice nurse: For many years student nurses were trained in a more disciplined approach with considerable time allocated to working in the hospital environment and specified times allowed for gaining theoretical knowledge throughout their formal training. Nurses therefore gained a tremendous amount of experience and competency in their practical skills. With the introduction of more specialized equipment and technology it was now desirable to improve the professional status of nurses and nursing education. The introduction of university trained nurses has been met with much criticism. Student nurses are now being empowered and informed with theoretical knowledge from many health disciplines that allows them to use a holistic approach to patient care. The changes to nurse education were hoped to improve the professional status of nurses although this transition has not been without problems. Integrating inexperienced nurses onto the unit with the nurturing and encouragement they need is a primary charge to the Nurse Manager. Yet the pressure of daily life on a nursing unit often precludes time for true mentoring and the TLC that is integral to fostering trust and commitment in orienting staff. A failure in this realm leads to diminished morale and high turnover among the nursing staff. Experienced nurses who are already working in stressful conditions with continuous staff shortages and poor recognition of service see the student nurse sometimes as an extra hindrance to their already increasing workload. Student nurses are theoretically competent but lack the clinical expertise and experience to complement this knowledge which can also add to the professional pressure that experience nurses encounter. Most nurses would like to see themselves, as promoters of nursing but are frustrated and disillusioned with their profession. It would seem then that student nurses as a result of this dissatisfaction are often devoured by some nurses instead of being encouraged and nurtured in their enthusiasm for nursing. the novice nurses has no enough experience to grasp aspect and recurrent meaningful component of the current situation for example a newly graduated nurse student, he has no understanding of situation exists he can not perform well as we aspect, in that case the responsibility of the manager is much, he is responsible for all activities more work load and stress due to the novice nurses. He determines which aspects of situations are important and which can be ignored him in the case of novice nerse,the manager kept one question in mind, he can perform this work or not. So the responsibility of the nurse manager is more in case of novice nurse. The performance of novice nurse is guided by principals and rules of conduct, so the manager has another responsibility to create some rules and limitation for novice nurse. Expert nurses have an ability to take decision according to the situation, Able to focus on the accurate region of the problem of the situation because judgment is based on understanding of paradigms. Effectiveness of practice not hindered by any wasted regard of alternative diagnosis or solutions. In this case the responsibility of the manager is less, and free to perform to another work. Novice nurse has no experience so he can not judge, what is the actual situation and he can not take decision, he is waiting the order of manager, so the responsibility and the work varies. Novice nurses can main health problem but experienced nurse can do well, all discussed problem. The main thing is, satisfaction of patient, it is only possible by experienced nurse. Expectation of medical surgical team by new nurse manager with respect of experienced nurse: Nursing has always been a physically demanding profession. Today the physical demand is as great as ever with the added challenge of highly technical and increasingly complex treatment modalities. The nurse is an analyst, a communicator, a facilitator, a problem solver, a decision maker, and above all a clinical expert. Nursing requires a broad theoretical base and a new and ever changing clinical skill set, along with the ability to integrate theory with clinical practice. Without the necessary educational preparation and on-going in-service training the nurse will feel overwhelmed, stressed, and unsupported. And to the Nurse Manager falls the task of assuring that her staff doesn’t lag behind and that high quality patient care is sustained regardless of newly imposed expectations. The pressing need for health care reform in this century has contributed to an increasing interest in educating health care providers who can deliver cost-effective, high-quality care. Demand for primary care nurse practitioners has risen significantly, and nursing education has responded by increasing the numbers and graduates of nurse practitioner programs. Although this century brings new opportunities for expanded nursing roles, it also presents challenges for nurse practitioners to sustain a holistic perspective while providing quality care. The new Nurse Manager may be uncomfortable or frustrated when she realizes that she has 100% responsibility for everything that happens on her unit, without 100% authority. That’s because she has to rely partially on other departments e. g. housekeeping, food services, pharmacy, etc. for her success. The successful seasoned manager has developed interpersonal skills, interdepartmental relationships, and the skill to apply effective influence, even lacking formal authority. In this profession the main thing is that how we can control the critical condition. he main objective if this profession is, that how we can recover the patient as soon as possible and some times to save his life in the most serious condition, in these condition the expert or we can say having tremendous knowledge and ability to take decision it doesn’t matter, he is an manager or experienced nurse but the matter is that to take correct decision within time. it is the profession in which we prefer the experience and practice not degree, because in this field it is necessary to save life of anyone and this is comes from practice not achieve a degree of management . ere the expert means who has experienced in the care of patients with restrictive airway disease in an emergency department setting, has experience in the insertion of peripheral access devices on daily basis. He provides assistance with physician insertion of central venous access devices and arterial lines Expert has 25 years of experience in the management of pain in patients in variety of settings in acute care and in medical office practice, Expert has clinical experience in an acute care hospital setting. His areas of expertise include outpatient surgery, medical, surgical, telemetry, intensive care, and the emergency department. He carried out all patient care functions within the realm of hospital policy and nurse practice act as a licensed practical nurse caring for the urgent visit patient under the auspices of the emergency department. Nurse Experts provides healthcare consulting and technical advice to attorneys, physicians, insurance and accreditation organizations, health professionals, private investigators, injured and 3rd parties, media and production. Our nurse experts also provide special services to hospital and nursing home risk management departments. On the above discussion we can say that medical surgical team wants a person who can help in his case it does not matter he was a manager or a nurse but he has an ability to handle the situation with responsibilities, he can take active part in his operation and not commit mistake because in this profession there is no chance of mistakes. Now the one question arise that how they satisfied there job, the answer is that if he has ability to handle the situation, he has ability to satisfy the patient, provide good curing, in this profession the main thing is that how we can deal with the patient problems, provide better treatment so that the patient recover soon then they are perfect in there job and then we can say that they satisfied there job.