Accountability of public health service Essay Example | Topics and Well Written Essays - 1000 words

Accountability of public health service - Essay Example This paper provides an insightful study of the accountability issues involved in the British National Health Service organisation. The National Health Service is basically the most renowned government backed health care systemIt is the free provision of complete health care from the UK government to the general public that provides funding for its operations. The organisation is run by the Department of Health under the supervision of Secretary of State for Health. As it is a government funded and publicly run health service organisation, the accountability and answerability concerns are of utmost importance in the organisation. Hence, this paper investigates into the accountability requirements in the British National Health System and the types of accountability involved therein.Accountability has been defined several times with several meanings and perspectives such as Ijiri (1983), Robinson (2002), Sinclair (1995) etc. According to Mulgan (2000, p555), "complex and chameleon-like term", which calls for the usage of term as ever changing and available in various forms and ranges. In much simpler words, we can define accountability as the notion of being accountable and answerable for the deeds and doings. Accountability is involved in many forms in various aspects of human lives. For instance, an organisation is accountable to its shareholders, and a minister is accountable to parliament etc (Mosley 2000). Accountability is essential in the sense that it creates a sense of responsibility and sets a value framework for the actions to be performed. Accountability in public health service is of enhanced importance because of the nature of operations it conducts. If the funds provided by the government are to be allocated completely to the desired beneficiaries and if the prescribed operations are to be performed in the best manner, some necessary accountability measures need to be taken. Such strategies need to be undertaken so as to combat misuse of resources, ensure abidance to defined rules, and enhance efficiency in the health care system. Schedler (1999) says that answerability is the vital component of accountability, which refers to the notion of being answerable for the deeds and decisions. Accountability is pre-eminently important in public health service, because it the utmost responsibility of any government in the world to make the provision of best medical and health care facilities to its people. Any lack of accountability can lead to the corruption, mal-practice and misuse of the resources on the part of the government personnel. Brinkerhoff (2001) refers to the following types of accountability that should be enforced in public health care system: Financial Accountability It makes the public officials accountable for their use of financial resources of the organisation with the help of various tools such as accounting, auditing, and budgeting etc. As public health care system is funded by ministries, the government needs to enforce control measure using predetermined budget for specific facilities and setting limit standards for spending power granted to different levels of authority. This type of accountability is needed to reduce the corruption among public officials in the health sector. The Audit Commission and National Audit Office can take National Health Service bodies under investigation but not much of the information is disclosed outside the organisation. However, the recent reforms introduced by the government require the NHS bodies to publish and disseminate the organisation's annual reports plus their business plans. This counts for an enhanced accountability in financial aspect because the uses and outcomes of financial resources can ea sily be analysed through the financial statements. Managerial Accountability Managerial accountability lies in measuring the performance of the organisation in terms of the results achieved out of its various operations. The personnel can be made accountable through the

Risk Assessment Report Assignment Example | Topics and Well Written Essays - 1000 words

Risk Assessment Report - Assignment Example (2010). This assessment report discusses some of the risks and vulnerabilities associated with Transportation security Administration (TSA), the nature of the risks as well as their potential mitigations. One of the main risks that are currently facing TSA is the vulnerability of the organizations resource allocation process. This is particularly because TSA an agency has not been providing proper documentation that indicates how they develop their budget justifications based on risk analysis to justify or prioritize activities. For example, although the current assessment activities at TSA have independently addressed various individual risk components such as vulnerabilities and threats, they have failed to combine the main components of risk and develop a readable risk assessment as always required by the NIPP. Generally NIPP requires that credible risk assessments in organizations should not only be documented but must also include the three main components of risks so that they can effectively be used to support the processes of resource prioritization, planning and risk assessment at the national level. Another potential risk facing Transportation security administration (TSA) is the insider activities that may compromise the security of the agency’s sensitive information and data. This is attributed to the fact the TSA often depends on sensitive information regarding transport and security to meet some of its objectives. As an organization charged with the duty of providing effective and efficient security for passengers and freight transportation, TSA has its own predicament concerning goods and passengers security. Unsecured website has been a damning discovery on the company as clients personal information is exposed to identity theft. In December 2009, an employee working with the TSA posted a sensitive manual titled screening management SOP on confidential airport showing plan to a URL on the FedBizOpps website. This manual was first exposed but taken down though the breach raised eyebrows with questions arising on the security practices being compromised. Five TSA employees were thus placed on forced leave over the scandal. According to many analysts, another critical risk that of the organization faces is risk of destruction of its infrastructure and air craft hijacking. Destruction of the airline and rail infrastructure is a risk as such distraction from by vandalizes and terrorists can result to major loss and paralyze the whole transport sector. Hijacking of either highway motorists or aircraft on the other hand by terrorists or other criminals poses a major risk. This does only result to the loss of life but also a major economic loss. Another risk is that of highway hijackings as well as threat to security of the public (Hutto, 2009). Generally such risks often involves outcome of a given cause that has a likelihood of resulting to destruction. Transportation Security Administration is one of such agency that is charged with the responsibility of ensuring security of the travelling public. By virtue of its operations is likely to be affected negatively by any risk.

Sexual Assault Research Paper Example | Topics and Well Written Essays - 1750 words

Sexual Assault - Research Paper Example The attempt to or assaults to commit rape through threat or force are included. It excludes statutory rape. As of 2009, reports of forcible rape annually have reached 88,097. Of all the reported rape cases in 2009, 93% were rapes of force (URC). B. Rape by Fraud   Rape by fraud is a form of rape or sexual assault wherein the woman is made to believe that it is her husband whom she has sex with. Rape, as mentioned, is a woman’s the carnal knowledge in the absence of her consent and is obtained by threats, fraud, force, etc. The fraud here should be consist of certain strategies by which the woman is made to believe that the offender is her spouse (Lee v. State, 1902). C. Marital Rape   Marital rape, also referred to as intimate partner sexual assault, is one that is done or committed by the current or the past partner, whether boyfriend or spouse. It happens when there is forced intercourse within the marriage or the partnership. However, there are still many countries that do not consider marital rape as a crime. In the United States for instance, rape is defined as sexual conduct forced on an individual other than a wife since the wife sexual consent is presumed. D. Date Rape In acquaintance rape, the offender is usually somebody who the victim knows casually or by sight, such as a colleague or a neighbour. In date rape, the offender is somebody who the victim knows and who the victim has consented to spend time with. Somebody who commits acquaintance rape or date rape can make use of various tactics, such as seeing to it that she is isolated, locking the door, making promises of taking her home from an event or party but taking her someplace else instead; he may threaten the victim with public humiliation, telling her that he will tell their friends that they sexually romantic regardless of what might actually take place; he may pressure her emotionally, saying that if she doesn’t agree, he will leave her; or he may use economic pressure, sa ying that he deserves sexual intimacy because he paid for their dinner (Huff, 2009). II. Who are the offenders and their characteristics?   A. Age of Offenders According to Holmes (1991), sex offenders and rapists are likely to be young men below the age of 30 during the time of the assault. In a study conducted by Quinsey and Upfold (1985) involving 72 rape offenders, the average age of these offenders was 24 years old. The relationship between age and offense is seldom taken into consideration in the literature on rape beyond its descriptive qualities in the methodology. It was suggested that hormonal factors existing in young men were linked with sexual offense (Marshall and Barabee, 1984). B. Gender of Offenders According to researchers (e.g. Lievore, 2003; Avakame, 1999), between 97% and 99% of alleged sex offenders are male. While physiologically and legally females are also capable of committing rape, for example, by digitally or orally penetrating victims (both male and fe male), such instances seldom reach the criminal justice system (Matthews et al 1991). C. Class of Offenders According to Holmes (1991), overwhelmingly, convicted rape offenders are from lower socio-economic backgrounds. Usually, they have inconsistent employment history in unskilled works, have high academic failure rates, and come from unstable backgrounds (Bard et al, 1987). The underrepresentation of males from upper and middle class backgrounds may indicate a higher involvement in marital and date rapes, which have lower conviction and

Video game industry Essay Example for Free

Video game industry Essay Whenever I look out from my window at home, nothing but memories come back to me. When the time that me and my friends playing together with many kind of Filipino games like â€Å"Patintero†, â€Å"Langit Lupa†, â€Å"Black123† and many more. I was about 7 years old when I was always want to go outside to play with my friends from morning up to afternoon. My only break was when my Mom calling me saying that â€Å"we’re gonna eat our lunch† so I need to come back home as soon as possible. When I’m with my friends, my life has been always happier than when I am inside of our house. I really loved to be outside and play with my friends because it gives me fulfillment of my childhood life. As I become aware that my street has become barren from children playing outside, those memories soon fade away into silence. The truth of the matter is that video games have affected the children who play them. Although video games have been quite influential on our generation, video games have had a lot of negative effects on the children of today. Children have become obsessed with video games. Since 1980’s, the video game industry has expanded so much in the market, it is only getting larger with the growth of technology. And although these games provide much entertainment, it does not come without a cost. Since the rise of video games, more children have become more obese, more violent and less social.

Lines composed upon Westminster bridge, Sept. 3 1802 and London Essay Example for Free

Lines composed upon Westminster bridge, Sept. 3 1802 and London Essay These two poems show very different views of London. Lines composed upon Westminster Bridge, written by William Wordsworth, describes London in detail. He captures the beautified city and expresses the calmness of the morning. William Blake, who lived around the same time, wrote London which expresses the chaotic and corrupt side of London. Wordsworth describes the city in much detail. A sight so touching in its majesty. The Earth has not anything to show more fair. He expresses his true feeling about the city from where he sees it. He goes on to personify the city and describe how it doth like a garment wear The beauty of the morning; silent, bare. He has captured the city in the morning when it is quiet and in a sense almost naked with no one yet bustling through the streets, there are no fume engulfed traffic jams or shouting street salesmen. There is only the calmness of the morning. All the man made objects and buildings, such as ships, towers, domes, theatres and temples lie open unto the fields and to the sky. The man built objects remain where they were left not yet being used by Londoners. The atmosphere is sublime, the sun is just rising and soaking everything in its light, Never did sun more beautifully steep Neer saw I, never felt, a calm so deep! the scene is so peaceful he is feeling peace within himself. The natural body of the city, the river, is gliding in its own free way, the way it wants the river glideth at its own sweet will Its free will is moving it naturally through the city as though it were the countryside. The river has also been personified to give more emphasis of its freedom. He is so overwhelmed by the atmosphere and calmness of the city. Dear God! The very houses seem asleep everywhere he sees is not yet awake, again he has personified an object to give it more emphasis. His final line is describing the city as a mighty heart that is lying still. The capital, like the giant mechanism of a heart is just lying still. The aim from the poem is to describe the amazement he sees when looking over a massive city and seeing the calmness. He wants to express to others how peaceful and calm it makes him feel and pass that feeling on to the reader. The first two stanzas describe what the city is like, and what he sees around him. The sestet after this shows his personal response to what he has already described and how he feels about the city. Blake presents a much more depressing, morbid scene of London describing the corruptness of everything in the city. He is describing the attitudes and goings on in London that are normally never spoken about, the things which people may or may not know but which go on behind closed doors. A lot of repetition is used, unlike in Wordsworths poem, to give emphasis to the points which he is trying to make. In every cry, of every Man, In every Infants cry of fear, In every voice he only lists one example in each line but gives the effect of a lot of crying and pain and fear. He speaks in a first hand account throughout the poem I wander, I hear, and I meet. By speaking in the present tense it makes the reader more inclined to think it is going on here and now however old the poem may be. By beginning the first line with I wander thro each chartered street It makes it easier to visualise what he is describing because it is a first hand account. The chartered streets are each set out neatly and ordered, the chartered Thames is also very regulated and gives the impression of it being divided and bought and sold. He notices a mark in every face I meet Marks of wisdom, marks of woe. This evidence of scars of weakness and great sadness in faces contrasts with the peaceful and happy atmosphere Wordsworth gave to London. He hears mind-forgd manacles in crys of every man and Infants cry of fear he is referring to the fake, made up manacles that he cannot actually hear but knows that something is wrong. His repetition of cry continues to the next stanza where he talks of chimney-sweepers which are doing the dirty, hardest jobs and suffering for their work, an example of the depressed and morbid London. The description of the blackening church shows the soot taking over London and the church becoming almost evil, involved with dirty money or becoming corrupt. Even the church is starting to lose its faith. Another large part of London life is also criticised, the hapless soldiers sigh Runs in blood down palace walls. Fighting is going on around the palace but going unnoticed, the palace is oblivious to the corruptness going on inside its own walls. He contrasts the third stanza with the 4th final stanza, not only the church and palace and the huge industries of London are corrupt the streets are also. Thro the midnight streets I hear How the youthful harlots curse there is a lot of prostitution going on in the streets of London but was something that wasnt spoken about. The STDs, or curses blasts the new born infants tear. Implying that prostitutes pass on STDs and then these in turn get passed on to the newborn babies of those who have any disease. Another example of a corrupt system in London, which now effects the innocent. And blights with plagues the marriage hearse. Sleeping with prostitutes while married destroys the whole point of marriage and then if the partner becomes pregnant another generation is born into corruption. The use of hearse shows how marriage is carried away as though dead and not taken seriously. The extremely regular meter helps put across the ordered ways he describes the beginning. These chartered and regulated ways soon give way to the examples of how corruption is slowly taking over the whole city, the government, the church, the palace and the streets. The first poem also used a regular meter, which, also worked well in describing the city peacefully and happily. The two poems contrast greatly in not what they describe but how they describe it. Wordsworth has a much more calming poem, which in effect leaves the reader much more calm and peaceful. This is unlike Blakes who describes so much evil and chaos going on, his poem leaves the reader much more depressed and almost disgusted with how the people and industries of London are behaving. Their use of language is also quite different, Wordsworths entire poem is full of description of beauty, bright and glittering and full of splendour. He uses very grand descriptions of everything unlike the descriptions of Blake, which are quite harsh and blunt, blasts the new born infants tear, blights with plagues and runs in blood down palace walls. I did enjoy both poems but preferred the first, Lines composed upon Westminster because of its use of more soothing, happy descriptions of London. It made me feel much more relaxed after reading it whereas London left me feeling slightly more depressed and sad. Although this may have been the aim of Blakes poem I preferred Wordsworths poem because it was much calmer.

Measuring Patient Dependency in Clinical Settings

Measuring Patient Dependency in Clinical Settings Title: Should patient dependency be used to set nurse-staffing levels in general hospital wards? Introduction: In this section, we perform a literature review to discuss patient dependency in clinical settings, and examine how we can measure patient dependency levels. We also discuss whether patient dependency levels should and could form the criteria for setting nurse-staffing levels in the hospital. We will also analyze the other different methods and criteria that can help to determine nurse staffing levels within the clinical setting. Patient dependency levels indicates the requirements of nurses and the extent to which patients will need nurses for their continuous care. Nurse patient ratios are often used to discuss the nurse staffing levels and these figures indicate whether staffing levels have to be increased or decreased. We would aim our discussion of patient dependency necessitating increase in staffing levels and the patient nurse ratio as indicators of nurse staffing both within general hospital wards and at critical care and emergency units. Evidential Information Patient dependency may just form an important part of nursing staff and workload of an individual nurse. Hurst (2005) conducted an important study on the nature and value of dependency acuity quality (DAQ) demand side nursing workforce-planning methods, which are set in the context of nursing workforce planning and development. Extensive DAQ data was obtained from UK nursing workforce in 347 wards, which involved 64 high quality, and 62 low quality hospital wards. The study gives special consideration to workload and quality contexts. New insights have been generated with this study and Hurst emphasizes that poor quality care is more common in larger wards that have fluctuating and unstable workload and nurse – patient ratio. Smaller workloads having consistent and high workload of nursing staff results in inflexible nurse staffing so staff levels and performed duties remain the same. Studies definitely suggest that nursing activity and staffing differences do form an importan t part of defining and contributing to the quality of the wards with higher staffing levels and more consistent work for nurses at high quality wards and lower staffing levels and irregular services with low nurse-patient ratio in low quality wards. From this evidence, it is possible to provide recommendations for nursing management and practice and probe into more accurate relations of dependency acuity quality in DAQ measures. In a study using assessment of patient nurse dependency systems for determining nurse-patient ratio in the ICU and HDU, Adomat et al (2004) point out that a huge range of patient classification systems or tools are used in critical care units to inform workforce planning, and nursing workload although the application of these methods may not always be relevant, complete or appropriate. The systems or tools used for patient classification and categorization were developed solely for the purpose of more efficient distribution of patient across hospital sections, although now the same systems are used for workforce planning, distribution of workload, determining nurse-patient ratio in critical care settings. However these changes can raise a number of issues related to workforce planning, staffing levels and nursing management in general. Adomat and Hewison evaluate the three main assessment systems used in critical care units to effectively determine the necessary nurse-patient ratio t hat can provide the best quality service in the wards. The application of these tools is to enhance the quality of care by keeping nurse-patient ratio at its optimum. The authors suggest that decisions relating to workload planning and determining the nurse patient ratio are dependent on an understanding of the origins and purpose of the classificatory tools that categorizes patients and measures their dependency on care services. Patient dependency and classification systems as well as patient dependency scoring systems for severity of illness are measures indicating mortality and morbidity although Adomat points out that these dependency measure may not be real indicators or determinants of the nurse-patient ratio that help in measuring nursing input. The costs of providing a nursing service within critical care uses nursing intensity measures to give a framework for nursing management and patient care and also determines the exact role of patient dependency in nurse staffing leve ls. However, components of the nursing role and how it determines standards of care have not been fully determined (Adomat and Hewison, 2004). They point out that careful consideration of patient dependency and classification systems may be necessary to plan, organize and provide a cost effective critical care service. In a similar study, Adomat and Hicks (2003) evaluates the nursing workload in intensive care a there is a growing shortage of nurses in these care units. The problem identified in this shortage lies in the method for calculating the nurse/patient ratio using the Nurse Workload Patient Category scoring and classificatory system use in most intensive care units. The nurse-patient ratio is determined by using the patient category or dependency scales and the general assumption is that the more critically ill a patient is, the more care and nursing time will be required for the patient. Many critically ill patients placed on a high level of mechanical care such as a feeding or ventilator tube and in intensive units may however require less direct personal nursing care than patients who are self ventilating or have been considered to have lower levels of dependence. Thus patient dependence may be addressed by means other than direct nursing care and artificial care and support systems may b used instead of nursing staff. These and other factors show that patent dependency may not be a completely relevant measure for determining nurse –patient ratio or nurse staffing levels and many associate factors have to be considered. This study by Adomat and Hicks use a video recorder to document nurse activity in 48 continuous shifts within two intensive care units and helped to determine the accuracy of the Nursing Workload Patient Category scoring system to measure nurse workload. The data obtained from the video of nurse activity was then correlated with the Patient category scale score that was allocated to the patient by the nurse in charge. The results of this study showed that the nursing skills required in these care units were of low skill type despite the needs of care being complex in general. It was found that nurses spent less time with patients who were categorized as in need of intensive care than those in need and in high dependency range in all units. T he findings indicate that existing nurse patient ratio classifications are inappropriate as nurses spend less and less time with critically ill patients. The authors expose the flaws of classification or scaling systems that tend to correlate care with critical illness. They suggest that radical reconsideration of nursing levels and skills mix should make it possible to increase provisions and levels of intensive care providing the right numbers of staff at the appropriate units where patients need them most suggesting more flexible and alternative approaches to the use of nurse-patient ratios. In a similar study discussing relationship between workload, skill mix and staff supervision, Tibby et al (2004) proposes a systems approach and suggests that hospital adverse events or AE are more likely when sub-optimal working conditions occur. Proper working conditions are thus absolutely necessary to ensure the smooth working of the clinical setting. Tibby and colleagues analyzed the adverse events in a pediatric intensive care unit using a systems approach and observational study to investigate the association between the occurrence of these adverse events and latent risk factors including temporal workload, supervision issues, skills mix, nurse staffing and the interactions between established clinically related risk factors (Tibby et a, 2004). The data was collected form 730 nursing shifts and the analysis was done with logistic regression modeling. The rate of adverse events was 6 for every hundred patient days and the factors associated with increased AE including day shift , patient dependency, number of occupied beds, and simultaneous management related issues although these were considerably decreased with enhanced supervisory ability of the nurses. Decreased number of adverse events have been found to be related to the presence of a senior nurse in charge, high proportion of shifts handled by rostered, trained, permanent staff and the presence of junior doctors. Patient workload factors such as bed occupancy and the extent to which the patient needs help and nursing supervisory levels and level of staffing such as presence of a senior nurse have been found to be associated. This study sheds light on the factors increasing or decreasing adverse events and helps in identifying the issues closely related to the need of regulating and optimizing nurse staffing levels. As we have already suggested through a study by Adomat and Hicks, patients in high dependency units may require more frequent nursing care and higher nurse-patient ratios than critical care units where patients may be supported by artificial methods. According to a study by Garfield et al (2000) high dependency units are increasing in the hospitals and becoming more important as part of a hospital’s facilities. Although the optimum staffing ratio for patients is unknown for such units, the Department of Health and Intensive Care Society recommend a level of one nurse for every two patients. Garfield et al recorded Therapeutic Intervention Scoring System scores and Nurse Dependency Scores in high dependency units over 7 months. The results indicated a weak correlation between nurse dependency score and therapeutic intervention scoring system score. The authors argue that a nurse-patient ratio of 1:2 may be insufficient for the management of a high dependency unit and based on t heir findings recommends a nurse to patient ratio of 2:3. Balogh (1992) points out that the literature on audits of nursing care shows a strong relation between the quality of nursing care provided and nursing labour force and staffing issues. Balogh suggests that all assumptions for setting nurse staffing levels on the basis of variations in patient dependency are unscientific and there are moreover no opportunities to use personal judgment in decision-making within hospitals to determine nurse-patient ratios. Balogh points out that such methods for determining staffing levels as well as audit instruments are outdated and insufficient to optimize service levels. The paper highlights the need for greater flexibility, more decision making power, and a more significant role of nurses’ personal judgment in selection and management of appropriate nurse staffing levels in dependency and critical care units. Conclusion: In this review of literature on the exact role of patient dependency in determining nurse staffing levels, we began by suggesting that it is generally believed that the more critical condition a patient is in, the higher the requirements of direct care suggesting that nurse patient ratio should be high in critical care units. This assumption however has been refuted by studies which shows that such clear criteria may not be sufficient for nurse management and staffing level decisions and other factors have to be considered. These include artificial means of life support and other mechanical devices that minimizes the need for manual staffing and reduces a critical patient’s nursing needs. A related study suggested that high dependency units rather than critical care units should be provided with higher levels of staffing although many other factors such as supervisory levels of senior nurses, skills available and already established method of determining nurse patient ratios s eem to be crucial factors. Along with the approach taken by several authors we can also suggest that personal judgment of nurses on the care needed by patients rather than inflexible scaling or scoring systems should be used by hospitals to determine staffing levels, considering patient dependency levels as well. Bibliography Adomat R, Hicks C. Measuring nursing workload in intensive care: an observational study using closed circuit video cameras. J Adv Nurs. 2003 May;42(4):402-12. Adomat R, Hewison A. Assessing patient category/dependence systems for determining the nurse/patient ratio in ICU and HDU: a review of approaches. J Nurs Manag. 2004 Sep;12(5):299-308. Ruth Balogh Audits of nursing care in Britain: A review and a critique of approaches to validating them International Journal of Nursing Studies, Volume 29, Issue 2, May 1992, Pages 119-133 The importance of data in verifying nurse staffing requirements Intensive Care Nursing, Volume 4, Issue 1, March 1988, Pages 21-23 Lynne Callaway and Edward Major Curtis C. A system of measurement of patient dependency and nurse utilization. Aust Nurses J. 1977 Apr;6(10):36-8, 42. Donoghue J, Decker V, Mitten-Lewis S, Blay N. Critical care dependency tool: monitoring the changes. Aust Crit Care. 2001 May;14(2):56-63. Garfield M, Jeffrey R, Ridley S. An assessment of the staffing level required for a high-dependency unit. Anaesthesia. 2000 Feb;55(2):137-43. Hurst K. Relationships between patient dependency, nursing workload and quality. Int J Nurs Stud. 2005 Jan;42(1):75-84. Hearn CR, Hearn CJ. A study of patient dependency and nurse staffing in nursing homes for the elderly in three Australian states. Community Health Stud. 1986;10(3 Suppl):20s-34s. Miller A. Nurse/patient dependencyis it iatrogenic? J Adv Nurs. 1985 Jan;10(1):63-9. OBrien GJ. The intuitive method of patient dependency. Nurs Times. 1986 Jun 4-10;82(23):57-61. Prescott PA, Ryan JW, Soeken KL, Castorr AH, Thompson KO, Phillips CY. The Patient Intensity for Nursing Index: a validity assessment. Res Nurs Health. 1991 Jun;14(3):213-21. Seelye A. Hospital ward layout and nurse staffing. J Adv Nurs. 1982 May;7(3):195-201. Tibby SM, Correa-West J, Durward A, Ferguson L, Murdoch IA. Adverse events in a paediatric intensive care unit: relationship to workload, skill mix and staff supervision. Intensive Care Med. 2004 Jun;30(6):1160-6. Epub 2004 Apr 6. Williams A. Dependency scoring in palliative care. Nurs Stand. 1995 Oct 25-31;10(5):27-30. For scoring systems Depatment of health – www.dh.gov.uk

Women Seeing the World through a Different Lens in Three Guineas and Th

At the time Virginia Woolf wrote The Years and Three Guineas, there were many differences between men and women, one of which was education. Most women were not educated, which prevented them from entering into agency. Women allowed themselves to be played by history. In order for them to change a world that was dominated by men, women needed to refuse what history said was their essence, and rather, use that essence to create critical ways of being in the world. The photograph, "a crudely colored photograph--of your world as it appears to us who see it from the threshold of the private house; through the shadow of the veil that St. Paul still lays upon your eyes; from the bridge which connects the private house with the world of public life," must be taken from a different perspective, (Three Guineas 18). In Three Guineas, Woolf shows her readers how women were enslaved by men, why it was so important that women receive an education, and the different ways in which women could e nter into agency in order to change a world that was dominated by men. In Three Guineas, Woolf describes all of the ways in which women were being enslaved by men. There were many differences among men and women, which deprived women of their freedom. At this time, there was a power imbalance; men were dominant and women were not valued by society. Many doors were still locked for women. Men had been educated for five or six hundred years, while women, only sixty. Even though both sexes contributed to university funds, the number of women who were allowed an education was extremely limited. "Though we see the same world, we see it through different eyes," (Three Guineas 18). Men were taught to think and act through tradition. They wer... ...en how they were being enslaved by men, explained the importance of an education, and proposed ways in which women could enter into agency in order to change a world that was dominated by men. Women should strive, " to assert `the rights of all--all men and women--to respect in their persons of the great principles of Justice and Equality and Liberty,'" (Three Guineas 143). Women must look at the whole picture and burn the old photograph, the crudely colored photograph, and retake the picture from a different angle, from the angle of a world that let the light into the private house. Take the picture from the perspective of an educated woman, an educated woman looking through a different lens than she had before. Works Cited Woolf, Virginia. Three Guineas. Â ©1938, 2008. Harcourt, Inc. Orlando, Florida. Woolf, Virginia. The Years. New York: HBJ, 1937.