Figurative Language versus Literal Language Essay - 2

Figurative Language versus Literal Language - Essay Example The American language is a living, breathing, and ever evolving language. As such, it is composed of words, phrases, and sentences that find their origins in the most ancient of historical times with its meaning evolving over the years as people use the word for various purposes and to invoke various meanings.There can be figurative uses for the word, or even literal uses which manage to change the context of the word regardless of the word etymology. This paper will look into the etymology and meaning of 10 of the most popular words used in the American English language. The discussion will be started off by looking into the history and meaning of the word Idiom. The word Idiom first came into play in 1580 and was meant to connote a "form of speech peculiar to a people or place â€Å". Although Latin in origin from the word â€Å"idioma†, the modern form of the word actually comes from the French original idiome. (Online Etymology Dictionary) Idioma therefore describes a a l anguage, dialect, or style of speaking that is unique to a particular set of people. It's actual definition is that of a noun that â€Å"an expression whose meaning is not predictable from the usual meaning of its constituents† (dictionary.com). Idioms are therefore cultural in nature (Garland, â€Å"Oh Idioms: Overused, Amusing, and Often Confusing) and should not be confused wih the figurative metaphors that uses an image for comparison purposes, it is also not a simile or a hyperbole. (Garland, â€Å"Oh Idioms: Overused, Amusing, and Often Confusing).... (Online Etymology Dictionary). It is often confused with the word analysis is the word that is used to describe the process of comparing two things. An example of the use of the word Analogy is â€Å"The analogy between the heart and a pump†. (dictionary.com) Now we come to the word Metaphor which is a â€Å"figure of speech in which a term or phrase is applied to something which it is not literally applicable in order to suggest a resemblance† (dictionary.com). The origin of the word dates back to the 1530's from the Latin word Metaphora which meant â€Å"a transfer†, specially of one word to a different word (dictionary.com). A sample of a metaphor is â€Å"Our fortress is God†. Therefore a metaphor cannot be confused with a simile. A Simile on the other hand is a â€Å"figure of speech where two unlike things are compared†. It is the opposite of a metaphor and dates back to 1393 when the word simile was first used to describe like things. An exam ple of a metaphor would be â€Å"She is like a rose.† Now a Cliche, is a â€Å"trite, stereotyoed expression that usually expresses a popular or common thought of idea that has lost originality due to overuse.† (dictionary.com) An example of a cliche would be â€Å"strong as an ox†. It is most often confused with the word stereotype. An Amphiboly is â€Å"an ambuguity of speech, especially from uncertainty of the grammatical construction rather than that of the meaning of the words†. It seems to describe nonsensical sentences such as â€Å"The Duke yet lives that Harry shall depose†. (dictionary.com) In our modern era of speech, new words have been coined to describe the actions of people over the internet. One such word is Flame Word

Describe How Income Flows Into The Organisation Where You Work Nursing Essay

Describe How Income Flows Into The Organisation Where You Work Nursing Essay Cash inflow, as defined by Brideau (2004) is the measurement of the movement of cash into the organization, usually generated from operating, investing and financing activities. The components of cash flow must be visible on a planner so that it will be easily understood exactly what occur. Without cautious monitoring of the cash flow, the organization may not have the profit realization as they scheduled it (Donaldson Gerard, 2005). Hence, by having the knowledge of how income flows into ones organization is vital. So, corrective actions can be done to prevent incidents that may run the organization into economic failure. The current clinical setting where I work in is conveniently located at the annex block of Mount Elizabeth hospital. The unit consists of 24 beds, involving a team of 32 healthcare workers, ranging from doctors, nurses, pharmacists and laboratory technicians. Our center is mainly specialized in haematological disorders such as anaemia, leukaemia, thalasemmia and so on. Majority of our patients are those who required blood transfusion, Bone Marrow Aspiration (BMA) and chemotherapy. Primarily, the core income will be coming from the consultation fees generated by our team of haematologists. Beside consultation fees, procedural fees commonly involved are BMA, intra-thecal chemotherapy and insertion of Central Venous Catheter (CVC). On the nursing part, services provided for patients normally include blood taking, blood transfusion, performing dressing to CVC site and giving injections to post chemotherapy patients to boost their immunity. Furthermore, our clinic is involved in the blood donation drive and counselling is mandatory for both the donors and recipients. All the above mentioned services delivered would drive income into our department. Currently, the nurses have the authority to recommend some of the topical skin moisturiser for patients undergoing chemotherapy, who will usually encounter dry skin conditions. Hence, this will further increase the income flow into the department. A built in laboratory and a pharmacy are also available in our clinic, which provide blood test services and dispensing of medicines respectively. External funding and donations from other organisations also constitute part of the income flow into our department. In general, our revenue is generated through a variety of means, along with billable patient services, investments and donations to the organization. Specific unit-based revenue is generated through billing for services such as invasive diagnostic or therapeutic procedures, physical therapy and so on. Revenues are also arising through the provision of multiple services overtime, such as hourly rates for chemotherapy administration or blood transfusion. Hence, nurses need to be informed and partner with the management team to generate revenue and control expenses in relation to patient care (McCue et al, 2003). Ultimately, these are the ranges of services available in the clinic that will be involved in the generating of income flow. 2. Critically evaluate the steps you would take when reviewing the skill mix in your own clinical setting. Discuss how you might balance the financial implications of your actions? The challenge in healthcare is to ensure that quality of care and the calibre of the staffs are not comprised in this ever-changing, cost-controlled environment. Many healthcare organizations are looking into skill mix (SM) as a potential solution to healthcare service delivery problem. As stated by Adam et al (2003), SK is the percentage of registered nurses (RNs) to other direct care staffs such as enrolled nurses (ENs) and SM plays a critical role in improving organization effectiveness and the quality of care. So what is the specific role of the RNs and ENs based on my current clinical setting? These questions need to be answered prior to the reviewing of the skill mix in the clinical setting. Serrano Slunecka (2006) stated that, the RNs are responsible for patient assessment, diagnosis, care planning and evaluation, whereas, the ENs are trained to perform bed-side duties such as bathing, feeding, toileting and ambulating patients. In my current setting, our main issue is inadequate staffing due to inappropriate SM. As evidenced by Gillies (2003), insufficient staff is the most common contributing factor causing negligent of patients, thus, leading to poor quality of care. Hence, significant steps must be taken to efficiently establish a staffing pattern, a plan that articulates how many and what kind of staffs are required per shift to staff a unit of department (McCue et al, 2003). We must first examine the following factors and take into consideration that a novice nurse takes longer to accomplish the same task than an experienced one. The acuity of patients, the capabilities of the staffs, the complexity of the nursing task, the amount of supervision a RN will be able to provide and the number of available staffs assigned to accomplish the unit workload are the key points when reviewing SM in a clinical setting (Adam et al, 2003). For illustration, in an intensive care unit, the RNs skill mix will be much higher than in a nursing home where the skills of RNs are required to much lesser degree. Lastly, Hall et al (2004) stated that cost is associated with the nature of SM. In developing a staffing pattern that leads to a budget, it is important to benchmark against other organization with similar patients population. It is important to note that RNs hours of care are more costly than those of lesser skilled workers, hence, it is important to evaluate the patient care required and who can perform necessary functions (Hall et al, 2004). Allocating ENs appropriately and freeing RNs from uncalled for duties can assist in cost control. As evidenced by Rothberg et al (2005), it is cheaper to have ENs to perform supportive care than to have RNs to perform them. Therefore, SM is accountable for the distribution and consumption of resources. It is essential that nurses need to be informed and collaborate with the management team so that appropriates decisions can be made regarding cost-effective practices (McCue et al, 2003). The key is to have the right number and skill level of caregiver available to ensure safe, effective and appropriate care. 3. Develop a system which would enable you to audit your staffing expenditure on a monthly basis. Give a detailed critical discussion of your rationale underpinning your system. Table 1: Budgeting and spending of an individual staff Spending: Pay/wages Shift allowance Meal allowance Medical entitlement Total Spend/budget Spend/Budget Spend/Budget Spend/Budget Spend/Budget Spend/Budget Staff Nurse (1 year experience) $1500/$1500 $100/$100 $15/$22 $130/$350 $1745/$1972 Staff Nurse II (2 year experience) Senior Staff Nurse (5 year experience) $1700/$1700 $2300/$2300 $150/$150 $180/$180 $28/$28 $20/$30 $200/$600 $1320/$1200 $2078/$2478 $3820/$3710 Enrolled Nurse (1 year experience) Enrolled Nurse II (2 year experience) $1200/$1200 $ 1450/$1450 $75/$75 $125/$125 $15/$15 $28/$23 $110/$250 $250/$300 $1400/$1540 $1878/$1898 Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Staff A $2970 $2800 $2900 $2700 $2890 $2700 $2900 $3000 $2700 $2830 $2790 $6800 Staff B $2900 $2910 $2900 $2780 $2810 $2700 $2800 $2780 $2730 $2700 $2890 $6500 Staff C $2550 $2500 $2520 $2300 $2600 $2650 $2400 $2600 $2420 $2520 $2490 $6000 Staff D $2570 $2500 $2400 $2450 $2500 $2420 $2400 $2450 $2430 $2530 $2340 $6100 Table 2 (12 month wages) Late for work Medical leave Patient compliments Staff A 0 1 0 Staff B 1 1 0 Staff C 15 0 1 Staff D 6 2 1 Table 3 (monthly audit for staff) Staffing expenditure (SE) generally accounts for the expenses associated with labours. According to Brambleby (2005), healthcare services are very labour intensive and it is estimated that salary and benefits accounts for 50% to 60% of an organization cost. As defined by Payne Keep (2004), staffing expenditure is determined by identifying the expenses of every staffs in the organization. SE is commonly broken down into monthly basic salary, staff benefits, allowances and lastly, annual increment and bonus. Besides the above listed, it is compulsory for every organization in Singapore to contribute 13% of total gross income to Central Provident Fund. In an organization, the first most common expense is the basic salary of every individual staff. However, the amount of salary a particular staff will be eligible to depend on their individual experience. Medical fees entitlement, staff allowances and benefits would include meal allowances and shift allowances, which would fluctuate every month within an individual pending on numbers of working years. Whereas, annual bonus and increment will depends on individual performance. Looking at Table 1, it keeps a record on the spending and budgeting of an individual staff based on their wages, meal allowance, shift allowance, medical fees and the total wages draw by the individual staff in the month of January. As for Table 2, in this table showed the collection data of the total wages each individual staff draw from January to December over a period of 12 month. Zooming in at the month of December in Table 2, all the staffs are drawing a higher wages as compare to all the other month. This is the amount of the annual bonus given to the individual staff. According to Kanji (2004), staff performance can be benchmarked by the number of utilized medical leave, the number of compliments from patients and the punctuality of the employees. By keeping a record of staff performance, it will reduce instance of bogus sickness, hence increase work productivity and increased job satisfaction of staffs (Murray Frenk, 2004). The system ensures that expenses are kept within the budgeted amount, revenue generated is consistent with projected productivity and standards and necessary corrective actions are carried out. You are required to give a detailed discussion how you would audit non-staff expenditure on a monthly basis in your clinical setting. What reasonable cost effective strategy would you implement in order to maintain best practice? _______________________________________________________ Jan Feb Mar Out Balance Out Balance Out Balance Gauze 100 150 90 180 130 100 Glove 20 40 20 50 35 20 Syringes 300 200 320 200 350 150 Needles 190 200 210 220 250 200 Dressing set 50 100 30 120 70 100 Alcohol swab 30 30 32 20 35 15 Figure 1 Jan Feb March Budget Spent Budget Spent Budget Spent New equipment $5000 $3000 $5000 $5500 $5000 $2000 Equipment Maintainers $1000 $800 $1000 $500 $1000 $500 Laundry $500 $300 $500 $600 $500 $550 Utility Bills $5000 $4500 $5000 $3500 $5000 $5000 Stationary $1000 $900 $1000 $500 $1000 $700 Figure 2 As stated by Payne Keep (2004), non-staff expenditure can be subdivided into direct expenses and indirect expenses. Direct expenses are associated with the patients, such as medical and surgical supplies and drugs. Whereas, indirect expenses are expenses for items such as utilities, comprising of gas, electricity, maintenance and support functions. Referring to Table 1, it displayed the number of consumables being utilized and its balance stock in a month. This stock inventory system is being performed on a monthly basis. On top of that, a First in first out system is being imposed, meaning those with the nearest expiry items should be placed at the outer shelf and to be used first. All these system will help to monitor the amount of usage of the items, preventing the wastage of unnecessary items which resulted from overstock or under-stock. Hence, by saving resources, it will enhance cost-effectiveness. While searching for a supplier, key points to look for will be an item of good quality and with the lowest cost. By exploring new products with vendor representatives and networks with colleagues, discussing the quality and cost differences of supplies with other staffs and management, who had tried both new and modified products, cost wastage can be reduced. Usually, bulk ordering will take place for frequently used consumables, thus, saving cost. Budget monitoring is generally carried out on a monthly basis, to ensure that revenue generated is consistent with projected productivity and standards. Staffs are encouraged to discuss the implementation or reinforcement of strategies that can positively affect the budget. For example, they should learn to plan for supplies needed for every patient encounter and consciously eliminate unnecessary items. Typically, budgets are monitored monthly because if deficiencies arise throughout the year, financial improvement plans can be instituted early. Corrective action is often initiated to prevent long-term effects in a particular area, such as wastage or loss of supply items. Therefore, by acquiring a working knowledge of how a department monitors financial and quality indicators, and participate in the development of actions is vital (McCue, 2003). It helps to increase patients satisfaction or to create the best patient experience. All these strategies act as a tool to foster collaboration with an organization because individuals must work together to achieve cost-effectiveness by utilizing consumables appropriately. You are required to describe in detail essential information which would enable you to successfully manage your staff and non-staff budget. From your information, what do you consider to be key issues in terms of successful management? An effective management encompassed the ability to develop a budgeting plan that would provide the necessary for staffs and effective nursing care. Only through effective planning can a balanced relationship between quality services and cost of services begin to be achieved. As Donaldson Gerard (2005) had stated, budgeting is an ongoing activity in which revenues and expenses care managed to maintain responsibility and health. A basic management plan through which all expenditures and revenues from all sources maybe projected and controlled is critical, so that excellent and cost-effective healthcare services can be delivered. Certain elements are necessary to establish an effective budgeting system. Firstly, according to Mitton Donaldson (2004), commitment to strategic planning is a basic requirement, where well-defined and objectives are developed. The budget should be an outcome of discussions at all levels and departments within the company related to priority setting in accordance with the companys goal, acknowledgement of achievements, responses to new demands and looking beyond the time frame of the ensuing year. Secondly, effective organizational structure and chart, presenting with clear and direct lines of authority is essential. As supported by Dixon (2005), it is only when authority is clearly defined, than an individual can be held responsible for the activities of the department. Hence, major objectives of the budget can be more easily accomplished. For example, the manager has the responsibility and accountability for managing the nursing budget; they are required to make all the decision on adjusting the nursing budget to manage the program and cost. This will include adding and removing programs, expanding and controlling the program and modification of revenues and expenses within the nursing department. Lastly, an uniform budget reporting system is required, so as to facilitate program monitoring and aids in strategic planning, ensuring that plan is updated by periodically and allowing the evaluation of the progress of the organization. An important factor is ensuring that the time period within which a service development must be achieved, the projected budget is able to balance against the complexity and defining area of scale of change required and the existing resources envelope (Fine, 2006). Overall, the process of setting and monitoring budgets should be an important part of both the planning and performance management cycle. It should always be remembered that within the resource package are included staff (clinical and non-clinical), equipments and building as well as money. An essential part of management planning process is to assess the ability of current resources to be used in new and different ways to meet changing needs and to increase the productivity of existing resources, while acquiring new resources (Murray Frenk 2000). By having a well-conceived budget in place, it is possible to foresee the results of quality standard of care; best practice in the organization.

The International Community and Responsibility to Protect Essay

The International Community has a Right to Intervene in Sovereign States in order to end Serious Human Rights Abuses? Discuss. Humanitarian intervention is definitely one of the most controversial subjects of the recent decades- among states, international organizations, non-governmental organizations (NGOs) and academia. The centre of the debate is the clash of traditional principles of state sovereignty and new adopted norms on use of force for humanitarian purposes. Despite the political controversies between the countries, humanitarian intervention is now an international norm which calls for action anytime there are serious mass life threatening occurrences in any country. In 2001, ICISS (International Commission on Intervention and State Sovereignty) - supported by the Canadian Government - introduced a report which would advance Humanitarian Intervention concept to a "Responsibility to Protect" (or â€Å"R2P). ICISS Report referred to the "right of humanitarian intervention" as a "coercive - and in particular military - action, against another state for the purpose of protecting people at risk in that other state" (ICISS, 2001, p. vii). Lack of political will, disagreement in the international community, or over-rationality about the costs of intervention has caused terrible atrocities - which have taken forms of genocide or ethnic cleansing - that have cost lives of millions (Power, 2011; J. Bajorja & R. McMahon, 2013). Humanitarian Intervention's new doctrine "Responsibility to Protect" is embraced by United Nations as a necessary means to prevent and punish atrocities. Yet, there are state actors as China and Russia which challenge its implementation. I argue that it is very important to save Humanitarian Inter... ...reviews . Power, S. (2011). Bystanders to Genocide. The Atlantic Monthly , 84-108. Roth, K. (2004). War in Iraq: Not a Humanitarian Intervention. Human Rights Watch . S. N. Macfarlane, C. J Thielking & T. G Weiss. (2004). The Responsibility to Protect: Is anyone interested in human intervention? Third World Quarterly , 977-992. Secretary-General, U. (2002, February 15). Secretary-General Addresses International Peace Academy Seminar on The Responsability to Protect. UN document SG/SM/8125 . Selfa, L. (2002). A new colonial "age of empire"? International Socialist Review . Traub, J. (2012, February 18). The End of American Intervention . New York Times . (1648). Treaty of Westphalia. International Relations and Security Network. United Nations Secretary-General. (1999). Report of the Secretary-General on the Work of the Organisation, A/54/1. United Nations.

The Code of Hammurabi

After the fall of the third dynasty of Ur, King Hammurabi came to power in ancient Babylon from 1792 to 1750 BC. As an influential ruler, he accomplished many things, including the reunification of Mesopotamia. His interest in state affairs and his opinion of himself as a â€Å"shepard to his people† most likely led to his greatest contribution to Mesopotamian life, the Code of Hammurabi. The 282 laws mainly focus on responsibilities of public officials, standards for agriculture and commerce, expectations for women, and regulations of sexual relations.Hammurabi believed that the laws were sent by the gods, which explains their strict expectations. In addition, the laws generally follow the philosophy of â€Å"an eye for an eye, and a tooth for a tooth†, revealing the importance of a strict justice system in Mesopotamian society and establishing the authority of the gods and the state. Overall, the punishments were very harsh, with most offenses resulting in death or di sfigurement.Although today's legal standards greatly differ from those of 18th century BC, the Code of Hammurabi can be seen as the foundation for modern day Western legal codes. One reason why modern society's legal system differs from Hammurabi's is because the concept of order in society and, even, in the family has changed greatly. While there are still economic classes today, they are not judged differently in the court of law. In ancient Babylon the social classes of the offender and victim were factors in determining the severity of the penalty.Family life has also changed from a power based (patriarchal) system to a more nurturing and supportive (unified) atmosphere. For example, during Hammurabi's reign, if a son were to hit his father, he would be punished by having his hand cut off. In today's society this would be considered â€Å"cruel and unusual†. Except in extreme situations, the law would not even have reason to get involved. Such is the case for many of the 18th century BC's codes. Mahatma Ghandi made this distinction clear when he said, â€Å"An eye for an eye makes the whole world blind. Modern legal codes aim more at consequences that will help change the behavior, as opposed to punishments that â€Å"get back at† the offender. Despite the differences, Hammurabi's approach to justice was very influential to the development of modern Western legal systems. They were not the first set of laws of this time, but they were the most structured and thorough. In other cultures the law was simply whatever the king said it was, which inevitably would change depending on certain factors.However, with Hammurabi's laws set in stone and displayed for everyone to see, it was clear what was expected of the people. This concept of a fixed law is the primary similarity between Hammurabi's legal codes and those of today. In addition, the code of Hammurabi established that there be a â€Å"process† in law. Because there were now penaltie s for wrongfully accusing another, it made people think twice before bringing up false charges against somebody. In modern society, specifically the U. S. , this concept is found in the fifth amendment under the clause â€Å"without due process†.The Code of Hammurabi may seem harsh when applying it to modern society, but since values, practices, and standards were different at that time, it really wasn't too far fetched. The inhabitants of Mesopotamia valued the individual rights of the people and the means by which to protect those rights. Even though the process may be different today, the general goal of establishing justice within the society is the same. Hammurabi not only marked his place in Babylonian history, but also throughout the world, by constituting a model of moral codes that civilizations would duplicate for centuries.

Essay over the electoral college Essay

In the United States today, we use the Electoral College to decide who is going to be the next president. The presidency is not necessarily won by popular vote. The founding fathers opted for the Electoral College, because they were afraid of the masses. They wanted the president to be chosen by those who are qualified, well informed, and have the ability to chose a president more efficiently then the so called â€Å"mob.† Although I believe the Electoral College needs many changes, it is necessary in order to have a successful government that is fair. Thee main argument against the Electoral College is that the presidency should be won by popular vote alone. It shouldn’t be that one candidate could win the popular vote, but lose the election. At first I completely agreed with this, because we do live in a democracy, and I believe that a democracy is a government for the people by the people. This would mean that the mass population decides who is the president, not a hand picked group of men to vote on who they wish, because they do not always have to vote on the candidate in which the state has voted the majority on. Although the Electoral College may take away the presidency from the candidate that won the majority vote, it evens things out across the nation. The Electoral College is necessary to make every state important in the voting process. If you did not have the Electoral College, those who were running for office would only campaign in the major states, that way they could get the majority of the population. For example the candidate would advertise and campaign in New York, especially New York City, because there is such a vast amount of people who live there, so he would try to assure that he had the votes for this city, and majority of the state, and would not have to worry about Montana. They candidate would then not go to smaller less populated states like Montana, South or North Dakota. He would not worry about the states or cities that had little populations, because are all he needs to worry about is that the majority of the people in the United States vote for him. It would be much easier to win an election by getting more people in more populated cities to vote, and not worrying about the little populations. This in fact takes away from the idea of a democracy, because it conveys the message that the only thing a presidential candidate  needs to worry about is getting the majority of the votes, and this does not have to be all over the nation, because there are parts of the nation that the population well exceeds other parts. The founding fathers developed the electoral college because they were afraid of what the government would be like if the â€Å"masses† were allowed to determine who they wanted in office. They were aware that it would turn into a popularity thing, and that is not what was needed in order to run a government efficiently. Although the population must have a say in the government, there has to be some form of control, and that was the basis of the Electoral College. I think that in order for the Electoral College to be successful, and to function properly, there has to be some major changes to it. The biggest change needs to be the fact that the electors themselves need to be abolished. I think that it should be set up to where the popular vote in the state decides whom the electoral votes from the state go. The majority of the time this is what happens, but it does not have to. If an elector wanted to vote for someone other then that the state allotted popular vote to, they very well could. I do not think that it should be allowed, because by doing that it takes the democracy out of the government, because it is never a certain thing that the populace’ wish will be carried out. If you want to go even farther you could break it down into districts with in the state. Each district gets one Electoral College vote, and the vote goes to the candidate in which has the majority of that district. The Electoral College is definitely needed in this country in order for the election process to be fair to all states and thus to all constituents. Although winning by popular votes sounds like the way to go in a democracy, it is not. If that were the case then there would be no equality among states, and the fact that everybody matters in a democracy would not be. There would be very little concentration on other small or less populated states, because you could win the election without them.